Short stature as a significant marker in celiac disease

Background: Celiac disease (CD) is a genetically determined gluten-sensitive enteropathy resulting in nutrient malabsorption, can have extra gastrointestinal tract (GIT) presentations, short stature may be the only presenting clinical feature, even in the absence of gastrointestinal symptoms. The aim and objective of this study was toMethods: This cross-sectional study was performed on 1000 children between ages 5 to 10 year of different schools, in Jaipur, district of Rajasthan. An anthropometric measurement (height, weight) was done for all children. Serum samples were analyze for IgA antibodies to human tissue transglutaminase (tTG) with lower detection limit of 1.0 U/ml and 15 U/ml. Positive samples for tTG antibodies were reanalyzed human endomysial autoantigens (EmA).Results: Out 1000 children screened, six were seropositive, of those four were females and two were males. The serological proportion of CD in this population was 1:166. These Six seropositive group tends to have lower height, weight than the seronegative group, but the difference was only significant for height (P=<0.01).Conclusions: Although gastrointestinal manifestations are important presentation of celiac disease, nevertheless short stature alone or in combination with other symptoms of celiac disease has been present.

Intraoperative breakage of Sachse's knife blade: A rare complication of optical internal urethrotomy (one case managing experience)

ABSTRACT Optical internal urethrotomy (OIU) is the most common procedure performed for short segment bulbar urethral stricture worldwide. This procedure most commonly performed using Sachse’s cold knife. Various perioperative complications of internal urethrotomy have been described in literature including bleeding, urinary tract infection, extravasation of fluid, incontinence, impotence, and recurrence of stricture. Here we report a unique complication of breakage of Sachse knife blade intraoperatively and its endoscopic management.

Assessment Of Examination Stress And HRV in Adolescents.

Objective.The present study was designed to define and evaluate examination stress among ,adolescents in the age group of 12–18 years in relation to heart rate variability (HRV), an index of sympathovagal interplay, one of the sensitive neurophysiological axes to be influenced initially, when an individual is exposed to any stressor.Methods. Hari’s stress inventory for students was used to qualify examination stress was collected on 69 healthy school students, free from any acute or chronic ailment, one month and seven days before the start of final examinations along with acquisition of short – term HRV to profile the sympathovagal interplay, a sensitive index of both physical and mental stress. Results. The stress inventory depicted that the sample population was under an enhanced mental stress 7 days before the examination as compared to that observed 1 month before the ratios of HRV 1month and 7 days before the final examination. Significant appreciable difference could also be appreciated in the values of SDANN in time domain and amplitude of the waveforms in HF, LF on the frequency domain of HRV.Conclusion. An enhanced sympathetic outflow as discerned through increase in LF/HF ratio and LF power with a concomitant decrease in HF power along with significant decrease in SDANN values profiling a decreased vagal outflow of the student population denotes an autonomic neurophysiological status that needs a specialist attention in terms of proper and adequate guidance and counselling.

Phylogenetic Variation of Muscle Flexor Digitorum Brevis- Rare Variation on the Right Foot.

Background: Flexor digitorum breves is an intrinsic muscle of the sole of the foot that lies superior to the central part of planter apponurosis and inferior to the tendons of flexor digitorum longus. This flat spindle shaped muscle arise from the medial process of tuber calcanei, proximal part of planter apponurosis, inter muscular septa and adjacent fascial layers. The muscle fiber conver anteriorly forming four tendons one each for the four lateral toes at the bases of proximal phalenges each tendon splits into two slips around the tendon of flexor digitorum longus, reunites into a chiasma, devides again to insert into margins of intermediate phalenges of lateral four toes. Methods: This study was carried out by routine dissection classes for undergraduate medical students classes from July 2010 to January 2014 in the department of anatomy, Teerthanker Mahaveer medical college Moradabad; department of anatomy, Rama medical college Kanpur; Department of Anatomy, Hamdard Institute of Medical Science & Research, Jamia Hamdard New Delhi. Total no. of 80 cadavers (48 male and 32 female) all the cadavers were been preserved in 10% of formalin and age ranged between 45 to 67 years. Results: Summarising the result indicates out of 80 cadavers 25% were having none anatomical variation, 46% of cadavers had bilateral absence of tendon for fifth toe of flexor digitorum breves while 18% of cadavers having variation on the left foot and rare 9% of cadavers were represented having variation on the right foot while the left foot was anatomically normal. Conclusion: Variation of flexor digitorum breves may occur as phylogenetical changes due to minimal use of little toe in evolved bipedal posture.

Differential Criteria to Evaluate Parasite (Plasmodium) and Bacteria (Salmonella) for Diagnosis of Malaria and Typhoid Fever.

Background: In the investigation of fever, Malaria and Typhoid are major health problems in tropical and subtropical countries. Both cause significant morbidity, mortality and economic loss. The aim of study is to evaluate the prevalence of Malaria and Typhoid. Methods: Five hundred three samples were collected from patients suspected for malaria and typhoid fever. Peripheral blood smears (thick and thin) were used for microscopic examination and also malaria card test used for malaria parasite. For Typhoid, Widal agglutination test and Typhi dot IgG/IgM conducted for the identification of antibodies. Result: The study indicated that out of 503 patients, in which 158 male (69%) followed by 71 female (31%) were found positive. The prevalence rate of infection was 45.52%. Conclusion: The prevalence rate of malaria and typhoid fever was high. Salmonella typhi appears to be the most prevalent species infecting people. In other studies prevalence rate were quite low. Most of the studies should be done on the other determinants of plasmodium, salmonella and their co-infection in different format of diagnosis and case study.

Anterior Chest Wall Tuberculosis Involving Lungs, Pleura and Lymph Nodes in an Immunocompetent Patient: A Case Report.

Aims: The chest wall tuberculosis accounts for 1-5% of all cases of musculoskeletal tuberculosis. Here we are presenting a rare case of anterior chest wall tuberculosis in an immunocompetent patient. Presentation of Case: A 20-year-old male came for routine medical check-up, which was prerequisite for his job. He had no respiratory complaints with no history of fever and weight loss. Local examination revealed a swelling over the right chest in the infraclavicular region. Discussion: Tubercular anterior chest wall abscess is a rare form of extra pulmonary TB. Simultaneous involvement of lung, pleura and lymph nodes of mediastinum, neck and axilla has rarely been reported in an immunocompetent individual. Conclusion: Cold abscess of chest wall is not common. Anti-tubercular therapy should be recommended as initial treatment.

A Study Investigating the Absorption and Pharmacokinetics of a Newly Developed Paracetamol/Caffeine Formulation Containing Sodium Bicarbonate in Healthy Volunteers.

Aims: To assess pharmacokinetic (PK) bioequivalence between a newly developed formulation, rapid-relese paracetamol plus sodium bicarbonate and caffeine (RAPC), containing 500 mg paracetamol + 65 mg caffeine + 325 mg sodium bicarbonate), and the currently marketed Panadol® Extra product in both the fasted and semi-fed states. Study Design: A single center, randomized, open label, four-way crossover, PK study. Place and Duration of Study: MDS Pharma Services (Now Celerion), 2420, W. Baseline Road, Tempe, AZ 85283, between July 17, 2009 to August 10, 2009. Methodology: We included 30 healthy volunteers (20 males, 10 females; age range 18- 55 years). The characterized PK parameters included total and partial area under the concentration time curve (AUC0-30min, AUC0-60min, AUC0-t/AUC0-∞), time to reach peak drug plasma concentration/therapeutic level (Tmax/Tc≥4ug/ml), and maximum measured plasma concentration (Cmax). The safety of the study treatments was also assessed. Results: In both fasted and semi-fed states, the exposure to paracetamol and caffeine for new RAPC formulation was bioequivalent to Panadol® Extra for AUC0-10 hrs, AUC0-∞ and Cmax with 90% confidence intervals (CIs), all being within the range 0.80 to 1.25, except for a higher paracetamol Cmax for RAPC in fasted state. RAPC exhibited significantly greater early absorption for both paracetamol (≥1.8-fold greater) and caffeine (≥1.3-fold greater) as determined by AUC0-30min and AUC0-60min, as well as significantly faster Tmax for both paracetamol (about 30 minutes faster) and caffeine (≥15 minutes faster) compared to currently marketed Panadol® Extra in both fasted and semi-fed states. The time to reach the therapeutic paracetamol plasma concentration (Tc≥4μg/ml) was about 12 and 33 minutes faster in fasted and semi-fed states respectively. The new formulation was safe and well tolerated. Conclusion: The newly developed RAPC formulation was found to be bioequivalent to Panadol® Extra caplets, and showed significantly faster absorption in both fasted and semi-fed states.

Cornu Cutaneum on the Penis-A Case Report.

A 60-years-old male presented with a cornu cutaneum (cutaneous horn) on the penis. Histopathology showed a well differentiated squamous cell carcinoma. Majority of the lesions at the base of the keratin mound are benign. The incidence of malignancy increases in cornu cutaneum of the penis with squamous cell carcinoma being the most common type.

Role of Magnectic Resonance Imaging of Brain in Paediatric Patients with Partial Seizures.

The study was carried out for one year to find out the role of magnetic resonance imaging brain in pediatric patients with partial seizures. Children from age 28 days to 18 years who presented with partial seizures were included and the information obtained from the history, clinical examination and investigations particularly MRI brain were noted down and analyzed.Maximum numbers of patients were in the age group of 5-10 years (48.84%).27.91% had simple seizures and the rest 72.09%had complex partial seizures with none having secondary generalization. The risk factor for seizures were present in 54.19% of cases. Most of the lesions involved parietal region (44.19%) followed by temporal lobe involvement in 13.95%. 55.81% had findings of neurocysticercosis (NCC), 29.91% showed tuberculoma, 8.30% had normal MRI findings and 6.98% had findings suggestive of cerebritis, sturge weber syndrome and porencephalic cyst. 89.74% lesions showed contrast enhancement on MRI. Contrast enhancement MR altered the radiological diagnosis in many patients with partial seizures. It helped to diagnose infections like tuberculoma and NCC in various stages of evolution and also helped to rule out other structural lesions, thus helping in planning modalities of treatment.

Comparison of an Immuno-chromatographic Technique-based Kit (Malaria Card) with Microscopy for Rapid Diagnosis of Malaria in and Around Loni, Maharashtra.

Although Plasmodium vivax is the major species responsible for malaria in most parts of India, P. falciparum infections have now increasingly been reported from some parts of India. A study was therefore, undertaken to compare immuno-chromatographic technique (ICT) based Malaria card test with microscopic examination of peripheral blood film in diagnosis of malaria in and around Loni, Maharashtra. A total of 143 (about 24%) samples of 590 febrile patients tested were detected positive for malarial infection- 74 samples for P. vivax (approx. 52%) and 69 for P. falciparum (approx. 48%). With Malaria card test, the sensitivity and specificity of 93.8% and 92.6% were recorded for P. vivax and 95.2% and 95.5% for P. falciparum, respectively. Therefore, the test is a valuable adjunct in an emergency for rapid diagnosis of malaria, though microscopy remains the mainstay for routine use in countries, like India.

Acute toxicity of organophosphate insecticide, dichlorvos in relation to selected water hardness for the freshwater zooplankters.

Toxicity of organophosphate insecticide, i.e. dichlorvos has been investigated in relation to selected water hardness for the freshwater zooplankters such as Moina, Daphnia, cyclops and nauplii. Results revealed that dichlorvos was highly toxic to the tested zooplankters, as the LC50 values are noticed in ppb. Trend of sensitivity for different zooplankters to dichlorvos was recorded as Moina < Daphnia < nauplii < cyclops. The LC50 were found to change significantly with the change in water hardness. The zooplankters were more susceptible to dichlorvos at water hardness of 275 mgl(-1) as compared to water hardness of 540 mgl(-1) as revealed from low LC50 values. The range of safe dischargeable concentrations (1.063-1.137ppb) were too low as compared to harmless or safe concentrations (43.895-89.194 ppb) for the zooplankters at both the hardness.

Histoenzymological study on the toxicity of copper sulphate in the digestive glands of Lymnaea luteola.

During 24 and 48 hr of exposure, the digestive glands of Lymnaea treated with a lethal concentration of 0.038 mgl(-1) CuSO4 revealed intense activity of acid phosphatase in perilobular margin. On the other hand, same area of the gland showed moderate activity of ATPase during 24 and 48 hr of exposure. However, alkaline phosphatase showed average activity in perialveolar region and perilobular margin during 24 and 48, and 72 hr of exposure respectively The changes in the activity of these enzymes were nonsignificant in alveolar margin and perialveolar region of the gland. It is interesting to note moderate activity of acid phosphatase in perialveolar region during 24 hr of exposure.

MSCT angiography diagnosis of thrombosis in external jugular venous aneurysm: case report and review of literature.

True venous aneurysms are rarely-observed causes of neck swelling reported in children. We describe a 59-year-old female with a history of left-sided neck swelling due to external jugular venous aneurysm diagnosed by MSCT angiography. Thrombosis in external jugular venous aneurysm as in this case is extremely rare. Incidental note was made of the coexistent right internal jugular phlebectasia. A brief review of literature of this entity has been discussed.

Prevalence of Seizures in Hospitalized Neonates

The present study was conducted in all neonates < 28days of life who were hospitalized in the neonatal division, Department of Pediatrics, SMGS hospital, Govt. Medical Collage Jammu, over a period of 6 months from Dec. 2000 to May 2001 to assess the prevalence of neonatal seizures. The study revealed a seizure prevalence in hospitalized neonates of 19.2% with male sex preponderance. 71.4% neonates had early onset serizures.

Implantation of Dual-Chamber Cardioverter-Defibrillator through Left Iliac Vein in a Patient with Occluded Superior Vena Cava.

The occlusion of the superior vena cava is a known complication of repeated procedures related to pacemaker and implantable cardioverter-defibrillator devices. The insertion of implantable cardioverter-defibrillators in patients with this complication entails the practical problem of how to gain access to the heart. Surgical placement of epicardial leads and patches, using thoracotomy,is an established alternative but has its inherent problems, including high surgical risk. Also, the necessary hardware is not easily available. The existing literature has few reports of the insertion of implantable cardioverter-defibrillators through alternative transvenous routes. We report a case of implantation of a dual-chamber implantable cardioverter-defibrillator through the left iliac vein in a patient with arrhythmogenic right ventricular dysplasia, recurrent ventricular tachycardia and an occluded superior vena cava.

Acute toxicity of mercury to the fingerlings of Indian major carps (catla, rohu and mrigal) in relation to water hardness and temperature.

In the present study short-term (96 hr) toxicity of mercury in relation to water hardness (270 and 560 mg/l) and temperature (16 degrees C and 35 degrees C) to the fingerlings of Indian major carps, i.e. catla, rohu and mrigal has been evaluated using static bioassay. The LC5o indicates that both water hardness and temperature played significant role in mercury toxicity. The test fishes were found most resistant with water hardness of 560 mg/l at 16 degrees C as compared to that of water hardness of 560 mg/l at 35 degrees C and water hardness of 270 mg/l at both the temperatures, i.e. 35 and 16 degrees C. Whereas the order of relative sensitivities of these fishes for mercury ions were recorded as catla>rohu>mrigal. The safe concentrations of mercury were ranged in between 12.133 to 19.689 microg/l for catla; 64.039 to 82.555 microg/l for rohu and 73.510 to 89.585 microg/l for mrigal for both the water hardness and temperature.