Management of recurrent polymorphous low grade adenocarcinoma: a case report / Manejo de adenocarcinoma polimorfo recorrente de baixo grau: relato de caso

The Polymorphous Low Grade Adenocarcinoma (PLGA) is a common minor salivary gland carcinoma. It mostly affects the buccal mucosa and retromolar region, but the palate is an unusual site. As the carcinoma is low grade the recurrence is also uncommon. Our patient had a PLGA initially in the palate which was treated initially through surgical management but had a recurrence after four years. Hence we planned a partial maxillectomy along with level I nodes. Post-operatively follow-up is successful till date. So the management of a recurrent PLGA through careful surgery and post-operative follow ­up with prosthetic rehabilitation is discussed in this article... (AU)

Chemical composition and in vitro antioxidative potential of essential oil isolated from Curcuma longa L. leaves

Objective: To determine the chemical composition and antioxidant potential of essential oil isolated from the leaves of Curcuma longa (turmeric). Methods: Chemical composition of the oil was analyzed using GC-MS. Antiperoxidative potential was evaluated using linoliec acid emulsion system. Free radical scavenging activity was evaluated using stable DPPH and ABTS free radicals. Results: GC-MS analyses showed that major compound present in the turmeric leaf oil is b-sesquiphellandrene (22.8%) followed by terpinolene (9.5%). Essential oil also exhibited reductive potential and antioxidant potential in linoleic acid emulsion system along with DPPH and ABTS free radical scavenging potential. Conclusions: The overall result suggests that turmeric leaf oil is capable of retarding oxidation reaction and free radical mediated damage and can be developed as a potent natural antioxidant.

Absent coronary venous sinus: a rare anomaly.

A 42-year-old man, presenting with dyspnea on exertion and ST segment depression on treadmill test, was found to have absent coronary venous sinus on coronary angiography. We report this case of isolated congenital absence of coronary venous sinus because of its rarity.

Kinetic studies of purified malate dehydrogenase in liver of streptozotocin-diabetic rats and the effect of leaf extract of Aegle marmelose (L.) Correa ex Roxb.

The functional basis of diabetes-mellitus to a certain extent, can be elucidated by studying diabetes-induced changes in metabolic enzymes. Malate dehydrogenase (MDH), is an enzyme directly involved in glucose metabolism. The kinetic parameters of MDH and its purified cytosolic isozyme, S-MDH, have been studied in the liver of streptozotocin-diabetic rats; also the potential of the leaf extract of A. marmelose as an anti-diabetic agent was investigated. The Km of the liver enzyme increased significantly, in both crude and purified preparations in the diabetic state when compared to the respective controls. Insulin as well as leaf-extract treatment of the diabetic rats brought about a reversal of Km values to near normal. Vmax of purified S-MDH was significantly higher in the diabetic state when compared to the control. Insulin and leaf extract treatment did not reverse this change. Since MDH is an important enzyme in glucose metabolism, the variation in its quantitative and qualitative nature may contribute to the pathological status of diabetes. The fact that leaf extract of A. marmelose was found to be as effective as insulin in restoration of blood glucose and body weight to normal levels, the use of A. marmelose as potential hypoglycemic agent is suggested.

Transesophageal echocardiography for the detection of left atrial thrombus.

We performed transesophageal two-dimensional echocardiography (TEE) and compared its results with those of transthoracic echocardiography (TTE) in a series of 120 patients with rheumatic mitral stenosis (MS). The patients were selected from a pool of 2000 patients of rheumatic heart disease assessed earlier by clinical examination and TTE. The selection criteria for TEE included one or more of the following: 1. Atrial fibrillation, 2. Embolic episode, 3. Before closed mitral valvotomy or balloon mitral valvuloplasty, 4. Large left atrium (LA) and 5. Evidence of clot or spontaneous echo-contrast in LA. The aim was to study the usefulness of TEE as compared to TTE in the detection of thrombus in LA. LA thrombus was imaged in 34/120 TEE studies as compared to 21/120 TTE studies. In 12/13 patients in whom TTE failed, the clot was present in the left atrial appendage (LAA). In the remaining one patient, poor echo window for TTE was responsible. In 2/6 patients with embolic episode, neither TTE nor TEE could document the presence of clot in LA. The procedure of TEE was well tolerated and there were no complications. We conclude that TEE is a safe and valuable adjunct to TTE with better diagnostic ability for the detection of LA thrombus and should be performed in all patients with MS in whom a clot in LA is suspected or needs to be excluded.

Distribution of cholesterol in HDL and its subfractions in patients with coronary atherosclerotic heart disease.

The distribution of HDL-C and its subclasses HDL3-C and HDL2-C and other serum lipids was studied in patients with coronary atherosclerotic heart disease grouped as young males (group 1) and older males (group 2) along with age matched controls. All the patients had significantly higher levels of serum cholesterol, triglycerides, LDL-C and VLDL-C and lower levels of HDL-C. The analysis of HDL - subclasses clearly demonstrated that the low levels of HDL-C was due to the significant decrease of cholesterol in both HDL3 (group 1: 32%; group 2: 30%) and HDL2 subclasses (group 1: 55%; group 2: 48%) compared to the respective control values. Further it has also been observed that this low level of HDL-C is a characteristic feature of patients irrespective of whether the levels of serum cholesterol and triglycerides are high or normal. Although both the HDL subclasses were decreased, the percentage of reduction of cholesterol was greater in the HDL2 than in HDL3 subclass. In addition, the levels of cholesterol either in HDL or any of its subclasses, HDL3 and HDL2 did not show any change in relation to the extent of coronary disease which was assessed by coronary angiography. This study confirms the inverse relation of HDL-C with coronary atherosclerosis and also indicates that, of all the lipid parameters examined, only HDL-C, particularly its subclass HDL2-C, shows independent inverse relation to the incidence of coronary atherosclerotic artery disease in men.