Colloid nodular goitre associated with hemiagenesis of the thyroid gland.

Hemiagenesis of the thyroid gland is a rare congenital abnormality usually left unnoticed without associated thyroid disorders. The most common congenital anomaly of the thyroid gland is a thyroglossal cyst, followed by ectopic thyroid tissue and thyroid dysgenesis, which may be agenesis or hemiagenesis. Preoperative underevaluation of the thyroid hemiagenesis (THA) associated with other thyroid disorders may cause intraoperative difficulty in identifying the gland and difficulty in preservation or even identification of major neurovascular structures during neck exploration. We report a patient who presented to us with right-sided neck swelling. On further evaluation and neck exploration, the patient was diagnosed with THA of the left lobe with right colloid goitre.

A Rare Case of Dorsal Agenesis of Pancreas, Choledochal Cyst, and Hirschsprung Disease in a Young Patient.

Dorsal pancreatic agenesis is a rare congenital pancreatic malformation. There is just 1 reported case associating it with choledochal cyst. However, no cases have reported yet with both coexisting with Hirschsprung disease. We report a case of a 23-year-old man, presenting with on and off epigastric pain, sometimes radiating to the back. His medical records showed he had Hirschsprung disease as a neonate, for which he underwent Duhamel procedure. Ultrasound imaging revealed a choledochal cyst and a nonvisualized distal portion of the pancreas. Further cross-sectional imaging confirmed the findings-a type 1 choledochal cyst and a dorsal agenesis of the pancreas in a patient with Hirschsprung disease.

Giant Celiac Artery Pseudoaneurysm in a Case of Chronic Pancreatitis: A Rare Case Report With Literature Review.

Pancreatic pseudoaneurysms though uncommon can result in life-threatening spontaneous acute gastrointestinal or intraperitoneal hemorrhage. Celiac artery pseudoaneurysm in a background of chronic pancreatitis is a very rare event. Digital Subtraction Angiography is an important adjunct in the diagnosis and follow-up with the advantage of providing therapeutic options along with giving other details regarding the site, size, and flow characteristics. It has replaced emergency surgical procedures with the added advantage of fewer postoperative complications and lower morbidity and mortality. An urgent surgical intervention remains the only option when such endovascular management fails, not feasible, or is unavailable. Surgical options include proximal arterial ligation or a pancreatic resection, depending on the location of the pseudoaneurysm. We report a case of a 35-year-old gentleman, a known patient of chronic pancreatitis, who presented to our emergency with clinical features of hypovolemic shock and was diagnosed to have celiac artery pseudoaneurysm. Following a failed endovascular coiling, he was successfully managed with operative celiac artery ligation.

147 Pancreatoduodenectomies: a Single Center's Perspective into the Epidemiology and Surgical Outcomes of Periampullary and Pancreatic Cancers in South India.

BACKGROUND: Pancreatoduodenectomy (PD) is the only curative procedure for resectable periampullary cancers. This study aims to survey the various outcome variables of the procedure at our institute, which is in the early process of evolving into a high-volume center for PDs. METHODS: Data of patients, who underwent PDs, was collected retrospectively from January 2010 to December 2017 and prospectively from January 2018 to December 2019. Various preoperative, intraoperative, and histopathological parameters were compared with the outcome variables-morbidity and mortality rates. RESULTS: A total of 147 patients underwent PDs over the last decade. From January 2010 to December 2014 (period A), 29 patients underwent PD, while 118 patients underwent PD from January 2015 to December 2019 (period B). Clinically relevant (CR) delayed gastric emptying (44.8% vs 23.7%), CR post-pancreatectomy hemorrhage (37.9% vs 18.6%), and blood loss (850 ml (400-5300 ml) vs 600 ml (150-2500 ml)) improved in period B with no improvement in CR postoperative pancreatic fistula (20.7% vs 28.8%). The rates of SSI (63.6%), pulmonary complications (29.9%), and mean postoperative stay (19.87 ± 11.59 days) were found to be higher than most of the major centers. Mortality rates decreased significantly from 27.6% in period A to 10.2% in period B (p = 0.029). Median overall survival was 30 months (95% CI 20.76-39.23 months) CONCLUSION: Over the last decade, there has been a significant improvement in the mortality rate, but morbidity remains high and must be looked into as the department enters the new decade as a young high-volume center.

Arterio-Hepatic Venous Fistula Following Liver Biopsy: A Rare Case Report and Literature Review.

Arterio-hepatic venous fistula (AHVF) is an exceedingly rare phenomenon compared to arterio-portal venous fistula with only 8 cases reported in world literature. Many listed causes can be attributed to the development of there are no reported cases of AHVF following a core-needle biopsy. We report a case of 38 year-old-female with EHPVO, who underwent splenectomy with a proximal splenorenal shunt. She had an injury to left hepatic artery, consequent to a blind intra-operative core needle biopsy from the liver, which led to the development of a fistulous connection between left hepatic artery and middle hepatic vein causing high output cardiac failure. She was successfully managed with trans-arterial embolization. The present review emphasizes the possibility of AHVF following a liver biopsy and the role of digital subtraction angiography in the diagnosis, therapeutic intravascular interventions, and follow-up.

The Impact of Early Childhood Caries on Oral Health-Related Quality of Life of Children and Caregivers Residing in Rural and Urban Areas of the Rangareddy District.

Early childhood caries is a condition that impacts oral health-related quality of life of children's development and well being and also affects parents' work hours and poses a financial burden on them. Our objective was to study and compare the impact of early childhood caries on the quality of life of preschool children aged 22-70 months and their caregivers in an urban and rural population using the early childhood oral health impact scale. The study was conducted on children of the Rangareddy district, Telangana state, aged between 22 -70 months affected by early childhood caries and their parents/guardians. The subjects were given a questionnaire to measure the early childhood oral health impact scale, and the filled questionnaires were analyzed and tabulated. The mean early childhood oral health impact scale and domain scores for the rural population were significantly higher than that of the urban population signifying a more mediocre quality of life. There was a weak positive and insignificant relationship between early childhood caries and the early childhood oral health impact scale in the rural population, whereas there was a moderately strong, significant positive relationship between the two in the urban population. Oral health-related quality of life of young children enables parents and caregivers to implement positive dental care practices.

Agenesis of Permanent Mandibular Central Incisors: A Concordant Condition in Siblings.

Concordance is an identical expression of phenotype in two related individuals. Concordance expression of hypodontia is an uncommon condition where associated individuals are affected with exactly similar kind and number of missing teeth. There is very limited documentation of this condition either in twins or in siblings, and literature shows paucity of data with regard to this anomaly. To the best of our knowledge, there is only one such case reported in the literature, which has actually showed similar missing lower central incisors in siblings. This report presents a case of two girl siblings aged 11 and 13 years with congenital bilateral missing of permanent mandibular central incisors, which is an absolute concordant condition. Apart from discussing etiology, clinical implications and management, this article highlights the significance of concordant and discordant condition of hypodontia and expression of this condition in twins and siblings. How to cite this article: Kagitha PK, Namineni S, Tupalli AR, Challa SK. Agenesis of Permanent Mandibular Central Incisors: A Concordant Condition in Siblings. Int J Clin Pediatr Dent 2016;9(1):74-77.

Evaluation of the Erosive Potential of Various Pediatric Liquid Medicaments: An in-vitro Study.

BACKGROUND: The present in-vitro study was a scanning electron microscope (SEM) study conducted in primary teeth in order to evaluate the erosive potential of ten commonly used pediatric liquid medications (PLMs). MATERIALS & METHODS: 10 commonly used PLMs and 33 exfoliated or extracted primary teeth were collected. The 33 teeth were divided into two groups, the control group (n=3) and the study group (n=30). The endogenous pH of all the teeth was measured using a pH electrode meter. The control group teeth were immersed in artificial saliva for three different time intervals- 1 minute, 10 minutes and 8 hours. The study group teeth were also maintained for 1 minute, 10 minutes and 8 hours in various selected PLMs. The primary enamel surface (PES) changes were then observed under the SEM for all the teeth of both groups. RESULTS: All the PLMs used in the study showed an erosive effect on the PES when viewed under SEM. Majority of the medications caused etched prism pattern followed by crater formation and sporadic rod ends in that order on PES. CONCLUSION: There is a need to educate parents and professionals about the association between dental erosion and PLMs which predisposes to dental caries. How to cite the article: Tupalli AR, Satish B, Shetty BR, Battu S, Kumar JP, Nagaraju B. Evaluation of the Erosive Potential of Various Pediatric Liquid Medicaments: An In-vitro Study. J Int Oral Health 2014;6(1):59-65.