Superior vena cava obstruction as manifestation of synovial cell sarcoma: a case report and review of literature

Synovial cell sarcomas are one of the most common soft tissue tumors affecting adolescents and young adults. The common location of these tumors is often extremities. Primary involvement of mediastinum is a very rare presentation of this tumor, only few cases have been reported so far. We are reporting the case of a 27-year-old male patient who presented to us with a history of dyspnoea and chest discomfort of one week duration along with features of SVC obstruction. Chest is a frequently involved site of metastasis and lymphomas but rarely involved in synovial sarcoma. The learning point from this case is that rare causes like synovial sarcoma of mediastinum should always be included in differential diagnosis of mediastinal mass and SVC obstruction. We are reporting this case in view of its rarity.  Though uncommon this case report emphasizes that synovial cell sarcoma should also be considered in differential diagnosis of mediastinal mass and early recognition with HPE, IHC and prompt institution of treatment can be lifesaving

Studies on Some Aspects of Diaeretiella Rapae (M, Intosh), A Parasitoid of Mustard Aphid, Lipaphis Erysimi Kalt

Two aspects in relation to host Lipaphis erysimi and parasitoid Diaeretiella rapae are studied. It in found that parasitization percentage depond on the host as well as the parasitoid density. Even single copulated female. Diaeretiella rapae in capable of parasiting 94 aphids within the three days. If number of host decrease super parasitism may also occur. Parasitization also effect the development rate of the parasitoid and it depends upon the stage of the host aphid.  In I and II Instar nymphs of aphid development of Diaeretiella rapae is delayed and in other stages of aphid nymphs, normal development occurs

Pre/post electron transfer regioselectivity at glycine modified graphene electrode interface for voltammetric sensing applications

In the last few years, glycine (GL) showed good experimental evidence as an electron transfer (ET) mediator at the carbon (in particular graphene (GR)) interface. However, ET properties of GL modified GR interface are still not known completely. These can be achieved using density functional theory-based models. Modelling of modified carbon electrode interfaces is essential in electroanalytical chemistry to get insights into their electronic and redox properties. Here we have modelled glycine modified graphene interface to find out its interfacial redox ET properties. Conceptual density functional theory concepts like frontier molecular orbital (FMO) theory and analytical Fukui functions were utilized to predict the ET sites on the modified graphene surface. It is shown that at the glycine-modified graphene interface, amine groups act as additional oxidation sites and carboxylic acid groups as additional reduction sites. Therefore, glycine acts as an ET mediator at the graphene-based electrode interface. The obtained results are well supported by previously published experimental reports

Addition of temozolamide as radiosensitizer in brain metastasis: experience from a resource limited centre in sub-Himalayan region

Background: Brain metastasis is a common, debilitating and undesirable neurological complication of systemic cancer and a significant cause of morbidity and mortality. Methods: 39 patients of brain metastasis with Ca breast/Ca lung as primaries were randomized into a study arm and control arm in between 1st August 2018 to 31st July 2019 at IGMC Shimla. Control arm consisted of WBRT (30 GY/10 fractions/5 days a week). Study arm consisted of WBRT with same dose and temozolamide administered 75mg /m2/day during RT days. Results: Out of 39 patients 34 patients completed treatment out of which 17 in study and 17 in control arm. Response to brain lesions could not be assessed in 20 out of 39 patients. In remaining 19 patients 36.8% patients in study arm and 20% patients in control arm had partial response (PR). 5.3% patient in study arm and none in control arm has complete response (CR). 25% patients in control arm and 15.8% patients in study arm had stable disease. Improvement in QOL (FACT- G) seen in both study and control arm post Rx, however improvement sustained in study arm at 1st F/u. Conclusions: Leveraging the additional radio-sensitizing effect of TMZ may hold promise as an attractive strategy to enhance the quality of life in patients with a favourable performance status. Moreover, RPA could serve as a decisive factor in tailoring the treatment approach, guiding the choice between palliative radiotherapy and best supportive care for these individuals

Is Optimal Cytoreduction Post Neoadjuvant Chemotherapy the Only Prognostic Factor in Advanced Ovarian Cancer?

Background  Epithelial ovarian cancer (EOC) is one of the leading causes of cancer-related death in women. Approximately 70% of patients with EOC are diagnosed in advanced stage [The International Federation of Gynecology and Obstetrics(FIGO stage III and IV)] with an expected 5-year survival rate of 30%. Numerous studies have shown that survival with neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) is noninferior to primary debulking surgery followed by chemotherapy. Materials and Methods  In this retroprospective observational study, 50 patients with advanced ovarian cancer, diagnosed from January 2012 to January 2015, were included and followed-up till January 2017. Correlation of NACT with patient profile, CA125 levels, clinicopathologic parameters, progression-free survival (PFS), and treatment response was studied. Statistical analysis was performed using log-rank test and Kaplan-Meir survival plots. Results  The extent of cytoreduction significantly correlated with PFS. The PFS was maximum in patients who had optimal cytoreduction (19 months) and 10 months in patients with suboptimal cytoreduction with p -value < 0.05. The survival was not significantly correlated with other parameters such as age, stage, preoperative CA125 levels, and ascites. Conclusions  The extent of cytoreduction following NACT in this study was associated with statistically significant PFS advantage in patients who were able to undergo optimal cytoreduction, but not significantly correlated to other factors such as age, stage, preoperative CA125 levels, and ascites. NACT followed by interval cytoreduction is an important modality affecting survival in advanced EOC. Further studies and longer follow-up are needed to demonstrate survival advantage over standard treatment

Scrub Typhus Presenting as Acute Myocardial Infarction.

Scrub Typhus, or tsutsugamushi disease is a febrile illness caused by bacteria of the family Rickettsiaceae and named Orientia tsutsugamushi. Recently it has been found to endemic in Subhimalayan region of India. Scrub typhus affects skeletal muscles, skin, lungs, kidneys, brain and cardiac muscles.We report a rare case of scrub typhus presenting as acute myocardial infarction

Prevalence of congenital heart disease in rural population of Himachal – A population-based study

Aim: There is no community-based study about the prevalence of congenital heart disease (CHD) in Himachal; hence, we undertook this study. Methods and results: A population-based survey was done in four villages of different districts of Himachal Pradesh. In total, 1882 persons were examined. 909 were male and 973 were female. There were 12 cases of CHD in the population (6.3/1000): four of these were male (33.3%) and 8 were female (66.6%). Mean age of these patients was 19.5 ± 11.07 years. Atrial septal defect (ASD) was the commonest lesion followed by ventricular septal defect (VSD). Conclusion: Prevalence of CHD in general population was 6.3/1000. ASD was the commonest lesion. CHD was more common in female