The Chettinad Health City Medical Journal’s second issue of 2015 has an assortment of articles from various specialties. The dilemma surrounding the early diagnosis of endometriosis is highlighted in the perspective article. The development of speech and language function is a fairly common type of developmental delay in children and these children may have learning disabilities. Early identification of these group of children helps in proper training and prevent further problems and the Language Evaluation Scale Trivandrum (LEST) is very useful in this regard. The original article in this issue highlights the use of LEST in a group of 200 children.

Developmental Delay in speech and language domain is the most common developmental disorder in children. Awareness of the delay is very important because early identification definitely paves a way for appropriate intervention and prevention of consequences.

Coronary artery disease (CAD) is the most common cause of mortality in India. Deaths due to CAD occur 5–10 years earlier in the Indians than in Western countries. Coronary artery disease (CAD) in young women, who are previously considered as low risk group, is on rise now due to various reasons. This study is aimed to find out the incidence of CAD in young women admitted for evaluation of chest pain.

Radiofrequency catheter ablation (RFA) is a therapeutic procedure usually done during Electrophysiological (EP) study that is performed to diagnose arrhythmias or abnormal heart rhythm. It is done to treat supraventricular and ventricular tachycardias which are abnormal, rapid heart beats starting in atria or ventricles.

Human Influenza Virus when it got mixed with swine/bird influenza virus it manifested as Swine flu in 2009. Subsequently it caused epidemics and pandemics and has remained as endemic disease. Clinically swine flu and seasonal flu present with similar presentation. Hence there is a need for categorization of disease, sub typing and laboratory confirmation. In our OPD out of 27 cases tested for swine flu, 13 were positive including 2 cases of pneumonia, all of which recovered. In this article early diagnosis and appropriate management is highlighted. Also a review of literature from India between 2009 to 2014 has been discussed.

History is replete with prejudice, pathos and superstition. The history of cardiac and great vessel surgery and anesthesia to sustain surgical effort is no exception1 . The early history of anesthesia for operations on the heart is that of anesthesia itself. The evolution of heart surgery per se was slow. Experimental work had started in 1882.

Trochlear palsy due to brainstem lesions usually accompanies other neurological deficits. Isolated trochlear palsy can occur in various clinical conditions. Isolated palsy due to brainstem stroke is a very uncommon presentation1,2,3,4. Only very few cases have been reported in literature so far.

There are many causes for hemolysis in a preterm neonate. To our knowledge there are no reports of high environmental temperature associated haemolysis in preterm neonates. Investigators have reported on the effects of heat on blood. We report hemolysis associated with high environmental temperature in a preterm neonate after discharge from the hospital.

The frequency of duodenal diverticula is second after the colonic diverticula in the gastrointestinal tract, but the presentation of Intraluminal Duodenal Diverticulum is very rare in Asian population. Most such diverticula are asymptomatic and located in the second part of duodenum. We report a female patient who presented with symptoms of postprandial epigastric pain and fullness since 3 years. Diagnosis was established by uppergastrointestinal radiography. She was advised few diet modifications and was put on prokinetics. Follow up after 3 months showeda significant improvement from her symptoms. This case report highlights the importance of non-surgical approach in uncomplicated Duodenal Diverticula where Diverticulectomy may not be needed.

Schwannomas affect mainly head, neck and flexor aspect of the limbs. Axillary Schwannoma1,2 is extremely uncommon. Here we present such a rare occurrence in our patient.

LASER has been a great boon in Periodontics. Soft tissue LASERS ensure greater hemostasis, bactericidal effect and minimal wound contraction than conventional surgery. Granuloma Gravidarum is a pyogenic granuloma that occurs during pregnancy with multi factorial aetiology. It is mostly painless and does not warrant prompt treatment and can be carried out post partum, however in cases with pain and loss of function excision is advised but the only challenge which remains is achieving hemostasis. This article consists of a case presentation of a 25 year old pregnant female patient in the third trimester with granuloma gravidarum who was successfully treated using soft tissue diode LASER (iLase).

We describe here the first known reported case of breakage of a disposable venous stripper in the context of varicose vein surgery. Although the current climate in the treatment of varicose veins and superficial venous disease favours sclerotherapy and endovenous ablative therapies, open venous surgery still remains a useful option in skilled hands. The purpose of this report is to highlight that the equipment used in these open venous approaches is not failsafe and that careful inspection of venous strippers should be carried out prior to their use. Additionally, the possibility of equipment failure might need to be discussed with the patient during the consent process.

Usher syndrome is a rare heterogenous autosomal recessive genetic disorder with features of visual impairment due to retinitis pigmentosa and hearing loss. Other names for Usher syndrome include Hallgren syndrome, Usher-Hallgren syndrome, retinitis pigmentosa-dysacusis syndrome, and dystrophia retinae dysacusis syndrome.

We describe here 2 cases of congenital agenesis of the suprarenal inferior vena cava (IVC), which is a rare and often complex abnormality, in the setting of iliocaval deep venous thrombosis. This disorder often presents via a wide variety of symptoms and treatment modalities range from pharmacological thrombolysis to open venous reconstruction. We will review the embryology of the IVC and outline the presentation of 2 cases of its congenital absence. These cases highlight the significance of considering this abnormality in the setting of deep venous thrombosis involving the iliocaval system to avoid diagnostic pitfalls. We recommend the use of appropriate imaging modalities to delineate this pathology and discuss the various therapeutic approaches to this problem.

Screening or early diagnosis of a disease refers to early identification of disease conditions for which early and timely interventions can lead to the elimination or reduction of associated mortality, morbidity and disabilities. In this perspective article, we have tried to focus on the futility of early diagnosis of endometriosis, a common gynecological disorder with many complexities. Much attention, time and efforts are spent in diagnosing this condition early with a near impossible goal of cure or amelioration.