Atypical Presentation of Anti-phospholipid Syndrome with Triple Antibody Positive (ATAP) Syndrome Presented as Non-healing Foot Ulcer in a Middle-aged Adult Female

Middle aged women presented with non-healing ulcer over foot following trivial injury. She was not having any comorbid condition. Investigations revealed APLA Syndrome with triple antibodies positive (Lupus anticoagulant, Anticardiolipin antibody and anti B2-glycoprotein antibodies). Patient responded well with anti-platelet and skin grafting at local site.

Evaluation of coverage and compliance to mass drug administration for lymphatic filariasis elimination in two endemic districts of Karnataka

Background: Lymphatic filariasis is a debilitating and disfiguring disease causing significant socioeconomic burden. India is endemic for filariasis which includes Kalaburagi and Yadgir districts in Karnataka. India has the target for filariasis elimination by 2020 and mass drug administration [MDA] is a strategy for elimination. The objective of the study was to evaluate the coverage and compliance of mass drug administration against lymphatic filariasis. Methods: The study was a cross sectional study conducted during the month of October 2018 in Kalaburagi and Yadgir districts. The study subjects included all the residents of cluster except subjects aged below 2 years and pregnant women. Multi stage sampling was used and three clusters from rural area and one cluster from urban area from each district. Data collection was done by household survey after informed consent using a standard questionnaire. Results: A total population of 1,963 subjects residing in 399 houses of two districts was included. Majority of the study subjects 1517 (77.27%) were in the age group of more than 15 years with predominantly males 984(50.12%). The coverage rate and compliance rate of MDA was 83.17% and 92.46% in Kalaburagi district and 86.71% and 86.98% in Yadgir district respectively. The effective coverage rate and coverage compliance gap was 76.89% and 7.53% in Kalaburagi district, 75.42% and 13.01% in Yadgir district. Incomplete dose of MDA was consumed by 17 subjects in Kalaburagi district and 21 subjects in Yadgir district. Conclusions: The effective MDA coverage in both the study districts is below 85% which is not satisfactory.

Study of medial end of fourth ribs with special reference to changes in pit shapes according to age, a qualitative approach.

Background: The objectives of this study were to find changes of pit shape at sternal end of fourth ribs in accordance with age in males, to find bilateral variability in changes of pit shape according to age and to compare the data with previous study. Methods: Total 180 ribs were obtained from male cadavers brought for post-mortem examination. Out of which 140 ribs belonged to 70 cases were included in the study. Each rib was classified according to different stages of pit shape. The data derived were statistically analysed. Results: Pit shape changes from shallow dent to „V‟, from „V‟ to „U‟, from „U‟ to „wide mouth U‟ up to sixties of age and after that the quality of the walls surrounding the pit decreases without changes in shape of pit. There was no any bilateral variation found in pit shape changes for age. Conclusions: Changes of pit shape at sternal end of fourth ribs are age dependent without bilateral variations. Age estimation by this method gives general idea about the age in decades only

Severe haematoma of the vulva--a report of two cases and a clinical review.

Haematoma of the vulva may occur following blunt trauma due to its highly vascular structure. We present two cases of haematoma of the vulva caused by domestic violence, following a kick on the perineum and falling astride on the perineum. Evacuation of the haematoma and repair of lacerated tissues were successfully performed.