ABSTRACT
The autopsy has for long been regarded as the gold standard as the most important tool for retrospective quality assessment of clinical diagnosis as well as a key education tool. In autopsy the kidneys are examined for disease, injury and other findings suggesting cause of death or related changes. Grossly some of the diseases may be easily noted on autopsy. Since kidney biopsy is usually avoided in critically ill patient ,histologic evaluation of autopsy of kidneys may be the first and the only opportunity to identify these diseases. Objectives: 1) To study the pattern of histological findings in kidney in minimum 150 autopsy cases based on the material received in Pathology department, GMC, Patiala. 2) To study the latent form of the disease, which couldn’t be diagnosed in lifetime, whenever full data is available. 3)To establish the exact cause of death on renal autopsy findings, wherever possible. 4) To find discrepancy with clinical diagnosis if the data are available. Methods: The present study is an observational study that was conducted over a period of two years. Postpartum renal specimens were received from August, 2016 onwards with a total of 150 cases. The specimens were preserved in 10% formalin immediately after autopsy and were received in fully sealed jars. A thorough gross examination of renal specimens including measurements, weights, consistency, cut surface, details of any lesions if preserved were recorded. Subsequently samples were processed for histopathology. The sections were thoroughly examined microscopically on 4x, 10x, and 40x power of the microscope for any pathology and the results were recorded. Results: In 57 cases (38%) microscopic findings were close to normal histology with no nephropathological diagnosis. 68 cases with tubular and interestial pathology included 43 cases of acute tubular necrosis (28.6%), 3 cases with acute pyelonephritis(2%), 2 cases with chronic pyelonephritis(1.3%) and 20 cases were noted to have cloudy swelling in the tubule(13.3%). Conclusion: In the present study majority of renal autopsies revealed histopathological pattern suggestive of tubular pathologies of which most common was acute tubular necrosis as a cause of sudden collapse of patient leading to death.
ABSTRACT
Lipomas are the most common type of soft tissue tumors. Intramuscular lipoma is a rare type of deep-seated lipomas, which arise within the skeletal muscle fibres. It can arise in the background of history of trauma, obesity, chronic irritation, metabolic disorders, etc. Lipomas are usually benign, but sometimes clinically and grossly, they simulate malignancy. Intramuscular lipomas also need separation from muscular dystrophies. Histopathology is must to differentiate. Prognosis of intramuscular lipoma is very good and marginal excision is the treatment of choice. We report a case of 32 years old female, who presented with a painless swelling shoulder since six months. She had history of trauma eight years back. Grossly, the received mass was yellow-tan coloured, well circumscribed swelling of soft tissue along with muscle. Histopathologically, features are consistent with intramuscular lipoma. We report this case because of its rarity.
ABSTRACT
Acalculus eosinophilic cholecystitis is a variant of chronic cholecystitis which is an inflammation of gall bladder. Here we presents a case of female child of 10 years age with features of abdominal pain for 6 months which after investigations found to be of an eosinophilic cholecystitis cuased by Ascaris lumricoides- a rare entity.
ABSTRACT
Retinoblastoma is the most common intraocular malignancy in children. With the improvement in diagnostic and treatment modalities, early diagnosis and prompt treatment have remarkably improved the survival and salvageable vision in retinoblastoma patients. We report a case of a 14-month-old female child who presented to us with intermittent deviation of both eyes and white reflex in both eyes along with redness and photophobia in right eye, she was diagnosed to liver bilateral retinoblastoma.
ABSTRACT
<p><b>OBJECTIVE</b>Metaphyseal-diaphyseal fractures of the distal radius are a major treatment dilemma and orthopaedic surgeons have to pay due consideration to restoration of anatomy of distal radius together with rotation of the radial shaft and maintenance of radial bow and interosseous space. We performed this study to evaluate the clinic-radiological outcome of metaphyseal-diaphyseal fractures of the distal radius treated with long volar locking plates.</p><p><b>METHODS</b>This prospective study involved 27 patients (22 males and 5 females) with metaphyseal-diaphyseal fracture of the distal radius. Their mean age was (30.12+/-11.48) years (range 19-52 years) and the follow-up was 26.8 months (range 22-34 months). All patients underwent open reduction and internal fixation with a long volar locking plate. According to AO/OTA classification, there were 7 type A3, 13 type C2 and 7 type C3 fractures. Subjective assessment was done based on the disabilities of the arm, shoulder and hand (DASH) questionnaire. Functional evaluation was done by measuring grip strength and range of motion around the wrist and the radiological determinants included radial angle, radial length, volar angle and ulnar variance. The final assessment was done according to Gartland and Werley scoring system.</p><p><b>RESULTS</b>Postoperative radiological parameters were well maintained throughout the trial, and there was significant improvement in the functional parameters from 6 weeks to final follow-up. The average DASH scores improved from 37.5 at 6 weeks to 4.2 at final follow-up. Final assessment using Gartland and Werley scoring system revealed 66.67% (n equal to 18) excellent and 33.33% (n equal to 9) good results. There was one case of superficial infection which responded to antibiotics and another carpel tunnel syndrome which was managed conservatively.</p><p><b>CONCLUSION</b>Volar locking plate fixation for metaphyseal-diaphyseal fractures of distal radius is associated with excellent to good functional outcome, early rehabilitation and minimal complications.</p>
Subject(s)
Humans , Bone Plates , Fracture Fixation, Internal , Prospective Studies , Radius , Radius FracturesABSTRACT
Plasmodium vivax [Pv] malaria is being increasingly recognized as a cause of severe malaria in children. To describe the various severe manifestations associated with vivax malaria by retrospective analysis of records. Children between the ages of 0 and 18 years with a confirmed diagnosis of Pv malaria monoinfection done by peripheral blood film [PBF] and/or rapid diagnostic test [RDT] admitted between June and September 2009 were included. Their clinical, hematological and biochemical manifestations were analyzed. Twenty-three patients of Pv malaria were retrospectively analyzed. Thrombocytopenia was present in 22 [96%] patients with counts less than 50,000/ micro L in 9 patients. Severe anemia [hgb < 5 mg/dl] was present in 8 [34%] patients. Cerebral malaria was present in 3 patients. Liver enzymes were elevated [>3 times normal] in 4 [17.3%] patients while jaundice [bilirubin > 2.5 mg/dl] was present in 2 patients [total bilirubin 5.2 mg/dl and 14.3 mg/dl]. Renal dysfunction [creatinine > 3 mg/dl] was present in 6 [26%] patients with 2 patients showing severely deranged renal functions [blood urea 168 mg/dl, 222 mg/dl and serum creatinine 5.0 mg/dl, 5.6 mg/dl, respectively]. Hypernatremia was present in one patient. One patient expired within 12 h of presentation because of severely deranged hepatic and renal dysfunction. Pv malaria can lead to unusual and fatal complications. All new guidelines should include "Severe Vivax malaria" as a clinical entity. Further research into the etiopathogenesis and treatment would be important
Subject(s)
Humans , Female , Male , Plasmodium vivax/pathogenicity , Child , Severity of Illness Index , Malaria, Vivax/complicationsABSTRACT
The pharmacokinetics of intravenously administered gatifloxacin, upon concomitant administration with meloxicam was investigated in buffalo calves. Meloxicam was administered subcutaneously (0.5 mg.kg-1) immediately followed by intravenous administration of Gatifloxacin (4 mg.kg-1). The concentration of gatifloxacin was estimated in plasma by microbiological assay. Pharmacokinetic parameters were calculated and appropriate dosage schedule was computed. The therapeutic plasma drug concentration was maintained up to 12 h. Gatifloxacin was rapidly distributed from blood to tissue compartment, which was evident from the high values of distribution rate constant, α1 (11.9 ± 0.52 h-1) and the ratio of rate constant of transfer of drug from central to peripheral compartments and vice versa, K12/K21 (3.05 ± 0.36) and K13/K31 (2.04 ± 0.12). The area under the plasma drug concentration-time curve and apparent volume of distribution were 12.0 ± 0.68 µg.ml-1.h and 2.69 ± 0.14 L.kg-1, respectively. The elimination half-life (t1/2β), total body clearance (ClB) and the ratio of drug present in peripheral to central compartment (P/C) were 5.59 ± 0.40 h, 337.6 ± 19.9 ml.kg-1.h-1 and 8.04 ± 0.50, respectively. The present study revealed that the most suitable dosage regimen of gatifloxacin when concomitantly administered with meloxicam in buffalo calves would be 2.5 mg.kg-1 followed by 2.0 mg.kg-1 at 12 h intervals.
Investigou-se a farmacocinética da gatifloxacina, administrada por via intravenosa, concomitante à aplicação de meloxicam em bezerros búfalos. O meloxicam foi administrado por via subcutânea (0,5 mg.kg-1), imediatamente seguido pela administração intravenosa de gatifloxacina (4 mg.kg-1). A concentração plasmática de gatifloxacina foi estimada por ensaio microbiológico. Os parâmetros farmacocinéticos foram calculados e a posologia adequada foi computada. A concentração plasmática do fármaco-terapêutico foi mantida por 12 h. A gatifloxacina foi rapidamente distribuída a partir de sangue para o compartimento de tecido, o que ficou evidente a partir dos valores elevados da taxa constante de distribuição, α1 (11.9 ± 0.52 h-1) e a proporção de velocidade constante de transferência de droga a partir de centrais para os compartimentos periféricos e vice-versa, K12/K21 (3.05 ± 0.36) e K13/K31 (2.04 ± 0.12). A área sob a curva plasmática de concentração-tempo da droga e o volume aparente de distribuição foi de 12.0 ± 0.68 µg.ml-1.h e 2.69 ± 0.14 L.kg-1, respectivamente. A meia-vida (t1/2β), a depuração corporal total (ClB) e relação da droga presente no sangue periférico para o compartimento central (P/C) foram 5.59 ± 0.40 h, 337.6 ± 19.9 ml.kg-1.h-1 e 8.04 ± 0.50, respectivamente. O presente estudo revelou que o regime de dosagem mais adequado de gatifloxacina quando administrada concomitantemente com meloxicam em bezerros búfalos seria 2,5 mg.kg-1 seguida de 2,0 mg.kg-1 em intervalos de 12 h.