ABSTRACT
Malignant peripheral nerve sheath tumor (MPNST) is a type of soft tissue sarcoma arising from peripheral nerves. They can be found in isolation, but about half of the cases are associated with neurofibromatosis type 1 (NF1), an autosomal dominant genetic disorder. They usually arise from the nerve plexus in extremities and trunk. MPNSTs arising from the viscera or internal organs are very rare. We hereby report a rare case of sporadic MPNST arising from pleural surface in a middle-aged male. The diagnosis of such a rare entity involved multimodal investigations with consideration of wide differential diagnosis.
Subject(s)
Neoplasms , Nerve Sheath Neoplasms/diagnostic imaging , Pleura/pathology , Antineoplastic Agents/therapeutic use , Diagnosis, Differential , Humans , Male , Middle Aged , Nerve Sheath Neoplasms/drug therapy , Nerve Sheath Neoplasms/secondary , Soft Tissue Neoplasms/diagnostic imaging , Soft Tissue Neoplasms/drug therapy , Soft Tissue Neoplasms/pathology , Tomography, X-Ray Computed , Treatment OutcomeSubject(s)
Adenocarcinoma of Lung/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Drug Resistance, Neoplasm , Lung Neoplasms/drug therapy , Oncogene Proteins, Fusion/genetics , Acrylamides/administration & dosage , Adenocarcinoma of Lung/genetics , Adenocarcinoma of Lung/pathology , Aged , Aniline Compounds/administration & dosage , Carbazoles/administration & dosage , Humans , Lung Neoplasms/genetics , Lung Neoplasms/pathology , Male , Piperidines/administration & dosage , PrognosisABSTRACT
BACKGROUND: Hyperglycemia is a common comorbidity in hospitalized patients and may add to adverse outcomes. Various associations have issued guidelines for optimal management of hyperglycemia in ill patients. This study aims to assess the adherence to current guidelines in inpatient setting and the impact of educational interventions on the improvement in adherence to guidelines as well as its effect on the level of blood sugar control and patient outcomes. MATERIALS AND METHODS: It was a quasi-experimental pretest and posttest study and was done in three phases, viz., observation of current practices, intervention in the form of educational interventions, and its effect on change in practices and patient outcomes. RESULTS: There was statistically significant 22% increase in the use of recommended insulin regimens (P = 0.028). The proportion of blood sugars within recommended range in the first 48 h, mean daily blood sugars, and the incidence of severe hyperglycemia improved in phase 3 vs phase 1 and was statistically significant. On comparing the subgroups, viz., those who followed and those who did not follow the guidelines, the results of the proportion of blood sugar in recommended range and proportions of blood sugar of more than 250 were found to be statistically significant. CONCLUSION: Dedicated educational interventions help in improving healthcare practices. According to current guidelines, rapid improvement in hyperglycemia and better glycemic control occur with adherence to protocol-based management of hyperglycemia.
