STUDY OF CLINICAL AND LABORATORY PROFILE OF PATIENTS WITH ADRENAL MASS.

Aims and objectives: AIM of this study was to observe and correlate clinical and laboratory profile of patients with adrenal mass. The objective was to study clinical and laboratory profile of patients with adrenal mass with the secondary objective to establish the etiological diagnosis with adrenal mass Methods: This observational study was carried out at tertiary care government hospital in north India from Jul 2020 to June 2022. Based on prevalence 4.4 of the disease as per previous study sample size for 95% confidence level & 5% precision works out 43. The inclusion Criteria were patients detected to have adrenal mass or symptoms related with adrenal mass. The exclusion criteria were any pre-existing known malignancy other than adrenal gland. Subsequent to enrolment the demographic data, clinical data, laboratory data, hormonal assays and radiological data was recorded as per predesigned proforma. The adrenal CT imaging protocol consists of three phases together are used for calculating absolute percentage washout and/or relative percentage washout to differentiate lipid-poor adenomas from primary carcinoma and metastases. Results: The mean age was 39± 15.41. Majority of patients were males 35(77.8%). 86.7% subjects had no comorbidity, 7.9 % had HTN. 6.7% patients were noted to have clinical cushings whereas in 4.4% subject acanthosis nigricans and goiter was seen. On Overnight dexamethasone suppression test, 16/45 patients were observed with value higher than <2.01 ug/dl, similar was the case with low dose dexamethasone suppression test. There was a significant rise in the mean plasma free metanephrine and urinary metanephrine noted in 12/ 45 patients. The minimum size of adrenal mass detected in the USG abdomen was 2.5 cm. The minimum size of adrenal mass detected in the CT abdomen was 1.21 cm. There is a significant association noted between absolute percentage washout (APW) outcome and hormonal activity with p-value <0.001. Conclusion: 6.7 % had features of cushing's disease and 4.4 % had acanthosis nigricans. On hormonal assays elevated metanephrine levels were seen in 26% subjects. On hormonal assays of ONDST and LDDST 35.5 % subjects were seen with elevated levels. Other hormonal assays aldosterone, renin and ACTH were normal. CECT was sensitive to identify a small adrenal mass up to 0.633 cm. 34 % of adrenal mass were hyper functional and 2 % were found malignant in this study.

Mural unicystic ameloblastoma crossing the midline: a rare case report / Ameloblastoma uniquístico mural traspasando la línea mediana: reporte de un caso infrecuente

Ameloblastoma is a benign odontogenic neoplasm which frequently affects the mandible. The term ameloblastoma includes several clinico-radiological and histological types. Apart from the most commonly encountered clinico- pathologic models there are few variants, whose biological profile is unknown or not elicited. The reason for lack of understanding is the scarcity of case report published in the literature. Among the types, unicystic ameloblastoma is the least encountered either it presents as unilocular or multilocular radiolucency, but peculiar radiographic presentation of multilocular radiolucency in posterior mandible with unilocular radiographic appearance crossing the midline is extremely rare, which has not been reported yet. Here we report a distinctive case of mural unicystic ameloblastoma of mandible in a 17-year- old- girl with the radiographic presentation as mentioned above.

El ameloblastoma es un tumor odontogénico benigno que frecuentemente afecta a la mandíbula. El término ameloblastoma incluye varias características clínico-radiológicas y tipos histológicos. Aparte de los modelos clínicopatológicos que se encuentran con frecuencia existen algunas variantes, cuyo perfil biológico es desconocido o aún no elucidado. La razón de la falta de comprensión es la escasez de informes de casos publicados en la literatura. Entre los tipos, el ameloblastoma uniquístico es el menos frecuente y puede presentarse como una radiolucidez unilocular o multilocular, pero la peculiar presentación radiográfica de radiolucidez multilocular en el posterior de la mandíbula con aspecto radiográfico unilocular que cruza la línea mediana es extremadamente rara, y aún no se ha reportado. Se presenta un caso de ameloblastoma uniquístico mural de la mandíbula en una paciente de 17 años con la presentación radiográfica anteriormente descrita.

Enhancement of dissolution rate of etoricoxib through solid dispersion technique.

Etoricoxib, a non-steroidal anti-inflammatory drug, is used to Osteoarthritis, Rheumatoid arthritis and Acute Gouty arthritis. Etoricoxib is practically insoluble in water; hence present study was carried out to enhance dissolution properties of Etoricoxib through the preparation of Solid Dispersions using PEG 6000 as carrier at various proportions by using different techniques like Physical mixtures, Kneading Method and Solvent Evaporation Method. The drug release profile was studied in 0.1N HCl containing 1 % SLS. U.V. Spectrophotometric method was selected for assay as well as in-vitro dissolution studies at 234nm.All the solid dispersions exhibited superior dissolution than pure drug. The drug dissolution studies followed first order kinetics. Solvent evaporation method was found to be superior to other methods.

Phaeohyphomycosis.

Phaeohyphomycosis, caused by heterogeneous group of phaeoid fungi causes both subcutaneous and systemic infections. The disease is more of a histopathological than a clinical entity. We present a case of phaeohyphomycosis in a 29-year-old male who presented with the complaint of painful swelling of the right eye of 1-year duration. Computed tomography (CT) scan showed an abnormal hyper dense enhancing soft tissue in the extra coronal aspect of the right orbit along the superolateral and superomedial aspect. A provisional clinical diagnosis of lymphoma or fungal infection was entertained. Histopathology revealed granulomas with numerous multinucleated giant cells and fungal hyphae within and in between the giant cells. Per-iodic acid Schiff (PAS stain) was used to confirm the presence of hyphae. Based on the clinical, CT and histopathological features, a diagnosis of Phaeohyphomycosis was given.