Melioidosis, a potentially fatal disease endemic in South East Asia and Northern Australia is caused by Burkholderia pseudomallei, a potential bioterror agent. It is a motile, aerobic non-spore forming gram negative bacillus often characterised by pneumonia and multiple abscesses, but it can also present as septic arthritis, cutaneous ulcer and osteomyelitis. Modes of acquisition are inhalation, inoculation and rarely ingestion from a contaminated environment.1 General and gastro surgeons rarely come across abdominal melioidosis and rare is a lesser sac haematoma secondary to mycotic aneurysm of splenic artery caused by melioidosis. Clinical manifestations can vary from asymptomatic infections to localised abscesses to fulminating diseases with multiorgan involvement and eventual death. Due to evolving lifestyle, extensive travel and climate changes the disease which was previously confined to specific countries has crossed its boundaries. Increase in cases of comorbid conditions like diabetes and immunocompromised states have added on to the cause of increasing rates of the disease worldwide. India has seen isolated case reports from few states. Most often Burkholderia pseudomallei is misreported as pseudomonas species especially in resource-poor laboratories making the disease potentially fatal due to error in the treatment protocol.2 Due to its high chance of recurrence, prolonged treatment with combinations of antibiotics is required for complete eradication.
Background: Respiratory complications are frequent in acute pancreatitis, and respiratory dysfunction, presenting as Acute lung injury (ALI) or Acute Respiratory Distress Syndrome (ARDS), is a major component of multiple organ dysfunction syndrome (MODS), with a frequent need for ventilator support, which contributes to early death in severe acute pancreatitis. The current study was done with the objective of assessing the morbidity and mortality of acute pancreatitis cases with respiratory complications and to find out whether there is any association between the aetiology of acute pancreatitis and respiratory complications. Methodology: It was a prospective observational study conducted in a tertiary care centre in Kerala. All participants admitted with symptoms suggestive of acute pancreatitis were screened for potential enrolment. The inclusion criteria employed were that the patients should be aged above 18 years, and presenting with the first episode of pancreatitis, irrespective of aetiology. All the patients who were admitted were monitored daily for the worsening of any respiratory complications and provided with adequate respiratory supports. Results: Out of the 101 participants recruited, males were 84.2%. Mean (SD) age was 42.1 (11.4) years. Majority of cases (61%) had alcoholic aetiology. Fourteen patients required high flow nasal oxygen support, four patients were given face mask support, five patients required ventilator support and three patients required tracheostomy support. Respiratory complications and requirement of support were found to be associated with higher morbidity as well as mortality. Respiratory complications were higher in those with alcoholic etiology but this was not significant in univariate analysis. Conclusion: Respiratory complications pose challenges in clinical course of acute pancreatitis in terms of morbidity as well as mortality. Aetiology did not seem to play a major role in development of respiratory complications.
Injury to the liver accounts for 3%–10% of blunt abdominal trauma injuries. Majority of these injuries are currently managed nonoperatively. Hepatic artery or portal triad injuries are less frequent. However, the mortality rates with portal triad injuries and with combined injuries are high. Hence, identifying these injuries are important to the trauma team to proceed with optimal management. We present the case of a patient with concealed hepatic artery injury with liver trauma who was managed by laparotomy and vessel repair. We highlight the importance of recognising the clinical and radiological signs that indicate the possibility of hepatic artery injuries. This case report aims at improving awareness of hepatic artery injuries that may occur alone or in association with liver injuries and their management.
BACKGROUND Colorectal carcinoma is the most frequently encountered malignancy worldwide. The main cause of mortality associated with colorectal malignancy is tumour invasion and metastasis. The major genomic alteration that has been found in colorectal carcinoma is mutation in the adenomatous polyposis gene. Mutated APC causes unrestricted action of the Wnt signalling pathway which results in accumulation of the β - catenin protein in the nucleus responsible for cell proliferation, differentiation and enhanced survival of colorectal epithelial cells. Role of β - catenin expression as a prognostic marker needs to be studied. It will help in aiding the possibility of the future of anti β - catenin targeted chemotherapy for the treatment of colorectal cancers. METHODS A total of 85 samples from histopathologically proven cases of adenocarcinoma colon were taken. Histomorphological features and their immunohistochemical expression of β - catenin were studied. Data thus obtained was analysed using SPSS version 25. Histopathological diagnosis is considered as the gold standard. RESULTS Among the 85 samples of adenocarcinoma 9 case were stage T1 tumours, 24 were stage T2. 31 cases were stage T3, and 21 colorectal cancers were stage T4. Statistically significant correlation was obtained between tumour stage and β - catenin expression. (P value = < 0.001) With regard to tumour grade 24 out of 85 cases were well differentiated and 45 were moderately differentiated, 16 cases were poorly differentiated. Correlation of tumour grading and β - catenin expression also were statistically significant (P value = < 0.001). 45 out of 85 cases were having no nodal metastasis. 22 cases showed metastasis in 1 to 3 lymph nodes. 18 cases were N2. No statistically significant correlation was obtained between lymph node status and β - catenin expression. (P value = 0.003) CONCLUSIONS In this study the membranous, cytoplasmic and nuclear scores of β - catenin shows the linear progression with the advancing stages of colorectal carcinoma. So β - catenin can be used as a prognostic marker in malignant colorectal neoplasm. KEYWORDS Immunohistochemistry, β – Catenin, Colorectal Carcinoma
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.