Ectopic lingual thyroid is a rare developmental anomaly. It is caused by aberrant embryogenesis during the thyroid descent to the neck. It may remain asymptomatic or present with dysphagia, hemoptysis, dyspnoea or dysphonia. Clinically, it presents as a mass lesion on the base of the tongue. The most important diagnostic tool for an ectopic lingual thyroid is the 99mTc radionuclide scan, but imaging modalities such as computed tomography scan and magnetic resonance imaging may also help to assess its location and extent and to rule out the presence of normal thyroid tissue in the thyroid bed. The management of an ectopic thyroid remains controversial. No treatment is required for asymptomatic patients in the euthyroid state. Patients with hypothyroidism should be treated with thyroid hormone substitution therapy. Malignant transformation is an indication for complete surgical resection. Ablative radioiodine therapy can be considered for older patients and those who are unfit for surgery. In complicated cases, surgical resection is recommended through the transoral, transhyoid or lateral pharyngectomy approach. We report a case of ectopic lingual thyroid in a 35-year-old man who presented with nasal twang and hemoptysis.

Syzygium cumini (S. cumini) (L.) Skeels (jambolan) is one of the widely used medicinal plants in the treatment of various diseases in particular diabetes. The present review has been primed to describe the existing data on the information on botany, phytochemical constituents, traditional uses and pharmacological actions of S. cumini (L.) Skeels (jambolan). Electronic database search was conducted with the search terms of Eugenia jambolana, S. cumini, jambolan, common plum and java plum. The plant has been viewed as an antidiabetic plant since it became commercially available several decades ago. During last four decades, numerous folk medicine and scientific reports on the antidiabetic effects of this plant have been cited in the literature. The plant is rich in compounds containing anthocyanins, glucoside, ellagic acid, isoquercetin, kaemferol and myrecetin. The seeds are claimed to contain alkaloid, jambosine, and glycoside jambolin or antimellin, which halts the diastatic conversion of starch into sugar. The vast number of literatures found in the database revealed that the extracts of different parts of jambolan showed significant pharmacological actions. We suggest that there is a need for further investigation to isolate active principles which confer the pharmacological action. Hence identification of such active compounds is useful for producing safer drugs in the treatment of various ailments including diabetes.

Despite of the potential role of service quality analysis from the beneficiaries’ perspectives in health system strengthening, its use has been limited in the developing world. More so, the analysis of socio-economic and demographic correlates of the perception differentials has been least addressed by the researchers. This study is an attempt to explore the perception of the urbanites regarding quality of health centres in Bhubaneswar, India and its socio-economic correlates. A cross-sectional study was carried out in which, data were collected from a sample of 180 respondents residing in six different types of residential localities of the city and an un-weighted hospital quality index was computed for analyzing the satisfaction level and its differentials, after carrying out the validity and reliability analyses of the index. Urbanites in this study were dissatisfied with many aspects of health care delivery in government health centres, like supply of medicines and availability of appropriate medical equipments. Although most of the respondents (78%) were quite satisfied with the private hospitals, there existed few lacunas to be bridged too. Overall satisfaction level was found to be associated with age (p=.134), migration status (p=.005), education (p=.000), residence type (p=.000), household size (p=.001) and income of the respondents (p=.000). A strong need of strengthening the government health centres was felt and so also taking measures to further improve private hospital quality in the city. There was also a need to address the disparity in health care service provision between slum and non-slum households, at an urgent basis.
Urban Health ; Urban Health Services ; India

In general, testicular artery (TA) usually arises from the antero-lateral part of the abdominal aorta below the origin of the renal arteries at second lumbar vertebrae level. Very rarely variations in the origin of the testicular arteries are observed. We here report a rare case of bilateral unusual origin and course of the testicular artery. On the right side, testicular artery aroused from the aorta about 0.5cm above the origin of the renal artery and gave off inferior suprarenal artery. In contrast, left testicular artery springs from the pre-hilar branch of the left renal artery, 2cm before reaching the hilum of kidney. On both sides, testicular arteries descended in front of the hilar structures of the kidney. Since, the origin and course of the testicular artery is important to consider during surgical and diagnostic interventions, knowledge of such variation may be helpful in avoiding diagnostic and surgical errors and adverse consequences especially during laparoscopic approaches.

Objective: To formulate diclofenac sodium as fast dissolving tablets (FDTs) using fenugreek gum as a natural superdisintegrant which also possess anti-inflammatory activity.Methods:physicochemical characterizations. The swelling index and viscosity of fenugreek gum was 221% and 293.4 mpa.s respectively. FDTs of diclofenac sodium was formulated by direct compression technique using different concentrations (1%-6%, w/w) of fenugreek gum as a natural superdisintegrant and compared with renowned synthetic superdisintegrants like sodium starch glycolate and croscarmellose sodium. The anti-inflammatory activity of a formulation was evaluated with carrageenan induced experimental rats.Results:An attempt was made to extract the fenugreek gum and evaluated it for various friability, hardness and results complied with the limits. The drug release from all the formulations ascertained first order kinetics. Among all the formulations F3 containing fenugreek gum with the concentration of 6% produced least disintegrating time 21 seconds resulting in higher drug release rate 93.74% at the end of 25 min. Hence, it was considered as optimized formulation. The present study revealed that the fenugreek gum as a natural superdisintegrant showed better disintegrating property than the most widely used synthetic superdisintegrants like sodium starch glycolate and croscarmellose sodium in the formulations of FDTs. The formulated tablets were evaluated for various physical tests like weight variation, Conclusions: The results suggested that the fenugreek gum act as a good super disintegrating agent and it showed promising additive anti-inflammatory activity with diclofenac sodium.

The study is to investigate the foot care practices among filarial lymphoedema patients, which is relevant to strengthen the second pillar of the Programme to Eliminate Lymphatic Filariasis (PELF). The patients are drawn randomly from a clinic as well as from the community. After getting verbal consent, each patient was subjected to an in-depth interview by using a structured questionnaire on how she/he dealt with lymphoedema and probed about various foot care practices. Of the six foot care measures, most of the patients are practising one or two measures only. Substantial numbers of patients are practising the washing the affected limb regularly. Though majority use normal footwear, none of the patients use specially made footwear. Other foot care practices like, massaging, elevation and exercising of affected, limb and use of bandage are practised by a few patients. The patients' education and lymphoedema grade had significant influence on number of foot care practices adopted. The present results are not surprising, but disappointing, as a few patients are practising the measures specifically aimed to ameliorate the lymphoedema condition. Though the present study area is covered by the mass drug administration under PELF, no serious attempts are made to alleviate disability and morbidity control. Appropriate care of affected limb at early stage can help in prevention or reversal of the progression of the disease, in addition to decrease in frequency of acute lymphangitis attacks. PELF is one of the functions of primary healthcare (PHC) system and hence, peripheral level health institutions of PHC system including primary health centres, health sub-centres and their health workers should take lead in encouraging the patients to modify their behaviour with foot care practices.
Pes ; Lymphedema ; Health ; Extremities ; Surveys

BACKGROUND: Inflammatory myofibroblastic tumor is a histopathologically distinctive neoplasm of children and young adults. According to World Health Organization (WHO) classification, inflammatory myofibroblastic tumor is an intermediate-grade tumor, with potential for recurrence and rare metastasis. There are no definite histopathologic, molecular, or cytogenetic features to predict malignant transformation, recurrence, or metastasis. METHODS: A 5-year retrospective study of histopathologically diagnosed inflammatory myofibroblastic tumors of various anatomic sites was conducted to correlate anaplastic lymphoma kinase-1 (ALK-1) expression with histological atypia, multicentric origin of tumor, recurrence, and metastasis. Clinical details of all the cases were noted from the clinical work station. Immunohistochemical stains for ALK-1 and other antibodies were performed. Statistical analysis was done using Fisher exact test. RESULTS: A total of 18 cases of inflammatory myofibroblastic tumors were found during the study period, of which 14 were classical. The female-male ratio was 1:1 and the mean age was 23.8 years. Histologically atypical (four cases) and multifocal tumors (three cases, multicentric in origin) were noted. Recurrence was noted in 30% of ALK-1 positive and 37.5% of ALK-1 negative cases, whereas metastasis to the lung, liver, and pelvic bone was noted in the ALK-1 positive group only. CONCLUSIONS: Overall, ALK-1 protein was expressed in 55.6% of inflammatory myofibroblastic tumors. There was no statistically significant correlation between ALK-1 expression, tumor type, recurrence and metastasis. However, ALK-1 immunohistochemistry is a useful diagnostic aid in the appropriate clinical and histomorphologic context.
Antibodies ; Child ; Classification ; Coloring Agents ; Cytogenetics ; Humans ; Immunohistochemistry ; Liver ; Lung ; Lymphoma ; Myofibroblasts* ; Neoplasm Metastasis ; Pelvic Bones ; Recurrence ; Retrospective Studies ; Tertiary Care Centers* ; Tertiary Healthcare* ; World Health Organization ; Young Adult

Osteoma is a benign bony outgrowth of membranous bones and is found mostly on skull and facial bones. In the head and neck region they are commonly seen in the frontoethmoidal regions. The lesions are usually asymptomatic and sometimes may impinge on surrounding areas and cause symptoms. Osteomas may be present in a solitary or multiple sites. The present article reports a case of multiple osteomas of head located in the craniofacial region with imaging details.

Background and objective: While Chlamydia pneumoniae infection and hyperhomocysteinemia have been shown to contribute independently to the atherosclerotic risk, recent evidence has linked the association of C. pneumoniae positivity and hyperhomocysteinemia in patients with established atherosclerosis. The aim of this study was to investigate whether such a relationship can be replicated in India, where both infections and hyperhomocysteinemia are prevalent. Methods: Patients of acute ischemic stroke enrolled consecutively and prospectively in the Nizam’s Institute Stroke Registry, Hyderabad, India (NISHI) were subjected to thorough clinical and neuroimaging evaluation. Blood was drawn in fasting state for estimation of homocysteine level and the titers of C. pneumoniae antibodies (IgG and IgA) by microimmunofluorescence method. Results: Of the 200 stroke patients, 72 (36%) were tested positive for C. pneumoniae antibodies, and 128 (64%) tested negative. The percentage of subjects with hyperhomocysteinemia, smoking, hypercholesterolemia and C-reactive protein positivity was higher in C. pneumoniae positive group compared with C. pneumoniae negative group. Multiple logistic regression analysis showed that hyperhomocysteinemia was an independent variable in the C. pneumoniae positive group (Odds ratio 4.71 95% CI 2.2-9.8). Conclusion: This study has shown that C. pneumoniae seropositivity is linked with hyperhomocysteinemia in patients with ischemic stroke in a sample of South Indian population.

Ciprofloxacin, commonly used in India as an anti-microbial for prolonged use in chronic and non-specific indications, may affect the bioavailability of the drug. The drug prescribed is commonly taken with multivitamins, calcium and milk. A simple and reliable analytical methodology obtaining a correlation with in vivo urinary excretion studies using UV and HPLC and in vitro dissolution studies (IVIVC) has shown a significant increase in elimination rate of ciprofloxacin co-administered with multivitamins, calcium and milk. Appreciable IVIVC results proved that dissolution studies could serve as an alternative to in vivo bioavailability and also support bio-waivers.