Peutz-Jeghers Syndrome: Lessons to be Learned in the Clinical Diagnosis.

Introduction: Peutz-Jeghers Syndrome (PJS) is an autosomal dominant disease presenting with hamartomatous polyps in the gastrointestinal tract and hyperpigmented macules on lips and oral mucosa. The incidence of this syndrome is approximately 1 in 1,20,000 births.

Materials And Methods: In this article, we are presenting 11 cases of PJS which were misdiagnosed and patients were compelled to visit hospital repeatedly.

Evaluation of Hemodynamic Changes in Retrobulbar Blood Vessels Using Color Doppler Imaging in Diabetic Patients.

Background—Diabetic retinopathy is a common complication of long-standing hyperglycemia. Microangiopathy-induced retinal changes are well-visualized on ophthalmoscopic examination. However, certain hemodynamic alterations have also been documented in the diabetic population, which have not been completely understood.

Breast screening revisited.

Breast screening is the medical screening of asymptomatic, apparently healthy women for breast lump in an attempt to achieve an earlier diagnosis. The assumption is that the early detection will improve outcomes. In western countries, breast screening programs have led to a significant reduction in mortality and improved prognosis of patients with breast cancer.

Evaluation of digital infra-red thermal imaging as an adjunctive screening method for breast carcinoma: a pilot study.

Background: Early screening plays a pivotal role in management of breast cancer. Given the socio-economic situation in India, there is a strong felt need for a screening tool which reaches the masses rather than waiting for the masses to reach tertiary centers to be screened. Digital infra-red thermal imaging (DITI) or breast thermography as a screening test offers this possibility and needs to be carefully assessed in Indian scenario.

Prospective randomized controlled comparison of caudal bupivacaine and ropivacaine in pediatric patients.

Background: Bupivacaine and ropivacaine are commonly used agents for caudal anesthesia in pediatric patients. Several studies have shown different motor and cardiovascular effects of two drugs.

Aim: The primary objective of this study was to evaluate the efficacy of both drugs and secondary objective was to compare motor blockade and hemodynamic effects caused by them.

Postmyomectomy gossypiboma: A surgical mishap.

Gossypibomas or retained surgical foreign bodies, although uncommon causes of abdominal lumps, still remain a major cause of concern for surgeons worldwide. Their early identification and treatment are mandatory to prevent morbidity as well as mortality. The major diagnostic dilemma still remains in the vagueness of presentation of this callous entity.

Unusual case of frontoethmoid mucopyocele with intracranial and orbital extension.

A case report of rare occurrence of frontoethmoid mucopyocele with Intracranial and orbital extension with complete recovery after endoscopic surgery.

Epidemiological trends of pediatric trauma: A single-center study of 791 patients.

Aim: To assess the various epidemiological parameters that influence the causation of trauma as well as the consequent morbidity and mortality in the pediatric age group.

Materials And Methods: A prospective study of 791 patients of less than 12 years age, was carried out over a period of 1 year (August 2009 to July 2010), and pediatric trauma trends, with regards to the following parameters were assessed: Age group, sex, mode of trauma, type of injury, place where the trauma occurred and the overall mortality as well as mortality.

Results: Overall trauma was most common in the school-going age group (6-12 years), with male children outnumbering females in the ratio of 1.

Paediatric pancreatic problems: a five-year experience.

Background: To analyse a tertiary care experience with various pancreatic problems in the paediatric age group and clarify the frequency of various pancreatic diseases in the same patient population as well as the role of surgical or conservative management in their treatment.

Patients And Methods: All patients with clinical suspicion of disease pertaining to the pancreas, substantiated by laboratory investigations or imaging modalities over a period of five years are included in our study.

Results: Of the total 228 patients with various pancreatic problems, who presented to us, mostly with acute pancreatitis and pancreatic trauma, 64 needed surgical interventions.

Primary tubercular caecal perforation: a rare clinical entity.

Background: Intestinal tuberculosis is a common problem in endemic areas, causing considerable morbidity and mortality. An isolated primary caecal perforation of tubercular origin is exceptionally uncommon.

Case Presentation: We report the case of a 39 year old male who presented with features of perforation peritonitis, which on laparotomy revealed a caecal perforation with a dusky appendix.

Penetrating craniofacial arrow injury.

Arrow injuries are an extinct form of injury in most parts of the developed world, but are still seen, albeit infrequently in developing countries. Reports of penetrating injuries of the craniofacial region secondary to projectiles are few and far between. The morbidity-free outcome of surgical removal, in case of penetrating arrow injuries, despite the delay in presentation and, moreover, in the emergency surgical practice, are the salient points to be remembered whilst managing such cases, for 'what the mind knows is what the eyes see and what the eyes see is what can be practiced'.

Comparative study of catheter drainage and needle aspiration in management of large liver abscesses.

Objective: To compare the effectiveness of percutaneous catheter drainage (PCD) and percutaneous needle aspiration (PNA) in the management of large (>10 cm diameter) liver abscesses.

Methods: Seventy-two patients with liver abscess (amebic 48, pyogenic 24) were randomly allocated to PCD or PNA (36 each), which were done within 24 hours of admission. Both groups received parenteral antibiotics for at least 10 days.

Mucormycosis of nose and paranasal sinuses with orbital complication in young diabetic.

A case report of mucormycosis of nose and paranasal sinuses with sudden loss of vision in a young diabetic with good recovery after endoscopic debridement, systemic and topical amphotericin B and control of Diabetes mellitus.

Estimation of BCL-2 protein in carcinoma of the breast and its clinical correlation in locally advanced breast cancer.

Unlabelled: The change in expression of apoptotic markers (Bcl-2 and Bax proteins) brought about by various chemotherapeutic regimens is being used for its predictive value for assessing response to neoadjuvant chemotherapy (NACT) in locally advanced breast carcinoma (LABC).

Aims: (1) Estimation of Bcl 2 expression in LABC, (2) Any change in Bcl 2 expression following chemotherapy in LABC, (3) Any relation of Bcl 2 estimation to changes in size of tumor, nodal status, age, and menopausal status.

Settings And Design: This was a prospective study of 120 cases of LABC.

Efficacy and safety of PDE-5 inhibitor tadalafil in pulmonary arterial hypertension.

Background: Pulmonary arterial hypertension (PAH) is a life threatening disease for which phosphodiesterase-5 inhibitor sildenafil is recently approved. We aimed to evaluate the efficacy and safety of tadalafil, a long acting congener of sildenafil, in treatment of PAH related to previous left to right shunt lesions.

Methods: In this blinded, cross over study, 11 patients with severe PAH related to congenital left to right shunt lesions (Eisenmenger syndrome) were randomly assigned to tadalafil (20 mg daily) or placebo for 4 weeks period, separated by a wash out period of at least 2 weeks.

The efficacy and tolerability of sildenafil in patients with moderate-to-severe pulmonary hypertension.

Background: Pulmonary arterial hypertension is a life-threatening disease for which continuous intravenous infusion of prostacyclin has proved effective. However, it carries the risk of serious complications arising from the complex delivery system. Prostacyclin analogs, endothelin antagonists, and the phosphodiesterase-5 inhibitor sildenafil are emerging promising therapies.

An epidemiological study of drug abuse in urban population of madhya pradesh.

The present epidemiological survey was carried out to estimate the prevalence and pattern of drug abuse in urban population of Madhya Pradesh because such studies were lacking from this state. In the population of 5326, we found that 38.6% were current users.