Pendred syndrome with retrosternal goitre- a rare case report.

Pendred syndrome is a recessively inherited disorder characterized by goiter associated with sensory-neural deafness. The thyroid glands of affected individuals cannot organify iodide efficiently due to a defective gene in chromosome 7. Here we report a case of Pendred syndrome with retrosternal goitre.

A novel and accurate technique of photographic wound measurement.

CONTEXT: Wound measurement is an important aspect of wound management. Though there are many techniques to measure wounds, most of them are either cumbersome or too expensive. AIMS: To introduce a simple and accurate technique by which wounds can be accurately measured. SETTINGS AND DESIGN: This is a comparative study of 10 patients whose wounds were measured by three techniques, i.e. ruler, graph and our technique. MATERIALS AND METHODS: The graph method was taken as the control measurement. The extent of deviation in wound measurements with our method was compared with the standard technique. The statistical analysis used was ANOVA. RESULTS: The ruler method was highly inaccurate and overestimated the wound size by nearly 50%. Our technique remained consistent and accurate with the percentage of over or underestimation being 2-4% in comparison with the graph method. CONCLUSIONS: This technique is simple and accurate and is an inexpensive and non-invasive method to accurately measure wounds.

A prospective randomized controlled trial comparing negative pressure dressing and conventional dressing methods on split-thickness skin grafts in burned patients.

INTRODUCTION: Split-thickness skin grafting (SSG) is a technique used extensively in the care of burn patients and is fraught with suboptimal graft take when there is a less-than-ideal graft bed and/or grafting conditions. The technique of Negative Pressure Dressing (NPD), initially used for better wound healing has been tried on skin-grafts and has shown to increase the graft take rates. However, comparative studies between the conventional dressing and vacuum assisted closure on skin grafts in burn patients are unavailable. The present study was undertaken to find out if NPD improves graft take as compared to conventional dressing in burns patients. MATERIALS AND METHODS: Consecutive burn patients undergoing split-skin grafting were randomized to receive either a conventional dressing consisting of Vaseline gauze and cotton pads or to have a NPD of 80 mm Hg for four days over the freshly laid SSG. The results in terms of amount of graft take, duration of dressings for the grafted area and the cost of treatment of wound were compared between the two groups. RESULTS: A total of 40 split-skin grafts were put on 30 patients. The grafted wounds included acute and chronic burns wounds and surgically created raw areas during burn reconstruction. Twenty-one of them received NPD and 19 served as controls. Patient profiles and average size of the grafts were comparable between the two groups. The vacuum closure assembly was well tolerated by all patients. Final graft take at nine days in the study group ranged from 90 to 100 per cent with an average of 96.7 per cent (SD: 3.55). The control group showed a graft take ranging between 70 and 100 percent with an average graft take of 87.5 percent (SD: 8.73). Mean duration of continued dressings on the grafted area was 8 days in cases (SD: 1.48) and 11 days in controls (SD: 2.2) after surgery. Each of these differences was found to be statistically significant (p<0.001). CONCLUSION: Negative pressure dressing improves graft take in burns patients and can particularly be considered when wound bed and grafting conditions seem less-than-ideal. The negative pressure can also be effectively assembled using locally available materials thus significantly reducing the cost of treatment.

Chondroid syringoma with extensive ossification.

Chondroid syringoma is a rare appendagel skin tumor. Due to its uncharacteristic presentation, it is rarely diagnosed clinically. Here we present one such case in a 50-year-old lady. She presented with a hard mobile lesion over her nose which was excised. The histologic picture is characterized by a combination of epithelial and myoepithelial structures within a chondromyxoid and fibrous stroma. For these tumors, excision is the treatment of choice.

A retrospective study of 75 cases of splenic abscess.

Splenic abscess is an uncommon and life-threatening condition. Due to its nonspecific clinical picture, it remains a diagnostic challenge. Multiple radiological modalities are used for the diagnosis. In this retrospective study we analyzed 75 patients treated between 1999 and 2009. The patients were divided into three groups depending on the treatment received. Group I (n = 14) consisted of patients treated with only antibiotics, Group II (n = 19) patients were treated with percutaneous drainage and Group III (n = 42) with splenectomy. We tried to establish epidemiologic and clinical features and therapeutic options in splenic abscess. Our study suggests that percutaneous drainage is a safe and effective alternative to surgery especially in unilocular or bilocular abscesses thus allowing preservation of the spleen. It should be considered as the first line of treatment although splenectomy remains the final definitive procedure if percutaneous drainage fails.

Jatropha curcas - poisoning.

Jatropha curcas is common plant found all over India more commonly in the southern parts. Though it is a common cause of accidental poisoning among children in these parts, standard texts rarely cover it. Gastrointestinal manifestations are predominant feature of poisoning with the seeds of Jatropha curcas. Mortality is rare.

Jatropha curcas-poisoning.

Jatropha curcas is common plant found all over India more commonly in the southern parts. Though it is a common cause of accidental poisoning among children in these parts, standard texts rarely cover it. Gastrointestinal manifestations are predominant feature of poisoning with the seeds of Jatropha curcas. Mortality is rare.