In cases of impacted dentures in the oesophagus, a positive history helps in the diagnosis, but a high degree of clinical suspicion aids early detection. Conventional radiographs are important but may not always be of assistance. Early intervention reduces complications. Dentures that are poorly maintained and old are more likely to be swallowed accidentally. The inclusion of radiopaque filler within dentures would assist localisation following accidental swallowing.

ABSTRACT

Dermatofibrosarcoma protuberans (DFSP) is an uncommon, slow growing and locally aggressive tumor of the skin with a high rate of recurrence even after supposedly wide excision. The reports of regional lymph node metastasis and distant metastasis are very rare. Because of the extreme rarity of these cases with metastasis, the experience with management of such patients is very limited. A case of recurrent DFSP of scalp, with metastasis to the regional lymph nodes, in a 17-year-old boy is reported here. This is the second case of DFSP involving scalp and 16th case of DFSP of all sites metastasizing to the regional lymph nodes reported in literature. The patient was treated with wide excision of the lesion and ipsilateral radical neck dissection (including excision of overlying involved skin).

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Objectives To assess the efficacy of calciuria as a diagnostic test for the prediction of preeclampsia, and also to determine the changes in urinary excretion of calcium in preeclampsia and normotensive women. Methods A prospective study was conducted on 60 primi mothers in the age group of 20-30 years, and all were enrolled at 16 weeks of gestation with clinical follow up by 4 weeks and 24 h urinary calcium and creatinine estimation. Ten mothers developed preeclampsia (study groups) and fifty remained normotensive (control groups). By means of Receiver-operator curve, a cut-off level of urinary calcium in 24 h was chosen for predicting preeclampsia. Results Preeclamptic women excreted significantly less total urine calcium (87.0 ± 3.59 mg/24 h) than normotensive women (303.68 ± 17.699 mg/24 h) (p \ 0.0001) at 40 weeks of gestation. Urinary calcium and calcium/ creatinine (Ca:Cr) ratio decreases progressively from 28 weeks to 40 weeks in the study group when compared to normotensive group. Conclusions Preeclamptic women excrete less calcium than normotensive women. This parameter would predict preeclampsia earlier in pregnancy.

Background: Blood is the only oxygen transporter in the body and is crucial in saving lives. Research has failed to find a true substitute for blood and blood components and depends on human donors. There are several infectious and non-infectious risks associated with transfusion. An unsafe transfusion is very costly from both human and economic points of view. In that perspective the present study is aimed to assess the profile of blood donors. The objectives of the study were to assess the profile of blood donors as per records of Blood Bank of a private medical college of Kolkata and to find out the prevalence and trends of transfusion transmitted infections among those donors.Methods: A record based cross sectional study was conducted for the period May 2013 to April 2016 at Blood Bank of a private medical college and information regarding 5383 blood donor’s profile were collected and analysed. Results: The total donors were found to be 5383 out of which (87.72%) were voluntary donors and (12.28%) replacement donors. The donors had a male predominance (79.84%). The most available blood group was B+ (49.42%) and the least available blood group was A- (0.38%). The commonest transfusion transmitted infection was Hepatitis B (1.11%) followed by Hepatitis C (0.28%) and HIV (0.21%). The transfusion transmitted infections (TTI) shows a decreasing trend over the 3 years. Conclusions: The voluntary donors have increased over the 3 years but there is always a male predominance. The pattern of TTIs in the blood bank depicts the national trend too.

Background & objectives:Failure to adhere to anti-retroviral therapy (ART) can lead to a range of unfavourable consequences impacting upon people living with HIV (PLH) and society. It is, therefore, paramount that ART adherence is measured in a reliable manner and factors associated with adherence are identified. Lack of such data from West Bengal necessitated undertaking the current study.Methods:Participants were included during August-October, 2011 from three Drop-In-Centres (DICs) from the three districts of West Bengal, India. ART-adherence was calculated by using formula based on pill-count and records collected from ART-card in possession of each of the 128 consenting adult PLH. Information on self-reported adherence, socio-demography, and adherence influencing issues was also collected through interviewer-administered questionnaire.Results:Of the 128 PLH, 99 (77%) and 93 (73%) PLH had ≥90 per cent and ≥95 per cent adherence, respectively to ART. Conversely, subjective reporting captured much higher proportion of PLH as ‘well adherent’; a finding having implications for ongoing ART programme. Factors, independently associated with poor adherence (<90%), were ‘7th to 12th month period of ART intake’ (adjusted OR=9.5; 90% CI 1.9 - 47.3; P=0.02) and ‘non-disclosure of HIV status to family members’ (adjusted OR=4; 90% CI 1.3 - 13; P=0.05. Results at 95 per cent adherence cut-off were similar.Interpretation & conclusions:Enabling environment, which would encourage people to disclose their HIV status and in turn seek adherence partners from families and beyond and ongoing adherence-counselling appear to be important issues in the programme. Relevance of these study findings in wider context is conceivable.

Background: The study demonstrates the use of latent class analysis (LCA) to segregate population in two latent classes e.g. susceptible or not susceptible to adverse health outcomes according to the observed risk factors as a method of medical diagnosis. Methods: The present study uses a secondary data set on 420 patients referred to the University of California, Los Angeles (UCLA). Adult Cardiac Imaging and Hemodynamics Laboratories for Dobutamine stress echocardiography (DSE) between March1991 & March1996. LCA is used for estimating the individual item-response probabilities in each latent group and also the latent class sizes. The observed variables or indicators of the latent subgroups are the common risk factors viz. history of smoking, history of cardiac issues etc. The interaction effect of hypertension & diabetes is also included in the analysis. Results: Based on the behaviour of the estimates of latent class model parameters, the unobserved groups are identified and named. Proportion of individuals falling in each latent class are approximately 0.20 & 0.80 respectively. The susceptibility to adverse health outcomes in future is the most in male individuals having a positive history of hypertension and/or diabetes, as the corresponding indicators have higher positive item-response probabilities (0.72 & 0.83 respectively) than the rest. Conclusions: The study briefly explains the application of LCA for identifying subgroups according to susceptibility to adverse health effects in a large population. Assessment of common risk factors in predicting latent class sizes provides estimates of probabilities for being a member in each class. The importance of the combined effect of hypertension & diabetes in predicting future health problems related to cardiac issues is highlighted. Class assignments of individuals according to their pattern of response are also listed.