Biliary adenofibroma: a precursor lesion of intrahepatic cholangiocarcinoma

ABSTRACT Biliary adenofibroma (BAF) is an uncommon liver tumor with a high propensity for malignant transformation. The histomorphology of BAF with malignant transformation can show a spectrum of changes ranging from benign, dysplastic to frank malignancy. Thus, the diagnosis of BAF imposes the pursuit of dysplasia/ malignancy focus. We presented a case of intrahepatic cholangiocarcinoma arising from BAF in a 49-year-old woman with detailed histomorphology. We also performed a PubMed database search and tabulated all previously reported cases of BAF with dysplasia/ malignant transformation. A statistic comparison of age, sex ratio, size of the tumor, and survival following complete resection between BAFs with and without dysplasia/ malignancy from the retrieved data is presented. Our analysis did not highlight any statistically significant difference between BAFs with and without dysplasia/ malignancy in age, sex ratio, tumor size, and survival following complete surgical resection. Our study highlights the histopathology and immunohistochemistry of a case of BAF with malignant transformation and highlights the importance of this diagnosis in management. Further longitudinal studies on a larger cohort of patients are required to validate our findings.

Alcoholic foamy degeneration: an unusual presentation of the alcoholic liver disease diagnosed on autopsy

ABSTRACT Alcoholic foamy degeneration (AFD) is an uncommon presentation of alcoholic liver disease (ALD) with characteristic histologic findings of foamy-looking hepatocytes due to the presence of abundant microvesicles of fat within the cytoplasm predominantly in perivenular and midzonal regions without inflammation and fibrosis. It is underdiagnosed as the patients quickly recover after alcoholic abstinence and are rarely caught on biopsies. AFD has better prognosis than alcoholic hepatitis, and the injury mechanism is different, warranting a different diagnosis. We present an uncommon case of AFD incidentally diagnosed during autopsy in a chronic alcoholic and diabetic man.

Lithium Toxicity Associated with Pancytopenia And Megaloblastic Anaemia.

A 29-year-old male was treated for Bipolar Affective Disorder since 5 months with Lithium 400 mg per day which was gradually up titrated to 800 mg in 10 days of start of treatment in view of minimal improvement in symptoms. After 2 months of treatment patient started experiencing weakness and fatiguability. During third month of treatment patent had complaints of 3 episodes of vomiting associated with nausea, mild abdominal pain, diarrhea, dyspnea on exertion, restlessness, tremors, dry mouth and decreased sleep. Patient was brought to emergency department and all baseline investigations were done which were suggestive of Pancytopenia. Hematology reference was done, and lithium toxicity was considered as contributing factor for above symptoms and results. Short-term lithium administration may be life-threatening and should thus be prescribed cautiously in hematological disorders as in other conditions

Clinical Evaluation Of Araghvadhadi Virechana Yoga In The Management Of Hypothyroidism

Thyroid gland is the most important gland of the endocrine system. Thyroid hormones manage the metabolic activity of the body. When the secretion of these hormones gets hampered, the thyroid gland fails to complete the metabolic need of the body. This condition is called as hypothyroidism. This problem is a great challenge for both developing as well as developed countries. It is seen 7 to 8 times more common in females than males. The only treatment available is levo-thyroxine tablets which patients have to take lifelong. Due to high prevalence of the disease in the society, the present study was taken to evaluate the efficacy of the management by Ayurvedic principles. In Ayurvedic literature there is no direct reference of this disease. It may be considered due to the disfunctioning of Jatharagni which may leads to the manifestation of this disease. According to the symptoms of this disease, dominance of Dosha may be understand as Pittaand Kapha. Virechanais the best treatment for the Pitta Dusthi and also an effective treatment for the Kapha Dosha. Hence, in present study, total 20 patients of hypothyroidism with TSH more than 5.0 mIU/ml irrespective of the level of serum T3 and T4 were selected and treated with Virechana karma with Araghvadhadi yoga. Effect of Virechana karma was seen extremely significant on symptoms like fatigue, dry and coarse skin, unexplained weight gain, muscle ache, puffiness of face and breathlessness. After the treatment, the average TSH value reduced from 153.03 to 138.41. This is observed that the TSH level was reduced up to 9.88%.

The Scope Of Ayurvedic Medicine And Therapy In The Managment Of Infertility

Infertility is described as an inability to conceive despite unprotective sex for duration of one year or more. Male, female or both can be a victim for this disorder. There may be many biological causes of infertility including some can be treated with medical or surgical intervention. Ayurveda consider this problem as a cause of deterioration of quality of four factors i.e., time of ovulation, female health in context of reproductive system, quality of sperm and ovum and female抯 proper nutrition. There are different treatment methods and medicines used according to the deficit in male, female or in both. Vajikaran drugs like Ashwagandha, Madhuyasthi, Vidarikanda, Gokshura etc., are used in male fertility problems and Satavari, Punarnava, Dasmoola, Aloevera etc., used in female infertility problems. The purificatory procedures like Vamana, Virechana, Basti etc., are also found very effective to improve the quality and strength of required reproductive factors in both sexes. The effect of Uttar basti is also evidenced in different researches to treat female infertility.