Spindle cell sarcoma presenting as pancoast syndrome

This report describes a patient who presented with pancoast syndrome, secondary to spindle cell sarcoma of the lung

A 56-year man presented with dyspnea, engorged neck veins and bilateral upper limb pitting edema

The patient also had ptosis and miosis in the right eye. Right ulnar nerve palsy with atrophy of hand muscles was seen. His chest X-ray showed bilateral pleural effusion with an opacity involving the apex of the right lung along with mediastinal widening

Echocardiography revealed a pericardial effusion which was drained

The patient's CT scan of chest strongly suspected a malignant mass in right upper lobe with extensive mediastinal lymphadenopathy, pleural metastases and pericardial involvement. He was started on oxygen inhalation, dexamethasone, and clopidogrel. Bronchoscopic biopsy confirmed the diagnosis of spindle cell sarcoma

Meanwhile, he was advised radiotherapy. The tumour was not amenable to surgery. Spindle cell sarcoma is a rare connective tissue tumor that replicates rapidly. To the best of the authors' knowledge, it is hereby reported the first case of spindle cell sarcoma of the lung presenting as Pancoast syndrome

Association of oral lichen planus with hepatitis-C and diabetes mellitus

The aim of the study is to determine the association of oral lichen planus with hepatitis C and diabetes mellitus

A retrospective cohort study was carried out at the Department of Oral and Maxillofacial Surgery, Sardar Begum Dental College, Peshawar from January 201 1 to July 2015. A total of 34 male and female patients having oral lichen planus were selected with age range 20-60 years and mean age 39.4 +/- 15.8 years. Only clinical features were included to diagnose oral lichen planus which was made through the clinical evaluation of patient's oral cavity by a specialist team at the Department as proposed by van der Meij et al in 2003 based on the WHO definition of oral lichen planus. The data were analyzed through SPSS 22 with significance level ofp-value <0.05 and chi-square statistics were applied for association

The results showed that the data was statistically not significant with p-value >0.05 for all diseases having lichen planus and chi-square statistics revealed that no association exist among lichen planus, diabetes mellitus and hepatitis C. This study fails to find any association between oral lichen planus, hepatitis C and diabetes mellitus

Causes of tooth extraction amongst diabetic patients seen in a dental hospital in Peshawar

The aim of the study was to evaluate the causes of common conditions leading to tooth extraction, male/female ratio in diabetic patients. This was a retrospective cohort study. Data were collected from previous records between January 2011 to July 2015 from the Department of Oral and Maxillofacial Surgery, Sardar Begum Dental College, Peshawar. Among 2,103 total diabetic patients presented to the department, 1,618 diabetic patients have their complete record for tooth extractions. The primary reasons for exodontia specified in the records were Caries, Periodontitis, others. Others include those patients who have extractions either due to preprosthetic purpose, trauma or fracture or any other reason other than caries and periodontitis. The data was analysed through SPSS 22. The mean age presentation was 47.50 +/- 19.82 years and the age range 25-70 years. There were 1,618 extractions carried out in 2,103 subjects [76.94%]. The female diabetic patients predominate n=983 [60.75%] the male patients n=635 [39.25%]. Caries was the dominant cause of tooth extraction in both subjects n= 1042 [64.40%] followed by periodontitis n= 416 [25.71%] and others n=160 [9.90%]. Caries is the dominant cause of extraction in diabetic patients and female diabetic patients predominate male diabetic patients in terms of tooth extraction

Bacteria etiological agents causing lower respiratory tract infections and their resistance patterns

Lower respiratory tract infections [LTRIs] are among the most common infectious diseases with potential life-threatening complications. The study consisted of 426 patients with suspected LTRIs from mid and far western region of Nepal between September 2011 and July 2014. The specimens were collected and processed according to the standard microbiological methods at the Central Laboratory of Microbiology of Nepalgunj Medical College, Nepal. Among the isolated Gram-positive organisms, Streptococcus pneumonia [n = 30, 51.7%] was the most predominant pathogen, followed by Staphylococcus aureus [n = 28, 48.3%]. Among the isolated Gram-negative organisms, Pseudomonas aeruginosa [n = 71, 35.32%] was the most predominant pathogen, followed by Haemophilus influenzae [n = 68, 33.83%], Klebsiella pneumonia [n = 36, 17.19%], and Escherichia coli [n = 26, 12.94%]. The pattern of resistance varied regarding the bacteria species, and there were multi-resistant isolates. Also, a significant difference [P < 0.05] was observed between males and females for each type of bacterial species. Among 259 isolates, 86 [33.20%] were from children aged 1-10 years, which were statistically significant [P < 0.05] compared to the other age groups. P. aeruginosa and H. influenzae [Gram-negative] and S. pnemoniae [Gram-positive] were the most common bacterial isolates recovered from LTRIs. Age group of 1-10 years old was at a higher risk. Many isolates showed appreciable levels of antibiotic resistance due to antibiotic abuse. There is a need to increase surveillance and develop better strategies to curb the increasing prevalence of LRTI in this region of Nepal

Dyspepsia; frequency of common upper gastrointestinal endoscopic findings in elderly patients with iron deficiency anemia

The most common single cause of anemia worldwide is Iron deficiency. It results from other underlying diseases and to look for its cause is very crucial and is of far greater importance than restoring the iron stores and hemoglobin levels. To determine the frequency of common upper gastrointestinal endoscopic findings in elderly patients with iron deficiency anemia presenting with dyspepsia. Cross sectional descriptive study. Department of Medicine, Khyber Teaching hospital, Peshawar. March, 2011 to September, 2011. 116 patients, all the patients with iron deficiency anemia presenting with dyspepsia were subjected to upper gastrointestinal endoscopy to detect common findings as gastric erosions, peptic ulcer and gastric carcinoma. Data was analyzed with SPSS 10.0. On upper gastrointestinal endoscopy, normal findings were noted 30 [25.86%] patients and abnormal findings were noted in 86 [74.14%] patients including 45 [38.79%] patients with gastric erosions, 30 [25.86%] patients with peptic ulcer and 11 [9.48%] patients were found with gastric malignancy. Upper gastrointestinal lesions are common in elderly patients with iron deficiency anemia presenting with dyspepsia and must be screened by gastrointestinal endoscopy

synthetic mouthwash the final choice to treat oral malodour?

The aim of the review was to critically appraise the various pros and cons of the synthetic and herbal agents used in mouthwashes against halitosis and facilitate users to choose appropriate mouthwashes according to their need. Oral Malodour [OMO] or halitosis is a global epidemic with social and psychological impact. Use of mouthwash has been adopted worldwide to control halitosis within a past few decades. Alcohol and Chlorhexidine are common agents in synthetic mouthwashes, while Tannins and Eugenol are derived traditional herbal extracts. Each agent signifies some unique properties distinguishing them from others. Herbal ingredients are gaining the attention of the profession due to its mild side effects and competitive results. Herbal mouthwashes can be a safer choice in combating OMO, as an alternate to synthetic mouthwashes