Eccrine Spiradenoma

Introduction: Eccrine spiradenoma is extremely rareadnexal tumor of the sweat gland, mainly affecting middleaged persons with equal incidence in males and females. Itis frequently a benign tumor characterized as solitary, painfuldeep - seated dermal nodule with most common sites being theupper thorax and face.Case report: A 35 year old male presented with multiple,painful swellings over scalp,face,anterior chest and backsince 6 months with loss of weight and appetite for 2 months.On examination, patient had a single cervical lymph node ofsize 1*1cm in the right posterior triangle of neck. Multipletender subcutaneous, hard, nonmobile swellings present overseveral areas with largest(2*1cm) over anterior chest wall.Histopathologically diagnosed as Eccrine spiradenoma whichrevealed clusters and sheets of cells having mild pleomorphicround to ovoid bland nuclei with indistinct cytoplasmicborders, occasional duct or follicular appearance and emptylooking lumina with no necrosis or mitotic activity.Conclusion: Eccrine spiradenoma, a rare benign adnexaltumor confirmed by histopathological examination.Differential diagnosis include, Neuroma, Dermatofibroma,Glomus tumor, Angiolipoma, Cylindromas and leiomyomas.Diagnosis confirmation by histopathological examination iscrucial because of its potential for malignant transformation.Its prognosis is poor as it has multiple recurrences.Histopathological examination is gold standard for thediagnosis.

Clinical and aetiological profile of Pneumonia in age group between 1 month to 1 year: a hospital based prospective study

Background: Pneumonia is one of the leading causes of morbidity and mortality in children under five years of age across the world. The present study was designed to clinically evaluate the children of age 1 month to 1 year with pneumonia, correlate it with bacteriological, radiological findings and to study the risk factors.Methods: Clinical, bacteriological, radiological features and risk factors of community acquired pneumonia in children of age group 1 month to 1 year were noted and analysed.Results: As per WHO ARI control programme, 72% had pneumonia, 25.3 % had severe pneumonia and 2.6% had very severe pneumonia. Bacterial pneumonia was detected radiologically in 4.6% and viral pneumonia in 88.6% of cases. Chest X-ray was normal in 6.6% of cases. Tachypnoea, chest retractions, crepitations alone and crepitations with rhonchi correlated well with positive radiological findings. Inappropriate immunization for age, lack of breast feeding, preterm birth, smoking in family were significant risk factors for severe Pneumonia. 39.3% had leucocytosis and 24% had positive CRP. Culture was positive in 23 cases (15.3% culture positivity).Conclusions: Radiologically confirmed Pneumonia should be treated with antibiotics because, in clinical practice, it is virtually impossible to distinguish exclusively between viral pneumonia and bacterial pneumonia. As the viruses are most common causative agents of Pneumonia in 1 month to 1 year, PCR kits should be used to identify viral etiological agents. Early and exclusive breast feeding should be promoted to decrease the risk of pneumonia.

Comparative study of Socio-economic status of mothers who delivered term low birth weight babies with mothers who delivered normal birth weight babies in a tertiary care rural hospital.

Objectives: To compare the demographic profile of mothers who delivered term low birth weight babies with that of mothers who delivered normal birth weight babies and study the association between the demographic variables of mother and the delivery of low birth WEight babies. Material and methods: Study conducted at Department of Pediatrics and Department of Obstetrics of Narayana medical college hospital, Nellore, India. Participants were 120 postnatal mothers who 60 mothers who delivered term low birth weight babies and 60 mothers who delivered normal birth weight babies were include in the study. Five demographic variables: age of the mothers at the time of conception, educational status of the mothers, monthly family income, occupation of the mothers and presence or absence of consanguinity were recorded. Using chi-square test these variables are compared between two groups of mothers and association of these demographic variables with the delivery of low birth weight babie is studied. Results: Significant association was found between the family income and low birth weight (p-value 0.002.) and between consanguineous marriage and low birth weight (P-value 0.000). Significant association was not found between the age of the mothers and low birth weight (P-value 0.000). Significant association was not found between the age of the mothers and low birth Weight (P value 0.924), between occupation of the mother and low birth weight value (p value 0.15) and between educational status of the mother and low birth weight babies (p value 0.062). Conclusion: Low family income and consanguineous marriage have significant association with delivery of low birth weight babies.

Study of incidence of helminthic infestation in children aged 1 to 15 years attending to a tertiary care hospital.

Background: Helminthic infestation is common in children because of their habits and opportunity for exposure. The present study was undertaken in the Narayana Hospital, Nellore to determine the incidence of various helminthes, the symptomatology and clinical manifestations of various helminthes and to correlate type of helminthic infestatioin. Material and methods: This is a prospective study, was done in 1 to 15 years children who attended O P D or admitted to the pediatric ward, Narayana Hospital, Nellore. The material for the study comprises of 500 children’s, who attended OPD or admitted to the Pediatric ward belonging to 1 to 15 years age groups. A detailed clinical examination including stool examination was done for all the 500 children. Blood examination was done for knowing the degree of anemia. Results and discussion: Out of 500 children examined in various age groups, 275 children’s were found to be positive for one or other helminthic ova in the stool samples examined giving an overall incidence of 55%. Number of stool samples examined Number of stool samples infested with Helminths. Out of 500 children examined, 235 were males and 265 were females, of which 130 males and 145 females were found to be infested for one or other helminthic ova. Out of 500 stool examples examined 275 were positive for one or other helminthic ova, 160 were positive for ascariasis, 20 were positive for Hookworm, 40 were positive for Trichuris trichura, 10 were positivefor hymenolepis nana and 5 was positive for Taenia infestation. Out of 500 children studied, 130 children belong to class V Socio - economic class, 150 children belong to class IV socio - economic class, 120 children belong to class III Soci -economic class and 100 children belong to class II Socio – economic class, giving a percentage of infestation according to Socio - economic class, giving a percentage of infestation according to Socio-–economic class as 80% in class V, 63.3% in class IV, 41.7% in class - III and 30% in class II respectively. Anemia in hookworm infestation was of mild degree in all 15 children. Anemia in mixed infestation was of mild degree in 20 children and moderate degree in 5 children. Out of 500 children studied 300 children had normal nutritional status a nd positive percentage of helminthic infestation in them was 26.7%, 140 children had Grade – I malnutrition and positive percentage of helminthic infestation in them 96.4, 40 children had Grade-II and 20 children had Grade - 111 malnutrition. Positive percentage of helminthic infestation in Grade – II and Grade – III malnutrition was found to be 100%. Conclusion: This study confirms the finding of the other authors all over india regarding helminthic infestations in respect to epidemiology, clinical manifestations and relation with nutritional status. There was a high co-relation with poor nutritional status.

Tracheal lymphoepithelioma-like carcinoma: a case report.

Lymphoepithelioma like carcinoma is rare in locations other than nasopharynx. We report the second case of this tumour in trachea, in a young female patient, who was managed with concomitent surgery, radiotherapy and chemotherapy. The patient is disease free in the one-year follow up. The tumour presented difficulties during intubation for general anaesthesia and during surgery. Association with Epstein-Barr virus was not found in our case.

A double blind controlled study of propranolol and cyproheptadine in migraine prophylaxis.

Role of propranolol and cyproheptadine in the prophylaxis of migraine was studied in a controlled double blind trial. Two hundred fifty-nine patients were divided into four groups. Each group was either given a placebo, cyproheptadine, propranolol or a combination of the latter two drugs. The patients were followed for a period of three months. Significant relief in frequency, duration and severity from migranous attacks was seen in all drug treated groups over placebo. Significant correlation in response was seen in frequency, duration and severity in all the groups which received drugs. Statistically more significant relief was seen in cyproheptadine and propranolol treated group as compared to individual drug treated groups. In cyproheptadine and propranolol treated groups, the dropout rate was lower and associated symptoms were better relieved than in other groups. The study shows efficacy of combination of cyproheptadine and propranolol in migraine prophylaxis.

Bilateral simultaneous retinal vein occlusion.

Central retinal vein occlusion (CVO) is a common retinal vascular disorder with potentially blinding complications. However, a simultaneous bilateral affection is not a common entity. One such patient is described here.

Adult Wilms' tumour (report of two cases).

Wilms' tumour, an embryonic neoplasm, the most common renal tumour in childhood, had occasionally been reported in adults. Authors report two such cases and have reviewed the relevant literature. While Wilm's tumour in children classically demonstrates the curative potential of combined modality treatment, no such clear guide lines are available for those occurring during adulthood. Pathologic diagnosis of adult Wilm's tumour is difficult because of the multiplicity of undifferentiated adult tumours that must be considered in the differential diagnosis. As no predictive parameters for optimal therapy exist, a combination of surgery, irradiation and chemotherapy probably is indicated for all stages of disease.