A Rare Cause of Breathlessness in a Patient on Hemodialysis

Background: The possibility of recurrence in COVID-19 is very rare and hence mostly underdiagnosed. In the face of pandemic, this can lead to circulation of the virus like a hidden iceberg. Better understanding about this topic can improve our knowledge of the COVID-19 pathogenesis and ways to control the transmission. Case presentation: A 41 year old male with no known comorbidities was admitted five times during a period of 7 months each time after being detected RTPCR positive for SARS-CoV-2 and more symptomatic than previously. He had no contact with other COVID-19 patients and was asymptomatic in between admissions. Despite this, he did not develop antibodies against SARS- CoV-2. Later on, he was diagnosed with thymoma on biopsy of the anterior mediastinal mass. Patient’s condition deteriorated on last hospitalization and he died, despite the treatment. Here we present an interesting report on multiple times recurrent COVID-19 infection, probably a case of reactivation and different plausible explanations on the role of thymoma. Conclusion: Acknowledging the potential of SARS-CoV-2 to cause recurrence is very important during the pandemic as a part of the long term transmission mitigation. The case report shows that previous infection does not guarantee complete immunity from COVID-19, especially in immuno-compromised patients. Hence, despite the status of prior infection, vulnerable individuals who recovered from COVID-19 should be under surveillance.

Study Of Chronic Fissure–In–Ano At Our Institute:

Anal fissure is common cause of anal pain. Exact aetiology of anal fissure is not known, but it is commonly seen due to constipation and hypertonic anal sphincter conditions. Studies on the method of treatment of anal fissure ranges from medical application to surgery. We have study of 200 cases of fissure in Ano for comparing in between treatment options of anal dilatation (AD) and lateral anal sphincterotomy (LAS). Patients were divided in two groups by randomly. In our study it has been shown that all the patients after anal dilatation significantly reduces the anal pain and provide symptomatic relief that is slightly better than lateral anal sphincterotomy

A Study Of 50 Cases Of Shoelace Repair For Midline Incisional Hernia.

Abstracts: Background & Objective: Incisional hernia of anterior abdominal wall is very common pathology come across in general surgical practice. Numerous surgical procedures have been described to repair them, with varying degree of success. This study aims to find the place of shoelace darn in the repair of anterior abdominal wall incisional hernias. Methodology: Fifty patients with anterior abdominal wall incisional hernias were managed by shoelace darn method in this prospective study. The details of operative technique have been described. Results: Shoelace darn repair of anterior abdominal wall incisional hernia was relatively easy procedure associated with fewer complications. There were no true recurrences noted. Conclusion: Shoelace darn repair still remains an excellent technique in the management of anterior abdominal wall incisional hernias, despite advent of mesh and laparoscopic repair.

Pulse cyclophosphamide therapy in the management of patients with macular serpiginous choroidopathy.

Purpose: To evaluate safety and efficacy of intravenous pulse cyclophosphamide (CyP) in acute macular serpiginous choroiditis (SC). Methods: Patients with acute macular SC with lesions threatening and/ or involving fovea were enrolled. All patients received CyP (1 g/m2) for 3 days followed by high‑dose oral steroids (1.5 mg/kg) tapered over 6 months and monitored for visual acuity, response to treatment and systemic side effects. Results: Eight patients (seven unilateral and one bilateral) with median age of 27 years (range: 13-40 years) were recruited. Mean visual acuity at presentation was 0.71 ± 0.35 logarithm of the minimum angle of resolution while postpulse visual acuity was 0.40 ± 0.32. Final mean visual acuity at 1‑year was 0.31 ± 0.23 (P ≤ 0.05). Three eyes had recurrence and 3 patients developed transient hair loss with no other adverse effect. Conclusion: Intravenous CyP provides rapid resolution of lesion activity and thereby helps in maintaining good functional acuity.

A study of 50 cases of Stoppa’s pre-peritoneal repair of bilateral inguinal hernia.

Abstracts: Backround: Recurrent and complex bilateral inguinal hernias are associated with high recurrence rate. Giant prosthetic repair of visceral sac (GPRVS) is popular in America and Europe. In India it is less frequently performed procedure .we wanted to prospectively analyse the procedure. Methodology: In this prospective study 50 patients were operated, at our institute, over 2.5 years, for bilateral inguinal hernias, which included direct, indirect, recurrent and re-recurrent hernias. Patients were treated by GPRVS method of stoppa. Patients were observed for complications and followed up in O.P.D. for at least 1 year. Results: Developing pre-peritoneal plane was quite easy and there were minimal complications. Operative time varies from 30 minutes to 90 minutes and recurrence rate was nil at 1 year follow up. Conclusion: GPRVS is a very good operation for recurrent and re-recurrent inguinal hernias with minimal morbidity and mortality.

Novel occurrence of Axenfeld: Rieger syndrome in a patient with blepharophimosis ptosis epicanthus inversus syndrome.

is a complex eyelid malformation characterized by the classical tetrad of blepharophimosis, telecanthus, ptosis, and epicanthus inversus. It has been reported to be associated with other ocular anomalies such as euryblepharon, strabismus, nystagmus, amblyopia, microphthalmos, lacrimal drainage apparatus abnormality, extra ocular muscle abnormalities, microcornea, trabecular dysgenesis, optic nerve hypoplasias, and colobomas of the optic disk. We describe a case of BPES with Axenfeld–Rieger syndrome, a neurocristopathy characterized by maldevelopment of the anterior segment with predisposition to development of glaucoma. Interestingly, both syndromes are caused by mutations in the same class of genes, namely the winged‑helix/ forked transcription factors (FOX) involved in a variety of developmental processes.