Management of Bhagandar (Fistula in ano) by Ksharasutra – A Review

Bhagandara is a single or multiple opening around guda Pradesh associated with different types of discharge along with pain. Acharya sushruta has described bhagandara on its consequences under astamahagada. The disorder has reached a height due to an unhealthy lifestyle. It can be correlated with fistula in ano. Fistula in ano is an abnormal hollow tract or cavity lined with granulation tissue. It is a nasty condition for the patient and often creates issue which leads to unease. It affects their daily lifestyle. For the treatment number of the surgical method are available.In Ayurveda, Acharya Sushruta has described various types of treatment like Chedana karma, Ksharasutra therapy. In modern science fistulectomy, fistulotomy, seton, and so on. But due to reoccurrence, damage of the anal ring, incontinence, and complication, Ksharasutra stands as a major para surgical procedure to cure bhaganadara. Ksharasutra is a unique medicated thread that helps in cutting as well as drainage of the fistulous tract. It works as cutting and healing of fistulous tract simultaneously. Hence the possibility of damage to the anorectal sphincter muscle is less and chances of incontinence are null. It is safe minimal, cheap, and easy to use. It works effectively on various stages.

Description of a new species of Kermicus Newstead (Hemiptera: Coccomorpha: Pseudococcidae) from bamboo in southeast China

A new species, Kermicus huizhouensis Wu & Huang sp. n. (Hemiptera: Coccomorpha: Pseudococcidae), is described and illustrated based on the adult female, second instar female and first-instar nymph. It was collected at Qianfeng village, Huiyang District, Huizhou City, Guangdong Province, P. R. China, inside the stem of bamboo Bambusa rigida (Poaceae) and attended by the ant Tetraponera binghami (Forel) (Hymenoptera: Formicidae). It differs from K. wroughtoni Newstead, 1897 by the adult female lacking multilocular disc pores in the marginal region of the venter, and both the adult female and first-instar nymph having the anal ring bearing 16–20 setae. Keys to genera of legless mealybugs on bamboo based on adult females, and the immature stages of Kermicus, are provided.

Thoracic Endodermal Sinus Tumor with Root Compression Mimicking Guillain–Barre Syndrome in Clinical Presentation, CSF Studies, and EMG/NCV Findings

A 2-year-old boy who presented with clinical, cerebrospinal fluid, and electrophysiological findings consistent with Guillain–Barre syndrome (GBS) was found to have a thoracic spinal cord mass due to a yolk sac tumor. On examination, he had an absent anal wink and flaccid anal ring which is atypical for GBS. This case demonstrates the need for a thorough physical examination on presentation of a child with a clinical and laboratory presentation of GBS and highlights the importance of prompt imaging studies when clinical suspicion arises because of atypical clinical signs, such as absent anal wink or low rectal tone.

A revision of the mealybug genus Scaptococcus McKenzie (Hemiptera: Coccomorpha: Pseudococcidae), with descriptions of the adult male and female of Scaptococcus occultans sp. n. from the southwestern United States, and the male of S. milleri McKenzie

The adult female and male of Scaptococcus occultans sp. n. (Hemiptera: Coccomorpha: Pseudococcidae), a new mealybug species from the southwestern United States, are described and illustrated, as well as the male of S. milleri McKenzie. Females of the new species can be recognized by their unmodified prothoracic legs, anal ring with two rows of cellular pores, and presence of a circulus; the adult female is further characterized by the presence of bands across the thoracic and abdominal segments containing numerous dorsal modified oral collar tubular ducts (with the inner half of the outer duct sclerotized), quinquelocular pores and multilocular pores. The adult male of the new species differs from that of S. milleri by having unmodified prothoracic femora, small spine-like prothoracic claw denticles, fewer dorsal and ventral setae on abdominal segments II–V, and no sclerotized abdominal tergites laterally on the abdomen. The generic description of Scaptococcus is revised to include the new species, and an updated key to the adult females, diagnostic notes for the female nymphal instars, and updated distribution and host data for all the three species are provided.

A new ortheziid (Hemiptera: Coccoidea) from Australia associated with Acropyga myops Forel (Hymenoptera: Formicidae) and a key to Australian Ortheziidae

A peculiar new genus of Ortheziidae is described from Queensland, Australia. Acropygorthezia williamsi LaPolla & Miller, n. gen. & sp. was discovered in two localities in the nests of Acropyga myops. Descriptions and illustrations are provided for the adult female, adult male, first-instar nymph, prepupa, and pupa; descriptions only are provided for the secondand third-instar nymphs. Prior to this study, Acropyga ants were known to enter into trophobiotic relationships only with mealybugs (Hemiptera: Pseudococcidae). Therefore, this study represents the first non-mealybug association between a scale insect and Acropyga. The new ortheziid genus has a number of unusual morphological attributes: no definite wax plates; no ovisac; an anal ring lacking setae and pores, located dorsally in the middle of the abdomen; simple, large metasternal and mesosternal apophyses; numerous spines over the body, and various instars that are so similar that they are difficult to separate. These characteristics may represent adaptations to its relationship with ants. A key is provided to the Australian Ortheziidae.

Down-Staging after Two Different Preoperative Chemoradiation Schedules in Rectal Cancer

Aims To compare preoperative downstaging, toxicity and sphincter-saving procedures obtained with preoperative radiotherapy and two different concomitant chemotherapy schedules. Methods From February 1997 to August 2001, 68 consecutive patients were treated with external radiotherapy (5040 cGy in 28 fractions) and concomitant chemotherapy: group a) 36 patients (10T2, 19T3, 7T4, 25 adenocarcinoma and 11 mucinous histology) were treated with cis-diamminedichloroplatinum bolus + 5-fluorouracil continuous infusion; group b) 32 patients (14 T2, 18 T3, 27 adenocarcinoma and 5 mucinous histology) were treated with 5-fluorouracil bolus ± mitomycin C. The interval between the end of radiotherapy and surgery ranged from 4 to 9 weeks. Results Group a) Overall downstaging was 63.9%. Longitudinal shrinkage of the neoplasm allowed conservative surgery in 6 of 11 patients with a pre-chemoradiation tumor location ≤3 cm from the external anal ring. When patients with adenocarcinoma (25/36) were studied separately from patients with mucinous histology, 7/25 patients (28%) were found to have no microscopic evidence of residual tumor (pTO); 8/25 (32%) were found to have only rare isolated cancer cells (pTmic); only 7/25 patients (28%) were found to have no change. Overall, 72% patients had downstaging. In contrast, only 5/11 (45.5%) of mucinous tumors had partial downstaging and 6/11 (54.5%) no downstaging at all. Group b) Overall downstaging was 46.9%. When patients with adenocarcinoma (27/32) were studied separately, 7/27 (26%) were found to have pTO, 3/27 (11.1%) pTmic, and 13/27 (48.1%) no change. Only 1/5 (20%) of mucinous tumors had downstaging and 4/5 (80%) had no downstaging at all. Overall toxicity was comparable among groups a and b, except for lower hematologic and gastrointestinal G3-4 toxicity observed in group a. Conclusions The overall response allowed conservative surgery in 56 (82.3%) of the 68 patients. Continuous infusion of 5-fluorouracil and diamminedichloroplatinum as a radipsensitizer determined better results in group a than group b (63.9% downstaging vs 46.9% even with a higher incidence of mucinous histology). Mucinous histology, for a definitely lower response rate, could benefit from an even more aggressive approach.

The Coccidae of South Africa—V.

This subfamily comprises a large number of genera, which are, as a rule, easily distinguished by the presence or absence of secretionary matter in one form or another. All agree, however, in having the anal ring with a number of hairs and, further, in having the hind margin cleft. The anal ring is covered above by a pair of more or less triangular plates which are usually densely chitinised. The eighteen genera known to be represented in South Africa are tabulated.

TWO REMARKABLE NEW COCCIDÆ

Of the two Coccidæ now described, the first is the type of a very peculiar new genus; the other is a very beautiful and interesting lac-insect.Stictococcus, n. g. —An aberrant genus of Lecaniinæ, with the anal orifice in the middle of the back, not connected with the hind margin by a slit or groove. Anal ring with six hairs in larva; none in adult. Anal plates so modified in adult as to be unrecognizable. Legs small, but well developed. Antennæ with 5 or 6 joints. Margin with long bristles, and flattened bifid or palmate plates or spines. Dorsum with numerous large pits.

TWO NEW ANTS'-NEST COCCIDS FROM TEXAS

Dactylopius Wheeleri,n. sp.– ♀ flesh colour, covered with a white, fluffy material, elongate oval,1¾ mm. long, 1 broad ½ high, convex, very flat beneath. Segmentation distinct. Boiled in potash, they turn brown; transferred to cold water, the internal juice becomes colourless. Pressed under cover-glass, the skin is colourless, with several long hairs anteriorly and on the caudal region above the anal ring and caudal tubercles. Anal ring normal, with six stout bristles. Caudal tubercles very prominent, with two long bristles 120 and 260 μ long. Legs stout, front leg coxa 140. Femur and trochanter 220. Tibia 148. Tarsus 100 μ long. Claw thin, sharp, with a distinct tooth near the end. Tibia and tarsus have several short hairs. Digitules of tarsus and claw very small. Labium small. Rostral loop exceedingly long.