Diaphragmatic hernia may be congenital or traumatic in origin. Traumatic hernia may menifest immediately or several months/years after the incident. Congenital hernia usually manifests in the early years of life. Diaphragmatic hernia may be complicated by gastric volvulus. Acute gastric volvulus is surgical emergency where as chronic gastric volvulus presents with nonspecific abdominal symptoms. Diagnosis of gastric volvulus is difficult and is based on imaging studies. We describe four cases of diaphragmatic hernia complicated by gastric volvulus, diagnosed on imaging and managed surgically.

Acute Disease↗

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Stone composition, metabolic profile and the presence of the gut-inhabiting bacterium Oxalobacter formigenes as risk factors for renal stone formation.

OBJECTIVE: To examine stone composition, metabolic evaluation and colonization of Oxalobacter formigenes as risk factors for renal stone formation. SUBJECTS AND METHODS: Eighty patients with renal stones and 70 healthy controls were enrolled in the study. Of the 80 patients, 48 were first-time stone formers (FSF) and 32 were 'recurrent' stone formers (RSF), recurrent indicating 2 or more episodes of stone formation. Stone analysis by X-ray crystallography, 24-hour urine metabolic profile and detection of O. formigenes-specific DNA by PCR were performed for each patient. Detection of O. formigenes was also performed on 45 and urinary metabolic profile on an additional 25 controls. RESULTS: Calcium oxalate monohydrate was the major component of stones, hyperoxaluria and hypocitraturia were the most common urinary abnormalities in the 80 patients, 46% of RSF patients had hypercalciuria. Urinary abnormalities were far less frequent in the controls, with the exception of hypocitraturia (40%). Of the urinary metabolites, only calcium levels were significantly different (p < 0.05) between FSF (6.50 +/- 4.08 mmol/24 h) and RSF (8.21 +/- 5.26 mmol/24 h) patients. Colonization of O. formigenes was higher in controls (62.2%) than in FSF (33.3%) or RSF (28%) patients, it was least in patients with more than 4 episodes (7%) of stone formation. CONCLUSION: The findings indicate that lack of colonization of O. formigenes may be an important risk factor for recurrence of stone formation (calcium oxalate monohydrate).

Adult↗

PubMedDate not supplied

Complication associated with general anesthesia: report of case.

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Anesthesia, Dental↗

PubMedDate not supplied

Adenosine deaminase activity in pleural fluid--a diagnostic test of tuberculous pleural effusion.

Adenosine deaminase (ADA) activity in pleural fluids was studied in 47 patients with pleural effusion of different etiology. Patients were divided into two groups: Group I - Tuberculous pleural effusion (21 patients): Group II - Non tuberculous effusion (26 patients) and these included malignant pleural effusion (9 cases), synpneumonic pleural effusion (9 cases) and transudative pleural effusion (8 cases). The mean ADA activity was 64.67 IU/L +/- 21.68 in group I and 6.99 +/- 3.69 in Group II. Increased mean pleural fluid ADA activity in tuberculous pleural effusion was highly significant (p < 0.001) when compared with pleural effusion of non-tuberculous etiology. Based on lowest value of ADA activity found in tuberculous pleural effusion (30 IU/L), the test has a sensitivity and specificity of 1.

Adenosine Deaminase↗

PubMedDate not supplied

A comparative study of clinico-radiological spectrum of tuberculosis among HIV seropositive and HIV seronegative patients.

BACKGROUND: A study to determine the prevalence of human immunodeficiency virus (HIV) infection among tuberculosis patients and to compare the clinico-radiological spectrum of tuberculosis among HIV seropositive and seronegative patients was carried out in the Department of TB and Chest Diseases, CSM Medical University, Lucknow (Uttar Pradesh), India. METHODS: A total of 1105 radiologically and/or bacteriologically confirmed patients of tuberculosis were screened for HIV infection during the years 1995 to 1997 and from 2000-2001. RESULTS: Out of a total 1105 patients screened, 31(2.8%) were found to be HIV seropositive. Tuberculin positivity was less among HIV seropositive patients as compared to HIV seronegative patients (22.6% vs 76.4%; p < 0.001). There was no statistically significant difference in sputum smear positivity for acid-fast bacilli (AFB) among HIV seropositive and seronegative patients. Among HIV seropositive patients, mid and lower zone involvement, exudative lesions and mediastinal lymphadenopathy was more common as compared to the seronegative patients. CONCLUSION: HIV seropositivity rates among tuberculosis patients was 2.8 percent. The presentation of tuberculosis was more often atypical among these patients.

Adolescent↗

PubMedDate not supplied

Distribution of malignancies in head and neck regions and their management.

A retrospective, cross sectional, series of cases were currently studied in the department of ENT-Head & Neck Surgery of Tribhuvan University Teaching Hospital (TUTH) Kathmandu, Nepal to find out the distribution of different malignancies in head and neck regions and to identify their treatment modalities during the period of one year from January 2003 to December 2003. Altogether 159 new cases of histopathologically/cytopathologically confirmed malignancies of head and neck regions and their treatment modalities were analyzed. Out of 159 cases, malignancies of larynx (41), pharynx (31) and oral cavity (30) were found to be the commonest head and neck malignancies where as malignancies of ear (1), and salivary glands (4) were found to be the least common. Likewise surgery with or without radiotherapy and/or chemotherapy was found to be the commonest treatment modality. Of the 159 cases seven were occult primary. As the laryngo-pharyngo-oral malignancies are the commonest malignancies and surgery with or without radiotherapy and/or chemotherapy the commonest treatment modalities for these head and neck malignancies. A well equipped head and neck unit is needed at TUTH along with proposed radiotherapy and medical oncology support for better management of these malignancies.

Adolescent↗