Incidence of rectal carcinoma has been rising in younger people in recent decades. Skeletal metastasis without other organ metastasis from primary rectal carcinoma is very rare, spine and the pelvis are the first sites of bony metastasis. Leptomeningeal Metastases (LM) is a very rare complication of solid tumour progression and its incidence in colorectal carcinoma is far less. A nineteen-year-old male presented in the OPD with rectal bleeding and low back pain with colonoscopic biopsy proving rectal carcinoma. MRI of pelvis revealed multiple osseous metastases to vertebrae and pelvic bones. After four cycles of palliative chemotherapy, he developed lower back pain. Repeat MRI revealed multiple lesions in the vertebrae and long bones for which he received palliative external beam radiation therapy (EBRT). Subsequently seven months later he developed meningeal metastases and received whole brain radiation and supportive care. LM in patients with primary colorectal cancer (CRC) remains an exceedingly rare complication of metastatic disease progression in CRC.
Colorectal cancer (CRC) is the third most common cancer diagnosed in both men and women.[1] The incidence of it has been rising in young adults.[2] The common metastatic sites of CRC include the liver (57.6%), abdominal lymph nodes (48.3%), lungs (37.6%) and Peritoneum.[3,4,5] Skeletal metastasis without other organ metastasis is very rare. Bone metastasis is seen in 4.7% to 10.9% in clinical cases and often indicates advanced disease with a poor prognosis with 5-year survival rate less than 5%,[6] leading to significantly high rate of morbidity and mortality.
Leptomeningeal Metastases (LM) or neoplastic meningitis, is an uncommon metastatic complication of solid tumour progression. Most commonly arising from breast, non-small-cell lung cancer, and melanoma with a frequency of 5% to 25%.[7] The incidence of LM in colorectal cancer (CRC) is far less than 1%.[8]
Here we report a case of rectal carcinoma, with extensive skeletal metastases and their pattern of bone involvement, who later presented with meningeal metastases.
{"title":"Leptomeningeal Metastases in Carcinoma Rectum with Extensive Skeletal Metastasis - A Case Report","authors":"None Chayan Paul, None Abhishek Basu, None Abhay Chakravarty","doi":"10.14260/jemds.v12i10.502","DOIUrl":"https://doi.org/10.14260/jemds.v12i10.502","url":null,"abstract":"Incidence of rectal carcinoma has been rising in younger people in recent decades. Skeletal metastasis without other organ metastasis from primary rectal carcinoma is very rare, spine and the pelvis are the first sites of bony metastasis. Leptomeningeal Metastases (LM) is a very rare complication of solid tumour progression and its incidence in colorectal carcinoma is far less. A nineteen-year-old male presented in the OPD with rectal bleeding and low back pain with colonoscopic biopsy proving rectal carcinoma. MRI of pelvis revealed multiple osseous metastases to vertebrae and pelvic bones. After four cycles of palliative chemotherapy, he developed lower back pain. Repeat MRI revealed multiple lesions in the vertebrae and long bones for which he received palliative external beam radiation therapy (EBRT). Subsequently seven months later he developed meningeal metastases and received whole brain radiation and supportive care. LM in patients with primary colorectal cancer (CRC) remains an exceedingly rare complication of metastatic disease progression in CRC.
 Colorectal cancer (CRC) is the third most common cancer diagnosed in both men and women.[1] The incidence of it has been rising in young adults.[2] The common metastatic sites of CRC include the liver (57.6%), abdominal lymph nodes (48.3%), lungs (37.6%) and Peritoneum.[3,4,5] Skeletal metastasis without other organ metastasis is very rare. Bone metastasis is seen in 4.7% to 10.9% in clinical cases and often indicates advanced disease with a poor prognosis with 5-year survival rate less than 5%,[6] leading to significantly high rate of morbidity and mortality.
 Leptomeningeal Metastases (LM) or neoplastic meningitis, is an uncommon metastatic complication of solid tumour progression. Most commonly arising from breast, non-small-cell lung cancer, and melanoma with a frequency of 5% to 25%.[7] The incidence of LM in colorectal cancer (CRC) is far less than 1%.[8]
 Here we report a case of rectal carcinoma, with extensive skeletal metastases and their pattern of bone involvement, who later presented with meningeal metastases.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135871426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND
Among Indian population, benign as well as malignant breast lesions are quite common. Fine needle aspiration cytology (FNAC) is frequently carried out as it is a simple, safe, reliable and time saving procedure. A short retrospective study was designed to evaluate the role of fine needle aspiration cytology (FNAC) & frequency of palpable breast lesions/lumps. Early diagnosis of breast lesions through FNAC prompts early treatment without the need for biopsy. The purpose of this study was to analyse the cytomorphological patterns of non-neoplastic and neoplastic lesions diagnosed by FNAC over a time period at a tertiary care hospital.
METHODS
This retrospective observational study was conducted as a hospital opd based procedure from June 2019 to December 2019. A total of 210 patients having breast lesions/lumps were included, among which 5 patients were excluded because of unsatisfactory FNAC aspirate. Smears were processed and their cytological evaluation was done by experienced pathologists.
RESULTS
Among all breast lesions, non-neoplastic was most commonly seen in 2nd decade of life and neoplastic in 5th decade of life. Fibroadenoma was the most common benign breast lesion followed by fibrocystic disease while among neoplastic lesions invasive ductal carcinoma was most common. Involvement of left breast was most common.
CONCLUSIONS
Benign breast diseases are quite common in younger population. Fibroadenoma is the most common benign condition among females of reporductive age group. FNAC is routinely done to separate malignant lesions from benign ones which makes it an important tool in guiding further management as it is a quick, simple, feasible, and cost-effective method.
{"title":"Cytomorphological Pattern of Neoplastic and Non-Neoplastic Breast Lesions - An Institutional Experience of a Rural Tertiary Care Center","authors":"None Pinki Pandey, None Sanjeev Kumar Singh, None Monisha Gupta, None Roopak Aggarwal","doi":"10.14260/jemds.v12i10.501","DOIUrl":"https://doi.org/10.14260/jemds.v12i10.501","url":null,"abstract":"BACKGROUND
 Among Indian population, benign as well as malignant breast lesions are quite common. Fine needle aspiration cytology (FNAC) is frequently carried out as it is a simple, safe, reliable and time saving procedure. A short retrospective study was designed to evaluate the role of fine needle aspiration cytology (FNAC) & frequency of palpable breast lesions/lumps. Early diagnosis of breast lesions through FNAC prompts early treatment without the need for biopsy. The purpose of this study was to analyse the cytomorphological patterns of non-neoplastic and neoplastic lesions diagnosed by FNAC over a time period at a tertiary care hospital.
 METHODS
 This retrospective observational study was conducted as a hospital opd based procedure from June 2019 to December 2019. A total of 210 patients having breast lesions/lumps were included, among which 5 patients were excluded because of unsatisfactory FNAC aspirate. Smears were processed and their cytological evaluation was done by experienced pathologists.
 RESULTS
 Among all breast lesions, non-neoplastic was most commonly seen in 2nd decade of life and neoplastic in 5th decade of life. Fibroadenoma was the most common benign breast lesion followed by fibrocystic disease while among neoplastic lesions invasive ductal carcinoma was most common. Involvement of left breast was most common.
 CONCLUSIONS
 Benign breast diseases are quite common in younger population. Fibroadenoma is the most common benign condition among females of reporductive age group. FNAC is routinely done to separate malignant lesions from benign ones which makes it an important tool in guiding further management as it is a quick, simple, feasible, and cost-effective method.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135870100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-31DOI: 10.14260/jemds.v12i10.505
None Sai Sri Hari Rao Nutakki, None Abhishek Kankipati, None Sujana Gogineni, None Vamsi Krishna Kotagiri
Trauma induced Vernet’s syndrome is a rare presentation and very few case reports exist in medical literature. Here we report a 40-year-old male with no significant medical history who presented with clinical features of right IX, X, and XI cranial nerve palsy after trauma to the neck and was diagnosed with right internal jugular vein thrombosis on imaging causing compression and symptoms. Patient symptomatically improved with anti-coagulation and was advised regular follow-up.
This case report emphasizes on the need for identifying trauma induced thrombosis as one of the uncommon causes of Vernet’s syndrome with better prognosis and the need for early imaging techniques in such cases.
The jugular foramen-crossing IX, X, and XI cranial nerves are paralyzed in Vernet syndrome. The posterolateral sulcus of the medulla oblongata is where the glossopharyngeal nerve, vagus nerve, and spinal accessory nerves emerge. They then travel via the basal cistern before leaving the skull by the jugular foramen.[1] Primary tumours like paraganglioma, meningioma, and schwannoma, metastatic tumours at the base of the skull, inflammation like meningitis and malignant otitis external, sarcoidosis, Guillain-Barre syndrome, vascular events like dissection, thrombosis, or aneurysm, and trauma are the main causes of Vernet syndrome.
Vernet syndrome caused by trauma is incredibly rare and is typically brought on by penetrating trauma or fractures impacting the posterior skull base. Approximately 30 cases of Jugular foramen syndrome caused by a fracture in the jugular foramen area have been documented to date.[2,3] Only one posttraumatic Vernet case without a fracture has, however, been documented so far,[4] and this is one of them.
{"title":"Case Report - Trauma Induced Vernet’s Syndrome","authors":"None Sai Sri Hari Rao Nutakki, None Abhishek Kankipati, None Sujana Gogineni, None Vamsi Krishna Kotagiri","doi":"10.14260/jemds.v12i10.505","DOIUrl":"https://doi.org/10.14260/jemds.v12i10.505","url":null,"abstract":"Trauma induced Vernet’s syndrome is a rare presentation and very few case reports exist in medical literature. Here we report a 40-year-old male with no significant medical history who presented with clinical features of right IX, X, and XI cranial nerve palsy after trauma to the neck and was diagnosed with right internal jugular vein thrombosis on imaging causing compression and symptoms. Patient symptomatically improved with anti-coagulation and was advised regular follow-up.
 This case report emphasizes on the need for identifying trauma induced thrombosis as one of the uncommon causes of Vernet’s syndrome with better prognosis and the need for early imaging techniques in such cases.
 The jugular foramen-crossing IX, X, and XI cranial nerves are paralyzed in Vernet syndrome. The posterolateral sulcus of the medulla oblongata is where the glossopharyngeal nerve, vagus nerve, and spinal accessory nerves emerge. They then travel via the basal cistern before leaving the skull by the jugular foramen.[1] Primary tumours like paraganglioma, meningioma, and schwannoma, metastatic tumours at the base of the skull, inflammation like meningitis and malignant otitis external, sarcoidosis, Guillain-Barre syndrome, vascular events like dissection, thrombosis, or aneurysm, and trauma are the main causes of Vernet syndrome.
 Vernet syndrome caused by trauma is incredibly rare and is typically brought on by penetrating trauma or fractures impacting the posterior skull base. Approximately 30 cases of Jugular foramen syndrome caused by a fracture in the jugular foramen area have been documented to date.[2,3] Only one posttraumatic Vernet case without a fracture has, however, been documented so far,[4] and this is one of them.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":"568 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135870962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nephrotic syndrome is a spectrum of kidney disorders with clinically significant proteinuria, peripheral oedema, hypertension, hypoalbuminemia, hyperlipidaemia, and hypercoagulable state. Pregnancy complicated with nephrotic syndrome poses significant challenges leading to maternal and foetal morbidity even in the absence of significant renal impairment. It leads to preeclampsia, foetal growth restriction, preterm birth and higher incidence of operative deliveries. Multidisciplinary approach involving high risk pregnancy team, nephrologist and neonatal care can improve neonatal and maternal outcomes. Here are the case reports of nephrotic syndrome managed with multidisciplinary approach with successful outcomes.
Proteinuria in pregnancy is common ranging from mild increase to significant proteinuria. If there is significant increase it does not always necessarily be preeclampsia, it could be an underlying renal disorder. It is characterized by proteinuria in excess of over 3.5 g/day, peripheral oedema, hyperlipidaemia, hypoalbuminemia. Renal biopsy may reveal microscopic abnormalities. Prompt diagnosis, and multidisciplinary management can lead to successful outcomes. Here we are presenting case reports on pregnancies complicated with gross proteinuria which were managed with multidisciplinary inputs with positive outcomes.
{"title":"Nephrotic Syndrome in Pregnancy - Case Reports","authors":"None Madhushree Vijayakumar, None Ramya Chinnaswamy, None Meghana Vijayakumar","doi":"10.14260/jemds.v12i10.503","DOIUrl":"https://doi.org/10.14260/jemds.v12i10.503","url":null,"abstract":"Nephrotic syndrome is a spectrum of kidney disorders with clinically significant proteinuria, peripheral oedema, hypertension, hypoalbuminemia, hyperlipidaemia, and hypercoagulable state. Pregnancy complicated with nephrotic syndrome poses significant challenges leading to maternal and foetal morbidity even in the absence of significant renal impairment. It leads to preeclampsia, foetal growth restriction, preterm birth and higher incidence of operative deliveries. Multidisciplinary approach involving high risk pregnancy team, nephrologist and neonatal care can improve neonatal and maternal outcomes. Here are the case reports of nephrotic syndrome managed with multidisciplinary approach with successful outcomes.
 Proteinuria in pregnancy is common ranging from mild increase to significant proteinuria. If there is significant increase it does not always necessarily be preeclampsia, it could be an underlying renal disorder. It is characterized by proteinuria in excess of over 3.5 g/day, peripheral oedema, hyperlipidaemia, hypoalbuminemia. Renal biopsy may reveal microscopic abnormalities. Prompt diagnosis, and multidisciplinary management can lead to successful outcomes. Here we are presenting case reports on pregnancies complicated with gross proteinuria which were managed with multidisciplinary inputs with positive outcomes.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135870778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND
This study was conducted to determine the incidence of cystoid macular edema after small incision cataract surgery by means of OCT, study the clinical profile and compare the incidence in non-diabetic and diabetic patients with and without retinopathy.
METHODS
This was a hospital based prospective study, conducted among 325 patients in the age group of 40 to 85 years who underwent Small Incision Cataract Surgery [SICS] conducted in Sree Mookambika Institute of Medical Sciences, Kulasekharam, Kanyakumary District, Tamil Nadu, over a period of one year from January 2022 to December 2023, after obtaining clearance from the institutional ethics committee and written informed consent from the study participants.
RESULTS
The incidence of CME was higher among diabetic patients when compared with non-diabetic patients and was statistically significant. Patients with a history of uveitis had a statistically significant increase (p<0.05) in the incidence of CME in the 6th postoperative week. Patients with complicated surgery with iris prolapse, vitreous prolapse, difficult nucleus delivery and posterior capsular rent had an increased incidence of CME. This was statistically significant (p<0.05) during all three postoperative evaluations.
CONCLUSIONS
Following cataract surgery, 18.8% of patients developed cystoid macular edema six weeks after the procedure. Three months following surgery, 13.2% had CME, which further declined to 5.2% at six months after surgery. The incidence of clinically significant cystoid macular edema was 4% at six weeks after surgery. It further declined to 1.2% at 3 months after surgery and was present in only 0.6% at 6 months after surgery. The incidence of CME was higher among the diabetic patients throughout the study when compared with non-diabetic patients and was statistically significant (p<0.01). The association between the severity of diabetic retinopathy and the incidence of cystoid macular edema was not statistically significant. Patients with a history of uveitis had a statistically significant increase (p<0.05) in the incidence of CME in the 6th postoperative week. Patients with complicated surgery with iris prolapse, vitreous prolapse, difficult nucleus delivery and posterior capsular rent had an increased incidence of CME. Patients not using topical NSAIDS were found to have an increased incidence of CME.
{"title":"Clinical Profile of Cystoid Macular Edema Following Small Incision Cataract Surgery","authors":"None Rajeevan Palpoo, None Janie Salor, None Vaduva Krishnan","doi":"10.14260/jemds.v12i10.500","DOIUrl":"https://doi.org/10.14260/jemds.v12i10.500","url":null,"abstract":"BACKGROUND
 This study was conducted to determine the incidence of cystoid macular edema after small incision cataract surgery by means of OCT, study the clinical profile and compare the incidence in non-diabetic and diabetic patients with and without retinopathy.
 METHODS
 This was a hospital based prospective study, conducted among 325 patients in the age group of 40 to 85 years who underwent Small Incision Cataract Surgery [SICS] conducted in Sree Mookambika Institute of Medical Sciences, Kulasekharam, Kanyakumary District, Tamil Nadu, over a period of one year from January 2022 to December 2023, after obtaining clearance from the institutional ethics committee and written informed consent from the study participants.
 RESULTS
 The incidence of CME was higher among diabetic patients when compared with non-diabetic patients and was statistically significant. Patients with a history of uveitis had a statistically significant increase (p<0.05) in the incidence of CME in the 6th postoperative week. Patients with complicated surgery with iris prolapse, vitreous prolapse, difficult nucleus delivery and posterior capsular rent had an increased incidence of CME. This was statistically significant (p<0.05) during all three postoperative evaluations.
 CONCLUSIONS
 Following cataract surgery, 18.8% of patients developed cystoid macular edema six weeks after the procedure. Three months following surgery, 13.2% had CME, which further declined to 5.2% at six months after surgery. The incidence of clinically significant cystoid macular edema was 4% at six weeks after surgery. It further declined to 1.2% at 3 months after surgery and was present in only 0.6% at 6 months after surgery. The incidence of CME was higher among the diabetic patients throughout the study when compared with non-diabetic patients and was statistically significant (p<0.01). The association between the severity of diabetic retinopathy and the incidence of cystoid macular edema was not statistically significant. Patients with a history of uveitis had a statistically significant increase (p<0.05) in the incidence of CME in the 6th postoperative week. Patients with complicated surgery with iris prolapse, vitreous prolapse, difficult nucleus delivery and posterior capsular rent had an increased incidence of CME. Patients not using topical NSAIDS were found to have an increased incidence of CME.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135871744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-31DOI: 10.14260/jemds.v12i10.506
None Vithal D. Udagatti, None Dinesh Rajendran Kumar, None Ashu Madhogaria, None Sanika D. Rege, None Karthika B., None Srirangaprasad K., None Ashish Rao
Rhinosporidiosis is a mucocutaneous infection, primarily involving the nose. It rarely presents as a disseminated disease, with a polypoidal lesion of the mucous membrane of the nose and its subsite. Rhinosporidiosis affects commonly the mucous membrane of the nasopharyngeal subsite, conjunctiva and palate. The causative organism is Rhinosporidium seeberi and this disease is more prevalent in tropical countries.
{"title":"Rhinosporidiosis of Nasal and Nasopharyngeal Subsite from Raichur District, Karnataka – Case Reports","authors":"None Vithal D. Udagatti, None Dinesh Rajendran Kumar, None Ashu Madhogaria, None Sanika D. Rege, None Karthika B., None Srirangaprasad K., None Ashish Rao","doi":"10.14260/jemds.v12i10.506","DOIUrl":"https://doi.org/10.14260/jemds.v12i10.506","url":null,"abstract":"Rhinosporidiosis is a mucocutaneous infection, primarily involving the nose. It rarely presents as a disseminated disease, with a polypoidal lesion of the mucous membrane of the nose and its subsite. Rhinosporidiosis affects commonly the mucous membrane of the nasopharyngeal subsite, conjunctiva and palate. The causative organism is Rhinosporidium seeberi and this disease is more prevalent in tropical countries.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":"227 9","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135871676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 60-year-old gentleman with uncontrolled diabetes (HbA1C- 10.3%), presented with fever and chills, and right flank pain with dysuria for a week with no respiratory symptoms. On examination, he had tachycardia with a pulse rate of 130/min, blood pressure of 96/60 mm Hg, respiratory rate of 20/min, and saturation of 95% on room air. Per abdominal examination revealed left flank fullness (Fig.-1) and tenderness. On laboratory evaluation, he had a leucocyte count of 36700 cells/mm, a platelet count of 4.1 lakhs, and a blood glucose of 385 mg/dl. On the renal function test- serum creatinine was raised - 2.2 mg/dl. Urine analysis showed 25-30 leukocytes/HPF and the presence of sugar and no ketones. The report of urine culture obtained later was positive for Escherichia coli sensitive to Piperacillin + tazobactam. CXR was normal. Computed Tomography (CT) KUB (Fig.-2) revealed thinning of the right renal parenchyma along with large air pockets of perinephric emphysematous changes with the extension of the gas into IVC and left renal vein (Huang and Tseng classification 3b). Considering the above history, examination, and relevant investigation, a diagnosis of emphysematous pyelonephritis with a further extension of air in the inferior vena cava was made. The patient was treated with intravenous fluids, Piperacillin + tazobactam, metronidazole, and insulin. After stabilization, under general anaesthesia, the patient underwent open nephrectomy (Fig. 3) instead of PCN or DJ as the patient was hemodynamically stable, and bedside 2 D Echo did not reveal the extension of the gas into the atrium or ventricles, it was thought that removing the kidney as the source of gas production would curtail the process of intravasation of gas in the IVC. The patient underwent postoperative CT KUB after 72 hours which revealed complete spontaneous resolution of air in IVC (Fig.-4). The patient improved clinically with intensive post-operative care and was discharged after 14 days.
{"title":"Emphysematous Pyelonephritis with Extension of Air in the Inferior Vena Cava","authors":"None Nirmit Agrawal, None Sujata Kiran Patwardhan, None Bhushan Patil, None Sachin Bhujbal, None Seshang Kamath","doi":"10.14260/jemds.v12i10.504","DOIUrl":"https://doi.org/10.14260/jemds.v12i10.504","url":null,"abstract":"A 60-year-old gentleman with uncontrolled diabetes (HbA1C- 10.3%), presented with fever and chills, and right flank pain with dysuria for a week with no respiratory symptoms. On examination, he had tachycardia with a pulse rate of 130/min, blood pressure of 96/60 mm Hg, respiratory rate of 20/min, and saturation of 95% on room air. Per abdominal examination revealed left flank fullness (Fig.-1) and tenderness. On laboratory evaluation, he had a leucocyte count of 36700 cells/mm, a platelet count of 4.1 lakhs, and a blood glucose of 385 mg/dl. On the renal function test- serum creatinine was raised - 2.2 mg/dl. Urine analysis showed 25-30 leukocytes/HPF and the presence of sugar and no ketones. The report of urine culture obtained later was positive for Escherichia coli sensitive to Piperacillin + tazobactam. CXR was normal. Computed Tomography (CT) KUB (Fig.-2) revealed thinning of the right renal parenchyma along with large air pockets of perinephric emphysematous changes with the extension of the gas into IVC and left renal vein (Huang and Tseng classification 3b). Considering the above history, examination, and relevant investigation, a diagnosis of emphysematous pyelonephritis with a further extension of air in the inferior vena cava was made. The patient was treated with intravenous fluids, Piperacillin + tazobactam, metronidazole, and insulin. After stabilization, under general anaesthesia, the patient underwent open nephrectomy (Fig. 3) instead of PCN or DJ as the patient was hemodynamically stable, and bedside 2 D Echo did not reveal the extension of the gas into the atrium or ventricles, it was thought that removing the kidney as the source of gas production would curtail the process of intravasation of gas in the IVC. The patient underwent postoperative CT KUB after 72 hours which revealed complete spontaneous resolution of air in IVC (Fig.-4). The patient improved clinically with intensive post-operative care and was discharged after 14 days.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135869389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-03DOI: 10.14260/jemds.v12i9.493
None Kumaran Chinnappa, None Sangeetha N.
Metaplastic carcinoma is a diverse subgroup of invasive breast cancer (IBC) characterised by differentiation of the neoplastic epithelium into squamous cells and/or mesenchymal-looking components, such as but not limited to spindle, chondroid and osseous cells. [1] The clinical characteristics are comparable to those of ER-negative IBC of no special type (NST), although they are more likely to present at an advanced stage. The aetiology is complicated and doesn't seem to be different from IBC-NST (especially the triple-negative subtype). [2] They account for 0.2-1 % of all IBCs. This variation in prevalence stems from the different definitions of metaplastic carcinoma used by different authors.
{"title":"Metaplastic Carcinoma Masquerading as Tuberculous Mastitis – An Interesting Case Report","authors":"None Kumaran Chinnappa, None Sangeetha N.","doi":"10.14260/jemds.v12i9.493","DOIUrl":"https://doi.org/10.14260/jemds.v12i9.493","url":null,"abstract":"Metaplastic carcinoma is a diverse subgroup of invasive breast cancer (IBC) characterised by differentiation of the neoplastic epithelium into squamous cells and/or mesenchymal-looking components, such as but not limited to spindle, chondroid and osseous cells. [1] The clinical characteristics are comparable to those of ER-negative IBC of no special type (NST), although they are more likely to present at an advanced stage. The aetiology is complicated and doesn't seem to be different from IBC-NST (especially the triple-negative subtype). [2] They account for 0.2-1 % of all IBCs. This variation in prevalence stems from the different definitions of metaplastic carcinoma used by different authors.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135696453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-03DOI: 10.14260/jemds.v12i9.492
None Shabana Andleeb Ansari, None Azmat Kamal Ansari
Pleural effusion is accumulation of fluid in the pleural cavity. The most common etiological factors are infections (e.g. tuberculosis), systemic disorders (e.g. Congestive Cardiac Failure, Portal hypertension, etc.) and solid tumours.[1] Leukemic infiltration into other organs has been documented,[2] however pleural effusion is rarely observed in association with acute leukaemia.[1,2] If it occurs, other possibilities such as infection, various disseminated solid tumours and treatment associated toxicities have to be ruled out.[1,2,3,4] Most common haematological malignancies associated with pleural effusion are Hodgkin’s Lymphoma and Non-Hodgkin’s Lymphoma.[1,4,5] Leukemic pleural effusion is thought to be associated with poor prognosis especially if it develops in the first six months after the diagnosis of leukaemia.[1,5,6,7]
{"title":"A Rare Case of Leukemic Infiltration in Pleural Effusion","authors":"None Shabana Andleeb Ansari, None Azmat Kamal Ansari","doi":"10.14260/jemds.v12i9.492","DOIUrl":"https://doi.org/10.14260/jemds.v12i9.492","url":null,"abstract":"Pleural effusion is accumulation of fluid in the pleural cavity. The most common etiological factors are infections (e.g. tuberculosis), systemic disorders (e.g. Congestive Cardiac Failure, Portal hypertension, etc.) and solid tumours.[1] Leukemic infiltration into other organs has been documented,[2] however pleural effusion is rarely observed in association with acute leukaemia.[1,2] If it occurs, other possibilities such as infection, various disseminated solid tumours and treatment associated toxicities have to be ruled out.[1,2,3,4] Most common haematological malignancies associated with pleural effusion are Hodgkin’s Lymphoma and Non-Hodgkin’s Lymphoma.[1,4,5] Leukemic pleural effusion is thought to be associated with poor prognosis especially if it develops in the first six months after the diagnosis of leukaemia.[1,5,6,7]","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":"100 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135696454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-03DOI: 10.14260/jemds.v12i9.489
None Shahad Fadhil Bunyan, None Fatanah Mohamad Suhaimi, None Faraedon Mohidden Mostafa Zardawi, None Siti Noor Fazliah Mohd Noor, None Muhammad Azrul Zabidi
BACKGROUND
Facial prostheses are made to restore a missing part of the face, so they must be made from a material that mimics the surrounding soft tissues and skin in properties. The studies nowadays show that the maxillofacial silicone elastomer is widely used for this purpose because of its biocompatibility, can be easily colored by intrinsic or extrinsic coloration, and good elasticity. The drop points of the pure silicone elastomers are the mechanical properties such as the tear strength and the tensile strength, which need to be improved to be clinically applicable. This improvement may be done by the addition of some types of Nano-oxide fillers. The objective of the study was to review the results of previous studies that evaluated the effect of adding different types of nanoparticles on improving the silicone maxillofacial rehabilitation material mechanical properties.
METHODS
Search Methods: An electronic search in PubMed/Medline was used to find applicable papers that were published in English before September 2022.
Selection Criteria: By examining the title, abstract, and full text of the articles to ensure that they fit the inclusion criteria, the relevance of the articles was confirmed. The term was chosen based on the following: silicone elastomer as the population, nanoparticles as the intervention, and silicone elastomer with and without nanoparticle reinforcement as the comparison (mechanical properties).
Data Collection: Data regarding the published articles on the effect of adding nanoparticles to silicone material to enhance its mechanical properties has been collected.
RESULTS
Out of 27 articles, 18 articles met the requirements for data extraction for review of the results of studies that evaluated the effect of different nanoparticle addition on improving the mechanical properties of the silicone elastomer. Among the essential properties to be considered was that the silicone’s mechanical characteristics were enhanced by the incorporation of various nanoparticles at concentrations ranging from 1% to 3%.
CONCLUSIONS
An ideal maxillofacial silicone that exhibits perfect mechanical properties in a variety of human and environmental aging situations hasn't yet been found.
{"title":"Nanoparticles in Enhancing Mechanical Properties of Silicone for Maxillofacial Rehabilitation - A Review","authors":"None Shahad Fadhil Bunyan, None Fatanah Mohamad Suhaimi, None Faraedon Mohidden Mostafa Zardawi, None Siti Noor Fazliah Mohd Noor, None Muhammad Azrul Zabidi","doi":"10.14260/jemds.v12i9.489","DOIUrl":"https://doi.org/10.14260/jemds.v12i9.489","url":null,"abstract":"BACKGROUND
 Facial prostheses are made to restore a missing part of the face, so they must be made from a material that mimics the surrounding soft tissues and skin in properties. The studies nowadays show that the maxillofacial silicone elastomer is widely used for this purpose because of its biocompatibility, can be easily colored by intrinsic or extrinsic coloration, and good elasticity. The drop points of the pure silicone elastomers are the mechanical properties such as the tear strength and the tensile strength, which need to be improved to be clinically applicable. This improvement may be done by the addition of some types of Nano-oxide fillers. The objective of the study was to review the results of previous studies that evaluated the effect of adding different types of nanoparticles on improving the silicone maxillofacial rehabilitation material mechanical properties.
 METHODS
 Search Methods: An electronic search in PubMed/Medline was used to find applicable papers that were published in English before September 2022.
 Selection Criteria: By examining the title, abstract, and full text of the articles to ensure that they fit the inclusion criteria, the relevance of the articles was confirmed. The term was chosen based on the following: silicone elastomer as the population, nanoparticles as the intervention, and silicone elastomer with and without nanoparticle reinforcement as the comparison (mechanical properties).
 Data Collection: Data regarding the published articles on the effect of adding nanoparticles to silicone material to enhance its mechanical properties has been collected.
 RESULTS
 Out of 27 articles, 18 articles met the requirements for data extraction for review of the results of studies that evaluated the effect of different nanoparticle addition on improving the mechanical properties of the silicone elastomer. Among the essential properties to be considered was that the silicone’s mechanical characteristics were enhanced by the incorporation of various nanoparticles at concentrations ranging from 1% to 3%.
 CONCLUSIONS
 An ideal maxillofacial silicone that exhibits perfect mechanical properties in a variety of human and environmental aging situations hasn't yet been found.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":"244 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135738777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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