Seroma following modified Blalock-Taussig shunt resulting in subsequent occlusion of the shunt which was opened by balloon angioplasty

We report the case of a 9-year-old boy with tetralogy of Fallot who had undergone left modified Blalock Taussig shunt. The patient developed seroma around the shunt which was excised surgically. The patient developed total occlusion of the shunt post-operatively with clinical deterioration. We used emergency percutaneous angioplasty to successfully treat the patient.     

Endoscopic and radiological appraisal of gastric varices

Of 104 patients with portal hypertension who were subjected to oesophageal variceal sclerotherapy, gastric varices were seen in 81 (78 per cent) at endoscopy and 69 (74 per cent) at splenoportography. In 50 (48 per cent) patients gastric varices were seen at the initial endoscopic examination and in 31 they developed during follow-up at intervals varying from 1 to 56 weeks. Gastric varices were seen significantly more often along the lesser curvature than in the gastric fundus and the left gastric vein was the main feeding vessel in 75 per cent of cases. Varices bled in nine of 81 patients and bleeding was seen significantly more often from fundal varices (30 per cent) than from lesser curve varices (5 per cent) (P less than 0.02). The incidence of gastric varices is high, and contrary to popular belief they are more often located along the lesser curvature of the stomach than in the gastric fundus.     

Nonfunctioning islet cell tumor presenting with ascites and portal hypertension.

Nonfunctioning islet cell tumors commonly cause no symptoms. A 22-year-old woman presented with lump in the left hypochondrium, refractory high-protein ascites and evidence of left-sided portal hypertension. At exploratory laparotomy, a 30 cm x 15 cm mass was seen at the splenic hilum, with large collateral vessels around. Distal pancreatectomy with splenectomy was done. Histology of the mass showed malignant islet cell tumor infiltrating the spleen. The patient died in the postoperative period.     

Protective effect of glutathione on the in vitro inhibition of hepatic cytochrome P-450 by captan.

The in vitro effect of various concentrations of captan on hepatic microsomal cytochrome P-450 from pehnobarbital-pretreated rats was studied. The I-50 value, namely the concentration of the inhibitor necessary to produce 50% loss of cytochrome P-450 was determined from theplotted inhibition curve. The presence of ethylenediaminetetraacetic acid (EDTA) in microsomal incubations prior to the addition of captan failed to prevent the loss of cytochrome P-450 by captan. In contrast, reduced glutathione (0.5 mM) added to microsomal incubations before captan (0.1 mM) afforded almost complete protection of cytochrome P-450 from captan inhibition. These data indicate that the inhibitory effect of captan on vitally important drug-metabolizing enzyme system, of which cytochrome P-450 is a major component, can be prevented by prior presence of reduced glutathione (GSH) but not of EDTA.     

Study of unment need for family planning among married women of reproductive age in urban health central field practice area of Govt. Medical College, Aurangabad

A community based cross sectional study was carried out in married reproductive age group women in Urban Health Centre field practice area of Govt. Medical College, Aurangabad. The study aimed to find out extent and socio-demographic correlates of unmet need for family planning. 20.54% of married women in reproductive age had unmet need for contraception, 3.61% for spacing births and 16.93% for limiting births. The main reasons for unmet needwere, littie perceived risk of pregnancy due to perimenopausal age (32.471/o) lactation (31.16%), ignorance (12.32%) etc.