HISTOLOGICAL STUDIES ON THE CISSUS QUADRANGULARIS PLANT EXTRACT TREATED FISH OREOCHROMIS MOSSAMBICUS PETER

Cissus quadrangularis L.belongs to the family vitaceae and is an indigenous medicinal plant of India. The present study was aimed to investigate the effect of Cissus quadrangularis on histological changes of normal and cissus quadrangularis plant extract treated fresh water fish, Oreochromis mossambicus tissues samples (gill, liver and muscle ) of Oreochromis mossambicus, at 7 , 14 and 21days.The fish exposed with Cissus quadrangularis when compared with control fish. The present study concludes that Cissus quadrangularis is an beneficial to the growth and development of fishes

Intramuscular hemangioma of the masseter muscle:a case report

Background - Intramuscular hemangiomas are benign vascular tumours that most frequently occur in the trunk and extremities.They constitute about <1% of all hemangiomas, only 10%–20% have been found to arise in the head and neck region, and 36% of cases involving masseter muscle.They usually present as gradually enlarging soft-tissue mass with or without pain. They are located deep within the muscle, hence rarely exhibit clinical signs or symptoms such as bruits, thrills, pulsation which are suggestive of vascular origin. Due to their rare occurrence, unique location they are often confused with other soft-tissue pathologies such as parotid swelling or other muscular lesions. Case report - 21 year old male came with complaints of swelling and pain over the left cheek for past 6 months which was insidious in onset and non progressive.Patient did not have any history of trauma or increased salivation.On examination swelling of about 2*2 cm over the left cheek,well defined,non tender,soft in consistency.There was no pulsation,bruits or palpable thrill.There was no compressibility and the overlying skin was normal.There was no facial nerve involvement and parotid duct orifice was normal. Conclusion - The possibility of an Intramuscular hemangioma of the masseter muscle should be included in the differential diagnosis of any intra-masseteric lesion. Appropriate radiologic examinations, especially MRI, can enhance accurate preoperative diagnosis; the treatment of choice should be individualized in view of the clinical status of the patient.

Rare case of paracaecal hernia with intussusception presenting as small bowel obstruction: case report

Primary internal hernias are very rare in adults. They are an unusual cause of small intestinal obstruction and lead to high morbidity and mortality if left untreated. Clinical presentation of internal hernia is highly nonspecific. Imaging has limited role in diagnosing the cause of acute intestinal obstruction. Internal hernias are usually detected at laparotomy. We report a case of a 61-year-old male who presented with acute intestinal obstruction which was attributed later to a very rare type of internal hernia on exploratory laparotomy. A loop of ileum was found to enter the retroperitoneum through a hernia gate which was located lateral to the caecum and ileo ileal intussusception was noted proximal to the herniated loop. The segment of intestine was resected and anastamosed then hernial defect was closed. Paracaecal hernias are the rare type of hernias in internal hernia. In our case, intussusception was noted proximal to the herniated ileal loop which is a very rare presentation. Intussusception was reported previously with paraduodenal type. One should always keep in mind while conducting emergency laparotomy, internal hernias can be a cause for intestinal obstruction.

Uncommon occurrence of pleomorphic adenoma in submandibular salivary gland in old age males: case series

Pleomorphic adenoma is the most common tumor of the benign salivary gland neoplasms, the submandibular gland is the second most common site of PA after the parotid gland. Authors present 3 series case of pleomorphic adenoma in submandibular salivary gland in institution which were admitted in institution within a month interval. Fine needle aspiration cytology (FNAC) of all 3 cases proved to be benign lesion arising from submandibular salivary gland. All 3 cases underwent excision in to and the postoperative period was uneventful. DT removed on 3rd POD and discharged in POD 10. Biopsy report proved to be pleomorphic adenoma in all cases. past studies showed pleomorphic adenoma most commonly occurs in the parotid gland and its occurrence in the submandibular salivary gland is uncommon. Also, age occurrence involves 30s-50s and is more common in females. But all this case was male and occurred in older age group. Early intervention with surgical excision in toto after definite confirmation with FNAC is the treatment of choice in preventing its malignant transformation.

Selected neurobehavioural evaluation of Leucas Aspera in wistar albino rats.

Background: Leucas Aspera is used in traditional medicine for many ailments. The present study was designed to evaluate the neuro behavioural effects in Wistar albino rats after oral administration of leaves of Leucas Aspera for 28 days. Methods: Wistar albino rats of either sex were treated with the aqueous suspension of dried powdered leaves of L. aspera. Three different groups of animals received L. aspera suspension in doses of 50 mg/kg/day, 100 mg /kg/day or 200mg/kg/day orally for 28 days. The animals were weighed once in a week and the food and water consumption was monitored every day. Behavioural changes in these animals were monitored every week using Rotarod, Actophotometer and William’s maze. Results: A significant increase in body weight, food and water consumption in rats could be recorded after 3rdand 4th week of treatment with 200mg/kg/dayL.aspera. However, there were no changes in any of the behavioural responses in L .aspera treated groups compared to control. Conclusions: The unaltered neuro behavioural responses after L. aspera treatment indicate the safe nature of this medicinal plant. The significant increase in food consumption and body weight changes suggest a potential anabolic/ nutraceutical property of L. aspera.

Anti-Inflammatory Potential of Ethanolic Extracts from Aerial Parts of Ipomoea Pes-Caprae (L.) R.Br Using Cotton Pellet Induced Granuloma Model.

Ipomoea Pes-caprae (L.) R.Br (IP) is a valuable medicinal plant, distributed in the tropics and subtropics regions and used in folk and tribal medicines. Traditionally IP is used in inflammatory conditions such as arthritis and also used to treat pain, ulcer, cancer and wounds. The acute anti-inflammatory activity of IP has been previously reported. The present study aims to discover the anti-inflammatory effect of ethanolic extracts from aerials parts of IP by sub-acute anti-inflammatory model. Completely dried leaves and stems of I.pes-caprae were extracted using ethanol by hot percolation method. The EELIP & EESIP (Ethanolic extract of Leaves & Stems of IP) thus obtained were subjected to preliminary phytochemical analysis and revealed the presence of alkaloids, carbohydrates, glycosides, flavonoids, tannins, sterols and terpenoids both in leaf and stem extracts. The LD50 of both EELIP & EESIP were found to be >2000 mg/kg by acute oral toxicity study. Both EELIP & EESIP exhibited significant anti-inflammatory activities in dose dependent manner.

Optimizing local control in anorectal melanoma.

Background: Wide local excision (WLE) of anorectal melanoma is associated with a high incidence of local recurrence. There is a paucity of literature on adjuvant radiation in this malignancy. Aim: To identify the optimal method of local treatment in anorectal melanoma. Settings and Design: Retrospective study in a tertiary cancer centre. Materials and Methods: Records of 63 patients who presented between 1980 and 2004 were reviewed. Results: Of the 63 patients, 18 were treated by either surgery with or without adjuvant radiation, or by radiation alone. The remaining had advanced disease and were offered only symptomatic treatment. The median overall survival in stage I patients was 12 months, while it was seven and four months in those with stage II and III disease respectively. The median survival in patients treated by WLE with adjuvant radiation (RT), WLE alone or Abdominoperineal resection (APR) was 34, 12 and 10 months respectively. Patients in whom the disease was confined to the mucosa had a better median overall survival than those in whom it had infiltrated beyond the mucosa (102 vs 11 months). The pattern of recurrence following WLE with adjuvant RT or APR was similar. None of the patients who received adjuvant RT after wide excision had a local or nodal recurrence. Conclusion: Local treatment of anorectal melanoma should be individualized. WLE with adjuvant radiation seems to offer good locoregional control without reducing the survival and may be an option of treatment for patients with small, superficial anorectal melanoma. However, APR should be offered for patients with locally advanced disease or as a salvage following recurrence.

Unexpected presentations--four cases of lead poisoning.

OBJECTIVE: To describe the clinical presentation and response to treatment of four patients who presented with abdominal pain and were diagnosed to have lead poisoning. METHODS: After ruling out the more obvious causes of abdominal pain by barium studies, gastrointestinal endoscopies, and biochemical studies, blood lead levels were estimated by atomic absorption spectrophotometry. The patients were treated with oral d-penicillamine. RESULTS: The four patients had blood lead levels from 79 microg/dL to 365 microg/dL. All four of them showed marked improvement in their clinical condition and lowering of blood lead levels on follow up. CONCLUSIONS: Clinicians need to develop a high index of suspicion of lead poisoning as a possible cause of unexplained abdominal pain or altered sensorium, especially against a background of environmental lead contamination in India.

Streptococcus agalactiae endocarditis.

Streptococcus agalactiae (S. agalactiae) is a rare cause of infective endocarditis, which is associated with a high mortality rate. Endocarditis in adults is generally related to immunocompromised states. We hereby report the case of a 35 year old man who presented with fever and delirium in whom aortic valve endocarditis due to S. agalactiae was detected. Though most patients with S. agalactiae endocarditis need surgical intervention along with antibiotics, our patient improved with medical therapy alone.

Angioplasty of membranous obstruction of inferior vena cava.

Membranous obstruction of vena cava (MOVC) is a common cause of hepatic venous outflow obstruction. Surgical procedures utilized to relieve symptoms carry a high morbidity and mortality. A patient who presented with gradual onset ascites and dilated, tortuous veins over the anterior abdominal wall and the back was found to have MOVC by inferior vena cavogram. Balloon dilatation of the obstruction was done successfully through a transvenous approach. Following this, the patient improved remarkably. The procedure is safe, effective and easy to perform. This balloon angioplasty provides alternative method for treatment of membranous obstruction of vena cava.

Management of chyle fistulae following surgery in the neck.

Chyle fistulae are seen in less than twenty percent of cases following head and neck surgery. At the Cancer Institute, Madras, India, chyle leaks were seen in 19 patients between 1990 and 1999. The leak subsided spontaneously in sixteen patients on conservative management. The neck was re-explored in three patient. The thoracic duct was ligated in one and the wound packed in two. Conservative management in the form of aspirations and strapping is more likely to succeed when the volume of drainage is low or decresing over time and the surgical incision and skin flaps remain healthy. Rightsided leaks and late appearing fistulae are also likely to close on conservative management. Dietary modifications may help in this process. Re-exploration of the neck would be required when conservative management fails. Early exploration would be advised when the drainage is large or does not decrease over a few days or if there is a tendency to wound breakdown. A thorough knowledge of the anatomy of lymphatic pathways from the thorax and abdomen, identification of the thoracic duct during surgery and detection and ligature of all lymphatic leaks intraoperatively using a trendelenburg position and valsalva maneuver will help reduce the occurrence of this problem.

Superficial temporal artery based flaps for reconstruction following resection of head and neck cancer.

Head and neck cancers account for over twenty five percent of all cancers in the Indian subcontinent. Most of them are treated primarily with radiation therapy. Reconstruction following resection of post radiation residue or recurrent disease requires well vascularised, thin, pliable and easy to do flaps which could be used for reconstructing mucosal and cutaneous defects simultaneously to achieve a well healed wound with maximum function and cosmesis. Short of the microvascular technique the temperoparietal fasciocutaneous island or temperoparietal fascial flaps based on the superficial temporal vessels come closest to fulfilling these requirements.

Isolated involvement of the mandible by non-Hodgkin's lymphoma.

A case report of isolated involvement of the mandible by non-Hodgkin lymphoma is presented. The patient presented with a non-healing ulcer following a tooth extraction. Biopsy revealed an undifferentiated cancer. Investigations failed to reveal any involvement of the organs. A hemimandibulectomy was performed followed by radiotherapy on receipt of the histopathological diagnosis of non-Hodgkin lymphoma. The patient is asymptomatic two and a half years after treatment.

Visceral larva migrans.

We present a case of visceral larva migrans which came as a complete histologic surprise. The patient was operated as a case of chronic cholecystitis and was found at operation to have multiple hepatic nodules. A cholecystectomy with a biopsy of the liver nodule was performed. Histopathologically a diagnosis of visceral larva migrans was made. To our knowledge this is the first case report of the disorder from India. A discussion based on the review of literature is presented.

Laser in the management of stenosing oropharyngeal scleroma.

We present here our experience of laser for the management of stenosed oropharyngeal scleroma. The diagnosis of scleroma was made 14 years ago and the patient underwent repeated procedures like dilatation, diathermy excision of adhesions and cryosurgery during this period. He attended our out-patient department with complaints of dysphagia and difficulty in breathing, progressing to stridor. On examination, severe oropharyngeal stenosis due to cicatrization extending between the base of the tongue and the post-pharyngeal wall was seen. Using CO2 laser, cicatrix was released by making radial cuts and the oropharyngeal opening was widened. No tracheostomy was needed; no blood loss occurred and the patient was discharged on the next day.