European Journal of Molecular & Clinical Medicine

An elderly male in seventies, diabetic, hypertensive and asthmatic, presented with chest pain, cough, dyspnea and a chest wall swelling in left posterior axillary line for 4 months. His X-ray chest showed left sided pleural effusion. A diagnosis of possible empyema necessitans was made by the treating physician and a pigtail catheter was inserted. The drain was however non-purulent, and the swelling remained unresolved. He was therefore referred to our institute. On examination, there was a large smooth round chest wall swelling in left posterior axillary line with no skin erythema and a strong impulse on coughing. On further imaging and investigations, it was diagnosed to be a chest wall herniation of the lung. Intraoperatively, it was found that only a very thin muscle layer existed in the entire left seventh intercostal space. It was repaired with a mesh. Patient is doing well after the surgery with no recurrence.

Epiphora is the overflowing of tears in the presence of normal tear production that could be due to obstruction in the lacrimal drainage apparatus. Immediate resolution might occur in most of the cases within one year of life. The objective of this study is to assess the clinical profile and treatment outcome of various children with epiphora.
Materials and Methodology: A total of 215 eyes of 175 patients (50 bilateral cases) aged less than 11 years. Demographic data such as age, gender, laterality and clinical history of the patients were recorder after getting details from the parents or attendants. Chi‑square and Fisher’s exact test were used to test the difference in the two proportions was done using SPSS (version 11) (SPSS Inc., Chicago, USA) P < 0.05 was denoted a statistically significant difference.
Results: A total of 175 patients were studied. The mean age of onset of symptoms was 1.6 ± 2 years (range, 1 month–8 years) and the mean age of presentation was 2.8 ± 2.5 years (range, 2 months–9 years). Ninety‑six patients (55%) had an early onset (<3 years) and 79 patients (45%) had a late‑onset epiphora (≥3 years). The male: female ratio in the early‑onset group was 1.5:1, and in the late‑onset group, it was 3.3:1, with an overall ratio of 1.9:1. Overall, 131 cases (75%) were unilateral (64% in early‑onset group and 88% in late‑onset group).
Conclusion: Increasing age invariably decreases the success rate of sac massage and probing. The factors that are predictive of treatment failure other than age are laterality, increasing symptom severity, presence of infection, and previous history of treatment.

Diaphragmatic hernias (DH) are known to complicate pregnancy and high mortality rates have been reported due to delay in surgical intervention. The reported mortality rates in presence of strangulation ranged from 22 to 80% and almost one third of the reported cases, did not have any symptoms. A literature review suggests that, out of 43 cases of DH diagnosed during pregnancy, only six cases of right-sided BH have been reported until 2020. Prolonged maternal malnutrition affects the intrauterine growth of the foetus and increases the morbidity and mortality of both the mother and foetus, leading to maternal weight loss, electrolyte imbalances, and vitamin deficiency. In the present case study, 21-year-old primigravida female with right-sided congenital BH was diagnosed during pregnancy, 7 days after the initial presentation of symptoms of acute obstruction. On exploration ischemic bowel was noted and it was associated with foetal loss.

Background: The incidence of congenital heart defect is 8-10/1000 live-births according to various reports from the different parts of the world.3 this incidence has remained constant worldwide.4 It is responsible for significant morbidity and mortality in infants worldwide. These account for about 30% of the total congenital abnormalities. Neonates with CHD presents with low oxygen saturation which can be screened with the help of pulse oximetry. Pulse oximetry is an easy and non-invasive method for measuring arterial oxygen saturation in newborns with a high level of accuracy.
Objective: To asses the role of Pulse Oximetry as a Screening Tool for Detecting Congenital Heart Disease.
Materials and Methods: The present prospective observational study was conducted by the Department of Paediatrics (Post Natal Ward) at Government Multi-specialty Hospital, Sector-16 and Chandigarh from December 2015 to June 2016.
Results: Among the study out of 528 study subjects nearly 5 (0.9%) of them were found to be positive and 523(99.1%) of them were found to be negative. The mean value of spo2 in positive screened cases of the upper limb was noted to be 91.20 which ranged from 89-94. In the lower limb, the mean value was found to be 90.20, which ranged from 84-94. The mean value of hand-foot difference was 3.00. The mean SpO2 Saturation in the upper and lower Limb between screen positive and Screen Negative was found to be statistically Significant with P Value of less than <0.0001.
Conclusion: Early diagnosis of CHD is crucial to reduce the significant morbidity and mortality of CHD as the first manifestation of CHD may be associated with circulatory collapse or death. Pulse oximetry can detect mild hypoxemia which is characteristic of CHD. Therefore, pulse oximetry screening should be implemented in routine post natal examination of neonates.

Background: Congenital talipes equinovarus is a paediatric congenital deformity with an occurence of 1 in 1,000 live births, it is distinguished with the development of equinus and varus deformity in the hind foot, cavus in the middle of the foot, forefoot adduction. Clubfoot assessment is essential to assess the initial severity of the clubfoot, to monitor treatment progress and to identify relapses. Currently, there is no measurement tool available to measure the extent of the deformity or control the treatment and it is difficult to do so using measures such as Pirani scoring and Dimeglio classification, as observer bias is susceptible. With Real Time Sonoelastography we can test changes in the properties of CTEV-affected Soft tissues. 
Objective :1)To evaluate initial properties of the tendons of Tibialis Anterior and Tendo Achilles by real time sonoelastography in CTEV.2) To compare changes in tendon substance of Tibialis Anterior and Tendo Achilles with Real time elastography in patients with Clubfoot after serial Ponseti’s cast correction.3)To evaluate sonoelastographic properties of normal Tibialis Anterior and Tendo Achilles in cases of unilateral club foot.
Methods and Material: A total of 30 unilateral clubfoot children who are less than 2 years old visiting the out patients department of AVBRH would be recruited. In this study, we will use a Real time sonoelastography, Real time sonoelastography will be performed using the (Hitachi Aloka ;Model: Arietta S 70) and the ultrasound probe ( MSK liner probe 12 to 18 MHz).
Results – The result will be compiled after the results of elastography, in well tabulated manner.
Conclusion – The conclusion will be based on the findings for study.

The incidence of Congenital Diaphragmatic hernias 1:2000 to 1:12500 amongst all live births. (1,2) It is rare adults with a incidence of 0.17%. (3) Presentation in adults is usually asymptomatic and are detected incidentally during imaging studies.Somepatients present when complications occur. Otherwise when symptoms are present, it is usually more of GI symptoms or rarely with respiratory symptoms. Here we report a case of a 39yr old female patient who presented with respiratory symptoms and had a Left side Bochdalek hernia which was treated successfully by laparoscopic mesh repair. Patient is fine after 1 year of follow-up.