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A cornual pregnancy is the most dangerous type of ectopic pregnancy since it can be misdiagnosed easily and has high mortality rate. It is diagnosed when the implantation site is at the junction between the fallopian tube and the uterus. It accounts for 2� of ectopic pregnancies. In a ruptured case, patient usually presents with hypovolemia and shock. For a successful outcome, early diagnosis and management are critical. A 29 years old woman, G3P0A2L0 with 8 weeks 5 days of amenorrhea conceived by IVF-ET with a history of left salpingectomy and right cornual cauterization, presented in emergency with complaints of lower abdominal pain, vomiting, burning micturition and giddiness. Per abdominal examination- soft with mild tenderness. Resuscitation started. All necessary investigations were done. Treatment started considering provisional diagnosis as septic shock following urinary tract infection (UTI). Ultrasound report showed uterus with thickened endometrium with hyperechoic irregular small gestational sac like structure in uterine cavity with hemoperitoneum in pelvis. Emergency laparotomy done considering a diagnosis of hypovolemic shock due to ruptured cornual ectopic pregnancy. Intra-operatively she was found to have hemoperitoneum with left sided ruptured cornual ectopic pregnancy. Early diagnosis is the cornerstone of cornual pregnancy before its rupture and to reduce the chances of maternal mortality. Combination of clinical features, increased serum ?-hCG, high resolution trans-vaginal ultrasonography gives the correct diagnosis in most of the cases. While doing antenatal ultrasonography in the first trimester, high index of suspicion is needed to diagnose cornual ectopic pregnancy. Conservative medical and surgical management is decided on clinical condition of the patient. Our case represents that a history of salpingectomy does not eliminate the potential of ipsilateral ectopic pregnancy.
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Around 2-7% of all vulvar cancers are represented by primary carcinomas of Bartholin gland. Here we are presenting such a rare case of carcinoma of Bartholin gland. 45/F P2L2 presented in our OPD with non-healing lesion in vulva for 2 months. She had history of Bartholin’s cyst excision (elsewhere), 2 months back (the exact time since when she is having the non-healing lesion in vulva). Diagnostic biopsy revealed it to be vulval squamous cell carcinoma. She was given two cycles of Neo adjuvant chemotherapy (Inj. Paclitaxel and Carboplatin). In view of better response to the treatment patient was planned for surgery. Patient underwent wide local excision with bilateral inguinofemoral lymphadenectomy. Although the majority of vulvar lesions are benign, especially in women younger than 50 years of age, any solid mass should be carefully evaluated for malignancy. Preferably biopsy of Bartholin gland should be considered if the patient is more than 40 years of age and should be mandatory in a menopausal woman.
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Worldwide cervical cancer is the fourth most common cancers among females. Pelvic recurrence, distant metastases, or a combination of both can occur in patients of carcinoma cervix. A 42-year-old P2L2 with a history of carcinoma cervix stage 3-b came to our OPD for routine follow up. Two year back she was managed with chemoradiation for her primary carcinoma which had parametrium extension. There was a 1 × 1 cm lesion on the anterior vaginal wall which was diagnosed to be cervical recurrence. Patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy with pelvic lymphadenectomy. Patient is disease free till now. Treatment decisions should be individualised based on the performance status of the patient, the site of recurrence and/or metastases, the extent of metastatic disease, and prior treatment.
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Acute colonic pseudo obstruction or Ogilvie’s syndrome is a rare entity that is characterized by acute dilatation of the colon without any mechanical obstruction. It is usually associated with medical disease or surgery and rarely occurs spontaneously. If not diagnosed early, Ogilvie’s syndrome may cause bowel ischemia and perforation. Its early diagnosis and prompt treatment are the keystones to avoid any subsequent fatal complications. We report a case of acute intestinal pseudo obstruction causing post-operative wound dehiscence in a patient who underwent colostomy reversal following a Hartman’s procedure for a rectal carcinoma. We also review the clinical characteristics, diagnostic methods, and management of Ogilvie’s syndrome with reference to literature.
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Current evidence on the efficacy and safety of Laparoscopic Radical Hysterectomy for early stage cervical cancer is adequate to support the use of this procedure provided that normal arrangements are in place for clinical governance, consent and audit. This study aims to present our single unit experience of Laparoscopic Radical Hysterectomy performed for early stage cervical cancers. Methods: 74 laparoscopic radical hysterectomies performed for early stage cervical cancers from 2012 to 2017 were reviewed. Results: Key efficacyoutcomes evaluated were completing the procedure without conversion to open surgery ( conversion rate – 3/74),the mean operating time (144 mts), intra operative complications ( rectal injury 2/74, primary hemorrhage 1/74), post operative complications ( ureteric fistula 2/74, vescico vaginal fistula 1/74 , port site hernia 1/74), number of LN removed ( mean - 14 LN on each side), recovery time (6 hrs on average ) and length of hospital stay (average – 5days); lone term outcomes viz recurrence rate and % year survival are under study. Conclusion: Our initial experience indicate that laparoscopic radical hysterectomy is safe ,feasible and effective with low morbidity and with comparable outcome to open approach; It does not compromise oncological radicality of resection; short term results are promising; long term results are awaited.
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Background: Rabies is one of the commonest zoonotic diseases due to Lyssa virus. Rabies is a 100% fatal disease. Understanding the epidemiological and clinical profile of the victims helps in the prevention of dog bite. But rabies is 100% preventable by pre and post exposure prophylaxis vaccination. Evaluation of side effects of anti-rabies vaccine (ARV) is helpful in the pre and post exposure prophylaxis.Methods: Authors did a descriptive study of 1450 dog-bitten children. Using the pro-forma, authors interviewed the parents, examined the children. Using W.H.O classification, authors classified the dog bite wounds. Anti-rabies vaccination was administered to category 2 dog bite wounded children. Side effects of vaccination are recorded.Results: Out of 1450 children, significantly more number of boys (67%) in the age group of 10-12 years (31%), from class IV socioeconomic category (52%), nuclear families (80%), sustained category III dog bite (52%) in the lower limb (48%) by unvaccinated (82%) stray dogs (60%) while playing or walking (52%) in the street (60%) during night (72%). Purified Vero cell culture rabies vaccine is having rare mild local side effects (2%), rare mild systemic side effects (4.16%) and very rare systemic allergic reaction (0.14%) but no major side effects.Conclusions: Dog bites can be prevented by not allowing the children to play or walk alone in the street especially during night. The severity of wound can be minimized by wearing fully covered extremities. Vaccination of dogs and population control of stray dogs will reduce rabies. There were no major side-effects or adverse events following vaccination (AEFI) with anti-rabies vaccination. Rare mild local side effects and very rare mild systemic side effects may happen.
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Acute kidney injury is a threatening complication of pregnancy causing serious maternal and fetal morbidity and mortality,common in developing countries.METHODS:A observational study was done between January 2018 to November 2018 to report the incidence,clinical spectrum and maternal&fetal outcome in AKI.RESULTS:Total number of patients 40,Mean age–25.3± 4.3 yrs.The incidence of AKI in pregnancy was 6%.Incidence of AKI most common in Postpartum period(80%),causes of AKI was Sepsis(40%),HELLP(20%),Postpartum hemorrhage (20%),Auptio placenta (15%),Acute fatty liver of pregnancy (5%).Among them 80% of patients having preeclampsia as common risk factor.Live births was 80%.Among total pregnancy related AKIs 14 patients were managed conservatively and 26 needed dialysis. recovered patients were (N=38) 95%,and mortality was (N=2)5%.CONCLUSION:AKI in pregnancy commonly occurred in Postpartum period and Sepsis is the most common etiology
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A 54-year-old male sustained ocular trauma with a projectile. Examination of the right eye revealed an intraocular foreign body (IOFB) adjacent to the optic nerve head, vitritis, vitreous hemorrhage, and translucent perivascular sheathing of the retinal vessels in all quadrants suggesting frosted branch angiitis (FBA). The patient underwent vitrectomy with removal of the IOFB and silicone oil tamponade under steroid cover. With continued use of systemic and topical steroids after surgery, complete resolution of FBA and improvement in vision were noted in a week. Prompt resolution of FBA after IOFB removal points toward a strong association between the presence of IOFB and FBA.
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The brown seaweed Padina tetrastromatica which can be collected from Gulf Of Mannar Sea shore Thoothukudi, India. In this present study was focused on the antimicrobial activity of the selected seaweed against six human pathogenic bacteria (Gram +ve: Staphylococcus aureus, Bacillus subtilis, Lactobacillus acidophilus and Gram -ve: Pseudomonas aeruginosa, Escherichia coli and Proteus mirabilis) by the agar well diffusion method. Here, different concentrations of the extract from Padina tetrastromatica were tested for probable antimicrobial activity and the extracts were prepared by five different solvents such as Acetone, Chloroform, Ethanol, Ethyl acetate and methanol. The experimental results shows that the highest antimicrobial activity 15mm was shown by Ethyl acetate extract against S. aureus and the lowest activity observed in methanol extract 1mm against E.coli. The experiment concludes that the extract of Ethyl acetate forms a good activity against all the six organisms.
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Estuaries are considered as highly potential area for that including feeding, spawning and nursery rearing of most of the finfishes and shellfishes. In the present investigation, two species of catfish (M.gulio and M.vittatus) were selected to study the impact of season on their immune organs (kidney and spleen) and selected immune response from Vellar estuary. The physico-chemical parameters (pH, temperature, salinity and rainfall) were measured during the sampling period 2009-10. The non-specific immune parameters (WBC count, lysozyme activity and NBT assay) were analyzed. The immune organs (head-kidney and spleen) variation was also observed by histological studies. Our results stated that the WBCs count of M. gulio and M. vittatus increased during summer (10.3 and 10.1 X 106 ml-1) season and decreased in monsoon (6.8 and 7.0 X 106 ml-1). In contrast, lysozyme activity was highest in post monsoon (1540 and 1525 U min-1 ml-1) and lowest in summer (1000 and 960 U min-1 ml-1). The activity of NBT was highest in monsoon (0.68 and 0.65 at 540 nm) and lowest in summer (0.012 and 0.2 at 540 nm). The histological observation implies that the cell variations were different in respect to different seasons.
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Granulomatous reactions have been reported in association with lymphomas, more often with Hodgkins disease than with Non-Hodgkins Lymphoma. Not many reports are available on the association of anaplastic large-cell lymphoma with sarcoid-type granuloma. Herein, we report a case of an elderly female with generalized lymphadenopathy who had a florid granulomatous reaction almost masking the lymphoma cells in the lymph node biopsy. A detailed clinical history, careful histological examination and immunohistochemistry helped in attaining the correct diagnosis.