Demography and clinical profile of patients with chronic pancreatitis in a tertiary referral hospital in eastern India

Background: Chronic pancreatitis is defined as a pathological fibro-inflammatory syndrome of the pancreas in individuals with genetic, environmental and/or other risk factors who develop persistent pathological responses to parenchymal injury or stress. Potential causes can include toxic factors (such as alcohol or smoking), metabolic abnormalities, idiopathic mechanisms, genetics, autoimmune responses and obstructive mechanisms. We studied the epidemiological patterns in relation to age, sex and socioeconomic status, the etiological factors and pattern of clinical presentations. the different modes of management of chronic pancreatitis.Methods: This prospective study on chronic pancreatitis was conducted in 55 patients admitted in Srirama Chandra Bhanja Medical College and Hospital (SCB M. C. H.), Cuttack, general surgery and surgical gastroenterology department.Results: In the study sample 37 patients (68%) were male and 18 patients (32%) were female. the etiological distribution of the study sample is shown. 29 patients (53%) showed topical etiology, 21 patients (37%) showed alcoholic and 5 patients showed idiopathic. The sign and symptoms (clinical) of the study sample, 54 patients (98%) showed abdominal pain, 26 patients (47%) had diabetes (type 2), 1 patient showed steatorrhea, 2 patients (4%) had jaundice, 2 patients (4%) had pseudocyst and 1 patient (2%) had ascites. Surgical drainage procedure performed on the patients 23 patients (42%) underwent Pvestow lateral (longitudinal) pancreatic jejunostomy, 18 patients (33%) underwent frey, 7 patients (13%) had lateral pancreatic jejunostomy,1 patient (2%) had V section, 1 patient (2%) underwent whipple, 3 patients (5%) had cystogastrostomy and cystodudenostomy and 2 patients (3%) underwent cholecystojejunostomy.Conclusions: The study revealed Puestow’s procedure was the most commonly performed surgical drainage procedure with satisfactory results

Environmentally relevant concentrations of Cadmium impair morpho-physiological development and metamorphosis in Polypedates maculatus (Anura, Rhacophoridae) tadpoles

Cadmium (Cd) poisoning has been globally reported causing detrimental health issues with severe toxic effects on certain physiological systems. Here the effects of different concentrations of Cadmium were assessed on the metamorphosis and development of common Indian tree frogs (Polypedates maculatus, Gray 1830). The tadpoles were exposed to environmentally relevant concentrations (up to 0.7 mg/l) of Cd in dechlorinated water from the larval stage to adulthood. Survival, growth traits (body length and body mass), external deformities and movement were some of the morpho-physiological characters compared between control and experimental samples. Followed by the determination of acute toxicity (median lethal concentration–LC50– after 24 h (5.603 mg/l) and 48 h (4.811 mg/l) of exposure), impacts associated with chronic toxicity of Cd to the tadpoles were inspected. The study showed multiple physiological deformities in the tadpoles chronically exposed to 0.5 and 0.7 mg/l Cd that included morphological malformations, pale skin colour, insipid motility, delayed metamorphosis and even high mortality. In addition to that, the tadpoles treated with 0.5 and 0.7 mg/l Cd showed significantly lesser growth traits than the controls over the study period. The paper aims to contribute in increasing ecotoxicological knowledge of an anuran species from which there is not much information of this type. Given the wide geographical distribution of the study species, it can serve as a bio-indicator of cadmium contamination, considering its applicability across a large swath of aquatic ecosystems in the Indian subcontinent

A rare case of mature teratoma. Has FDG PET/CT a role to play?

Authors describe a very rare case of mature teratoma with malignant transformation, preoperatively suggested by FDG PET/CT study. So the role of CT component in elucidating three embryonal components and hypermetabolism evident on PET part suggesting possible malignant transformation makes PET/CT a valuable modality in evaluation of these rare tumor

Options in the management of solid visceral injuries from blunt abdominal trauma

Non-operative management of solid visceral injuries from blunt abdominal trauma, especially in stable patients, has become the order of the day in developed countries. However, the safety and feasibility of such an approach in the absence of modern amenities like CT, angiography and ICU support has remained a point of controversy. This prospective study analyzes the manifestations, management and outcome of solid visceral injuries in 72 patients with blunt abdominal trauma, relying solely on readily available diagnostic modalities, viz. abdominal X-ray, ultrasonography and paracentesis, in the setting of a hospital lacking CT and ICU support. Road traffic accident was the most common mechanism of blunt abdominal trauma in our study, most victims being males in the third decade of life. Chest injury was the predominant associated injury (26%), but head injury was the most common extra-abdominal injury causing death. Plain abdominal X-ray accurately diagnosed all 3 cases of intestinal injury. Abdominal ultrasonography had a sensitivity of 89%, specificity of 100%, and accuracy of 100% in diagnosing abdominal solid visceral injuries. The sensitivity, specificity and accuracy of diagnostic paracentesis in detecting hemoperitoneum, were 82%, 86% and 90% respectively. 39% patients were ultimately subjected to laparotomy. Frequency of solid visceral injuries encountered were: liver 47.9%, spleen 29.2%, kidneys 14.6% and pancreas 8.3%. Organ salvage was possible in 90.3% of operated cases. Postoperative morbidity was 26%, mostly due to chest and wound infections. Non-operative morbidity rate was 20% with failure of non-operative management occurring in 10% cases. The overall mortality was 21%. All deaths in the non--operative group (mortality 9%) were due to associated head injury, whereas deaths in the operative group (14% mortality) were a consequence of the abdominal trauma and/or surgery. The average number of blood transfusions received by patients in the non-operative and operative groups were 0.5 and 3.0 respectively. The average duration of hospital stay was 7.8 days for the non-operative group and 10.4 days for the operative group. Thus, a multipronged approach employing abdominal X-ray, ultrasonography and diagnostic paracentesis, correlated with clinical findings, can be fairly useful and accurate in early diagnosis and management of solid visceral injuries from blunt abdominal trauma at a limited-resource set-up lacking CT and ICU support, with acceptable morbidity and mortality

Comparison of Magnetic Resonance Imaging and Mammography in the Evaluation of Carcinoma BreastA Longitudinal Observational Study

Introduction: Breast cancer is the most common malignancy in females worldwide. Mammography is a useful tool to diagnose breast cancer. Magnetic Resonance Imaging (MRI) has similar sensitivity like mammography to diagnose breast cancer, however MRI is more sensitive in diagnosing breast cancer in young females and patients with family history of breast cancer. Aim: To compare the sensitivity and specificity of MRI and mammography in the diagnosis of breast cancer. Materials and Methods: This was a longitudinal observational study done in the General Surgery Department of the study institute, from April 2018 to January 2020. Total 228 patients participated in the study. All patients, suspected to have breast cancer clinically, underwent mammography and MRI. The diagnosis was later confirmed by histopathological examination. The sensitivity and specificity of both MRI and mammography were determined by comparing with the results of histopathological examination using student’s t-test. Results: All 228 patients were females. In the study, it was found out that the sensitivity of mammography and MRI was 95% and 95.83%, respectively, in detecting breast cancer. The specificity of mammography and MRI was 89.28% and 83.33%, respectively. However, the differences were statistically non significant. Conclusion: From the study, it was found out that the sensitivity and specificity of MRI and mammography is similar in detecting breast cancer

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