Venous thromboembolism [VTE]: risk assessment in hospitalized patients

To determine the number of hospitalized patients at risk for developing venous thromboembolism [VTE] / deep vein thrombosis [DVT], identifying the most common risk factor and to document the use of thromboprophylaxis. Observational and cross-sectional study. Chandka Medical College Hospital, Larkana, from October to December 2011. A total of 170 patients underwent this study and these included 51 [30%] from general medical, and 119 [70%] from surgical units. Inclusion and exclusion criteria were defined and data was collected on printed format. VTE risk assessment was done according to Caprini Model and criteria defined by the American College of Chest Physicians- ACCP. Out of 170 patients, 91 were male and 79 female with mean age of 39 +/- 16 years. According to ACCP criteria for VTE risk assessment, 20% [n=34] patients were identified to be at low risk, 20% [n=34] at moderate risk, 47.65% [n=81] at high risk and 12.35% [n=21] at very high risk of developing VTE. The commonest risk factor significantly identified was immobility [54.7%, p < 0.005], followed by advancing age [41.17%, p < 0.005] and obesity [18.23%]. The most common risk factor in all types of surgical patients was anaesthesia for more than 45 minutes 82.35% [n=98/119] and in medical patients advancing age 45% [n=23/51]. Only 6 [3.5%] patients received thromboprophylaxis, all were surgical patients of very high-risk category. Majority of studied hospitalized patients were at high risk of developing VTE. Immobility was the commonest risk factor for developing VTE, followed by advancing age and obesity. Very few hospitalized patients actually received thromboprophylaxis

Double Meckel's diverticulum in a boy

Meckel's diverticulum is the remnant of vitello-intestinal duct and the most common congenital anomaly of gastrointestinal tract. Usually it is a single diverticulum. Finding a duplication of Meckel's diverticulum is an extremely rare incident. We report a ten year old boy who presented with abdominal pain in whom, at exploration double Meckel's diverticulum was found

Pseudo papillary tumour of pancreas

During 05 years period from January 2003 to December 2007, 45 cases of Ca. Pancreas were reported to LINAR and only one case of Pseudo Papillary Tumour of Pancreas is registered. It is a rare, low malignant potential pancreatic tumour. It has unknown pathogenesis and found in young females. We report a case of 24 years old female, who presented with pain in abdomen and low grade fever of 07 months duration. Lepratomy and excisional biopsy was done. H/P came as Pseudo Papillary Tumour of Pancreas. At presentation no any L.N. were found enlarged. Like other malignant pancreatic tumours, this neoplasm does not metastasize. Its definitive treatment is complete surgical removal, no any role of chemotherapy because it doesn't metastasize, limited role of radiotherapy in local invasive tumour or in residual mass

Diffuse fibrous pseudotumor of paratesticular tissue

Paratesticular tumors are uncommon and comprise less than 5% of all intra-scrotal tumors. Fbrous pseudotumours are reactive fibrous proliferations of inflammatory and fibrous tissue, usually in response to surgery, trauma, infection, or inflammation. We present a case of a 25 years old male patient who presented with an asymptomatic firm non-tender right testicular swelling. Plasma HCG and alpha fetoprotein [AFP] levels were within normal limits. A total right orchidectomy and epididymectomy revealed normal testis completely encased by a thick firm fibrotic band of tissue. A diagnosis of diffuse fibrous pseudo tumor of para testicular tissue was made on histology. The possibility of fibrous pseudotumor of paratesticular tissue should be considered in young patients presenting with testicular swellings and normal tumor markers