Clinical and Laboratory Presentation of Hydatid Disease: A Study From Northeast India.

Introduction Hydatid disease is an immense health problem in developing countries. The diagnosis of hydatid cyst is often difficult because of its protean manifestations. Our objective was to evaluate the various clinical and laboratory presentations of hydatid disease and various modalities of treatment from a tertiary care center. Materials and methods We reviewed the clinical and laboratory features of patients presenting with hydatid cyst through retrospective analysis from January 2018 to December 2019 from a tertiary care hospital in northeast India. Results Of the 26 adult patients with hydatid cysts who were part of the study, 14 (53.8%) were males and 12 (46.2%) were females. The mean age was 34.6 years. The most common site of involvement was the liver (69%) followed by lung (19.2%) and brain (7.7%). Palpable mass in the right upper quadrant of the abdomen was the most common symptom (88.3%) for liver hydatid cyst followed by pain abdomen (66.6%). Systemic symptoms like fever and weakness were present in most of the patients. The majority of patients (80%) were from rural areas. Conclusion Hydatid cysts present with varied symptomatology. History of exposure to infected animals may not be present. A high degree of clinical suspicion combined with meticulous history and clinical examination supported by laboratory investigations are required for its diagnosis.

Incidence of nonalcoholic fatty liver disease in patients undergoing laparoscopic cholecystectomy.

INTRODUCTION: Nonalcoholic fatty liver disease (NAFLD) includes a host of disease spectrum ranging from simple steatosis to steatohepatitis, cirrhosis liver, and even hepatocellular carcinoma. NAFLD can occur at all ages, and the highest prevalence is found in the age group of 35-55 years. NAFLD is becoming the commonest cause leading to hepatic cirrhosis, but there is no prescribed therapy for this common condition. Reduction in body weight may reverse the condition. AIM: To find the prevalence of NAFLD in a cohort of patients undergoing laparoscopic cholecystectomy in this part of the country and also to evaluate the usefulness of routine liver biopsy for the diagnosis of NAFLD. MATERIALS AND METHODS: Interventional type of cross-sectional study. In all, 200 consecutive patients underwent a liver biopsy at the end of a standard laparoscopic cholecystectomy, and detailed histopathological examination was done. Clinical, biochemical, demographic, and anthropometric variables were obtained prospectively. NAFLD Activity Score (NAS) was obtained for each patient. Statistical analysis was done using SPSS version 22. RESULTS: A total of 200 patients (140 females and 60 males) were included in the study. In all, 138 patients were categorized as non-nonalcoholic steatohepatitis (NASH), 39 patients as borderline/suspicious NASH, and 23 patients had definitive NASH. A higher body mass index, weight, total cholesterol, low-density lipoprotein, alkaline phosphatise, and weight circumference were found in patients with NASH. CONCLUSION: The high prevalence of NAFLD in patients with gallstone disease may justify routine liver biopsy during cholecystectomy to establish the diagnosis, stage, and possibly direct therapy.

Schwannoma of Upper Lip: Report of a Rare Case in a Rare Age Group.

Schwannoma is a benign, encapsulated perineural tumour originating from the schwann cells of the neural sheath of peripheral motor and sensory nerves. It may develop at any age but is extremely rare in paediatric age group. The tumour is frequently located on the head and neck region, the tongue being the most common site followed by the palate, floor of mouth, buccal mucosa, lips and jaws. Schwannomas rarely occur in the lip area and it is exceedingly rare in the upper lip. The lesion is usually solitary but can be multiple when associated with neurofibromatosis. The diagnosis is usually confirmed after biopsy and anti-S100 protein immuno-histochemical staining is usually used to identify the tumour. In the present study the patient was a 14-year-old young girl with the schwannoma on the upper lip which is probably the third such case in a paediatric age group being reported and was excised without any recurrence at 2 year after excision.

Study of Aortic Valve Sclerosis as A Marker of Atherosclerosis in Acute Coronary Syndromes.

INTRODUCTION: Aortic valve sclerosis has been shown to be associated with increased incidence, chances of developing myocardial infarction and even death. The epidemiological risk factors causing calcification of aortic valves have also been found to cause atherosclerosis. AIM: To analyse the epidemiological risk factors causing aortic valve sclerosis which have been studied in details and analysed to see whether they cause any significant increase in the incidence of cardiovascular events. MATERIALS AND METHODS: This prospective case-control study was conducted between 1st Jan 2015 to 31st Dec 2015 in NEIGRIHMS hospital and data for age, gender, socioeconomic status, hypertension, diabetes, tobacco use, Body Mass Iindex (BMI), cholesterol levels, Electrocardiography (ECG) changes and Ejection Fraction (EF) were collected and analysed by using SPSS software version 22. RESULTS: Hypertension, diabetes, weight, BMI, hyperglycaemia and hyperlipidemia were not found to be significantly associated with aortic valve sclerosis in patients presenting with acute coronary syndromes. The presence of aortic valve sclerosis was also not associated with increased risk of cardiovascular mortality and morbidity. CONCLUSION: The risk factors for atherosclerosis were found to be associated with the presence of aortic valve sclerosis more in the control group and hence finding of a sclerosed aortic valve in the apparent normal population might identify those persons at increased risk of developing coronary artery disease and appropriate preventive measures should be taken before the disease sets in.