Prevalence, risk factors and pattern of severe retinopathy of prematurity in eastern Madhya Pradesh

Purpose: To describe the prevalence, characteristics including risk factors, and pattern of severe ROP from eastern Madhya Pradesh region of India. Methods: In this 5-year retrospective study, Baseline characteristics, systemic risk factors, and findings of ROP screening were noted. Factors associated with severe ROP including aggressive posterior ROP (APROP), stage IV and V ROP were analyzed. Statistical analysis was done using SPSS version 20. Results: Of 763 babies screened, 30% were diagnosed to have ROP. Prevalence of severe ROP was 14.2% (109) of which 60 (55.5%) were classic and 30 (27.7%) were APROP. Eighteen (16.6%) were diagnosed as advanced ROP (stage IV and V). Mean gestational age (GA) and birth weight (BW) for severe ROP were 31.05 weeks and 1.34 kg, respectively which were inversely associated with severe ROP. But a significant 10% of severe ROP were seen in late preterm babies, >34 weeks. Low GA and respiratory distress syndrome (RDS) were significant risk factors for APROP. Most important factor for stage IV and V ROP was late presentation for screening. Conclusion: The study found a high prevalence of severe ROP including APROP. Almost 7% severe ROP cases were outside screening guidelines of NNF. Late presentation for screening is the most important factor associated with ROP related blindness.

Unusual presentation of polycystic liver disease in a young man.

Polycystic disease of the liver is usually asymptomatic. The main symptoms of cystic disease are those of an enlarging liver or due to compression of the adjacent organs caused by a large cyst. Less than 5% of these patients present with clinically challenging and life threatening complications. We present a patient with polycystic disease of the liver who developed an aneurysm arising from the right hepatic artery presenting with surgical obstructive jaundice. In spite of intraperitoneal rupture of the aneurysm the patient was managed successfully.

Benign cystic peritoneal mesothelioma in a man.

Benign cystic mesothelioma of the peritoneum is uncommon and usually occurs in women. We report this condition in a man, who was treated successfully by surgical excision of the tumor.

An unusual cause of haemorrhagic ascites following blunt abdominal trauma.

Slow intraperitoneal haemorrhage following blunt abdominal trauma may present as haemorrhagic ascites. Such haemorrhage is usually due to rupture of spleen, liver or damage to small bowel mesenteric vasculature. We encountered a patient with bleeding from ruptured exogastric leiomyoblastoma. Two cases of traumatic rupture of gastric leiomyosarcomas have been reported previously. The operative treatment is usually delayed and the diagnosis established only at laparotomy. We suggest a high level of suspicion and early laparotomy.

Multiple large pyogenic liver abscesses of the tropics: a new entity.

BACKGROUND: Pyogenic liver abscesses most commonly occur in males in -he sixth decade, are usually associated with biliary tract disease, malignancy and immunosuppression and the mortality rate is high. We describe another form of pyogenic abscess occurring in females which, if treated aggressively, carries a much better prognosis. METHODS: Between 1986 and 1993 we treated 8 patients with multiple pyogenic liver abscesses. Diagnosis was established by ultrasound and CT scan followed by needle aspiration to confirm pus. Amoebic aetiology was excluded by a serology, poor response to metronidazole and biopsy of the abscess wall. RESULTS: The mean age of our patients was 30 +/- 7 years and there were 2 males and 6 females. They presented with fever and abdominal pain for more than 2 months, tender hepatomegaly, a raised ESR and alkaline phosphatase. US and CT scans showed multiple large abscesses in the right lobe. Histology suggested chronic inflammation and with no definite organism isolated except for visceral larva migrans in one case. All patients underwent surgery--deroofing with drainage was done in four, segmental hepatic resection in three and right hepatectomy in one. One patient had a recurrence and underwent repeated resection. Only one patient died and 7 did well with no recurrence at a mean followup of 24 +/- 27 months. CONCLUSIONS: Large multiple cryptogenic pyogenic abscesses of the liver occurring mostly in young females, which respond well to aggressive excisional surgery may constitute a distinct clinical entity.