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Hydatid disease is an endemic zoonotic disease in many areas of the world. An intracranial hydatid cyst is a relatively rare entity, accounting for only 1–2% of all intracranial space-occupying lesions. Most commonly they are seen in children and young adults. Here, we present 9 cases of pediatric intracranial hydatid cyst operated at Sher-I-Kashmir Institute of Medical Sciences, Srinagar, India, between 2009 and 2015. The mean age of presentation was 11.5 years. The male to female ratio was 5: 4. In 7 cases, a history of contact with pet dogs was present. Seizure was the most common finding, present in 7 cases. Seven patients had solitary cysts and 2 had multiple cysts on presentation. All patients were operated on, and recurrence was observed in 2 patients. The features of this rare disease are retrospectively analyzed in this presentation and the literature is reviewed.

The aim of this study is to evaluate the role of bleomycin as a primary mode of nonsurgical treatment in lymphangiomas of head and neck and study their complications. This is a prospective study of 8 patients diagnosed with lymphangioma of head and neck presenting to ENT department of Tata main Hospital from December 2014 to January 2017. They were clinically and radiologically evaluated and treated with intralesional injection of bleomycin diluted in normal saline. Complete resolution was seen in 62.5% (5/8) of patients, 25% (2/8) had good response while 12.5% (1/8) had a poor response. No major complications were noted apart from fever and inflammation. Intralesional bleomycin can be used as a primary modality of treatment.

BACKGROUND Malnutrition affects 40%-90% of patients with cirrhosis of the liver. L3 skeletal muscle index (L3SMI) is presently accepted as the most objective and quantitative measure available for sarcopenia, a surrogate marker of malnutrition. L3SMI application is, however, limited by non-availability of computed tomography scanning in remote areas, cost, need for extensive training, and the risk of exposure to radiation. Therefore, an alternative dependable measure with wider availability is needed. Malnutrition causes sarcopenia not only in skeletal muscles but also in other muscular structures such as the psoas muscle, diaphragm and tongue. We therefore hypothesised that the tongue, being easily accessible for inspection and for measurement of thickness using ultrasonography, may be used to document sarcopenia. AIM To measure and compare tongue thickness in healthy individuals and in patients with cirrhosis of the liver and to study its correlation with conventional prognostic scores for patients with cirrhosis of the liver. METHODS Tongue thickness was measured using ultrasonography. One hundred twenty subjects of either gender aged 18 to 65 years were studied, with 30 subjects in each group. The tongue thickness was compared between groups based on “Child Turcotte Pugh” (CTP) scores. The correlations between measured tongue thickness and “Model for end stage liver disease” (MELD) score and between age and measured tongue thickness were also assessed. RESULTS Mean tongue thickness (mean ± SD) in patients with CTP class A, B and C was 4.39 ± 0.39 cm, 4.19 ± 0.53 cm, and 3.87 ± 0.42, respectively, and was 4.33 ± 0.49 cm in normal healthy individuals. Significant differences were seen in tongue thickness between patients with CTP class C and those with CTP class A and B ( P < 0.05). Patients with CTP class C also had a significantly reduced tongue thickness than normal individuals ( P < 0.05). However, no significant difference was seen in tongue thickness between patients with CTP class A and B and normal individuals. A statistically significant, negative correlation was found between MELD score and tongue thickness ( r = -0.331) ( P < 0.001). No correlation was observed between L3SMI and MELD score ( r = 0.074, P = 0.424). L3SMI (mean ± SD) in healthy subjects was 39.66 ± 6.8 and was 38.26 ± 8.88 in patients with CTP class C, and the difference was not significant. No significant correlation was found between age of the patients and tongue thickness. Intra-class correlation coefficient was used to determine the reliability of the tongue thickness measurements. The intra-class correlation coefficient was 0.984 (95%CI: 0.979-0.989) and was indicative of good reliability. CONCLUSION Tongue thickness measured by ultrasonogr...

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