Unilateral Pure Trigeminal Motor Neuropathy.

A 17-year-old male reported to us in the Department of Medicine, Maharishi Markandeshwar Institute of Medical Sciences & Research, Mullana, Ambala, Haryana, India, in July 2019 with a complaint of left sided facial asymmetry since one and half years which was insidious in onset. The patient was himself unaware of the facial asymmetry and it was initially noticed by his mother. Gradually, the asymmetry of face became more prominent and was noticed by the patient and other relatives as well. There was no history of pain, numbness, difficulty in chewing or mouth opening, swallowing of food. He had no preceding febrile illness or local trauma. On local examination, there was no tenderness on left side of face

Preponderance of Inferior Wall Myocardial Infarction in Smokers with no other Cardiovascular Risk Factors

Introduction: Smoking is an independent risk factor forischemic heart disease and acute myocardial infarction.Smoking raise both heart rate and blood pressure, thusincreasing myocardial oxygen demand, moreover it alsodecreases the dimension of coronary vessel and coronaryblood flow. Inferior wall Myocardial Infarction is consequenceof disease in usually Right coronary artery, whereas anteriorwall Myocardial Infarction is usually disease in left coronaryartery. The aim of the study is to evaluate whether smokinginfluence the incidence of inferior wall MI (Right coronaryartery). Study objective was to find out whether there was anassociation between smoking and inferior wall MyocardialInfarction and an early association of atherosclerosis andischemic heart disease with smoking.Material and methods: 126 patients of ST ElevationMyocardial Infarction admitted from the outdoor patientdepartment/ emergency department/ Cardiology OPD inMMIMSR, Mullana, Ambala, considered for study. Thosewho are willing to participate and fulfilling the inclusion andexclusion criteria.Result: In our study there was a high proportion of smokerin patient with inferior wall MI than other location of MI.Smokers were prone to get myocardial infarction at a youngerage as compared to others. Mortality was higher in anteriorwall MI as compared to Inferior wall MI. Anterior wall MIpresented with more complications i.e. cardiogenic shock andarrhythmias.Conclusion: Smoking enhance the risk of inferior wall MImore than other MI. Smoking thus appear to adversely affectthe Right coronary artery to greater extent than left coronaryarterial circulation by mechanism yet to be explored. Smokingleads to ischemic heart disease at early age.

Street Peddlers and Poor Respiratory Health Outcomes in Lucknow, India

Introduction: There are few studies which aim towards theawareness of using protective masks and respiratory problemsamong street peddlers in India. The focus of this study wasto identify the major pollutants (i.e., PM 2.5, PM 10, etc.)present in the air which may be responsible for the adverserespiratory effect on the human population in street peddlersof Lucknow, India.Material and Methods: Street Peddlers, who were notindulge in smoking in recent few days and have no knowledgeof any diagnosed respiratory diseases, were asked toparticipate from roadside of different localities in Lucknowcity, India. Volunteering Members (n=30) described havinglower respiratory, upper respiratory, and other symptoms.Result: The result of the study was estimated on the basisof a self-analysis form. Symptoms of upper (sour throat36.3%) and lower respiratory tract (coughing 40%) and eyeirritation (40%) was present in all the participants None ofthe participants used the N-95 respirator (PPE: masks) in thisstudy. Some peddlers who is using PPE, are improper for thePM present in the air.Conclusion: Results suggests awareness about respiratoryproblems and proper use of protective equipment like theN-95 type respirator mask among street Peddlers in Lucknow,India.

Giant vesical calculus

Author presented a case report of a 42-year-old male patient who presented with dysuria, heaviness in lower abdomen since last 3 years associated with pain over bilateral lumber region since 2 years. He had history of recurrent urinary tract infection for last 6 months with blood in urine occasionally. Routine urine examination detected red and white blood cells with culture growth of E. coli. Ultrasound of abdomen confirmed the presence of vesical calculus of 10x7x5 cm.

Diagnostic Assessment of Bone Marrow Aspiration Smears, Touch Imprints and Trephine Biopsy in Non- Haematological Disorders.

Diagnostic Assessment of bone marrow aspirate particle smears, imprints and biopsy sections was done on 10 Non- Haematological disorders. Core needle biopsy of the bone marrow is a safe and useful procedure. It is a valuable diagnostic aid for measurement of marrow cellularity, metastatic tumours and fibrosis . Bilateral trephine biopsy was conducted wherever necessary. Touch imprints were useful for studying cell morphology, where aspiration yielded dry tap.All the three procedures of bone marrow aspiration, trephine biopsy and touch imprints were found to be complementary to each other and superiority of one method over the other depended on the specific disease process.

Diagnostic Assessment of Bone Marrow Aspiration Smears, Touch Imprints and Trephine Biopsy in Haematological Disorders.

Diagnostic Assessment of bone marrow aspirate particle smears, imprints and biopsy sections was done on 40 haematological disorders. Core needle biopsy of the bone marrow is a safe and useful procedure. It is a valuable diagnostic aid for measurement of marrow cellularity and fibrosis.Bilateral trephine biopsy was conducted wherever necessary.Bone marrow aspiration was the most effective method for studying morphological details and was able to diagnose most of the cases except the 2 cases of myelofibrosis which yielded dry tap for which trephine biopsy was diagnostic.Trephine biopsy was also found to be superior for staging of lymphomas and to study the ALIP in MDS.Touch imprints were useful for studying cell morphology, where aspiration yielded dry tap.All the three procedures of bone marrow aspiration, trephine biopsy and touch imprints were found to be complementary to each other and superiority of one method over the other depended on the specific disease process.

Delirium in general practice.

Delirium is a complex neuropsychiatric syndrome characterized by disturbances in consciousness, orientation, memory, thought, perception, and behaviour due to one or more structural and/or physiological abnormalities directly or indirectly affecting the brain. It is quite prevalent in medical and surgical settings and is associated with high rates of death and healthcare costs. We review its prevalence, clinical features, risk factors, pathogenesis, assessment instruments, differential diagnosis, management, prognosis and prevention. Special emphasis is given on the Indian research, which is quite meagre.

Lupus Vulgaris of Nose.

Lupus vulgaris represents a rare manifestation of infection by Mycobacterium tuberculosis.It is important to consider tuberculosis in the differential diagnosis of all nasal lesions and take biopsy samples for histological and bacteriological studies. Antitubercular chemotherapy is satisfactory with good result. We hereby report 3 cases of Lupus vulgaris of nose.

Inflammatory pseudotumour of the liver: a diagnostic dilemma.

Inflammatory pseudotumour is a rare, focal, benign inflammatory lesion of the liver parenchyma. It is largely a self-limiting entity and has favorable prognosis; it is thus important to preoperatively distinguish this lesion from malignancy, which it closely imitates. Inflammatory pseudotumour may present variously. We present the case of a 54-year old gentleman who presented with a three-month history of low-grade intermittent fever. Ultrasonography and computed tomography revealed a mass in the left lobe of the liver and the erythrocyte sedimentation rate was raised with coincident hypergammaglobulinaemia. A diagnostic laparotomy with left lateral hepatectomy was performed and histopathological evaluation of the specimen along with special staining and tissue culture revealed an inflammatory pseudotumour. On the second day post-operative the fever subsided and following an uneventful five days the patient was discharged and remains well at one-year follow up with no recurrence or relapse.

Psychosocial predictors of adolescent sexual behavior.

OBJECTIVE: To find out the psychosocial factors associated with adolescent sexual behavior. METHODS: A cross sectional study was carried out in Chandigarh Union Territory of India by enrolling 11 th class students from six randomly selected schools. A pre-tested questionnaire containing 83 items was administered after ensuring privacy and confidentiality. Socio-economic status, residence, gender, grade in the class, religion, acculturation level, self esteem, social support and coping behavior were considered as independent explanatory variables and physical sexual contact (which included kissing, hugging and sexual intercourse) was taken as dependent variable. RESULTS: Two hundred and fifty seven students enrolled for the study had mean age of 17 yr. The prevalence of sexual activity was 20% (95% CI: 13.6%-28.1%) among males and 6% (95% CI: 1.3%-18.8%) among females. Four percent of males and 1% of females reported sexual intercourse. The main reason for not having sexual physical contact was societal norms. After adjusting for confounders in multivariate analysis, male gender (OR: 3.5; 95%CI: 1.5-8.1) and modern attitudes (OR: 0.77; 95%CI: 0.6-0.98) were found to be the risk factors for initiation of sexual activity in adolescence. CONCLUSION: Cultural norms rather than the individual/psychological factors tend to govern adolescent sexual behavior in Indian society.

Flap reconstruction and interstitial brachytherapy in nonextremity soft tissue sarcoma.

Radiotherapy is an integral component of management of high-grade soft tissue sarcomas. Interstitial brachytherapy is used to deliver a boost or radical dose with several advantages over external beam radiotherapy. There has always been a concern to use brachytherapy with flap reconstruction of skin defects after wide excision. We preset our initial experience with interstitial brachytherapy in two patients of recurrent high-grade non-extremity sarcomas treated with surgical excision and soft tissue reconstruction of surgical defect.

Spontaneous bacterial peritonitis in isolated splenic vein thrombosis with portal hypertension.

Spontaneous bacterial peritonitis (SBP) is a known complication of ascites due to cirrhosis; it has also been reported in some non-cirrhotic conditions with ascites. We report a 50-year-old lady with isolated splenic vein thrombosis who developed SBP due to E. coli .

Cystic ductal adenocarcinoma of pancreas: an unusual variant.

Cystic lesions of the pancreas are usually pseudocysts (90%); only 10% of them are cystic tumors. These cystic tumors constitute less than 10% of all pancreatic neoplasms, making them an extremely uncommon type of pancreatic malignancy. What is more important is that these tumors are very easily misdiagnosed as pseudocysts because their characteristics are very similar to those of the benign pseudocysts. This gains importance as the cystic tumors have a high cure rate and good prognosis if diagnosed and treated on time. Of all the cystic tumors, the most common are the benign serous cystadenomas, mucinous cystic tumors, intraductal papillary mucinous neoplasms etc. Ductal adenocarcinoma of pancreas presenting in cystic form is an uncommon type of cystic tumor, making it extremely rare among all pancreatic malignancies (solid or cystic). We present the following case report. The review of literature concerning the diagnosis and management has also been discussed.