Metastatic hepatocellular carcinoma to the parotid gland: A diagnostic dilemma with review of the literature

Hepatocellular carcinoma (HCC) is the most common primary hepatic malignancy and is a leading cause of cancer-related death worldwide. It has a very aggressive clinical course, with a mean survival rate of much less than a year if left untreated. Here, we present a case of a 68-year-old male with progressively enlarging painful right facial swelling, involving the ramus and condyle of mandible on contrast-enhanced computed tomography mimicking an osteosarcoma. Eventually, the final diagnosis of HCC metastatic to the right parotid gland was made. We report a case of a rare metastasis of HCC to the parotid gland. Furthermore, the present case demonstrates the importance of tissue biopsy and immunohistochemistry for obtaining an accurate final diagnosis.

Establishing gene Amelogenin as sex-specific marker in yak by genomic approach

Yak, an economically important bovine species considered as lifeline of the Himalaya. Indeed, this gigantic bovine is neglected because of the scientific intervention for its conservation as well as research documentation for a long time. Amelogenin is an essential protein for tooth enamel which eutherian mammals contain two copies in both X and Y chromosome each. In bovine, the deletion of a fragment of the nucleotide sequence in Y chromosome copy of exon 6 made Amelogenin an excellent sex-specific marker. Thus, an attempt was made to use the gene as an advanced molecular marker of sexing of the yak to improve breeding strategies and reproduction. The present study confirmed that the polymerase chain reaction amplification of the Amelogenin gene with a unique primer is useful in sex identification of the yak. The test is further refined with qPCR validation by quantifying the DNA copy number of the Amelogenin gene in male and female. We observed a high level of sequence polymorphisms of AMELX and AMELY in yak considered as novel identification. These tests can be further extended into several other specialized fields includingforensics, meat production and processing, and quality control.

Traditional healing practice and folk medicines used by Mishing community of North East India.

Assam and Arunachal Pradesh have very rich tradition of herbal medicines used in the treatment of various ailments. Tribal communities practice different types of traditional healing practices. Enough documentation is available on the healing practices in other tribal communities except Mishing community of Assam and foot hill of East Siang district of Arunachal Pradesh hence the attempt was made for the same. A survey on folk medicinal plants and folk healers of Mishing tribe was conducted in few places of Lakhimpur and Dhemaji district of Assam and East Siang district of Arunachal Pradesh, where this ethnic group is living since time immemorial. All information was collected based on interview and fi eld studies with local healers within the community. The identifi cation of medicinal plants collected with help of indigenous healers was done. Such medicines have been shown to have signifi cant healing power, either in their natural state or as the source of new products processed by them. This study is mainly concentrated with plants used to cure diseases and to enquire about different healing systems. Detail note on the method of preparation of precise dose, the part/parts of plants used and method of application is given.

Dermatology referrals in the hospital setting.

BACKGROUND AND AIMS: Dermatology consultation occurs mainly in the outpatient setting. The reasons for inpatient dermatologic consultation by other specialties in a hospital, its frequency and its impact on health care are largely unrecorded. METHODS: We retrospectively studied the records of 971 hospitalized patients or patients being evaluated in emergency services for which a dermatologist's consultation was requested over a 5-year period in a medium sized military hospital. The demographic details, specialties requiring consultation, provisional diagnosis and dermatological investigations done were tabulated. RESULTS: Dermatologic consultation changed the dermatologic diagnosis and treatment in more than 2/3rd of the patients. Generally, the dermatologic diagnoses most frequently missed by the referring service were common conditions with established treatment. CONCLUSION: The overall impact of dermatologic consultation on health delivery to patients was substantial. Important recommendations to any health care system are offered.

Temporal bone carcinoma with intradural extension.

A case of temporal bone carcinoma having intradural extension is reported. To the best of our knowledge, no such case has been reported so far.

Diffuse neurofibroma of scalp.

Diffuse neurofibroma is an uncommon but distinct variety of neurofibroma, usually affecting trunk, head and neck regions of adolescents and young adults. The clinical features, gross macroscopic and histopathological findings are enunciated and the criteria for instituting the preferred modality of treatment for such lesions has been reviewed, stressing upon the need to exclude the neurofibromatoses preoperatively.

Clinical significance of pituitary apoplexy.

A retrospective analysis of 280 cases of pituitary adenoma operated on over a period of 10 years from 1985-94 revealed 15 cases (5.3%) presenting with apoplexy, though there were 48 cases in which haemorrhage in pituitary adenoma was confirmed at operation. In the apoplectic group all but one had abrupt onset of severe headache. Seven of these 15 patients had diminution of vision and ocular motility defects were detected in 5 patients. There were 5 patients of amenorrhoea/galactorrhoea syndrome and 2 had acromegalic features. In the remaining 8 patients retrospective analysis failed to reveal any conclusive evidence of pituitary dysfunction. Trans-sphenoidal surgery was performed in 9 cases and the rest had transcranial surgery. Visual acuity loss improved in most of the affected patients, residual ocular motility defects were mild. Urgent trans-sphenoidal surgery to decompress the expanding mass seems to be the preferred mode of surgery.

Acute respiratory disease survey in Tripura in case of children below five years of age.

This epidemiological study has been carried out in urban and rural areas of West Tripura district, to determine the incidence, causes, risk factors, morbidity and mortality associated with acute respiratory infection (ARI) and impact of simple case management in children under 5 years of age. The annual attack rate (episode) per child was more in urban area than in rural area. Monthly incidence of ARI was 23% in urban area, 17.65% in rural area. The overall incidence of ARI was 20%. The incidence of pneumonia was 16 per 1000 children in urban area and 5 per 1000 in rural area. The incidence of pneumonia was found to be the highest in infant group; 3% of ARI cases in rural area and 7% in urban area developed pneumonia. Malnourishment in urban area was 54% and in rural area 65%. Malnourished children have higher likelihood for developing respiratory infection. The relative risk (RR) of developing pneumonia was 2.3 in malnourished children. Most children (59%) had been immunised with measles and diphtheria, pertussis and tetanus (DPT) vaccine earlier. The immunisation had a protective role in pneumonia. The RR was 2.7 in non-immunised group. Air pollution of the urban area had stronger relation for bronchial asthma than pneumonia. Breastfeeding had protective role in pneumonia and severe disease. Bottlefeeding had greater risk of developing pneumonia. Lower socio-economic status had the greater risk of ARI episodes. ARI was decreased as the per capita income increased. An increase in magnitude of ARI was observed with the decrease of literacy rate. Administration of co-trimoxazole for pneumonia case by trained health worker using simple case management strategies can reduce deaths from pneumonia significantly. Health education can change health care seeking behaviours and attitude of parents and other family members to take care of the ARI child in the home itself for preventing pneumonia death.

Mitomycin C induced inhibition of adrenal steroidogenesis in female rats.

Mitomycin C (MC), an antibiotic which depresses DNA synthesis causes suppression of enzyme delta 5 3 beta-hydroxysteroid dehydrogenase (delta 5 3 beta OHD) and glucose-6 phosphate dehydrogenase (G-6 PD) in the rat adrenal tissue. The treatment resulted in a fall in DNA content together with an accumulation of cholesterol and ascorbic acid in the gland. The results suggest a diminution in adrenal steroid biogenesis similar to gonadal inhibition previously reported.