Leveraging the Multidimensional Poverty Index to estimate Helicobacter pylori prevalence in districts in Karnataka, India.

The prevalence of Helicobacter pylori (Hp) in India is approximately 64%. However, substantial regional variations necessitate high-fidelity, locality-specific studies to characterise its population distribution in India. We conducted a cross-sectional study including 2998 dyspeptic patients at a tertiary care centre in Karnataka and investigated the relationship between Hp prevalence and the Multidimensional Poverty Index (MPI) by district. Helicobacter pylori prevalence in our population was 43.2% with a significant correlation between district-specific Hp prevalence and MPI. This data can be leveraged for evaluating local Hp infection control strategies, planning interventions for Hp hotspots in Karnataka and predicting a dyspeptic patient's risk of Hp infection.

May-Thurner syndrome: an unusual cause of unprovoked deep vein thrombosis of the left lower limb.

May-Thurner syndrome, an unprovoked form of deep vein thrombosis (DVT), should be kept in mind in case of DVT with no predisposing factors. We present a case of a 37-year-old male with DVT of left lower limb due to May-Thurner syndrome, treated with anticoagulants with a plan of left common iliac vein (LCIV) stenting and inferior vena cava (IVC) filter later. Venous duplex scan showed features suggestive of May-Thurner syndrome. Hence, we proceeded for CT abdominal aortogram with bilateral lower limb angiogram, which confirmed the above findings. Management of May-Thurner syndrome is a stepwise approach, with initial anticoagulation for dissolution of the thrombus followed by endovenous stenting of the LCIV and concomitant IVC filter.

Concomitant malignancies in the neck: follicular dendritic cell sarcoma; a rare tumour presenting as a right-sided neck nodal mass and papillary carcinoma thyroid.

Follicular dendritic cell sarcoma is a rare low-grade sarcoma of mesenchymal origin. It involves the lymph nodes more commonly and rarely extranodal sites. The most common lymph node is cervical and usually presents as a painless asymptomatic mass. More often, it is a misdiagnosis, and there is a delay in treatment. It is rarely associated with Castleman disease, myasthenia gravis. Diagnosis of this condition is by histopathology and immunochemistry. Surgery is the primary modality of treatment, and adjuvant therapy has been tried with no definite trials due to the rarity of the disease. Here, we report a case of concomitant follicular dendritic sarcoma of the right cervical lymph node and papillary carcinoma of the thyroid managed in our institute. There was a line of investigations approaching towards a diagnosis, and she underwent total thyroidectomy and right modified radical neck dissection.

Jarcho's Syndrome: Bone Marrow Infiltrates from a Gastric Malignancy.

Bone and bone marrow metastasis is extremely rare in adenocarcinoma particularly from the stomach. We present a case of gastric carcinoma primarily manifesting as anemia and pancytopenia. On evaluation, he was found to have bone marrow secondaries from a gastric primary tumor. Though such metastasis is rare, patients with refractory anemia must be evaluated to search for solid organ malignancy like the stomach.