Paravertebral retroperitoneal ancient schwannoma mimicking irritable bowel syndrome.

We report a case of paravertebral retroperitoneal ancient schwannoma (RPAS) with symptoms suggestive of irritable bowel syndrome that was relieved after resection. Very few cases have been reported of RPAS with gastrointestinal symptoms. Increased bowel activity associated with RPAS has not been reported. Our case report suggests that RPAS may present with increased bowel frequency that could be relieved after surgical resection.

R0 resection of linitis plastica of the stomach with synchronous bilateral Krukenberg tumours in a young woman.

We report a case of linitis plastica (LP) with synchronous bilateral Krukenberg Tumours in a young woman, which could be resected fully. Such a case is rarely reported because of rarity (LP), dismal prognosis (LP and Krukenberg Tumours), nonresectability due to peritoneal spread at presentation, and lack of clear treatment protocols (LP and Krukenberg Tumours). This case report suggests that LP, with Krukenberg Tumours, can achieve complete resection in a select subset of cases; this may improve survival.

An unusual presentation of acute abdomen: infarcted peritoneal cyst-a probable asbestos-related benign cystic mesothelioma.

This is a report of a rare case of an infarcted pelvic intra-abdominal cyst, having no mesenteric connection presenting as an acute abdomen. The patient had significant asbestos exposure. The cyst was treated successfully by surgical excision. Histopathology showed an infarcted cyst; the lining was destroyed, precluding marker studies. A diagnosis of benign cystic peritoneal mesothelioma (BCPM) was made by excluding other causes of solitary pelvic intra-abdominal cysts. BCPM has been classified as an asbestos-related neoplasm and is usually seen in the pelvis adjunct to the urinary bladder. One-year post-surgery, there was no recurrence. The case report shows that infarcted pelvic mesothelial cysts can present as an acute abdomen and can be treated successfully by total excision with no recurrence.

Silico-tuberculosis, silicosis and other respiratory morbidities among sandstone mine workers in Rajasthan- a cross-sectional study.

BACKGROUND: Exposures to respirable crystalline silica causes silicosis, pulmonary tuberculosis, chronic obstructive pulmonary disease, lung cancer, autoimmune disorders and chronic renal disease. The aim of this study was to find out the prevalence of silico-tuberculosis, silicosis and other respiratory morbidities in sandstone mine workers in Jodhpur district of Rajasthan. METHODS: It was a cross-sectional study done in sandstone mines in Jodhpur. A total of 15 mines were selected. The sample size was calculated and fixed to 174 mine workers. Chi-square and t-test were applied to draw inferences. RESULTS: The mean age of the mine workers was 39.13 ± 11.09 years. Three fourth (75.3%) of the workers were working for more than ten years in mines. Around 30.0% had a history of tuberculosis. Abnormal spirometry was found in 89.2% of workers. Around 42% of mine workers were found with abnormal chest x-rays. Prevalence of silicosis was 37.3%, silico-tuberculosis was 7.4%, tuberculosis was 10.0%, and other respiratory diseases like emphysema and pleural effusion were diagnosed among 4.3% workers. CONCLUSION: Prevalence of silico-tuberculosis, silicosis and other respiratory morbidities are high among sandstone mine workers.

A case from India of pleural malignant mesothelioma probably due to domestic and environmental asbestos exposure: a posthumous report.

India is the largest consumer of asbestos in the world. There is no report from India of mesothelioma related to asbestos. The case is a 42-year-old man who died of pleural mesothelioma. He was exposed to asbestos domestically and from the environment since birth. Two of his close family members worked in a factory that used asbestos. The living quarter of the family was within the premises of the factory. Asbestos waste was strewn on the grounds surrounding the quarters. After decades of legal battles by workers and families exposed to asbestos, Indian courts have ordered remedial measures and compensation to people, who are exposed to asbestos at work and the environment. Mesothelioma, currently in epidemic proportions in the west where asbestos production was banned in the 1990s, could rise to alarming levels in the next decades in India if the legal remedial measures are not implemented soon.

Simultaneous occurrence of hepatic hydatid cyst and mucinous cystadenoma of the liver in a middle-aged female patient: report of a rare case.

We present a rare case of simultaneous occurrence of mucinous cystadenoma of the liver (MCN-L) and a hepatic hydatid cyst (HD-L) in a middle-aged female patient. This is the first case report of a common disease (HD-L) and a rare condition (MCN-H) occurring concurrently. MCN-H of the left lobe was inadequately resected in a rural centre leading to recurrence. She presented with a large upper abdominal lump and upper gastrointestinal symptoms. Radiological investigations and an ultrasound revealed a multilobulated cyst involving both lobes of the liver. There was no ascites. Liver function, basic haematology and renal function were normal. The recurrent MCN-L was removed totally. There was no communication between the MCN-L and the right lobe cyst, which turned out to be a hydatid cyst. The hydatid cyst was evacuated. She was discharged on albendazole and is asymptomatic with no recurrence at 8 months.

Parenchymal asbestosis due to primary asbestos exposure among ship-breaking workers: report of the first cases from Bangladesh.

We report for the first time asbestosis among ship-breaking workers of Sitakunda in Bangladesh who were exposed to asbestos during ship-based and beach-based operations for at least 10 years. Asbestosis was present among 35% of workers. Years of work (>20) and forced vital capacity (<80% of predicted) were significantly associated with the disease. Currently, global ship-breaking operations are mainly concentrated in the Indian subcontinent, and Bangladesh has the majority share. Ninety per cent of domestic steel is produced in the ship-breaking operations in Bangladesh and is an important contributor to the economy. It also gives employment to more than 100 000 people. It is imperative to medically check up all the workers for benign and malignant diseases causally related to asbestos among these vulnerable population of workers.

Non-pseudomonal ecthyma gangrenosum caused by methicillin-resistant Staphylococcus aureus (MRSA) in a chronic alcoholic patient.

We report for the first time a case of non-pseudomonal ecthyma gangrenosum (EG) caused by methicillin-resistant Staphylococcus aureus in a chronic alcoholic without an associated immunocompromised state or disease. EG is an infection of the skin, commonly associated with Pseudomonas aeruginosa bacteraemia, though other organisms are also known to be causally related. It usually occurs in patients who are terminally ill and the immunocompromised. In our case, chronic alcoholism with suppression of innate immunity may have led to the development of the condition.

Forensic investigation into a death: post-traumatic amnesia in a worker with a work-related head injury sustained in a coal-fired thermal power plant in India.

This is the first reported case of a work-related head injury in a coal-fired thermal power plant in India. This case highlights the trend of not reporting work injuries due to fears of reprisal from the management team that may include the termination of employment. Post-traumatic amnesia in a worker presenting with head trauma must be recognised by coworkers, so the cause of injury can be elicited early and the victim gets timely medical help. There are few published studies on work-related traumatic brain injury, and they provide no information on either anatomical localisation or signs and symptoms. It is imperative that this under-researched area is studied, so detailed epidemiology and accurate national and global statistics are made available to address this dangerous yet preventable condition.

Basic occupational health services (BOHS) in community primary care: the MSF (Dhaka) model.

The Médecins Sans Frontiérs (MSF) established basic occupational health services to diagnose and treat work-related diseases among tannery, metal, plastics and garment workers and families in one of the more polluted areas of the world populated by 600 000 people. In spite of project limitations, an analysis of the 6-month data showed that of the original cohort of 5000, 3200 (64%) came for at least 1 consultation. Among them, 468 (14.6%) were diagnosed with suspected work-related diseases as per defined protocols. Follow-up consultation was performed for 1447 cases of occupational diseases and work-related injuries. The MSF experience begs the need for replication of such services in densely populated urban areas in developing nations like Bangladesh and India, where no specialty occupational health clinics exist in primary care but are desperately needed and where occupational health clinics on factory premises are exclusive to industry workers and are not accessible to communities.