Rajesh Chaudhary

Paraneoplastic syndrome are rare disorders associated with cancers. Among then paraneoplastic cerebellar degeneration is classical PCS, presents acutely and sub acutely with walking incoordination, slurring of voice. Anti YO anti bodies are strongly associated with this PCS. Presence of anti YO antibody shows poor prognosis, and mild recovery with immunosuppressants. Treatment is not very promising in severely affected patient.

Background: Cardiovascular diseases (CVDs) have a huge social and economic impact all over the world. Therefore research needs to analyse emerging risk factors for CVDs. Bruxism is a health problem that has low prevalence in the community but may be associated with CVDs. It leads to poor oral health and significantly impacts the quality of life. Studies showing association of CVDs and Bruxism are sparse and, none in Indian context.Methods: This study was conducted in two hospitals of Kangra region of Himachal Pradesh between the months of April 2020 to June 2020. Due to rising infection rates of COVID-19 cases, 160 patients were enrolled in the study and divided into two groups. 80 patients with a positive history for CVD were included as cases while another 80 patients without any known history for CVD were included in the control group. Self-reporting questionnaire and tooth wear index (TWI) were used as research instruments.Results: An unadjusted odd’s ratio of 2.43 (95% CI, 1.28-4.68) and p value of 0.0069, was found when only self-reported bruxism was taken into account. But when self-reporting of bruxism was combined with TWI, an unadjusted odd’s ratio (logit OR) of 3.16 (95% CI, 1.66-6.21) and p value of 0.000529 was found, explaining that the odds of having CVD are 3.16 times higher in patients with bruxism than in those without bruxism.Conclusions: Bruxism is significantly associated with cardiovascular diseases. More studies, with larger sample size are required to firmly establish the causative relationship between bruxism and CVDs.

Background: Acute appendicitis is the most common surgical emergency worldwide. The treatment of choice is emergency appendectomy. A delayed diagnosis and hence a delayed treatment increases the complication rate. Despite the best efforts negative appendectomy rate is still high since there is no single best test available to reach the diagnosis. Methods: This was an institutional study conducted at DRPGMC Tanda, comprising of 28 patients and 7 healthy controls. The patients with clinical diagnosis of acute appendicitis were subjected to appendectomy after taking a blood sample for serum procalcitonin and performing an ultrasonogram of abdomen. Results: We observed that mean levels of procalcitonin (PCT) were significantly higher in patients of acute appendicitis in comparison to healthy controls. The range of PCT levels in group 2 i.e., patients with uncomplicated acute appendicitis were from 0.54 to 0.74 ng/ml with mean value of 0.61 ng/ml, whereas in group 3 i.e. patients with complicated acute appendicitis, the range were from 1.14 to 2.56 ng/ml with mean value of 1.62 ng/ml. PCT levels were significantly higher in group 3 as compared to group 1 and group 2 (pConclusions: This study concludes that levels of serum PCT can be used as a laboratory marker for making a diagnosis of acute appendicitis and also for predicting its severity.

Introduction: The diagnosis of acute appendicitis has essentially been clinical, but USG abdomen has been said to be highly accurate in diagnosing AA. The surgeon’s perspective may not always be the same. Materials and methods: Appendectomy data of 106 patients from two hospitals of Kangra region was retrospectively analysed. The data was collected for age, sex, initial pre-operative diagnosis, USG findings, intra-operative findings, Histo-pathological examination (HPE) report, post operative hospital stay. Observations: It revealed a sensitivity of about 54% and specificity of 100% for diagnosing AA with the help of USG abdomen. AA was seen most commonly in males as compared to females. Mean age of presentation was 29.34 +/- 14.4 years. Mean hospital stay was 3.68 +/- 2.25 days. Most common initial preoperative diagnosis was AA (84%). Most common position of the appendix during surgery was retrocecal (53.7%). HPE report revealed AA in 105 patients. Conclusion: USG abdomen is often falsely assuring, leading to unnecessary delay in effectively managing a patient of AA further leading to increased complications. Only the clinically equivocal cases require further radiological investigations where CECT abdomen is the preferred investigation, but it should be used judiciously.

Severe acute respiratory syndrome corona virus-2 (SARS-CoV-2), a novel coronavirus initially reported in Wuhan, China, is the causative agent of coronavirus disease (COVID-19) pandemic. Symptoms of the disease comprise of fever, tiredness, dry cough, aches and pains, nasal congestion, runny nose, sore throat, diarrhoea and pneumonia at the late stage. SARS-CoV-2 has severely crippled the healthcare system and has caused huge economic losses. Following the outbreak, the SARS-CoV-2 was recognized timely and its genome was sequenced, leading to the development of real-time polymerase chain reaction assays for its detection in clinical samples collected from suspected cases. The management of the pandemic is limited by a number of misconceptions and insufficient information about laboratory testing for SARS-CoV-2 to confirm the disease. This includes a lack of awareness about procedures for the collection, transport, testing, and handling of biological samples for COVID diagnosis. This article provides an overview of the current laboratory diagnostic methods with a purpose to provide information and guidance to laboratories, stakeholders, broader community and especially public health professionals involved in laboratory testing for SARS-CoV-2.

Introduction: The minimally invasive approach has become the method of choice for treating most benign abdominal diseases that require surgery. However, it is obvious that laparoscopic procedures are not risk free. The aim of this study was to evaluate the prevalence of intra abdominal adhesions underneath umbilical scar following laparoscopic sterilization, in patients who are undergoing abdominal surgeries. Materials and Methods: The present study was a hospital based prospective observational study conducted in the Department of Surgery, Dr Rajendra Prasad Government Medical College (Dr. RPGMC), Kangra at Tanda (HP). The study group consisted of patients admitted to department of surgery during a period of one year and who fulfilled inclusion criteria. During intraoperative period, they were examined for presence or absence of adhesions at the site of previous laparoscopic sterilization scar at Periumblical area. Results: Total of 60 patients were taken in this study. Two out of 60 (3.3%) patients had adhesions underneath previous Laparoscopic Sterilization scar around umbilicus and adhesive structure was omentum in both cases. Conclusion: Adhesion formation is expected in any abdominal surgery whether open or laparoscopic surgery. In our study only 3.3% of patients had adhesions underneath previous laparoscopic sterilization scar in periumblical region. Therefore umbilical port can be considered for re-entry of index port in next laparoscopic surgery, in patients with history of laparoscopic surgery through umbilical region.

Pelviureteric junction obstruction (PUJO) is the condition where flow of urine from the renal pelvis to the ureter is hindered due to various intrinsic or extrinsic causes. Lower pole renal vessels are mostly associated with this condition. Unlike our case, there have been reports of ureter being kinked around the Veins of Retzius but there has been no case report of ureter being kinked around the superior mesenteric vein directly causing features of PUJO.

A 68-year-old man presented with the features of intestinal obstruction for 48 hours. Patient was subjected to exploratory laparotomy. He had nearly three fourth of his small gut herniated behind the gastrojejunostomy. The bowel was found viable during laparotomy which was reduced free and the defect was closed.