Streaks Of Blood Research Articles

Cryptosporidiosis in puppies: clinical and epizootical characteristics

Gastrointestinal diseases of puppies aged 2–6 months account for 62% of all pathologies of these animals registered in the clinic. The lifestyle of dogs is associated with close tactile contact with the environment. The presence of protozoa in the digestive tract causes the inclusion of its representatives in the pathological process, which leads to the complication of disorders that have arisen due to various etiological factors. The study aimed to determine the role of the ubiquitous protozoa Cryptosporidium spp. in the pathogenesis of digestive tract diseases in puppies. General clinical, laboratory tests of blood (haematological, biochemical), faeces (coprogram, parasitological), statistical processing were performed. It was found that protozoa were detected in 52 % of sick animals with digestive disorders. The protozoan fauna included Cryptosporidium spp. (100 %), Isospora spp. (29 %), Giardia lamblia (21 %). Animals with cryptosporidium were examined without associations. The manifestation of the disease was noted most often in puppies with weak immune system functions, especially in the age group of 4–5 months, which is associated with the period of tooth change and a decrease in the overall immunological reactivity of the body. Clinically, the disease is characterized by enteritis development with accompanying symptoms. A characteristic clinical sign that should guide further diagnostic search is watery diarrhoea with an unpleasant odour, foamy, mucus, sometimes blood streaks. Laboratory findings include hypoalbuminemia with a decrease in the albumin-globulin ratio, hyperbilirubinaemia due to conjugated bilirubin, hyperfermentation of indicator enzymes of the liver and pancreas, and uremia. Such indicators indicate concomitant insufficiency of the digestive glands – the liver and pancreas, and a general inflammatory reaction. In coprological diagnostics, the qualitative data of the coprogramme confirm the lesions of the small intestine, liver and pancreas. Examination of fecal smears stained by the Ziehl-Nielsen method revealed cryptosporidium oocysts. The average intensity of invasion was 786.4 ± 23.1 oocysts per gram of feces.

Foreign Body Trapped in the Oropharynx Requiring Emergency Tonsillectomy in a Case at Nianankoro Fomba Hospital in Ségou

Introduction: Pharyngeal foreign bodies, particularly in oropharyngeal locations, should raise concerns about the presence of an associated wound. They constitute a common pathology. Their diagnosis is most often easy, but difficult in the case of an unknown foreign body. We report a foreign body embedded in the lateral wall of the oropharynx which required emergency tonsillectomy. Observation: This is a 6-year-old child received urgently at the Nianankoro Fomba Hospital in Ségou 6 hours after the introduction of the foreign body (wheel spoke) into the tonsillar compartment. On admission to the ENT and head and neck surgery department, the child's general condition was poor, consciousness remained and the conjunctivas were normal-colored. On oropharyngeal examination, we note a sharp metallic foreign body measuring 30 cm and 2 mm in diameter located at the level of the posterior fold of the right amygdala. Furthermore, there is hypersialorrhea with blood streaking. Faced with the failure of an extraction attempt; we decided to take him to the operating room after a minimum assessment. The immediate postoperative course was unremarkable. The evolution was very favorable on the 10th day of the intervention. Conclusion: Pharyngeal foreign bodies constitute a vital emergency due to their appearance or location. Their management requires rapid intervention with suitable equipment. Prevention remains the best solution.

Mitigation of Indomethacin-Induced Gastric Ulcer in Rats by 2,3-Dichloro-6-(trifluoromethoxy) quinoxaline: Modulation of Inflammatory Mechanisms

Objective: To investigate the gastroprotective influence of 2,3-Dichloro-6-(trifluoromethoxy) quinoxaline in a rat model of indomethacininducedgastric ulcers. Methods: Thirty male Wistar rats were randomly divided into five groups (n = 6) as follows: Group 1 (control), Group 2 (indomethacin only, 30 mg/kg), Group 3 (indomethacin and 2,3-Dichloro-6-(trifluoromethoxy) quinoxaline, 30 mg/kg), Group 4 (indomethacin with 2,3-Dichloro-6-(trifluoromethoxy) quinoxaline, 60 mg/kg), and Group 5 (indomethacin with esomeprazole, 30 mg/kg). The efficacy of 2,3-Dichloro-6-(trifluoromethoxy) quinoxaline in mitigating gastric ulcers induced by indomethacin in rats was evaluated based on gastric morphology, histopathology, and inflammatory biomarkers. Results: Indomethacin-induced stomach ulcers resulted in epithelial damage and blood streaks on the gastric mucosa. However, treatmentwith indomethacin and 2,3-Dichloro-6-(trifluoromethoxy) quinoxaline (60 mg/kg) significantly (P < 0.05) reduced ulcers compared to the indomethacin-only group. Inflammatory cells were observed in the indomethacin group, while the 60 mg/kg 2,3-Dichloro-6- (trifluoromethoxy) quinoxaline-treated group exhibited the restoration of normal epithelial tissue and minimal inflammatory cells, similar to the control and esomeprazole-treated groups. Furthermore, 2,3-Dichloro-6-(trifluoromethoxy) quinoxaline significantly decreased inflammatory biomarkers (TNF-α, IL-6, INF-γ, and IL-β1) and increased gastroprotective mediator levels (PGE2 and mucin), both with P-values below 0.05, in contrast to the effects of indomethacin. Conclusion: This study provides clinical evidence highlighting the gastroprotective properties of 2,3-Dichloro-6-(trifluoromethoxy) quinoxaline. Its initial application reveals, for the first time, its efficacy in treating gastric ulcers induced by indomethacin. However, further tests are warranted to validate these findings.

Challenges in Diagnosing and Managing Pulmonary Conditions: A Case Series Highlighting Pulmonary Tuberculosis and Lung Cancer

This study delves into the intricate challenges encountered in diagnosing and managing pulmonary conditions, focusing on tuberculosis (TB) and lung cancer, especially in individuals with a history of cancer treatment and tobacco use. Through a detailed analysis of clinical cases, we explore the complexities associated with TB reactivation post-cancer therapy and the hurdles in timely diagnosing lung cancer in tobacco users. Three cases are presented: A 60-year-old male with a history of pulmonary TB, bidi smoking, and a diagnosis of adenocarcinoma after presenting with persistent cough and imaging findings suggestive of lung cancer. A 57-year-old male, post-cancer treatment, presenting with cough, diagnosed with TB after immunosuppression, highlighting diagnostic challenges in this population. A 63-year-old female with a prolonged cough and blood streaks in sputum, not responding to anti-TB treatment, ultimately diagnosed with lung cancer due to tobacco use. These cases underscore the need for vigilant monitoring and early intervention in post-cancer individuals vulnerable to latent TB reactivation, comprehensive diagnostic approaches for immunocompromised patients, and heightened awareness of the association between tobacco use and lung cancer. The study emphasizes the importance of thorough assessments, timely interventions, and collaborative efforts among healthcare providers to optimize outcomes in patients with overlapping health concerns. In conclusion, this study sheds light on the complexities of managing patients with a history of cancer, TB, and tobacco use, advocating for a holistic approach in diagnosis and management to improve patient outcomes and quality of life. Further research and clinical guidelines are warranted to refine treatment strategies and enhance the care of individuals facing these dual health challenges. Keywords: Lung Cancer, Pulmonary Tuberculosis, Lung Cancer and Pulmonary.

Gastroprotective Effect of 2,3-Dimethylquinoxaline Against Indomethacin-Induced Gastric Ulcer in Rat.

Gastric ulcers pose a significant health risk due to an imbalance between protective and aggressive factors on the mucous membrane. Nonsteroidal anti-inflammatory drug (NSAID)-induced gastric damage affects 25% of users. Quinoxaline compounds, known for their diverse biological properties, have potential applications in cancer therapy and as antimicrobial agents targeting various pathogens. Our study aimed to investigate the impact of DMQ on gastroprotective mechanisms in an experimental model of indomethacin-induced gastric ulcer. Thirty male Wistar rats were randomly assigned to five groups. Group 1 served as the control, while Group 2 received a single oral dose of IND (30 mg/kg). Groups 3 and 4 received oral DMQ (30 mg/kg and 60 mg/kg, respectively) for three days, with the final dose administered intragastrically one hour before IND administration. Group 5 received esomeprazole (30 mg/kg) orally for three days, with the final dose given one hour before IND administration. Rats were sacrificed four hours after IND induction. Indomethacin-induced ulcers were associated with epithelial damage and blood streaks on the gastric mucosa. However, DMQ significantly decreased levels of inflammatory biomarkers (TNF-α, IL-6, Cox-2, IFN-γ, and IL-β1) while increasing gastroprotective mediator prostaglandin E2 (PGE2) and mucin levels. Histopathological analysis revealed a significant reduction in ulcer-induced pathological alterations and upregulation of tumor suppressor genes (NF-κB levels) following DMQ treatment. Rats treated with Indo+DMQ showed a significant decrease in ulcer index compared to the Indo group, with mild injuries observed. DMQ demonstrated promising gastroprotective effects against IND-induced gastric ulcers, as evidenced by alterations in histopathological data and upregulation of gene expression.

Chronic thromboembolic pulmonary hypertension in a patient with myxoma of the heart and thrombophilia of mixed genesis

Objective. To describe the clinical case of a young patient with chronic thromboembolic pulmonary hypertension (CTEPH) with heart myxoma and thrombophilia of mixed origin, who underwent surgical treatment.Materials and methods. Patient Z., 24 years old, was admitted to the cardiology department with cough with sputum production that occurs during physical activity, including streaks of blood, shortness of breath with slight physical exertion, legs and feets edema, weakness and dizziness. The examination was carried out: electrocardiography; multislice computed tomography pulmonary angiography; echocardiography (EchoCG); transesophageal EchoCG; magnetic resonance imaging of the heart with contrast; screening for coagulopathy.Results. Based on clinical data, medical history, laboratory, instrumental diagnostic, we have put the diagnosis: Myxoma of the right atrium. Patent foramen ovale. Thrombophilia of mixed origin: hereditary – heterozygous mutation of the prothrombin gene (factor 2), acquired – hyperhomocysteinemia. Postthrombotic deep vein disease of the left lower limb. Recurrent pulmonary embolism (last relapse dated October 19, 2022). CTEPH functional class III (World Health Organization), moderate risk. Congestive heart failure with reduced right ventricular ejection fraction, functional class III (by the New York Heart Association). Relative tricuspid valve regurgitation grade 3. The patient underwent surgery: thromboendarterectomy from the right pulmonary artery under conditions of circulatory arrest and deep hypothermia, removal of a right atrium myxoma under conditions of artificial circulation and blood cold cardioplegia: tricuspid valve plasty according to De Vega. After surgery patient’s condition was significantly improved.Conclusion. The features of diagnosis and treatment of a patient suffering from CTEPH and cardiac myxoma are outlined. Surgery: Pulmonary thrombectomy and cardiac myxoma removal may improve the patient’s condition with CTEPH and left atrial myxoma.

Mandibulectomía total en un perro con ameloblastoma: Reporte de caso

Ameloblastoma is the most common among all oral cavity neoplasms. It is benign and happens because of a genetic malfunction of the cells responsible for the enamel, called ameloblasts. These tumors may occur in any place of the oral cavity, and often present quick growth. Surgery is the main course of treatment, seeking full tumor excision. Surgery may be associated with chemotherapy or radiation. This paper aims to report a case of bilateral total mandibulectomy of a patient with ameloblastoma. The patient had no previous medical history and had a large jaw tumor that caused sialorrhea with blood streaks, cachexia, problems with mouth occlusion, pain and anemia. Left total mandibulectomy was the first-choice treatment, but a right partial mandibulectomy was needed afterwards. However, 2 other reinterventions were necessary, which led to total bilateral mandibulectomy. In conclusion the chosen procedure was effective in bringing quality of life and well-being to the patient.

Effect of Cartap hydrochloride (50% SP) insecticide on Liver and Kidney histology of the fish, Cirrhinus mrigala (Hamilton)

Effect of Cartap hydrochloride on the liver and kidney of the Indian major carp, Cirrhinus mrigala was studied. Fingerlings were exposed to sub-lethal (0.0376 mg-1) and lethal (0.376 mg-1 ) concentrations of Cartap hydrochloride for 24 and 96 hours. The histological changes in the liver of fish Cirrhinus mrigala exposed to sublethal and lethal concentrations of cartap hydrochloride were characterized by the formation of the prominent yellowish-brown pigment cytoplasmic vacuoles, pycnotic nuclei, degeneration of hepatopancreatic tissue, eosinophilic granules, Melano macrophages aggregate, appearance of blood streaks, degeneration of hepatopancreatic tissue, hypertrophic nuclei, cytoplasmic degeneration change in the shape of the hepatocytes, disappearance of hepatic cells, hyperplasia of cells, hypertrophic nuclei and degeneration of cell membrane. The kidney of the treated fish showed the appearance of prominent tubular yellowish brown pigment, formation of vacuoles, swelling of glomerulus, separation of the tubular epithelium, tubular architectural loss, damage of bowmans capsule, tubular cytoplasmic degeneration, cloudy swelling degeneration, damage to renal tubules, damaged haemopoitic tissue, necrosis of cell and renal tubules, disorganization of connective tissue, degeneration of cytoplasm, pyknotic nuclei, hypertrophy of nuclei, disintegration of cell membrane were also seen. The results obtained were discussed at length with the available literature. By studying these histological deformities, it was concluded that the pesticide caused enough damage to the liver and kidney of the fish and can influence on the survival of the fish.

A Case Study on Parikartika W.S.R Fissure in Ano

Abstract: Parikartika is one of the well-known ano-rectal diseases. Reference to this can be found in the Bruhatrayees. Around the Rajasthan Pradesh, the term "Parikartika" refers to Parikartanavatvedana. Additionally, it exhibits symptoms like anus bleeding, burning sensation and sometimes swelling. Parikarthika (Fissure in Ano) is regarded one of the most painful anorectal diseases. As a result of improper changes in modern lifestyle and irregular eating patterns, this disease is become more common now. Due to this, it has recently occurred in all age groups and regardless of gender. This case study describes how an acute fissure in ano was effectively treated using Ayurvedic treatment modalities. A 35year-old male patient arrived with symptoms of pain and burning both during and after defecation, as well as having blood streaks appear in his stool. The patient was diagnosed with acute fissure, due to the presence of a longitudinal ulcer in the lower part of the anal canal. Both internal and external Ayurvedic treatment plan was used. He was treated with Ayurvedic medicines, which gives effective results within 3 days of Ayurvedic treatment.

Present Pasts of Colonial Modernity: Embroideries by Lucie Kamuswekera

Present Pasts of Colonial Modernity: Embroideries by Lucie Kamuswekera

POST MENOPAUSAL BLEEDING PATTERNS IN PREDICTION OF ENDOMETRIAL CARCINOMA

Objective: To determine the demographic profile, patterns of bleeding and histopathological patterns of endometrial biopsy in women presenting with postmenopausal bleeding. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Department of Obstetrics and Gynaecology, CAIMS, Karimnagar from October 2020 to April 2022. Material and Methods: This descriptive cross-sectional study included women of any parity and age >45 years who had spontaneous cessation of menstruation for the last one year and who presented with abnormal uterine bleeding. Premenopausal women, drug or irradiation induced, or iatrogenic menopause cases were excluded. All patients were admitted, transvaginal ultrasound done (cut off endometrial thickness >4mm) and subjected to dilatation and curettage under anesthesia and endometrial biopsies obtained. Samples were sent for histopathology and followed. Results: A total of 70 women were included. Commonest age group was 61-70 years, and was seen in 38 (54.3%) women, followed by the 52-60 years age group where 18 (25.7%) subjects were observed. Mean age was 62 ± 2.54 years. Twenty-four (35%) women were hypertensive while Type 2 Diabetes Mellitus (T2DM) was seen in 14 (20%). forty (57%) women complained of streaks of blood on the sanitary pad, and in 56 (80%) (P=0.032) there were recurrent episodes. Forty-eight (68.57%) women were multiparous. Atrophic endometrium was the most common benign histopathological pattern, seen in 18 (26%) followed by 16 (23%) chronic endometritis. Endometrial carcinoma was seen in 16 (23%). (p=0.041) Conclusion: Postmenopausal bleeding is an alarming symptom and should be thoroughly investigated with transvaginal ultrasound followed by endometrial biopsy for timely diagnosis and treatment.

S1912 A Rare Case of Recurrent Hemosuccus Pancreaticus

Introduction: Hemosuccus pancreaticus is a rare cause of GI bleeds characterized by intermittent bleeding from the major duodenal papilla. Chronic pancreatitis, via arterial wall necrosis, can form a visceral pseudoaneurysm in 10% of cases. Here is a rare case of recurrent hemosuccus pancreaticus caused by a gastroduodenal artery (GDA) pseudoaneurysm, despite repeated embolization. Case Description/Methods: A 65-year-old man with alcoholic pancreatitis and pancreaticoduodenal pseudoaneurysm status post embolization in 2019 was being evaluated for hematochezia for 6 months. The patient underwent several negative EGDs and colonoscopies. Video capsule endoscopy showed scant blood streaking in proximal small bowel. Initial CT showed an enlarged pancreas with dilated pancreatic duct. EUS showed a 3x2.5cm well-defined cystic lesion at the pancreatic head with an anechoic center with vascular flow. Repeat CT showed a 1.6cm saccular aneurysmal dilation of the superior pancreaticoduodenal artery (SPDA). Prior to follow-up, he was admitted with hematochezia, with his hemoglobin down from 12 to 7.8. EGD showed blood in the second part of duodenum with fresh oozing from ampulla. An aortogram showed a non-bleeding pseudoaneurysm of the GDA, which was successfully embolized. One month later, he presented again with hematochezia. CTA showed a recurrent 1.5cm pseudoaneurysmal dilation of the SPDA and possible lower GI bleed. Colonoscopy showed dark red blood mixed with stool. NM scan showed a slow bleed from left common/internal iliac artery. An angiogram showed extravasation from the GDA, which was embolized along with the recurrent pseudoaneurysm. Seen 45 days after discharge, the patient was asymptomatic (Figure). Discussion: Hemosuccus pancreaticus caused by GDA pseudoaneurysm is reported in less than 2% of population. Successful embolization in the first 6 months is estimated to be 67%, with rebleeding risk at 37%. Rebleeding is thought to be due to collateral vessels, but in this case, no extravasation was seen after each embolization. Our patient developed recurrent symptoms with development of an aneurysm involving the same artery 1 month later. Recurrence or formation of new pseudoaneurysms usually occur within the first 6 months after embolization. This case is unique in that the patient initially had a successful embolization in 2019 of an aneurysm involving the same artery without any bleeding for 2 years, showing that hemosuccus pancreaticus can recur even after the initial 6 month period after a successful embolization.Figure 1.: A: EGD showing bleeding from ampulla. B: Angiogram of celiac trunk with GDA pseudoaneurysm. C: CTA showed 1.5cm saccular pseudoaneurysmal dilatation of the superior pancreaticoduodenal artery. D: EUS showed a 3.4 x 2.5 cm cystic lesion with anechoic center.

Comparison between Lateral Internal Sphincterotomy And Lord’s Operation for Chronic Anal Fissure

Introduction: Anal fissure is an elongated ulcer in lower anal canal which presents with severe perianal pain during and after defecation with red streaks of blood. Chronic anal fissure is a fissure for more than six weeks with a skin tag (sentinel tag). Surgical options include Lord's dilatation of anus, lateral internal sphincterotomy (LIS) and posterior anal flap.
 Aims & Objectives: To compare LIS and Lord's operation in cases of chronic anal fissure in terms of occurrence of incontinence.
 Place and duration of study: Department of General Surgery, Ayub Teaching Hospital Abbottabad from September 2018 to March 2019.
 Material & Methods: This quasi-experimental study was carried on 92 patients with anal fissure. By convenience (non- probability) sampling patients were divided into two equal groups of 46 patients as group A for LIS and group B for Lord's dilatation. Data was collected on a structured proforma and analyzed using SPSS 20.
 Results: Flatus incontinence was observed in 1 (1.1%) fecal incontinence was in 11 (12.0%). Flatus incontinence occurred in 1 (1.1%) patient of group A while no flatus incontinence was reported in patients of group B. Fecal incontinence is observed in 10 (10.9%) patients with group A while 1(1.1%) of patients in group B had fecal incontinence. The result was significant with chi square value 9.614 and p value 0.008.
 Conclusion: Lord's dilatation is a better procedure than Lateral internal sphincterotomy in terms of fecal incontinence.

Traditional Chinese Medicine Constitution Identification Based on Objective Facial and Tongue Features: A Delphi Study and a Diagnostic Nomogram for Blood Stasis Constitution.

Objective The aim of this study was to systematically summarize and form an expert consensus on the theoretical experience of tongue and facial features for the identification of nine types of traditional Chinese medicine (TCM) constitution. Additionally, we sought to explore the feasibility of TCM constitution identification through objective tongue and facial features. Methods We used Delphi method to investigate the opinions of experts on facial and tongue feature items for identifying TCM constitution. We developed and validated a diagnostic nomogram for blood stasis constitution (BSC) based on objective facial and tongue features to demonstrate the reliability of expert consultation. Results Eleven experts participated in two rounds of expert consultation. The recovery rates of the two rounds of expert consultation were 100.0% and 90.9%. After the first round, 39 items were screened out from 147 initial items, and 2 items were supplemented by experts. In the second round, 7 items were eliminated, leaving 34 items for 8 types of TCM constitution. The coefficient of variation in the first round was 0.11–0.49 for the 147 items and 0.11–0.29 for the included items. The coefficient of variation in the second round was 0.10–0.27 for the 41 items and 0.10–0.20 for the included items. The W value was 0.548 (P < 0.001) in the first round and 0.240 (P < 0.001) in the second round. Based on expert consultation, we selected BSC as an example and developed and validated a diagnostic nomogram consisting of six indicators: sex, hair volume, lip color-dark purple, susceptibility-facial pigmentation/chloasma/ecchymosis, zygomatic texture-red blood streaks, and sublingual vein-varicose and dark purple. The nomogram showed good discrimination (AUC: 0.917 [95% confidence interval [CI], 0.877–0.956] for the primary dataset, 0.902 [95% CI, 0.828–0.976] for the validation dataset) and good calibration. Decision curve analysis demonstrated that the nomogram was clinically useful. Conclusion This is the first study to systematically summarize the existing knowledge and clinical experience to form an expert consensus on the tongue and facial features of nine types of TCM constitution. Our results will provide important prior knowledge and expert experience for future constitution identification research. Based on expert consultation, this study presents a nomogram for BSC that incorporates objective facial and tongue features, which can be conveniently used to facilitate the individualized identification of BSC.

Случай развития постинфекционного колита у девочки 7 лет, перенесшей COVID-19

Numerous studies and clinical observations demonstrate the role of the new coronavirus infection in the formation of various organs and systems pathologies. The article presents a clinical case of the development of post-infectious colitis in a girl who suffered COVID-19. Gastrointestinal symptoms appeared as early as in the acute period of the disease and, despite the symptomatic treatment, progressed within 6 months. During the examination, there was a sharp increase in the level of fecal calprotectin, a moderate increase in the level of CRP, stool with mucus and streaks of blood, the girl lost several kilograms in six months. According to endoscopic and morphological examination, superficial inflammation was noted without signs characteristic of ulcerative colitis and Crohn’s disease. Against the background of taking mesalazine, the condition somewhat improved, but after 2 months it worsened again; during repeated examination, a high level of calprotectin remained with negative serological markers and no endoscopic signs of inflammatory bowel disease. Obviously the girl has postinfectious colitis; further observation will allow establishing its nature and the disease prognosis.

STUDY TO EVALUATE THE EFFECT OF AABZAN OF WARM WATER IN CASES OF INSHEQAQ MAQADHAAD (ACUTE ANAL FISSURE)

Insheqaq Maqadhaad (Acute Anal fissure) is an ulcer in the longitudinal axis of the lower anal canal. Clinical presentation of patients includes Common in middle aged w omen, not in elderly. Constipation, bleeding discharge and stools are hard pellet like and there is drop of blood or streaks of fresh blood. Chronic fissures are characterized by a hypertrophied anal papilla internally and a sentinel tag externally (both consequent upon attempts at healing and breakdown), between which lies the slightly indurated anal ulcer overlying the fibers of the internal sphincter. When chronic, patients may also complain of itching secondary to irritation from the sentinel tag, discharge from the ulcer or discharge from an associated intersphincteric fistula, which has arisen through infection penetrating via the fissure base. In Aabzan Therapy only hips are immersed in medicated water, level of water should not be above navel (umbilicus). This therapy is very common and is used to relieve pain and discomfort of lower and upper limbs. It is indicated in Anal fissure, hemorrhoids, rectal prolapsed, uterine prolapsed, oligomenorrhoea, hysteria, dysentery, diarrhoea, cystitis, uterine cramps, vaginitis, IBS and prostitis. Present study was conducted on 30 Lord's anal dilatation post operative patients of Insheqaq Maqadhaad (Acute Anal fissure) to evaluate the effect of Aabzan of warm water in cases of InsheqaqMaqadhaad(Acute Anal fissure). The significant reduction in various scores was found after the completion of the study.

Clinical case of associative course of panleukopenia and intestinal yersiniosis in cats

The study of the course and manifestation of mixed infections is an important modern problem of both humane and veterinary medicine because their diagnosis is quite complex and time-consuming. The clinical manifestation of double and sometimes triple infection has its characteristics, which depend on various biotic and abiotic factors. To date, it has been proven that the associative course of several infectious diseases is registered more and more often, which confirms the case of simultaneous manifestation of panleukopenia and intestinal yersiniosis in domestic outbred cats. Diagnosis of mixed infection was comprehensive through general clinical and laboratory studies, the use of rapid test systems to confirm the diagnosis of panleukopenia and RNGA with specific yersinia antigens to determine the status of intestinal yersiniosis in cats. The latter was caused by serovar Y. enterocolitica O: 9 with a diagnostic titer of 1: 400. Thanks to microbiological studies, the causative agent of intestinal yersiniosis Y. enterocolitica was isolated. Its biological properties were determined, and antimicrobial sensitivity to enrofloxacin and doxycycline was established against the background of polyresistance to ceftriaxone and tetracycline. During treatment, it was found that the clinical case of intestinal yersiniosis was also due to the simultaneous infection of Y. enterocolitica with two types of serotypes O: 3 and O: 9. Which also have their own specific features. But in most cases, we have different sensitivity to antibacterial drugs, in contrast to the case we described. Clinical signs of the associated course of panleukopenia and intestinal yersiniosis in domestic outbred cats were characterized by prolonged diarrhea, streaks of blood and mucus, apathy, refusal to feed, general weakness. Therapeutic measures containing antibacterial drugs, energy sources, crystalloids, buffer infusions which were aimed at reducing dehydration and maintaining water-salt balance in the complex, were effective, clinical signs of the disease disappeared on the eighth day of treatment, and complete isolation of the pathogen in the environment ceased on the thirteenth day, which indicated the complete recovery of the animal. However, to prevent re-infection, it was recommended to treat disinfectants with care items and utensils. And also to avoid direct contact with animals that have pronounced clinical signs of disease. To prevent the occurrence of panleukopenia, scheduled mass vaccinations with mandatory observance of time limits.

Herpetic oesophagitis in an immunocompetent infant with gastroesophageal reflux

A 7-month-old boy presented to our emergency department because of persistent vomiting with streaks of blood despite esomeprazole treatment for gastroesophageal reflux for 3 months. Additionally, he refused solid food and showed failure to thrive (decrease of two standard deviation scores for weight-for-age). The boy's mother was known to have recurrent herpes labialis. Abdominal ultrasound showed no pyloric hypertrophy, but a barium swallow radiogram revealed a dilated distal oesophagus with a pinpoint stenosis (figure A). Oesophagogastroscopy showed extensive inflammation with whitish exudate and friable mucosa of the distal part of the oesophagus (figure B; video), as well as stenosis of the lower oesophageal sphincter. During oesophagogastroscopy, the stenosis was dilated to 8 mm and multiple biopsies were taken. Histopathological examination revealed features typical for herpes simplex virus oesophagitis (HSVE; figure C), which was confirmed by herpes simplex virus (HSV) immunohistochemistry (figure D). Moreover, HSV-1 was detected by PCR analysis. Additional laboratory tests revealed normal levels of T, B, and NK lymphocyte subpopulations and immunoglobulins. The patient was treated with valaciclovir (30 mg/kg per day in two doses) for 10 days, high-dose omeprazole (2 mg/kg per day in one dose), and nasogastric tube feeding. 2 weeks after initiation of treatment, the patient was symptom free and gained weight. 4 weeks after valaciclovir treatment, oesophagogastroscopy showed remarkable improvement with complete disappearance of mucosal inflammation, but clearly visible was a mild sliding hiatal hernia. Nasogastric tube feeding was discontinued after the endoscopy and omeprazole treatment was continued to treat reflux oesophagitis.

Haematemesis

Haematemesis, the vomiting of blood, is the major sign of an upper gastrointestinal bleed. It encompasses fresh bright red blood, streaks of blood mixed with stomach contents and the classically described ‘coffee ground’ vomit indicating old, partially digested blood. It can be scary for patients and doctors alike, and is not an easy thing to assess or manage in the community setting. The focus must be on the haemodynamic stability of the patient and on identifying factors associated with increased mortality. Significant haematemesis is a poor prognostic factor and needs prompt transfer to hospital for assessment and resuscitation.

Anal Fissures in Pediatrics, and Its Non-Surgical Management, A Review Study

The aim of this study is to show the effect of conservative therapy in management of anal fissures in pediatrics.Study samples were patients presenting to Central Teaching Hospital of Paediatrics between Feb. 2012 to Mar.2013. In prospective descriptive-analytical study,50 cases with anal fissures were evaluated in the pediatricsurgery outpatient clinic. All cases were subjected to medical history and clinical examination. The collecteddata were classified in tables. In history we focused on dietary habits , bowel habits , rectal bleeding, painfuldefecation &amp; constipation. The collected data consisted of age, sex, presentation &amp; location of fissure. In clinicalexamination we assessed the site , presence of skin tags &amp; PR if needed. All cases underwent conservativetreatment for anal fissure by using proctocidar ointment locally 2-3 times daily for 3-6 weeks &amp; lidocaine gel2% applied 10 minutes before defecation to minimize the pain. Lactulose syrup was given 2-3 times dailywith meal to soften the stool &amp; Purgative (Dulcolax) orally in addition to dietary habit instructions. Twopatients only not responded to this regimen , so underwent anal dilatation under general anaesthesia. In ourstudy a total of 50 cases (30 cases 60% Males &amp; 20 cases 40% Females) at age between (6 months - 3years)presented in central teaching hospital of pediatrics mainly as pain during defecation. All were evaluated ,diagnosed &amp; managed during the period from Feb.2012 to Mar. 2013 &amp; followed up for 3-6 weeks. In about48 cases (96%) associated with constipation &amp; 2 cases (4%) associated with diarrhea. 34 cases (68%) hadpain during defecation &amp; 27 cases (54%) had bleeding per rectum (streaks of blood or small drops of blood).All Patients were diagnosed clinically by history from parents &amp; local examination. 45 cases of fissures inano were located posteriorly, 3 were anteriorly located &amp; only 2 cases have fissures on both sides. 48 caseshad history of developing symptoms within 2 weeks period &amp; underwent medical management in the formof laxatives e.g. lactulose &amp; purgatives e.g. dulcolax in addition to lidocaine gel 2% which is topicallyapplied for about 3 to 6 weeks resulting in complete healing. 2 cases (4%) only were not responded to thisregimen &amp; needed anal dilatation. We found that an acute anal fissure is more common than chronic inpediatrics. The most common presenting symptoms were pain during defecation &amp; constipation.&#x0D; Conclusion: Anal fissures can be simply and effectively treated medically by topical proctocidar ointmentand lidocaine gel 2% in addition to lactulose syrup &amp; purgative. These are an excellent combination,associated with a low recurrence rate and minimal side effects.