ABSTRACT
Histoplasmosis is a systemic mycotic infection caused by Histoplasma capsulatum. Although rare in India, it is endemic in over 300 countries. If immunity is good in a healthy person, even if this fungus is inhaled, it may cause mild symptoms and can be controlled by supportive therapy. However, in persons with very low immunity, as in the case of human immunodeficiency virus-positive persons, a serious disseminated form could be life-threatening in delayed diagnosis and delay in proper treatment. Due to pulmonary symptoms, it is commonly misinterpreted as tuberculosis and treated accordingly without results. However, oral lesions which occur can reveal the correct diagnosis by biopsy procedure and microscopic confirmation of this rare disease. We had a 76-year-old patient suffering from pulmonary signs of cough, weakness, and with gums and tongue lesions, who was referred by a general dental practitioner for diagnosis of oral lesions. The tongue and gums lesions biopsy revealed the correct diagnosis of granulomatous lesion with yeast-like organisms of giant cells, indicating histoplasmosis capsulatum diagnosis which was later treated by immunology experts in the hospital with proper antifungal agents like amphetericin B and management of this disseminated histoplasmosis with other investigations. Therefore, systemic diseases also need oral examination to rule out many unusual diseases.
ABSTRACT
Augmentation cystoplasty has traditionally been used in the treatment of low capacity, poorly compliant or contracted bladders. Various bowel segments can be used for augmentation with its own advantages and disadvantages like ileum, sigmoid, cecum, ileo cecal, stomach etc. The surgical technique involves detubularisation and reconfiguration of bowel to create a patch. A successful clinical outcome depends on creating a large capacity, low pressure reservoir to store urine. Present study was retrospective study conducted from November 2010 to March 2014 on 7 patients (5 men, 2 women with mean age 32 years). Early complications: wound infection in 3 cases, wound dehiscence in 2 cases, urinary leakage in 1 case. Late complications: recurrent UTI in 2 cases, increased mucus production in one case, bladder stone formation in one case. All were grade I to III according to Clavien- Dindo classification. No major (grade IV or V) complications. As in our experience ileocystoplasty for augmentation of tuberculous bladder is a safe and effective procedure.
ABSTRACT
Pelvic fracture urethral injuries are typically partial and more often complete disruptions of the most proximal bulbar and distal membranous urethra. Emergency management includes suprapubic tube placement. Subsequent primary realignment to place a urethral catheter remains a controversial topic, but what is not controversial is that when there is the development of a stricture (which is usually obliterative with a distraction defect) after suprapubic tube placement or urethral catheter removal, the standard of care is delayed urethral reconstruction with excision and primary anastomosis. This paper reviews the management of patients who suffer pelvic fracture urethral injuries and the techniques of preoperative urethral imaging and subsequent posterior urethroplasty.
ABSTRACT
During a mitral valve replacement surgery in a girl of 22 years of age, it was accidentally discovered that the valve was destroyed due to a tumor and the histopathology and immunohistochemistry findings have proved it to be undifferentiated sarcoma. She was advised by the surgeon to go for chemotherapy. There was a delay of three months from the side of the patient to reach us and during that interval she has developed secondaries in the brain. This case is being presented here for its rarity.