Adenoid cystic carcinoma of the parotid metastasizing to liver: case report

BACKGROUND: Adenoid cystic carcinoma is a rare malignant parotid tumor. Metastasis can occur even a decade or more after initial treatment of the primary. CASE PRESENTATION: We report a 60 year old female patient who presented with adenoid cystic carcinoma of the parotid gland. She underwent a total conservative parotidectomy followed by adjuvant radiotherapy. While on follow up, patient developed multiple liver metastases which manifested three years later. Patient lived for another two years before she died of her disease. CONCLUSIONS: Although distant metastases of adenoid cystic carcinoma develop frequently, isolated metastasis to liver is unusual. Even after manifestation of distant metastasis, patients can be expected to live for a number of years. Palliative chemotherapy can be considered in symptomatic cases while the usefulness of metastatectomy is controversial

Problems Faced by Married Women in the Novel “Manamana En Tholikku”

It is through the marriage relationship children are born, men and women attain the status of parents and their lives do not end just by giving birth to a child. A relationship formed in marriage is a bond that continues till their end. A woman can be a doer of good and as well as a destroyer too.  Not a single atom can move without her. Women is the beginning and end of a world. The world was born out of her and the world was born for her. She is the mother, girlfriend, wife, daughter, granddaughter, friend and so on. She is the goddess of education, wealth, and valor. The phrase "A woman to be protected in childhood by a father, in youth by a husband, and in old age by a son" is a great insult for her. Isn't she responsible for the happiness of her family, her parents, her children? Isn't a woman who puts aside all her likes and dislikes and devotes her entire life to her parents, husband and children a martyr by birth? The article deals with the question, what is women’s condition and how is she treated today

Critical Analysis on the Concept of Kashyapa’s Phakka Chikitsa in the Management of Motor Developmental Delay

Acharya Kashyapa is considered as the father of Kaumarabhritya and author of a book Kashyapa Samhita or Vruddajeevakeeya Tantra has described the diagnosis of many pediatric diseases and concepts of management. Phakka is a disease complex characterized by a symptom as the child is unable to walk even after the age of one year. Phakkatva denotes that it is a syndrome developing due to various causes characterized mainly with emaciation and gross motor function deficit. Kashyapa has explained the concept of phakka chikitsa in detail. Presently, these types of symptoms are commonly seen in children during early period of childhood as “developmental disorder.” Many conditions are included in developmental disorders, such as developmental delay, cerebral palsy, failure to thrive, motor function deficit, global motor delay, gross motor delay, Down’s syndrome, etc., wherein the development is delayed and child is not able to perform the motor activities. Applicaton of Kashyapa’s concept of phakka chikitsa in motor function disabilities helps to improve the children’s condition in the present scenario

Management of Meniere’s Disease - An Analytical Ayurveda Perspective

Meniere’s disease, also called endolymphatic hydrops, is a disorder of the inner ear where the endolymphatic system is distended. It is characterized by vertigo, sensorineural hearing loss, and tinnitus. The main pathology in Meniere’s disease is distention of endolymphatic system due to increased volume of endolymph. This can result either from increased production of endolymph or its faulty absorption or both. As the Meniere’s disease pathology, clinical signs and symptoms may be correlated to karnakshweda, karnanada, badirya and bhrama in which the vitiation of karnagata tarpaka kapha vikruti can be seen. Hence the treatment protocol for Menier’s disease should include agni deepana, amapachana, anuloma, shirovirechana, vatashamana sneha, and rasayana therapies which will give promising results

Effect of Alternanthera brasiliana in experimentally induced inflammatory bowel disease in albino rats

Background: Inflammatory bowel disease (IBD) is a chronic inflammatory condition affecting the gastrointestinal tract with limited therapeutic options. The present study aimed to investigate the effect of methanolic extract of Alternanthera brasiliana in acetic acid-induced inflammatory bowel disease (IBD) in albino rats.Methods: A total of 36 animals were included in the study. Animals were divided into six groups (n = 6 ): group I - control (normal saline), group II-AA+ normal saline, group III-Sulfasalazine (360mg/kg)+AA, group IV A-methanolic extract of Alternanthera brasiliana (300 mg/kg), group IV B-methanolic extract of Alternanthera brasiliana (600 mg/kg)+AA, group IV C-methanolic extract of Alternanthera brasiliana (900 mg/kg)+AA. Group IV was divided into three subgroups, namely IVA, IV B and IV C, on the basis of different doses of methanolic extract of Alternanthera brasiliana. After completion of 7 days of treatment, rats were sacrificed under ether anesthesia for assessment of intestinal inflammation using parameters namely colon weight change, macroscopic and histopathological evaluation.Results: There was a statistically significant decrease in colonic weight, macroscopic scores and microscopic scores in groups treated with methanolic extract of Alternanthera brasiliana at a dose of 600 mg/kg.Conclusions: The present study indicates the efficacy of methanolic extract of Alternanthera brasiliana in acetic acid-induced IBD. The effects are more pronounced at a dose of 600 mg/kg than at 300 mg/kg and 900 mg/kg of methanolic extract of Alternanthera brasiliana

Intracervical foleys catheter: Can it serve as an alternative to standard pharmacological method of cervical ripening?

Background: Ripening of cervix is a prerequisite for successful labour induction. Use of prostaglandins for this purpose incurs a high risk of uterine hyperstimulation and a relatively higher cost of treatment. intracervical Foleys catheter insertion is a mechanical method stated in literature. The present study was to compare the efficacy and safety and cost of intracervical Foleys catheter balloon insertion with intracervical dinoprostone application for preinduction cervical ripening in patients requiring labour induction at term.Methods: This was a randomized, parallel group, active controlled study conducted in the obstetrics department of a tertiary care centre over a duration of one year. Group A received Dinoprostone cervical gel 0.5mg instilled in the cervical canal. Maximum of three doses (1.5mg dinoprostone) could be administered 6 hours apart. Patients randomized to group B were subjected to Foleys catheter insertion. Foleys catheter number 16 was used and balloon was inflated with 60ml of water. Primary efficacy parameter was change in Bishops score as compared to baseline and safety was monitored by comparing the total number of adverse events in the two groups.Results: Total of 89 patients were enrolled into the study during one year period out of which 45 received dinoprostone gel and 44 received Foleys catheter insertion respectively. Change in Bishops score, mode of delivery and total number of maternal and foetal adverse events did not differ significantly between the two groups.Conclusions: Efficacy and safety of Foleys catheter as a cervical ripening agent prior to induction of labour is comparable to dinoprostone gel. Since use of Foleys catheter is advantageous in terms of lack of specific storage conditions and cost of treatment, it could be considered a cost effective alternative for preinduction cervical ripening

Axillary Arch (Of Langer): Incidence, Innervation, Importance

The present study was planned to find out the incidence of accessory muscle arches in the axilla of 68 upper limb (38 right and 30 left) dissections. Langer’s arch was observed in one right limb out of the 68 limbs, total incidence was 1.47%. The arch extended from the latissimus dorsi to the fascia covering the biceps brachii. The incidence is low in South Indian population (Dravidians) compared to the various other populations reported in literature. A branch from the lateral cord of brachial plexus supplied it in contrast with the previous reports. The surgical significance of this muscle is reviewe

Periodic evaluation of drug utilization in intensive coronary care unit patients in a tertiary care hospital

Background: A wide and gradual variation exists periodically in the patterns of pharmacotherapy among patients admitted with CVDs in CCU. Periodic evaluation of drug utilization in the CCU is necessary for optimization of health care system, proper use of resources and making prescription policy.Methods: It was retrospective and prospective study. Study was carried out at Tertiary care hospital in Mangalore. Retrospective study period was from 1/07/2010 till 31/12/2010 and Prospective study duration was from 1/01/2016 till 30/06/2016. Patients from CCU were participants of this study.Results: Data of total 278 patients were taken, out of which 138 patients from 2010 and 140 patients in 2016 were analyzed respectively and were compared among drug therapy for IHD - Nitrates, dual antiplatelet therapy (aspirin and clopidogrel), dyslipidemic drugs and beta blockers remain drug of choice in both retrospective and prospective study. But, anticoagulant (heparin/ LMWH) use increased in prospective studies. In Heart failure - nitrates, antiplatelet, dyslipidemic drugs followed by inotropes and diuretics was used in both study. Cardiomyopathy was managed with diuretics, ACEIs, and nitrates in both retrospective and prospective study.Conclusions: In conclusion, predominance of male gender and poly-pharmacy were observed. However, it has identified areas to further rationalize and optimize patterns of polypharmacy and evidence based use of medications like beta blockers, anticoagulants/antiplatelet agents and antiarrythmisc. The results on the major determinants of cardiovascular drug use in CCU matched with the existing indications and cautions for use with each drug class

A study on management of oral cancer in a tertiary care hospital

Background: Oral cancers form nearly 30% of the cancers. The most effective way of combating oral cancer is by early diagnosis followed by concurrent chemo-radiotherapy which is the most popular approach in current practice. The adverse effects seen in oral cancer patient’s due to their treatment are nausea & vomiting, mucositis, constipation, diarrhoea, fatigue & radiation dermatitis. Polypharmacy is due to variety of treatment options in oral cancer patients, which needs to be addressed.Methods: Over a period of 18 months, the in-patient records of 79 patients with oral cancers, admitted to oncology ward of Justice K. S. Hegde Charitable Hospital, Mangalore, were scrutinized and the data collected in a specially designed proforma. Descriptive analysis of the data was done.Results: Required data was collected from 79 patients, out of which 55.7% of the patients underwent surgery and later received chemotherapy and radiotherapy. Most commonly seen adverse effects due to treatment were weight loss (75.9%), reduced appetite (67.1%), fatigue (75.9%), pain (79.7%) and skin discoloration (50.6%), etc. Various classes of adjuvant drugs were used for complications caused due to the treatment of oral cancers. Drugs like topical applicant /mouth washes constituted the bulk of the prescriptions (22%) followed by nutritional supplements (15.34%), NSAID/opioids (12.76%) hematinic (12.59 %) and other groups of drugs were also used.Conclusions: Present study helped us to plan evidence based strategies to reduce or prevent post treatment complications. Most of the adverse effects were treated accordingly to keep the patient comfortable

Visualization of conformational changes and membrane remodeling leading to genome delivery by viral class-II fusion machinery

Chikungunya virus (CHIKV) is a human pathogen that delivers its genome to the host cell cytoplasm through endocytic low pH-activated membrane fusion mediated by class-II fusion proteins. Though structures of prefusion, icosahedral CHIKV are available, structural characterization of virion interaction with membranes has been limited. Here, we have used cryo-electron tomography to visualize CHIKV's complete membrane fusion pathway, identifying key intermediary glycoprotein conformations coupled to membrane remodeling events. Using sub-tomogram averaging, we elucidate features of the low pH-exposed virion, nucleocapsid and full-length E1-glycoprotein's post-fusion structure. Contrary to class-I fusion systems, CHIKV achieves membrane apposition by protrusion of extended E1-glycoprotein homotrimers into the target membrane. The fusion process also features a large hemifusion diaphragm that transitions to a wide pore for intact nucleocapsid delivery. Our analyses provide comprehensive ultrastructural insights into the class-II virus fusion system function and direct mechanistic characterization of the fundamental process of protein-mediated membrane fusion