Congenital malformation of lung parenchyma: 15 years experience in a thoracic surgical unit.

OBJECTIVE: To review the surgical management of congenital malformations of lung parenchyma in a thoracic surgery unit over a period of 15 years. METHODS: We carried out a retrospective analysis of records of all patients who had surgery for congenital malformations of lung parenchyma between 1995 and 2010. RESULTS: Forty-five patients underwent surgery for congenital lung lesions out of 3735 thoracotomies performed during the study period. The lesions included 29 lung sequestrations, 12 bronchogenic cysts, 3 congenital lobar emphysema and one congenital cystic adenomatoid malformation. Only 26 (26%) cases were diagnosed preoperatively. Twenty-eight (62.2%) patients underwent lobectomy, 5 (11.1%) patients had pneumonectomy, and 10 (22.2%) patients had removal of cyst while 2 (0.45%) patients had lung resection with repair of the oesophageal connection. No mortality was recorded. One patient had post-operative complication of oesophageal fistula which was successfully managed conservatively. The follow-up was between 8 months to 14 years. All patients were asymptomatic and had no physical limitations during the follow-up. CONCLUSIONS: Surgery is curative and produces good long-term result in patients with congenital malformations of lung parenchyma. It should be offered to patients as a therapeutic option where indicated and feasible.

Study of the intake of fluid, output and titratable acidity of urine in medical students.

183 students of 17-22 years age group were studied in respect of fluid intake, urine output and urine titratable acidity under normal conditions for two consecutive days. The study was performed in early winter in eastern part of U.P. Male students were observed to have higher fluid intake and urine output as compared to female. Average fluid intake and urinary output in male students were observed to be 2860 S.D. +/- 780 ml and 1860 S.D. +/- 880 ml respectively while corresponding readings for female students were 1980 S.D. +/- 390 ml and 1550 S.D. +/- 840 ml. Titratable acidity was observed to be high with a mean of 47.46 meg S.D. +/- 16.2 meq as compared to commonly accepted average range of 25-35 meq. Nonvegetarian subjects were found to have significnatly higher titratable acidity. Fluid intake and urine output did not have any significant effect on titratable acidity of urine in both the sexes. Need for further studies on this subject has been stressed.

A study of urinary creatinine and creatinine coefficient in healthy young adults.

Daily urinary creatinine excretion and creatinine coefficient of eighty-four healthy medical students have been studied for three consecutive days. Daily creatinine excretion has been observed to be higher in the male subjects compared to the female counterparts. Creatinine excretion has been observed to be dependent on body weight of the subjects. The variability from subject to subject was higher than observed by most other workers. Day to day consistency within the same subject was rather low. Creatinine coefficient was computed per kg of body weight as well as per kg of lean body weight. In both the cases, it has been found to be higher in the males than in the females. Though an important factor, yet body weight of a subject alone could not explain satisfactorily wide variability of creatinine excretion in the present study. The possible influencing factors have been discussed along with clinical implications.