Successful Embolization of an Ovarian Artery Pseudoaneurysm Complicating Obstetric Hysterectomy

Transcatheter arterial embolization is becoming the therapy of choice for controlling obstetric hemorrhage, affording the ability to control persistent bleeding from pelvic vessels while avoiding the morbidity of surgical exploration. The clinicians are left with little choice if pelvic hemorrhage continues after hysterectomy and ligation of anterior division of both internal iliac arteries. We present one such case of intractable post-obstetric hysterectomy hemorrhage in which an ovarian artery pseudoaneurysm was diagnosed angiographically and sucesssfully embolized, highlighting the role of transcatheter embolization.     

Long-term protection against tuberculosis following vaccination with a severely attenuated double lysine and pantothenate auxotroph of Mycobacterium tuberculosis

We report the safety and immunogenicity of a double lysine and pantothenate auxotroph of Mycobacterium tuberculosis in mice. The DeltalysA DeltapanCD mutant is completely attenuated in immunocompromised SCID and gamma interferon knockout mice yet induces short-term and long-term protection in immunocompetent and CD4-deficient mice following single-dose subcutaneous vaccination.     

Knowledge, attitude and practices related to occupational health problems among salt workers working in the desert of Rajasthan, India

Workers in the salt industry are exposed to direct sunlight, salt dust and contact with brine. To assess their awareness, attitude and practices related to occupational health problems, 205 salt workers were interviewed about health hazards and problems related to their working conditions, usage of protective measures and suggestions for their improvisation. The brine workers had a fair knowledge of their occupational health problems (98.7%), protective measures (100.0%) and their benefits (100.0%) as compared to non brine workers for whom these figures were 89.0%, 85.8% and 78.7% respectively. The brine workers (29.5%) and non brine workers (31.5%) used unconventional measures to prevent contact with salty water, salt dust, raw salt and glare. There was a huge gap between their knowledge and practice with protective devices, though they suggested improvements in protective devices to increase their acceptability.     

Hemoperitoneum complicating snake bite: rare CT features

Russelss viper bite victims with systemic poisoning may present with hemorrhagic manifestations, including spontaneous bleeding and incoagulable blood associated with disseminated intravascular coagulation and primary fibrinolysis, two of the most prominent manifestations of the systemic envenoming by this species. Various vascular complications of viperine snake bite have been reported in the literature. We report the computed tomographic findings in a case of snake bite resulting in hemoperitoneum, which, to the best of our knowledge, has not been reported in the literature.     

A newer technique for glaucoma tube trimming

Long silicone glaucoma tubes within the anterior chamber are frequently detrimental to the corneal endothelium and other anterior chamber structures. Tube shortening often involves extensive and potentially complicated surgery that requires tube removal and reinsertion. A new technique is described for trimming the silicone tube in situ. Besides permitting tube length modification within the anterior chamber, it also decreases operative time substantially. A representative case is described.     

Eagle’s Syndrome: Report of Three Cases

Eagle’s syndrome is defined as the symptomatic elongation of the styloid process or mineralization of the stylohyoid ligament complex. It can present as a variety of different symptoms which can mislead the otolaryngologist and the dentist in diagnosing the condition. We are presenting three cases of Eagle’s syndrome describing the importance of digital palpation through tonsillar fossa and use of panoramic radiographs in confirming the elongation of styloid process.     

Development of organ-specific donor risk indices

Because of the shortage of deceased donor organs, transplant centers accept organs from marginal deceased donors, including older donors. Organ-specific donor risk indices have been developed to predict graft survival with various combinations of donor and recipient characteristics. Here we review the kidney donor risk index (KDRI) and the liver donor risk index (LDRI) and compare and contrast their strengths, limitations, and potential uses. The KDRI has a potential role in developing new kidney allocation algorithms. The LDRI allows a greater appreciation of the importance of donor factors, particularly for hepatitis C virus-positive recipients; as the donor risk index increases, the rates of allograft and patient survival among these recipients decrease disproportionately. The use of livers with high donor risk indices is associated with increased hospital costs that are independent of recipient risk factors, and the transplantation of livers with high donor risk indices into patients with Model for End-Stage Liver Disease scores < 15 is associated with lower allograft survival; the use of the LDRI has limited this practice. Significant regional variations in donor quality, as measured by the LDRI, remain in the United States. We also review other potential indices for liver transplantation, including donor-recipient matching and the retransplant donor risk index. Although substantial progress has been made in developing donor risk indices to objectively assess donor variables that affect transplant outcomes, continued efforts are warranted to improve these indices to enhance organ allocation policies and optimize allograft survival.