Laparoscopic assisted reduction of jejuno-jejunal intussusception with resection of jejunal polyp in children: A case series

Jejunojejunal intussusceptions secondary to polyp as a lead point are extremely rare. Only a few cases have been reported in the English literature. Here, we report the case series of two such cases who presented to us as irreducible intussusceptions and were managed successfully by laparoscopic-assisted transumbilical reduction and resection. Thus laparoscopic-assisted management of this rare presentation is feasible even in smaller children

Surveillance of drug-resistant tuberculosis in the state of Gujarat, India

BACKGROUND: Limited information about the prevalence of drug-resistant tuberculosis (TB) has been reported from India, the country with the world’s highest burden of TB. We conducted a representative state-wide survey in the state of Gujarat (2005 population: 56 million). METHODS: Mycobacterium tuberculosis isolates from a representative sample of new and previously treated smear-positive pulmonary TB (PTB) cases were subjected to drug susceptibility testing (DST) against fi rst-line drugs at a World Health Organization supranational reference laboratory. Isolates found to have at least both isoniazid (INH) and rifampicin (RMP) resistance (i.e., multidrugresistant TB [MDR-TB]) were subjected to second-line DST. RESULTS: Of 1571 isolates from new patients, 1236 (78.7%) were susceptible to all fi rst-line drugs, 173 (11%) had any INH resistance and MDR-TB was found in 37 (2.4%, 95%CI 1.6–3.1). Of 1047 isolates from previously treated patients, 564 (54%) were susceptible to all fi rst-line drugs, 387 (37%) had any INH resistance and MDR-TB was found in 182 (17.4%, 95%CI 15.0–19.7%). Among 216 MDR-TB isolates, 52 (24%) were ofl oxacin (OFX) resistant; seven cases of extensively drug-resistant TB (XDR-TB) were found, all of whom were previously treated cases. CONCLUSION: MDR-TB prevalence remains low among new TB patients in Gujarat, but is more common among previously treated patients. Among MDR-TB isolates, the alarmingly high prevalence of OFX resistance may threaten the success of the expanding efforts to treat and control MDR-TB