ABSTRACT
Background:Discuss the role of ultrasound in detecting various gallbladder and biliary tract pathologies in patients presenting as right upper quadrant/epigastric pain/obstructive jaundice especially in emergency situations and demonstrating the incidence of various gallbladder and biliary tract pathologies. Material And Methods:A retrospective observational study of 85 patients having upper abdominal/epigastric pain/obstructive jaundice was carried out at SVP Hospital, ahmedabad. Ultrasound was performed by using MINDRAY RESONA 6 machine. Both curvilinear and linear probes were used for the scanning.Result:The study included 85 patients with 50 female patients and 35 male patients.Most common pathology found was gallbladder calculus (47%). Female gender (72.5%) wasmore prone for having gallstones than male gender (27.5%). Gallstones were commonly associated with diffuse wall thickening and most common pathology associated with diffuse wall thickening was acute calculus and acalculous cholecystitis with both havinga frequency of 30 % each. Gallstones were found a common risk factor for gallbladder perforation as well as gallbladder malignancy. Common pathologies presenting with obstructive jaundice were CBD stones and CBD stricture in which distal CBD was the commonest site for the stones (39%) as well as stricture (50%).In paediatric age group presenting with jaundice common pathologies were choledochal cyst and biliary atresia.Conclusion:Ultrasound is a non-invasive, least expensive,highly sensitive imaging modality and free from radiation for the assessment of the gallbladder and biliary tree pathologies especially in emergency situations
ABSTRACT
Purpose of Study: The western and North-Western parts of India are usually considered non-endemic for histoplasmosis. On the contrary, we observe histoplasmosis cases with relatively higher frequency from this region although the awareness and laboratory facility to diagnose the disease are not adequate. Hence, we planned the present retrospective study to compile the cases and to analyse different clinical parameters. Materials and Methods: Medical records of the patients diagnosed with histoplasmosis during January 2012–August 2017 at two infectious disease clinics of Ahmedabad were included in this study. Results: During the study, 12 cases of histoplasmosis were diagnosed. The median age of the patients was 53 years; all males except one. The diagnosis of histoplasmosis was confirmed on histopathology for 11 cases, and one patient was diagnosed as probable histoplasmosis. The patients were either from Gujarat or Rajasthan without any travel history to endemic zone of histoplasmosis, except one patient. The majority (67%) of the patients had no apparent immunosuppression. Adrenal enlargement, oral ulcers and lymphadenopathy were common presentations in four patients each. We lost two patients in follow-up, and rest 10 patients responded to either to amphotericin B deoxycholate and/or itraconazole therapy. Conclusion: This study highlights that Gujarat and Rajasthan are an endemic region for histoplasmosis, and a systematic study is required to understand epidemiology of the disease. Histoplasmosis should be a differential diagnosis in a patient presenting with adrenal enlargement, lymphadenopathy, oral ulcers and fever of unknown origin in this region.