Role of Mesenchymal Stem Cells on Tonsillar Hypertrophy: An Unexplored Enigma

Tonsillar or adenoid hypertrophy is a common childhood finding which can cause significant health problems like respiratory infections and sleep apnea. Though normal growth of children is also attributed to such enlargement, infection, environmental pollutants, allergens, and gastroesophageal reflux are proposed triggering factors for tonsillar hypertrophy. While tonsilar enlargement in adults is more associated with malignancy and chronic infections like the human immunodeficiency virus, the immunology of childhood adenotonsillar hypertrophy is less understood. We postulate that upon stimulation, mesenchymal stem cells are found to reduce the secretion of interferon-gamma but increase the secretion of interleukin-4 from activated T cells. Both of these factors inhibit apoptosis in the tonsillar tissue leading to its hypertrophy. Under the umbrella of evidence, it implicates the role of mesenchymal stem cells in tonsillar hypertrophy. However, further longitudinal large studies are needed to validate the proposition

Bilateral Adductor Nerve Palsy Following Total Thyroidectomy: A Case Report

Recurrent Laryngeal Nerve palsy following thyroidectomy is usually attributed to surgery whereas sometimes the cause can be non-surgical and can result in adductor palsy. Bilateral Recurrent Laryngeal Nerve (RLN) paralysis is a rare complication of thyroidectomy. We present a 35 years female patient who developed dysphonia due to bilateral adductor RLN palsy following total thyroidectomy. The clinical findings and recovery were suggestive of a non-surgical cause for palsy in this patient. The management of these patients differs and the knowledge in this regard is very important for the surgeons. Tracheostomy is not required, and recovery of the nerve occurs in most cases in adductor palsy.

Evaluation of hearing level in patients on long term aspirin therapy [version 2; referees: 1 approved, 2 approved with reservations]

Introduction: Aspirin is a routinely prescribed drug, most notably for cardiovascular diseases, such as myocardial ischemia. This cross sectional, comparative study study aims to explore differences in hearing status between the cardiovascular disease patients on aspirin therapy and age matched controls. Methods: The study population consisted of 182 patients with heart disease taking long term aspirin (i.e., for more than one year). The control population consisted of 221 age matched controls who were not taking aspirin. Results: It was found that age of patient, not aspirin intake, was more important risk factor contributing to hearing loss.  Conclusions: When confounding factors like age of the patient, hypertension and diabetes were taken into account, aspirin in its antiplatelet dose was not found to be the cause of any audiological problems like tinnitus and hearing loss

Case report: An interesting case of large colloid goiter with dyspnea

Benign nodular goitre is one of the most common endocrine disorder, especially in countries like Nepal where iodine deficiency is endemic. Case History: A 59 years old female presented with large thyroid swelling. Investigations showed it to be colloid goiter compressing the airway. Left hemithyroidectomy was done. Post operative period was uneventful.Discussion: Management of thyroid nodules depends upon assessment of thyroid function, fine needle aspiration cytology and imaging. Surgery is the common method of treatment.   </p

Small Cell Lung Cancer, Version 2.2022, NCCN Clinical Practice Guidelines in Oncology.

The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Small Cell Lung Cancer (SCLC) provide recommended management for patients with SCLC, including diagnosis, primary treatment, surveillance for relapse, and subsequent treatment. This selection for the journal focuses on metastatic (known as extensive-stage) SCLC, which is more common than limited-stage SCLC. Systemic therapy alone can palliate symptoms and prolong survival in most patients with extensive-stage disease. Smoking cessation counseling and intervention should be strongly promoted in patients with SCLC and other high-grade neuroendocrine carcinomas. The "Summary of the Guidelines Updates" section in the SCLC algorithm outlines the most recent revisions for the 2022 update, which are described in greater detail in this revised Discussion text