Approach to Cystic Lesions of the Pancreas: Review of Literature.

Pancreatic cystic lesions (PCL) have a wide range of demographical, clinical, morphological and histological characteristics. The distinction between these lesions is of paramount importance due to the risk of malignancy in specific categories of PCL. Considering the malignant potential for pancreatic cystic neoplasm (PCN) lesions, guidelines have been made to balance unnecessary treatment and manage the progression to malignancy. Various surgical procedures can be done for PCN depending on the location and size of the cyst; pancreatoduodenectomy is done for PCN located in the head of the uncinate process, whereas distal pancreatectomy is done for PCN in the body or tail. In the neck and proximal body of the pancreas, less extensive resections such as central pancreatectomy can be performed. Active surveillance of PCN is typically offered to asymptomatic PCNs of subtype intraductal papillary mucinous neoplasms (IPMN) and mucinous cystic neoplasms (MCN) without any concerning features. In recent years, numerous guidelines have been created to augment PCN diagnosis, classification and management. Despite this, the management of PCNs remains complex. Thus, discussions with multidisciplinary teams involving surgeons, gastroenterologists, pathologists, and radiologists are required to ensure optimum care for the patient.

Assessment of precipitate formation on interaction of irrigants used in different combinations: an in vitro study.

INTRODUCTION: Irrigants play an essential role in the successful debridement and disinfection of pulp space. Various combination of irrigants used during root canal treatment enhance their efficacy, but some form precipitates which affects the diffusion of intracanal medicaments and the seal of the obturated root canal. AIM: To evaluate the combination of various irrigants whether it forms the precipitate and also to quantify the amount of precipitate formed. MATERIALS AND METHODS: Five different irrigants were taken in ten test tubes each having the combination of two irrigants and observed for 2 min for precipitate formation. RESULTS: One-way-ANOVA test revealed more amounts of precipitate with 2% Chlorhexidine (CHX) 5% Tulsi followed by 2% CHX, 5% Neem and 3% Sodium hypochlorite 2% CHX. CONCLUSION: Precipitate formation is seen more with the 2% CHX-5% Neem followed by 2% CHX-5% Tulsi when compared with the control group. When these combinations of irrigants were used, intermediate flushes of saline or distilled water reduced the amount of precipitate.

Quantitative surface EMG in the diagnosis of neuromuscular disorders.

This paper describes a non-invasive quantitative method for the diagnosis of neuromuscular disorders using surface EMG (sEMG). We found sEMG to be a reliable method that can be used to differentiate neuropathic and myopathic patients from the normal subjects. The multivariate discriminant analysis of sEMG data assisted in separating myopathic from neuropathic disorders. Nevertheless sEMG is not robust enough to replace needle EMG as a stand-alone diagnostic tool. However quantitative sEMG that is described in this paper could be adopted as a simple, rapid and non-invasive technique to be used in the out patients clinic by EMG-naive clinicians as a screening method for neuromuscular disorders, before referring the patients for detailed clinical neurophysiological examinations.