Competence of algal consortia under municipal wastewater: remediation efficiency, photosynthetic performance, antioxidant defense mechanisms and biofuel production.

Utilizing monoalgal species for wastewater treatment is facing tremendous challenges owing to changing wastewater complexity in terms of physico-chemical characteristic, nutrient and metal concentration. The environmental conditions are also fluctuating therefore, the formation of robust system is of utmost importance for concomitant sustainable wastewater treatment and bioenergy production. In the present study, the tolerance and adaptability potential of algal consortia-1 (Chlorococcum humicola and Tetradesmus sp.) and consortia-2 (Chlorococcum humicola, Scenedesmus vacuolatus and Tetradesmus sp.) treated with municipal wastewater were examined under natural environmental conditions. The results exhibited that consortia-2 was more competent in recovering nitrate-nitrogen (82.92%), phosphorus (70.47%), and heavy metals (31-73.70%) from municipal wastewater (100%) than consortia-1. The results further depicted that total chlorophyll, carbohydrate, and protein content decreased significantly in wastewater-treated consortia-1 as compared to consortia-2. However, lipid content was increased by 4.01 and 1.17 folds in algal consortia-1 and consortia-2 compared to their respective controls. Moreover, absorption peak at 1740.6 cm-1 reflected higher biofuel-producing potential of consortia-1 as compared to consortia-2 as confirmed through FTIR spectroscopy. The results also revealed that consortia-2 showed the highest photosynthetic performance which was evident from the increment in the active photosystem-II reaction center (1.724 ± 0.068), quantum efficiency (0.633 ± 0.038), and performance index (3.752 ± 0.356). Further, a significant increase in photosynthetic parameters was observed in selected consortia at lag phase, while a noteworthy decline was observed at exponential and stationary phases in consortia-1 than consortia-2. The results also showed the maximum enhancement in ascorbic acid (2.43 folds), proline (3.34 folds), and cysteine (1.29 folds) in consortia-2, while SOD (1.75 folds), catalase (2.64 folds), and GR (1.19 folds) activity in consortia-1. Therefore, it can be concluded that due to remarkable flexibility and photosynthetic performance, consortia-2 could serve as a potential candidate for sustainable nutrient resource recovery and wastewater treatment, while consortia-1 for bio-fuel production in a natural environment. Thus, formation of algal consortia as the robust biosystem tolerates diverse environmental fluctuations together with wastewater complexity and ultimately can serve appropriate approach for environmental-friendly wastewater treatment and bioenergy production.

Assessment of different carrier materials for the preparation of microbial formulations to enhance the shelf life and its efficacy on the growth of spinach (Spinacia oleracea L.).

The current study was undertaken to determine the ability of different carrier materials for sustaining the viability of microbial consortium during storage. Different bioformulations consisting of carrier material and microbial consortium were prepared and examined for viability and stability for one year stored at 4 °C and ambient temperature. Total 8 bio-formulations were prepared consisting five economically viable carriers (gluten, talc, charcoal, bentonite, broth medium) and a microbial consortium. In present study, maximum enhanced shelf-life of consortium based on colony forming unit count were recorded for talc + gluten based (B4) bioformulation (9.03 log10 cfu/g) over other bio-formulations stored for 360 days. Furthermore, the pot experiments was conducted to evaluate the efficacy of B4 formulation on growth of spinach in comparison with recommended dose of chemical fertilizer, uninoculated and no amendment control. The results depicted that B4 formulation increased biomass (176-666%), leaf area (33-123%), chlorophyll content (131-789%) and protein content (68.4-94.4%) of spinach over controls. Further B4 application significantly increased the nutrients like available nitrogen (131-475%), phosphorus (75-178%) and potassium (31-191%) of pot soil along with noteworthy improvement in root colonization as evident from scanning electron microscope analysis in comparison to controls at 60 days after sowing. Therefore, exploiting B4 formulation can serve as the environmentally sound approach to enhance the productivity, biomass and nutritional value of spinach. Thus, Plant growth promoting microbes-based formulation can be the novel paradigm to improve the soil health and eventually the crop productivity in economical and sustainable manner.

Microalgal competence in urban wastewater management: phycoremediation and lipid production.

The present study was conducted to assess the strain aptness, phycoremediation potential and lipid yield in microalgae Chloroccocum humicola and Oscillatoria sp. Results revealed that microalgae treated with different concentration of wastewater (25%, 50%, 75% and 100%) recovered nutrients (Nitrogen: 50.55-85.90%, Phosphorus: 69.98-93.72%) and removed heavy metals (24.17-88.10%) from wastewater. Microalgae C. humicola showed significant reduction in physico-chemical parameters of wastewater at 25% and 50% respectively with considerable increase in lipid production (1.61 folds) at 50% wastewater concentration. In order to counterbalance the wastewater induced toxicity, both microalgae exhibited stimulated antioxidants viz., proline (1.26-4.04 folds), ascorbic acid (1.01-9.21 folds), cysteine (1.44-4.92 folds), catalase (0.99-3.63 folds), superoxide dismutase (1.15-1.43 folds) and glutathione reductase (1.43-6.67 folds) at different wastewater concentrations. Further, Fourier transforms infrared spectroscopy spectral elucidation of Chloroccocum humicola at 50% reflected high lipid peak in the regions 3000-2800 cm-1 as compared to Oscillatoria sp. Thus, growth characteristics, biochemical responses and lipid yield presented the suitability of the Chloroccocum humicola to be used in phycoremedation, resource recovery as well as lipid production, which may be further utilized as potent feedstock for third generation energy demand.

Vehicular stress a cause for heavy metal accumulation and change in physico-chemical characteristics of road side soils in Pahalgam.

In an effort to determine vehicular impact on soil quality, soil samples were collected from three different zones (Pahalgam, Batakote, and Chandanwari) in Pahalgam forest ecosystem. Results showed that a significant decrease in moisture content, organic carbon, available nitrogen, and potassium was observed in nearby road side soils. However, pH was observed to be on neutral side and available phosphorus recorded high concentration. The concentration of heavy metals Pb2+, Cu2+, Zn2+, Ni2+, and Cd2+ estimated was also significantly high. Furthermore, concentration of Pb2+ at high vehicular load subzones was observed to be highest (1.168 mg/Kg) followed by Zn2+ (0.896 mg/Kg), Ni2+ (0.649 mg/Kg), Cu2+ (0.415 mg/Kg), and Cd2+ (0.079 mg/Kg). An inter-zone analysis revealed that the concentration of the heavy metals (Pb2+ > Ni2+ > Cd2+) was observed to follow the trend, Z-I > Z-II > Z-III. Variation along the temporal gradient and the impact on soil qualities were notably higher in summer. Vehicular pollution to a great extent impacts physico-chemical characteristics and more interestingly adds substantial concentration of heavy metals in soils.

Choroid Metastasis from Testicular Carcinoma: A Rare Entity.

The aim of this report is to contribute to the clinical understanding of choroid metastasis from testicular carcinoma. A young male patient presented with loss of vision in his left eye with ptosis and proptosis. Fundoscopy revealed bullous retinal detachment with dark hazy vitreous. The preliminary diagnosis of choroid carcinoma with vitreous involvement was made by an ophthalmologist. Later in the physical examination, there was a firm painless left testicular swelling. Testicular tumor markers were raised. Based on ultrasonography, MRI and PET-CT, a clinical diagnosis of left testicular carcinoma metastasizing to the left choroid and vitreous was made. A mixed germ cell tumor was reported on histopathological examination. After cisplatin-based chemotherapy, serum tumor markers normalized and vision improved. Exceptional choroidal and vitreous metastases with absence of other visceral and bony involvement constituted the presenting sign. Although rare, testicular carcinoma must be considered to metastasize to the eye, especially if loss of vision is the chief complaint.

Pattern of Clinical Presentation, Laboratory Findings and Mortality Risk Among Patients of Scrub Typhus in Western Himalayas.

OBJECTIVE: To study the pattern of the clinical presentation, laboratory findings and mortality risk among patients infected by scrub typhus in Western Himalayan region of India. METHODS: We studied all serologically confirmed cases of scrub typhus admitted to our hospital from July 2010 through December 2011. Presence of IgM antibodies to scrub typhus antigens by ELISA was considered as serological confirmation of the diagnosis. We observed the symptoms, signs, laboratory findings, risk factors for death from the time of admission till discharge/death. We performed bivariate and logistic regression analysis to look for independent risk factors for death. RESULTS: Total 253 patients were studied. All patients came from rural areas. More than 2/3rd were women and below 50 years of age each. High grade fever (90%), chills and rigors (68%), conjunctival suffusion (50%), body aches (43%), headache (41%), myalgias (37%), abdominal pain (21%), lymphadenopathy (17%), splenomegaly (17%), cough (16%), altered sensorium (16%), vomiting (15%), hepatomegaly (13%) were main presenting features. Eschar was present in 112 (44%) patients. Transaminitis (49%); and abnormal renal functions (31%) were predominant biochemical abnormalities. All patients were empirically treated with doxycycline/azithromycin. Thirteen (5%) patients died. CONCLUSIONS: In our region, rural women below 50 years of age presenting with high grade fever with or without eschar should be strongly suspected to be having scrub typhus. Renal dysfunction and altered sensorium are significant mortality risk factors (p < 0.05) and need to be identified at early stage to improve the treatment outcomes.

Evaluation of bacteriological profile and antibiotic sensitivity patterns in children with urinary tract infection: A prospective study from a tertiary care center.

INTRODUCTION: Development of regional surveillance programs is necessary for the development of community-acquired urinary tract infection (UTI) guidelines, especially for sub-urban and rural areas where empirical treatment is the mainstay in the absence of proper diagnostic modalities. Our aim was to evaluate the bacteriological profile and antibiotic sensitivity patterns in children with UTI prospectively from a tertiary care center. METHODS: A total of 800 children up to 18 years of age with suspected UTI attending our center were included. For all suspected cases urine microscopy, gram staining, and culture were done. Antibiotic sensitivity was performed on selected antimicrobials using disk diffusion method following Clinical Laboratory Standards Institute guidelines. RESULTS: Majority of pathogens were isolated from female (54.2%) patients. Pre-teens (52.1%) and teens (27.1%) were most commonly affected age group. The most common presentation in culture-proven UTI was fever with urinary symptoms (33.3%). In a group of 192 patients 26.7% had proven UTI. Escherichia coli (42.3%) was the most common aetiological agent, followed by Enterococcus fecalis (13.5%), Klebsiella spp. (11.5%) and Staphylococcus aureus (11.5%). Most active antibiotics against Gram-negative isolates were nitrofurantoin, cefotaxime, and amikacin. Gram-positive isolates were sensitive to nitrofurantoin, cotrimoxazole, and novobiocin. CONCLUSION: E. coli was the commonest isolate. The organisms grown in significant numbers were E. fecalis, Klebsiella spp. and S. aureus, causing UTI in 0-18 years of age group. Gram-negative isolates were sensitive to nitrofurantoin, amikacin, and cefotaxime. Gram-positive isolates were sensitive to nitrofurantoin, cotrimoxazole, and novobiocin. Prospective, regional studies are ensured periodically to explain bacteriological profile and antibiotic sensitivity patterns to be applicable for children with UTI over that geographic area.

A comparative randomized prospective study to evaluate efficacy and safety of combination of tamsulosin and tadalafil vs. tamsulosin or tadalafil alone in patients with lower urinary tract symptoms due to benign prostatic hyperplasia.

INTRODUCTION: Lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) and erectile dysfunction are common disorders of advancing age. AIM: To evaluate the efficacy and safety of tamsulosin and tadalafil in patients with LUTS due to BPH. METHODS: In this prospective randomized study, 133 men complaining of LUTS due to BPH were included. Forty-five patients received tamsulosin 0.4 mg/day alone (Group A), 44 patients received tadalafil 10 mg/day (Group B), and combination therapy (tamsulosin and tadalafil both) was instituted in 44 patients (Group C). After a 2-week medication free run-in period, they were evaluated for International Prostatic Symptom Score (IPSS), International Index of Erectile Function score (IIEF5), quality of life (IPSS QoL), maximum urinary flow rate (Qmax), post-void residual urine (PVR) volume, and safety parameters before and at 3 months of treatment. MAIN OUTCOME MEASURES: There were primary (IPSS, IPSS QoL index, Qmax, and PVR) and secondary (erectile function [EF] domain scores from IIEF5) efficacy end points. Safety assessment included laboratory tests and patient's reporting of adverse event. RESULTS: A significant improvement in IPSS score was observed in all the 3 groups A, B, and C (-50.90%, P < 0.05; -33.50%, P < 0.05; and -53.90%, P < 0.05, respectively). IIEF5 score increased significantly in these three groups (+39.28%, P < 0.05; +45.96%, P < 0.05; and +60.23%, P < 0.05, respectively). A significant increase in Qmax and decrease in PVR were also observed (33.99%, P < 0.05; 29.78%, P < 0.05; and 37.04%, P < 0.05) and (-60.90%, P < 0.05; -49.45%, P < 0.05; and -62.97%, P < 0.05, respectively). The QoL scores improved significantly (-73.35%, P < 0.05; -70.26%, P < 0.05; and -79.65%, P < 0.05, respectively). Side effects were dyspepsia, heartburn, headache, flushing, myalgia, and backache. Adverse effect dropout was 3.7%. No participant experienced any severe or serious adverse events. CONCLUSIONS: In patients with LUTS due to BPH, tamsulosin and tadalafil alone or in combination cause a significant improvement in patients with LUTS. Their EF also improves with these medications. The improvement is better with combination therapy compared with single agent alone.

Unusual cause of urethral bleeding in an adolescent: a case in dilemma.

Numerous cases of self-inflicted foreign bodies in the male urethra have been reported. A case of a self-inflicted urethral injury or hemangioma in an adolescent that presented a dilemma is described here. An adolescent male of 14 years presented with a complaint of intermittent urethral bleeding for a week. He attributed this to blunt trauma sustained while playing in school. On examination, there was no sign suggestive of any trauma or any abnormal lesion on the genitalia or surrounding area. On cystourethroscopy, there was a solitary hemorrhagic lesion of 0.5 cm with a bluish base on the ventral surface of the pendular urethra, 1 cm proximal to the fossa navicularis, which was ablated using Ho:YAG laser fiber (365 µm) through a working channel mounted in an OIU (optical internal urethrotomy) sheath. The absence of any sign of external trauma or presentation after 1 week of the incident suggests an element of falseness in the history. It may be due to embarrassment or fear, which contributes to self-insertion of foreign bodies into the urethra as the primary cause, especially in adolescent males. However, the trauma can be coincidental, with the bleeding of the urethra caused by a urethral lesion like a hemangioma and might present after a long gap of 1 week due to a lack of understanding or lack of severe symptoms. Most patients of self-inflicted injuries are too ashamed to admit that they inserted any object. A psychiatric evaluation is recommended for all these adolescents, with appropriate medical therapy when indicated.

Partial reimplantation of Tenckhoff catheter for channel perforation and aneurysm: A case series.

Tenckhoff catheter placement is a well established procedure to facilitate continuous ambulatory peritoneal dialysis (CAPD) in end-stage renal disease (ESRD) management. The removal and replacement of the catheter following complications adds morbidity in an already immunocompromised patient of ESRD. A salvage procedure with partial replacement was undertaken in four patients on CAPD. By catheter repositioning, the complications of catheter removal (like wound hematoma, abscess, need of break-in period hemodialysis) and of reinsertion (like leak, obstruction, migration, infection and failure) are avoided. It also reduced the economic burden of insertion in a new catheter.

Vehicular emission and its impact on heavy metal accumulation and photosynthetic pigments on pine needles in Pahalgam forest ecosystem.

Human interference is rising day by day which adds more problems to conserve valuable forest resources. Vehicular exhausts are the main source of heavy metals that have detrimental impacts on the vegetation. The research provides comprehension about the increase in vehicular traffic along the Pahalgam highway, which is disturbing the balance of the forest ecosystem. The concentration of heavy metals and leaf pigments were determined in the leaf tissues collected along with the roadside pine trees in the Pahalgam resort. A total of 25 samples at each sampling site were collected in 100 m diameter along main road. High vehicular movements in summer correlated with the high accumulation of heavy metals such as Pb2+ (0.563 mg/kg), Ni2+ (0.271 mg/kg), and Cu2+ (0.202 mg/kg) in pine needles. However, Zn2+ exhibited higher concentration (0.468 mg/kg) at Batakote and Cd2+ (0.05 mg/kg) at Pahalgam in autumn. Moreover, total chlorophyll content determined low (1.97 mg/g) at Pahalgam in autumn and high (3.81 mg/g) at Chandanwari in summer. In general, the chlorophyll content in the pine needles was certainly affected by the accumulation of heavy metals which indicating a negative correlation of chlorophyll content with heavy metals. Thus, the increase in traffic movement and tourist influx significantly affects the accumulation of heavy metals and decreases the pigment content in the pine needles. Rapid tourist influx in world-famous health resorts is dramatically influencing the forest ecosystem. Therefore, the need is to use green fuel or ban the old vehicles which can be helpful in maintaining the balance of the forest ecosystem.

Algal consortia based metal detoxification of municipal wastewater: Implication on photosynthetic performance, lipid production, and defense responses.

The present investigation was carried out to assess the competence of artificially engineered microalgal consortia i.e. consortia 1 (Scenedesmus vacuolatus + Chlorococcum humicola), consortia 2 (Tetradesmus sp. + Scenedesmus vacuolatus), and consortia 3 (Chlorococcum humicola + Scenedesmus vacuolatus + Tetradesmus sp.) for municipal wastewater treatment and lipid production under laboratory conditions. The purpose of the present study was to screen the competent microalgae consortia based on wastewater remediation, photosynthetic performance, and antioxidant defense responses. The outcome based on nutrient reutilization (78.98-98%), metal detoxification (50-94%), and biomass production (1.43-1.65 folds) reflected greater adaptability and tolerance of consortia 2 against different concentrations of wastewater. The photosynthetic performance parameters such as active photosystem II reaction centre, the quantum yield, and photosynthetic performance index were increased by 1.20-2.35 folds in consortia 2 after treatment with different concentrations of wastewater. Additionally, Fourier transform infrared spectroscopy peak showed at 1750 cm-1 confirmed neutral lipid accumulation in consortia 2 at 100% concentration of wastewater. The measurement of oxidative stress markers such as thiobarbituric acid reactive species and hydrogen peroxide showed considerable decline in consortia 2 as compared to consortia 1 and 3. Interestingly, increased non-enzymatic (1.02-2.44 folds) and enzymatic antioxidant (1.05-4.14 folds) activity in consortia 2 reflected that oxidative stress was attenuated by the amplified activity of ascorbic acid, proline, cysteine, superoxide dismutase, catalase, and glutathione reductase. Overall, photosynthetic performance, lipid production, and antioxidants activity represented that the consortia 2 can be effectively used for sustainable wastewater treatment and lipid production. Thus, the synergistic association of two microalgae may be the superior and neoteric paradigm with multilevel benefits such as sustainable nutrient resource utilization, metal detoxification, and lipid production.

Vulnerability of municipal solid waste: An emerging threat to aquatic ecosystems.

Dumping waste materials into aquatic ecosystems leads to pollution, which directly and indirectly poses a danger to all life forms. Currently, huge quantities of wastes are generated at a global scale with varying constituents, including organic fractions, emerging contaminants and toxic metals. These wastes release concentrated contaminants (leachates), which are lethal for all ecosystems around the globe because they contain varying concentrations of chemical constituents with BOD5 and COD in the order of 2 × 104-2.7 × 104 mg/L, and 3.4 × 104-3.8 × 104 mg/L, respectively. Herein, in-depth knowledge of municipal solid waste dumping into the aquatic ecosystems, changes in physicochemical characteristics, availability of in-/organic contaminants, and long-term unhealthy effects are presented. Moreover, an attempt has been made here to summarize the facts related to identifying the deadly impacts of waste on different ecosystem components. The unresolved challenges of municipal waste management are emphasized, which will help employ suitable waste management techniques and technologies to conserve the everlasting freshwater resources on earth.

Sustained systemic response paralleled with ovarian metastasis progression by sunitinib in metastatic renal cell carcinoma: Is this an anti-angiogenic potentiation of cancer?

Metastatic renal cell cancer is associated with poor prognosis and survival and is resistant to conventional chemotherapy. Therapeutic targeting of molecular pathways for tumor angiogenesis and other specific activation mechanisms offers improved tumor response and prolonged survival. A 48-year-old, female patient presented with large right renal mass with features suggesting of renal cell cancer without metastasis on contrast enhanced computed tomography (CT). Right radical nephrectomy was done. After 9 months of surgery, she got metastasis in lung, liver and ovary. The patient received sunitinib via an expanded access program. After eight 6-week cycles of sunitinib, a reassessment CT scan confirmed an excellent partial response with the almost complete disappearance (90%) of liver and lung metastasis but the adnexal mass had increased in size (>10 times) and the possibility was thought of second malignancy. Excision of the mass performed. Histopathology of the mass depicted metastatic renal cell cancer. There is possibility of a 'site-specific anti-angiogenic potentiation mechanism' of malignancy in relation to sunitinib based upon the preclinical studies, in reference to the index case. Regression of one site with concurrent progression is possible. The exact mechanism of site-specific response, especially organ specific progression by vascular endothelial growth factor inhibitors in metastatic renal cell cancer warrants further study.

Fulminant Buddchiari syndrome caused by renal primitive neuroectodermal tumor with inferior vena cava thrombus extending to atrium.

Primitive neuroectodermal tumors (PNET) of the kidney are rare, the diagnosis usually being made at histopathology. A young female presented with a massive right renal mass with features of hepatic dysfunction. Computed tomography scan of the abdomen revealed a large tumor of right kidney with tumor thrombus extending from inferior vena cava (IVC) to right atrium with features suggesting Buddchiari syndrome (BCS). Needle biopsy of mass showed a round cell neoplasm and positive staining for neuron specific enolase and minimum inhibitory concentration-2 on immunohistochemistry. She was managed with neo-adjuvant chemotherapy, surgery and adjuvant chemotherapy. To the best of our knowledge this is the first case of renal PNET with inferior IVC tumor thrombus extending to right atrium with BCS. We suggest that renal PNET should be kept in mind as a differential diagnosis in young adults presenting with a large kidney mass extending to IVC that shows evidence of necrosis on imaging, which may be associated with BCS as in index case.

Anterior urethral valves without diverticulae: a report of two cases and a review of the literature.

Two unusual cases of anterior urethral valves (AUV) without diverticulae are presented. The first case is a male child born with prenatal diagnosis of bilateral hydronephrosis. On cystoscopy, iris-like diaphragm valves were encountered about 3 mm distal to the skeletal sphincter. In the second case, an 18-month-old male child was investigated for recurrent febrile urinary tract infections and obstructed urinary symptoms. Cystoscopy confirmed the presence of slit-like valves 5 mm distal to the skeletal sphincter. Fulguration of the AUVs was performed in both cases. It may be worthwhile to review all cases of anterior urethral obstruction collectively and re-categorize them appropriately to include the unusual AUVs without diverticulum in that classification.

Service delivery through public health care system to control sexually transmitted infections in Himachal pradesh.

INTRODUCTION: The National AIDS Control Organization has designed multiple synergistic interventions to identify and control curable sexually transmitted infections (STIs). OBJECTIVE: To assess the impact of services offered at designated STI clinics in the state of Himachal Pradesh, India and the profile of the attending clients. MATERIALS AND METHODS: This was a two-year prospective study, conducted from April 2011 to March 2013. Training on delivering STI/RTI services was imparted to the staff of 16 designated STI clinics including recording of data. The staff in each STI clinic comprises of one doctor, one counselor, one nurse, and one laboratory technician. The clients attending these designated clinics were offered counseling, syndromic case management (SCM), and diagnostic services wherever possible. Monthly data of STI clinic attendees was collected, compiled, and analyzed. RESULTS: A total of 65,760 clinic visits were reported, of which 32,385 (49%) visits were for index STI/RTI complaint(s). The ratio of male to female attendees was 1:2. The commonest age group accessing the STI clinics was 25-44 years (n = 38,966; 59.3%). According to SCM, 52.9% clients were managed. The commonest presenting syndrome was urethral discharge (n = 4,500; 41%) in males, and vaginal discharge (n = 13,305; 56%) in females. Genital ulcer disease was treated in 2099 cases. Laboratory tests were performed only in 6466 patients, and 39,597 antenatal mothers were screened for syphilis. Counseling services were provided to 51,298 (f = 34,804; 68%: m = 16,494; 32%) clients and of these, 48% (n = 25,056) of the clients were referred to integrated counseling and testing centers. Forty-three clients (m = 24: f = 19) were detected positive for HIV infection. CONCLUSION: Uniform and standardized services delivered to clients attending public health clinics can gather reliable data to monitor trends of STI infection.

Giant renal angiomyolipoma: unusual cause of huge abdominal mass.

We present the imaging and histopathological characteristics of a giant renal angiomyolipoma (AML) in a 49-year-old female patient, who presented with bloating sensation in the abdomen and a steadily increasing abdominal girth for about 3 years. Contrast enhanced computed tomography (CECT) scan films of abdomen revealed that a large fat containing tumor had replaced the left kidney while displacing the rest of the abdominal contents toward the other side of the midline. Intraoperatively the left kidney was completely replaced by a fat containing tumor. The recovered surgical specimen measured 39 cm × 25 cm × 9 cm and weighed 7500 g. Histopathological investigation with immuno-histochemical staining of the specimen with hydroxy beta-methylbutyric acid-45 confirmed this lesion as AML. CECT scan of the head did not show any lesion suggestive of tuberous sclerosis. The giant tumor of the present case is the heaviest AML in both syndromic and sporadic categories and largest by dimensions as sporadic AML ever reported in the literature.

Incomplete transverse vesical septum: An unusual congenital anomaly.

A rare case of incomplete transverse vesical septum with urinary tract tuberculosis is being reported. A 52-year-old male presented with lower urinary tract and systemic symptoms. On investigation he had anemia, leucocytosis, and high serum creatinine. On cystopanendoscopy, there was a transverse ledge of tissue connecting the two lateral walls of the bladder approximately 4 cm proximal to the bladder neck dividing the caudal vesical cavity into anterior and posterior parts. Also, the left ureteric orifice had double barrel look. To our knowledge this is the first ever reported case of incomplete transverse vesical septum.