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Mammary analogue secretory carcinoma (MASC) of parotid gland- A case report 腮腺乳腺类似分泌性癌(MASC) 1例
IF 0.6 Q3 Medicine Pub Date : 2023-08-15 DOI: 10.18231/j.ijashnb.2023.014
Pratiksha Pawar, Shubhanshi Kangloo, Ameya Bihani, Kunal G, Chetna B
Mammary analogue secretory carcinoma is a rare salivary gland carcinoma which shares morphologic and immunohistochemical features with the secretory carcinoma of breast and was first proposed by Skalova in 2010 with translocation of (q13; q25), t (12; 15), subsequently giving ETV6-NTRK3 gene rearrangement. Usually, it is a benign tumor that affects the parotid gland, with slight predilection for males. The present article report a case of secretory carcinoma of right parotid gland with special emphasis on histological feature and immunohistochemistry for diagnostic purpose and its management. Differential diagnosis includes AciCC, ADC-NOS and MEC. In a review by Chiosa et al (2012) in 337 cases of salivary gland malignancy included AciCC, ADC-NOS, MEC, LGCC, non-ITAC, signet ring adenocarcinoma, PLGA and most common malignancy reclassified as MASC were AciCC (11/89), ADC-NOS (14/37), MEC (1/165). Management for MASC includes surgical excision of the lesion (either superficial or total parotidectomy) for local, less aggressive disease like for low-grade malignant salivary gland neoplasms. For more invasive, metastatic disease and positive margins- neck dissection, radiotherapy and chemotherapy are reserved. There is no standard multidisciplinary treatment protocol established due to scarcity of this disease.
乳腺类似分泌性癌是一种罕见的涎腺癌,与乳腺分泌性癌具有相同的形态学和免疫组织化学特征,于2010年由Skalova首次提出,易位为(q13;Q25), t (12;15),随后给予ETV6-NTRK3基因重排。通常,它是一种影响腮腺的良性肿瘤,男性略占优势。本文报告1例右腮腺分泌性癌,并着重讨论其组织学特征及免疫组化诊断及治疗。鉴别诊断包括AciCC、ADC-NOS和MEC。Chiosa等(2012)回顾了337例唾液腺恶性肿瘤,包括AciCC、ADC-NOS、MEC、LGCC、非itac、印环腺癌、PLGA,最常见的被重新分类为MASC的恶性肿瘤为AciCC(11/89)、ADC-NOS(14/37)、MEC(1/165)。对于低度恶性唾液腺肿瘤等侵袭性较弱的局部疾病,MASC的治疗包括手术切除病变(浅表或全腮腺切除术)。对于侵袭性、转移性疾病和阳性边缘颈夹层,保留放疗和化疗。由于这种疾病的稀缺性,没有建立标准的多学科治疗方案。
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引用次数: 0
A cross-sectional analysis of the histopathologic structure of thyroid patients undergoing thyroid surgery 甲状腺手术患者组织病理结构的横断面分析
IF 0.6 Q3 Medicine Pub Date : 2023-08-15 DOI: 10.18231/j.ijashnb.2023.011
Tshetiz Dahal, Raghav Ghimire
Major health issues in the contemporary world, thyroid illnesses are distinguished by changes in hormone output, thyroid gland hypertrophy, or both. The purpose of this study was to identify thyroid histological patterns in people who had thyroid surgery. At Kathmandu University Hospital, a retrospective study was conducted over a two-year period, from January 10, 2021, to December 30, 2022. This study includes all 300 patients who underwent thyroid surgery. gender, age, residency, the outcome of a fine needle aspiration biopsy (FNAB), and post-operative histological patterns were all taken into account. Patients who underwent FNA exclusively were ineligible.Participants' average ages ranged from 35.06 ± 15.19 years. Thyroid disorders were more frequently found in females (90%) than in males ( 10%). Nodular colloid goitre (65.1%), adenoma (5.8%), papillary thyroid neoplasms (25.4%), follicular thyroid carcinoma (6.8%), medullary thyroid carcinoma (8.5%), thyroiditis (9.3%), and anaplastic thyroid cancer (3.9%) were the histopathologic patterns. With a prevalence of 64 (23.1%), papillary thyroid cancer was the most prevalent type. The combined accuracy of the final histology and FNAB was 90.04%. However, 50% of follicular cancer preoperative diagnoses made by FNAB were insufficiently accurate. While FNAB specificity varied from 95.1% to 98.9%, FNAB sensitivity ranged from 75.8% to 90.8%. The most common thyroid condition is nodular colloid goitre, while papillary thyroid carcinoma is the most common cancer seen in this study. We suggest more research with a bigger sample size to confirm our findings.
当今世界的主要健康问题,甲状腺疾病的特点是激素分泌的变化,甲状腺肥大,或两者兼而有之。本研究的目的是确定甲状腺手术患者的甲状腺组织学模式。在加德满都大学医院,从2021年1月10日至2022年12月30日,进行了为期两年的回顾性研究。这项研究包括所有300名接受甲状腺手术的患者。性别、年龄、居住地、细针穿刺活检(FNAB)结果和术后组织学模式均被考虑在内。仅接受FNA的患者不符合条件。参与者平均年龄为35.06±15.19岁。甲状腺疾病在女性(90%)中比在男性(10%)中更常见。结节状胶体甲状腺(65.1%)、腺瘤(5.8%)、乳头状甲状腺肿瘤(25.4%)、滤泡性甲状腺癌(6.8%)、甲状腺髓样癌(8.5%)、甲状腺炎(9.3%)、间变性甲状腺癌(3.9%)为组织病理类型。甲状腺乳头状癌是最常见的类型,患病率为64(23.1%)。最终组织学和FNAB的综合准确度为90.04%。然而,50%的卵泡癌术前诊断FNAB不够准确。FNAB特异性为95.1% ~ 98.9%,敏感性为75.8% ~ 90.8%。最常见的甲状腺疾病是结节状胶体甲状腺肿,而乳头状甲状腺癌是本研究中最常见的癌症。我们建议更多的研究和更大的样本量来证实我们的发现。
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引用次数: 0
Subacute sclerosing panencephalitis (SSPE): Late onset of measles complication - Case of IVIG treatment failure 亚急性硬化性全脑炎(SSPE):晚发性麻疹并发症- IVIG治疗失败病例
IF 0.6 Q3 Medicine Pub Date : 2023-08-15 DOI: 10.18231/j.ijashnb.2023.013
Athira Mohan S, Anoop V Somarajan, Dhanya Dharman
Subacute sclerosing panencephalitis (SSPE) is characterized by gradual deterioration of cognitive motor and cognitive functions. SSPE more often occurs in individuals who had a history of measles viral infection. We present a case of 8 year old male child who was presented with generalized progressive weakness, recurrent falls to one side, multiple episodes of seizure, urinary incontinence. On liaison it was understood that he had a history of measles at the age of 3 years. Examination showed elevated serum measles antibody titer, electro-encephalogram (EEG) analysis revealed stereotyped polymorphic discharge seen periodically, suggestive of SSPE. He was treated with IVIG and other symptomatic treatment. However he had recurrent episodes of vomiting after IVIG administration, Ribavirin administration caused multiple oral lesions. Upon discharge he was given Syr. Valproate, Oral Steroid (Prednisolone) tapering therapy, THP 2 mg BD, PPI and Laxatives. Parents were advised to maintain RT feed of 150 mL, once in 3 hours. After 1 week, he succumbed to his illness at his residence.
亚急性硬化性全脑炎(SSPE)以认知运动和认知功能逐渐恶化为特征。SSPE多见于有麻疹病毒感染史的个体。我们提出一个8岁的男孩谁是表现为全身性进行性虚弱,反复跌倒向一侧,多次发作癫痫,尿失禁。经联络了解,他在3岁时有麻疹病史。检查显示血清麻疹抗体滴度升高,脑电图(EEG)分析显示周期性的定型多态放电,提示SSPE。给予IVIG及其他对症治疗。然而,他有反复发作的呕吐IVIG给药后,利巴韦林引起多发性口腔病变。出院后给予丙戊酸钠,口服类固醇(强的松龙)减量治疗,THP 2mg BD, PPI和泻药。建议家长维持RT喂养150 mL,每3小时1次。一周后,他在家中病逝。
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引用次数: 0
Effect of ambient noise in NICU on infant hearing 新生儿重症监护病房环境噪声对婴儿听力的影响
IF 0.6 Q3 Medicine Pub Date : 2023-08-15 DOI: 10.18231/j.ijashnb.2023.009
Prajakta Patil, S. Mhashal, R. Harkut
It is known that high noise levels can be harmful to preterm infants, causing physiological and psychological disorders. The ambience of NICU should have sound or noise levels within safe limits for the healthy development of preterm infants. The aim of present study was to create awareness about the effect of ambient noise in NICU on infant hearing. Study was done in three local NICUs’ and four private nursing homes, obstetrics service. The study population included all babies born at the three local NICUs’ and four private nursing homes. Noise levels and questionnaire Sound level meter was used to determine the sound level. Exposure to excessive noise in NICU may result in high frequency hearing loss in association with other risk factors (co morbid conditions) and drugs (rampant use of not needed Neosporin powder) may result in cochlear damage. Paediatrician is encouraged to monitor sound in the NICU as proposed by US (EPA) noise level of more than 45db is of concern.
众所周知,高噪音水平可能对早产儿有害,导致生理和心理障碍。新生儿重症监护病房的环境应在早产儿健康发育的安全范围内。本研究旨在提高人们对新生儿重症监护病房环境噪声对婴儿听力影响的认识。研究在三家地方新生儿重症监护病房和四家私人疗养院进行,产科服务。研究人群包括所有在三家当地新生儿重症监护病房和四家私人疗养院出生的婴儿。噪声级和问卷用声级计测定声级。在新生儿重症监护室暴露于过度噪音可能导致高频听力损失,并伴有其他危险因素(合并症)和药物(大量使用不需要的新孢菌素粉末)可能导致耳蜗损伤。根据美国环保署的建议,儿科医生被鼓励监测新生儿重症监护室的声音,噪音水平超过45分贝是值得关注的。
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引用次数: 0
Presentation of mucormycosis in post Covid-19 infected patients and an approach to its management in a tertiary care centre of central India 在印度中部的三级保健中心,Covid-19感染后患者出现毛霉病及其管理方法
IF 0.6 Q3 Medicine Pub Date : 2023-05-20 DOI: 10.18231/j.ijashnb.2023.001
Sameeksha Mishra, D. Bhojani, S. Vaidya
Background: This is a case study of 70 cases admitted in our hospital post covid-19 infection with different complaints and signs and symptoms indicating Rhino-Orbital-Cerebral-mucormycosis (ROCM). Materials and Methods: All the cases were again screened for COVID infections and comorbidities like Diabetes mellitus, Hypertension or any other immunocompromised state. The level of involvement like nasal cavity, septum, turbinates, sinuses, pterygopalatine fossa, palate, orbit or any cerebral involvement was noted and the protocol of medical and surgical management was decided in accordance to that. Post surgery KOH mount and HPE report, CT and MRI findings were the major pillars in this regard. Results: In 100% of cases we did middle meatus antrostomy with partial middle turbinectomy and in 57% cases we did medial maxillectomy with Modified Denker’s.Rest middle meatus mega antrostomy with ethmoidectomy with partial middle turbinectomy & full house FESS was done in 21% of cases. Conclusion: The first step in the management of mucormycosis is to have a high index of clinical suspicion especially in those with COVID- 19 who have diabetes mellitus, and who have received systemic corticosteroids while on treatment.
背景:对我院收治的70例新型冠状病毒感染病例进行病例分析,这些病例的主诉和体征及症状均为鼻-眶-脑-毛霉菌病(ROCM)。材料与方法:对所有病例再次进行COVID感染及糖尿病、高血压等合并症或其他免疫功能低下状态的筛查。像鼻腔、鼻中隔、鼻甲、鼻窦、翼腭窝、腭、眶或任何大脑受累的程度都被记录下来,医疗和手术管理的协议是根据这些来决定的。术后KOH mount和HPE报告,CT和MRI结果是这方面的主要支柱。结果:100%的病例行中鼻甲部分切除术,57%的病例行改良登克尔上颌骨切除术。其余中鼻道大窦口造口联合筛窦切除术+部分中鼻甲切除术+全室FESS占21%。结论:毛霉病管理的第一步是提高临床怀疑指数,特别是对合并糖尿病的COVID- 19患者,以及在治疗期间使用全身糖皮质激素的患者。
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引用次数: 0
Caution in usage of clobazam in elderly patients 老年患者使用氯巴唑的注意事项
IF 0.6 Q3 Medicine Pub Date : 2023-05-15 DOI: 10.18231/j.ijashnb.2023.007
Divya KP, A. Cherian, Aswin R M
Clobazam, one of the newer benzodiazepines, is now used extensively as first add on therapy in focal epilepsy.A 67-year-old diabetic and hypertensive gentleman with a history of frontal contusion one year ago, presented with clustering of seizures. He was started on clobazam 20 mg, and levetiracetam 1000 mg/day. Recurrence of seizures prompted a dose escalation of clobazam to 40 mg/day. The patient developed hepatic encephalopathy and his decompensation was probably precipitated by the use of high dose of clobazam. Clobazam was thus gradually tapered off along with hepatic precoma regimen, and other supportive measures leading to an uneventful recovery.Caution must be taken while administering clobazam to elderly and debilitated patients or those with organic brain syndrome as they are more prone to the central nervous system (CNS) depressant activity of benzodiazepines. Since clobazam requires dealkylation and hydroxylation prior to conjugation, it should be used with caution in patients with hepatic involvement.
氯巴唑是一种较新的苯二氮卓类药物,现在广泛用作局灶性癫痫的第一种辅助治疗。一位67岁的糖尿病和高血压患者,一年前有额部挫伤病史,表现为丛集性癫痫发作。他开始服用氯巴唑20毫克,左乙拉西坦1000毫克/天。癫痫复发促使氯巴唑剂量增加至40毫克/天。患者发展为肝性脑病,其失代偿可能与使用大剂量氯巴唑有关。因此,氯巴唑随着肝性昏迷前治疗方案和其他支持措施逐渐减少,导致平静的恢复。老年和衰弱患者或器质性脑综合征患者服用氯巴唑时必须谨慎,因为他们更容易受到苯二氮卓类药物中枢神经系统(CNS)抑制剂活性的影响。由于氯巴唑在结合前需要脱烷基和羟基化,因此对肝脏受累的患者应谨慎使用。
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引用次数: 0
Morphological variations of vermiform appendix: A cadaveric study 蚓状阑尾的形态变异:尸体研究
IF 0.6 Q3 Medicine Pub Date : 2023-05-15 DOI: 10.18231/j.ijashnb.2023.005
Mohini M. Joshi, S. V. Pakhale
: A common and deadly cause of sudden abdominal discomfort is acute appendicitis. The surgeons frequently had trouble locating the vermiform appendix in its regular location. For an effective therapy, a thorough analysis of the vermiform appendix's various locations is required. The objective of this study is to investigate and compile extensive anatomical data on the location variation of the vermiform appendix in the cadavers of western Indians. The structure's morphometry was determined. The study of appendix was carried out on 25 cadavers available in the department of anatomy. Metrical parameters such as length, diameter and distance of appendicular orifice from ileum were measured. The different positions of appendix in and the variations of the mesoappendix were noted. Mean and standred deviations were calculated.: Length of appendix was 5.47± 1.59, diameter at base was 6.85±1.82, diameter at tip was 3.94± 1.11, distance of appendicular orifice below ileum was 1.14±0.85 and Distance of appendicular orifice below ileum inside was 2.19 ±0.78 The most common position of mesoappendix was mesoappendix reaches the tip 37 (74%) followed by mesoappendix does not reaching the tip was 13 (26%).The most common position was retrocaecal 20(40%) followed by pelvic 15 (30%) least common was midinguinal. From various positions of vermiform appendix we can understand the possible outcome of the appendicitis specifically location of site of pain.
急性阑尾炎是引起腹部突然不适的常见且致命的原因。外科医生经常难以将蚓状阑尾定位在正常位置。为了有效的治疗,需要对蚓状阑尾的各个位置进行彻底的分析。本研究的目的是调查和收集有关西印度人尸体中蚓状阑尾位置变化的大量解剖学数据。测定了结构的形态计量学。对解剖科提供的25具尸体进行了阑尾研究。测量了盲肠口到回肠的长度、直径和距离等测量参数。观察阑尾的不同位置及阑尾系膜的变化。计算平均值和标准差。:阑尾长度为5.47±1.59,尾底直径为6.85±1.82,尾尖直径为3.94±1.11,回肠下盲肠口距离为1.14±0.85,回肠内盲肠口距离为2.19±0.78。阑尾系膜最常见的位置为阑尾系膜到达顶端37例(74%),其次为未到达顶端13例(26%)。最常见的位置是盲肠后20(40%),其次是盆腔15(30%),最不常见的是腹股沟。从蚓状阑尾的不同位置,我们可以了解阑尾炎的可能结局,特别是疼痛部位的位置。
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引用次数: 0
Intranasal insulin therapy in the treatment of alzheimer’s disease – A narrative review 鼻内胰岛素治疗阿尔茨海默病的研究综述
IF 0.6 Q3 Medicine Pub Date : 2023-05-15 DOI: 10.18231/j.ijashnb.2023.006
A. Nene, Jenifer Rodriguez Santoni
The administration of intranasal insulin improves symptoms related to Alzheimer’s disease. The research was conducted through a hypothesis-based review, such as, PubMed, DynaMed, and EBSCOhost. The articles published between 2011 and 2020 were included. The studies included randomized controlled trials and cohort studies. The study populations included participants associated with cognitive-related conditions. The group of humans and animal models were also considered. All ten articles showed how the administration of intranasal insulin can improve the symptoms related to Alzheimer’s disease. However, these findings varied on the level of dose used, the duration of the treatment and the type of insulin formulations used. Future studies can consider to provide a more homogenous group of study population, cognitive-related activities to observe, and duration of the administration in order to provide a more credible result.
鼻内注射胰岛素可改善阿尔茨海默病相关症状。本研究通过PubMed、DynaMed和EBSCOhost等基于假设的综述进行。收录了2011年至2020年间发表的文章。这些研究包括随机对照试验和队列研究。研究人群包括患有认知相关疾病的参与者。还考虑了人类和动物模型组。这10篇文章都显示了鼻内注射胰岛素如何改善阿尔茨海默病的相关症状。然而,这些结果在使用的剂量水平、治疗持续时间和使用的胰岛素制剂类型上有所不同。未来的研究可以考虑提供一个更均匀的研究人群、观察认知相关活动和给药时间,以提供更可信的结果。
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引用次数: 0
Study on sacralization of 5 lumber vertebrae on human cadavers in the region of Telengana 泰伦加纳地区人类尸体上5块椎骨的圣化研究
IF 0.6 Q3 Medicine Pub Date : 2023-05-15 DOI: 10.18231/j.ijashnb.2023.002
S. V. Durge
Sacrum is made up of fusion of 5 sacral vertebrae, which gives strength to the human body and transmits the weight to pelvic girdle which is made up of three bones ilium, ischium and pubis. Lumbosacral transitional vertebrae are congenital anamolies seen in some individuals in such individuals sacralization of 5 lumber vertebrae is seen and in such individuals low back pain is seen throughout there life.
骶骨是由5节骶骨融合而成,它给人体提供力量,并将重量传递给骨盆带,骨盆带由髂骨、坐骨和耻骨三块骨头组成。腰骶过渡椎是一种先天性畸形,在一些人身上可以看到,在这些人身上可以看到5个椎体的骶骨化,在这些人身上,腰背痛会伴随他们的一生。
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引用次数: 0
Effects of oral prednisolone and fluticasone nasal spray in the management of chronic rhinosinusitis with polyposis: A prospective observational study 口服泼尼松龙和氟替卡松鼻喷雾剂治疗慢性鼻窦炎伴息肉病的疗效:一项前瞻性观察研究
IF 0.6 Q3 Medicine Pub Date : 2023-05-15 DOI: 10.18231/j.ijashnb.2023.003
S. Jonnalagadda, A. Jaiswal, N. Sharma, Prachi Mene
To study the effects of combination therapy with oral prednisolone and topical fluticasone propionate nasal spray in patients with Chronic Rhinosinusitis with Nasal Polyposis (CRSwNP). To study the improvement in symptom scores, Endoscopic and CT scores before and after treatment with combination therapy.This prospective observational study was conducted on 50 patients attending the Outpatient Department of Otorhinolaryngology, J.L.N Hospital and Research Centre, Bhilai (Chhattisgarh), India over a period of 6 months from February 2020 to July 2020. Patients with symptoms of CRSwNP persisting for more than 12 weeks were thoroughly examined clinically along with Nasal endoscopy and Computed Tomography scan of Nose and Paranasal sinuses (CT PNS) and pre-treatment Visual Analog Scale (VAS), Lund & Mackay Scores for Endoscopic and CT findings were noted. Patients were treated with combination therapy of oral prednisolone and fluticasone propionate nasal spray and post treatment scores were noted using similar scales during the follow up visits and the results were statistically analysed.Total mean age of patients suffering from CRSwNP in our study was 47.3 ± 12.58. Males were affected more by CRSwNP than females (76% vs 24%). At the end of 3 months from baseline 48 patients (96%) showed a reduction in nasal discharge, 47 patients (94%) showed a reduction in nasal obstruction, 25 patients (50%) showed improvement in facial pain and 17 patients (34%) showed improvement in hyposmia. Overall post treatment Visual Analog Symptom (VAS) score improved in 42 patients (84%), Nasal endoscopy (Lund - Mackay scoring) improved in 43 patients (86%) and Radiological CT PNS & Nose (Lund - Mackay Scoring) improved in 33 patients (66%).We found that combined therapy with oral prednisolone and fluticasone propionate nasal spray for 3 weeks is very effective in reducing the symptoms of chronic rhinosinusitis along with decrease in nasal secretions, edema and polyp size.
目的:探讨口服强的松龙与外用丙酸氟替卡松鼻喷雾剂联合治疗慢性鼻窦炎伴鼻息肉病(CRSwNP)的疗效。探讨联合治疗前后症状评分、内镜及CT评分的改善情况。这项前瞻性观察研究是在2020年2月至2020年7月的6个月期间,对印度比莱(恰蒂斯加尔邦)J.L.N医院和研究中心耳鼻咽喉科门诊的50名患者进行的。对症状持续超过12周的CRSwNP患者进行彻底的临床检查,并进行鼻内窥镜检查和鼻及鼻窦炎CT扫描(CT PNS)和治疗前视觉模拟评分(VAS),记录内窥镜和CT表现的Lund & Mackay评分。患者接受口服强的松龙和丙酸氟替卡松鼻喷雾剂联合治疗,随访时采用类似量表记录治疗后评分,并对结果进行统计分析。本研究中CRSwNP患者的总平均年龄为47.3±12.58岁。男性比女性更容易受到CRSwNP的影响(76%对24%)。3个月后,48例(96%)患者鼻排出物减少,47例(94%)患者鼻塞减少,25例(50%)患者面部疼痛改善,17例(34%)患者低氧症状改善。总体治疗后视觉模拟症状(VAS)评分改善42例(84%),鼻内窥镜检查(Lund - Mackay评分)改善43例(86%),放射CT PNS和鼻(Lund - Mackay评分)改善33例(66%)。我们发现口服强的松龙和丙酸氟替卡松鼻喷雾剂联合治疗3周对减轻慢性鼻窦炎的症状以及减少鼻分泌物、水肿和息肉大小非常有效。
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引用次数: 0
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Indian Journal of Otolaryngology and Head and Neck Surgery
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