A rare location of primary extrahepatic hydatid cyst in the soft tissue

Hydatid cyst or cystic echinococcosis in human is rare disease caused by tapeworm Echinococcus granulosa. Hydatid cyst of soft tissue is a rare condition and we had a case of large hydatid cyst in lumbar region. This is a case of 48 years old female presented to us during October 2018 with a large diffuse swelling over the left lumbar region which was gradually grown over the last 2 years without pain. The diagnosis of hydatid cyst was not sure even in CT scan but it was in our differential diagnosis. It is confirmed during surgery after seen the multiple cyst removed from the large cystic lesion. No recurrence even after 15 months of follow up. Presence of hydatid cyst in soft tissue is usually rare and its diagnosis is not expected clinically when it presents as a soft tissue swelling. We need to confirm it during surgery or by presence of typical germinal membrane under microscope.

Three-year experience with neonatal ventilation from a tertiary care hospital in Delhi.

Ninety neonates were ventilated over a period of 33 months of whom 50 (55.5%) survived. Fifty seven babies received IPPV while 33 CPAP. IPPV mode was being used more frequently recently and survival rates have steadily improved over past 3 years. Survival was cent per cent in babies above 1.5 kg on CPAP mode while 16/26 (57.7%) survived on IPPV mode. Of 22 extremely VLBW (< 1 kg) babies, six survived. HMD was the commonest indication of ventilation (50%), of which 53% (24/45) survived. The other important indications of ventilation were apnea in 13 and transient tachypnea in 11 babies. All babies requiring ventilation for transient tachypnea survived. Nosocomial infections were common in association with ventilation 34/90 (37.7%), out of which in 14 was responsible for about a third of deaths. Pulmonary air leaks developed in 12 babies of which 6 died. Two babies developed BPD and one ROP. Neonatal ventilation should be ventured in centres where basic facilities for level II care already exist. It may not be cost effective to ventilate extremely low birth weight neonates.

Prevalence of atypical mycobacteria in sputum of patients undergoing treatment at a tuberculosis clinic.

A total of 4,554 sputum specimens of 3,943 patients were examined with a view to isolate atypical mycobacteria. Of these 604 (13.3%) specimens were culture positive for AFB, out of which 48 cultures (7.9%) from 47 patients were identified as atypical mycobacteria. Two patients were considered as probable cases of atypical mycobacterial disease while in the remaining 45 patients, atypical mycobacteria appeared to colonize the lungs without producing any disease.