Clinical profile of primary hyperparathyroidism in Northeast India: a single centre experience

Background: A retrospective study of the presentation of primary hyperparathyroidism was done at a tertiary care centre in northeast India and was compared with variable features in other parts in India and worldwide.Methods: The clinical presentation, biochemical parameters, radiological and histopathology findings of 27 subjects of primary hyperparathyroidism who presented to us over a period of 5 years were retrospectively analysed. Chi-square test, student t test and 'one way ANOVA' were used to compare different variables. Statistical significance was set at p<0.05.Results: The age distribution ranged from as young as 13 years to 72 years (39±16.7). The male:female ratio was 1:1.25. The duration of symptoms at presentation ranged from 2 to 72 months (21.7±20.3). The most common presentation was bone pain in 59.2% of cases, followed by proximal myopathy (48.1%), fatigue (44.4%), abdominal pain (44.4%), constipation (11.1%), hypertension (18.5%), palpable neck swelling (22.2%), limb deformity (22.2%) and fracture (14.8%). The mean serum calcium was 12.2±0.87mg/dl. Parathyroid adenoma was localized radiologically in all patients and single adenoma was the most common cause in 96.3%. Left inferior parathyroid adenoma was the most common site of involvement in 51.8%.Conclusions: Hyperparathyroidism at our centre in northeast India has a classic symptomatic presentation with severe bone and renal involvement and younger age at diagnosis, and equal gender distribution.

Comparison of Super-oxidized Solution versus Povidone Iodine in Management of Infected Diabetic Ulcers: Our Experience

Background: Diabetic foot ulcer is a challenging problem to every clinician in day to day practice. Super-oxidized Solution is a newer concept in the wound management. The present study was aimed to compare the efficacy of dressings with super-oxidized solution versus povidone iodine in the management of infected diabetic ulcers. Materials and methods: This one year randomized controlled trial was conducted on a total of 60 patients presenting with infected diabetic ulcers. Patients were divided into two groups of 30 each based on computer generated randomization that is, group A (Topical super-oxidized solution dressing) and group B (Topical povidone iodine dressing). Wound was observed for decrease in size of the ulcer, granulation, tissue quality and discharge from the wound at the end of each week for two weeks. Results: In the present study, 76.67% of patients in group A and B were males and the male to female ratio was 3.2:1. The mean group A was 55.90 ± 14.27 years compared to 51.50 ± 13.18 years in group B. Type 2 diabetes was present in 96.67% and 93.33% of patients in group A and B. The mean initial ulcer area in group A was 3882 ± 1890 mm2 compared to 3992 ± 2000 mm2 in group B. The mean final area in group A was significantly low (1607 ± 862 mm2 ) compared to group B (2351 ± 1240 mm2 ; p=0.009) and the comparison of mean change in ulcer area was significantly high in group A compared to group B (2215 ± 1060 mm2 vs 1641 ± 856 mm2 ; p=0.024). The mean percentage reduction in ulcer area among patients with group A was significantly high (58.90 ± 5.21 percent vs. 40.90 ± 8.76 percent; p=0.024).The commonest organism isolated in group A was Escherichia coli K. B. S. Prabhakar, G. Purushotham, K. Uma. Comparison of Super-oxidized Solution versus Povidone Iodine in Management of Infected Diabetic Ulcers: Our Experience. IAIM, 2016; 3(5): 151-158. Page 152 (26.67%) and in group B, it was staphylococcus. The culture was positive in 26% of the patients in group A compared to 50% in group B (p=0.063). Conclusion : Overall, topical super-oxidized solution dressings accelerated the healing process resulting in faster recovery through reduction in ulcer area in patients infected with diabetic ulcers compared to topical povidone iodine dressing

Nutritional evaluation of earthworm powder (Lampito mauritii).

Dried earthworm powder from culture of Lampito mauritii in vermicomposting units and subjected to analysis of protein, carbohydrate and mineral content. The EWP contained large amounts of protein (31.7 % ), iron (241.1ppm), soluble nitrogen (1.8%), zinc (32.34ppm), manganese (17.2ppm) and copper (4.501ppm) together with notable quantities of potassium, calcium, magnesium, phosphorus and carbohydrate indicating that this type of earthworm contain potentially useful quantities of many nutrients, that are important to the human health.

Role of nail biopsy as a diagnostic tool.

Nail biopsy (NB) is an investigation that is not routinely resorted to by most of the dermatologists. The commonly cited reasons are the complexity of the procedure, risk of scarring and the reluctance of the patient. However, in cases with isolated nail psoriasis, isolated nail lichen planus, onychomycosis not confirmed on direct microscopy and culture, or longitudinal melanonychia, the treating dermatologist is left with no choice but to resort to this procedure. Nail as a unit, is capable of projecting only a limited number of clinical manifestations. This is responsible for the more or less similar clinical presentation of many different nail disorders. Hence, a practical knowledge of the indications, appropriate patient selection, procedural details and histopathological interpretation of a NB is a must-have for any practicing dermatologist. The risk of scarring is none to minimal if appropriate type of biopsy is performed, not to mention the wealth of histopathological data that can be retrieved from the nail unit. This article aims to explore the various practical do's and don'ts for the NB and tells us what to expect from of the procedure.

Asian society of gynecologic oncology workshop 2010 / 부인종양

This workshop was held on July 31-August 1, 2010 and was organized to promote the academic environment and to enhance the communication among Asian countries prior to the 2nd biennial meeting of Australian Society of Gynaecologic Oncologists (ASGO), which will be held on November 3-5, 2011. We summarized the whole contents presented at the workshop. Regarding cervical cancer screening in Asia, particularly in low resource settings, and an update on human papillomavirus (HPV) vaccination was described for prevention and radical surgery overview, fertility sparing and less radical surgery, nerve sparing radical surgery and primary chemoradiotherapy in locally advanced cervical cancer, were discussed for management. As to surgical techniques, nerve sparing radical hysterectomy, optimal staging in early ovarian cancer, laparoscopic radical hysterectomy, one-port surgery and robotic surgery were introduced. After three topics of endometrial cancer, laparoscopic surgery versus open surgery, role of lymphadenectomy and fertility sparing treatment, there was a special additional time for clinical trials in Asia. Finally, chemotherapy including neo-adjuvant chemotherapy, optimal surgical management, and the basis of targeted therapy in ovarian cancer were presented.

Malnutrition in children with congenital heart disease (CHD) determinants and short term impact of corrective intervention.

OBJECTIVE: To identify determinants of malnutrition in children with congenital heart disease (CHD) and examine the short-term effects of corrective intervention. METHODS: Patients with CHD admitted for corrective intervention were evaluated for nutritional status before and 3 months after surgery. Detailed anthropometry was performed and z-scores calculated. Malnutrition was defined as weight, height and weight/height z-score <or= -2. Determinants of malnutrition were entered into a multivariate logistic regression analysis model. RESULTS: 476 consecutive patients undergoing corrective intervention were included. There were 16 deaths (3.4%; 13 in-hospital, 3 follow-up). The 3-month follow-up data of 358 (77.8%) of remaining 460 patients were analyzed. Predictors of malnutrition at presentation are as summarized: weight z-score <or= -2 (59%): congestive heart failure (CHF), age at correction, lower birth weight and fat intake, previous hospitalizations, >or= 2 children; height z-score <or= -2 (26.3%): small for gestation, lower maternal height and fat intake, genetic syndromes; and weight/height z-score <or= -2 (55.9%): CHF, age at correction, lower birthweight and maternal weight, previous hospitalizations, religion (Hindu) and level of education of father.Comparison of z-scores on 3-month follow-up showed a significant improvement from baseline, irrespective of the cardiac diagnosis. CONCLUSIONS: Malnutrition is common in children with CHD. Corrective intervention results in significant improvement in nutritional status on short-term follow-up.

Malignant nasal paraganglioma: a case report and review of the literature.

A rare case of malignant nasal paraganglioma is described. A 30 year old female patient presented with a one year history of bilateralnasal obstruction, nasal deformity and recurrent epistaxis. CT scan demonstrated an enhancing mass occupying both nasal cavities, right maxillary antrum and anterior ethmoid sinus. Histopathologic diagnosis was malignant paraganglioma. A total maxillectomy with excision of growth was performed. Post-operative radiotherapy and chemotherapy was given but patient expired before the completion of therapy. Nose being a rare site for paragangliomas, these lesions present a diagnostic challenge to histopathologists and clinicians alike. A review of the four previously described malignant nasal paragangliomas is also presented.

Isolated involvement of the mandible by non-Hodgkin's lymphoma.

A case report of isolated involvement of the mandible by non-Hodgkin lymphoma is presented. The patient presented with a non-healing ulcer following a tooth extraction. Biopsy revealed an undifferentiated cancer. Investigations failed to reveal any involvement of the organs. A hemimandibulectomy was performed followed by radiotherapy on receipt of the histopathological diagnosis of non-Hodgkin lymphoma. The patient is asymptomatic two and a half years after treatment.

Visceral larva migrans.

We present a case of visceral larva migrans which came as a complete histologic surprise. The patient was operated as a case of chronic cholecystitis and was found at operation to have multiple hepatic nodules. A cholecystectomy with a biopsy of the liver nodule was performed. Histopathologically a diagnosis of visceral larva migrans was made. To our knowledge this is the first case report of the disorder from India. A discussion based on the review of literature is presented.