Bariatric surgery as an option for diabetes mellitus prevention and treatment in obese persons.

Bariatric surgery has been found to be very useful in treating established type-2 diabetes in obese persons, as well as in borderline diabetics, besides giving a good weight loss. Various modifications of the primary bariatric procedures have been introduced, with differ advantages and better efficacy. Good incretin responses from the distal gut give the best results and combining medical treatment are helping patients to get very good glycemic control over a longer term.

Inflammatory pseudotumor arising from the right ventricular outflow tract causing pulmonary stenosis.

Inflammatory pseudotumor (also known as inflammatory myofibroblastic tumor) is an uncommon spindle cell lesion that was initially recognized in the lung and is now known to occur in virtually every major organ of the body. We report a case of a seven-year-old male who had an inflammatory pseudotumor of the right ventricular outflow tract involving the pulmonary valve causing pulmonary stenosis.

Accessory mitral valve tissue: an unusual cause of congenital mitral stenosis.

Accessory mitral valve tissue (AMVT) is a rare congenital anomaly of endocardial cushion. Usually, it arises from the anterior mitral leaflet and causes the left ventricular outflow tract obstruction. We report here the first and a rarest presentation of the AMVT in a 19-year old female patient diagnosed to have double outlet right ventricle, ventricular septal defect (VSD), infundibular stenosis and congenital mitral stenosis (MS). She presented with a history of shortness of breath and chest pain over 3 years. Diagnosis was made by chest X-ray, transthoracic and transoesophageal echocardiography, which was confirmed by cardiac catheterization, and angiography. A successful closure of the VSD with excision of the right ventricular bundle and excision of the AMVT was done. Post-operative course was uneventful and an echocardiogram before the discharge showed no residual shunt, no right ventricular outflow gradient or mitral regurgitation, and the gradient across the mitral valve was 5/3 mmHg. We emphasize that, although AMVT commonly produces left ventricular outflow tract obstruction, it should be considered a rare but an important cause of congenital MS.

(1E,4E)-1,5-Bis(thio-phen-3-yl)penta-1,4-dien-3-one.

The title compound, C(13)H(10)OS(2), exhibits twists between the central C(3)O and ethene residues [O-C-C-C torsion angles = -8.4 (3) and 11.8 (3)°], and between the ethene and adjacent thio-phenyl residues [C-C-C-C torsion angles = -4.2 (3) and 10.5 (3)°]. As a result, the mol-ecule is non-planar, the dihedral angle formed between the terminal thio-phenyl groups being 15.45 (10)°. The presence of C-H⋯O inter-actions involving the bifurcated carbonyl O atom leads to supra-molecular arrays in the ac plane. These are linked into a three-dimensional architecture by C-H⋯π inter-actions involving both thio-phenyl residues.

A comparative evaluation of 3 root canal filling systems.

OBJECTIVE: This in vitro study was conducted to evaluate and compare the microbial leakage of a new obturation system: Guttaflow with resin-based Resilon cones and Epiphany sealer, keeping gutta-percha with AH plus sealer as the standard. STUDY DESIGN: The microbial leakage was tested using Enterococcus faecalis ATCC 29,212 as the bacterial marker in the microbial leakage test. These results were supplemented with scanning electron microscopy (SEM). RESULTS AND CONCLUSION: The microbial leakage test indicated good sealing abilities for Resilon and Guttaflow, with the latter resisting microbial leakage for a longer period. AH plus with gutta-percha showed poor sealing ability. Results of the scanning electron microscopy correlated with the microbial leakage test. This study indicates that newer obturation systems like Guttaflow and Resilon cones with Epiphany provide better seal against microbial leakage than the standard obturation material, gutta-percha used with AH plus sealer.

Visual outcome of pars plana vitrectomy with intraocular foreign body removal through sclerocorneal tunnel and sulcus-fixated intraocular lens implantation as a single procedure, in cases of metallic intraocular foreign body with traumatic cataract.

AIM: To evaluate visual outcome following pars plana vitrectomy (PPV) and intraocular foreign body (IOFB) removal through the sclerocorneal tunnel combined with simultaneous cataract extraction and sulcus-fixated intraocular lens (IOL) implantation as a single procedure in penetrating ocular trauma with IOFB and traumatic cataract. MATERIALS AND METHODS: Eighteen cases of penetrating ocular trauma with retained IOFB and traumatic cataract who underwent PPV, IOFB body removal and cataract extraction with posterior chamber IOL (PCIOL) implantation in the same sitting, between June '04 and December '05 were retrospectively analyzed. All the foreign bodies were removed through the sclerocorneal tunnel. RESULT: All the 18 patients were young males, with an average follow-up period of 12 months. In 12 cases the foreign body was intravitreal and in six cases it was intraretinal but extramacular. Thirteen cases had a best corrected visual acuity ranging from 20/20 to 20/60 at their last follow-up. Five cases developed retinal detachment due to proliferative vitreoretinopathy (PVR) changes postoperatively and were subsequently managed by surgery. CONCLUSION: Primary IOL implantation with combined cataract and vitreo-retinal surgery is a safe option reducing the need for two separate surgeries in selected patients with retained IOFB and traumatic cataract. This combined procedure provides good visual outcome with early rehabilitation in young working patients.

Intravitreal live adult Brugian filariasis.

Human ocular infestation by live filarial worm is a rare occurrence and has been reported mostly form South-East Asia. It involves the eyelids, conjunctiva, cornea, anterior chamber and uvea. No case of intravitreal Brugian microfilaria / adult worm has been found by Medline search. Here we report a case of live intravitreal adult Brugian filaria, where the parasite was successfully removed by pars plana vitrectomy. Identification of the worm was done by light microscopy and confirmed by immuno chromatographic test.