Hydatid disease is a parasitic infestation of humans and herbivorous animals, caused by Echinococcu granulosus. Dogs and some wild carnivores, like foxes, are definitive hosts, harboring worms in their intestines. Musculoskeletal cysts account for 0.7-3% of total cases of hydatidosis. Primarymuscular hydatidosis without involving the thoracic or abdominal organs is extremely rare. Intramuscular infestation may mimic a soft tissue tumor leading to inappropriate cyst rupture with the attendant risks of anaphylaxis and dissemination to other organs. So preoperative evaluation is critical to avoid lifethreatening complications. We report a case of 34-year-old male patient with a cystic gluteal swelling turning out to be hydatid cyst on surgical exploration. Surgical excision with a pharmacology complementary treatment with antihelementhics is necessary to achieve the complete healing.
Background: Anal fissure is common condition in general population which cause severe pain at the anal region while defecation and associated with bleeding. These symptoms cause reduction in quality of life with considerable morbidity. The objective of this study was to compare the difference in outcome between open lateral anal sphincterotomy and application of topical 0.2% nitroglycerin ointment for the treatment of chronic anal fissure and their individual efficacy.Methods: 68 cases with a clinical diagnosis of anal fissure were recruited in the study. All selected patients met with inclusion criteria. Thus, selected cases were assigned to one of the other groups by odd and even method. Group A was managed conservatively using topical 0.2% nitroglycerin ointment, whereas Group B underwent open lateral anal sphincterotomy. Both groups were followed up at 3 week, 6 weeks, and 12 weeks, after the treatment.Results: Among all the 68 patients, all patients had come with complaint of pain whereas 31 patients had bleeding per rectum along with pain. On clinical examination, hypertonic anal sphincter elicited in 47 patients, sentinel skin tag was noted in the 23 patients. Group A included 34 patients treated with topical 0.2% nitroglycerin ointment and group B included 34 patients who underwent lateral internal sphincterotomy. In group A, 25 (73.5%) patients treated successfully, 9 (26.4%) patients were uncured who underwent lateral anal sphincterotomy, with no fresh complaints during follow up. By contrast, all patients in group B were successfully treated and only one (0.03%) patient came with unexplained discomfort and one patient suffered from flatus incontinency.Conclusions: This prospective study, demonstrates that open lateral internal sphincterotomy is superior to topical nitroglycerin application in the treatment of anal fissure with good symptomatic relief, high rate of healing with very low rate of early incontinence. Patients who are not willing to undergo surgery the glycerin trinitrate ointment can be used as medical line for fissure in ano.
Assessment of age by radiological examination of ossification centers of bones is useful to solve several medicolegal and civil cases. Radiological examination plays a crucial role in sensitive cases where dispute of age arises with evidence of birth certificates, school records and hospital records produced by the concerned parties. Present study is aimed at age estimation by the process of appearance and fusion of ossification centers of bones at the elbow so as to formulate the reasonable acceptance of the age by various authorities including the judiciary and comparision of the above said with the date of birth certificates of the subjects. MATERIALS The number of subjects studied are 75 cricket players. Inclusion criteria Healthy male students aged between 10-20 years. Exclusion criteria No skeletal malformations or visible physical abnormalities. The subjects chosen for study have been grouped into 2 as follows as per their age groups:-1. About 35 subjects are within the age group of 11-14 years. 2. About 40 subjects are within the age group of 15-18 years. The groups were made based on evidential proof of date of birth certificates given by the subjects. The bone age is compared with the date of births of the subjects. METHODS Anteroposterior position of the elbow joint of right hand is used. RESULT Paired T test is done. Significant P value is seen. In the age group of 10-15 there is a correlation in 26 cases. In the age group of 15-20 there is a correlation in 28 cases. DISCUSSION Assessment of appearance, maturity and union of ossification centers of bones by radiological means is an important and useful study to determine the age of a person though various physical, dental and other anthropometric methods are available. Age determination by skeletal maturity is said to be an accurate process. CONCLUSION Present study indicates that there is significant disagreement of evidential proof of age provided and the scientific observation of age of the candidates by the forensic procedure in all the two categories of age groups investigated. This study clearly indicates that a few of the parents have changed the original date of births of their children in order to get future educational benefits and service benefits.
Apocrine malignancies are rare to occur. Axilla and the anogenital skin are the most common sites of primary tumour. Apocrine malignancy carries high risk of lymphatic and vascular spreading to lung, liver and bone. A 40 years old painter, presents with diffuse swelling and pain in the left lower limb up to left inguinal region since 5 to 6 months. With generalised lymphadenopathy. On evaluation, revealed adenocarcinoma of apocrine, skin adnexa in the extremities of the limb with extensive distant metastasis. Apart from Dermatologists other board specialty consultant should be aware of the possibility of apocrine adenocarcinoma while differentiating cutaneous tumor located in the extremities. Apocrine malignancy should be treated aggressively with wide local excision or amputation the involved part for improving the life expectancy. Since prevalence of apocrine malignancy are rare, and it is associated with increased mortality, it provoke us the field of research for discovering other modalities of treatment.
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