Medicolegal Consequences of Death due to Stevens Johnson Syndrome: A Case Report

Conditions like Stevens Johnson syndrome are very rare and mortality arising out of it is still a rarest entity. It is immune complex mediated hypersensitivity reaction; most common factors to trigger the immunity are drugs, followed by infection with various organisms, which starts the chain of events in SJS. It sometimes associated with HLA Antigen and 25-50% cases are idiopathic. In present case an emphasis is given on progression of this life threatening condition, mode of death, responsibilities of the physician and legal as well as criminal consequences arise out of it while treating such cases

Glycan based detection and drug susceptibility of influenza virus

ABSTRACT: We have developed a panel of synthetic glycans as receptor mimics for the specific capture of influenza viruses. The glycans were printed onto commercial glass slides using a free amine at the end of a spacer to generate a small focused microarray. The microarray was evaluated for its ability to capture three different strains of influenza A virus, two H1N1, A/Brisbane/59/2007 and A/Solomon Islands/3/2006 and one H3N2, A/Aichi/2/1968. We observed an excellent detection ability with some compounds exhibiting clinically relevant (101 plaque forming units) limit of detection. We also tested the drug susceptibility of current antivirals, Zanamivir and Ostelamivir using this microarray and could determine antiviral resistance for these strains

CLINICAL COURSE OF FETAL PELVI-CALYCEAL DILATATION DIAGNOSED ON EARLY SECOND TRIMESTER ULTRASOUND.

Aims and Objectives: Incidental finding of fetal pelvi-calyceal dilatation is common finding on early second trimester anomaly scan. [18 to 23 weeks] It causes significant parental anxiety. The present study aims to apply stringent criteria for accurate assessment.  It also studies the natural course of such findings, pathological cause for such findings and its postnatal outcomes.&#x0D; Study Design: This study includes 9500 cases that underwent anomaly at 18 to 23 weeks gestation period.&#x0D; &#x0D; The fetal pelvi-calyceal dilatation [PCD] was diagnosed and categorized according to criteria set by European Society for Pediatric Radiology [ 1]. PCD 0 – renal calyces and pelvis not or hardly visible. PCD 1 – renal calyces not visible and axial renal pelvis diameter is less than 7 mm. PCD 2 – some calices are visible but with normal forniceal and papillary shape, axial renal pelvis less than 10 mm. PCD 3 - marked dilatation of calices and pelvis. Pelvic axial width usually more than 10 mm with flattened papilla and rounded fornices but without parenchymal thinning. PCD 4- gross dilatation of entire collecting system and thinning of renal parenchyma. PCD 5- Only thin membrane like residual renal parenchymal rim.&#x0D; &#x0D; Result: Among 9500 women who underwent routine anomaly scan at 18 to 23 weeks gestation, total 390 had PCD findings [4.1 %] Single kidney taken as one case while bilateral findings were taken  as 2 cases.&#x0D; 98 [25.1 %] pregnancies had bilateral PCD findings and rest 292[74.9%] had unilateral PCD changes. These findings correlate well with as shown by S Sairam et al, Livera et al, Gunn et al [2, 3, 4]  &#x0D;  PCD 1 findings were noted in 317 cases, PCD2 findings were noted in 38 cases, PCD3 findings in 23 cases and PCD4 findings in 12 cases. All these fetuses were followed till either PCD findings resolved naturally or till 2 years of their life. These findings also compare well with S Sairam et al, and Persutte et al [ 2, 5]&#x0D; About 00 cases of PCD1, 3 cases of PCD2 and 2 cases of PCD3 were lost for follow up for various reasons.&#x0D; Two cases of PCD1 were lost due to additional diagnosis of Down syndrome in one case and multiple anomalies in other cases. Both were excluded from the present study.&#x0D; Rest of them [383] were studied and analyzed for this paper.&#x0D; Out of 315 PCD1 cases, all turned out to be normal&#x0D; Out of 35 PCD2 cases,   19 were resolved, 12 remain unchanged at second year of child age rest were&#x0D; 4 worsened&#x0D; Out of 21 PCD 3, 2 cases resolved spontaneously, 5 remain unchanged and 14 cases worsened&#x0D; Out of 12 PCD 4 cases, all needed and underwent surgical intervention. 04 kidneys were saved and rest 8 had nephrectomies.</jats:p

ROLE OF TRANSVAGINAL SONOGRAPHY IN FIRST TRIMESTER VAGINAL BLEEDING

Vaginal bleeding during the first trimester has been estimated to occur in 16% of all pregnant women, while the frequency of spontaneous abortion is estimated at around 10-20%. The clinical approach though helpful here is not of much value. Despite the latest technological developments and laboratory diagnosis the desired goal of early recognition is not achieved.&#x0D;  This study was therefore planned with an objective to evaluate role of ultrasound in patients with first trimester vaginal bleeding. It was an Hospital based study where in a total 300 cases presented with complaint of bleeding per vaginum during first trimester, were enrolled for study. All patients underwent trans-abdominal and transvaginal sonography. About 60 % patients had normal viable pregnancy at time of initial sonography. Rest of the cases had a variety of abortions and other pregnancy related complications. Some of the conditions like molar pregnancy and ectopic pregnancy were life threatening and required immediate clinical intervention. &#x0D; The Ultrasonographic examinations were done per abdominally by using ultrasound equipment. In the present study normal live embryo with subchorionic bleed was the most common cause of first trimester bleeding. Various types of abortions constituted the second commonest cause of first trimester bleeding. All cases were diagnosed correctly on ultrasonography with 100% sensitivity and accuracy and managed appropriately. Hence it can be suggested that ultrasound helped in establishing correct diagnosis timey and decides the line of management (1)&#x0D; Keywords: Vaginal bleeding, first trimester, transvaginal sonography.</jats:p