Pre-emptive Designing of Immediate Surgical Obturator.

The significance of fabricating and delivering an immediate surgical obturator is well known. Nevertheless, its design has not been given much consideration owing to a short duration of usage. The utilization of a surgical obturator has a long-term effect on the patient's tissues and, if not fabricated using an appropriate technique, can result in deleterious biological as well as psychological effects on the patient. This article sheds light on its importance, suggesting a modification in its design which attempts to either eradicate or diminish the deleterious effects. This in turn could bring about a more aesthetic outcome, improving the overall quality of life of the patient in the long run.

Analysis of Malignant Thyroid Neoplasms with a Striking Rise of Papillary Microcarcinoma in an Endemic Goiter Region.

According to National Cancer Registry Program, Thiruvananthapuram district of Kerala, has the highest relative frequency of thyroid carcinomas; nevertheless, limited data exist regarding its socio-demographic and clinico-pathological characteristics. The aims of the study were to assess the: (1) demographic characteristics, (2) histopathological features and the relative frequency of various thyroid carcinoma cases and papillary thyroid carcinoma (PTC) subtypes, (3) rising trend of papillary microcarcinomas, and (4) associated lesions. A retrospective study wherein 170 cases of thyroid malignancies reported in our single institution over a period of 8 years period was reviewed. PTC accounted for 97% cases, followed by medullary (n = 4; 2.4%) and follicular carcinoma (n = 1; 0.6%). There was female preponderance (p = 0.0379) with a lower median age in females (p = 0.0275). Among the PTCs, conventional type constituted 53.4% cases (n = 87), followed by microcarcinomas (n = 34; 20.9%), follicular variant (n = 28; 17.2%), and others 14 cases (8.5%). Thirty-three cases (19.4%) showed multifocality, 5 cases (2.9%) extra-thyroid extension, and 19 cases (11.2%) lymph node metastasis. Two cases developed recurrences and three cases, metastasis. The associated lesions were significantly higher in females (p = 0.0059); most common being multinodular goiter (MNG; n = 67; 41.1%), followed by Hashimoto thyroiditis (n = 44; 27%) and lymphocytic thyroiditis (n = 28; 17.2%); MNG being associated with follicular (p = 0.0129), and Hashimoto thyroiditis with conventional variant (p = 0.0475). The frequency of microcarcinomas significantly increased in the past 4 years (p = 0.0291) and was associated with MNG (p = 0.0055), Hurthle cell nodule (p = 0.0315) and absent lymph node metastasis (p = 0.0147). The primary treatment modality was total thyroidectomy. Papillary microcarcinoma cases increased significantly in the past 4 years and were significantly associated with MNG and Hurthle cell nodule. It is challenging to distinguish the various PTC subtypes as recognition of these histological variants warrants better patient management.

Molecular characterization, recombinant expression and bioactivity profile of an antimicrobial peptide, Ss-arasin from the Indian mud crab, Scylla serrata.

Antimicrobial peptides (AMP) are potential alternatives to conventional antibiotics with the prospect to treat infections caused by multidrug resistant bacteria. This is the report of the first arasin sequence from the mud crab, Scylla serrata, designated as Ss-arasin. The complete cDNA sequences of the open reading frame (ORF) is comprised of 198 bp encoding 65 amino acid with a predicted molecular weight of 7 kDa and a predicted isoelectric point of 10.68. The sequence of the N-terminal 24 amino acid residues is indicative of a signal sequence directing the newly synthesize protein toward the secretory pathway. The 41-residue mature peptide is composed of two domains, an N-terminal Gly/Arg-rich domain and a C-terminal cysteine-rich domain. Challenging the mud crab with lipopolysaccharide (LPS) increased expression of Ss-arasin mRNA in haemocytes, reaching the highest level at 6 h, before dropping to basal levels at 24 h. Recombinant rSs-arasin showed antimicrobial activity against three bacterial species Staphylococcus aureus (40 mM), Pseudomonas aeruginosa (40 mM) and Escherichia coli (40 mM) implying significant anti-bacterial action. In addition, recombinant rSs-arasin inhibited human cervical carcinoma (HeLa) and colon carcinoma (HT-29) cell growth. These initial findings are encouraging to further study the structure-activity relationships to optimize these biological functions for future drug development.

Post-thyroidectomy suture granuloma: A diagnosis on fine needle aspiration cytology.

Suture granulomas result from the use of nonabsorbable suture and is an infrequent complication following thyroidectomy. When they occur, suture granulomas may mimic both benign and malignant diagnoses, posing a potential diagnostic challenge. Ultrasound-guided fine needle aspiration cytology is an accurate diagnostic modality for the workup of nodules within the thyroidectomy bed. We herein present 2 cases of post-thyroidectomy suture granulomas, presenting as a painless, palpable mass in the surgical bed and occurring as a late complication of thyroidectomy that were diagnosed on fine needle aspiration cytology.

A review of antihistamines used during pregnancy.

Antihistamines are one of the most common drugs that are used extensively in various dermatological and nondermatological conditions. The use of H-1-antihistamines during pregnancy has been very controversial due to possible teratogenic effects of these drugs. None of the antihistamines available today have been categorized as safe during pregnancy. Control studies are available for certain first generation drugs regarding their safety in pregnancy, but the newer agents require further studies to be declared safer in pregnancy. A few drugs are comparatively safer to use in pregnancy than others. Every drug used in pregnancy carries a risk for teratogenicity and careful risk/benefit assessment should be done before prescribing them.

Scrofuloderma--a case series from rural India.

Cutaneous tuberculosis is the rarest presentation of all the forms of tuberculosis. Scrofuloderma is a frequent manifestation of cutaneous tuberculosis in Indian scenario. Males are affected one and half times more than females. The most common affected age group showing clinical infection is within the first three decades of life. A series of cases mostly malnourished children attending a tertiary care centre in a rural area of central India is being reported. They have presented with a wide spectrum of clinical features, forcing us to establish the final diagnosis by Mantoux test, fine needle aspiration cytology and histopathological examination. The mainstay of treatment remains medical therapy but the underlying cause for severe immunosuppression needs to be ruled out and treated.

Diabetic retinopathy: a preventable scourge.

In recent years, the India has witnessed a rapidly exploding epidemic of diabetes mellitus. It would not be hyperbolic to state that diabetes mellitus is the mother of morbidity of all vital organs. Diabetic retinopathy and its complications cause considerable ocular morbidity as well. With effective management strategies visual loss due to the disease can be controlled and further dissemination of the disease could be prevented. The key to proper management of diabetic retinopathy includes prophylaxis by controlling blood sugar, periodical screening of retina for early detection, prompt referral for prevention of progression by appropriate laser photocoagulation, surgical correction of various anatomical abnormalities, low vision aids and rehabilitative measures in patients with severe visual loss. Howerver, the awareness level of visual consequences of this widely prevalent disease even amongst diabetics is lacking.

Neuroendocrine carcinoma of supraglottis - A case report.

Neuroendocrine carcinoma of the larynx is a rare entity constituting about 0.6% of all laryngeal malignancies. An interesting case of neuroendocrine carcinoma of supraglottis in a 70 year old lady is being reported.

Study of gastric carcinomas with special reference to intestinal metaplasia.

An attempt was made to classify 61 cases of gastric carcinomas according to Lauren's classification from the period January 1992-December 1993. All the gastrectomy specimens resected for carcinoma of stomach were included in the study. Of 61 cases, 57 were classifiable according to Lauren's criteria. 38 (62.3%) were of intestinal type and 19 (31.1%) were of diffuse type. 4 cases could not be classified into either group. There were significant correlation of type III intestinal metaplasia with intestinal type gastric carcinoma.