A case of hereditary sensory and autonomic neuropathy type 4 presenting with chronic trophic ulcers

Hereditary Sensory and Autonomic Neuropathy (HSAN) is a rare group of diseases involving varying degrees of peripheral nervous system. It is classified into five main types. HSAN type 4 is associated with insensitivity to pain and temperature and anihidrosis. The method of this study was to authors present a case report of a 3 year-old boy with Hereditary Sensory and Autonomic Neuropathy Type 4 presenting with chronic ulcers. Conclusions of this study was to HSAN type IV is a rare condition. There is no definitive treatment available presently for this condition

A clinico-radiological study of mild traumatic brain injury using the national emergency x-radiation utilization study decision instrument

Background: While traumatic Brain Injury (TBI) is one of the leading causes of morbidity and mortality in the Indian subcontinent, little is known regarding its basic characteristics. While CT scanning plays an important role in primary assessment of TBI, it is not always indicated in cases of mild TBI. Thus, the present study was carried out to describe the characteristics of cases of mild TBI presenting to a tertiary care hospital in India and determine the need for CT scanning in them using the National Emergency X-radiation Utilization Study (NEXUS) decision instrument.Methods: In this prospective study, a detailed history was obtained, and clinical examination performed for each patient, followed by calculation of the NEXUS score. CT scan findings were recorded. Outcome measures were safe discharge, need for neurosurgical intervention or death.Results: Out of the 425 patients, 87.05% were males. Road Traffic Accident (RTA) was the most common mode of injury. 206 patients had significant intracranial injuries, with skull fractures and hemorrhagic contusions being the most common.138 out of these 206 had a positive NEXUS score. ENT bleed and history of loss of consciousness were also found to be important predictors of significant intracranial injuries. 83 patients were discharged safely from the emergency department, 14 required neurosurgical intervention and 2 died during the course of their stay in the hospital. Conclusions: NEXUS decision instrument can be a useful tool to determine the need for CT scanning in patients of mild TBI

A case of an uncorrected double outlet right ventricle with ventricular septal defect in pregnancy

Congenital Heart Diseases (CHD) lead to various changes in the normal mechanisms of hemodynamics. Pregnancy in women with CHDs is rare. Double Outlet Right Ventricle (DORV) is a rare disorder, in which both the aorta and the pulmonary artery arise from the right ventricle. We present a case of a thirty-year-old pregnant woman who presented to us with 22 weeks of amenorrhea. She had DORV with VSD, which was undiagnosed till she came to our hospital. Double Outlet Right Ventricle (DORV) is a rare congenital heart disease. Pregnancy in a patient with DORV needs early diagnosis and a stepwise multidisciplinary approach for successful outcomes