Isolated Medial Rectus Cysticercosis mimicking pre-septal cellulitis: A Case Report
Abstract— Man is the intermediate host in the life cycle of the pork tapeworm Taenia solium. Its larval form Cysticercus cellulosae is the causative agent of cysticercosis. Both intraocular and extra ocular cysticercosis is observed in tropical countries like India. A case of extra ocular cysticercosis is reported here. An eight year old female patient who was brought to emergency department with pain and swelling around peri-orbital region, diminution of vision along with ptosis in left eye. CT scan showed scolex of Taenia solium in left medial rectus muscle. The patient recovered completely with oral albendazole steroids for four weeks. So a case with pain and swelling around peri-orbital region, diminution of vision along with ptosis in left eye should be investigated for cysticercosis.
Keywords: Taeniasis, Extra ocular Cysticercosis, Medial Rectus, Peri-Orbital Region.
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Superior orbital fissure syndrome due to Metastatic prostatic malignancy: A Case Report
Abstract— Superior orbital fissure syndrome (SOFS) is a rare disease. So when a case of this came at Aravind Eye Institute, a detailed case report was prepared to publish. A 56 years old male patient, a known case of prostatic malignancy with skeletal metastasis presented with ptosis, exotropia, diminished pupillary reflex and limitations in extraocular movements of left eye. MRI brain revealed diffuse skull base and leptomeningeal metastasis. Whole body CT scan showed metastasis in ribs, scapula and in pelvic bones. He was diagnosed to have superior orbital fissure syndrome due to metastatic prostatic malignancy and was offered steroids and radiotherapy.
Keywords: Ptosis, Prostate, Metastasis.
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Clinico-epidemiology and outcome of ectopic pregnancy: An experience of 7 years in St. Stephen’s hospital, Delhi
Abstract— Ectopic pregnancy is an important cause of maternal morbidity & mortality in the first trimester. Treatment of ectopic pregnancy was limited to surgery. In spite of advancement of diagnosis & management it is still a very serious threat to maternal safety, so this case-series type of study was conducted on 58 ectopic pregnancies to study the clinico-epidemiology and outcome of medically managed ectopic pregnancy at a tertiary level hospital. Out of total 20,354 pregnancies, 443 (2.1%) were ectopic pregnancies. Most common site of ectopic pregnancy was Fallopian tubes in 94.8% cases followed by ovary in 3.4% cases and heterotopic in 1.7%. Age range was 17 years to 36 years with mean age 28.12 ± 4.10 years. Parity wise maximam were nulliparous (53.4%) followed by para one (25.9 %), para two (19%) and para three (17.2 %). Ectopic pregnancies on right side were found in 55.2% while in left side in 44.8% 75.8% had bleeding per vaginum and 74.1 % had pain abdomen as their chief complaints. History of abortion was found in 44% cases and past history of ectopic pregnancy was found in 8.6% cases whereas past history of pelvic inflammatory disease in 22.4% cases and infertility in 13.8% cases. 1.7% cases had IUCD in situ while 5.2% cases had history of past IUCD insertion. History of ovulation induction was present in 8.6% cases, 3.4% cases were IVF conceived and 1.7% underwent laparohysteroscopy for infertility treatment. In this study success rate of methotrexate therapy was found 93.1%. Emergency surgery was needed only in 6.9% of cases. So it can be concluded that bleeding per vegina and pain abdomen may be investigated for ectopic pregnancy and ectopic pregnancies should be treated first line with methotrexate before surgery.
Keywords: Ectopic Pregnancy, Methotrexate, Clinico-epidemiology.
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Clinico-epidemiological study of cutaneous tuberculosis in a tertiary care hospital of Rajasthan
Abstract—India constitutes about one fourth of the Global TB burden. Cutaneous TB is less common clinical form of tuberculosis accounting for 1-2 % of the total extra-pulmonary cases. Objective of this study was to describe the clinical and epidemiological pattern of Cutaneous TB presenting in the Skin Outpatient Department (OPD). Patients presenting with clinically suspected skin lesions of Cutaneous TB from January 2015 to August 2016 were included in the study. Dermatological and systemic examination was carried out and histopathogical examination of skin punch biopsy was done. It was observed that out of a total of sixty patients, 45 (75%) patients were found to have features of Cutaneous TB on histopathology. Lupus vulgaris (42.2%) was the most common form of Cutaneous TB. Most patients were in age group of 11-30 years. Male to female ratio was 1.6:1. Most common sites of involvement were lower limbs and neck. Mantoux test was positive(≥15 mm induration) in 66.7% cases. Typical tuberculoid histology was found in 91.1% cases. No cases of tuberculids were seen and non-specific chronic inflammation was seen in six cases. It was concluded that Cutaneous TB may present with different morphological patterns resembling other inflammatory, infective and neoplastic conditions. Proper and thorough investigations are necessary for detection of Cutaneous TB as the annual incidence of total TB cases in India is high.
Keywords: Cutaneous TB, Lupus vulgaris, Mantoux test, Clinico-epidemiology.
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Menstrual pattern among school girls with special reference to determinants of amount of menstrual blood loss: A cross-sectional study in Jaipur city
Abstract— Menstruation had many tremendous psychological response in adolescent. And there are many myths prevalent regarding menstruation. So this study was conducted with the aim to study menstrual pattern in adolescent school going girls and association of menstrual blood flow with their BMI, diet, sports activities and gadgets. This study is a descriptive type of cross-sectional study in which adolescent girls who attained menarche were included. Present study was carried out on in government schools Jaipur City (Rajasthan) on 1233 girls aged between 13 to 19 years. BMI was significantly associated with amount of blood loss. Girls whose BMI was <18.5 kg/m2 or underweight had moderate to severe degree of dysmenorrhoea compare to those BMI 18.5-24.9 kg/m2. Proportion of girls involved in sports activities were having less amount of blood loss compared to those who were leading sedentary life. B So it can be concluded that BMI has direct co-relation with menstrual blood loss; the girls involved in sports had less amount of menstrual blood loss.
Keywords: Menstrual Pattern, Menstrual Blood Loss, Adolescence, BMI, Sports Activities.
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Dosimetric evaluation of carcinoma nasopharynx using Volumetric Modulated Arc Therapy (VMAT): An institutional experience from Western India
Abstract— Treatment of nasopharyngeal carcinoma is done by advanced radiotherapy techniques like VMAT (Volumetric Modulated Arc Therapy) where dose to critical organs around tumour is of concern. Present study aimed to describe radiation dose to critical organs in nasopharyngeal cancer patients using VMAT technique. Study was conducted on 10 carcinoma nasopharynx patients treated by VMAT technique at a super-specialty cancer institute in Rajasthan. The structures were contoured using RTOG (Radiation Therapy Oncology Group) guidelines and dose prescription to PTV (Planning Target Volume) was such that 95% iso-dose covered 100% of PTV. Constraints to the OARs (Organs at risk) were as per QUANTEC (Quantitative Analysis of Normal Tissue Effects in the Clinic). VMAT planning was done by double arc using Eclipse (v 10.0.42) treatment planning system. Mean dose to brain stem, spinal cord and optic chiasma were 51.79 Gy, 45.92 Gy and 18.8 Gy respectively. Mean dose to left and right temporal lobes was 22.7Gy and 24.3Gy. Dose to right and left eye were 20.6 Gy and 19.2 Gy while dose to right and left lenses were 5.9Gy and 5.8 Gy respectively. Dose to brain stem, spinal cord, optic chiasma, eyes, lens and temporal lobes were below the dose constraints. VMAT is an effective way to deliver maximum radiation to tumour tissue while providing better sparing of normal tissue and less doses to OARs in carcinoma nasopharynx.
Keywords: Nasopharyngeal carcinoma (NPC), Volumetric Modulated Arc Therapy, Radiation Therapy Oncology Group.