Antinuclear antibodies and their detection methods in diagnosis of connective tissue diseases: a journey revisited

It has been more than 50 years since antinuclear antibodies were first discovered and found to be associated with connective tissue diseases. Since then different methods have been described and used for their detection or confirmation. For many decades immunofluorescent antinuclear antibody test has been the "gold standard" in the diagnosis of these disorders. However to increase the sensitivity and specificity of antinuclear antibody detection further approaches were explored. Today a battery of newer techniques are available some of which are now considered better and are competing with the older methods. This article provides an overview on advancement in antinuclear antibody detection methods, their future prospects, advantages, disadvantages and guidelines for use of these tests

Papillary glioneuronal tumor: a new entity awaiting inclusion in WHO classification

Papillary glioneuronal tumor (PGNT) is a recently described lesion of the brain, which is still not included as a separate entity in WHO classification. To date 32 cases of PGNT have been reported in the world literature. We report the 33(rd )case, a 41-year-old male who presented with pain in the nape of the neck. MRI showed a large, predominantly solid mass involving the cerebral parenchyma of the left temporal and parieto-occipital lobes with extension across the midline. Histologically, it was a mixture of glial and neuronal components. Architecturally, the tumor was notable for its pseudopapillary pattern with hyalinized vessels. PGNT is considered as a low grade neoplasm and surgical excision has been curative in most of the cases. More cases of PGNT need to be reported as they may add further knowledge about its biologic behavior and allow its recognition and classification

Renal cell carcinoma metastasizing to duodenum: a rare occurrence

BACKGROUND: Duodenal metastasis is rare in renal cell carcinoma (RCC) and early detection, especially in case of a solitary mass, helps in planning further therapy. CASE PRESENTATION: We present the case report of a 55 year old male with duodenal metastasis of RCC. This patient presented with jaundice and abdominal lump one year after nephrectomy. On upper gastrointestinal endoscopy a submucosal mass lesion was noted in the duodenum, the biopsy of which revealed metastasis. CONCLUSION: In a nephrectomized patient presenting with jaundice and an abdominal mass, the possibility of metastasis should be suspected and a complete evaluation, especially endoscopic examination followed by biopsy, should be carried out

AMLEORATIVE ROLE OF ESCULETIN􀇧MEDIATED RENOPROTECTION AGAINST GENTAMICIN􀇧INDUCED NEPHROTOXICITY AND POSSIBLE INVOLVEMENT OF N􀇧METHYL􀇧D􀇧ASPARTATE RECEPTORS

Objective: In this investigation, the amleorative role of esculetin (Esc) was investigated in gentamicin (Genta) nephrotoxicity in rats and the possible role of N-methyl-D-aspartate receptors (NMDAR) in genta-induced nephrotoxicity.Methods: Genta (100 mg/kg/day, i.p. for 7 days) was administered to rats for the induction of nephrotoxicity, and subsequently, the extent of renal damage was measured by estimating creatinine clearance (CrCl), blood urea nitrogen (BUN), uric acid, microprotienuria and fractional excretion of sodium, and potassium. In addition, renal superoxide anion generation (SAG), Thiobarbituric acid reactive substance (TBARS), and reduced glutathione (GSH) level were used to evaluate renal oxidative parameters. Renal myeloperoxidase (MPO) activity was used to measure renal inflammation. D-serine, NMDA agonist was used in this study to evaluate the role of NMDA antagonist in genta-induced nephrotoxicity. Histopathological examination was performed using hematoxylin and eosin staining method.Results: Genta-treated rats exhibited remarkable changes in renal parameters like increase in BUN, uric acid, microprotein fractional excretion of sodium and potassium with decrease in CrCl and similarly biochemical parameters like increase in SAG, thiobarbituric acid reactive species (TBARS), MPO activity with decrease in GSH level. Treatment with Esc (5 and 10 mg/kg/day, i.p for 7 days), NMDAR antagonist attenuated the genta-induced nephrotoxicity but did not shown significant effect on combined use of genta and D-serine treated group. Histopathological examination of gentatreated rats. The coadministration of Esc + genta-protected kidney tissue from nephrotoxic effect of genta as illustrated by normalization of tubules but not with the combined use of Esc + genta + D-serine treated rats.Conclusion: Esc displayed protective effect in genta-induced nephrotoxicity but combined effect of Esc + genta + D-serine abolished the protective effect of Esc thus confirming that NMDAR may be involved in genta-induced nephrotoxicity

Delayed involution of lactation presenting as a non-resolving breast mass: a case report

<p>Abstract</p> <p>Introduction</p> <p>Involution of lactation is a physiological process. Rarely, it may be delayed and troublesome for the lactating woman. Though lactation-induced changes in breast are well known, morphological features of delayed involution are not clear.</p> <p>Case presentation</p> <p>We report a case of a 22-year-old lactating mother who presented with a painful, non-resolving breast mass 5 months after delivery. Clinically, it simulated an inflammatory carcinoma. Histopathology, however, revealed involuting lactational changes.</p> <p>Conclusion</p> <p>To the best of our knowledge, lactational involution with such a presentation has not been described in the English literature. The case needs to be reported so that this entity can be considered among the differential diagnoses of breast masses in a lactating patient.</p