Millsmcpherson7562

Intestinal malrotation (IM) results from abnormal midgut rotation during embryogenesis and usually presents in early infancy. IM in adults is often an incidental radiological diagnosis. Right colon cancer with IM has been sparingly reported in the world literature. Only 44.7% of these documented cases underwent successful laparoscopic resection, all of which were reported from Japan. The presence of aberrant anatomy and altered vascular orientation in IM presents challenges for laparoscopic resection with adequate nodal clearance. We present the case of a 72-year-old female diagnosed with carcinoma of the ascending colon, with IM incidentally detected on pre-operative cross-sectional imaging. She underwent laparoscopic right hemicolectomy. We also reviewed the documented cases of successful laparoscopic surgery for right colon cancers with IM. Aided by accurate delineation of vascular anatomy on pre-operative cross-sectional imaging, laparoscopic colectomy in the setting of IM is safe and feasible, and should be favourably considered.Leiomyomas are the most common benign tumours of oesophageal smooth muscle origin. In this era of constantly evolving medical technology, video-assisted, robot-assisted and endoscopic approaches are the minimally invasive strategies for the excision of these lesions. Here, we report our modification of this surgery. The lesion was excised with uniportal video-assisted thoracoscopic surgery in a semi-prone position with single-lumen endobronchial intubation.Gastric cancer (GC) constitutes a major health problem. In addition to the popularity of laparoscopic gastrectomy, many reconstructive procedures have been reported in the literature. Surgical resection and lymphatic dissection determine long-term survival; however, the election of a reconstruction procedure determines the postoperative quality of life for patients with GC. At present, no consensus exists regarding the optimal reconstructive procedure. A new reconstructive approach was recently adopted at our center. Laparoscopic distal or total gastrectomy with D2 lymphadenectomy and a so called 'double-loop' reconstruction method with intracorporeal mechanical anastomosis was performed in our patients and we describe the technical note and outcome. The intuition in its use comes from the packaging of gastric bypasses in bariatric surgery. The double-loop method is a valid simplification of the traditional technique of construction of the Roux-limb that could increase the feasibility and safety in performing a full laparoscopic intracorporeal reconstruction with greater ergonomics for the surgeon.Ciliated foregut cysts (CFCs) are rare anomalies of the foregut epithelium. The common sites in the abdomen are liver and gall bladder. There are only 16 cases of CFC reported in the gall bladder to date. A 20-year-old girl presented with pain in the right upper abdomen. There was a radiological evidence of cystic lesion in the region of Calot's triangle. A differential diagnosis of either type 2 choledochal cyst or CFC was made. Intraoperative and histopathological findings were suggestive of CFC. CFC should be kept in mind as a rare differential diagnosis when evaluating cysts in the gall bladder fossa.Lymphatic filariasis (LF) is a vector-borne neglected tropical disease, causing permanent disability. The disease is debilitating and widespread, leading to tremendous productivity and economic loss. The Government of India (GOI) prioritized the elimination of LF through the annual mass drug administration (MDA) programme in 2004 and continued with a single dose of diethylcarbamazine citrate (DEC), 6 mg/kg of body weight, plus albendazole annually over a period of 5-6 years. The GOI had set the target to achieve LF elimination by 2015 and now by 2030. The progress so far has been suboptimal. Much remains to be done as about 84 per cent of the total 328 endemic districts are still under MDA. The major challenge in implementing MDA is poor compliance. It is necessary to have a feasible alternative strategy addressing the above challenge to achieve the desired goal of LF elimination. At this juncture, a well-researched approach, i.e. the use of DEC-fortified salt, also advocated by the World Health Organization,trategy will ensure the complete cessation of LF transmission within two years from its introduction. If the said strategy is implemented in 2022, it is expected that India will be able to achieve the LF elimination by 2024, much before the global target of 2030.Histoid leprosy is an expression of multibacillary leprosy with unique histopathology and characteristic bacterial morphology. It is characterized by the occurrence of asymptomatic firm, dome-shaped succulent papulonodules on apparently normal skin, or subcutaneous tissues. There are very few reports of the detection of Mycobacterium leprae in the epidermis in leprosy, which may have a possible role in transmission. We report five de novo cases of histoid leprosy with transepidermal elimination.This is a case report of patient suffering from multiple central nervous system tuberculoma which progressed to tubercular abscess. Patient developed signs and symptoms of mass effect and compression. Computed tomography of brain and magnetic resonance spectroscopy confirmed the diagnosis. Patient underwent left temporal craniotomy with evacuation of pus. The abscess wall and the pus sent for histopathological and microbiological examination which confirmed the etiological agent - Mycobacterium tuberculosis. Appropriate treatment was started and discharged. Hence, early diagnosis and treatment of intracranial tuberculoma are pivotal in preventing morbidity and mortality of the condition.Intramedullary tuberculoma (IMT) is considered to be a rare form of spinal tuberculosis (TB). Eltanexor CRM1 inhibitor Overall, TB of the central nervous system accounts for approximately 1% of all cases of TB and 50% of these involve the spine. The clinical presentation of spinal intramedullary TB is similar to an intramedullary spinal cord tumor mass. The factors attributable could be malnutrition, poor socioeconomic conditions, and immunodeficiency syndromes. As per the reports, the incidence of primary intramedullary TB is 2 in 100,000 cases among patients with TB. We describe one such patient who presented with progressive asymmetrical paraparesis due to histologically confirmed intraspinal tuberculoma. Paraparesis in spinal IMT is considered to be rare. Hereby, we present the case of a 29-year-old female who presented with asymmetric onset paraparesis of 6 months with associated numbness and tingling began in the left foot 3 months which was ascending in nature. There was no history of stiffness, involuntary movements, flexor spasms, thinning, or fasciculations of muscles. There was a loss of sensation pain, touch, and temperature below L3 with normal reflexes. Power in both the lower limbs was 1/5 as per Medical Research Council (MRC) grading. She underwent a contrast magnetic resonance imaging spine which was suggestive of an intramedullary SOL at D12 vertebral level. The patient underwent surgical intervention with resection of the SOL. Histopathology was confirmed to be an IMT. She was started on Category 1 (antitubercular drugs) and further investigated for primary source, which was found to be negative. We want to emphasize that TB can involve any part of the body. It should be kept as a differential diagnosis of any chronic inflammatory lesion involving the bony skeleton, especially in endemic countries where combined surgical and medical treatment is usually sufficient to provide a cure.Tuberculosis verrucous cutis (TBVc) is a skin infection caused by M. tuberculosis, characterized by the presence of a solitaire verrucous plaque but may present as a varies of different clinical morphologies on the finger and or feet. The diagnosis is often late because of its mimicking other diseases with different etiology. Bacterial culture examination is negative because there are few pathogens in the lesion. Meanwhile, other diagnostic methods provide lower sensitivity and specificity which add further diagnostic challenges. We presented one case report of TBVc mimicking chromoblastomycosis. A 26-year-old man complain a multiple papule-plaque verrucose on the dorsum of the right foot and extending to all of fingers for 2 years ago. The first lesion appears as a small papule verrucous then progressively to form plaque with curst yellow-red and central healing. Examination of bacterial culture with Ziehl-Neelsen stain and GeneXpert did not find M. tuberculosis but could not rule out the diagnosis of TBVc. The diagnosis was established based on the correlation of clinical manifestations and dermoscopy with histopathological examination. To date, there is no gold standard for TBVc testing. Correlation analysis of clinical manifestations, dermoscopy, and histopathology can be considered to establish the diagnosis of TBVc, especially if the culture is negative and the limitations of polymerase chain reaction tools.Weil's syndrome, a severe form of the disease, may present with symptoms such as jaundice, renal dysfunction, and hemorrhagic diathesis and it can progress to multi-organ failure leading to death. In patients with coinfection of tuberculosis with leptospirosis, there may be severe hepatic and renal dysfunction rendering the standard antitubercular therapy (ATT) regimen useless, thus requiring alternate drug selection and dose modification of antitubercular drugs. We present a case of a 57-year-old female who presented with high-grade fever and yellowish discoloration of the eyes. She was diagnosed with Weil's disease and started on treatment. She later developed altered sensorium and lumbar puncture was suggestive of tubercular meningitis. Due to her deranged renal and hepatic function tests, she was started on a modified regimen of ATT with intermittent dialysis. The patient responded to treatment and was shifted to the standard Isoniazid, Rifampicin, Pyrazinamide, Ethambutol (HRZE) regimen once renal and hepatic functions returned to normal.Tuberculosis (TB) and lung cancer are the leading causes of mortality and morbidity in the world. The burden of TB is significantly high in developing countries causing serious public health concern, and the incidence of lung cancer is also increasing all around the world with high mortality. Pulmonary TB coexisting with lung cancer can mask the underlying disorder producing diagnostic dilemma resulting in a delay in diagnosis leading to decreased survival of the patients. Here, we report a rare case of a 66-year-old male diagnosed with microbiologically confirmed TB along with coexisting small cell neuroendocrine carcinoma of the lung presenting with syndrome of inappropriate antidiuretic hormone.Spontaneous hydropneumothorax (HP) and mediastinal emphysema (ME) are infrequently presented complications of pulmonary tuberculosis (TB). A-34-year-old Pakistani male presented with dyspnea, productive cough, and right-sided pleuritic chest pain. He had no history of any surgery, TB, comorbid disease, or other serious pulmonary diseases. Chest radiography revealed a right-sided HP and parenchymal infiltration. The laboratory results of pleural effusion showed elevated adenosine deaminase levels with the empyema features. Acid-fast bacilli were detected and Mycobacterium tuberculosis without any drug resistance grew in the culture both in the sputum and pleural fluid. A chest tube was inserted immediately. A prolonged airway leak was detected. Hepatotoxicity protocol has been initialized (due to increased hepatic enzymes in the initial presentation) and followed without observing any complications associated with the treatment. On the 25th day of the standard TB treatment protocol, we observed hepatic enzymes in the normal range.