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Gayathri Devi D.G.,Ms Ramaiah Medical College And Teaching Hospital
Journal, Indian Academy of Clinical Medicine

Polyparasitism of protozoans (Entamoeba histolytica and Giardia intestinalis) and trematodes (Fasciolopsis buski and Gastrodiscoides hominis) is not reported. A young lady presented with bilateral pitting pedal oedema of 2 months duration. Laboratory evaluation showed microcytic anaemia, low total protein and albumin. Endoscopy and colonoscopy revealed multiple motile worms which were retrieved for species identification. She benefitted with praziquantel, albendazole, along with metronidazole, and collected stools revealed all the four parasites. Poor hygiene, consumption of undercooked food, the climatic compatibility for the parasites, swine population, and usage of faecal manures for farming maintain the endemicity. A simple use of anti-helminthic/anti-protozoal in areas of high endemicity can prevent poor outcome in these patients. © 2014 Indian Academy of Clinical Medicine. All rights reserved. Source

Praveen Kumar S.,Ms Ramaiah Medical College And Teaching Hospital
Dermatology online journal

Primary cutaneous nocardiosis can present in various forms. Clinically, it can present as acute infection (abscess or cellulitis), mycetoma, or sporotrichoid infection. Mycetoma over the back is rare. We herein describe a case of primary cutaneous nocardiosis presenting as a mycetoma, caused by Nocardia brasiliensis. The patient had extensive lesions over the back, which can be attributed to the fact that the patient, being an agriculturist, has been exposed to recurrent trauma while carrying firewood and soiled sacks. He responded well to a modified Welsh regimen. Initially, within 2 cycles, the patient showed dramatic improvement clinically, wherein the sinuses, granulation tissue, and induration were no longer apparent. However, the patient showed a small discharging sinus at the end of 3rd pulse, so a total of 6 cycles were given. An additional 2 months of maintenance phase treatment with cotrimoxazole and rifampicin were given. On follow-up, the patient showed no recurrence at 6 months. We report a case of primary cutaneous nocardiosis presenting as a mycetoma on the back. Enlisting the help of a microbiologist allowed us to isolate the causative organism. Early recognition and prompt treatment prevents unwarranted surgical debridement and complications. Source

Devadass C.W.,Ramaiah Medical College and Teaching Hospital | Patil Okaly G.V.,Ramaiah Medical College and Teaching Hospital | Sudha H.M.,Ramaiah Medical College and Teaching Hospital | Pai S.A.,Ms Ramaiah Medical College And Teaching Hospital | Sridher H.,Ramaiah Medical College and Teaching Hospital
Journal of Clinical and Diagnostic Research

Duodenal adenocarcinoma (DACa) is a rare malignancy, the presenting symptoms of which are vague and nonspecific. We report the case of a patient presenting with symptoms of subacute small bowel obstruction whose CT scan revealed i) left adnexal mass and ii) compression of 3rd portion of duodenum with reduced aortomesentric angle consistent with Wilkie's syndrome (WS). Laparatomy in addition revealed a distal duodenal stricture, which showed a well differentiated DACa causing subtotal intestinal obstruction. The ovarian mass revealed adenocarcinoma with similar morphology. Immunophenotypic analysis revealed positive expression of CK 20 and CDX 2 and absence of CK 7 staining in the tumours consistent with Primary DACa with ovarian metastasis. We further concluded that the WS resulted from reduced mesenteric fat pad caused by DACa induced cachexia.The case highlights the elusive nature of duodenal malignancy and emphasises the importance of meticulous small bowel examination during exploration of ovarian masses. Source

Beena B.,Ms Ramaiah Medical College And Teaching Hospital | Gayathri Devi D.R.,Ms Ramaiah Medical College And Teaching Hospital | Sreenivas Babu P.R.,Ms Ramaiah Medical College And Teaching Hospital
Biomedical Research

Renal abscesses remain a significant cause of morbidity and mortality as well as a diagnostic dilemma because a plethora of microorganisms can cause this condition. A definitive diagnosis is made by isolating the organism from the aspirate. Here, we report a case of rightsided pyonephrosis due to Salmonella Typhi secondary to right staghorn calculus. Though enteric fever is the most common presentation of Salmonella Typhi, Salmonella species have also been isolated from aberrant sites with preexisting abnormality. © 2012, Scientific Publisher of India. Source

Chandrashekar N.K.,Ms Ramaiah Medical College And Teaching Hospital | Krishnappa R.,Ms Ramaiah Medical College And Teaching Hospital | Reddy C.,Ms Ramaiah Medical College And Teaching Hospital | Narayan A.,Ms Ramaiah Medical College And Teaching Hospital
Journal of Global Infectious Diseases

A 43-year-old male living in Bengaluru sought emergency services due to high-grade fever, headache, myalgia, abdominal pain and distension. Platelet count (except the first-96,000/mm 3 ) and coagulation profile was in normal limits. The dengue serology was positive for IgM and Ig G (immunoglobulin M and G) antibodies. Ultrasound abdomen showed gross ascites, mild bilateral pleural effusion and hepatosplenomegaly. The patient continued to have abdominal pain and progressive distention Ascitic tap was hemorrhagic. Later laparoscopy showed 1.5 liters peritoneal fluid with blood clots and mild diffuse congestion of the peritoneum. Liver, spleen and blood vessels were normal. Then what would be the possible mechanism to explain hemoperitoneum, is it the increased vascular permeability caused by the virus? India being endemic for dengue illness, it is an interesting and rare case presentation. Source

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