We present the case of a young primigravida who developed severe life threatening hemolytic anemia in the last trimester of three successive pregnancies with spontaneous recovery after each delivery and remained normal during the entire nongravid state. Corticosteroid and high-dose intravenous immunoglobulin therapy, although reported as useful, was ineffective in our case. She was managed only with the support with top-up blood transfusions. Extensive investigations were carried out to determine the cause of hemolysis, but these proved unfruitful. Fewer than two scores of such cases have been described in the literature. The paucity of such cases merits its presentation. It is suggested that this anemia should be referred to as "pregnancy-induced hemolytic anemia."
Background: Medical science is a blend of Art and Science. Technology evolved conceived presumably to improve the medical science. Increasing incidence of bile duct injury during laparoscopic cholecystectomies proved otherwise. Multiple factors e.g. cognitive psychology, laparoscopic environment and no proper algorithms to manage, factor may be responsible for these results. To understand properly the mystique, we under took this study.Methods: This study was conducted on 200 cases which underwent laparoscopic cholecystectomies. 12 cases developed bile duct injury during laparoscopic cholecystectomies and 10 cases of bile duct injury sustained through open cholecystectomies were studied in detail results noted and analyzed.Results: All these cases 12/200 laparoscopic cholecystectomy, 10/200 open cholecystectomies were followed up, sign and symptoms noted, USG studies, ERCP stenting, sphincterotomy studies reviewed and sequence of management underlined.Conclusions: Early realisation of bile duct injuries remains the hall mark of she success. Even in cases detected late, conservative procedure and stenting with or without sphincterotomy given relief in number of cases. Finally, if surgery is contemplated Roux-Y-biliary enteric procedure gives much better results.
The present study was carried out with an aim to perform a prospective study to establish the role of sodium tetradecyl sulfate (3 %) (STDS) as a safe and effective sclerosant in the management of primary hydrocele. Sclerotherapy was performed with 3 % STDS on an outdoor basis. The amount of sclerosant injected depended on the amount of fluid drained. All patients were given prophylactic antibiotics. Patients were clinically reassessed at 1 week, 1 month, 3 months, and 6 months and earlier if complications occur. The data were analyzed using Statistical Package for Social Sciences Version 15.0. The data have been represented as frequencies and percentages. Chi-square test was used to compare the data. A total of 57 patients with primary vaginal hydrocele gave consent for being enrolled in the study. The age of patients ranged from 18 to 65 years with a mean age of 35.72±13.18 years. The success rate at the end of the study was observed to be 84.2 %. As regards patient satisfaction, in present study, in a limited time period of follow up, all the patients who had a successful procedure were satisfied. Overall, sclerotherapy was observed to be a relatively cost-effective (including both direct and indirect costs) procedure with low complications, high satisfaction, and a high success rate within the limited period of follow-up.
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