RESUMEN
Small intestine ischaemia caused by volvulus is difficult to diagnose during pregnancy, as the signs and symptoms may be masked by pregnancy. An early diagnosis and a prompt surgical intervention is necessary, as morbidity and mortality of this disorder are significant. We are presenting a case of a 35-year-old pregnant woman with volvulus of small bowel.
RESUMEN
INTRODUCTION: Rise of hypertension among younger age group has increased the prevalence of intracranial haemorrhage. Conflicting reviews regarding the mode of treatment has been a concern to the treating physicians especially in a developing country like India. This study was undertaken to underline the importance of management and propose a local protocol for primary supra-tentorial haemorrhage. MATERIALS AND METHODS: Patients presenting with primary supratentorial (ST) haemorrhage fulfilling inclusion criteria are included in the study. Decompression craniotomy done in all the patients and the patient particulars noted. The primary outcome of death is correlated with various particulars and statistical analysis done with SPSS version 16. RESULTS: Mean age of presentation was 54.2 years, ranging from 38-71years. Male comprised 82.1% (23 patients). Seven out of eight patients with Glasgow coma scale (GCS) ≤7 (87.5%) expired whereas only 3 out of 20 (15%) patients with GCS >7 expired. 50% of the patients with intracranial haemorrhage (ICH) in temporo-pari et al., (2/4) or in basal ganglia with cortical extension (5/10) expired whereas the mortality in cases of ICH in parietal lobe and frontal lobes were 25% (1/4) and 20% (2/10) respectively. Clot volume ≤100ml had a mortality of 19% (4/21) whereas the mortality was as high as 85.7% (6/7) with clot volume >100ml. CONCLUSION: Emergency Craniotomy and Evacuation of the Hematoma could be a feasible option in between 40 ml to 100ml of Primary ST ICH without intra-ventricular extension. In cases of intra-ventricular extension of haematoma surgery is less helpful. Midline shift of 5 mm or more might be a poor prognostic factor.
RESUMEN
Marjolin's ulcer is a carcinoma that develops in chronic benign ulcers or scars. It was first found to be associated with chronic osteomyelitis. Squamous cell carcinoma is the most common cancer which is being noted in Marjolin's ulcer. Suspicion of such lesions should be raised in chronic wounds which demonstrate characteristic changes. Diagnosis is made by doing a biopsy and it is treated by wide local excision. We are reporting here a case of 65-year-old female who presented with a growth in a long standing scar over her back. Scar was caused by an incision and drainage for an abscess performed 30 years back. On biopsy, features of pigmented variety of Basal Cell Carcinoma (BCC) were seen. Though occurrence of basal cell carcinoma in Marjolin's ulcer is known, pigmented variety is yet to be reported. The rare varieties like pigmented type of basal cell carcinoma in Marjolin's ulcer, must be borne in mind by histopathologists.