Urachal carcinoma is an uncommon neoplasm. Benign urachal tumours are extremely rare. All urachal mucinous tumours, regardless of tumour type, have the potential to behave in an aggressive clinical manner that includes the development of pseudomyxoma peritonei. We report a 58-year-old man who presented with lower abdominal pain. Ultrasound and CT imaging defined a large lobulated cystic mass superior to the urinary bladder. At laparotomy, the multiloculated cystic mass, 10 x 8 x 6 cm, could be completely separated from the bladder and was excised. It was smooth-walled and filled with thick mucinous fluid. Histology revealed a complex mucinous cystadenoma of undetermined malignant potential of the urachus. The cystic spaces were lined by mucin-secreting columnar epithelium that showed focal areas of mild atypia. The epithelium lacked architectural features of villous adenoma. There was no stromal invasion to support an invasive neoplastic process. No pseudomyxoma peritonei was present. The patient was well, with no tumour recurrence, at 6 months follow-up.

We report a case of Ewing's sarcoma of the sacroiliac joint in a 21-year-old male mimicking tubercular sacroiliitis, a rare entity not reported in literature. He presented with pain in the lower back radiating to the right lower limb along with constitutional symptoms of 3 months duration. On examination, the right sacroiliac joint was tender. The laboratory investigations showed anaemia, leukocytosis and raised erythrocyte sedimentation rate. On X-ray, features of right sacroiliitis were seen. This was further investigated with magnetic resonance imaging (MRI), which showed features consistent with tubercular sacroiliitis. Patient was then started on antitubercular treatment, but the improvement was not consistent. So, a contrast MRI was done, which indicated features of primary sarcoma. It was then further confirmed by a computed tomography-guided biopsy, which showed features consistent with Ewing's sarcoma of the sacroiliac joint.
Biopsy ; Blood Sedimentation ; Humans ; Leukocytosis ; Lower Extremity ; Magnetic Resonance Imaging ; Male ; Sacroiliac Joint* ; Sacroiliitis* ; Sarcoma ; Sarcoma, Ewing* ; Young Adult

Mosquitoes are the vectors of several life threatening diseases like dengue, malaria, Japanese encephalitis and lymphatic filariasis, which are widely present in the north-eastern states of India. Investigations on five local plants of north-east India, selected on the basis of their use by indigenous communities as fish poison, were carried out to study their mosquito larvicidal potential against Anopheles stephensi (malaria vector), Stegomyia aegypti (dengue vector) and Culex quinquefasciatus (lymphatic filariasis vector) mosquitoes. Crude Petroleum ether extracts of the roots of three plants viz. Derris elliptica, Linostoma decandrum and Croton tiglium were found to have remarkable larvicidal activity; D. elliptica extract was the most effective and with LC50 value of 0.307 μg/ml its activity was superior to propoxur, the standard synthetic larvicide. Half-life of larvicidal activity of D. elliptica and L. decandrum extracts ranged from 2-4 days.

STUDY DESIGN: We performed a multicentric, randomized, comparative clinical trial. Eligible patients were randomly assigned to receive 150 mg of Tolperisone thrice daily or 8 mg of Thiocolchicoside twice daily for 7 days. PURPOSE: To assess the efficacy and tolerability of Tolperisone in comparison with Thiocolchicoside in the treatment of acute low back pain with spasm of spinal muscles. OVERVIEW OF LITERATURE: No head on clinical trial of Tolperisone with Thiocolchicoside is available and so this study is done. METHODS: The assessment of muscle spasm was made by measuring the finger-to-floor distance (FFD), articular excursion in degrees on performing Lasegue's maneuver and modified Schober's test. Assessment of pain on movement and spontaneous pain (pain at rest) of the lumbar spine was made with the help of visual analogue scale score. RESULTS: The improvement in articular excursion on Lasegue's maneuver was significantly greater on day 3 (p = 0.017) and day 7 (p = 0.0001) with Tolperisone as compared to Thiocolchicoside. The reduction in FFD score was greater on day 7 (p = 0.0001) with Tolperisone. However there was no significant difference in improvement in Schober's test score on day 3 (p = 0.664) and day 7 (p = 0.192). The improvement in pain score at rest and on movement was significantly greater with Tolperisone (p = 0.0001). CONCLUSIONS: Tolperisone is an effective and well tolerated option for treatment of patients with skeletal muscle spasm associated with pain.
Colchicine ; Head ; Humans ; Low Back Pain ; Muscle Spasticity ; Muscle, Skeletal ; Muscles ; Spasm ; Spine ; Tolperisone

<p>OBJECTIVETo study the modulation effect of pro- and anti-inflammatory cytokines following long term use of water soluble ethanol extracts from different organs of Nyctanthes arbortristis (NAT) in mouse model of arthritis.p><p>METHODSArthritis was induced in mice by two injections of Freund's complete adjuvant on days 0 and 12 in the sub-planter surface of the right hind paw.p><p>RESULTSInjection of adjuvant resulted in a maximum primary edema of the footpad with erythema, and edema and distortion of joints of the right hind paw after 24-48 hours. Second injection of FCA led to the formation of secondary swellings persisting more than four weeks that spread onto the other hind limb but to a lesser extent. Histological analysis of the ankle on day 47 showed marked evidence of cartilage destruction in association with pannus formation and moderate bone resorption. Proinflammatory cytokine levels in the inflamed joint homogenate were elevated on days 2, 14, and 47. Oral administration of leaf and fruit extracts in arthritic mice reduced joint homogenate levels of tumor necrosis factor-alpha, interleukin-1beta, and interleukin-6 on days 2, 14, and 47 in comparison to untreated arthritic mice. Interleukin-10 level was elevated in the inflamed joint on days 2, 14, and 47 in comparisons to untreated arthritic mice.p><p>CONCLUSIONEvidence of lesser inflammation of the footpad and joint and associated histological observation support the therapeutic benefit of leaf and fruit extracts from Nyctanthes arbortristis. This study helps in understanding the mechanism of anti-inflammatory action of Nyctanthes arbortristis in the light of pro- and anti-inflammatory cytokine balance.p>
Animals ; Arthritis, Experimental ; drug therapy ; immunology ; pathology ; Cytokines ; metabolism ; Disease Models, Animal ; Female ; Mice ; Mice, Inbred BALB C ; Oleaceae ; chemistry ; Phytotherapy ; Plant Extracts ; isolation & purification ; therapeutic use

In most of the medical colleges in India, unclaimed bodies from various mortuaries reach the dissection hall; and here, the body donors club has yet to gain the desired dimensions. In spite of all the adverse circumstances, the cadaver and the dissection both have survived the most rigorous test of pedagological fitness--the test of time. Today, many of the Western countries have long donor waiting lists where cadavers are acquired as anatomical gifts or through body donor programmes. Thailand's approach to body donors offers a role model for resolving the present situation. The spirit of volunteerism reflects the drastic shift in public perception and a global change in approach is needed in the present time.
Anatomy ; education ; Cadaver ; Dissection ; Education, Medical, Undergraduate ; Humans ; India ; Tissue Donors

OBJECTIVE: A clinically relevant approach to patient care grounded in neurobiological constructs and evidence based practice which emphasizes a relevant psychopharmacology is needed to optimally train psychiatry residents. METHODS: We implemented a biological psychiatry course that now incorporates neurobiology, psychopharmacology, and evidence-based practice in conjunction with a Research Domain Criteria (RDoC) perspective. A survey launched prior to course implementation and following each class session, served as the outcome metric of residents' attitudes toward the new curriculum and followed a baseline attitudinal survey designed to evaluate the program. RESULTS: Greater than 90% of the psychiatry residents at Duke University who took the attitudinal survey agreed or strongly agreed with needing a course that helped them develop an understanding of neurobiology, psychopharmacology, and evidence-based practice concepts. Most residents also indicated a less than adequate understanding of the neurobiology and psychopharmacology of psychiatric disorders prior to sessions. CONCLUSION: Our biological psychiatry curriculum was associated with enthusiasm among residents regarding the incorporation of neurobiology, psychopharmacology, and evidence-based practice into course topics and discussions. A biological psychiatry curriculum with integrated neurobiology and psychopharmacology built on an evidence base approach is possible, well-received, and needed in training of future psychiatrists.
Biological Psychiatry* ; Curriculum* ; Evidence-Based Practice* ; Learning* ; Neurobiology* ; Patient Care ; Problem-Based Learning ; Psychiatry ; Psychopharmacology* ; Teaching

<p>INTRODUCTIONKnowledge of anatomical variations of the great vessels of the abdomen, including the coeliac trunk, is important for clinicians planning surgical intervention and radiological imaging. The present study aimed to record the prevalence of variations in the vascular pattern of branches of the coeliac trunk in cadavers.p><p>METHODSA total of 50 properly embalmed and formalin-fixed cadavers from the Indian population were selected for the study. Dissection included surgical incision, followed by mobilisation of the anatomical viscera, to observe and record the branching pattern of the coeliac trunk.p><p>RESULTSThe left gastric, common hepatic and splenic arteries were found to arise from the coeliac trunk in 86% of cadavers. In 76% of cadavers, the origin of the gastric artery was proximal to the bifurcation of the coeliac trunk into the common hepatic and splenic arteries. In one case, all three branches arose directly from the abdominal aorta, and the origin of the splenic artery was 1 cm distal to the origin of the left gastric and common hepatic arteries. In another case, the common hepatic and left gastric arteries arose from the coeliac trunk, and the origin of the splenic artery was 1.5 cm distal to the abdominal aorta.p><p>CONCLUSIONVessel ligation and anastomosis are important in surgical procedures like liver transplantation, and background knowledge of the different vascular patterns of branches of the coeliac trunk is vital. The findings of our study could help to minimise complications related to abdominal surgery, including bleeding and necrosis, and facilitate better and more accurate radiological interpretations.p>
Adult ; Aged ; Anastomosis, Surgical ; Aorta, Abdominal ; anatomy & histology ; surgery ; Cadaver ; Celiac Artery ; anatomy & histology ; surgery ; Female ; Hepatic Artery ; anatomy & histology ; surgery ; Humans ; Liver ; blood supply ; surgery ; Liver Transplantation ; methods ; Male ; Middle Aged ; Splenic Artery ; anatomy & histology ; surgery ; Vascular Surgical Procedures ; methods ; Young Adult

<p>INTRODUCTIONThe sciatic nerve is the largest nerve, with a long course in the inferior extremity. Its division into the tibial and common peroneal nerves can occur at any level from the sacral plexus to the inferior part of the popliteal space. These anatomical variations may contribute to clinical conditions such as piriformis syndrome, sciatica and coccygodynia.p><p>METHODSThis study was performed on cadavers in order to study the level of sciatic nerve division. The inferior extremities of 43 cadavers were classified into six groups depending on the level of sciatic nerve division in the gluteal region, the upper, middle and lower parts of the back of the thigh, and the popliteal fossa.p><p>RESULTSThe highest incidence of sciatic nerve division (40.7 percent) was observed in the lower part of the posterior compartment of the thigh. In 34.9 percent of the specimens, the sciatic nerve was divided into tibial and common peroneal nerves in the popliteal fossa. 16.3 percent of extremities showed sciatic nerve division proximal to its entrance in the gluteal region.p><p>CONCLUSIONIn sciatic nerve neuropathies, the extent of neurological deficits depends on the level of sciatic nerve division. Sciatic nerve division into tibial and common peroneal components at a higher level can result in the involvement of only one out of the two divisions from sciatic neuropathy. It can also result in a failure of the sciatic nerve block while performing popliteal block anaesthesia.p>
Cadaver ; Female ; Humans ; India ; Lumbosacral Plexus ; pathology ; Male ; Models, Anatomic ; Models, Neurological ; Piriformis Muscle Syndrome ; pathology ; Reproducibility of Results ; Sciatic Nerve ; anatomy & histology ; physiopathology ; Sciatica ; pathology ; Tibia ; innervation ; pathology

This is the first Indian case report of a biopsy proven temporal arteritis that presented as acute ischemic stroke. The 60 year old woman presented with an isolated pure motor flaccid fractional weakness of the left distal hand, as a rare stroke chameleon due to isolated infarction of the ‘hand motor cortex’ area. The hand motor cortex infarction masquerades as ‘pseudoperipheral palsy’.