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EDITORíS CHOICE


Ulcerative colitis is nowadays being diagnosed more often because of frequent use of sigmoidoscopic examination. On pg 574, Sheetal Shah et al from Bombay Hospital Medical Research Centre report a very important finding wherein 15 patients out of 30 having this disease, when followed up had undergone surgery. The interesting conclusion drawn was that the quality of life was as good in medically treated patients as in surgically treated patients. This finding is of extreme importance in our country where not many patients agree or can afford this surgery. These group of authors headed by Deepak Amarapurkar must be congratulated for bringing out such an important fact.

Though very costly, immunotherapy is being used in more and more conditions in medicine. It is an excellent treatment to raise low platelet count which can be fatal otherwise or to revive patients from lupus crisis where in the past plasmapheresis was used. Similarly in many neurological conditions like acute viral polyneuritis, exacerbation in multiple sclerosis, myaesthenic crisis the therapy is becoming very important. Now on page 579, Sreedhar and Jayakar from TN Medical College report on the use of intravenous immunoglobulin in neonatal sepsis. If this can reduce the incidence of infection among newborn it will be worth the expenditure.

Maternal mortality in our country has to be brought down. In this connection, Chaudhari and Vaswani on pg 583, present their analysis of 18 cases of obstetric hysterectomy which was used as a last resort to save the motherís life at the cost of sacrificing the future reproductive capability.

In an obstetric unit any admission test to screen and predict the neonatal outcome is welcome. On pg 586, Chaudhari and Pai from Bhabha Hospital recommend that the admission test offered by them if carried out has a positive predictive value of 31.3% and a negative predictive value of 95.3%.

On pg 589, Singhal and Pandey from Benaras Hindu University used argyrophilic nucleolar organizer regions (AgNORs) staining in 112 female patients including 10 normal age matched controls by a method described by Crocker and Smith. The observations revealed significant increase of AgNOR count in cancerous lesions than in benign and precancerous lesions. AgNOR staining and scoring is a simple, inexpensive and useful adjunct to routine histopathology, though scores can not be standardized and fixed for a particular lesion as there are intra laboratory variations.

In the Special Issue of Bombay Hospital Journal celebrating fortieth anniversary of its publication, we published tuberculosis involving various organs in the body. Now, Ganesh Bakshi et al from KEM Hospital on pg 617, report an unusual case of appendicular tuberculosis and warn all the surgeons that after removal of any appendix, histopathological examination is a must. This case report further confirms our impression, for which the authors should be congratulated and further confirm the impression that tuberculosis does not spare any organ in the body.

Roundworms can cause any abdominal emergency in Indian children. However on pg 619, Ravi Bapat et al from Seth GS Medical College, report a case of biliary ascariasis in a 58 year old male, in whom the diagnosis was made by an emergency gastroscopy followed by sonography and CT scan, and lastly surgery. These authors remind us that in our country, the common causes even in the pathology of the biliary tract should be thought of.

From the same hospital and TN Medical College, Irani et al on pg 621, report involvement of the cavernous sinus intracranially by a juvenile nasopharyngeal angiofibroma which is a vascular tumour. They successfully treated this patient surgically by the conventional lateral rhinotomy and transpalatal approach.

Hereditary neuropathies have been reported in the literature but Harish Hosalkar et al from Bai Jerbai Wadia Hospital report on pg 625, a similar case in a 5 year old female child. Indeed it is a rare type of neuropathy.

Kishore Sandu et al from ENT department, KEM Hospital made a very good use of their sino nasal endoscope in diagnosing a CSF Rhinorrhoea (CSFR) in a patient of adenoid carcinoma of the pituitary gland who had taken radiotherapy which they have discussed on pg 629.

Shrikhande and Patil from Bombay Hospital should be congratulated for reporting the first case in world literature of metastatic mesenteric granulosa cell tumour on pg 633, In the search of 30 yearsí of literature they did not find a single case report of such a patient.

Inguinal hernia is a common condition, but a lumbar hernia is a very uncommon condition. On pg 635, Satish Ranka et al from KEM Hospital report a rare case of superior lumbar hernia.

And finally, it is commonly taught that priapism is a common cause of untreated myeloid leukaemia. Ranka et al from Seth GS Medical College, on pg 638, report a case who presented with priapism and had a chronic myeloid leukaemia but in remission phase. Indeed this is very rare and worth noting.


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