Ascaris lumbricoides (Round Worm) is the most common human helminth with a world wide distribution. Incidence of ascariasis remain very high in the tropical and sub tropical countries with poor sanitation, personal hygiene, and rural areas where defaecation in open place is still a common practice. Ascariasis is classified as a neglected tropical disease. Infections have no symptoms in more than 85 percent of cases specially if the number of cases are small. Pathogenecity and clinical features are either due to migrating larvae or due to adult worms. Larval migration may lead to allergic reactions, ascaris pneumonia. Adult worms are often responsible for nutritional deficiencies, toxic effects due to hypersensitivity &mechanical effects leading to intestinal obstruction. Ectopic ascariasis can lead to acute biliary obstruction, cholangitis, acute pancreatitis, acute obstructive appendicitis and peritonitis due to perforation of an intestinal ulcer or break down of a post operative suture line. Medical therapy with Albendazole is the first line drug ascariasis can be eliminated by preventing faecal contamination of soil. Advancement in recombinant protein technology may provide first step in discovery of Ascaris vaccine as well as pan helminthic Vaccine. This chapter is a updated review of ascariasis.
Anomalies of testicular descent are very common but scrotal wall deformity leading to extrusion of testes is very rare. This anomaly is described as scrotoschisis or testicular exstrophy. In English literature less than 15 cases were reported till date to the best of our knowledge. A rare case of unilateral testicular exstrophy in a full term 3-day-old neonate is reported here along with review of literature and discussions on probable etiology.
Background: Blunt abdominal trauma (BAT) is one of the common causes of admission in surgical ward in any hospital. It requires high level of suspicion, urgent evaluation and timely management to decrease morbidity and mortality. Objective was to evaluate the role of clinical and ultrasound assessment in early diagnosis of intra-abdominal injury following blunt abdominal trauma and follow up in patients with intraabdominal injury for detecting complications.Methods: 130 patients who presented to the emergency room were evaluated by clinical and focused abdominal sonography for trauma (FAST) and follow-up sonography was done after 6-12 hours upto 72 hours.Results: In our study, road traffic accidents (RTA) were the most common cause of blunt abdominal trauma (70.76%) with 75% patients being were males. X-ray erect abdomen and ultrasound of the abdomen were the most sensitive investigation for hollow viscous injury and solid organ injuries, respectively, with bowel (38.33%) and liver injury (26.67%) being the most common organ involved in this study. This study found sensitivity (93.7%) and specificity (98.5%) of focused abdominal ultrasonography (FAST).Conclusions: Initial resuscitation followed by clinical and ultrasonography assessment is considered the best modality in initial evaluation of blunt abdominal trauma patients as it is noninvasive, readily available, and requires minimal preparation time and also due to restricted use of modern amenities such as CT-scan in tertiary care in India.
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