Comparative evaluation of FESS and septoplasty with FESS in cases of DNS with chronic maxillary sinusitis

Background: Present study compares basic FESS and septoplasty with FESS alone in DNS with maxillary sinusitis.Methods: Sixty patients of DNS with chronic maxillary sinusitis were divided into two groups alternatively. After pre-operative symptoms score and computerized tomography (CT scan), twenty patients underwent FESS with septoplasty (group A) and other 20 underwent FESS alone (group B) under local anaesthesia and topical 4% lignocaine with 1:1000 adrenaline. At 6 weeks, post-operative symptom score and CT scan findings were documented and compared statistically by using unpaired student t-test.Results: Ninety six percent of patients in group A and 87.6% in group B have shown complete improvement in facial pain/pressure. Ninety three percent of patients in group A and 83.3% in group B have shown complete improvement in headache. Ninety percent patients in group A and 63.3% in group B has shown complete improvement in nasal obstruction. Seventy six percent of patients in group A and 63.3% of patients in group B have shown complete improvement in nasal discharge. Eighty six percent and 63.3% of patients in group A and group B respectively were satisfied from the surgery. Ninety three percent of patients in group A and 70% in group B were found to have normal maxillary sinus mucosa on HRCT nose and PNS after 6 weeks following surgical treatment. Hundred percent patients in group A and 96.7% of patients in group B were found to have normal OMC on HRCT nose and PNS 6 weeks after surgery.Conclusions: It was observed that FESS with septoplasty is effective for the treatment of chronic rhinosinusitis with deviated nasal septum on VAS as well as radiologically (the Lund and Mackay staging system: radiologic staging) than FESS alone

Spontaneous cholecysto-cutaneous fistula draining through an old abdominal surgical scar

BACKGROUND: Though cholelithiasis and cholecystitis are common clinical problems, spontaneous cholecysto-cutaneous fistula is a rare complication of cholelithiasis in present-day practice. Very few cases have been reported in literature after 1950s. CASE REPORT: A 60-year-old male presented with pain and discharging sinus in the upper abdomen. Ultrasonography and computed tomography confirmed the presence of perforation of the gall bladder and cholecysto-cutaneous fistula. External opening of the fistula was overlying an old surgical scar. Less than five cases of spontaneous cholecysto-cutaneous fistula draining through an old surgical scar have been reported in literature. Initially, the patient was managed conservatively, followed by elective open cholecystectomy and excision of the fistula tract. CONCLUSIONS: Though very rare in the present era of advanced medical care, cholecysto-cutaneous fistula as a potential diagnosis should be kept in mind in patients presenting with acute upper abdomen pain and discharging sinus. High degree of suspicion is required for early diagnosis and treatment of this condition

Isolated fracture of lateral pterygoid plate by penetrating foreign body : a rarity indeed

BACKGROUND: Fractures of mid-face were first described by Le Fort and are classified into three categories - Le Fort I, Le Fort II and Le Fort III. The pterygoid processes of the sphenoid bone are fractured in all the three categories of Le Fort fractures as the sphenoid bone connects the cranium vault to the facial bones. Fractures of the pterygoid processes without associated Le Fort fractures are rare and are usually associated with fractures of the mandible, temporal bone or other facial bones. An isolated fracture of pterygoid plates without associated Le Fort fractures or fractures of other mid-face bones are exceedingly rare. CASE REPORT: We present a case of an isolated fracture of the right lateral pterygoid plate by a penetrating foreign body (wooden twig) in an adult male who presented with discharging sinus in the oropharynx. The presence of the foreign body was confirmed on computed tomography and was removed under general anesthesia via submandibular incision. The patient had an uneventful postoperative hospital stay and was asymptomatic on a follow-up five months later. CONCLUSIONS: This article emphasizes the fact that pterygoid plates may be fractured without an associated Le Fort fracture or a fracture of the mandible. This is the first case of an isolated pterygoid plate fracture in the literature

Giant atretic occipital lipoencephalocele in an adult with bony outgrowth

BACKGROUND: We present unique case of a giant extracranial atretic occipital lipoencephalocele in an adult patient with new bone formation within it which was not associated with any developmental malformation of brain. Resection of the lipoencephalocele was performed for esthetic reasons. CASE REPORT: 18 year old female patient presented to the surgery OPD with complains of a large mass in the occipital region present since birth. It was of size of a betel nut at the time of birth and gradually increased in size over a long period of time. It was painless and not associated with any other constitutional symptoms. On examination the rounded fluctuant mass was present in the midline in occipital region covered with alopecic skin with dimpling in the overlying skin. On MRI there was mass showing both T1 and T2 hyperintense signal area suggestive of fat component. Herniation of meninges and atretic brain parenchyma was also seen through a defect in the occipital bone in the midline. There was a Y shaped bony outgrowth seen arising from occipital bone into the mass which was quite unusual in association with an atretic lipoencephalocele. CONCLUSIONS: A large lipoencephalocele with bony outgrowth in an adult patient is a rare presentation of atreic occipital encephalocele

To Compare Diagnostic Ability of Contrast-Enhanced Three-Dimensional T1-SPACE with Three-Dimensional Fluid-Attenuated Inversion Recovery and Three-Dimensional T1-Magnetization Prepared Rapid Gradient Echo Magnetic Resonance Sequences in Patients of Meningitis

Aims: The aim of this study is to compare postcontrast three-dimensional (3D) T1-Sampling perfection with application-optimized contrasts by using different flip angle evolutions, 3D fluid-attenuated inversion recovery (FLAIR), and 3D T1-magnetization prepared rapid gradient echo (MPRAGE) sequences in patients of meningitis. Settings and Design: A hospital-based cross-sectional study done in the Department of Radiodiagnosis, IGMC Shimla for a period of 1 year from June 1, 2016, to May 30, 2017. Subjects and Methods: A total of 30 patients suspected of meningitis underwent magnetic resonance imaging evaluation with postcontrast 3D T1-MPRAGE, 3D T1-SPACE, and 3D FLAIR sequences. The abnormal leptomeningeal enhancement was noted by two radiologists together on these sequences and scores were given to the abnormal leptomeningeal enhancement. Statistical Analysis Used: The sensitivity of 3D T1-SPACE, 3D T1-MPRAGE, and 3D FLAIR was calculated and compared. The level of agreement between these sequences was assessed by kappa coefficient. P < 0.05 was taken as statistically significant. Results: 3D T1-SPACE shows superiority in meningeal enhancement along basal cisterns, Sylvian fissure and along cerebral convexities. It is also found to be better in delineating parenchymal lesions. 3D FLAIR failed to demonstrate enhancement along cerebral convexities however found to be better than 3D T1-MPRAGE in delineating enhancement along basal cisterns and Sylvian fissures. 3D T1-MPRAGE has shown subtle enhancement in basal cisterns, Sylvian fissure and along cerebral convexities. 3D T1-SPACE, 3D FLAIR, and 3D T1-MPRAGE has sensitivity of 91.67%, 66.67%, and 54.17%, respectively. Conclusion: Postcontrast 3D T1-SPACE sequence is an excellent tool than postcontrast 3D T1-MPRAGE and 3D FLAIR sequences in the evaluation of meningeal enhancement and depiction of additional lesions in brain parenchyma

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Portfolio of Outpatients Attending Centre for Urban Health, Madhya Pradesh, Central India

Background: Knowledge on distribution and burden of diseases in a community is essential for planning of public health services. In the absence of information on morbidity profile through community-based surveys, facility-based data provide a good alternative. The aim of this study was to describe the morbidity profile of patients attending the Centre for Urban Health All India Institute of Medical Sciences (AIIMS) Bhopal (CUHA). Methodology: A record-based descriptive study was carried out in the CUHA Bhopal, Madhya Pradesh, Central India. Information on age, gender, residence, new case, and principal diagnosis were extracted from the outpatient registers for the period between January 2014 and December 2014. Only newly registered patients for the study year (2014) were included. Descriptive analysis was done. Results: A total of 6685 new episodes of illnesses were treated. Adults (>15 years) constituted about 85.0%. Overall, the respiratory disorders were the most common (27.2%) followed by the digestive disorders (10.9%), circulatory disorders (9.9%), musculoskeletal disorders (8.8%), and infectious and parasitic disorders (7.4%). Conclusion: This study gives a brief description of the morbidity profile of patients attending a primary health care center over a period of 1 year. This knowledge would help in planning health services to meet the patients’ needs and help in training health staff

Ramji Gupta et.al Indian Journal of Research in Pharmacy and Biotechnology ISSN: 2321-5674(Print) ISSN: 2320 – 3471(Online) Anti-osteoporotic effect of Urtica dioica on ovariectomised rat

This study was undertaken to check the anti-osteoporotic activity of Urtica dioica on ovariectomised (OVX) rats. Bilateral ovariectomy was performed in rats under aseptic condition and ether anaesthesia. Healthy albino rats were randomly divided in to 4 groups of 6 animals each. First group Assigned by sham operated and served as control, all remaining are Ovariectomy. Group (II) is ovearctomised control, group (III) Urtica dioica extract (20mg/kg), group (IV) treated with Raloxifene (5.4mg/kg as standard drug) respectively for 8 weeks. At the last of study blood wear collected to estimate serum calcium (Ca), phosphorus (Ph), bone specific alkaline phosphate (b-Alp) and osteocalcin (OC) level. Rats were euthanized femur, liver and uteri wear taken for bone analysis and weighed respectively. Result indicate that ovariectomy(OVX) gp show increased serum calcium (Ca), phosphorus (Ph), bone specific alkaline phosphate (b-Alp) and osteocalcin (OC) level also decreased Bone Mineral Density (BMD), Ca + in bone ash. Femur and uterine wear weighted. When OVX gp treated with Urtica dioica (200mg/kg) it normalise all elevated serum calcium (Ca), phosphorus (Ph), bone specific alkaline phosphate (b-Alp) and osteocalcin (OC) level and increased femur, uterine weight, it also increased BMD and Bone Volume. This study assess on the basis of biochemical, biomechanical parameter which show that administration of Urtica dioica is beneficial for women who are suffering for postmenopausal osteoporosis due to its good antiosteoporotic activity. KEY WORDS: Ovariectomised rats, osteocalcin, alkaline phosphate, BMD, Bone fragility 1