Thiamine deficiency related peripheral neuropathy in peripartum women of Kashmir, India: a hospital based study

Background: Beri Beri is still seen in Asian countries due to the large-scale consumption of thiamine depleted polished rice. Thiamine deficiency related disorders are increasingly being reported from Kashmir from last two decades. Specifically, a sensorimotor axonal neuropathy occasionally develops from thiamine deficiency and may occur even without associated Wernicke’s encephalopathy.Methods: This study is a retrospective observational study. All peripartum females referred to our departments from January 2016 to December 2017 with complaints of generalized weakness and or sensory symptoms in form of paresthesias /numbness in limbs were enrolled. Clinical features, electrophysiological features, course in hospital and response to treatment in suspected thiamine deficiency related neuropathy patients were recorded.Results: Forty-three cases were included in the study. Twenty-nine patients were suspected to have nutritional neuropathy because of thiamine deficiency at the time of admission. Out of these 27 showed improvement on treatment with thiamine.Conclusions: Thiamine responsive neuropathy is common in peripartum women of this part of world. Diagnosis is usually made clinically, in at risk individuals presenting with characteristic clinical features.

Clinicopathological spectrum of gall bladder cancer in Kashmir - an institutional study

Gallbladder cancer is a highly aggressive malignancy that usually presents at an advanced incurable stage. It is the fifth most common gastro-intestinal tumor and leads to approximately 2800 deaths in United States annually. This was a retrospective study carried out in the Department of Pathology, Sher-i-Kashmir Institute of Medical Sciences, a 650-bed super speciality hospital in Kashmir valley. We reviewed the histopathological records of all the patients who were diagnosed as carcinoma gallbladder from Dec 2009-Dec 2013. Gross findings and histopathological findings were noted from the departmental archival material and clinical records of the patients including the clinical presentation, laboratory investigations, radiological investigations, pre-operative diagnosis and intra-operative findings, were retrieved from the hospital records. We analyzed 57 cases of carcinoma gallbladder for their clinicopathological features It included 19 males and 37 females. In our study, adenocarcinomas accounted for 87.5% of total carcinomas. Incidentally, all but one patient where gall stones were found, adenocarcinomas were seen. We have 4 patients of squamous cell carcinoma. In our series we have a single case of small cell carcinoma which was positive for neuroendocrine markers. In our study, gall stones were seen only in 8 cases [14%] of the total cases

Auditing the use of percutaneous pinning as a technique of fixation of unstable humeral supracondylar fractures in Sudanese children

Supracondylar fractures of the humerus in children are commonly treated with closed reduction and percutaneous pin fixation. There has been controversy regarding the optimal pin configuration in the management of supracondylar humeral fractures in children. To evaluate the effectiveness of closed percutaneous pinning [P.C.P.] as a treatment modality of supracondylar fractures of humerus in Sudanese children. Hospital based prospective study conducted in Khartoum teaching hospital during the period from July 2006 to March 2007. It included all children less than 14 years of age, with closed type III supracondylar humeral fracture, extension variant, who treated by closed reduction and percutaneous cross pinning. 34 patients were included in the study. Their age ranged between 4 -12 years, with mean +/- SD of 7.68 +/- 2.34 years. Twenty-four [70.6%] fractures were fixed with crossed pins whereas ten [29.4%] fractures with two lateral pins. The two lateral pins fixation was found to be significantly associated with loss of reduction [p=0.004]. PCP is safe and effective with good functional outcome in treatment of unstable supracondylar fractures. The best wires configuration is that which gives ability to extend elbow with much stability

Auditing the use of percutaneous pinning as a technique of fixation of unstable humeral supracondylar fractures in Sudanese children

Supracondylar fractures of the humerus in children are commonly treated with closed reduction and percutaneous pin fixation. There has been controversy regarding the optimal pin configuration in the management of supracondylar humeral fractures in children. The objectives of this work are to evaluate the effectiveness closed percutaneous pinning [P.C.P.] as a treatment modality of supracondylar fractures of humerus in Sudanese children; To overall improve the strategy of treatment technique local experience in treating displaced supracondylar fracture of the humerus in children and; to assess the results of treatment by closed reduction and percutaneous pin fixation of humeral supracondylar fractures in children. Hospital based prospective analytical observational study conducted in Khartoum teaching hospital during the period from July 2006 to March 2007. Included all children less than 14 years of age, with closed type III supracondylar humeral fracture, extension variant, who treated by closed reduction and percutaneous cross pinning. The results show that 34 patients were available for the final assessments at nineth weeks. Their age ranged between 4-12 years, with mean +/- SD of 7.68 +/- 2.34 years. Twenty-four [70.6%] fractures were fixed with crossed pins whereas ten [29.4%] fractures with two lateral pins. The two lateral pins fixation was found to be significantly associated with loss of reduction [p=0.004]. It was concluded that PCP is safe and effective with good functional outcome in treatment of unstable supracondylar fractures. The best wires configuration is that give ability to extend elbow with much stability

Multiple carpo-metacarpal joint dislocations without fracture

Although carpometacrpal injuries are relatively uncommon, it is rare for multiple carpometacarpal dislocations to occur without associated fractures. Therefore, any pure multiple dislocation of the CMC joint without associated fracture is worth to be reported. Untreated the dislocations disrupt both the longitudinal and transverse arches of the hand resulting in an impaired grip and loss of normal axial length. We would like to report an uncommon case of carpometacarpal dislocation without associated fractures in a 28-year old man following a fall from a vehicle at speed. To the best of our knowledge, this is first case being reported in Sudan literature on such injury

Metastatic signet ring cell adenocarcinoma of proximal femur with uncertain primary site

Although bone metastases can be found commonly in some malignant tumours, diagnosing a primary malignancy site is not a usual event. Secondary signet ring cell carcinoma of the bone is a very rare tumour. We present a case with pure metastatlc signet ring cell carcinoma of the bone, with an uncertain primary site. A 48-year old man was admitted with Rt thigh swelling and inability to walk. One of first diagnostic effort performed was histopathological examination that revealed a metastatic signet ring cell carcinoma, compressing the regional lymphatics. To our knowledge, in Sudan literature, we believe that this case is the first report of metastatic signet ring cell carcinoma of the proximal femur. Because of the very short survival of many patients, all investigational procedures should be judged in view of their rationality, and should be focused on treatable primary tumours

[Evaluation of co-administration of omperazole with H[2] blockers and antacids]

Omperazole as a very useful drug in peptic ulcer which needs to be converted to active form and its activation requires acidic environments. H[2] blockers and antacids can prevent this activation by elevation of pH in the gastrointestinal system thus diminishing omperazole effectiveness. In this study, cases of coadministration of omperazsole with H[2] blockers and antiacids has been evaluated. This descriptive study included 1200 prescriptions containing omperazole alone or in combination with other drugs at the Chamran Pharmaceutical Store of Yazd. In 599 cases, omeprazole was administered with other drugs of which 211 cases [35.3%] was with H[2] blockers and l 16 prescriptions with antiacids. Only in 55 cases [4.6%], both antiacids and H[2] blockers were administered in combination with omperazole. On the basis of previous studies and considering the physiology of acid secretion in parietal cells and pharmacological mechanism of drugs used in the treatment of peptic ulcer, coadministration of antacids and H[2] blockers with omperazole decrease its efficacy and must therefore be avoided

Hexadecyl- phosphorylcholine ointment for treatment of cutaneous leishmaniasis: an animal trial

A placebo- controlled trial compared 6% hexadecyl- phosphorylcholine [HePC] and 12% benzethonium chloride ointment with placebo ointment for treatment of cutaneous leishmaniasis. Cutaneous lesions were experimentally induced by inoculation with leishmania promastigotes in 60 golden hamsters. Forty [40] animals were treated with drug and 20 with placebo ointment applied twice daily for 15 days. After treatment, all lesions were significantly reduced in size in the treatment group compared with the placebo ointment. No parasites were detected in smears from 35/ 40 of the drug- treated lesions and no relapses occurred over 120 days of observation

Study of lumbar vertebral canal in Pakistanis and comparison with other races

An osteometric study of the anteroposterior diameter of the lumbar vertebral canal of normal adult Pakistani males and comparison to Nigerians was done. Fifty complete sets of adult male lumbar vertebra were studied. In Pakistani the mean sagittal diameter was narrow at the level of L1, L3, L4 and wider at L2 and L5. The canal body ratio was maintained at 0.5 at all levels. Inferior vertebral notch maintained its ratio at 0.3 at all levels except at L2 it was 0.4. The diameter of vertebral canal is narrow in Pakistanis as compared to Nigerians