Category Archives: July 2015

Thalessemia_Narang

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ThALeSSEMIA
Narang S
Professor
Department of Pathology, Index Medical College Hospital and Research Center, Indore, Madhya Pradesh, India
MEDICAL POEM
-As Mediterranean or Cooley’s anemia knownTo haemolysis, the patient is prone.-Microcytic Hypochromic RBC’s and also target cellsIs the story which the blood film tells.

-Reticulocytes and bilirubin indirect increased

With MCV, MCH, MCHC all decreased

-Haemoglobin Electrophoresis is a must

Gives a diagnosis, which one can trust

-High HbF and HbA2 levels are seen

Absent or variable HbA noted has been

-A handy tool is the iron stain

Siderotic granules are the finding main

-The homozygote is of types two

Beta zero and plus, label them you do.
KEY WORDS
Cooley,s anemia, Thalessemia, Hemoglobinopathy, Sideroblastic granules.

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Hydrops Fetalis_Joseph

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The role of ultrasonography in the diagnosis of hydrops fetalis: A case report
Joseph DZ,1 Igashi J,2 Joseph G,1 Aliyu L,1# Kadas S,1,2 Samuel S3
Clinical Radiographer,1,3 Consultant Radiologist,2 Consultant Obstetrician,1# Nurse1
1Department of Radiology, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria, 2Department of Radiology, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria,3Department of Radiography and Radiological Sciences, Nnamdi Azikiwe University, Awka, Nigeria
ABSTRACT
The objective of this report was to show the role of ultrasonography in the diagnosis of hydrops fetalis. The sonographic assessment revealed that there was increased amniotic fluid with hyperplacentosis. The transonic fluid interface was noted in the fetal abdomen in keeping with fetal ascites. There was bilateral pleural effusion with obvious subcutaneous scalp edema and right scrotal hydrocele. Ultrasound imaging is very effective and adequate in the diagnosis of hydrops fetalis.
KEY WORDS
Diagnosis, fetalis, hydrocele, hydrops, ultrasonography.

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Suprascapular foramen_Jangde

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Bony suprascapular foramen, a potential site for suprascapular nerve compression: A case report
Jangde S,1 Arya R,2 Paikra S3
Assistant Professor,1 Associate Professor,2 Demonstrator3
1-3Department of Anatomy, Chhattisgarh Institute of Medical Science, Bilaspur, Chhattisgarh, India
ABSTRACT
Suprascapular notch is the site where the suprascapular nerve traverses the upper border of the scapulae under the superior transverse scapular ligament (STSL). The anterior coracoscapular ligament runs in the suprascapular notch, below the STSL. Narrowed bony foramen by complete ossification of these ligaments may be one of the predisposing factors for suprascapular nerve compression. We report the two cases of the bony suprascapular foramen, scapula with complete suprascapular foramen and scapula with suprascapular foramen with the notch. The aim of our case report is to provide knowledge on the variations along the course of suprascapular nerve which is essential to understanding the source of the entrapment syndrome. A thorough knowledge of anatomical variations in the suprascapular region and ossification of suprascapular ligament is important for anatomists, orthopedicians, radiologists, and neurosurgeons to obtain a safe zone which would be useful to avoid iatrogenic nerve lesion and for better diagnosis and management of the nerve entrapment syndrome.
KEY WORDS
Anatomical variations, anterior coracoscapular ligament, entrapment syndrome, superior transverse scapular ligament, suprascapular foramen and notch, and suprascapular nerve.

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Rhinolith_Mundra

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Rhinolith a rare presentation in adolescent age group
Mundra RK,1 Verma JR,2 Koshta V,3 Gupta A3
Associate Professor and Head of Department,1 Assistant Professor,2 Postgraduate Student3
1-3Department of ENT, Mahatma Gandhi Memorial Medical College, Indore, Madhya Pradesh, India
ABSTRACT
Rhinolith is rare calcareous concretions that are formed by the deposition of salts on an intranasal foreign body. The foreign body acts as a nidus that causes obstruction of nasal secretions, acute and chronic infl ammation, deposition of minerals and enzymatic activities of bacterial pathogens, leading to slow and progressive increases in size. Symptoms are normally progressive unilateral nasal obstruction, rhinorrhea (usually purulent and fetid), cacosmia, and epistaxis. Other less common symptoms include headaches, facial pain, and epiphora. They are usually found in the anterior part of the nasal cavity and are usually diagnosed on history and anterior rhinoscopy. A 16-year-old female presented with complains of headache, diffi culty in breathing from left nostril, prolonged runny nose with foul smell, and at times bloody nasal discharge for the 1 year. Otolaryngeal clinical examination revealed deviated nasal septum toward the right side. The left nasal cavity appeared wide with a hard mass lying on the fl oor of the left nasal cavity which was irregular in shape with a rough surface and was slightly mobile but tender and with bleeding tendency. A diagnosis of rhinolith was clinically made, and the patient was admitted for removal of the rhinolith. Computed tomography paranasal sinuses were done, the impression was irregular shaped calcifi ed rhinolith seen in left nasal cavity. Although rhinoliths are rare, attending clinicians should keep in mind during the examination of patients. It requires a high index of suspicion when dealing with nasal symptoms such as progressive unilateral nasal obstruction, rhinorrhea (usually purulent and fetid), cacosmia, and unilateral nasal bleeding.
KEY WORDS
Foreign body, nasal obstruction, rhinolithiasis.

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Tonsillar Papilloma_Mundra

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Tonsillar papilloma: A rare case
Mundra RK,1 Verma JR,2 Gupta A,3 Vishal Koshta,3 Rathore SK3
Associate Professor and Head of department,1 Assistant Professor,2 Postgraduate Student3
1-3Department of ENT, Mahatma Gandhi Memorial Medical College, Indore, Madhya Pradesh, India
ABSTRACT
Benign oropharyngeal tumors are far less common compared to malignant tumors. Squamous papillomas are exophytic masses of the oral cavity. It is an innocuous lesion that is neither transmissible nor threatening. Pedunculated squamous papilloma usually arises from the soft palate, tonsil, or the epiglottis. A 32-year-old female presented with odynophagia on and off for 5 months. History regarding the growth revealed that it was fi rst seen 6 months prior as a slow-growing non-tender papule. The present lesion was exophytic and sessile in nature, pinkish in color with a pebbled surface, soft in consistency, 2 cm × 2 cm in size, and situated on left tonsil. Surgical excision of the lesion was performed. The histopathological diagnosis of squamous papilloma was made. The squamous cell papilloma is a benign tumor with a rare entity arising on tonsil which caused unusual odynophagia (symptomatic) of long duration.
KEY WORDS
Odynophagia, pedunculated, squamous papilloma, tonsils.

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Pancreatic Pseudocyst_Sonkar

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A rare case of pancreatic pseudocyst involving liver and spleen
Devangan M,1 Sonkar SK,2 Sharma S3
Assistant Professor,1,2 Associate Professor3
1-3Department of Surgery, Pt. J. N. M. Medical College, Raipur, Chhattisgarh, India
ABSTRACT
A pancreatic pseudocyst is a common complication of acute and chronic pancreatitis. We present the case of a 27-yearold man with pancreatic pseudocyst involving liver and spleen. Most of the pseudocysts are located within the head and the body of the pancreas but 20% are extrapancreatic. Several locations of the pancreatic pseudocyst such as pleura, mediastinum, and the pelvis, have been described. We present a rare case of pancreatic pseudocyst involving left lobe of liver and upper pole of the spleen.
KEY WORDS
Liver, pancreatic pseudocyst, spleen.

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Pentalogy of cantrell_Ambey

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Incomplete pentalogy of cantrell associated with hydrocephalus
Ambey R,1 Singh A2
Assistant Professor,1 Professor2
1Department of Pediatrics, Gajra Raja Medical College, Gwalior, Madhya Pradesh, India, 2Department of Pathology, Index Medical College Hospital and Research Centre, Indore, Madhya Pradesh, India
ABSTRACT
An unbooked primigravida delivered vaginally a female neonate with ectopia cordis, supraumbilical abdominal defect, and sternum defect that is consistent with incomplete pentalogy of cantrell. The neonate was also having central nervous system malformation in the form of hydrocephalus. Neonate expired within 30 min of birth.
KEY WORDS
Ectopia cordis, hydrocephalus, pentalogy of cantrell.

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Diabetes Mellitus Anthropometry_Chaurasia

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Identify the existence of general and central obesity and anthropometric measurements in the diabetic population
Chaurasia HL,1 Chaorasia RS2
Assistant Professor1,2
1Department of Physiology, Sewakunj MIMS Medical College & Research Centre, Indore, Madhya Pradesh, India, 2Department of Anatomy, Index Medical College Hospital & Research Centre, Indore, Madhya Pradesh, India
ABSTRACT
Introduction:Obesity is usually defined according to body mass index (BMI) cut-offs. However, BMI cannot provide information on the distribution of body fat. Central obesity, as assessed by waist circumference (WC), is more strongly associated with the risk of hypertension, dyslipidaemia, type 2 diabetes, cardiovascular disease, cancer and all-cause mortality.

Aim:

To identify the existence of general and central obesity by anthropometric measurements and to compare anthropometric parameters in the control and prediabetic subjects.

Material and Method:

The present study was conducted in the department of Physiology Gandhi Medical College and associated Hamidia Hospital Bhopal, during 2010 - 2011. The Fasting Blood sugar, Lipid Profile and Fasting Insulin Biochemical investigation was done in the department of Biochemistry of the institute. The anthropometric measurement including Weight (kg), Height (cm), Body mass index (kg/m2), Waist circumference (cm), Hip circumference (cm), Waist Hip ratio. was recorded.

Result:

The 120 subjects aged 30-60, maximum numbers of Prediabetic were in the age group of 40-50 years. In the control group 66% women as compared to the men 32%, In prediabetic group 72% subjects were showed general obesity, central adiposity was identified in 84%. It was observed that body mass index and waist circumference were significantly higher in prediabetic subject.

Conclusion:

This study has important implications for identification of subjects at higher risk for future type 2 diabetes and suggested that mass screening of prediabetic subjects and aggressive risk modification and close follow-up should be considered for prediabetic subjects with metabolic syndrome.
KEY WORDS
Anthropometric measurement, Diabetic, Obesity, Prediabetics.

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Distal radius frature_Jain

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Assessment of functional outcomes in late presenting elderly patients with unstable distal radius fractures by cast application: A prospective study
Jain VK,1 Verma A,2 Sharma G3
Associate Professor,1 Assistant Professor,2 Senior Resident3
1-3Department of Orthopedics and Traumatology, Pt. Jawahar Lal Nehru Memorial Medical College & Dr. B. R. Ambedkar Memorial Hospital, Raipur, Chhattisgarh, India
ABSTRACT
Aim: We will evaluate the functional outcomes in elderly patients with unstable distal end radius fractures who were not willing for operative treatment and were managed conservatively with cast application.Background:

Despite 200 years of medical literature proving the complexity and non-solved problems in treating distal radius fractures, in no other fracture, intra-articular mal-union, and metaphyseal mal-alignment is so broadly accepted.

Materials and Methods:

30 elderly patients with unstable distal radius fractures with mean age of 57.1 years were managed conservatively and observed for an average period of 6 months, and functional and radiological outcomes were assessed.

Results:

Patient related wrist evaluation system showed all groups had minimal functional disability. Radiological assessment by Sarmiento et al. modifi cation of Lidstorm’s scoring showed that 33.3% patients in Group 1A had poor radiographic scores, 50% patients in Group 1B had good radiographic scores whereas, in Group 2, 53.3% patients had fair radiographic scores. Functional results were not found to be correlated with radiological outcomes.

Conclusion:

In elderly patients, patients having low functional demands or patients presenting to us late and not willing for any surgical treatment, mal-alignment, and articular incongruence can be accepted, as radiological outcomes in this study does not correlate with the functional outcomes.
KEY WORDS
Colles, conservative, distal radius, elderly, low demand, patient related wrist evaluation.

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Intrauterine fetal death_Mathuria

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Evaluation of intrauterine foetal death at tertiary care center
Mathuriya G,1 Bunkar N2
Associate Professor,1 Resident2
1-2Department Department of Gynaecology & Obstetrics, M.G.M. Medical College & M.Y. Hospital, Indore, Madhya Pradesh, India
ABSTRACT
Aims and Objectives:To identify the risk factors and to evaluate measures, to reduce complications, and to improve maternal outcome.Materials and Methods:

This was a prospective study from December 2012 to December 2013 which was conducted at M.G.M. Medical College and M.Y. Hospital, Indore, Madhya Pradesh, India, in the Department of Obstetrics & Gynecology. All the patients are having fetal death beyond 20 weeks of gestation and/or birth weight >500 g were included in the study. Maternal and fetal outcome were analyzed. Mode of delivery and associated complications were studied.

Results:

Total numbers of deliveries were 13500. Incidence of intrauterine death (IUD) at our center was 38.30 per 1000. 68.83% were antepartum, and 36.17% were intrapartum. Congenital malformations were responsible for 12.77% cases. Among the identifi able causes, placental causes (17.99%), and hypertensive disorders (15.47%) were most common followed by severe anemia (6.58%). The most devastating complication of IUD was disseminated intravascular coagulation (DIC) found in 28 patients (5.42%).

Conclusion:

The present study has emphasized upon the need for augmentation of health services for the pregnant mother, because the extra attention paid to the mother during the pregnant state goes a long way in improving both maternal and fetal survival. The majority of fetal deaths in our study could have been prevented by appropriate antenatal and intranatal care. Decrease in the incidence of IUD would signifi cantly reduce the perinatal mortality.
KEY WORDS
Antepartum foetal deaths, disseminated intravascular coagulation, intrapartum foetal deaths, intrauterine foetal death.

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