Background: Complicated intra-abdominal infections (cIAI) remain challenging to treat because of their polymicrobial etiology including multi-drug resistant bacteria. The efficacy and safety of tigecycline, an expanded broad-spectrum glycylcycline antibiotic, was compared with imipenem/cilastatin (IMI/CIS) in patients with cIAI.
Thyroglossal duct cyst is a congenital malformation that occurs due to incomplete closure of the thyroglossal duct. Apart from being a quiescent embryological remnant, it presents itself clinically at any age and often requires surgical excision. Twenty four patients were encountered at Sri Ramachandra Medical College and Research Institute between June 2004 and June 2009 with thyroglossal duct cyst. The purpose of the study was to analyse their presentation, associated complications including malignancy and the approach to their management. Operative notes, histopathology files and medical records were used for the retrospective analysis of the patients with thyroglossal duct cyst. Thyroid profile and Radioisotope scan were performed on all the patients to document the position of the thyroid gland. Further, these patients were subjected to Ultrasonography and Computerised Tomography neck to conclusively map the location of the cyst. Fine Needle Aspiration of the tissue was done to diagnose malignancy. It was noted that there was maximum clustering of about 62.5% in males. About 45% of them belonged to the paediatric age group. The total number of symptomatic patients was about 59%. Unlike the various studies in literature, most of the thyroglossal duct cyst patients at our hospital were symptomatic. The symptoms were pain, dyspnoea, dysphagia, discharge and recurrence. Malignancy was diagnosed in two patients who were ironically asymptomatic. Other complications were looked into and treated. Thyroglossal duct cyst is a cervical anomaly that is usually found as an asymptomatic painless cystic swelling. However, most of our patients had a symptomatic presentation. Association with malignancy was noted. Surgical intervention was the cure for all the patients.
A balance between collagen formation and degradation is essential for normal wound healing. Inadequate wound healing results in wound breakdown, and exaggeration results in hypertrophic scars and keloids. We look at the aetiological factors, the biochemical alterations and the treatment modalities for keloids, in this clinical challenge.
Schwannomas are benign tumors of the nerve sheath, commonly seen in the vestibular nerve. Although they are common in the head and neck areas, their occurrence in extra-cranial locations is rare. We report a case of a sciatic nerve schwannoma and review the literature.
Necrotising fasciitis (NF) is an unusual though well-described soft tissue infection of the deeper tissues resulting in a progressive synergistic bacterial gangrene. In a small retrospective study in a single center, an association was observed between NF and diabetes, age, peripheral arterial disease, and high mortality.
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