RESUMO
A 36-year-old female with serum anti-aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder (NMOSD) on carbamazepine (CBZ) therapy for paroxysmal tonic spasms (PTS) developed Type 1 respiratory failure. High-resolution computed tomography chest showed diffuse ground-glass opacities in both lungs predominantly in bilateral perihilar region sparing subpleural regions and predominantly upper lobes with a smooth interlobular septal thickening. A transbronchial lung biopsy was consistent with hypersensitivity pneumonitis and following withdrawal of the CBZ and treatment with steroids her respiratory symptoms resolved. After stopping CBZ, PTS recurred, which was successfully treated with lacosamide. This is the first described biopsy-proven case of CBZ-induced hypersensitivity pneumonitis in the NMOSD patient.
RESUMO
Cupressus torulosa D. Don, known as the Himalayan or Bhutan cypress, is one of the medicinal plants commonly used in the Indian System of Medicine for various ailments. The present study evaluates the chemical composition and inhibitory potential of the essential oil and three different extracts (chloroform, methanol and aqueous) of aerial parts of C. torulosa. Chemical composition of essential oil was determined by GC-MS that showed the presence of four major components viz., α-pinene (45.44%), 3-carene (38.34%), terpinolene (5.36%) and aromadendrene (6.32%). Essential oil showed significant inhibitory activity against Bacillus subtilis, Pseudomonas alcaligenes, Micrococcus luteus and Bacillus cereus in comparison to the different extracts. Essential oil also showed good antifungal activity against the three fungal pathogens viz., Alternaria alternata, Curvularia lunata and Bipolaris specifera. TLC-bioautography was used to screen the antibacterial components of the essential oil. Analysis showed the presence of four zones of inhibition on bioautography plate at Rf values 0.80, 0.70, 0.61 and 0.46. This study has demonstrated the presence of four potential antibacterial compounds in the essential oil of Cupressus torulosa.
RESUMO
Dasatinib, a second generation multi-target tyrosine kinase inhibitor (TKI) is active against many imatinib-resistant BCR-ABL mutant forms, Src, and c-Kit tyrosine kinases. While skin hypopigmentation is a well recognized adverse effect of first generation TKIs; it has rarely been reported with dasatinib. We report a rare case of diffuse cutaneous hypopigmentation and bilateral supercilliary madarosis induced by dasatinib. A 51 year-old Indian male with no co-morbidities and with history of chronic myelogenous leukaemia with complex variant of Philadelphia translocation and E 225 V mutation in P loop domain of bcr-abl transcript who was initiated on imatinib followed by dasatinib as a part of treatment. After 5 months of treatment with dasatinib, he developed supercilliary madarosis bilaterally. Cutaneous side effects may adversely affect patient’s quality of life and, therefore, require prompt attention to prevent long-term complications or suboptimal outcomes due to poor compliance.
RESUMO
Primary hepatic leiomyosarcoma are very rare tumours with less than 50 cases reported. Due to nonspecific presentations, diagnosis is often delayed until they reach a large size. The rarity of these tumours has precluded our understanding of them and therefore the standard of care has not been well defined. We report a 45-year-old lady who presented with loss of appetite, abdominal distension and bilateral lower limb swelling and hepatomegaly. CT abdomen revealed nodular hepatomegaly with a hypodense lesion on plain scans, heterogenous enhancing lesion on arterial phase and delayed washout on portal venous phase occupying segments VII and VIII and involving right hepatic vein and infiltrating into inferior vena cava (IVC). The pathology report confirmed the diagnosis of leiomyosarcoma. IHC was positive for SMA, vimentin and weakly positive for desmin stain. Due to extensive nature and involvement of IVC, patient was planned for upfront neo-adjuvant chemotherapy (NACT) (Ifosfamide, and doxorubicin with MESNA. The patient has completed 6 cycles NACT and had stable disease. The patient was then switched to oral Pazopanib and is on follow up.