Tuberculous Bronchoesophageal Fistula in Nephrotic Syndrome: A Silent Assassin.

Tuberculosis, a global public health concern, is emerging as an important complication in children with nephrotic syndrome. We report a case of an adolescent with nephrotic syndrome who developed fatal miliary tuberculosis after initiation of steroid therapy, presenting as a bronchoesophageal fistula. The case highlights the importance of maintaining a high index of suspicion prior to starting immunosuppressive therapy in pediatric patients of nephrotic syndrome.

HAEMOcare: The First International Epidemiological Study Measuring Burden of Hemophilia in Developing Countries.

 Optimizing hemophilia care remains challenging in developing countries. Burden-of-disease studies are important to develop strategies for improving hemophilia care.  The HAEMOcare study evaluated the factors contributing to hemophilia-related orthopedic disease burden in developing countries.

Intramuscular Capillary Haemangioma of the Temporalis Muscle: A Rare Case with A Review of the Literature.

An Intramuscular Haemangioma (IMH) is a benign mesenchymal tumour of the endothelial cells that accounts for less than 1% of all haemangiomas. Here we report the case of a capillary type intramuscular haemangioma in a five-year-old boy, only the fourth such case reported in literature, along with a relevant review of the literature. The lesion was surgically managed, with no recurrence in the follow up period till date.

Hyperhomocysteinemia, MMPs and Cochlear Function: A Short Review.

Hyperhomocysteinemia (HHCY) has been demonstrated to affect cochlear microvasculature as well as cochlear epithelial cells directly, with a resultant alteration of the expression of matrix metalloproteinases (MMPs) and their inhibitors, tissue inhibitors of metalloproteinases (TIMPs). Hence, ascertaining the optimum concentration of MMPs and TIMPs in the cochlea could help to inhibit hearing loss due to HHCY by the administration of appropriate MMP inhibitors, Since infections/inflammations as well as ototoxic antibiotics have a similar mechanism of otic pathology, the cochlear damage they cause could also be similarly prevented.

Diagnostic Efficacy of Computed Tomography in Detecting Cervical Metastases in Clinically N0 Head and Neck Squamous Cell Carcinoma.

The search for a single non-invasive highly accurate diagnostic modality for identification of cervical metastasis in head and neck squamous cell carcinoma (HNSCC) is yet to bear fruit. Thirty proven cases of HNSCC with no palpable neck nodes were selected, requiring surgery for the primary tumour. Detailed clinical evaluation and contrast enhanced computed tomography (CECT) scans were done.

Prevalence of Risk Factors for Chronic Non-communicable Diseases Using WHO Steps Approach in an Adult Population in Delhi.

Objective: The burden of non-communicable diseases (NCDs) is increasing worldwide largely due to prevalence of various risk factors, which can be controlled. Therefore, the present study was undertaken to measure the prevalence of major preventable risk factors for chronic non-communicable diseases in an urban resettlement colony of Delhi, using STEPS approach.

Materials And Methods: A cross-sectional study, that included a random sample of 200 adults, was conducted.

Issues in prevention of iron deficiency anemia in India.

Iron deficiency anemia (IDA) continues to be major public health problem in India. It is estimated that about 20% of maternal deaths are directly related to anemia and another 50% of maternal deaths are associated with it. The question, therefore, is why, despite being the first country to launch the National Nutritional Anemia Prophylaxis Programme in 1970, the problem of IDA remains so widespread.

Hypertension and its correlates among school adolescents in delhi.

Background: Hypertension is fast emerging as a major health problem amongst all school adolescents, particularly in urban areas. Regular screening of the students for this is required for preventing the emergence of complications later in life. Therefore, the present study was undertaken with the objective to determine the prevalence of hypertension amongst urban school adolescents and its correlation with anthropometric measurements.

Knowledge and use of personal protective measures against mosquito borne diseases in a resettlement colony of delhi.

Background: Mosquito borne diseases (MBDs) are major public health problem in India. State of Delhi is endemic for dengue and other MBDs. The increasing incidence of MBDs in Delhi in recent years warrants a pro-active approach for their prevention.

Extraperitoneal Pelvic laparoscopic disconnection of accessory urethra from normal urethra in a case of urethral duplication.

We report an extraperitoneal pelvic laparoscopic approach to disconnect accessory urethra from normal urethra in complete urethral duplication. First stage consisted of chordee correction, partial excision of the accessory urethra and glansplasty. In the second stage the remaining accessory urethra was disconnected from the normal urethra through a pre-peritoneal minimal access approach to the retropubic space.

Low back pain and associated risk factors among undergraduate students of a medical college in Delhi.

Context: Low back pain (LBP) is the most common orthopedic problem worldwide and is known to affect both younger and older adults. The stressful and time consuming curriculum of medical students predisposes them to this problem. Few statistics are available on prevalence rates of LBP among medical students in India.

ABC-VED Analysis of a Drug Store in the Department of Community Medicine of a Medical College in Delhi.

A matrix based on coupling of cost (always, better and control) analysis and criticality (vital, essential and desirable) analysis was employed for drug inventory containing 129 items of drug store in the Department of Community Medicine of a Medical College in Delhi. The annual drug expenditure incurred on 129 drug items for the year 2010-2011 was found to be Rs. 4,35,847.

Bilateral first and second arch anomalies: a rare presentation.

Branchial sinuses are one of the most common congenital anomalies present. They are usually unilateral; bilateral cases are present but are rare. The presentation of bilateral branchial sinus anomalies along with bilateral first arch anomalies is very rare.

Epidermoid cyst of clitoris mimicking clitoromegaly.

Clitoromegaly in pediatric and adolescent age group is usually indicative of a disorder of sexual differentiation. We report a girl child presenting with clitoral enlargement due to an epidermoid cyst. The cyst was excised with complete cosmetic recovery.

Dermatofibrosarcoma protuberans of scalp with cervical lymph node metastasis.

Dermatofibrosarcoma protuberans (DFSP) is an uncommon, slow growing and locally aggressive tumor of the skin with a high rate of recurrence even after supposedly wide excision. The reports of regional lymph node metastasis and distant metastasis are very rare. Because of the extreme rarity of these cases with metastasis, the experience with management of such patients is very limited.

Celiac disease: association with adult-onset Still's disease: apropos of a clinical case.

Adult-onset Still's disease (AOSD) is a rheumatic disorder of unknown etiology characterized by a triad of fever, polyarthritis and evanescent rash. We present a case report of a 28-year-old female who presented with complaints of fever, joint pains, rash, weakness for the past 4 years and diarrhea for the past 2 years. On investigation the patient was diagnosed to be a case of AOSD.

Visceral leishmaniasis masquerading as chronic liver disease.

We report a patient with fever, progressive jaundice and abdominal distension, having marked pallor, icterus, ascites and hepatosplenomegaly. Investigations revealed pancytopenia and deranged liver functions. Doppler study revealed portal hypertension and endoscopy showed grade II oesophageal varices.

Efficacy of a fixed dose combination of diclofenac sodium and acetaminophen (Rhumacort) injection in postoperative pain.

To evaluate the efficacy and safety of a fixed dose combination of diclofenac sodium and acetaminophen injection a study was carried out in patients suffering from acute pain. Thirty-eight adult patients undergoing orthopaedic surgery received 3ml injection of diclofenac 25mg and acetaminophen 75mg per ml by deep intramuscular route 8 hourly for 6 doses. The pain assessment was made on a 1-100 mm visual analogue scale (VAS), onset of action, extent of pain relief and maximum fall in VAS score after the first dose was assessed.

Acute fulminant visceral leishmaniasis in children--a report of two cases.

Kala-azar usually presents in older children and young adults with insidious onset of fever, splenomegaly and pancytopenia. Characteristic L.D.

Accidental death resulting from acetylene cylinder impact.

Acetylene is an inflammable gas commonly used for welding in small-scale industries. We present a case of a 34-year-old male welder who died following injuries sustained from explosion of an acetylene gas-welding cylinder. In this case report, we discuss the circumstances leading to the explosion of the welding cylinder, the autopsy findings, and a brief review of the literature on deaths resulting from blasts of acetylene cylinders.

Nasal dermoid with intracranial extension.

Nasal dermoids are rare congenital anomalies, which usually present in early childhood as a midline nasal mass that requires surgical management. It is important to rule out any intracranial extension before subjecting the patient to surgery. We describe a case of nasal dermoid with intracranial extension.

Effect of losartan on albuminuria, peripheral and autonomic neuropathy in normotensive microalbuminuric type 2 diabetics.

Background: Angiotensin converting enzyme (ACE) inhibitors are emerging as effective agents for preventing microvascular complications of diabetes. Losartan (angiotensin II antagonist) has an antihypertensive efficacy equivalent to ACE inhibitors, however its role in microvascular complications is not yet known.

Material And Methods: We studied the efficacy of losartan (50 mg once daily for 12 weeks) on albuminuria, peripheral and autonomic neuropathy in 25 normotensive microalbuminuric type 2 diabetics who were asymptomatic for neuropathy.

Tuberculosis of zygoma.

A case of tubercular osteomyelitis of zygoma is reported. It is difficult to diagnose because of its rarity unless a high index of suspicion is kept in mind more so in an endemic area.