1.Cysticercosis Breast - A Rare Entity
Paras KP ; Nikhil M ; Ashwani K ; Anshul S ; Reetinder C ; Pankaj G ; Ashish K
Journal of Surgical Academia 2013;3(1):19-21
It is unusual for cysticercosis to occur in the substance of the breast. Diagnosis is usually made incidentally.
Only few cases are described in the literature. We here report a case of cysticercosis perched on fibroadenoma
of breast found on surgical excision in a 16-year-old unmarried female patient. The patient had no discernible
evidence of cysticercosis in the other organs. Surgical excision was performed and histological examination
demonstrated the presence of cysticercus cellulosae larvae. Characteristic features of this uncommon location
are discussed based on a review of the literature. Thus the possibility of cysticercosis of the breast should be
kept in mind while considering the differential diagnosis for a breast lump.
2.Jejunal Leiomyoma Presenting as Intussuception
Paras KP ; Pankaj KG ; Ashwani K ; Parul KG ; Ashish K ; Nikhil M
Journal of Surgical Academia 2013;3(1):32-34
Tumors of the small intestine are rare. Even though the small bowel accounts for 80% of the length and 90% of the
mucosal surface of the gastrointestinal tract, only 3% to 6% of gastrointestinal tumors and 1% of gastrointestinal
malignancies arise from the small bowel. Leiomyoma, adenoma, lipoma, haemangioma, fibroma and hamartoma of
the small intestine are considered to be benign neoplasm. Most small bowel tumors are incidental findings at
operation or autopsy. Here we present a case of benign tumour of the small intestine, histologically diagnosed as
leiomyoma, presented in Surgery Emergency Ward with intestinal obstruction, treated conservatively with no
improvement and hence subjected to emergency exploratory laparotomy which revealed intusussception and leading
cause of which was a benign leiomyoma. The literature is revised emphasizing issues of pathophysiology, specific
characteristics and the treatment of this tumour.
3.Malunion in displaced intracapsular fracture of femoral neck: A rare case.
Nikhil VERMA ; M P SINGH ; Rehan Ul HAQ ; Aditya N AGGARWAL ; Anuj JAIN
Chinese Journal of Traumatology 2015;18(5):307-310
Intracapsular fracture of femoral neck is treated by anatomical reduction (preferably closed) and cannulated cancellous lag screw fixation. Malunion of these fractures have been described in the coronal plane (coxa valga or coxa vara). We reported a case of young adult patient with displaced intracapsular fracture of femoral neck that had malunited in sagittal plane with callus formation with excellent functional outcome. The radiographs revealed intracapsular fracture of femoral neck right side (Garden type 4 and Pauwel type 3). The patient was operated and closed reduction and internal fixation with three cannulated cancellous screws was performed. The postoperative radiograph revealed a loss of reduction in the lateral view. Due to this technical error, the patient was counselled for revision fixation for which he refused. At 9 months we observed union of the fracture in the displaced position by callus formation. Harris hip score at 2 years was 96 that indicate excellent functional outcome and the radiographs did not reveal any evidence of avascular necrosis of femoral head. We advised revision surgery to our patient as he had increased chances of implant failure and nonunion. However he refused the revision surgery and was continued with the suboptimal reduction. However, the fracture united and that too with callus formation, which is not a described phenomenon in neck of femur fracture.
Adult
;
Bone Screws
;
Femoral Neck Fractures
;
diagnostic imaging
;
physiopathology
;
surgery
;
Fracture Fixation, Internal
;
Humans
;
Male
4. Hypoglycemic and hypocholesterolemic activities of the aqueous preparation of Kalanchoe Pinnata leaves in streptozotocin-induced diabetic rats
Nikhil MENON ; Jean SPARKS ; Felix OMORUYI
Asian Pacific Journal of Tropical Biomedicine 2015;5(1):3-9
Objective: To evaluate the hypoglycemic and hypocholesterolemic activities of the aqueous preparation of Kalanchoe pinnata (K. pinnata) leaves in streptozotocin-induced diabetic rats. Methods: Diabetes mellitus was induced in rats by a single administration of streptozotocin (60 mg/Kg). Diabetic rats were then treated with aqueous K. pinnata for 30 d. Serum glucose, proteins, lipid composition, liver and kidney function indices, inflammatory markers, and key enzymes of hepatic carbohydrate and lipid metabolism were determined. Results: The untreated and treated diabetic groups lost weight and consumed less food compared to the normal group. We noted 37.9% decrease in fasting blood glucose in the treated diabetic group compared to 13.2% and 17.0% increases in normal and untreated diabetic groups respectively. Serum cholesterol and triglyceride levels were significantly (P<0.05) reduced in the treated diabetic group compared to the untreated diabetic group. Blood urea nitrogen was significantly (P<0.05) elevated in the untreated and treated diabetic groups compared to the normal group. Serum alkaline phosphatase and hepatic pyruvate kinase activities were significantly (P<0.05) elevated in the treated diabetic group. Serum albumin level was significantly (P<0.05) reduced in the untreated diabetic group. Serum IL-6 was significantly (P<0.05) depressed in the treated diabetic group. Conclusions: The observed decrease in body weight, blood glucose and cholesterol level suggests that the aqueous K. pinnata preparation consumption may be beneficial in the management of diabetes mellitus. The observed adverse effect on alkaline phosphatase activity may be due to the combined effect of streptozotocin-induced diabetes and K. pinnata preparation administration.
5.Radiology Consultation in the Era of Precision Oncology: A Review of Consultation Models and Services in the Tertiary Setting.
Pamela J DIPIRO ; Katherine M KRAJEWSKI ; Angela A GIARDINO ; Marta BRASCHI-AMIRFARZAN ; Nikhil H RAMAIYA
Korean Journal of Radiology 2017;18(1):18-27
The purpose of the article is to describe the various radiology consultation models in the Era of Precision Medicine. Since the inception of our specialty, radiologists have served as consultants to physicians of various disciplines. A variety of radiology consultation services have been described in the literature, including clinical decision support, patient-centric, subspecialty interpretation, and/or some combination of these. In oncology care in particular, case complexity often merits open dialogue with clinical providers. To explore the utility and impact of radiology consultation services in the academic setting, this article will further describe existing consultation models and the circumstances that precipitated their development. The hybrid model successful at our tertiary cancer center is discussed. In addition, the contributions of a consultant radiologist in breast cancer care are reviewed as the archetype of radiology consultation services provided to oncology practitioners.
Breast Neoplasms
;
Consultants
;
Decision Support Systems, Clinical
;
Humans
;
Precision Medicine
6.Fluid Retention Associated with Imatinib Treatment in Patients with Gastrointestinal Stromal Tumor: Quantitative Radiologic Assessment and Implications for Management.
Kyung Won KIM ; Atul B SHINAGARE ; Katherine M KRAJEWSKI ; Junhee PYO ; Sree Harsha TIRUMANI ; Jyothi P JAGANNATHAN ; Nikhil H RAMAIYA
Korean Journal of Radiology 2015;16(2):304-313
OBJECTIVE: We aimed to describe radiologic signs and time-course of imatinib-associated fluid retention (FR) in patients with gastrointestinal stromal tumor (GIST), and its implications for management. MATERIALS AND METHODS: In this Institutional Review Board-approved, retrospective study of 403 patients with GIST treated with imatinib, 15 patients with imaging findings of FR were identified by screening radiology reports, followed by manual confirmation. Subcutaneous edema, ascites, pleural effusion, and pericardial effusion were graded on a four-point scale on CT scans; total score was the sum of these four scores. RESULTS: The most common radiologic sign of FR was subcutaneous edema (15/15, 100%), followed by ascites (12/15, 80%), pleural effusion (11/15, 73%), and pericardial effusion (6/15, 40%) at the time of maximum FR. Two distinct types of FR were observed: 1) acute/progressive FR, characterized by acute aggravation of FR and rapid improvement after management, 2) intermittent/steady FR, characterized by occasional or persistent mild FR. Acute/progressive FR always occurred early after drug initiation/dose escalation (median 1.9 month, range 0.3-4.0 months), while intermittent/steady FR occurred at any time. Compared to intermittent/steady FR, acute/progressive FR was severe (median score, 5 vs. 2.5, p = 0.002), and often required drug-cessation/dose-reduction. CONCLUSION: Two distinct types (acute/progressive and intermittent/steady FR) of imatinib-associated FR are observed and each type requires different management.
Adult
;
Aged
;
Aged, 80 and over
;
Antineoplastic Agents/*adverse effects/therapeutic use
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Ascites/pathology/radiography
;
Benzamides/*adverse effects/therapeutic use
;
Echocardiography/methods
;
Edema/pathology/radiography
;
Female
;
Gastrointestinal Stromal Tumors/drug therapy/pathology/*radiography
;
Gastrointestinal Tract/pathology/*radiography
;
Heart Failure/radiography
;
Humans
;
Male
;
Middle Aged
;
Molecular Targeted Therapy/*adverse effects
;
Pericardial Effusion/pathology/radiography
;
Peritoneal Neoplasms/diagnosis/radiography/secondary
;
Piperazines/*adverse effects/therapeutic use
;
Pleural Effusion/pathology/radiography
;
Pyrimidines/*adverse effects/therapeutic use
;
Radiology
;
Retrospective Studies
;
Tomography, X-Ray Computed
7.Outcome of bone marrow instillation at fracture site in intracapsular fracture of femoral neck treated by head preserving surgery.
Nikhil VERMA ; M P SINGH ; Rehan UL-HAQ ; Rajesh K RAJNISH ; Rahul ANSHUMAN
Chinese Journal of Traumatology 2017;20(4):222-225
PURPOSEThe aim of present study is to evaluate the outcome of bone marrow instillation at the fracture site in fracture of intracapsular neck femur treated by head preserving surgery.
METHODSThis study included 32 patients of age group 18-50 years with closed fracture of intracapsular neck femur. Patients were randomized into two groups as per the plan generated via www.randomization.com. The two groups were Group A (control), in which the fracture of intracapsular neck femur was treated by closed reduction and cannulated cancellous screw fixation, and Group B (intervention), in which additional percutaneous autologous bone marrow aspirate instillation at fracture site was done along with cannulated cancellous screw fixation. Postoperatively the union at fracture site and avascular necrosis of the femoral head were assessed on serial plain radiographs at final follow-up. Functional outcome was evaluated by Harris hip score.
RESULTSThe average follow-up was 19.6 months. Twelve patients in each group had union and 4 patients had signs of nonunion. One patient from each group had avascular necrosis of the femoral head. The average Harris hip score at final follow-up in Group A was 80.50 and in Group B was 75.73, which was found to be not significant.
CONCLUSIONThere is no significant role of adding on bone marrow aspirate instillation at the fracture site in cases of fresh fracture of intracapsular neck femur treated by head preserving surgery in terms of accelerating the bone healing and reducing the incidence of femoral head necrosis.
8.Small interfering RNA for cancer treatment: overcoming hurdles in delivery.
Nitin Bharat CHARBE ; Nikhil D AMNERKAR ; B RAMESH ; Murtaza M TAMBUWALA ; Hamid A BAKSHI ; Alaa A A ALJABALI ; Saurabh C KHADSE ; Rajendran SATHEESHKUMAR ; Saurabh SATIJA ; Meenu METHA ; Dinesh Kumar CHELLAPPAN ; Garima SHRIVASTAVA ; Gaurav GUPTA ; Poonam NEGI ; Kamal DUA ; Flavia C ZACCONI
Acta Pharmaceutica Sinica B 2020;10(11):2075-2109
In many ways, cancer cells are different from healthy cells. A lot of tactical nano-based drug delivery systems are based on the difference between cancer and healthy cells. Currently, nanotechnology-based delivery systems are the most promising tool to deliver DNA-based products to cancer cells. This review aims to highlight the latest development in the lipids and polymeric nanocarrier for siRNA delivery to the cancer cells. It also provides the necessary information about siRNA development and its mechanism of action. Overall, this review gives us a clear picture of lipid and polymer-based drug delivery systems, which in the future could form the base to translate the basic siRNA biology into siRNA-based cancer therapies.