Malignant peripheral nerve sheath tumor of temporoparietal region of brain mimicking as glioma: A rare case report

Malignant peripheral nerve sheath tumor (MPNST) is exceedingly rare to occur intracerebrally. The incidence of this subtype is 0.001%. Their typical origin is from peripheral nerves of the limbs, trunk, and lumbar and brachial plexuses. It carries a poor prognosis despite aggressive management due to high chances of local recurrence. We present a case of MPNST occurring intracerebrally in a 60-year-old male patient. Imaging showed a 63 × 74 × 46 mm mass lesion in the left temporoparietal region with mass effect. The patient underwent left temporoparietal craniotomy with maximum gross resection of the tumor. Histopathology was suggestive of spindle cell neoplasm. On immunohistochemistry, cells were positive for S-100 and SOX-10, which were consistent with the diagnosis of MPNST. The post-operative contrast-enhanced magnetic resonance imaging of brain showed gross residual disease. Post-operative radiotherapy was given of intensity-modulated radiation therapy followed by chemotherapy of doxorubicin and ifosfamide

A rare cause of right iliac fossa lump: contained fish bone perforation of caecum

Ingested foreign bodies usually pass uneventfully through the gastrointestinal tract but few of them can cause symptoms. They can get stuck at acute angulations or narrow part of intestine and can perforate leading to localized to generalized peritonitis, collection or abscess formation. We describe a case of 59 year old gentleman who presented with pain in right iliac fossa with fever and a hard, tender lump. Initial investigation revealed a mass in right iliac fossa adherent to anterior abdominal was in right iliac fossa region with a foreign body inside. Patient was managed with exploratory laparotomy, removal of a fish bone from cacecum and limited right hemicolectomy. Fishbone perforation of caecum is a rare entity. Careful corroboration between patient’s presentation and radiological findings with a high index of suspicion is needed for pre-operative diagnosis.

Hypoglycemia In Carbon Monoxide Poisoning: A Case Report

Carbon monoxide poisoning is a common presentation in the Emergency Department. The clinical presentation runs a spectrum, ranging from headache and dizziness to coma and death, with a mortality rate ranging from 1 to 3 %. Administration of normobaric 100% oxygen is the therapy of choice for most cases, while hyperbaric oxygen therapy is reserved for severe poisoning. Hyperglycemia is commonly seen with this poisoning but the association of hypoglycemia is not well described in human studies. Here, we present the case of hypoglycemia in carbon monoxide poisoning with good clinical outcome in a 22-year-old male.

Incidence and Risk Factors for Hypertension During Childhood Acute Lymphoblastic Leukemia Therap

Objective: To determine the incidence of hypertension among children during the inductionand re-induction phases of acute lymphoblastic leukemia (ALL) therapy and association withpossible risk factors. Methods: A retrospective analysis of 208 consecutive pediatric (age<18 y) ALL patients, treated per BFM-95 protocol between January 2009 and December2013. Data were analyzed to determine the incidence of hypertension and risk factors for itsdevelopment. Results: Incidence of hypertension requiring antihypertensive medication,was 29% (61/208) during induction and 17% (33/198) during re-induction (P=0.003). Median(range) age of patients developing hypertension was 4 y (4 mo to 8 y). Age <10 y andpresence of constipation were independently predictive of hypertension by multivariateanalysis. Conclusion: The present study reports a high incidence of hypertension amongchildren undergoing ALL induction therapy.

Breast cancer-related lymphedema in postmastectomy patients receiving adjuvant irradiation: A prospective study

AIM: Inflammation plays a lead role in the tumor microenvironment and promotes metastasis. Single-nucleotide polymorphism (SNP) in the tumor necrosis factor (TNF) gene locus may alter the expression of genes and proteins. The objective of the study is to find the distribution of genetic polymorphism in the sites of TNF-α −308G>A and TNF- β +252A>G in breast cancer and evaluate polymorphism effects on plasma levels. MATERIALS AND METHODS: The study group consisted of 109 invasive ductal primary breast cancer patients and 75 age-matched healthy female controls. Plasma cytokine concentrations were measured by the MILLIPLEX® MAP Human Cytokine/Chemokine Panel magnetic bead kits. The genotyping procedure for SNP included allele-specific polymerase chain reaction for TNFα and restriction fragment length polymorphism for TNFβ. RESULTS: Odds ratio with 95% confidence interval showed that these polymorphisms were not a causative risk factor, and both polymorphisms were consistent with Hardy–Weinberg equilibrium. Plasma TNFα and TNFβ median concentrations were significantly higher in cases when compared to controls (P < 0.01). When plasma TNFα levels were grouped under polymorphic subtypes, patients with mutant TNF- α −308A allele showed significantly higher values (P < 0.001). In addition, plasma TNFα values were significantly elevated in mutant TNF-β +252G allele (P < 0.01). CONCLUSION: This study demonstrated that there is no significant association between SNPs and breast cancer susceptibility in South Indian population. However, plasma TNFα level is significantly elevated with mutant-recessive TNF-α −308 A and TNF-β +252 G alleles of patients.

Synthesis and antibacterial activity of some 3-(5-aryl-4H-pyrazol-3-yl).

A series of 3-(5-aryl-4H-pyrazol-3-yl)anthracen-10(9H)-ones were synthesized from anthracen-10(9H)-one (1) and studied for their in vitro antibacterial activity. Anthracen- 10(9H)-one after Friedel crafts acetylation with acetyl chloride yielded 3-acetylanthracen- 10(9H)-one (2) which on further reaction with substituted aromatic aldehydes in the presence of catalytic amount of sodium hydroxide in water and ethanol furnished the corresponding 3-(3-arylacryloyl)anthracen-10(9H)-ones (3a-g) as intermediate compounds, which on further reaction with hydrazine hydrate in absolute ethanol formed the title compounds 3-(5-aryl-4H-pyrazol-3-yl)anthracen-10(9H)-ones (4a-g). These compounds were characterized by elemental analysis, IR, Mass and 1H-NMR spectral data. All the compounds were evaluated for their in vitro antibacterial activity against two gram positive strains (Bacillus subtilis and Staphylococcus aureus) and two gram negative strains (Escherichia coli and Pseudomonas aeruginosa) taking ciprofloxacin as a standard drug. Some of the compounds showed significant antibacterial activity.

Oral health knowledge, attitudes and behavior of elementary school teachers in India / Conhecimento, atitudes e comportamento de professores do ensino primário da Índia sobre saúde oral

Objective: This study assessed the oral hygiene attitudes and behavior of elementary school teachers, and determined the influence of variables likelanguage used in class and gender on oral health knowledge, attitudes and behavior. Methods: A stratified random sampling was done to collect a representative sample of teachers fromthe Udaipur district. The total sample encompassed 126 teachers who teach in Hindi, India?s official language along with English, and 104 teachers who teach in English. Of the 230 filled out questionnaires, 12 (5.2%) were rejected either because the answers were inconsistent, such as two replies to the same question, or because the answer was blank. Results: Teachers who taught in English were more likely to brush their teeth twice daily(77.6%) than those who taught in Hindi (63.3%). All teachers who taught in English used tooth paste while only 71.7% of those who taught in Hindi did. Most females (53.1%) used a soft brush to brush their teeth and were more likely (84.4%) to brush twice daily than males. The brushing frequency differed significantly between genders. All female teachers stated that regular tooth brushing prevents tooth decay. Conclusion: Most school teachers presented acceptable knowledge, attitudes and behavior. Teachers should be made aware of their responsibility as rolemodels, and school staff should be given incentives to encourage their participation.

Objetivo: Este estudo avaliou as atitudes e comportamento dos professores do ensino primário com relação à higiene oral e determinou a influência de variáveis, como o idioma usado na sala de aula e o sexo, sobre o conhecimento, atitudes e comportamento com relação à saúde oral. Métodos: Uma amostragem aleatória estratificada foi realizada para a coleta de dados de uma amostra representativa de professores do distrito de Udaipur na Índia. A amostra completa consistiu de 126 professores que ensinam em hindi, um dos idiomas oficiais da Índia junto com o inglês, e 104 professores que ensinam em inglês. Dos 230 questionários preenchidos, 12 (5,2%) foram rejeitados porque havia respostas inconsistentes, por exemplo, duas respostas para a mesma pergunta, ou respostas em branco. Resultados: Professores que ensinavam em inglês (77,6%) eram mais propensos a escovar os dentes duas vezes ao dia que professores que ensinavam em hindi (63,3%). Todos os professores que ensinavam em inglês usavam creme dental enquanto que apenas 71,7% dos que ensinavam em hindi o fazia. A maioria das mulheres (53,1%) usava uma escova macia para escovar os dentes, e as mulheres eram mais propensas (84,4%) que os homens a escovar duas vezes ao dia. A frequência de escovação entre homens e mulheres diferiu significativamente. Todas as mulheres afirmaram que escovação regular previne a cárie dentária. Conclusão: A maioria dos professores apresentou conhecimento, atitudes e comportamento aceitáveis com relação à saúde oral. Os professores devem estar cientes de sua responsabilidade como exemplo para os alunos e os funcionários da escola deveriam receber incentivos para estimular sua participação.

Radiotherapy-induced depigmentation in a patient with breast cancer.

Vitiligo is a common dermatological disorder. A middle-aged woman with preexisting vitiligo was diagnosed with breast carcinoma. After surgery and chemotherapy she received regional radiotherapy. Six months after the completion of radiotherapy she developed depigmentation in the irradiated area. This article discusses the etiology for this phenomenon and the literature in this regard.