Hypergiant hepatic hemangiomas: case series.

Hemangiomas are the most common benign tumors of the liver. Hepatic hemangiomas originate from the proliferation of vascular endothelial cells, and enlarge by ectasia rather than hyperplasia. They are very variable in size and are classified accordingly and their management in the larger variety is debatable.

Psychiatry and law: past, present and future.

It is important that every citizen knows the law of the state. Psychiatry and law both deal with human behaviour. This paper attempts to highlight the interplay between these two by discussing about various legislations like The Family Courts Act 1984, Narcotic Drugs and Psychotropic Substances Act 1985, Juvenile Justice Act 1986, Consumer Protection Act 1986, Persons with Disability Act 1995, The Maintenance and Welfare of Senior Citizens Act 2007.

Prospective evaluation of maternal morbidity and mortality in post-cesarean section patients admitted to postanesthesia intensive care unit.

Background And Aims: Critical illness may complicate any pregnancy. Timely intensive care management of critically ill obstetric patients has better outcomes than expected from the initial severity of illness. The aim was to study the indications of transfer of post-cesarean section patients to post-anesthesia intensive care unit (PACU).

Low serum iron as a possible risk factor for neuroleptic malignant syndrome.

Neuroleptic malignant syndrome (NMS) is a rare, but fatal condition characterized by rigidity, fever, dysautonomia and altered consciousness along with elevated serum creatinine phosphokinase levels and leukocytosis. Treatment of NMS includes symptomatic and specific treatment with drugs like bromocriptine may be given. Risk factors for NMS include dehydration, parenteral antipsychotics and high potency antipsychotics.

Microalbuminuria: a biomarker of sepsis and efficacy of treatment in patients admitted to a medical intensive care unit of a tertiary referral center.

Background: The outcome of sepsis is significantly affected by early institution of goal-directed therapies and hence, the search for an early marker of sepsis continues.

Aims And Objectives: To observe microalbuminuria levels between patients with sepsis and those without sepsis s admitted to the medical intensive care unit (MICU) of a tertiary referral centre (primary) as also to assess the change in microalbuminuria levels in the first 24 hours as a predictor of mortality and morbidity relative to the APACHE II and SOFA scores.

Materials And Methods: This was a prospective observational study where 125 patients with sepsis and 38 without were assessed.

Is trichoscopy a reliable tool to diagnose early female pattern hair loss?

Background: Female pattern hair loss (FPHL) presents with visible patterns of hair loss, thus making a bedside diagnosis possible. However, there are cases of FPHL presenting without any visible hair thinning, making it necessary to subject them to a scalp biopsy to make a diagnosis.

Aim: The aim of the following study is to determine if trichoscopy can be used as a bedside tool to diagnose Early FPHL in women presenting without any visible thinning of hair, using >20% hair diameter diversity - anisotrichosis, as the diagnostic criteria.

Gastrointestinal stromal tumours: a series of 12 cases.

Gastrointestinal stromal tumour (GIST) is a soft tissue sarcomas arising from interstitial cell of Cajal of the gastrointestinal tract. Since its description in 1983, its management has seen sea change - from surgery to drug therapy, for CD 117 positive patients. Though it has an indolent course compared to adenocarcinoma, over the decades it has surprised surgeons with its varied presentation.

Large retroperitoneal liposarcoma - a series of five cases.

Large retroperitoneal liposarcomas represent a unique situation and require a more aggressive surgical approach, including multiple resections for recurrences. We report a series of 5 cases of large retroperitoneal liposarcoma managed aggressively with surgical resection. All cases presented with lump and abdominal pain and diagnosis was established by Ultrasonography and CT scan.

Evaluation of effect of allopurinol and febuxostat in behavioral model of depression in mice.

Objective: To evaluate the effects of allopurinol and febuxostat on depression using Forced Swim Test (FST) in mice.

Materials And Methods: Allopurinol (39 mg/kg p. o) and febuxostat (15.

Neuropsychiatric symptoms in mild cognitive impairment: An analysis and its impact on caregiving.

Background: Neuropsychiatric impairments play a significant role throughout the course of cognitive decline. Many psychological and behavioral symptoms are present in patients of mild cognitive impairment (MCI) similar to that seen in individuals with dementia.

Aims And Objectives: To study the relevance of neuropsychiatric symptoms of MCI and the impact it has on caregivers of these patients.

Incidence of Clostridium difficile associated diarrhoea in a tertiary care hospital.

Background And Objectives: Rampant and injudicious use of broad spectrum antibiotics in hospitalized patients has increased the incidence of Clostridium difficile associated diarrhoea (CDAD). Though antibiotic use is the best known risk factor for CDAD, the occurrence of community acquired C. difficile suggests the presence of other risk factors too.

Inadvertent Provocative Oral Ondansetron use Leading to Toxic Epidermal Necrolysis in an HIV-infected Patient.

Toxic epidermal necrolysis (TEN) is a severe cutaneous adverse reaction to drugs, characterized by extensive detachment of epidermis and mucous membranes with a mortality of 30-40%. An increased occurrence of cutaneous drug reactions is seen in patients with human immunodeficiency virus (HIV) infection. We present this case of TEN caused by ondansetron in an HIV-infected patient.

Superior mesenteric artery syndrome secondary to tuberculosis induced cachexia.

Superior mesenteric artery (SMA) syndrome is a rare cause of obstruction of 3rd part of duodenum between abdominal aorta and the overlying superior mesenteric artery caused by decrease in the angle between the two vessels as a result of rapid loss of retroperitoneal fat. It is seen in conditions causing severe weight loss and catabolic states. We report a case of pulmonary tuberculosis leading to superior mesenteric artery syndrome.

Diagnostic utility of dermatoscopy in hydroquinone-induced exogenous ochronosis.

Background:   Hydroquinone is the preferred topical bleaching agent used in the treatment of melasma. The adverse effects of its chronic use are confetti-like depigmentation and exogenous ochronosis. Exogenous ochronosis manifests clinically with gray-brown or blue-black hyperpigmentation, as well as pinpoint hyperchromic caviar-like papules over the malar region.

Multiple focal nodular hyperplasia, an incidental finding on autopsy.

Focal nodular hyperplasia (FNH) is a benign condition of the liver often discovered incidentally on radiological investigation. Although FNH is a well-described lesion in the literature considerable diagnostic problems regarding this entity still remains. We report a case of multiple FNH in a 23-year-old male patient detected as an incidental finding in autopsy.

Extensive alopecia areata: not necessarily recalcitrant to therapy!

Background: Extensive alopecia areata includes alopecia universalis, alopecia totalis, ophiasis and patients having more than 50% scalp involvement. Alopecia universalis (AU) and totalis (AT) are considered to be resistant to single modalities of treatment. Our study highlights the efficacy and safety of combination therapy in extensive alopecia areata.

A study of the prevalence of diabetes, insulin resistance, lipid abnormalities, and cardiovascular risk factors in patients with chronic plaque psoriasis.

Background: The association between psoriasis, diabetes, and cardiovascular disease remains largely unelucidated in the Indian population.

Aims: To study the prevalence of diabetes, insulin resistance, lipid abnormalities, and cardiovascular risk factors in patients with chronic plaque psoriasis.

Materials And Methods: Seventy-seven patients of chronic plaque psoriasis and ninety two age- and sex-matched controls were enrolled in the study over a period of one year.

Clinical characteristics and outcomes of patients with acute lung injury and ARDS.

Background: Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are critical illnesses associated with significant morbidity and mortality.

Aims: This was designed to assess various etiologies of ALI/ARDS, to determine the correlation between the diagnostic criteria and need of mechanical ventilation, and to correlate biochemical factors with the outcome of patients.

Settings And Design: An observational, prospective study was conducted in a medical intensive care unit (MICU) of a tertiary care hospital, for a period of 1 year.

Anesthetic management of a patient with sickle cell disease for common bile duct exploration.

Patients with sickle cell disease (SCD) may present to the anesthetist in different clinical settings like perioperative care, management of acute painful crisis and intensive therapy for acute respiratory failure. We describe the successful management of a 34-year-old female patient with SCD, posted for cholecystectomy with common bile duct exploration under general and epidural anesthesia. The importance of preoperative stabilization and careful anesthetic strategy is emphasized.