Management of hepatic hydatidosis by laparoscopic approach in rural central India: a 3 year experience.

Background: Hydatid disease is still a major health problem in the infested areas of world, mainly in sheep-raising areas. But owing to increased travel and tourism all over the world, it can be found anywhere, even in developed countries.1 Thus, surgeons in nonendemic areas encounter the disease and should be aware of its optimum treatment. A safe, new method of laparoscopic management of hepatic hydatidosis is described along with the review of relevant literature. Methods: From April 2011 to October 2013, Fifteen cases of hepatic hydatid disease were operated on laparoscopically using the Palanivelu hydatid system. Results: The majority of the patients presented in the 4th decade (43.3%) with female sex predisposition (70% females). Most common presenting feature was pain the in upper abdomen. Most of the patients had only a single cyst (76.6%). The right lobe of the liver was most commonly involved. Cysts were bilateral in 6 patients. In all the patients simple evacuation of the hydatid cyst by the palanivelu hydatid system was done. The remnant cavity was dealt with by omentoplasty. The average follow-up period is 6 months. There have been no recurrences to date. Conclusions: Minimal invasive management, using Palanivelu hydatid system for aspiration and laparoscopic intervention, is an alternative to open surgery because of its ability to prevent spillage and thus minimize recurrences.

Open labelled evaluation of injection Manyana (a combination of diclofenac + pitofenone + fenpiverinium) in ureteric, biliary and intestinal spasm--a preliminary report.

To study the efficacy and safety of a parenteral formulation of 'Manyana' (a combination of diclofenac + pitofenone + fenpiverinium) in ureteric, biliary and intestinal colic, an open labelled study was conducted at two centres. A total of 206 patients were enrolled and evaluated for decrease in pain with time on a visual analogue scale. A statistically significant difference was observed in pain within 30 minutes of drug administration and the pain relief lasted for as long as 24 hours post dosing. The study shows definite synergism between the antispasmodics pitofenone and fenpiverinium with the NSAID-diclofenac, reducing the prostaglandin levels and also the spasm related to colic.

An evaluation of serum and tissue bound immunoglobulins in prostatic diseases.

In forty-four patients with different prostatic lesions serum immunoglobulins and tissue deposited immunoglobulins were studied by single radial immunodiffusion technique, and direct immunofluorescence and immunoperoxidase (PAP) methods respectively. Serum IgM levels were found reduced only in patients with prostatic carcinomas (80% of cases) as compared to controls. Serum IgA levels showed stage dependence in prostatic carcinoma being more raised in advanced malignancy (stage C and D) than in localized ones (stage B). Localization of immunoglobulins particularly IgM, was characteristically found in stroma and lumen along with intracellular localization in prostatic carcinoma; while normal and benign lesions of prostate only showed characteristic 'necklace' pattern. Also the intensity of deposits of immunoglobulins in poorly differentiated prostatic carcinomas was markedly low as compared to well differentiated carcinomas indicating lowered local immunological response in former. In prostatitis, IgA was also found localized in lumen indicating the immunological defence against infection by secretory antibody (IgA).