No abstract

Gossypiboma (GP) or retained surgical sponge is one of the rare surgical complications that can happen despite precautions. It is an avoidable surgical complication that can lead to increased patient Morbidity and profound Medicolegal implications. Abdominal textiloma may be asymptomatic or present serious gastrointestinal complications such as bowel obstruction, perforation or fistula formation because of misdiagnosis, it may mimic abscess formation in early stage or soft tissue masses in the chronic phase.

Background: Subclinical hypothyroidism (SCH) is a common disorder and has been implicated in increased cardiovascular morbidity and mortality. Therefore, it is important to study the effect of SCH on cardiac morphology and function. Thus, present study titled "Study of LV functions in patients of subclinical hypothyroidism in patients coming to rural medical of sub-Himalayan region of India" was conducted in the department of medicine, Rajinder Prasad government medical Tanda over a period of three years from December, 2010 to November, 2013 to study left ventricular function in subclinical hypothyroidism. Methods: The study was conducted in the department of medicine, Rajinder Prasad government medical Tanda over a period of three years from December, 2010 to November, 2013 to study left ventricular function in subclinical hypothyroidism. The data was analysed using computer software Epi-info version 6.0 and SPSS version 12.0 for Windows. Descriptive characteristics were presented as percentages for quantitative variables including measurement of thyroid hormones and ejection fraction. Mean and standard deviation were reported. Results: Diastolic parameters were markedly altered, mainly isovolumic relaxation time, which was increased and reduction of E/A wave ratio (<1). Systolic function parameters were within normal range. 155 patients had diastolic dysfunction with E/A wave <1.45 patients were not affected and they had E/A wave >1. Conclusions: Implication for echocardiography in SCH patients observed were that early recognition of silent diastolic dysfunction can be done. We can institute L-thyroxinee therapy which has been found to reverse diastolic dysfunction of heart along with improvement in lipid levels, decreased systemic vascular resistance, diastolic hypertension and coagulation profile. SCH, invariably affects heart and sooner or later and leads to diastolic dysfunction. Early recognition by echocardiography and then treatment with L-thyroxinee is indicated.

Guillain-Barré Syndrome (GBS) is an acute, immune-mediated polyradiculoneuropathy and an important cause of acute flaccid paralysis (AFP) worldwide. Respiratory insufficiency requiring v entilator occurs in 30% of patients that prolong the hospital stay, leading to morbidity and mortality. There had been relatively few studies of Guillain-Barresyndrome in adults from North India. Objective : To evaluate clinical profile, epidemiological, laboratory and electrodiagnostic feature of patients with Guillain Barre Syndrome in adults and use of intravenous immunoglobulin (IVIg) in addition to supportive care. Materials and Methods : This was a prospective study of 50 patients with GBS admitted to our medicine department in rural tertiary care institution Dr.RPGMC Tanda. We studied the epidemiological, clinical, electrophysiological features and their outcome. Result: In our study 50 cases were taken, motor weakness was the most common presenting feature. Antecedent illness was found in 48% of cases in the preceding two weeks, which included nonspecific illness, acute respiratory infection, diarrhea, and viral infection like chickenpox. At onset, sensory symptoms (pain and paresthesia) were noted in 16% of the cases and limb weakness in 77%. On admission, a majority (64%) was in Hughes neurological disability grading stage III-IV' all had limb weakness at the peak deficit; autonomic disturbance was seen in 35.8%, and bulbar palsy in 6%. Duration of illness was less than three weeks in 60% of cases. The one patient had undergone repiratory distress and kept on ventilator for 23 days and survived. Conclusions:Male preponderance and motor weakness was the most common presenting illness and a majority achieved full recovery in our study. Although IVIg may be useful in the treatment of GBS, the key issue is excellent intensive care unit management.

Pancreatitis is a rare manifestation of Acute myeloid leukaemia (AML) arising during or after onset of course of disease. It can be first and only manifestation of AML. AML is a type of blood cancer. Characterized by clonal proliferation of abnormal myeloid precursors and altered normal hematopoiesis. The world Health organization (WHO) classification retains the diagnostic threshold the infiltration of the bone marrow by more than 20% of non-lymphoidblasts. We reported a case of AML discovered in a 36-year-old female admitted with chief complaints of pain epigastrium. On Clinical examination she was conscious cooperated well oriented. Blood pressure: 110/70 mmHg, abdominal examination revealed epigastric tenderness, no organomegaly. CVS, Respiratory system and neurological examination were within normal limit. On investigation amylase was 856/ UL and Lipase 690 U/L, USG abdomen suggestive of acute pancreatitis. Complete haemogram was done as base line investigation which revealed leukocytosis 1.30 lac/microlit, Hb-8 gm, platelets 32 tuousands only. The blood smear revealed the presence of circulating Blast-28, Atypical cells32%, myelocytes 7% and metamyelocytes 6% and reduced platelets. The bone marrow aspiration and biopsy suggestive of AML. Myeloperoxidase staining was positive. The patient was diagnosed as Acute pancreatitis and managed symptomatically. After improvement she was referred to PGIMER Chandigarh for further management of AML.