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A 28-year-old woman presented with a 1-year history of severe progressive dysmenorrhea following suction evacuation and tubal ligation. Sonography showed a bicornuate uterus with hematometra in the left horn. Hysteroscopy ruled out a diagnosis of a congenital Müllerian anomaly, as both ostia appeared normal. Under laparoscopy, a mass was seen on the left fundal region near the insertion of the round ligament, and needle aspiration of a chocolate-colored fluid confirmed the diagnosis of an adenomyotic cyst. The cyst was excised. The patient recovered well and has been symptom-free since surgery. Adenomyotic cyst is a rare entity in young women and must be differentiated from obstructive Müllerian anomaly. Laparoscopy is the preferred minimally invasive modality for managing this rare disorder.
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Objective@#To determine the incidence of endometrial hyperplasia and endometrial cancer (EH/EC) in low-risk premenopausal women with abnormal uterine bleeding (AUB) undergoing endometrial biopsy and to build a predictive model that includes clinical variables for predicting EH/EC in these women. @*Methods@#This retrospective study was conducted between January 2015 and March 2020. All premenopausal women aged 25 kg/m2 (odds ratio [OR], 4.4705), age >40 years (OR, 1.14), endometrial thickness (ET) >13 mm (OR, 2.59), and hypothyroidism (OR, 1.35) were significantly associated with EH/ EC. Considering the pretest probability for an EH/EC of 4.7%, this prediction model with a likelihood ratio of 14.2% demonstrated a post-test probability of 41% in the presence of the above-mentioned variables. @*Conclusion@#The risk of EH/EC was lower in low-risk premenopausal women with AUB. However, premenopausal women with IMB aged >40 years, hypothyroidism, BMI >25 kg/m2, and thickened endometrium (ET >13 mm) are at high risk of EH/EC; therefore, endometrial biopsy should be considered early in their management plan.
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Background: Cholelithiasis is known to be one of the most common biliary pathologies. Laparoscopic cholecystectomy is the gold standard for the removal of the gallbladder, because of its cosmetic benefit, short stay, cost-effective and lesser side effects. But no procedure is immune to complications and other procedure-related side effects. The present study was conducted to study the patterns of complications and outcome of laparoscopic cholecystectomy.Methods: the present study was conducted prospectively on patients undergoing laparoscopic cholecystectomy for symptomatic gall bladder pathology. the patients undergoing laparoscopic cholecystectomy were distributed and analysed on various parameters i.e. age, sex, ultrasound abdomen findings, complications related to access, per-operative condition of gallbladder, per-operative and postoperative complication.Results: In our study cases major complication rate 1% leading to biliary stricture for which hepaticojejunostomy was done, minor complication rate 11% and conversion to open cholecystectomy rate 2%.Conclusions: It is concluded that laparoscopic cholecystectomy is the safe and standard procedure for the laparoscopic cholecystectomy and its major complication are preventable by strictly following the basic principles of laparoscopic cholecystectomy and keeping a low level of the threshold for converting to open cholecystectomy.
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Background: Tuberculosis still remains public health problems in Nepal. Previous studies among marginalized ethnic groups suggest that being poor increases the risk of tuberculosis. Dalit communities are those communities in Nepal, backward in social, economic and educational fields and are not excluded from the risk of tuberculosis. The objective of the study was to determine the level of knowledge on pulmonary tuberculosis among Dalit community of Bharatpokhari VDC of Kaski.Methods: Community based cross-sectional study was conducted to determine the level of knowledge on pulmonary tuberculosis among Dalit community of Bharatpokhari VDC, Kaski from January 2010 to July 2010. Samples were taken randomly from different wards of the VDC. Data was collected by using pretested structured questionnaire by home to home visit of age 15-49 years. Data was collected from 15th January 2010 to 15th May 2010.Results: Study revealed that 29% respondents had adequate level of knowledge on pulmonary tuberculosis. The factor, education status was associated with level of knowledge on pulmonary tuberculosis on bivariate analysis (p=0.005).Conclusions: More than two third of the respondents had inadequate level of knowledge on pulmonary tuberculosis. Thus, recommends for the awareness programme on pulmonary tuberculosis. The education status and level of knowledge on pulmonary tuberculosis was significantly associated on bivariate analysis, and recommends for improvement in the education status of dalit community would be beneficial.
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Background: The intradural extramedullary tumours of the spine are one of the commonest tumours of the spine. Early diagnosis and surgical removal helps in best outcome. The objective of the study was to analyze the clinical presentation, imageology, resectability, to know the incidence of different types of tumours in intradural extramedullary compartment and to study the surgical outcome. Methods: This was a prospective study of 32 cases of intradural extramedullary tumours. The clinical presentation, imageology, resectability, histopathology, surgical outcome were studied. The patients were investigated with plain spinal radiography and MRI. All cases were treated surgically by posterior or posterolateral approaches. Outcome and complications were evaluated. They were followed up regularly and the results were analyzed. Ambulatory status was classified on admission by using Nurick-grading scheme. Results: The incidence of intradural extramedullary spinal tumours was 57.14%. Most of the tumours presented in the third decade (37.5%). Mean age of Presentation for meningioma was 36 years and for nerve sheath tumours was 39.5 years. The nerve sheath tumours contributed 35% followed by meningioma 28%. Nerve sheath tumours were found to be most commonly located in thoracic region (56%). Total excision of tumour was achieved in 87.7% cases. Conclusions: Nerve Sheath tumours and Meningiomas were the most common in intradural extramedullary spinal lesions and complete excision was possible in almost all cases. Prognosis was usually good, in spite of poor neurological status at the time of presentation.
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Introduction: The left renal vein is preferred over the right in renal transplantation because of its longer length. It is important for the surgeons to know the course of the left renal vein and whether it is pre-aortic or not to avoid unexpected hemorrhage and even death. There are considerable no of radiological studies on Retro aortic Left Renal Vein but anatomical studies other than the Japanese were not found in the literature. In view of its anatomical, embryological, clinical and surgical importance the present study was undertaken. Materials and Methods : The present study was conducted in 60 adult cadavers (10 female and 50 male) allotted to 1st M.B.B.S and M.D P.G students at Pinnamaneni Siddhartha institute of medical sciences & research foundation Gannavaram & N.R.I. Academy of Medical Sciences, Andhra Pradesh, India for routine dissection over a period of 5 consecutive years (2010-2015). Results: Left Renal Vein anomalies can be classified into 4 types in the literature.Type1 is the most common in its occurrence followed by type 3,2and 4.Type 4 was rarely reported .In the present study the percentage of incidence of type 1, type 2 and type3 are 6.6%,1.6%,3.3% respectively and type 4 was not observed. Conclusion: Knowing the variable expressions of the renal venous system allows better understanding of the clinical events. Pre operative CT can be considered mandatory as it helps in safe surgical outcome particularly in the retro peritoneal area.
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Microbiota in the gut play essential roles in human health. Prebiotics are non-digestible complex carbohydrates that are fermented in the colon, yielding energy and short chain fatty acids, and selectively promote the growth of Bifidobacteria and Lactobacillae in the gastro-intestinal tract. Fructans and inulin are the best-characterized plant prebiotics. Many vegetable, root and tuber crops as well as some fruit crops are the best-known sources of prebiotic carbohydrates, while the prebiotic-rich grain crops include barley, chickpea, lentil, lupin, and wheat. Some prebiotic-rich crop germplasm have been reported in barley, chickpea, lentil, wheat, yacon, and Jerusalem artichoke. A few major quantitative trait loci and gene-based markers associated with high fructan are known in wheat. More targeted search in genebanks using reduced subsets (representing diversity in germplasm) is needed to identify accessions with prebiotic carbohydrates. Transgenic maize, potato and sugarcane with high fructan, with no adverse effects on plant development, have been bred, which suggests that it is feasible to introduce fructan biosynthesis pathways in crops to produce health-imparting prebiotics. Developing prebiotic-rich and super nutritious crops will alleviate the widespread malnutrition and promote human health. A paradigm shift in breeding program is needed to achieve this goal and to ensure that newly-bred crop cultivars are nutritious, safe and health promoting.
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Biotechnology , Health , Plants, Genetically Modified , Prebiotics , Gastrointestinal Microbiome , Carbohydrates , Crops, Agricultural , Transgenes , Food, Genetically Modified , Seed BankABSTRACT
Renal artery variations are becoming more important due to the gradual increase in interventional radiological procedures, urological and vascular operations, and renal transplantation. In the present study out of 80kidneys 40(50%) kidneys showed the presence of additional renal arteries. The results are statistically significant. The presence of additional renal arteries was found unilaterally in 14 cadavers and bilaterally in 6 cadavers. In 10 kidneys additional artery towards the superior pole (Superior polar artery) was observed and in 10 kidneys inferior polar arteries were seen. And superior and inferior polar arteries both are present in 20 kidney specimens. In 40 kidney specimens we were found duplicated renal arteries. This multiple renal artery variations are of great clinical significance to radiologists, nephrologists and urologists in imaging and urological procedures.
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The vascular anatomy of the human upper limb which is man’s important earning tool, is a complex and challenging area. The arterial supply of the upper limb is mainly maintained by brachial artery through its branches. Recent progress in vascular surgery has engendered a need for precise knowledge of the frequency of anatomical variations in the branching pattern of axillary artery. Upperlimb injuries are the most frequent occupational accidents. Awareness of variations in the anatomy of brachial artery and its branches is important to avoid serious complications while treating the cases of arterio-venous fistulae, aneurysms and abscess drainage in the region of axilla, arm and cubital fossa. The present study was undertaken on 54 upper limbs of both sexes from embalmed adult human cadavers . The specimens were studied by detailed dissection method. In the present study, 59.3% of specimens showed variations of axillary artery. Better anatomical knowledge about the branches of brachial artery and their variations are important for surgeons, physicians, radiologists and interventionists, because based on anatomical study, new diagnostic and therapeutic approaches can be proposed.
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Dermatoglyphics is study of pattern of fine ridges on fingers, palms and soles. The term dermatoglyphics was coined by Cummins. The type of finger print is unique and is based on genetic characters of each individual. They develop between 2nd and 3rd months of intra uterine life and remain unchanged in an individual through out life. Finger prints are regarded as the most reliable tool for personal identification. Due to their immence potential particularly in forensic medicine, the study of finger print pattern was carried out in relation to various ABO blood groups. The study was carried out in the Department of Anatomy, NRI medical college, Chinakakani, Guntur. 506 students of known blood group were selected for the study. The finger prints were collected, studied and analyzed statistically. Thumbs presented high frequency of whorls in A+ves. Index and ring fingers were associated with high frequency of whorls in A-ves and AB+ves.
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Adolescent , ABO Blood-Group System/analysis , ABO Blood-Group System/genetics , Dermatoglyphics/methods , Embryonic and Fetal Development , Female , Fingers/anatomy & histology , Fingers/growth & development , Forensic Medicine , Gestational Age , Humans , India , Male , Students , Young AdultABSTRACT
OBJECTIVE: The purpose of this study is to evaluate the effect of the corpus callosotomy and to elucidate possible prognostic factors. METHODS: The cases of 39 patients who underwent corpus callosotomy were reviewed retrospectively. Clinical outcomes were analyzed using Engel's classification, with consideration of various presurgical conditions and the extent of the callosal resection during follow-up more than one year. RESULTS: Satisfactory outcome (Engel's class I, II) was obtained in 20 patients (51%) of 39 patients. In 36 cases with drop attack seizures, the class I, II outcomes were 22 patients (61%). When the patients were grouped according to the extent of callosal resection, the class I, II outcomes were 50% of the patients with anterior 1/2 or 2/3, 50% of those with anterior 4/5 callosotomy, and 57% of those with total callosotomy, respectively. The mean follow-up period was 34 months (24 to 58 months). CONCLUSION: Although it is not statistically significant, the patients who had underwent total callosotomy show better outcomes than those with partial callosotomy. Corpus callosotomy is efficacious in controlling medically intractable epilepsy in appropriately selected patients.
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Humans , Classification , Epilepsy , Follow-Up Studies , Retrospective Studies , Seizures , SyncopeABSTRACT
A case of lung abscess due to a rare cause -Actinomycosis is presented. The patient presented with signs and symptoms of pneumonia and failed to respond to antibiotic therapy. CT findings and various modes of treatment are described. CT guided FNAC helped in the final diagnosis where the aspirated material showed several eosinophilic cotton wool colonies of filamentous microorganism consistent with actinomycosis. Due to the thick walled abscess and surrounding unresolved pneumonia the patient was treated with intercostals tube drainage
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Humans , Male , Actinomycosis/diagnosis , Lung Diseases , Lung Abscess/diagnosis , Tomography, X-Ray ComputedABSTRACT
Intravenous drug abusers are prone to many complications, one of which is development of pseudoaneurysm at the injection site. We report an unusual case of an intravenous drug abuser who developed a pseudoaneurysm of the external iliac artery with hematoma dissecting into the iliopsoas muscle and discuss the role of doppler and CT in the diagnosis
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OBJECTIVE: The authors report the operative methods and postoperative outcomes of 14 cases with intractable supplementary sensorimotor area(SSMA) seizures. METHODS: From September 1996 to July 2001, 14 intractable cases treated by operation were reviewed and analysed with the help of each clinical characteristics, magnetic resonance images, histopathologic findings, noninvasive and invasive electroencephalographies(EEG), subdural grid and strip insertion and intracranial electrocorticographies and brain mapping results, retrospectively. The follow-up duration was from 2 months to 70 months(average, 26 months). RESULTS: There were eight males and six females and the age ranged from 2 to 47 years(average, 26.2). In the MRI findings, six lesional and eight nonlesional cases, and there were six localized and eight lateralized cases in the semiology and noninvasive EEG studies. In the histopathologic findings, cortical dysplasia was eight cases, gliosis three cases, leukomalacia one case and normal finding was two cases. In the seizure outcome, Engel's class I was 71.4%, class II was 21.4% and class III was 7.2%. The postoperative neurologic deficits were 12 in 14 cases and nine in 12 cases were dramatically improved within two or three weeks postoperatively and the remained three cases, the lesion was involved in the eloquent area but, all of them were improved via the rehabilitation programs. CONCLUSION: In the intractable SSMA seizure, the surgical treatment is an excellent method of treatment and early transient postoperative neurologic deficits were dramatically improved within several weeks.
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Female , Humans , Male , Brain Mapping , Electroencephalography , Follow-Up Studies , Gliosis , Magnetic Resonance Imaging , Malformations of Cortical Development , Neurologic Manifestations , Rehabilitation , Retrospective Studies , SeizuresSubject(s)
Humans , Male , Discitis/etiology , Thoracic Vertebrae/pathology , Magnetic Resonance Imaging , HLA-B27 AntigenABSTRACT
We report a case of acute transient encephalopathy with mental alteration, myoclonic jerks, and periodic triphasic wave electroencephalographic patterns caused by a therapeutic dose of baclofen. The clinical and electroencephalo-graphic abnormalities improved to a normal range shortly after baclofen was discontinued. We discuss the pathogenesis and review the literature about baclofen-induced encephalopathies.
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Baclofen , Myoclonus , Reference ValuesABSTRACT
False arterial aneurysms are frequent late complication of penetrating injuries. They can also occur following diagnostic or therapeutic arterial puncture and following surgery. A case of traumatic aneurysm of the maxillary artery presumably caused by loose molar teeth is reported. The lesion was successfully treated by ligation of the external carotid artery and excision of the aneurysm
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Humans , Male , Maxillary Artery/pathology , Aneurysm/etiology , Molar , Aneurysm/diagnosisABSTRACT
Dilated cardiomyopaty is a rare occurrence in Hecker muscular dystropy. We report a case of Becken muscular dystrophy in 28 old man who presented with dyspnea, progressive muscle weakness, and dilated cardiomyopathy with severe left ventricular dysfunction which was detected by echocardiograpy. Muscle biopsy demonstrated diffuse degenerated changes consistent with progressive muscular dystropy, His brother has also Becker muscular dystrophy and dilated cardiomyopathy, The patient is on NYHA Class II~III with medical therapy.