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Onychomycosis is a major public health problem with high incidence, associated morbidity and long lasting treatment with anti-fungal agents. This study was carried out to know the clinico-mycological pattern of onychomycosis which can help in the control of this infection. The aim of this study was to determine the prevalence of various causative agents of onychomycosis, to identify the clinical pattern and to analyze the risk factors. This was a prospective study carried over a period of one year from Ist February 2010 to 31st january 2011 on samples from 150 patients with clinically suspected nail infections attending the dermatology department of SKIMS Medical college, Kashmir. The nails were evaluated clinically and the nail samples were subjected to direct microscopy and culture. 66.6% samples were positive by direct microscopy and culture. Males were infected more than females. The commonest age group infected was 21-30 years. Finger nails were affected more frequently than toe nails and distolateral subungal onychomycosis was the most common clinical type seen in 66% patients. The etiological agents were dermatophytes (62.68%), NDM (29.85%), yeasts (7.46%). Among dermatophytes T. rubrum was the commonest etiological agent. [ABSTRACT FROM AUTHOR]

Aim: To study the etiology, presentation and complications of Gastrointestinal tract (GIT) perforations due to ingestion of foreign bodies. Methods: A retrospective review of 21 patients with perforations in the GIT due to foreign body ingestion was done in the Department of General Surgery Sher-i-Kashmir Institute of Medical Sciences Srinagar (SKIMS) from January 2002 to December 2011. Data was reviewed in terms of the type and nature of the foreign objects, mode of entry into the gastrointestinal (GIT), preoperative diagnosis, perforation site, and treatment received. Results: 66.6% of patients were males with age ranging from 7 to 82 years and a median age of 65 years. A definitive preoperative history of foreign body ingestion was obtained in 4 (19.04%) of the 21 patients. The mean time from ingestion to presentation was 9.3 days. The various foreign bodies recovered were chicken bones in 10 (47 %), fish bones in 7 (33.33%), toothpick in 2 (9.5%) and metallic staple in 2 (9.5%) patients. A preoperative diagnosis of acute abdomen of uncertain origin was given in 12 (57.14%) of the 21 patients. Site of involvement in decreasing order of frequency was ileum in 14 (66.6%), colon in 5 (23.8%) and jejunum in 2 (9.5%) patients. Commonest surgery done on these patients was emergency laparotomy with primary repair in 11 (52.38%) and intestinal resection with ileostomy in 10 (47.6%) patients. Complication in terms of surgical site infection was seen in 3 (14.28%) patients and 2 (9.5%) deaths were recorded. Conclusion: Dietary foreign body is the most commonly ingested object giving rise to GIT perforation. Treatment consists of surgery and antibiotics. Patients are rarely aware of foreign body ingestion and a high index of suspicion is required to make a diagnosis of ingested foreign body in all acute abdomen conditions particularly at extremes of age as seen in the results. [ABSTRACT FROM AUTHOR]

Isolated involvement of the kidney is rare in hydatid disease and is even rarer in children. We present a case of primary right renal hydatid cyst in 6-year-old female child who presented with pain right flank of 4 months duration. The patient was managed by nephrectomy. [ABSTRACT FROM AUTHOR]

Primary splenic cyst is a rare entity and majority of the cases are classified as epithelial cysts. They are uncommon, comprising only about 10% of benign non-parasitic cysts. Most of the cysts are asymptomatic, and they are incidental findings during abdominal ultrasonography. We report a case of 20 years old male who presented with 1 year history of mild abdominal pain and left upper quadrant fullness. Ultrasound and computed tomography (CT) both were suggestive of splenic cyst. Serological tests were negative for parasitic infection. Splenectomy was done. Histopathological findings are consistent with splenic epithelial cyst. [ABSTRACT FROM AUTHOR]

Cystic echinococcosis is the larval cystic stage (echinococcal cysts) of a small taeniid-type tapeworm (Echinococcus granulosus) that may cause illness in intermediate hosts, generally herbivorous animals and people who are infected accidentally. Pulmonary hydatid cysts are typical, involving one lobe in 72% of cases, usually at the lung base. In the paediatric age group, boys are affected more commonly than girls. We present a case of isolated hydatid cyst of the lung in a 5-year-old boy from a nomadic cattle-rearing tribe. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented concerning a medical case involving a 15-year experience of unusual locations of the disease in an endemic area.

Pulse oximetry has emerged as a convenient and readily available tool for monitoring of resuscitation. This study was done to evaluate the ability of the pulse oximetry to record oxygen saturation of asphyxiated neonates as well to note serial changes in oxygen saturation during their resuscitation. The main outcome was time taken to reach 90% saturation as recorded by pulse oximeter. The other variables were the time when first recording could be taken by pulse oximeter and time taken to reach 75% saturation. 100 cases (asphyxiated newborns) and 30 controls (normal newborns) were included in the study. The mean heart rate at one minute of age was significantly lower in the asphyxiated group (91±5.24 per minute) as compared to controls (125.2±4.5 per minute). The mean oxygen saturation at one minute of age was also significantly lower for asphyxiated group (47.5%±1.42) as compared to controls (50.5%±2.08). The median (inter quartile range) time taken in seconds to reach 75% and 90% saturation was 290 (275-295) and 490(480-510) seconds in the asphyxiated group was significantly higher (p<0.05) as compared to controls where it was 205 (190-212) and 375 (357-398). Both Asphyxiated and normal newborns remain relatively desaturated in early minutes of life. Pulse oximetry could detect these significant differences in the oxygen saturation and heart rate during initial periods of resuscitation, but as resuscitation continued these differences became non significant indicating the adequacy of resuscitation in asphyxiated newborn. This can be utilized as a cost effective tool in the neonatal unit in peripheral centers with less facilities in developing countries as ours to check for adequacy of resuscitation and intensive care referrals if needed , particularly for the primary care physicians who need to be well versed about the adequacy of resuscitation. [ABSTRACT FROM AUTHOR]

Unlabelled: BACKGROUND The reported rates of Barrett's esophagus (BE) ranged from 2.6% to 23% in Indian patients with gastro-esophageal reflux disease (GERD) symptoms. The role of methylene blue chromoendoscopy during endoscopy, either for the diagnosis of Barrett's esophagus or for the detection of dysplasia and early cancer, remains controversial., Aim: Our study was designed to find out the endoscopic as well as histological prevalence of BE in India in a specified patient population affected by GERD, and whether methylene blue chromoendoscopy improves detection of specialized intestinal metaplasia in endoscopically suspected Barrett's esophagus in GERD patients. METHODS Three hundred and seventy eight patients with characteristic symptoms of GERD from Northern India were subjected to upper endoscopy. On endoscopic suspicion of columnar lined epithelium (CLE) either 4-quadrant conventional biopsies at 2 cm interval or Methylene Blue (MB) directed biopsies were obtained randomly. The two groups were compared for the detection of Specialized Intestinal Metaplasia (SIM), which was diagnosed if the intestinal goblet cells were present. RESULTS Out of 378 patients with GERD, 56 (14.81%) were suspected of CLE on endoscopy. After taking biopsy samples from the 56 patients, only 9 (2.38%) had specialized intestinal metaplasia on histopathological examination. Five (15.15%) patients in the conventional group and four (17.39%) patients in the chromoendoscopy group (p=0.55) were diagnosed as having BE. On univariate analysis the predictors of SIM were symptoms of reflux and length of CLE. CONCLUSION The prevalence of biopsy proven BE and CLE in Northern India was 2.38% and 14.81%, respectively in patients with symptoms of GERD. The results of MB directed biopsies were similar to conventional biopsies in detecting SIM.

Aim: To study clinical, microbiological and radiological profile of pyogenic brain abscess patients along with modes of treatment and their outcome., Material and Methods: This retrospective as well as prospective study included One hundred and fourteen patients of Brain Abscess who were admitted and evaluated in the Department of Neurosurgery over a period of ten years .This study had a retrospective component from Oct 2001 to May 2009 in which eighty six patients were included and a prospective component from June 2009 to Oct 2011 which included twenty eight patients. Patients were managed medically including intravenous antibiotics and surgical management including single burr hole and total resection with open craniotomy or craniectomy. To evaluate abscess size after aspiration, CT or MR imaging was performed [~ 24 hours after aspiration] and as and when demanded by worsening of the clinical condition or no response to medical and surgical treatment., Results: It was observed that majority of the patients in our study were males numbering 83(72.8%) where as there were only 31 females (27.2%). It was observed that among the underlying factors CSOM predominated with 57 patients ie (50%).