ABSTRACT
Vasa previa is defined as a condition where fetal vessels traverse the membranes in the lower segment below the presenting part unsupported by placental tissue or umbilical cord. Rupture of the membranes leads to fetal exsanguinations and even neonatal death. The etiology is uncertain, but risk factors include bilobed or succenturiate lobed placenta, velamentous insertion of cord, placenta previa, pregnancies resulting from In vitro fertilization (IVF) and multiple pregnancies. We report here a case of 24 year old woman, G3A2 at 34 weeks of gestation and history of 2 previous spontaneous abortions with vasa previa which was successfully managed. Prenatal sonographic diagnosis has the potential to improve or prevent the poor obstetric and neonatal outcome associated with it.
ABSTRACT
Histoid Hansen's disease is a form of lepromatous leprosy with characteristic bacterial morphology and very high bacillary load. The occurrence of de novo' Histoid leprosy in patients without other features of leprosy has been reported. We present our observations on eleven cases of Histoid Hansen's disease who had attended our Outpatient Department. A detailed clinical history and clinical examination was done. Slit skin smear for Bacteriological Index and skin biopsy were performed in all. All eleven cases were males. Cutaneous and subcutaneous nodules were the commonest skin lesions found. Slit skin smear revealed abundant organisms. Histopathology was consistent with Histoid Hansen. Seven were de novo cases. During treatment, one patient developed type II reaction. All patients except one showed clinical clearance of lesions and fragmented bacilli after one year of MB-MDT. The treatment was extended in this single case who did not respond well. Awareness about the clinical features, characteristic histology and early diagnosis of Histoid Hansen is of utmost importance. It will be important to determine the bacteriological and morphological indices at the end of the treatment for all Histoid Hansen disease patients. Continuation of treatment may be decided based upon the bacterial and morphological indices.