No abstract

Gastrointestinal duplications can occur anywhere from the mouth to the anal cavity. The occurrence of a duplication cyst in the tongue of a neonate is very rare. These cysts occur due to endodermal cells that are trapped during development. Congenital lingual cystic masses are challenging entities. They usually present in the neonatal period and surgical excision is curative. We report a 10-day-old, 3-kg neonate with a gastric duplication cyst in the oral cavity with inability to close his mouth or breast feed for whom we performed subtotal excision of the cyst.

Neuromyelitis optica spectrum disorders (NMOSDs) are rare immunological inflammatory disorders of the central nervous system (CNS) primarily involving the optic nerve, spinal cord, and brain. [1][2][3] It is more common, has younger age of onset, has higher brain/brainstem involvement in Africans and Asians than Caucasians, and is usually diagnosed in middle-aged females. 2,4 The majority of NMOSD patients have positive AQP4-Ab. 1 Diagnosis of NMOSD is based on International consensus diagnostic criteria, requiring certain clinical, laboratory, and imaging criteria to be met with the exclusion of differentials. 5,6 Acute attacks are primarily managed with intravenous corticosteroids. 1 In worsening cases, plasma exchange may be indicated. 1 Also, monoclonal antibodies, such as rituximab, eculizumab, tocilizumab, satralizumab, etc., can be used to modify the course of the disease. 7,8 Early diagnosis and intervention are crucial to prevent worsening and ensure optimum quality of life in these patients. 9,10 Herein, we present the case of a middle-aged Asian male with NMOSD with AQP4-IgG. | CASE REPORTA 52-year-old Asian male presented with multiple episodes of hiccups, vomiting, decreased bladder sensation,

Background: To predict the risk of mortality and morbidity in patients with perforative peritonitis using APACHE II scoring system. To evaluate the usefulness of APACHE II scoring system as a potential clinical and research tool which could be included as routine part of patient assessment in institution like ours.Methods: This was a prospective, observational study of prediction of outcomes in 80 patients of perforative peritonitis using APACHE II scoring system, conducted during the period of 2 years at our tertiary care institute.Results: Predicted death rate of the study was 17.31% and observed death rate was 25%. However, when observed and predicted death rates were compared in group of patients with APACHE II score of <10, it was over estimating the mortality. In group of patients with APACHE II score 11-20 and >20 it was underestimating the mortality. About 71.2% patients came under APACHE II score <10 with mortality of 3.5%. 23.7% came under group of patients with APACHE II score of 11-20 with mortality of 73.6% and only 5% patients had score >20 with 100% mortality were seen amongst them.Conclusions: In the present study, APACHE II scoring system was found to be accurate predictor of group outcome and can be effectively used in prediction of group outcome in similar population, but does not give sufficient confidence for outcome in an individual patient.

No abstract