Pneumoretroperitoneum and pneumomediastinum are rare complications of laparoscopy. We report one such case. The mechanism of development of these complications is explained. No specific treatment needs to be instituted in most of these patients.

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The surgical management of two patients with giant hydronephrosis in a solitary kidney treated by Boari flap calycovesicostomy is presented. In one patient, this operation was done following unsuccessful previous pyeloplasty, while in the other this was done as the primary operation. Though free reflux was observed in both the cases, the refluxed contrast emptied satisfactorily after double voiding. No deterioration of renal function was noted during the follow-up period of 12 months.

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Fifteen cases of proved gas gangrene infection were studied to assess the rapidity of control of infection and associated toxaemia, by hyperbaric oxygen therapy at 2 1/2 atmospheres pressure. Within 3-5 sittings, all the cases (100%) were found to become devoid of clostridial organisms as judged by smear and culture methods.

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Plasma fibrinogen levels were estimated in 56 patients of stroke, admitted in the hospital within 24 hours of symptoms. The levels were found to be raised significantly (531.73 +/- 74 mg%) compared to those of the age and sex matched control group (445.78 +/- 92.28 mg%). When the levels in stroke group with one risk factor were compared to those of individuals with comparable control group with same risk factor, a significant difference was observed in hypertensive, smokers, alcoholics and atherosclerotic stroke groups, which indicates that the observed rise is related to phenomenon of stroke rather than the associated risk factors. However, the rise observed in hypertensive stroke group (554.26 +/- 47.08 mg%) is significantly more (p. less than 0.01) than that occurring for nonhypertensive stroke group (497.82 +/- 93.12 mg%) indicating that the presence of hypertension does contribute to the rise.

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Twenty-three opponensplasties were performed in 21 subjects. Flexor sublimis transfer was carried out in 15 hands, brachioradialis transfer in 4 hands, Makin's translocation of flexor pollicis longus in 2 hands and our modification of Makin's procedure in 2. The results were graded as excellent in 13 hands, good in 6 hands, fair in 3 hands and poor in 1 hand. Further, the power of pinch was graded as good in 14 hands, fair in 7 hands and poor in 2 hands. We suggest that it is almost always possible to devise an appropriate procedure to restore the opposition of the thumb.

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Cystic degeneration though often seen in a leiomyoma, has not been reported so far in an adenomyoma. Hence, a unique case of cystic degeneration in an adenomyoma of the uterus is presented.

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A 6 1/2 year old female child with congenital lipodystrophy is being presented. The noteworthy feature in this case was the defective leucocyte function and its association with tuberculous pericardial effusion.

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Retrospective analysis of 17 cases of paroxysmal nocturnal hemoglobinuria (PNH) was carried out. The presenting feature of anaemia and hemoglobin of less than 9 gm% were observed in all cases. Fever, jaundice and bleeding tendency were observed in 8, 8 and 7 cases respectively. Bone marrow examination revealed megaloblastic features, erythroid hyperplasia and hypocellularity in 8, 7 and 2 cases respectively. Fourteen cases were refractory to the treatment, while only 3 showed response.

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Histiocytosis-X encompasses a wide clinical spectrum from a benign localised lesion to acute generalised disease with malignant behaviour. We have reviewed material from our 18 retrospective cases comparing histological features with clinical data. Degree of positivity for S-100 protein was studied by immunoperoxidase method. Our results indicate that diagnosis of histiocytosis-X necessitates histological confirmation but grading of histological criteria and S-100 positivity do not allow prediction of severity and extent of the disease.

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The mesonephric duct may fail to develop, resulting in congenital absence of the kidney and ureter. A unique case of persistence of the mesonephric duct without development into the kidney and ureter is presented.

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A case of late progressive myelo-radiculopathy associated with severe canal stenosis secondary to post-traumatic hypertrophy of thoracic laminae and ossification of spinal ligaments viz. ligamentum flavum and posterior longitudinal ligament in the absence of developmental spinal stenosis or post-traumatic deformity, is presented with a brief critical review of the relevant literature.

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A year long study of ocular injuries in children below the age of 15 years was conducted in the Ophthalmology Department of a general hospital. Fortyfour cases were studied. Of these 45.45% were in the age group of 6-10 years. The male to female ratio was 5.28 : 1. Pointed objects viz. sticks, wires etc. were found to be the common causative agents; the recent trend being of bow and arrow injuries. Ocular perforation was observed in 28 cases. On follow up of all the cases with ocular trauma, only 12 patients were found to have a visual acuity better than 6/18; perception of light was absent in 7 patients. A need for increased parental awareness and supervision of children is stressed upon.

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Thirty patients with diastolic blood pressure of 120 mm Hg or more were administered a bolus dose of verapamil (0.15 mg/kg) followed immediately by an intravenous infusion at a rate of 0.005 mg/kg/min for one hour. The patients were monitored during this period and three hours following the discontinuation of the infusion. The systolic, diastolic and mean blood pressures before verapamil administration were 221.4 +/- 7.5, 134.3 +/- 2.7 and 163.4 +/- 4.1 mm Hg respectively, which decreased to 170.1 +/- 5.2, 99.1 +/- 3.7 and 122.8 +/- 3.6 mm Hg after intravenous bolus of verapamil. The fall in all the levels of blood pressure was significant (p less than 0.001) and was maintained at the lower levels throughout the infusion period and even three hours after discontinuation of the therapy. No untowards effects were observed and there was no significant change in heart rate and electrocardiogram. It, thus, proves to be an useful addition to the therapeutic armamentarium in the acute management of severe hypertension.

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This report deals with a young girl with Duane's retraction syndrome who also had left facial hemiatrophy (Parry-Romberg syndrome). Report of such an association is probably first of its type to be documented in literature.

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Solitary plasmacytoma of the upper air and food passages is a rare tumour. This paper deals with such a case along with a brief account of the etiology, clinical features and therapeutic measures.

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A retrospective study of 14 cases of gastric carcinoma in the age group of 19 to 35 years is presented. The relevant literature has been reviewed.

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