Not All Primary Osteolytic Mandibular Swelling Is Malignant.

Tubercular infection of the oral tissues can be primary or secondary. Primary lesions develop when tuberculosis bacilli are directly inoculated into the oral tissues of a person who has not acquired immunity to the disease. Here we present a case of 66yrs old non-smoker male presenting with a swelling in the left mandibular region (Lumpy jaw) over a period of last 1yr now presenting with weight loss, pain and trismus for 6month. No past history of tuberculosis or dental extraction. On examination there was a 6x5cm firm to hard nonfluctuant mildly tender swelling with trismus and no palpable cervical lymph nodes. Investigations revealed leucocytosis, ESR 45mm and Mantoux 24mm after 48hrs.PNG radiograph showed osteolytic lesion in angle & body of left mandible with CECT showing retro mandibular trigon extension. USG guided FNAC was consistent with tubercular osteomyelitis with Ziehl Neelsen stain positive for acid fast bacilli. He was started on antitubercular therapy for 9 month showing reduction in size and symptom.

Neonatal Surgical Emergencies in a Tertiary Care Center.

Background: Congenital anomalies those are incompatible with life unless they are corrected. They constitute the primary justification for pediatric surgery specialty because they demand experienced judgment in early diagnosis, expeditious management as well as highly refined operative technique and post-operative care. Materials and Methods: The clinical material in the present study consists of 124 neonates admitted to pediatric surgical ward of Medical College hospital, Jabalpur from 1st January 2011 to 31st July 2012. Results: Incidence of neonatal surgical emergency was 12.3% among all pediatric surgical admission, i.e. 124 cases in 1007 admissions. The most common neonatal emergency was constituted by gastrointestinal group observed in 49.1% cases. Next in order of frequency was skin defect, i.e., in 25.8% cases followed by respiratory emergency observed in 13.7% cases. Anorectal malformation was the most common cause of gastrointestinal emergency (63.5%). Out of total 35 cases gastrostomy alone was performed in 2 cases, gastrostomy along with ligation and division of trachea-esophageal fistula was performed in 1 case. Transverse colostomy alone in 26 (74.2%) cases and along with gastrostomy in 1 case. Ileostomy and nephrostomy were performed in 1 case each. Ligation and division of tracheoesophageal fistula and end to end anastomosis was done in 5 cases, in which general condition, of patient was good. Excision and repair of meningomyelocele and meningoencephalocele was possible only in 9 (45%) cases out of 20 cases. The mortality in surgical treated patients was (30%), i.e., 27 out of 90 patient treated surgically. Conclusion: There is a need to improve on neonatal surgical diagnosis and care at both primary and secondary health facilities to promote early referral of neonates to these centers. Skilled and dedicated staff with improved infrastructural facilities such as ventilators, a specialized neonatal surgeon, and operating theater and intensive care unit (NICU) will greatly minimize complex problems.

Study Of Nerve Conduction Velocity In Type II Diabetes Mellitus.

Abstract: Background& Objectives: Diabetic neuropathy is the most common and troublesome complication of diabetes mellitus, leading to great morbidity and resulting in burden for diabetes care. The progression of neuropathy can be reduced by early detection and intervention. Nerve conduction studies are the most sensitive indices of the severity of neuropathy. These tests can be used to localize lesions and describe the type and severity of the pathophysiologic process, including alterations that are not recognized clinically. This study was undertaken to compare nerve conduction study results in diabetes mellitus patients with good glycemic control and poor glycemic control and to compare it with non-diabetic subjects. This study aims to signify the role of nerve conduction study in diabetes mellitus. This can help in identifying the asymptomatic stage of diabetic neuropathy so that suitable preventive measures can be taken. Methodology: Total 90 subjects were included in the study group. 30 were non diabetic subjects and 60 were known cases of Type II diabetes mellitus patients attending diabetic OPD at GMCH, Aurangabad of age 30-50 years with duration of 5-10 years. Glycated haemoglobin levels were estimated and on this basis the cases were divided into two groups; diabetic patients with good glycemic control and diabetic patients with poor glycemic control. Nerve Conduction parameters were measured by computerized micromed RMSEMG system. Results: There was an increase in mean latency and decrease in amplitude and velocity values in both the diabetic groups. Intergroup comparison showed that, the increase in latency and decrease in amplitude and velocity was more in diabetics with poor glycemic control as compared to other study groups and this difference was statistically highly significant. Conclusion: The study concluded that there is statistically significant changes in nerve conduction parameters in Type II diabetes.

Tuberculous Liver Abscess with Right Sided Pleural Effusion.

Tuberculosis is a rare cause of liver abscess even in countries where the tuberculosis is prevalent, liver may be involved as a part of miliary tuberculosis or as local tuberculosis. We present a case of tuberculous liver abscess in patient with smear positive pulmonary tuberculosis and right pleural effusion. A positive BACTEC culture and Polymerase chain reaction (PCR) for Acid Fast Bacilli (AFB) in the pus aspirated from abscess confirmed the diagnosis of tuberculous liver abscess.