The Diagnostic Dilemma of Cutis Laxa: A Report of Two Cases with Genotypic Dissimilarity.

Cutis laxa is a heterogeneous group of diseases, with loose, wrinkled skin folds and hyperelasticity of the skin. There are overlapping of clinical features of the group of syndrome associated with cutis laxa, including congenital cutis laxa, wrinkly skin syndrome and gerodermia osteodysplastica. All these conditions present a challenge to the clinician.

Impaired monocyte-macrophage functions and defective Toll-like receptor signaling in hepatitis E virus-infected pregnant women with acute liver failure.

Unlabelled: Acute viral hepatitis resulting due to hepatitis E viral infection (AVH-E) is often serious in pregnancy and could result in acute liver failure (ALF). The role of monocytes and macrophages (mono-macs) in the pathogenesis of AVH-E and development of ALF-E in pregnancy is unclear. We investigated the functions of mono-macs in pregnant (P), AVH-E (n = 44), ALF-E (n = 12), healthy controls (HC; n = 20) and compared with nonpregnant (NP) AVH-E (n = 10), ALF-E (n = 5), and HC (n = 10).

Posterior reversible encephelopathy syndrome presenting as quadriparesis in pregnancy induced hypertension.

Pregnancy Induced Hypertension (PIH) is a condition characterised by raised blood pressure in pregnancy. It affects approximately one out of every 14 pregnant women. Although PIH more commonly occurs during first pregnancy, it can also occur in subsequent pregnancies.

Non-functional paraganglioma of retroperitoneum mimicking pancreatic mass with concurrent urinary bladder paraganglioma: an extremely rare entity.

Paragangliomas are extra-adrenal tumours of the autonomic nervous system, which rarely present as primary retroperitoneal mass mimicking pancreatic malignancy (incidence 2-8 per million populations). Urinary Bladder Paraganglioma are also extremely rare (0.06% of all Bladder Tumour and 6% of Paragangliomas) with most being malignant and high grade tumours.

Tuberculosis of upper dorsal spine causing respiratory distress due to tracheo-oesophageal compression: an unusual presentation.

A cold abscess causing tracheo-oesophageal compression is quite unusual. A case of a 5-year-old boy with caries spine of D3-D4 vertebrea with respiratory distress due to mediastinal cold abscess pressing over trachea is being reported. Urgent costotransversectomy was done to decompress the cold abscess.

Anterior resection for rectal cancer with mesorectal excision: institutional review.

This study aims to compare the operative results and oncological outcomes of patients with total mesorectal excision (TME) for mid and distal cancer and partial mesorectal excision (PME) for proximal cancer. Anterior resection has become the preferred treatment option for rectal cancer. TME with sharp dissection has been shown to be associated with a low local recurrence rate.

Bile duct injuries during open and laparoscopic cholecystectomy: management and outcome.

Background: The widespread application of laparoscopic cholecystectomy has led to a rise in the numbers of major bile duct injuries (BDI). Perioperative management of these injuries is complex and challenging. There are few published reports locally regarding the perioperative management of BDI.

Sternal tuberculosis.

Extra-pulmonary tuberculosis constitutes 15-20% of total tuberculosis (TB) case load in immuno-competent patients. Affliction of the skeletal system is rare with still rarer presentation of sternal osteomyelitis even in endemic countries. A patient with primary sternal TB presenting with multiple cutaneous sinuses over the anterior chest wall is being reported.

Acute Compressive Ulnar Neuropathy In A Patient Of Dengue Fever: An Unusual Presentation.

Introduction: Dengue haemorrhagic fever is known for its haemorrhagic and neurologic complications. Neurologic complications are caused by three mechanism namely neurotropism, systemic complications causing encephalopathy and postinfectious immune-mediated mechanisms. However acute compressive neuropathy due to haemorrhage is not frequent and we could find no literature describing this.

A direct anastomosis between the stems of celiac trunk and left colic artery by an anomalous fourth celiac trunk branch: first cadaveric study.

Coeliac trunk (CT) is a ventral branch of abdominal aorta (AA) supplying the foregut through its three main branches, left gastric (LGA), common hepatic (CHA) and splenic artery (Standring et al., 2009). Branching pattern of CT may vary from above mentioned classical three to four, five or six.

Intravenous iron sucrose versus oral iron in treatment of iron deficiency anemia in pregnancy: a randomized clinical trial.

Aim: Iron deficiency is a leading cause of anemia in pregnancy. The present study aimed to compare the efficacy of oral and intravenous iron therapy in improving iron deficiency anemia in pregnancy and restoring iron stores, compare the obstetric outcome in the two groups and evaluate the safety of intravenous iron sucrose.

Material And Methods: This was a prospective study, where 100 anemic antenatal women with hemoglobin 7-9 g/dL, mean corpuscular volume <85 fL and serum ferritin <15 ng/mL, were randomized into two groups.

Total colonic aganglionosis--a diagnostic intricacy.

Total colonic aganglionosis (TCA) is an unusual variety of aganglionosis. Although appearing to be an extension of Hirschprung's disease (HD), it may differ from it in many ways and thus is difficult to diagnose on the basis of features applied for HD. The aim of this case report is to discuss the difficulties encountered in recognition of TCA and identification of features which can help in early diagnosis.

A rare case of homicidal insecticide (organochloro compound) poisoning by intraperitoneal injection.

We report a case of a 52-year-old businessman who was allegedly injected with organochloro compound (OC) in his abdomen by his business rivals by means of a surgical needle and a syringe. Homicide by OC injection via an intraperitoneal route has not been reported in the literature. Postmortem findings along with the toxicology report have been discussed particularly in view of the mode of poison administration with a review of literature.

Tobacco and metabolic syndrome.

Tobacco is a leading contributor to morbidity and mortality globally. Metabolic syndrome is a constellation of abdominal obesity, atherogenic dyslipidemia, raised blood pressure, insulin resistance (with and without glucose intolerance), pro-inflammatory state, and pro-thrombotic state. Tobacco use is associated with various core components of metabolic syndrome.

Diabetes and psychiatric disorders.

Interface of diabetes and psychiatry has fascinated both endocrinologists and mental health professionals for years. Diabetes and psychiatric disorders share a bidirectional association -- both influencing each other in multiple ways. The current article addresses different aspects of this interface.

Correlates of anxiety and depression among patients with type 2 diabetes mellitus.

Context: Research has established the relation between diabetes and depression. Both diabetes and anxiety/depression are independently associated with increased morbidity and mortality.

Aims: The present study aims at assessing the prevalence of anxiety/depression among outpatients receiving treatment for type 2 diabetes.

Pelvic angiomatosis: an unusual cause of recurrent obstructed labor: a case report and review of literature.

Background: Pelvic angiomatosis is a very rare cause of obstructive labor.

Materials And Methods: A 26-year-old P2 L2 had two cesarean sections for recurrent obstructed labor due to a large pelvic mass. Investigations after the first cesarean section suggested a benign nature of the mass for which she was advised surgical resection, but she refused due to social reasons.

Is sclerotherapy better than intralesional excision for treating aneurysmal bone cysts?

Background: Minimally invasive approaches such as sclerotherapy have been introduced to treat aneurysmal bone cysts. Sclerotherapy has been associated with reasonable healing rates during the past two decades. However, it is unclear whether sclerotherapy compares with the more traditional extended curettage and bone grafting.

Kimura's disease: an unusual glandular involvement with blood and tissue eosinophilia.

Kimura's disease is a rare cause of a progressive neck swelling associated with blood and tissue eosinophilia. Though it is a benign disease, however, its unrelating course and unpredictable response to the therapeutic interventions, poses a great challenge to the treating physician, the patients and the caregiver. Here is one such case of Kimura's disease.

Sublingual versus oral misoprostol for uterine evacuation following early pregnancy failure.

Objective: To compare the efficacy of misoprostol administered sublingually or orally for uterine evacuation after early pregnancy failure.

Method: Forty-eight hours after receiving 200 mg of mifepristone orally, 100 women were randomized to receive misoprostol sublingually or orally.

Results: The evacuation rates were 92% in the sublingual and 84% in the oral administration group; the mean+/-SD induction-to-evacuation intervals were 5.

Osteosynthesis for intra-articular calcaneal fractures.

Purpose: To correlate treatment results of intra-articular calcaneal fractures with their computed tomographic (CT) classification.

Methods: 36 men and 4 women with 48 intra-articular calcaneal fractures (8 bilateral) underwent open reduction and internal fixation with bone grafting via an extensile lateral approach. Based on 2-dimensional CT scans, the fractures were categorised using the Sanders classification.

Cutaneous manifestation of diabetes mellitus.

One hundred consecutive diabetes mellitus patients attending the diabetic clinic of the hospital constituted the study group. One hundred age and sex matched non-diabetics were taken as controls. The majority, 63%, belonged to the 41-60 years age group and 98% had non-insulin dependent diabetes.

Complex composite odontoma associated with impacted tooth: A case report.

Odontomas are the most common type of odontogenic tumors and are generally asymptomatic. This paper describes the case of a complex composite odontoma in a patient who had an asymptomatic swelling in the maxillary molar region, along with the impacted third molar. In this case, surgical excision of the lesion was performed, and the impacted third molar was intentionally left in situ so that it could erupt to the level of occlusion.