Aggressive salivary duct carcinoma with widespread dissemination: a case report

Salivary duct carcinoma is a rare and aggressive salivary gland malignancy with a poor prognosis. Due to the paucity of literature, very little is known about this neoplasm. We have described such a case in this case report and highlighted the clinical and histopathological features associated with this disease. A sixty-year old male patient reported in the outpatient department of a regional dental college and hospital with a circular firm growth in the mandibular anterior region and mobility of adjacent mandibular teeth. An array of investigations including radiographic, tomographic, ultrasonographic as well as histopathological were performed. It was diagnosed as invasive salivary duct carcinoma with distant metastases in the shoulder joint, ribs as well as pelvic bones. Currently, no National Comprehensive Cancer Network guidelines for the specific treatment of salivary duct carcinomas exist. National Comprehensive Cancer Network guidelines recommend complete surgical excision of tumors for major salivary gland tumors without nodal involvement (N0) with or without neck dissection for high-grade and T3/T4 salivary gland tumors.

Sarcomatous transformation of florid cemento-osseous dysplasia: a case report

Florid cemento-osseous dysplasia (COD) represents a rare group of benign fibro-osseous disorders, while osteogenic sarcoma (OS) on the other hand, is a malignant tumour of ominous prognosis. The malignant transformation of a benign fibro-osseous lesion of the jaw is quite uncommon and has few reported cases. The clinico-radiological findings and histopathological analysis of a lesion present in all four quadrants of the jaw of a patient who reported at the outpatient department of a regional dental college is presented here. The lesion underwent sarcomatous transformation over two months and the findings were confirmed by histopathological evaluation. Although florid cemento-osseous dysplasia is a benign lesion of the jaw with a very low propensity for malignant transformation, it should be closely monitored in patients with tumour predisposition syndromes. Further research and molecular studies are required for better understanding of inadvertent changes

Effect of photo-biomodulation therapy in decreasing postoperative pain after surgical removal of third molars compared to other treatment therapies: a systematic review

Post-operative pain, discomfort, and trismus are common postoperative complications after surgical extraction of third molars. Various therapeutic approaches like prescribing analgesic drugs, corticosteroids, and Non-steroidal anti-inflammatory drugs are followed to reduce these complications. Photo-biomodulation therapy (PBMT) utilizes a monochromatic light source that shows effects in all phases of inflammation by reducing edema, redness, heat, and pain. In vivo studies were searched to evaluate postoperative pain levels in patients who underwent photo-biomodulation therapy following extraction of impacted third molars. A comprehensive search was done from January 2023 to July 2023 in PubMed electronic databases. In addition, a manual search of the references mentioned in the studies and gray literature was done. The literature search yielded a total of 157 studies through a search in the electronic database PubMed. Among all the studies, 51 duplicate records were removed. Ninety-seven studies were removed after screening of titles and abstracts. A total of 9 studies were included for full-text reading. Five studies were included (one randomized single-blind study, two randomized double-blind split-mouth studies, and two randomized clinical trials) in the review. Four out of five studies that were included in this review demonstrated a positive impact of PBMT on reducing pain, especially during the post-operative period compared to other non-surgical treatment protocols. Photo-biomodulation therapy demonstrated an overall positive impact on reducing postoperative complications like edema and trismus

Relationship between inter-arm blood pressure differences and predicted future cardiovascular risk in hypertensive patients

Background: Hypertension stands as a widely recognized significant risk factor for cardiovascular disease. In clinical practice, it is advisable to measure blood pressure (BP) in both arms. The increasing attention on inter-arm blood pressure difference (IABPD) stems from its association with cardiovascular disease. This study aimed to assess the relationship between inter-arm blood pressure differences and predicted future cardiovascular risk in hypertensive patients. Methods: This cross-sectional study was conducted at the department of cardiology, Chittagong Medical College Hospital from July 2020 to June 2021. The study included 428 cases of previously or newly diagnosed hypertension, selected through convenient sampling. Data analysis was conducted using Microsoft Office tools and statistical package for the social sciences (SPSS) version 23.0. Results: In this study, 8.2% of patients exhibited noteworthy systolic IAD, and 2.3% demonstrated notable diastolic IAD. Median 10-year cardiovascular risk, assessed by Framingham and ASCVD calculators, was 21% and 11% respectively. A positive correlation was observed between sIAD and 10-year cardiovascular risk (p=0.003) and sIAD and 10-year ASCVD risk (p=0.041). Patients with significant sIAD had a higher incidence of ischemic heart disease compared to those without (p=0.041). Multiple regression analysis revealed a significant correlation between 10-year Framingham cardiovascular risk and sIAD (p=0.003). Conclusions: A significant difference in systolic blood pressure between arms is linked to a higher 10-year cardiovascular risk and the presence of cardiovascular disease in well-managed hypertensive patients. So, monitoring sIAD could be an additional factor in predicting future cardiovascular events in patients receiving hypertension treatment

Antinociceptive, anti-inflammatory and anti-diarrheal activities of the hydroalcoholic extract of Lasia spinosa Linn. (Araceae) Roots

Various parts of Lasia spinosa (Linn.) are widely used in many Asian countries to manage a wide range of diseases but so far no scientific study was done to find out its pharmacological properties which may support its uses in traditional medicine. The present study was carried out to evaluate the possible anti-nociceptive, anti-inflammatory, and anti-diarrheal activities of hydroalcoholic extract of root of Lasia spinosa in rodents. Anti-nociceptive activity was investigated using acetic acid-induced writhing and hot plate-induced pain in mice; anti-inflammatory activity using carrageenan-induced paw edema model rats and xylene-induced ear edema mice and anti-diarrheal activity using castor oil-induced diarrhea model mice. In acetic acid-induced writhing model mice, the extract caused a maximum of 50 % (p -1 body weight, which was comparable with standard drug, diclofenac sodium 60.71 % (p -1 and at 500 mg kg-1 also significantly increased pain threshold in hot-plate method in a dose dependent manner compared to the standard drug, nalbuphine. A dose dependent significant inhibitory effect on edema formation was found in xylene-induced ear edema model mice [17.0 5% at 250 mg kg-1 (p -1 (p -1 (p -1 (p < 0.001)]. In case of castor oil-induced diarrheal mice model, both standard drug (loperamide) and extract significantly reduced the number of stools and enhanced the latent period of diarrhea induction dose dependently. These findings indicate that the extract has significant anti-nociceptive, anti-inflammatory, and also antidiarrheal activity that supports its use in traditional medicine.Colegio de Farmacéuticos de la Provincia de Buenos Aire

How e-Health Has Influenced Patient Care and Medical Education: Lessons Learned from the COVID-19 Pandemic

The concept of e-Health involves the application of information and communication technologies from off-site locations to various domains of healthcare ranging from patient care, public health, and administration to health education. It refers to health informatics, telemedicine, electronic health records, and clinical decision support systems. The e-health initiatives aim to improve health outcomes in terms of quality, access, affordability, and efficient monitoring. The application of e-health interventions has particularly expanded in recent times because of the restrictions imposed by the pandemic. It has been proven to be nearly as effective as in-person care along with high patient and provider satisfaction and at decreased costs. We present our experience from the use of various e-health interventions during the COVID-19 pandemic along with a review of related literature. This ranged from Internet-based services, interactive TV or Polycom’s, kiosks, online monitoring of patient’s vital signs, and remote consultations with experts. Our success and experience with various e-health interventions during the pandemic allow us to provide a more hybrid form of healthcare in the future both for patient care and medical education and training

Antihistamines suppress upregulation of histidine decarboxylase gene expression with potencies different from their binding affinities for histamine H1 receptor in toluene 2,4-diisocyanate-sensitized rats

Antihistamines inhibit histamine signaling by blocking histamine H1 receptor (H1R) or suppressing H1R signaling as inverse agonists. The H1R gene is upregulated in patients with pollinosis, and its expression level is correlated with the severity of nasal symptoms. Here, we show that antihistamine suppressed upregulation of histidine decarboxylase (HDC) mRNA expression in patients with pollinosis, and its expression level was correlated with that of H1R mRNA. Certain antihistamines, including mepyramine and diphenhydramine, suppress toluene-2,4-diisocyanate (TDI)-induced upregulation of HDC gene expression and increase HDC activity in TDI-sensitized rats. However, d-chlorpheniramine did not demonstrate any effect. The potencies of antihistamine suppressive effects on HDC mRNA elevation were different from their H1R receptor binding affinities. In TDI-sensitized rats, the potencies of antihistamine inhibitory effects on sneezing in the early phase were related to H1R binding. In contrast, the potencies of their inhibitory effects on sneezing in the late phase were correlated with those of suppressive effects on HDC mRNA elevation. Data suggest that in addition to the antihistaminic and inverse agonistic activities, certain antihistamines possess additional properties unrelated to receptor binding and alleviate nasal symptoms in the late phase by inhibiting synthesis and release of histamine by suppressing HDC gene transcription