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Deralakatte, India

Girisha B.S.,Kshegde Medical Academy
Kathmandu University Medical Journal | Year: 2013

Incontinentia pigmenti is an X-linked dominant condition characterized by cutaneous lesions associated with developmental defects of the eye, skeletal system and central nervous system. We report a case of incontinentia pigmenti in a 30 day old female infant who presented to us with skin eruptions over bilateral upper limbs, lower limbs and trunk since birth. She had linear verrucous plaques and vesicles distributed along the Blaschko's lines in addition to macular hyperpigmentation in a linear and whorled pattern involving the concerned areas. On ophthalmological examination, proliferative retinopathy in the right eye was noted.

Hariprasad S.,Raja Rajeswari Medical College | Hariprasad P.,Kasturba Medical College | Srinivas T.,Kshegde Medical Academy
Journal of Clinical and Diagnostic Research | Year: 2013

Carcinoma of the male breast is a relatively rare disease that accounts for less than 1% of all the cases of cancer in men. Intracystic Papillary Carcinoma (IPC) is an extremely rare disease of the male breast, with a few case reports. The prognosis is excellent for the patients who are diagnosed with IPC, regardless of whether the tumour is in-situ or of an invasive type. We are reporting the case of a 50 year old man who presented with a painless cystic lump in the left breast. Ultrasonography revealed an intracystic tumour. Fine needle aspiration suggested a papillary tumour. The patient underwent simple mastectomy without a sentinel lymph node biopsy. The final pathologic examination revealed an intracystic papillary carcinoma of a low nuclear grade without an invasion.

Shetty A.,Kasturba Medical College | Kini A.R.,Tejasvini Hospital and SSIOT | Muthappa D.,Kshegde Medical Academy
Indian Journal of Orthopaedics | Year: 2011

Background: Global fusion is recommended in sub-axial cervical spine injuries with retrolisthesis, translation rotation injuries associated with end plate or tear drop fractures. We propose a modification of Stellerman′s algorithm which we have used where in patients are primarily treated via anterior decompression and fixation. Global fusion was done only in cases where post-decompression traction does not achieve reduction in cases with locked facets. Materials and Methods: Two hundred and thirty consecutive patients with sub-axial cervical spine injuries were studied in a prospective trial over a 7 year period. Seven cases with posterior compression alone were not subjected to our protocol. Of the other 223 cases, 191 cases who on radiological evaluation needed surgery were initially approached anteriorly. Decompression was effected through a corpectomy in 14 cases and a single or multiple level disc excisions were performed in the others. Cases with cervical listhesis (n=36) where on table reduction could not be achieved following decompression were subjected to progressive skeletal traction for 48 h. Posterior facetectomy and global fixation was done for patients in whom reduction could not be achieved despite post-decompression traction (n=11). Results: Of the 223 cases, 20 cases were managed conservatively, 12 cases expired pre-operatively, and the remaining 191 cases needed surgical intervention. Out of the 154 cases of distraction/ rotation/translation injuries on table reduction could be achieved in 118 cases (76.6%). Thirty-six patients had locked facets (23 cases were bifacetal, 13 cases unifacetal) and of these 36 cases reduction could be achieved with post-anterior decompression traction in 25 patients (16.2%); however, only 11 cases (7.1%)-8 bifacetal and 3 unifacetal dislocations-needed posterior facetectomy and global fusion.One hundred and forty-three patients were followed up for a minimum period of 6 months. One hundred and twenty-six patients showed evidence of complete fusion (88.1%) while the remaining 17 (11.8) showed evidence of partial fusion. There were no signs of instability on clinical and radiological evaluation in any of the cases. Reduction of graft height was noted in 18 patients (12.5%). There were eight cases of immediate postoperative mortality and two cases of delayed mortality in our series of cases. Conclusion: We feel that on table decompression and reduction followed by anterior stabilization can be used as the initial surgical approach to manage most types of cervical injuries. In rotation/translational cases where reduction cannot be achieved, monitored cervical traction on the decompressed spine can safely achieve reduction and hence avoid the need for a posterior facetectomy in a large percentage of cases.

Aroor A.R.,Kshegde Medical Academy | Rama Prakasha S.,JIPMER | Seshadri S.,Kasturba Medical College | Teerthanath S.,Kshegde Medical Academy | Raghuraj U.,Kshegde Medical Academy
Journal of Clinical and Diagnostic Research | Year: 2014

Background: Mediastinal tumours are uncommon lesions encountered in clinical practice. There has been a significant increase in the incidence of malignant mediastinal tumours over the past four decades. The presentation varies from asymptomatic lesions detected incidentally on imaging to severe life threatening presentations. Aim and Objectives: The study was conducted to assess the clinical characteristics, types, treatment modalities and outcome of mediastinal masses. Materials and Methods: In this two year prospective study, a total of 35 cases with or without symptoms of mediastinal mass, confirmed by Computed Tomography (CT) imaging were included. The results were expressed as percentages or proportions. Results: Maximum numbers of patients (25.71%) were seen in the 3rd decade and majority (94.3%) was symptomatic at presentation. Malignant lesions (68.57%) were more common than benign (31.43%) and lymphoma was the commonest malignant tumour (50%). Mediastinal widening on chest X-ray was seen in 27 cases (77.14%), pleural effusion and lung mass in 5 cases each (14.29%). On CT imaging and sub-classification, anterior mediastinum was the commonest compartment involved (42.86%). Conclusion: Mediastinal masses are usually symptomatic at presentation. Majority of the masses were malignant lesions and the symptoms of mediastinal obstruction was significantly higher in malignant lesions and anterior mediastinal masses. Lymphoma was the most frequent primary mediastinal mass and thymoma constituted the commonest benign anterior mediastinal tumour.

Hariprasad P.,Kasturba Medical College | Hariprasad S.,Raja Rajeswari Medical College | Srinivas T.,Kshegde Medical Academy | Jayrama Shetty K.,KS Hegde Medical Academy
Journal of Clinical and Diagnostic Research | Year: 2013

Primary fallopian tube carcinoma is an extremely uncommon neo- plasm of the female genital tract. Primary Fallopian Tube Carcinoma (PFTC) has a clinical and a histological resemblance to Epithelial Ovarian Cancer (EOC). We are reporting a case of PFTC in a 55 year old tubectomized, postmenopausal woman with the non-spe- cific complaints of a watery vaginal discharge and lower abdomi- nal pain. The clinical and radiological findings suggested a bilateral tubo-ovarian abscess. On laprotomy, a bilateral fallopian tube tu- mour was seen, with a focal extension to the surface of the right ovary from the right fallopian tube. Total abdominal hysterectomy, bilateral adnexectomy andomentectomy, along with excision of the draining lymph nodes, was done. The histopathological examina- tion revealed a bilateral papillary serous carcinoma of the fallopian tube. The patient was treated with adjuvant chemotherapy with Paclitaxel. There was no evidence of any recurrence, after 2 years of regular follow up. The clinical signs and symptoms of fallopian tube neoplasms are usually non-specific. The primary treatment remains a surgical resection, followed by adjuvant chemotherapy or radiation. The prognosis is poor, although long-term survivors have been reported.

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