Pre-operative staging of rectal cancer using multi-detector row computed tomography with multiplanar reformations: Single center experience.

BACKGROUND: Technical advancement in imaging has helped to stage and plan treatment modality for carcinoma rectum with still some objectives controversial. AIMS: The aim of our study was to evaluate the accuracy of multidetector row computed tomography (MDCT) with multiplanar reformations in the pre‑operative staging of rectal carcinoma and correlation with intraoperative and histopathologic staging of retrieved specimen with respect to the depth of tumor invasion (T‑staging), lymph node metastasis (N‑staging) and mesorectal fascia (MRF) involvement. MATERIALS AND METHODS: The study was a prospective one and consisted of 52 patients with biopsy proved rectal carcinoma. MDCT studies were performed on a 64‑slice computed tomography system. Images were reconstructed in axial, coronal and sagittal planes. MDCT findings were compared with intraoperative and pathologic (reference standard) findings. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were assessed. RESULTS: The diagnostic accuracy of MDCT for T1/T2, T3 and T4 lesions was 77%, 86.5% and 100%, respectively. For perirectal lymph node metastasis (N+), the diagnostic accuracy of MDCT was 84.1%. The diagnostic accuracy of MDCT for MRF involvement was 91%. CONCLUSION: MDCT is a reliable radiological tool for local staging of rectal cancer with excellent accuracy rates for T and N‑staging of rectal cancer.

Fracture of Testicle.

Testicular fracture is a rare injury. A testicular fracture occurring after being kicked in the scrotum in a young male is presented. Patient presented two days after trauma. Pain and swelling were presenting symptoms. Ultrasonography was used for diagnosis. Exploration of scrotum with repair of fracture was done and patient recovered well.

Cystic Hygroma of Wrist.

Cystic hygroma is the rare congenital lesion. This is a cystic variety of lymphangioma. Cystic hygroma arising outside of the cervicofacial, thoracic, and abdominal areas are extremely rare. Wrist is a very rare site for occurrence of cystic hygroma. Presentation depends on site of location of cystic hygroma. A case of cystic hygroma of wrist in a child is reported. This child presented with painless swelling of left wrist. Excision of cyst was done. This is first case report of literature reporting occurrence of cystic hygroma on wrist.

Joubert’s Syndrome: A Case Report.

Joubert’s syndrome is an autosomal recessive congenital disorder having characteristic clinical features like hypotonia, ataxia, developmental delay and many neurological problems. Other variable features include retinal dystrophy, cystic kidney disease liver fibrosis etc. Treatment for Joubert syndrome is symptomatic and supportive. Infant stimulation and physical, occupational, and speech therapy may benefit some patients. Infants with abnormal breathing patterns should be monitored.

Detection & characterization of Shiga toxin producing Escherichia coli (STEC) & enteropathogenic Escherichia coli (EPEC) in poultry birds with diarrhoea.

Background & objectives Limited information is available on shiga toxin producing Escherichia coli (STEC) in animals and birds from India. An outbreak of acute diarrhoea in poultry birds at Aizawl, Mizoram was investigated for detection and characterization of STEC and enteropathogenic E. coli (EPEC). Methods E. coli was isolated and identified from rectal swabs, intestinal contents, heart blood and spleen of 19 poultry birds that died due to acute diarrhoea during the outbreak. Phenotypic characterization was done by standard bacteriological and biochemical techniques. All the isolates were serotyped based on their somatic antigens. Virulence genes (stx1, stx2, eaeA and hlyA) were detected by multiplex PCR assay. Results A total of 42 E. coli isolates were obtained, of which 24 belonged to 3 serogroups (O64, O89 and O91) and the remaining 18 were untypable (UT). Altogether, 14 (33.33%) isolates carried at least 1 virulence gene, of which 10 (23.81%) and 4 (9.52%) were recorded as STEC and EPEC, respectively. Of the 10 STEC isolates, one carried only stx2, one carried stx2 and hlyA, four carried stx1, stx2 and hlyA, two carried stx1, eaeA and hlyA genes and two carried stx1 and eaeA. Of the four EPEC isolates, two carried eaeA and hlyA, one carried only eaeA gene and 1 carried only hlyA gene. Interpretation & conclusions This is the first report on the involvement of STEC in poultry in India.

Molecular characterization of shiga like toxin-producing Escherichia coli (STEC) isolates from pigs oedema.

BACKGROUND & OBJECTIVE: An oedema outbreak occurred in a Guwahati pig farm. Escherichia coli isolates from different necropsy samples collected from the dead piglets with oedema were characterized to confirm the virulence. METHODS: Haemolytic E. coli isolates recovered from liver, lung and intestine of pigs with oedema were examined for presence of genes encoding pathogroups such as enteropathogenic Escherichia coli (EPEC), (eae/bfpA), enteroaggregative Escherichia coli (EAggEC), (eagg), enterotoxigive Escherichia coil (ETEC), (elt/est) and shiga like toxin producing Escherichia coli (STEC), (stx1/ stx2) by PCR and molecular typing by randomly amplified polymorphic DNA-PCR (RAPD-PCR). RESULTS: The three haemolytic E. coli recovered from diseased pigs were STEC because of presence of the stx2 and eae genes. Analysis by RAPD-PCR indicated that two of the three isolates were genetically related. INTERPRETATION & CONCLUSION: The isolation of STEC isolates from pigs with oedema was shown. Although the three isolates were untypable, presence of eae and stx2 genes clearly indicated these as prime cause of pig oedema disease. Further, demonstration of STEC in pigs becomes a public health concern, as pigs are potential reservoir of such agents, which may cause human illness.

Ocular toxocariasis in a child: a case report from Kashmir, north India.

Toxocariasis is an important zoonotic disease caused by the second stage larva of Toxocara canis or Toxocara cati . The typical clinical syndromes of toxocariasis in humans are visceral and ocular toxocariasis. Ocular toxocariasis may presents as peripheral inflammatory mass, posterior pole granuloma and endophthalmitis. We report a serologically confirmed case of ocular toxocariasis in 12-year-old female. The diagnosis was confirmed by detection of anti- Toxocara antibodies in aqueous and vitreous sample by enzyme-linked immunosorbent assay. We suggest that ophthalmologist in this region should include ocular toxocariasis in differential diagnosis particularly in children and young adults.

Helminthic infestation in children of Kupwara district: a prospective study.

The present study deals with the investigation of the frequency of intestinal helminth parasites in children of Kupwara, Kashmir, India. Three hundred and twelve children in the age group of 4-15 years were examined for different intestinal helminths in three schools located in rural areas. Two hundred and twenty two of 312 (71.15%) tested positive for various intestinal helminths. The various helminth parasites included Ascaris lumbricoides , Trichuris trichiura , Enterobius vermicularis and Taenia saginata . By far, the highest frequency of 69.23% (216/312) was noted for Ascaris lumbricoides followed by Trichuris trichiura 30.76% (96/312), Enterobius vermicularis 7.69% (24/312) and Taenia saginata 7.69% (24/312). Single infection was found in 33.65% (105/312) and mixed infection was seen in 37.5% (117/312) children. This study emphasizes the need for improved environmental conditions, i.e., clean water supplies, enhanced sanitation and chemotherapy of school-age children in rural areas.