Patients on haemodialysis are usually at a high risk of contracting hepatitis B virus (HBV) and elicit a weak response to the hepatitis B vaccine. This study was aimed at determining the factors affecting the response to HBV vaccination in haemodialysis patients. HBV vaccination was administered to 50 patients on haemodialysis who were negative for HBsAg, anti-HBc (total), and anti-HCV antibody and did not previously receive any dose of the HBV vaccine. The patients were vaccinated with 40 μg (per dose) of Engerix B (GlaxoSmithKline Biologicals, Belgium) following 0, 1, 2, and 6 months schedule. Based on the level of antibody (anti-HBs) response after the completion of vaccination, the patients were divided into three groups: good responders (>100 mIU/mL, poor responders (10-100 mIU/mL), and non-responders (<10 mIU/mL). The overall seroconversion rate was 80%. The vaccine response rate was high (93.3%) in patients aged less than 40 years and lower (73.4%) in patients aged over 40 years. The response rate was also higher in users of erythropoietin than non-users (90.45% vs 72.41%). No other significant factors relating to the HBV vaccine response in the haemodialysis patients could be determined. Further studies with with a larger sample-size are necessary to confirm the findings of the present study.

Key Words : Hepatitis B vaccine, Immune response, Risk factors

Ingestion of caustic agent for suicidal attempts is alarming due to easy availability & lack of knowledge of post survival complications. In acute phase complication includes dysphagia, odynophagia, Oedema & ulceration followed by perforation & mediastinitis. Consequently, stricture and carcinoma develop in later stages. Thus, early assessment with endoscopy to evaluate the severity & extent of injury is gold standard within 48hrs of incident. Our patient was a 19-year-old female who had 3rd degree esophageal burn after ingestion of a bottle of caustic substance (Harpic). For swallowing difficulty & nutrition, maintenance Feeding Jejunostomy was done. Later, patient developed long segment esophageal stricture and pyloric stenosis, for which she underwent Transhiatal Esophagectomy & Colonic Interposition. The patient made a good postoperative recovery and was free from complications at the end of 2 years of follow up. 

Key Words: Caustic substance, Esophageal burn, Transhiatal, Colonic Interposition, pyloric stenosis.

Hepatocellular carcinoma (HCC) is the most common primary liver malignancy. In western countries, over 90% of HCC cases develop on cirrhotic liver. On the contrary, in Asia and Africa the percentage of HCC cases are relatively higher in non-cirrhotic individuals than cirrhotic. This case report describes an 18-years teenage female patient who presented with 4-5 months history of recurrent right hypochondriac pain and abdominal distension, swelling of feet for 1- 2 weeks. She also reported loss of appetite, significant weight loss, and occasional vomiting but there were no other symptoms. Triphasic computed tomography (CT) revealed large heterogeneously enhancing predominantly cystic mass in the right lobe of liver with of septal enhancement. Serum alpha fetoprotein level was high (567 ng/L) and histopathological study confirmed the presence of primary hepatocellular carcinoma. This case finding suggests that hepatocellular carcinoma could be maiden manifestation in teenagers without evidence of preexisting liver disease

Introduction: This case report focus on the role of endoscopic treatment of ureteral stricture. Mr. J, 31 years old, male came in urology OPD with left loin pain radiated to left inguinal area & performed Left Lower ureteric balloon dilatation + D-J stenting. Endoscopic ureteral balloon dilatation for benign ureteric stricture is a better & feasible treatment option in the era of minimally invasive surgery.

Key Words: Ureteral stricture, Endoscopic treatment, Balloon dilation