Sjögren Syndrome Complicated by Mucosa-Associated Lymphoid Tissue Lymphoma and Lymphocytic Interstitial Pneumonia.

Sjögren syndrome (SS) is an autoimmune disease with exocrine glands dysfunction and multiorgan involvement. It is associated with increased risk of lymphoproliferative disorders, especially B-cell marginal zone lymphoma. While the role of F-18 Fluorodeoxyglucose position emission tomography/computed tomography (F-18 FDG PET/CT) for evaluation of lymphoma has been established, its use in patients with a chronic history of SS to evaluate for possible lymphoproliferative disorders or multiorgan involvement is limited. We present a case of chronic SS in which F-18 FDG PET/CT demonstrated FDG avid intraparotid and cervical lymph nodes pathologically proven to be mucosa-associated lymphoid tissue lymphoma. In addition, the patient had bibasilar cystic changes consistent with lymphocytic interstitial pneumonia

Prospective, multicentre study of screening, investigation and management of hyponatraemia after subarachnoid haemorrhage in the UK and Ireland

Background: Hyponatraemia often occurs after subarachnoid haemorrhage (SAH). However, its clinical significance and optimal management are uncertain. We audited the screening, investigation and management of hyponatraemia after SAH. Methods: We prospectively identified consecutive patients with spontaneous SAH admitted to neurosurgical units in the United Kingdom or Ireland. We reviewed medical records daily from admission to discharge, 21 days or death and extracted all measurements of serum sodium to identify hyponatraemia (<135 mmol/L). Main outcomes were death/dependency at discharge or 21 days and admission duration >10 days. Associations of hyponatraemia with outcome were assessed using logistic regression with adjustment for predictors of outcome after SAH and admission duration. We assessed hyponatraemia-free survival using multivariable Cox regression. Results: 175/407 (43%) patients admitted to 24 neurosurgical units developed hyponatraemia. 5976 serum sodium measurements were made. Serum osmolality, urine osmolality and urine sodium were measured in 30/166 (18%) hyponatraemic patients with complete data. The most frequently target daily fluid intake was >3 L and this did not differ during hyponatraemic or non-hyponatraemic episodes. 26% (n/N=42/164) patients with hyponatraemia received sodium supplementation. 133 (35%) patients were dead or dependent within the study period and 240 (68%) patients had hospital admission for over 10 days. In the multivariable analyses, hyponatraemia was associated with less dependency (adjusted OR (aOR)=0.35 (95% CI 0.17 to 0.69)) but longer admissions (aOR=3.2 (1.8 to 5.7)). World Federation of Neurosurgical Societies grade I–III, modified Fisher 2–4 and posterior circulation aneurysms were associated with greater hazards of hyponatraemia. Conclusions: In this comprehensive multicentre prospective-adjusted analysis of patients with SAH, hyponatraemia was investigated inconsistently and, for most patients, was not associated with changes in management or clinical outcome. This work establishes a basis for the development of evidence-based SAH-specific guidance for targeted screening, investigation and management of high-risk patients to minimise the impact of hyponatraemia on admission duration and to improve consistency of patient care

Critical review on Haritaki w.s.r. to Sthaulya (obesity)

Obesity is a major risk factor for a number of chronic diseases, including Diabetes, Cardiovascular disease & Cancer etc. In 2013, the American Medical Association (AMA) declared Obesity a disease that requires a range of interventions to advance treatment & prevention.  So, it is the need of the hour to develop better treatment protocol to treat & prevent the condition. Ayurveda has the potential in the prevention, management & improvement of the quality of life in obese patient. Haritaki having properties like Kaphaghna, Medoghna, Deepana, Pachana, Ruksha, Laghu Guna, Katu, Tikta Rasa and Ushna Veerya, it does the Sthaulya Samprapti Vighatana. Various studies also suggested that Haritaki possesses an antiobesity and hypolipidemic effects based on Kaphanashak and Medoghna properties and presence of its biologically active components like saponins, phytosterols, chebulinic acid and corilagin. Therefore, Haritaki can be useful as an adjuvant therapy for Obesity

Sjögren Syndrome Complicated by Mucosa-Associated Lymphoid Tissue Lymphoma and Lymphocytic Interstitial Pneumonia.

Sjögren syndrome (SS) is an autoimmune disease with exocrine glands dysfunction and multiorgan involvement. It is associated with increased risk of lymphoproliferative disorders, especially B-cell marginal zone lymphoma. While the role of F-18 Fluorodeoxyglucose position emission tomography/computed tomography (F-18 FDG PET/CT) for evaluation of lymphoma has been established, its use in patients with a chronic history of SS to evaluate for possible lymphoproliferative disorders or multiorgan involvement is limited. We present a case of chronic SS in which F-18 FDG PET/CT demonstrated FDG avid intraparotid and cervical lymph nodes pathologically proven to be mucosa-associated lymphoid tissue lymphoma. In addition, the patient had bibasilar cystic changes consistent with lymphocytic interstitial pneumonia

Effect of oral versus intramuscular Vitamin D replacement in apparently healthy adults with Vitamin D deficiency

Context: A number of controversies exist regarding appropriate treatment strategy for Vitamin D deficiency. Aims: The aim of this study was to investigate the efficacy of equivalent doses of oral cholecalciferol (60,000 IU weekly for 5 weeks) versus intramuscular (IM) cholecalciferol (300,000 IU) in correcting Vitamin D deficiency in apparently healthy volunteers working in a hospital. Settings and Design: Prospective randomized open-label single institution study. Subjects and Methods: This study enrolled 40 apparently healthy adults with Vitamin D deficiency into 2 arms. The oral cholecalciferol group (n = 20) received oral cholecalciferol 60,000 IU weekly for 5 weeks while the IM cholecalciferol group (n = 20) received a single injection of cholecalciferol 300,000 IU. The main outcome measure was serum 25-hydroxyvitamin D (25OHD) levels at baseline, 6 and 12 weeks after the intervention. Statistical Analysis Used: Differences in serum 25OHD and other biochemical parameters at baseline and follow-up were analyzed using general linear model. Results: Mean 25OHD level at baseline was 5.99 ± 1.07 ng/mL and 7.40 ± 1.13 ng/mL (P = 0.332) in the oral cholecalciferol and IM cholecalciferol group, respectively. In the oral cholecalciferol group, serum 25OHD level was 20.20 ± 1.65 ng/mL at 6 weeks and 16.66 ± 1.36 ng/mL at 12 weeks. The corresponding serum 25OHD levels in the IM cholecalciferol group were 20.74 ± 1.81 ng/mL and 25.46 ± 1.37 ng/mL at 6 and 12 weeks, respectively. At 12 weeks, the mean 25OHD levels in IM cholecalciferol group was higher as compared to the oral cholecalciferol group (25.46 ± 1.37 vs. 16.66 ± 1.36 ng/mL; P< 0.001). Conclusions: Both oral and IM routes are effective for the treatment of Vitamin D deficiency. 25-hydroxyvitamin D levels in the IM cholecalciferol group showed a sustained increase from baseline

Understanding mechanistic aspects and therapeutic potential of natural substances as anticancer agents

ABSTRACT: Background: Cancer, a diverse class of illnesses that have a serious impact on the human population, is a severe, complicated challenge in health care delivery and public policy. A healthy lifestyle may help us avoid several types of cancer. In 2020, there were 10.3 million cancer deaths and 19.3 million new cases worldwide. A lot of anticancer medications have been discovered due to extensive screening of synthetic compounds and natural chemicals over the last 50 years. The search for new chemotherapeutic agents that are more effective, more selective, less toxic, and more unique is still underway. Purpose: Plant-derived anticancer drugs are potent inhibitors of cancer cell lines and are therefore in high demand. The exploitation of these active ingredients must be managed to keep up with demands and be sustainable. Study design: This paper describes various natural phytoconstituents from plant origin that have anticancer potential. The main goal of this article is to increase the use of natural products and also to increase the interest of the whole world in the anti-cancer activity of natural compounds. Conclusion: Plant-derived drugs are desirable for cancer treatment because they are natural and readily available. Several useful anti-cancer compounds come from plants and these compounds have played an important role in the treatment of various types of cancer. The list of these agents includes Vinblastine, Vincristine, Docetaxel, Etoposide derived from Epipodophyllotoxin and Paclitaxel (Taxol), Flavonoids, Ginkgo biloba, Curcuma longa, Berberine, etc. However, marine organisms and microbiological organisms provided various bioactive agents/compounds with high therapeutic effects Anti-cancer treatment potential alongside herbal natural products. Examples of such drugs are trabectedin, dolastin, halichondrin, anthracyclines and enediynes. This paper focuses on novel research to explore the potential anticancer activities of several natural products that have been reported to target the tumor cell microenvironment