Small cell osteosarcoma of mandible: a rare case report and review of literature.

Osteosarcoma is the most common primary malignant tumor of bone but only 5% of these tumours occur in the jaws. Of all the varieties of osteosarcoma, the juxtacortical type is rare and comprises only less than 4% of all osteosarcomas. Juxtacortical osteosarcoma is further subdivided into parosteal (low grade) and periosteal (high grade). Osteosarcomas can be categorized histologically mainly into chondroblastic, osteoblastic, fibroblastic and numerous others. One of the rare histological variant is small cell osteosarcoma which consists of sheets of round cells that produce an osteoid matrix. The aim of this article is to present a rare case of periosteal osteosarcoma of mandible which on histopathological examination showed characteristics of small cell tumour

Kaposiform hemangioendothelioma in tonsil of a child associated with cervical lymphangioma: a rare case report

Kaposiform hemangioendothelioma (KHE) is an uncommon vascular tumor of intermediate malignant potential, usually occurs in the extremities and retroperitoneum of infants and is characterized by its association with lymphangiomatosis and Kasabach-Merritt phenomenenon (KMP) in certain cases. It has rarely been observed in the head and neck region and at times, can present without KMP. Herein, we present an extremely uncommon case of KHE occurring in tonsil of a child, associated with a neck swelling, but unassociated with KMP. A 2-year-old male child referred to us with history of sore throat, dyspnoea and right-sided neck swelling off and on, since birth, was clinicoradiologically diagnosed with recurrent tonsillitis, including right sided peritonsillar abscess, for which he underwent right-sided tonsillectomy, elsewhere. Histopathological sections from the excised tonsillar mass were reviewed and showed a tumor composed of irregular, infiltrating lobules of spindle cells arranged in kaposiform architecture with slit-like, crescentic vessels. The cells displayed focal lumen formation containing red blood cells (RBCs), along with platelet thrombi and eosinophilic hyaline bodies. In addition, there were discrete foci of several dilated lymphatic vessels containing lymph and lymphocytes. On immunohistochemistry (IHC), spindle cells were diffusely positive for CD34, focally for CD31 and smooth muscle actin (SMA), the latter marker was mostly expressed around the blood vessels. Immunostaining for HHV8 was negative and Ki-67 (proliferation marker) displayed focal positivity. Diagnosis of KHE was made. Platelet count was towards lower side of range. Postoperative imaging showed discrete, multiple fluid containing lesions in the right neck that were high on T2-weighed sequences, on magnetic resonance imaging (MRI) and ipsilateral intraoral mucosal growth. Fine needle aspiration cytology (FNAC) smears from neck swelling showed blood, fluid and lymphocytes. Possibility of a coexisting lymphangioma was considered. The patient was offered sclerotherapy and is on follow-up. This case forms the second documented case of KHE at this site, along with its unique association with neck lymphangioma. KHE has distinct histopathological features and can be sorted out from its other differentials like juvenile hemangioma and Kaposi's sarcoma. IHC stains are useful in substantiating a definite diagnosis

Plumbagin inhibits invasion and migration of breast and gastric cancer cells by downregulating the expression of chemokine receptor CXCR4

<p>Abstract</p> <p>Background</p> <p>Increasing evidence indicates that the interaction between the CXC chemokine receptor-4 (CXCR4) and its ligand CXCL12 is critical in the process of metastasis that accounts for more than 90% of cancer-related deaths. Thus, novel agents that can downregulate the CXCR4/CXCL12 axis have therapeutic potential in inhibiting cancer metastasis.</p> <p>Methods</p> <p>In this report, we investigated the potential of an agent, plumbagin (5-hydroxy-2-methyl-1, 4-naphthoquinone), for its ability to modulate CXCR4 expression and function in various tumor cells using Western blot analysis, DNA binding assay, transient transfection, real time PCR analysis, chromatin immunoprecipitation, and cellular migration and invasion assays.</p> <p>Results</p> <p>We found that plumbagin downregulated the expression of CXCR4 in breast cancer cells irrespective of their HER2 status. The decrease in CXCR4 expression induced by plumbagin was not cell type-specific as the inhibition also occurred in gastric, lung, renal, oral, and hepatocellular tumor cell lines. Neither proteasome inhibition nor lysosomal stabilization had any effect on plumbagin-induced decrease in CXCR4 expression. Detailed study of the underlying molecular mechanism(s) revealed that the regulation of the downregulation of CXCR4 was at the transcriptional level, as indicated by downregulation of mRNA expression, inhibition of NF-κB activation, and suppression of chromatin immunoprecipitation activity. In addition, using a virtual, predictive, functional proteomics-based tumor pathway platform, we tested the hypothesis that NF-κB inhibition by plumbagin causes the decrease in CXCR4 and other metastatic genes. Suppression of CXCR4 expression by plumbagin was found to correlate with the inhibition of CXCL12-induced migration and invasion of both breast and gastric cancer cells.</p> <p>Conclusions</p> <p>Overall, our results indicate, for the first time, that plumbagin is a novel blocker of CXCR4 expression and thus has the potential to suppress metastasis of cancer.</p

Correlative study between handgrasp power with handwriting speed and legibility among medical students

Background: Medical students must possess four skills namely reading, writing, speaking and listening as potential doctors. Writing as a skill is particularly important as it helps them to perform well academically as well asprevent drawbacks of bad handwriting later like illegible prescriptions. The deterioration of handwriting starts in medical school due to time bound subjective assessment pattern in medical schools.Objectives:To assess if there was any association between grasp powerwith handwriting speed and legibility. This will help therapists deal with writing issues by improving handgrip strength which is a function of intrinsic muscles of hand.Material and methods:Grasp power (in Kgs) , handwriting speed (Letters per minute) and handwriting legibility score(1-4) were measured for 100(M=30,F=70) undergraduate medical students. Descriptive statistics was used to expressed quantitative variable as mean±S.D. Independent t test was used to compare mean grasp power left and right hand between male and female. Pearson correlation coefficient was used to find correlation between grasp power with letters per minute and legibility score. Results and conclusions:Mean Grasp power of right hand for female subjects was found to be 13.5±6.3 kgs while for males it was 33.23± 12.6 kgs.Grasp power on right and left side showed a statistically significant difference between the two genders.Handwriting speed for females was 117±9.25 letters per minute as compared to 124.13±14.46 letters per minute for males.. It was observed there is positive correlation between RGP(Right hand Grip power) and HWS(Letters per minute) ( r=0.24) . There was no correlation between grasp power and handwriting legibility.The present study establishes a positive corelation between grasp power and handwriting speed. This will help in addressing calligraphic issues amongst medical students

HAND ANTHROPOMETRY - A VALUABLE PARAMETER FOR GRIP STRENGTH AND HAND FUNCTIONAL ASSESSMENT

Objective: The objective is to study the relationship between hand length (HL) and hand width with grip strength and writing speed among medical students. This plays a crucial role in evaluating functional ability and motor skills. Methods: This cross-sectional observational study was conducted 255 undergraduate students (M=110, F=145); 18–25 age group was selected for the study. HL, hand width, grip strength, and handwriting speed were measured and correlated. Results: The average measurement for HL was 188.2 mm and 181.43 for right and left hand, respectively. The figures for hand width were 75.59 mm and 75.37 mm for right and left hand, respectively. The average values for grip strength 19.24 kg and 19.25 kg for right and left hand, respectively. Average handwriting speed was 119.6 letters/min. Conclusion: Provides normative data for hand anthropometry, handgrip strength, and handwriting speed in undergraduate medical students. Hand anthropometry correlated significantly with the grip strength. Handwriting speed is accentuated with increase in length as shown in this study

Our experience with CEA in the management of colorectal cancer – a prospective study

Introduction : In India, colorectal cancer is the 6th most prevalent cancer and population based time trend studies show a rising trend in its incidence. CEA is expressed in significant amounts post-natally by the carcinomas arising from large intestine. Currently, the most useful application of CEA is in the detection of liver metastasis from colorectal cancers and serial determination of CEA is recommended for detecting cancer spread to the liver. Aim: To assess the role of CEA in the management of colorectal cancer, and detection of early recurrence. Methods and Material: 30 patients with colorectal cancer admitted in Vydehi Institute of Medical Sciences &amp; Research Centre during the period of November 2012 to April 2014 were included in a prospective study. Statistical analysis used: Descriptive statistics were calculated for all variables. Analysis was performed using the SPSS 14.0 statistical package. Results: Total patients included in the study was 30. The mean age at presentation was 48.66yrs. The most common site of malignancy was rectum (46.66%), and most of the patients presented in stage I. Pre-operatively CEA was raised in 22 cases. On postoperative follow-up, CEA was found to be elevated in 7 cases. 6 out of these cases had proven recurrence. One case was found to have peritoneal deposit in spite of CEA levels being normal. The sensitivity and specificity of using CEA as an indicator for recurrence were 85.71% and 95.65% respectively. Conclusions: Since colorectal cancer is associated with considerable morbidity and mortality, early diagnosis and management provide a chance for better survival. The use of CEA as an early indicator for recurrence has been evaluated in this study and can be used for the same. However, a larger size and longer duration of study is needed to effectively prove the same

Utility of flexible fiberoptic bronchoscopy for critically ill pediatric patients: A systematic review.

AIM:To investigate the diagnostic yield, therapeutic efficacy, and rate of adverse events related to flexible fiberoptic bronchoscopy (FFB) in critically ill children. METHODS:We searched PubMed, SCOPUS, OVID, and EMBASE databases through July 2014 for English language publications studying FFB performed in the intensive care unit in children &lt; 18 years old. We identified 666 studies, of which 89 full-text studies were screened for further review. Two reviewers independently determined that 27 of these studies met inclusion criteria and extracted data. We examined the diagnostic yield of FFB among upper and lower airway evaluations, as well as the utility of bronchoalveolar lavage (BAL). RESULTS:We found that FFB led to a change in medical management in 28.9% (range 21.9%-69.2%) of critically ill children. The diagnostic yield of FFB was 82% (range 45.2%-100%). Infectious organisms were identified in 25.7% (17.6%-75%) of BALs performed, resulting in a change of antimicrobial management in 19.1% (range: 12.2%-75%). FFB successfully re-expanded atelectasis or removed mucus plugs in 60.3% (range: 23.8%-100%) of patients with atelectasis. Adverse events were reported in 12.9% (range: 0.5%-71.4%) of patients. The most common adverse effects of FFB were transient hypotension, hypoxia and/or bradycardia that resolved with minimal intervention, such as oxygen supplementation or removal of the bronchoscope. Serious adverse events were uncommon; 2.1% of adverse events required intervention such as bag-mask ventilation or intubation and atropine for hypoxia and bradycardia, normal saline boluses for hypotension, or lavage and suctioning for hemorrhage. CONCLUSION:FFB is safe and effective for diagnostic and therapeutic use in critically ill pediatric patients