ABSTRACT
Human subcutaneous dirofilariasis is a rare helminthic infection. It is caused by filarial worms of the Genus Dirofilaria, which is the natural parasites of dogs, cats, foxes, and wild mammals. Zoonotic filariasis caused by Dirofilaria species is rarely seen in the region of Dakshina Kannada. Most of them are seen in patients who are along the border of the district which shares its boundary with the state of Kerala, where dirofilariasis is constantly reported to occur. Here, we report a case of subcutaneous dirofilariasis, presenting as a subcutaneous nodule on the left cheek of a 28-year-old male from Cochin (Ernakulam), Kerala, South India. Two live worms were recovered from the subcutaneous nodular swelling.
ABSTRACT
OBJECTIVES: Few of the questionnaires available for evaluating the function and clinical state of the elbow have been validated. An ideal score would be consistent, sensitive, reliable and elbow-specific, incorporating both patient perception and clinician assessment. This was our aim. METHODS: Items were generated using 25 patients and expert opinion, and reduced using 25 new patients to yield a nine-item patient questionnaire and a six-item clinical evaluation (of strength, motion and ulnar nerve involvement). This was validated using 63 new patients (of whom 28 were studied twice without therapy and 18 were studied again after appropriate surgery). RESULTS: The test-retest reliability coefficient of determination (R2 = 0.93) and internal consistency (Cronbach's alpha = 0.98) were both good. Convergent validity was attested by good correlations with other scores, the Disabilities of Arm, Shoulder and Hand Questionnaire (DASH) and the Nottingham Health Profile (NHP) (physical) (R2 = 0.62 and 0.29, P < 0.0005). Sensitivity to change was demonstrated by correlating preoperative-postoperative changes to those in DASH and NHP (physical) (R2 = 0.50 and 0.27, P < 0.04). CONCLUSION: This is a reliable, internally consistent score, correlating well with other, non-elbow specific scores and sensitive to change on treatment.
Subject(s)
Elbow Joint/physiopathology , Health Status Indicators , Joint Diseases/rehabilitation , Activities of Daily Living , Humans , Joint Diseases/physiopathology , Joint Diseases/surgery , Patient Satisfaction , Reproducibility of Results , Sensitivity and Specificity , Surveys and Questionnaires , Treatment OutcomeABSTRACT
Four cases of salpingitis isthmica nodosa diagnosed from a total of 82 hysterosalpingograms, over a period of three years at the General Hospital, Kota Bharu, were reviewed. The diagnosis was made based on the radiographic appearance of globules of contrast medium in the periluminal tissues which were in continuity with the lumen of the fallopian tubes. Three of these patients had ectopic pregnancy. Diagnosis of salpingitis isthmica nodosa which is readily demonstrated by hysterosalpingogram, is extremely important because of its impact on ectopic pregnancy rates. Hysterosalpingography is indicated following ectopic pregnancy to show whether there is diverticulosis of the contralateral tube. By such knowledge, optimal treatment can be offered to patients wishing to attempt further conception. As the disease is relatively localised it is amenable to resection with reimplantation of the distal portion of the tube.
Subject(s)
Diverticulum/diagnostic imaging , Fallopian Tube Diseases/diagnostic imaging , Salpingitis/diagnostic imaging , Adult , Diagnosis, Differential , Diverticulum/surgery , Fallopian Tube Diseases/surgery , Female , Humans , Hysterosalpingography , Infertility, Female/diagnostic imaging , Infertility, Female/surgery , Pregnancy , Pregnancy, Tubal/diagnostic imaging , Pregnancy, Tubal/surgery , Salpingitis/surgeryABSTRACT
Incomplete form of tuberous sclerosis (TS) may present with acute complications such as haematuria, retroperitoneal haemorrhage or pneumothorax. Such cases may pose diagnostic difficulty. A patient with incomplete form of TS without any cerebral impairment who presented as an acute surgical abdomen is reported. The diagnostic criteria of TS are reviewed. Visceral manifestations of TS including acute complications are discussed. The importance of recognising such presentations is stressed.
Subject(s)
Tuberous Sclerosis/pathology , Abdomen, Acute/diagnosis , Acute Disease , Adult , Angiomyolipoma/pathology , Diagnosis, Differential , Humans , Kidney Neoplasms/pathology , Male , Polycystic Kidney Diseases/diagnosisABSTRACT
Retroperitoneal duodenal rupture due to blunt abdominal trauma is relatively uncommon. Diagnosis is difficult because the physical signs are subtle or they are difficult to interpret. A case of retroperitoneal duodenal rupture due to blunt abdominal trauma in whom the diagnosis was delayed is reported. Radiographic features are discussed. The role of early roentgen diagnosis is stressed in order to reduce the very high mortality which is associated with delay in diagnosis and treatment.
Subject(s)
Abdominal Injuries/diagnostic imaging , Duodenum/injuries , Wounds, Nonpenetrating/diagnostic imaging , Abdominal Injuries/complications , Accidents, Traffic , Adult , Duodenum/diagnostic imaging , Humans , Male , Radiography , Rupture , Wounds, Nonpenetrating/complicationsABSTRACT
A case of primary non-tuberculous psoas abscess is reported and the literature reviewed. The aetiology of psoas abscess is varied and there is a worldwide variation in the aetiology. Primary psoas abscess is due to Staphylococcal infection. The pathophysiology, clinical features, diagnosis and treatment are discussed with emphasis on the changing pattern in the aetiology and diagnosis.
Subject(s)
Psoas Abscess/diagnosis , Humans , Male , Middle Aged , Psoas Abscess/etiology , Staphylococcal Infections/complicationsABSTRACT
Two cases of tuberculosis of the thoracic spine with extrapleural extension of paravertebral abscesses, presenting radiologically as cold abscesses away from the spine in the PA chest radiograph, are presented. The radiographic features and response to antitubercular drugs are discussed.
