iosr-JDMS   Volume-14 ~ Issue-1 ~ January-2015

Abstract: Orbital and adnexal involvement in leukemia can occur as granulocytic sarcoma which is an infiltration of the soft tissues with myeloid leukemic cells in children.We investigated a 7-year old male child with mild proptosis, large masses in each of his upper lids and the fronto-temporal area and clinical features of endophthalmitis left eye. Histopathology showed blasts cells arranged in scattered singles and diffusely infiltrating fragments of skeletal and fibroconnective tissue with occasional eosinophilic myelocytes. Peripheral smear examination showed numerous type II myeloblasts.A diagnosis of granulocytic sarcoma both lids in a case of acute myelogenous leukemia with endophthalmitis left eye was given.

Keywords: Acute myeloid leukemia, Endophthalmitis, Granulocytic sarcoa,, Lid involvement

[1] J.A Shields, Eyelid, conjunctival, and orbital tumors: an atlas and textbook (Philadelphia: Lippincott Williams & Wilkins, 2008)
[2] C.W Taylor, Leukemic infilteration of the orbit: report of three cases and literature review, Pediatr Hematol Oncol, 22 (4),2005, 15-22.

Abstract: Background: The safety of the technique of uterine exteriorisation during Caesarean delivery though popular among obstetricians, remains controversial. Objective: To evaluate the effect of exteriorisation of uterus during uterine repair on Caesarean morbidity. Method: In this hospital based prospective study 200 women who underwent Caesarean delivery, were included. The women were randomly allocated in two groups 100 of each. Variables analysed were operative time, perioperative blood loss, length of hospital stay and postoperative morbidities. Results: The estimated perioperative blood loss, period of hospital stay and post operative febrile morbidity were significantly less in the exteriorised group than the intra-abdominal group, (P = 0.001, 0.001 & 0.005 respectively). Operative time is little shorter in exteriorisation group as compared to intra abdominal group. But there was no significant difference between two groups with respect to other outcome measures. Conclusion: Exteriorisation of uterus for repair following Caesarean delivery is not associated with significant problems and it is associated with less blood loss, shorter operative time, decreased hospital stay and less febrile morboidity.

KeyWords: Caesarean section, Uterine repair, Exteriorisation, Intra-abdominal repair, Maternal outcome, Neonatal outcome.

[1]. Young JH. The History of Caesarean Section. London : HK Lewis & Co, 1944.

[2]. Phaneuf LE. Caesarean section followed by temporary exteriorization of uterus: Fortes operation. Surg Gynecol Obstet 1927; 44: 788-792.

[3]. Hershey DW, Quilligan EJ. Extraabdominal uterine exteriorisation at Caesarean section. Obstet Gynecol 1978; 52; 189-192.

[4]. Magann EF, Dodson MK, Allbert JR, McCurdy CM, Martin RW, Morrison JC. Blood loss at time of Caesarean section by method of placental removal and exteriorisation versus in situ repair of the uterine incision Surg Gynecol Obstet 1993; 177: 389-392.

[5]. Magann EF, Washbume JF, Harris RL, Bass JD, Duff WP. Morrison JC. Infectious morbidity, operative blood loss, and length of the operative procedure after Caesarean delivery by method of placental removal and site of uterine repair. J Am Coll Surg 1995; 181: 517-520.

[6]. Kumar SA. Exteriorization of uterus at caesarean section. J Obstet Gynecol India2003;53(4):pp353-358.

Abstract: AimsAndObjectives:1.toevaluate the result of intra operative mitomycinc in dacryocystorhinostomycompared with the result of conventional dacryocystorhinostomy. 2To evaluate the efficacy of mitomycin c in maintining the patency of lacrimal passage after external dacryocystorhinostomy.
Methods: Our study is a prospective comparative case study in which 50 patients of primary acquired nasolacrimal duct obstruction were divided on the basis of random sampling into the conventional dacryocystorhinostomy group and the Mitomycin C group in which Mitomycin C 0.2 mg/ml was used intraoperatively. Patients were followed on 1st postoperative day, 1stweeak1st,month , 3rd and 6th months.. Patency of lacrimal passage was assessed by lacrimal syringing and patient symptoms were recorded on each follow-up.

[1]. Liao L.S., Kao S.C.S., Tseng J.H.S., Chen M.S., Hou P.K. Results of intraoperative mitomycin C application in dacryocystorhinostomy. Br J Ophthalmol. 2000;84:903–906. [PubMed]
[2]. Chieh-Chih Tsai, Hui-ChuanKau, Shu-Ching Kao, Wen-Ming Hsu, Jorn-Hon Liu. Efficacy of probing the Nasolacrimal duct with adjunctive Mitomycin C for epiphora in adults.Ophthalmology. 2002;109(1):172–174. [PubMed]
[3]. Nerad J.A. Lacrimal surgery. Section VI. In: Bosniak Stephen., editor. Principles and practice of ophthalmic plastic and reconstructive surgery. 1st ed. WB Saunders Company; Philadelphia: 1996. pp. 729–834.
[4]. Duke Elder S, MacFaul PA. Diseases of lacrimal passages. In: Duke Elder, editor. The ocular adnexa in system of ophthalmology, St Louis Mosby Company; 1974. p. 675–773. (CH. X).
[5]. Iliff C.E. A simplified dacryocystorhinostomy.Arch Ophthal. 1971;85:586–591. [PubMed]
[6]. Pico G.A. Modified technique of external dacryocystorhinostomy.Am J Ophthalmol. 1971;72:679–690.

Abstract: Nevus Lipomatosus Cutaneous Superficialis: (NLCS) is a rare benign developmental anomaly characterized by accumulation of mature fat cells within the upper dermis. Two forms were described and the classical multiple formswere first reported by Hoffman and Zurhelle in 1921.The other being the solitary form. These two forms may occur at birth or may appear at later age. There is no specific gender predilection. Here we report a case of Giant classical type NLCS in a 20- year- old woman.

Keywords: Nevus Lipomatosus Cutaneous Superficialis, benign fat tumor, surgical excision

[1]. Goucha S, Khaled A, Zeglaoui F, Rammeh S et al. Nevus ipomatosuscutaneoussuperficialis: Report of eight cases, DermatolTher (Heidelb).Dec 2011; 1(2)25-30. ( http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3437641/ )
[2]. Yap FB. Nevus lipomatosussuperficialis, Singapore Med J .2009; 50(5):e161- 2. (Pub Med)
[3]. Prasad P. Neavuslipomatoides cutaneous superficialis. Indian J DermatolVenereolLeprol1995; 61:243-4

Abstract:Isoniazid also known as isonicotinylhydrazine(or INH) is the first line medication in the prevention and treatment of tuberculosis. It is an essential component of all antitubercular drugs.The other first line oral anti tubercular drugs are Rifampicin, Pyrazinamide and Ethambutol. TB is a chronic granulomatous disease which is a major health problem in India. Here we report a case a erythroderma secondary to INH. According to RNTCP this patient was given Pyrazinamide 750mg 2 tablets, Etambutol 600 mg 2 tablets, Isoniazid 300mg 2 tablets, Rifampicin 450mg 1 capsule .After 10 days of starting the treatment the patient developed Generalised exfoliative dermatitis and was diagnosed as erythroderma.The patient was admitted and ATT(anti tubercular treatment) was stopped. She was given IV fluids and IV steroids .After 2 weeks the patient recovered. Finally the patient was prescribed R,Z,E,Lfx (Rifampicin,Pyrazinamide,Ethambutol,Levofloxacin) respectively.

Keywords: INH ,erythroderma, antitubercular therapy ,tubercular lymphadenitis, Rifampicin.

[1]. James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN0-7216-2921-
[2]. a)ftp://ftp.cdc.gov/pub/nchstp/tb/...web/.../3.0%20Drug%20Resistance.ppt,b)http://harrisons.unboundmedicine.com/harrisons/ub/view/Harrisons-Manual-of-Medicine/148139/all/Antituberculosis_Treatment_Regimens_%5Btable%5D
[3]. Rosado FG, Stratton CW, Mosse CA Clinicopathologic correlation of epidemiologic and histopathologic features of pediatric bacterial lymphadenitis. Arch Pathol Lab Med. 2011 Nov;135(11):1490 http://www.archivesofpathology.org/doi/pdf/10.5858/arpa.2010-0581-OA
[4]. Product Information. Rifater (isoniazid/pyrazinamide/rifampin). Anonymous SmithKline Beecham, Philadelphia, PA.
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[6]. Van Weemen BK, Schuurs AH (1971). "Immunoassay using antigen-enzyme conjugates". FEBS Letters 15 (3): 232–236. doi:10.1016/0014-5793(71)80319-8.PMID 11945853..

Abstract: Reproductive Tract Infections and sexually Transmitted Infections are a group of communicable diseases that are transmitted predominantly by sexual contact and caused by a wide range of bacterial,viral,protozoal,fungal and ecto parasites.They constitute a huge health and economic burden for developing countries and account for 17%economic losses because of ill health.Each year nearly 1.3 million women die of reproductive health problems and are largely preventable1.The problem of RTI/STI morbidity in women is largely due to ignorance,low level of awareness,low female literacy,cultural factors and taboos – all withholding the women from seeking health care for RTI/STIs.Many of these infections are asymptomatic and unnotified (80%Gonococal and chlamydial)2.Some of the possible consequences of untreated RTI/STIs in women include menstrual abnormalities,plivic inflammatory diseases,recurrent urinary tract infections,ectopic pregnancies,tubal infertility,still births,abortions and neonatal deaths&maternal deaths4

[1]. Rita caroline Issac .An Intervention Programme for RTIs among women in a selected area in Rural Tamil Nadu,India.South East Asian Studies Manual2000;112-120.
[2]. Yasmin Irfan.Study of Reproductive Tract Infections and awareness in Tribal women in Keamari dist,Karachi,Pakistan.South East Asian Studies Manual 2000;141-142.
[3]. Mayaud P,mabey D.Approaches to the control of STIs in developing countries: old problems and modern challenges.Sex Transm INFECT 2004;80:174-182
[4]. Greeda Selvarani.An Intervention Programme for RTIs among women in a selected area in rural Tamil Nadu,India.South East Asian Studies Manual2000;121-133.
[5]. Jaya Chatyrvedi.Screening of married women in the reproductive age group for Reproductive Tract Infections in a village of Garhwal.South East Asian Studies Manual 2000;134-138
[6]. Bang RA,Bang AT,Baitule M,ChoudharyY,Sarmukaddam S&Tale O.High prevalence of gynaecological diseases in rural Indian women.Lancet,1989;14(1):85-88.

Abstract: Sturge Weber angiomatosis is a rare, nonhereditary developmental condition characterized by a hamartomatous vascular proliferation involving the tissues of brain and face. A report of a case with no facial port wine stains, and only CNs abnormality is described.

Keywords: sturge weber syndrome III,neurocutaneous markers, convulsion.

[1]. Chaundhary SC, Sonkar SK, KumarV, GolchhaS, Sturge Weber Syndrome, J Associ Physicians India, 2011 May:59:327-9 (Abstract)
[2]. The Sturge Weber Foundation: http://www.sturge-weber.org
[3]. National Institute of Neurological Disorders and Stroke: http://www.ninds.nih.gov/disorders/sturge_weber/sturge_weber.htm
[4]. http://www.seattlechildrens.org/medical-conditions/common-childhood-conditions/sturge-weber/
[5]. http://www.sturge-weber.org/medical-matters/sturge-weber-syndrome.htm
[6]. Kliegman,Stanton,St.geme,Schor,Berhman,Sturge Weber syndrome, Nelson textbook of pediatrics,19thed pg 2051-2052 [7]. Rajendran R. Benign and malignant tumors of oral cavity. In: Rajendran R, Sivapathasundharam B, editors. Shafer's Textbook of Oral Pathology. 6th ed. Noida: Elsevier; 2009. pp. 144–5.

Abstract: The incidence of a higher-order multiple pregnancy has increased during the last decades mainly due to assisted reproductive techniques. Quintuplets are a rare occurrence. This is even rarer if they are born to a woman without fertility treatment. The survival of the infants is even rarer. We here report a case of a woman who presented at 26 weeks of gestation and gave birth to five babies through vaginal route.

Keywords: Quintuplets, spontaneous conception, monochorionic monoamniotic, monochorionic biamniotic

[1]. Fellman J, Eriksson WA. On the History of Hellin's Law. Australian Academic Press. 2009;12:183–190. [2]. S Carrara, A Cavaliere, S Ermito, A Dinatale, E M Pappalardo, M Militello Case report: successful of a spontaneous quadruplet pregnancy J Prenat Med. 2009 Jan-Mar; 3(1): 10–11.
[3]. M Fatima ,P M Kasi , RRehman , S N Baloch . Quintuplets born to a woman without fertility in Pakistan. Fertil Steril. 2008 Nov;90:2007.17-20
[4]. K Francois, A Alperin,, J P Elliott. Outcomes of quintuplet pregnancies. J Reprod Med. 2001; 46: 1047–1051
[5]. I B Fajolu , V C Ezeaka,O F Adeniyi, E O Iroha, M T Egri-Okwaji. Prevalence and outcome of higher order multiple pregnancies in Lagos,Nigeria. J Matern Fetal Neonatal Med. 2013 Sep;26:1342-5
[6]. S Skrablin, I Kuvacic, D Pavicic, D Kalafatic, T Goluza. Maternal and neonatal outcome in quadruplet and quintuplet versus triplet gestation. Eur J Obstet Gynecol Reprod Biol. 2000 Feb;88: 147-52
[7]. R Chibber, M Fouda, W Shishtawy, M Al-Dossary, J Al-Hiiji, Amen A et al. Maternal and neonatal outcome in triplet, quadruplet and quintuplet gestations following ART. Arch Gynecol Obstet. 2013 Oct;288(4):759-67

Abstract: Background and Objectives: Endoscopic DCR is a surgical procedure to drain the lacrimal sac in instances of postsaccular lacrimal obstruction. The most common causes of failure of dacryocystorhinostomy are obstruction of the rhinostomy site and of the common canaliculus. Various methods to prevent the recurrence of obstruction at rhinostomy site following endoscopic dacryocystorhinostomy have been tried such as silicone stent, prolene stent, and use of Mitomycin-C and steroid nasal sprays. Stenting involves more cost and more time consuming, whereas Mitomycin-C appears to be cost-effective and simple procedure to achieve the above result. So we undertook a study to compare the results of Primary Endoscopic DCR with and without Mitomycin-C application to the rhinostomy site.

[1]. Caldwell GW, Two new operations for obstruction of the nasal duct with preservation of the canaliculi and an incidental description of a new lachrymal probe,NY Med J 1893 ; 57 : 581 – 582.
[2]. West JM. A window resection of the nasal duct in cases of stenosis,Trans Am Ophthalmol Soc 1914; 12: 654.
[3]. Mosher HP. Re-establishing Intranasal drainage of the lachrymal sac. Laryngoscope 1921; 31: 492 - 521.
[4]. Jokinen K, Karja J. Endonasal dacryocystorhinostomy. Arch Otolaryngol 1974; 100: 41-44.
[5]. Heermann J, Neues D. Intranasal microsurgery of all paranasal sinuses, the septum, and the lacrimal sac with hypotensive anesthesia. Ann Oto Rhino Laryngol 1986; 95: 631 - 638.
[6]. Mc Donogh M, Meiring JH. Endoscopic transnasal dacryocystorhinostomy. J Laryngol Otol 1989; 103: 585 – 587.

Abstract:A 2 year old female child presented with a tender visible lump progressing into an abscess in the sacral region. MRI revealed a huge sacral mass pushing the rectum anteriorly. Serum alpha fetoprotein was abnormally elevated. Histhopathological examination of the surgical specimen suggested a sacrococcygeal yolk sac tumor.

Keywords: Alphafetoprotein,MRI, sacral mass, sacrococcygeal yolk sac tumor

[1]. Merchant A, Stewart RW. Sacrococcygeal yolk sac tumor presenting as subcutaneous fluid collection initially treated as abscess. South Med J 2010 103: 1068– 70.
[2]. Pantoja MD, Rodriquez-lbanez I: Sacrococcygeal dermoids and teratomas. Am J Surg 1976 132: 377– 83.
[3]. Vijay Kumar, Pushpa Kini, Vepabomma D, Basant M. Vaginal EST: A case report. Indian J Paediatr 2005 72: 100– 1.
[4]. Davidoff AM, Hebra A, Bunin N, Shochat SJ, Schnaufer L. Endodermal sinus tumor in children. J Pediatr Surg 1996 31: 1075– 8
[5]. Brown NJ. Teratomas and yolk-sac tumours. J Clin Pathol 1976 29: 1021– 5.
[6]. Olsen MM, Raffensperger JG, Gonzalez-Crussi F, Luck SR, Kaplan WE, Morgan ER. Endodermal sinus tumor: a clinical and pathological correlation. J Pediatr Surg 1982 17: 832– 40.

Abstract: The common cold is the most frequent infectious disease in humans occurring with two to four infections in adults per year and its incidence has grown dramatically around the world. Steam inhalation is one of the most widely prevalent home made practices preferred in low income countries as its inexpensive and easily available. Decongestant inhalant capsules containing camphor, menthol, thymol, pine oil are readily commercially available. The aim of this study is to evaluate the efficacy of adjunct treatment of steam inhalation with inhalant capsules to relieve respiratory symptoms in common cold and to evaluate its side effects. 100 patients with common cold infection were taken up for study. 50 patients in study arm were given steam inhalation with inhalant capsules along with other medications. Remaining 50 patients in control arm were not given steam inhalation.

[1]. Pitkaranta A, Hayden FG. Rhinoviruses: important respiratory pathogens. Ann Med. 1998; 30: 529 - 537.
[2]. Couch RB.The common cold: control? J Infect Dis.1984; 150: 167 - 173.
[3]. Diehl HS. Medicinal treatment of the common cold. JAMA 1933; 101: 2042 - 2049.
[4]. Bender BG, Berning S, Dudden R, Milgrom H, Tran ZV. Sedation and performance impairment of diphenhydramine and second-generation antihistamines: a metaanalysis. J Allergy Clin Immunol 2003; 111(4): 770 - 776.
[5]. Singh M, Singhi S, Walia BN. Evaluation of steam therapy in acute lower respiratory tract infections: a pilot study. Indian Paediatr 1990; 27: 945 - 951.
[6]. Eccles R. Understanding the symptoms of the common cold and influenza. Lancet Infect Dis 2005; 5(11): 718 - 725.

Abstract: Nowadays mosquitos are growing every where. In this winter season, mosquito born diseases are more common. To prevent mosquito born diseases, every one is widely using mosquito repellants every where. But no one is aware of the safety usage of repellants. Recent studies show repellants are carcinogenic, teratogenic , nephrotoxic, neurotoxic and hepatoxic on basis of chronic exposure and concentration of chemical present in it. By knowing safety usage of repellants, we can prevent chronic health hazards in future generations and protect health. This is the aim this review aticle.

Key words: repellants, teratogenic, nephrotoxic, neurotoxic.

[1]. Case Studies and Management Resources http://www.icmrindia.org/free%20resources/casestudies/alloutmarketing%204.htm [2]. Cheng, V., Lee, H. R. and Chen, C. S., Toxicol. Lett., 1992, 62,163–177.
[3]. Toxicological effects of prolonged and intense use of mosquito coil emission in rats and its implications on malaria control http://revistas.ucr.ac.cr/index.php/rbt/article/viewFile/11972/11274
[4]. Liu, W. K. and Sun, S. E., Toxicol. Lett., 1998, 41, 145–157
[5]. http://www.babycenter.in/a1011642/how-do-mosquito-repellents-work
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[7]. Record in the Household Products Database of NLM

[8]. Matsuda, Brent M.; Surgeoner, Gordon A.; Heal, James D.; Tucker, Arthur O.; Maciarello, Michael J. (1996). "Essential oil analysis and field evaluation of the citrosa plant "Pelargonium citrosum" as a repellent against populations of Aedes mosquitoes".journal of the American Mosquito Control Association 12 (1): 69–74. PMID 8723261.

Abstract: The placenta has been described as the mirror of the prenatal mortality. A glance of the literature reveals that eclampsia; pre-eclampsia syndrome exerts its deleterious effect on the placenta. So, the present study was undertaken to analyse and assess the morphological variations of placenta like size, shape, weight, attachment of umbilical cord and number of cotyledons and its correlations to the neonatal weight changes in normal pregnancy, eclampsia and pre-eclampsia. A comparative morphological study of placenta between normal pregnancies complicated by toxemia was carried out.150 placenta from uncomplicated full term deliveries were considered as "control group" and 150 placentas from pre-ECLAMPSIA and ECLAMPSIA were considered as "study group".The weight of the placenta was less when compared to normal placenta in pre ECLAMPSIA and ECLAMPSIA

[1]. Nobis P and Das. Placental morphology in hypertensive pregnancy. .J. Obste and Gyane1980; 166-169.
[2]. Dutta DC. The placental and foetal membrane, hypertensive disorders in pregnancy. D.C. Dutta, Editor. Textbook of obstetrics. 5th Edition. Calcutta, India. New Central Book Agency; 2001; 28, 224.
[1]. Williams PL, Banister LH, Berry M. Early human development, Churchill Livingestone, Editor. Gray‟s anatomy the anatomicalbasis of medicine and surgery. 38th Edition. Edinburgh, London: Harcourt publishers 2000; 166.
[2]. Bandana Das, D. Dutta, S. Chakraborthy, P. Nat: Placental morphology in hypertensive disorders of pregnancy and its correlationwith foetal outcome. J. Obstetric and Gynecol India, 1996; 46(1) :40-46.
[3]. Yetter,J.F.(1998) Examination of the Placenta, American Academy of Family Physicians,57(5):1045-1054.
[4]. Claire L, Cynthia K, Trevor M, Elizabeth M, Keith P, Barasa C, Cathy M, Susan C, Guy G. Practice guidelines for examination of the placenta. Arch. Pathos. Lab .Med. 1997; 121:449-496.

Abstract: Anaemia in pregnancy is a public health problem in India, where nutrition mass education and availabiliaty and blood are far from satisfactory. It is paradoxical that the while iron is one of the least expensive and most readily available medicinal substance, its deficiency particularly in female population still presents serious problems. Low availability and absorptions of iron and repeated and closely spaced pregnancies place a constant drain on the iron stores of pregnanct women resulting in development of iron deficientl anaemia. All women who were attending antenatal check ups were asked to participate diagnosis of moderate deficiency was done by Hb and Sr. Ferritin and those who have fulfilled the criteria were enrolled after written informed consent. All patients were asked to come at day 14 and day 28 for laboratory tests. On day 14, Hb was done and on day 28 CBC, Sr. Feritin were done and at delivery Sr. Ferritin, CBC were done. The prevalence of anaemia was similar in both supplemented (88.1%) and the unsupplemented groups (87.5%) suggesting that the supplement provided was not adequate or the compliance was poor . The choice of treatment of iron deficiency anemia is oral iron replacement because it is the safest and least expensive.

Keywords: Anaemia ,iron,Hb,deficiency.

1]. Government of India. National Family Health Survey-3 (2005-06),Maternal Health. International Institute for Population Sciences 2007: Vol-I Chapter-8,191-222.
[2]. Breymann C. Iron deficiency and anemia in pregnancy: Modern aspects of diagnosis and therapy. Blood Cells Mol Dis 2002;29: 506-16.
[3]. Breymann C; Anemia working group. Current aspects of diagnosis and therapy of iron deficiency anemia in pregnancy. Schweiz Rundsch Med Prax 2001; 90: 1283-91.
[4]. Arias F.Daftary SN. Bhide AG. Practical guide to high risk pregnancy and delivery, 2008;3:465-88.
[5]. Centres for disesase control and prevention. CDC criteria for anemia in children and child bearing aged women.morb moralwklyrep1989;38:40
[6]. DiMeglio G. Nutrition in adolescence. Pediatr Rev. 2000 Jan;21(1):32-3
[7]. Aggarwal KN. Aggarwal DK .Prevalence of anemia in pregnant and lactating women in India .Indian J Med Res124,august 2006 :124(2):173-84.

Abstract: Mixed medullary-papillary thyroid carcinoma is a rare thyroid malignancy accounting for less than 1% of all the thyroid malignancies. Here we report a case of 50-year-old female with complaints of gradually increasing thyroid swelling for last 2 years. Fine-needle aspiration was suggestive of follicular neoplasm. Serum calcitonin levels were elevated. The patient underwent total thyroidectomy with regional cervical lymph node excision. Histopathological diagnosis of mixed medullary-papillary carcinoma of the thyroid was given. The aim of presenting this case is to know about this entity for its prognostic implications and to prevent diagnostic dilemmas.

Keywords: Thyroid carcinoma, mixed medullary-papillary, calcitonin.

[1] K. Akhtar, S.S. Ahmad, S. Zaheer, S.M. Vasenwala, Mixed medullary and follicular carcinoma of the thyroid - A rare entity, Medical Case Studies, 2(1), 2011, 12-14.
[2] S. Rossi, L. Fugazzola, De Pasquale L., P. Braidotti, V. Cirello, P. Beck-Peccoz, S. Bosari and A. Bastagli, Medullary and papillary carcinoma of the thyroid gland occurring as a collision tumour: report of three cases with molecular analysis and review of the literature, Endocrine Related Cancer, 12(2), 2005, 281-289.
[3] M. Papotti, G. Bussolati, P. Komminoth, X. Matias-Guiu and M. Volante, Mixed medullary and follicular cell carcinoma, in R.A. DeLellis, R.V. Lloyd, P.U. Heitz, C. Eng (Ed.), World Health Organization Classification of Tumors: Pathology and Genetics: Tumors of Endocrine Organs. (Lyon: IARC Press, 2004), 92-93.
[4] M.J. Gero, S. Lipper, A.E. Chernys and L. Silver, Medullary and papillary carcinomas occurring as a collision tumor: report of a case. Clinical Nuclear Medicine, 14(3), 1989, 171-174.
[5] D.J. Marsh, D.L. Learoyd, S.D. Andrew, L. Krishnan, R. Pojer, A.L. Richardson, L. Delbridge, C. Eng, B.G. Robinson, Somatic mutations in the RET proto-oncogene in sporadic medullary thyroid carcinoma, Clin Endocrinol (Oxf), 44(3), 1996, 249–257.
[6] M.S. Alavi, N. Azarpira, Medullary and papillary carcinoma of the thyroid gland occurring as a collision tumour with lymph node metastasis: A case report, Journal of medical case reports, 5(590), 2011, 1-4.

Abstract: Aim: To identify the non invasive predictors of esophageal varices in patients with cirrhosis of liver, so as to reduce number of unnecessary endoscopies. Methods: Ninety two patients with cirrhosis of liver irrespective of etiology were analysed prospectively between October 2011 and October 2013. Appropriate clinical, biochemical and ultrasonographic parameters were selected as variables to compare with esophageal varices. The data were assessed by univariate and multivariate analysis. Results: Univariate analysis of the studied parameters showed that decreased platelet count, albumin levels and platelet count/splenic diameter ratio and increased bilirubin levels, prothrombin time, splenic size, portal vein size were significantly associated with the presence of esophageal varices and their values correlated with increasing size of varices. On multivariate analysis of variables, the independent predictors for the presence of varices were platelet count/splenic size <1433.1, splenic size >115.75 mm.

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Abstract: Myositis ossificans progressiva is a rare congenital connective tissue disease characterized by wide spread soft tissue ossification and congenital stigmata of the musculoskeletal system. We report here about one female child 11-year old with bilateral hypoplastic hallux and little finger, multiple nodules over back, restricted chest expansion, and progressive stiffness of neck, trunk and extremities that limit her activities of daily life. The purpose of reporting this case is to raise awareness about this rare entity. It highlights the importance of early diagnosis as the key part of management to reduce the propensity of disease progression by trauma and other stimulating factors as no specific treatment is available till date.

Keywords: Myositis ossificans progressiva, fibrodysplasia ossificans progressiva, heterotropic ossification, autosomal dominant, bone morphogenic protein.

[1]. Agarwal RP, Verma SK, Garg RK, Upadhyay VK, Sharma DK. Myositis ossificans progressiva. Indian Pediatr 1991;28:931-4.
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Abstract: Introduction: Hydatid disease caused by Ecchinococcus parasite commonly presents as a cystic disease in, Liver, Lung ,Spleen and Brain. Hydatid cys in the bone is a rear manifestation ,our study presents cystic disease in entire femur with multiple fractures in femur ,which a rear presentation. Case report: A female patient aged 58 years presented with pain and swelling left thigh gradually increasing in nature snce 1 year. The patient couldn't walk since 2 weeks. Clinically there is a huge swelling of left thigh with a crepitus .No other complaints from any other part of the body. Conclusion: Hydatid disease of the bone poses difficulties in the treatment, because bone biopsy cannot be attempted to avoid the danger of anaphylaxis reactions. We did closed Intramedullary Supracondylar nailing of the femur, which took 12 months for healing with shortening of the limb. .

Keywords: Hydatid cyst, Pathological fracture, Nailing, Supracondylar.

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