Primary angiosarcoma of the oral cavity in a young adult

Angiosarcoma is a rare neoplasm, constituting only 2% of all the soft tissue tumors and most frequently involves the skin of the head and neck region in elderly males. They are extremely aggressive tumors with high rates of metastasis and poor outcomes. We report a unique case of angiosarcoma involving an unusual site - upper alveolus and maxilla in a young patient highlighting the diagnostic challenges in such a scenario. A 29 years old female presented with a non-healing wound of the oral cavity, which had progressed to the current maximum size of 6.4 cm within one month. Magnetic resonance imaging (MRI) scan revealed the involvement of maxilla up to the floor of the orbit and adjacent soft tissue. However, no distant metastasis was detected on Positron Emission Tomography (PET) scan. Biopsy of the lesion showed an irregular, highly pleomorphic, and mitotically active epithelioid soft tissue tumor conclusively diagnosed as angiosarcoma.

Diagnosis In Ayurveda With Special Reference To Trividha Bodhya Samgraha

Ayurveda is comprehensive in its approach which emphasizes naming a disease is not necessary rather knowledge about Nidana (Etiological Factors), Dosha, Dushya and Samprapti of disease (Pathology) are crucial. Several diseases mentioned in the Samhitas (Classical texts) does not match with clinical presentation of disease thus in order to ascertain a working diagnosis clinical history and detailed physical examination are critical to the diagnostic process. Based on the ‘Purush Purush Veekshya Nyaya’, various Siddhantas (principles) ought to be adopted to diagnose the disease, as diagnosis is always individual to each patient. Acharya Charaka has mentioned the concept of Trividha Bodhya Samgraha (Vikara Samuthana, Vikara Adhishtana and Vikara Prakruti Vishesha that deals with the principles of etiology and different stages of pathology of a disease. This concept holds basis for Ukta Gada (listed diseases) as well as for Anukta Gada (unlisted diseases). Thus it can be applied to diagnose any of the disease. If accurate diagnosis is made in proper and sequential manner it provides the best outcome by assessing the response to multimodal approach of Ayurveda through treatment modality. This present article aims to provide an insight to develop a clinical approach to Ayurveda diagnosis enunciated in Samhitas in context of Trividha Bodhya Samgraha underneath the spectrum of Anukta Vyadhi.

Correlation between Trans-Vaginal Ultrasound and Endoscopy in Infertility

Introduction: Infertility is defined as inability to conceiveafter one or more years of unprotected intercourse. Thisstudy was taken up to evaluate the correlation of transvaginal ultrasound with endoscopies both hysteroscopy andlaparoscopy in the evaluation of infertile patients.Material and methods: A prospective study was carriedout in the department of Obstetrics and Gynaecology, MMMedical College and Hospital, Kumarhatti, Solan, HP, Indiafor a period of 6 months from October 2017 to March 2018conducted on 50 subjects.Results: 50 patients were evaluated with diagnosis of primaryand secondary infertility. TVS (Transvaginal scan) showedabnormal findings correctly in 38% of cases, and 62% caseswere undiagnosed. Hysteroscopy showed alterations in 58%cases, predominantly uterine synechiae and endometrialpolyp. There were no complications during hysteroscopy.Diagnostic Laparoscopy showed, normal pelvic findings andpatent tubes in 30% cases of primary infertility and 8% casesin secondary infertility.Conclusion: Hystero-Laparoscopy is better than TVS alonefor the diagnosis of infertility pathology as its diagnosis ismore précised and we can treat them simultaneously, butstill TVS remains the best non-invasive method for study ofuterine as well as adnexal pathology in infertility.

The quality of life and coping skills of patients with human immunodeficiency virus among different occupation

Background: Nowadays, HIV and AIDS has become an important public health issue across the world. Quality of life (QOL) is an important tool to assess general wellbeing of HIV patients. Coping skills are the psychological skills to face the difficult situations like HIV or AIDS. The workplace plays an important role in determining general wellbeing and the psychological problems in HIV patients. Therefore, it is very important to assess the quality of life and coping skills of HIV patients among different occupations.Methods: A cross-sectional study consisting of conveniently selected 200 HIV patients was conducted at ART center LLRM Medical College, Meerut. The study subjects were interviewed by using questionnaire consisting of WHOQOL HIV BREF (WHO quality of life questionnaire) and Brief-COPE scale questionnaires. Descriptive statistics and ANOVA test were used for analysis of the data.Results: 36% of HIV patients were housewives and 26.5 % of HIV patients were drivers. The quality of life score was higher in HIV patients who were in unemployed (14.98) and farmers (14.49) whereas was lowest in all others category (10.73). The housewives, farmers, government jobs or service, drivers and other had maximum adaptive coping in religion and minimum adaptive coping in humour. There was no uniform pattern of maladaptive coping skills of HIV patients among different occupations.Conclusions: Quality of life score was better in HIV patients who were unemployed and farmers as compared to HIV patients who were drivers, housewives, government jobs or service. Religion was most effective adaptive coping strategy and humour was least effective adaptive coping strategy in HIV patients.

Beckwith-Wiedemann Syndrome- A Rare Case Report

Beckwith-Wiedemann syndrome is a pediatric overgrowth disorder with classical features of macroglossia,exomphalocele and gigantism. Estimated incidence rate of BWS is 1in 13,700 in population. The incidence ofBWS is equal in both the sexes. We got a rare case of Beckwith-Wiedemann syndrome in our NICU. Thediagnosis is made by clinical findings suggestive of BWS. Baby born with a macroglossia and abdominal walldefects (exomphalocele), ear anomalies, renal abnormalities seen under ultrasound and neonatal hypoglycemia.Additional supportive findings were polyhydramnios and LGA baby, cardiomegaly, hemangioma over face,enlarged placenta and characteristic facies and infraorbital creases.

Correlation of placental thickness with gestational age in antenatal women

Background: Accurate estimation of gestational age and fetal wellbeing is mandatory to ensure safe pregnancy and healthy delivery. With recent development in USG, basic scan, Doppler imaging and interventional radiology helped greatly in accurate estimation of gestational age and delivering timely care. The objectives of this study was to determine the USG placental thickness at the level of insertion of cord in antenatal women from gestational age 11 to 40 weeks. To correlate placental thickness with gestational age. To calculate composite gestational age from USG parameters; CRL, BPD, HC, AC, FL. To compare the relationship of menstrual gestational age with placental thickness and composite gestational age separatelyMethods: It is a comparative study of 2 years duration. Total 322 patients were included. Gestational age was determined from LMP. Patient’s routine obstetric USG was done and composite gestational age was calculated from fetal parameters like BPD, HC, AC and FL (CRL in 11 to 14 weeks). At the same time placental thickness was determined at the level of insertion of umbilical cord. The plane of USG image was adjusted so that the thickness measured from cord insertion is perpendicular to the margin of uterine wall.Results: The following parameters were noted: correlation of period of gestation (weeks) with composite gestational age (weeks) correlation of period of gestation (weeks) with gestational age calculated by placental thickness (weeks).Conclusions: Placental thickness can give an estimation of gestational age. The linear correlation and statistical compatibility of placental thickness makes it an alternate parameter for gestational age. Knowledge of correct gestational age helps in delivering proper antenatal care, assessing fetal wellbeing, identifying pathology at the earliest and timely decision of termination and providing safe motherhood.

A Study on Deciding the Route of Hysterectomy

Background: Hysterectomy is a common major gynaecological procedures and the choice of route for the same, whether abdominal, vaginal or laparoscopic route is controversial. Aims: To compare the outcome measures and rate of complication following vaginal, abdominal and laparoscopic hysterectomy. Methods: This prospective, randomised study was performed at a tertiary care centre from July 2012 to June 2014. A total of 180 patients undergoing hysterectomy for benign conditions were studied and 60 patients were randomly assigned for abdominal, vaginal and laparoscopic hysterectomy.  The outcome was assessed and compared between groups. Results: Outcome in majority of the parameters studied showed that vaginal hysterectomy is the most beneficial method with least complications. Conclusion: Vaginal hysterectomy was the most beneficial method as compared to other methods and was associated with least complications.

Single Layer Versus Double Layer Closure of Uterus during Caesarean Section - A Prospective Study in Index and Subsequent Pregnancy

Background: Suturing of caesarean incision leads to reduction in maternal mortality, suturing can be done in either single layer or double layer. Many studies have shown both of them to be effective, with no conclusive evidence of preference of any one of them. The objective of this study was to compare method of uterine closure by single-layer and double-layer closure keeping in mind the intraoperative and postoperative morbidity in index pregnancy and risk of uterine rupture in future pregnancy. Methods: This prospective randomized controlled study was done from March 2007 to January 2009, a total of 357 women were enrolled for lower segment caesarean section either to single layer (n=188) or double layer (n=169) closure of uterine incision. Primary outcome measures studied were operating time, intraoperative blood loss, and febrile morbidity in index pregnancy and chances of uterine rupture in subsequent pregnancy. Secondary outcome measures were cystitis, wound infection and hospital stay. Results were compared by Chi-square test. Results: Patients with single layer closure had significantly (p<0.05) less operative time and estimated blood loss as compared to double layer closure. There was also a statistically significant (p<0.05) difference in febrile morbidity and hospital stay in single layer closure of uterus. There was however no significant difference in other variables also, in subsequent pregnancy with previous caesarean section there was no difference in pregnancy outcome in both groups was not statistically significant (p-value>0.05). Operative findings in subsequent pregnancy don’t differ much. Conclusions: Single layer closure was associated with lesser operating time, intra-operative blood loss, febrile morbidity and hospital stay in index pregnancy as compared to double-layer closure.

Comparative organoleptic quality of Indian major carps collected from pond and reservoir.

An attempt was made to distinguish the possible organoleptic differences between the pond reared and wild fish species of reservoirs and correlate these with the physicochemical characteristics of water bodies. The texture was found to firmer in wild varieties of fishes than pond reared fish, with best in Catla catla followed by Labeo rohita and Cirrhinus mrigala. All the cultured fishes had lighter colour than wild fish species which were darker in appearance. Comparatively, higher dissolved oxygen and transparency levels with low temperature and alkalinity levels were found in reservoirs. Hydrobiologically, the efficient ecosystem of reservoir was responsible for stronger texture and dark colouration in wild fish species. The fishes from reservoir exhibit tendency to lead active and agile life, comparatively the fishes from ponds are docile. Reservoirs have the potential of enhanced quality fish production.

Fusion of main trunks of median and musculocutaneous nerves (an anatomic variation).

Median nerve (MN) and Musculocutaneous nerve (MCN) around their origin from brachial plexus are known to have many variations. A unilateral variation in the course of MCN in 65 years male cadaver was observed during routine dissections for medical undergraduates. In the present case, MCN was observed to be formed by its normal pattern, as the continuation of lateral cord of brachial plexus. Thereafter instead of piercing coracobrachialis, it fuses for some distance with MN and then separates out to supply all the muscles of anterior compartment of the arm. It then ends as lateral cutaneous nerve of forearm. Such a case of fusion of main trunks of MN and MCN has not been clearly reported in literature. Knowledge of this variation is important owing to its numerous clinical implications.

AgNORs Scoring in Benign Intermediate and Malignant Soft Tissue Tumor.

One of the most recent methods to determine the proliferative activity is silver stained nucleolar organizer region(AgNORs).The purpose of present study is by using mean AgNOR count per nucleus was found to be higher in benign soft tissue tumour as compared to apparently normal soft tissue and found to be statistically significant. An increase AgNOR score in benign, intermediate, malignant soft tissue tumour as compared to apparently normal soft tissue tumour. After histological confirmation, one more section was prepared which was subjected to AgNOR staining. Study was done in taking 32 benign, 05 intermediate and 23 malignant soft tissue. Benign soft tissue neoplasm which comprised 32 cases showed a range of mean AgNORs count 2.2-3.20 and intermediate group showed 3.10-4.61 and malignant group 4.90-6.70, so on comparing benign, intermediate and malignant group p value is found to be <0.0001. Hence results are statistically significant.

Synthesis and antimicrobial studies of substituted 2-phenylbenzimidazole derivatives.

The substituted 2-phenylbenzimidazole derivatives were synthesized by introducing different substituents at different positions. Six novel benzimidazole derivatives were synthesized successfully in appreciable yields and characterized physicochemically. The structures of all the synthesized derivatives were confirmed by IR and 1HNMR. Furthermore, the synthesized compounds were screened for antimicrobial activity (antibacterial activity and antifungal activity) by tube dilution method. Some of the synthesized compounds showed appreciable antifungal activity.

Synthesis and Antimicrobial studies of novel Benzimidazole derivatives.

Two series of novel benzimidazole derivatives were synthesized. The first one comprise of 2-methyl, the second one comprise of 2-phenyl substitution on benzimidazole moiety. Seven novel benzimidazole derivatives were synthesized successfully in appreciable yields and characterized physicochemically. The structures of all the synthesized derivatives were confirmed by IR and 1HNMR. Furthermore, the synthesized compounds were screened for antimicrobial activity (antibacterial activity and antifungal activity) by tube dilution method. Some of the synthesized compounds showed appreciable antifungal activity.