Bombay Hospital Journal

A Pulmonary artery pseudoaneurysm secondary to tuberculosis and its occlusion using a vascular plug.

Vishwas Pandurangappa — 2024-09-16

Pulmonary artery aneurysms (PAAs) and pseudoaneurysms are rare entities in the spectrum of pulmonary arterial diseases. The etiology of these aneurysms is varied and patients present with nonspecific symptoms which make their diagnosis both difficult and less often considered. In this review, we will discuss the clinical manifestations, etiologies, methods of detection, imaging features, and the current role of endovascular treatment in the management of PAAs.

A TRAUMATIC VERTEBRO-VERTEBRAL ARTERIO VENOUS FISTULA TREATED BY COIL EMBOLISATION- A CASE REPORT

SARASWATHI HAJARI — 2024-09-16

Cervical vertebral AV fistulae are uncommon vascular lesions involving abnormal communication between the extradural vertebral artery and surrounding venous structures. We examine the case of a male with a post-traumatic vertebral AV fistula and later successfully treated with standard endovascular techniques. A discussion on the etiology, pathophysiology and management of vertebral AV fistulae follows.

A Primary Mesentric Hydatid Cyst- A case report

Deepa Agarwal Deepa Agarwal — 2024-09-16

Hydatid disease is caused by a parasite known as Echinococcus granulosus. Most common sites are the liver and lungs. Primary mesenteric hydatid cyst is very rare1. In this article, the author presents a rare case report of a primary mesenteric hydatid cyst treated laparoscopically. The patient presented to us with a very short duration of history and non specific complaints. As the pre operative investigations were not very conclusive of the diagnosis, we made some differential diagnosis and decided to go ahead with the surgery.

A THERAPEUTIC EFFECT OF STEROIDS ON OSMOTIC DEMYELINATION SYNDROME DUE TO HYPONATREMIA IN OLD AGE WITH ALMOST COMPLETE RECOVERY

amishi amishi — 2024-09-16

77 yrs. Old male presented with metabolic encephalopathy following hyponatremia. Clinically patient improved following correction of Sodium within 5 days and sent home. After 6 days of discharge, patient was readmitted with central pontine myelinolysis manifested as quadriplegia with lower cranial nerve palsy. Patient improved dramatically following methyl prednisolone therapy to complete recovery.

A CASE OF CONTRACTED SOCKET RECONSTRUCTION IN RURAL PART INDIA

Priyanka Asgaonkar — 2024-09-16

A CASE OF CONTRACTED SOCKET RECONSTRUCTION IN RURAL PART INDIA

Abstract / summary:

An empty orbit can result in facial disfigurement and thereby have an emotional and psychologic impact on the patient and can lead to an economic setback. Treating the patient with an orbital reconstruction can help the patient to live a normal life and gain acceptance in society. Reconstruction of a severely contracted anophthalmic socket is a challenge for an ophthalmic surgeon as there is shrinkage of orbital tissue with shallow fornices and deep superior sulcus and can give rise to a cosmetic anomaly^. In our case we could correct to a maximum extent the cosmetic defect arising due to enucleation following trauma except some amount of dystopia in a 26 years old male by dermis fat grafting which gave the patient cosmetic satisfaction. Even though the surgery was performed as per the usual recommended technique it was a novel surgery for us as it was performed in a rural setup with limited resources and minimal expertise support.

Keywords :

Anophthalmic socket, contracted socket, orbital prosthesis, orbital reconstruction, dermis fat grafting

Original Article Predictors of Post per cutaneous nephrolithotomy sepsis – A prospective comparative study of bacteriology of Mid stream urine culture, Renal pelvis urine culture and stone culture with a view to prevent and treat sepsis.

Dr swapnil vaidya — 2024-09-16

Abstract:

Aim: To find the correlation between preoperative midstream urine culture, intraoperative renal pelvis urine culture and renal stone culture with the postoperative infections and clinical episodes suggestive of urosepsis, in patients treated with percutaneous renal surgeries for renal stone disease.

Background:

1) To study correlation between preoperative midstream urine culture, intraoperative renal pelvis urine culture and intraoperative renal stone culture.

2) To understand which of these culture specimens i.e. preoperative midstream urine culture, intraoperative renal pelvis urine culture or intraoperative renal stone culture, will predict urosepsis in patients undergoing percutaneous renal surgery for renal

Conclusion

Postoperative sepsis is one of the most feared events associated with PCNL.

We found that preoperative midstream urine culture may not accurately reflect the bacteriological status of the renal stone and pelvic urine.

Both positive renal pelvis urine culture and positive preoperative midstream urine culture had statistically significant association with stone culture positivity. Positive renal pelvis urine culture had stronger association with stone culture positivity compared to preoperative midstream urine culture.

Preoperative midstream urine culture is not a good predictor of SIRS/sepsis following PCNL.Sepsis related complications can arise despite sterile urine or adequately treated preoperative urine culture. Intraoperative renal pelvis urine culture and renal stone cultures are better predictors of postoperative sepsis/relevant clinical events.

These culture results can help to identify causative organism of urosepsis and helps to direct antimicrobial treatment, if sepsis develops

Clinical Significance - Sepsis related complications can arise despite sterile urine or adequately treated preoperative urine culture. Intraoperative renal pelvis urine culture and renal stone cultures are better predictors of postoperative sepsis/relevant clinical events

A A Case of Severe Refractory Residual Sensory-neural Hearing loss in Guillain Barre Syndrome : An Unexplored Entity

Darshan Pandya — 2024-09-16

Guillain-Barre syndrome is an acute areflexic rapidly progressive polyradiculoneuropathy with albumin-cytological dissociation. Cochlear nerve demyelination is a rare cause of hearing loss in GBS patients. Here, we are reporting a 28-year-old man with Guillain-Barré Syndrome (GBS) with Bilateral facial and acoustic neuropathy. On neurological examination, he had bifacial weakness, bilateral hypo-acusia, generalized areflexia and sensory motor deficits in the distal limbs. The nerve conduction tests showed the evidence of the demyelinating polyneuropathy. A pure tone audiogram showed bilateral sensorineural hearing loss of 40-50 dB. Thus, auditory dysfunction in GBS patients must be evaluated particularly in the setting of facial palsy.

Original Article Intraocular Lymphoma - Lessons learnt by an ophthalmologist

Mayur Morekar — 2024-09-16

Introduction: PIOL can have various presentations; most commonly, it masquerades as an intermediate and/or posterior uveitis. It usually originates from vitreoretina, known as primary vitreoretinal lymphoma (PVRL) or from uveal tissue and the optic nerve. This gives the ophthalmologist an avenue to use the eye as a window to the brain or the body and suspect / diagnose disease prior to its spread.

Methods: Retrospective chart review of patients with PVRL; from January 2014 to December 2019.

Results: In the study period; 4 patients (2 females / 2 males) had PVRL. Two patients (both females) were 50 years; one was 53 and one was 65 years. Initial diagnoses were “tubercular sub-retinal abscess”, “VKH Disease”, “viral uveitis” & “Optic neuritis”. With a high index of suspicion for PVRL based on clinical picture and inadequate response; an initial cytological analysis of the vitreous was done in 3 patients and was normal. CNS involvement occurred in all patients; in10, 5, 35 and 9 months after initial vitreoretinal involvement. Histopathological diagnosis made in all patients after a brain biopsy leading to chemotherapy.

Conclusion: PVRL is increasingly presenting in younger age group and should be kept in mind in patients with atypical uveitis. The eye indeed is a window to the brain or the body for an ophthalmologist to suspect / diagnose intraocular lymphoma; a disorder masquerading as intraocular inflammation; prior to its CNS spread.

A CURIOUS CASE OF COLD ABSCESS MASQUERADING AS A BREAST LUMP

Shivani Desai — 2024-09-16

A case report on a 36 year old woman who presented with a painless right breast lump of 3 months duration, which turned out to be a cold abscess and was drained and tissue sent for histopathology proved tuberculosis.