An unusual anomaly of deep venous system in the lower limb: Complete unilateral agenesis of iliofemoral veins in the absence of persistent sciatic vein

Venous anomalies are the most common congenital vascular anomalies. The rarest of these is complete deep venous agenesis. Here,we report a case of a 15-year-old male patient evaluated on color Doppler and computed tomographic venogram with complete rightiliofemoral deep venous agenesis with the inferior vena cava continuing as the left common iliac vein and the right popliteal veindraining into superficial anomalous veins of the thigh. These superficial veins were seen to drain through a superficial suprapubicarcuate connector vein into the dilated left common femoral vein. Uniquely in our case, there was no persistent embryonic sciaticvein and no demonstrable reflux into the superficial connector vein, suggesting an uncommon embryological mechanism underlyingits pathogenesis. Surgical resection of the dilated superficial veins is absolutely contraindicated in cases of deep venous agenesis andhence accurate diagnosis by the radiologist is absolutely essential in such cases

Atypical exophytic liver mass: Giant pedunculated hepatic haemangioma masquerading as a gastrointestinal stromal tumour of the gastric wall

Haemangioma is the most common benign tumour of the liver. However, an exophytic hepatic haemangioma, especially the pedunculated form, is very rare. Giant pedunculated haemangiomas are prone to complications because of the narrow size of the pedicle. A large number of lesions can potentially present as exophytic liver masses, and accurate diagnosis can sometimes be challenging. We report a case of an incidentally discovered asymptomatic giant pedunculated liver haemangioma in the region of the lesser sac in a prospective renal donor, which was initially suspected to be a gastrointestinal stromal tumour of the stomach wall. Multiphasic computed tomography and confirmatory magnetic resonance imaging scans ultimately revealed the true nature of the lesion, which turned out to be an exophytic pedunculated hepatic haemangioma from the left lobe of the liver. The lesion was then surgically resected and histopathologically confirmed to be a haemangioma. The patient subsequently underwent successful renal donation as planned. Being a benign lesion with characteristic imaging features, accurate radiological diagnosis is absolutely essential for the appropriate management of such atypical haemangiomas

Water quality under the changing climatic condition: a review of the Indian scenario

The current work reviews the state of Indian water quality under the climate change regime. Rising temperatures will lead to higher concentration of pollutants like nutrients (nitrates, phosphates etc.), persistent organic pollutants and pesticides. Probable negative consequences include increase in harmful algal blooms, toxicity hazards in people etc. Rising temperatures could lead to release of higher amounts of fluoride and uranium due to prevalence of drier oxic conditions, and also arsenic due to release from iron (hydr)oxides. Implications on emerging contaminants, a new class of pollutants without any regulatory status, is not clearly understood. Prevalence of microbes in water is also predicted to increase. Coastal aquifers appear to be at risk from salt water intrusion. Conflicts on the international and national platform is predicted to rise due to issues with sharing of water. Lastly, we also discuss the sustainability options for water in India under a changing climatic regime, under three broad subcategories signifying the roles of (1) science, (2) policies and legal framework and the (3) people perspective, while also highlighting the existing lacunae.by Nilotpal Das, Chandan Mahanta and Manish Kuma