Cystic disease of the bile duct is a congenital abnormality of the biliary tree that most commonly affects the neonatal population, and is uncommon after childhood, it is rarely diagnosed in adults. We report the case of a 42-year-old woman affected by choledochal cyst type I, according to Todani’s classification, found unintentionally. The patient was submitted to the complete surgical excision of choledochal cyst, and discharged on the 11th postoperative day without complications.

Paracetamol is one of the most used drugs in the world. We report here two cases of children poisoning (less than 3 years old) who were accidentally administered an adult form of rectal suppository containing a combination of paracetamol-codeine (1000 mg/60 mg). The first child received a dose of 154 mg /kg of paracetamol and 9 mg/kg of codeine two times daily for 2 days. Clinical signs were vomiting and epigastric abdominal pains. Biochemistry showed an increase of liver enzymes (4 to 40 fold), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma glutamyl transpeptidase (GGT). The second child received the suppositories discontinuously (two times daily) and showed less severe signs of intoxication. The administration of N-acetylcysteine at admission into hospital limited the toxic effects of paracetamol. The toxic effects of codeine, such as central nervous system (CNS) depression were not obvious in both cases.

The presence of a large bulky pancreatic tumour in a young female should raise suspicions of the diagnosis of solid-pseduopapillary tumour of the pancreas. Solid pseudopapillary neoplasms of the pancreas are uncommon, accounting for only 1-2% of all pancreatic neoplasms. These tumors are being detected at an increased rate, probably due to the increased awareness and the liberal use of imaging. We report a case of a 28-year-old North African woman with no prior medical or surgical history diagnosed with solid pseudopapillary pancreatic tumor. Our immunohistochemical study demonstrated that the tumor cells were positive for CCK-2/gastrin receptors and that were highly expressed within the cytoplasmic area of the cells. Hence we attempted to raise a hypothesis and to establish a link between some female hormones which represents powerful regulators of the expression of CCK and their possible impact on the development of solid pseudopapillary pancreatic tumours in young women.

Background: Being differently abled is a complex phenomenon and also concept of disability has shifted from individual impairment to social phenomenon. Objective: Present simple review is to get information for planning services and to share. Context Incidence: Numbers vary across countries, lowest reported incidence is from Lithuania (0.58%), highest from Poland (4.0%). European Academy of Childhood Disabilities reported a disabled child rate of 2.5%, additional 8% child population has learning and/or behavioural disorders. In India with lack of awareness, lack of resources, lack of community based services, many babies born with abnormalities continue to live without proper diagnosis, therapy. Sometimes it goes beyond childhood to adulthood, years beyond. Types of disabilities: There are many disabilities which make person differently abled. Hearing loss is one of the most common birth disorders. There are 285 million people with visual impairment worldwide. Limb deformities vary. Psychiatric disorders, by virtue of their very nature, display different patterns of disabilities when compared to physical ailments.

Pasteurella spp is the first organisms to consider in any patient who presents with a soft tissue infection following cat or dog bites. Pasteurella canis is most common isolate of dog bites, but there are no reports of pastereulla canis infection caused by sheep bite. A case of a 66 years old farmer woman with symptoms of infected left hand with wrist septic arthritis, after a lamb bite is described (the sheep was sick after a dog bite). Microbiological examination of the wrist articular liquid was performed. The specimen was both aerobic and anaerobic cultures were performed. After 24 hours, growth of smooth, greyish-white colonies was observed only on Columbia agar. Another Gram stained slide was performed from those colonies and Gram negative cocobacilli to short rod shaped morphology with bipolar staining was observed. They demonstrate positive catalase and oxidase positive reaction. The bacterium was susceptible to all tested antimicrobial agents. Although systemic forms of Pasteurella are possible, cutaneous infections from animal bites are the most common presentation. Most animal-bite injuries can be treated with oral antimicrobials on an outpatient basis, but in this case the patient needed intravenous antimicrobial aggressive therapy.

Introduction: Isolated right ventricular myocardial infarction is an uncommon entity in the spectrum of acute coronary syndrome. It is often overlooked during the assessment of patients suspected to have acute coronary syndrome. Case Presentation: A 58 years old male presented with atypical chest discomfort. The initial ECGs were not supporting. The Echocardiogram revealed an isolated right ventricular myocardial wall motion abonrmality that was initially missed. Coronary angiogram revealed a co-dominant circulation with 100% occlusion of proximal right coronary artery. The distal right coronary artery was receiving collateral from left circulation. Successful angioplasty of right coronary artery was done with almost complete recovery of right ventricular function.

Lutembacher syndrome is a combination of ostium secundum atrial septal defect with acquired rheumatic mitral stenosis. This is a case of middle aged woman who had lutembacher syndrome with severe pulmonary hypertension with class IV symptoms. She had very severe mitral stenosis with valve area of 0.7 cm2 and ostium secundum atrial septal defect of 14 mm size. The management of lutembacher syndrome was only surgical till 1990s. Total percutaneous management has been described in late 1990s. Percutaneous management is relatively cheaper option and saves the patient from artificial valve and related complications. However, only a small number of cases of total percutaneous management of this condition are available in world literature.

Background: The coexistence of giant cell tumor (GCT) and metacarpal bone tuberculosis (TB) of the hand has never been described before in the English written literature. We report here a first observation. Case presentation: We report the case of a 49-year-old male who presented with severe pain in his left hand following a blunt trauma. A plain X-ray of the metacarpal bones showed a pathological fracture of the 4th metacarpal bone (diaphysis), and computerized tomography and magnetic resonance imaging studies confirmed the diagnosis of destructive (lytic) lesions. biopsy of the metacarpal lesion revealed a GCT, and tissue cultures were positive for mycobacterium tuberculosis (TB). He was treated by a standard 4-drug protocol of isoniazid, rifampicin, pyrazinamide and ethambutol for 2 months and an additional 6 months of isoniazid and rifampicin. He then underwent excision of the metacarpal lesion, and the pathological examination showed a GCT with cultures negative for TB.

There is a paucity of literature on this potentially devastating side effect of vacuum-assisted delivery. We present here a significant subdural haemorrhage associated with tentorial tear following vacuum-assisted delivery that resolved with only supportive medical measures without resulting in any neurological deficits nor delays on thorough examination and formal neuro-developmental assessment.

Diabetic management requires a continuous assessment of performance, looking at successes and failures. Especially in community setting, the development of a Collaborative Diabetes Management [CDM], Low Sugar Volunteers [LSVs], core-community working group, vigorously participated in all community activities to manage diabetes disease and its relevance. CIPP model was used to guide an evaluation of all activities that happened during a CDM development. Context, input, process, product, and appraisal sustainability were presented via LSVs community driven. CDM via community participation strategies prejudiced community health impacts, community health policy, and community sustainability. Moreover, various findings from CDM development influence actions and community direction either immediately or in the future.