Hemangioendothelioma is a rare vascular tumor with involvement of the liver, brain, long bones, and lung. Among the 6 histological subtypes, epithelioid hemangioendothelioma (EHE) is the most aggressive. Its occurrence in the mediastinum is quite rare, and very few cases have been documented. The reported cases in the literature have described difficulties in the preoperative diagnosis due to the unusual histological appearance of the tumor. Immunohistochemistry remains the mainstay for a definitive diagnosis. Due to its low incidence, there is no standard treatment for mediastinal EHE, but curative resection is the preferred treatment option where possible, with chemotherapy used as an adjuvant treatment or in cases of widespread inoperable disease. The present case study describes an aggressive EHE occurring in an 18-year-old woman in the anterior mediastinum.
Adolescent ; Brain ; Diagnosis ; Drug Therapy ; Female ; Hemangioendothelioma ; Hemangioendothelioma, Epithelioid* ; Humans ; Immunohistochemistry ; Incidence ; Liver ; Lung ; Mediastinum* ; Vascular Neoplasms

AIMThe aim of this study was to measure the level of Oncostatin M (OSM) a gp130 cytokine in the gingival crevicular fluid (GCF) and serum of chronic periodontitis patients and to find any correlation between them before and after periodontal therapy (scaling and root planing, SRP).

METHODOLOGY60 subjects (age 25-50 years) were enrolled into three groups (n=20 per group), group I (healthy), group II (gingivitis) and group III (chronic periodontitis). Group III subjects were followed for 6-8 weeks after the initial periodontal therapy (SRP) as the group IV (after periodontal therapy). Clinical parameters were assessed as gingival index (GI), probing depth (PD), clinical attachment level (CAL), and radiographic evidence of bone loss. GCF and serum levels of OSM were measured by using Enzyme Linked Immunosorbent Assay (ELISA).

RESULTSIt was found that mean OSM levels had been elevated in both the GCF and serum of chronic periodontitis subjects (726.65 +/- 283.56 and 65.59 +/- 12.37 pg mL(-1), respectively) and these levels were decreased proportionally after the periodontal therapy (95.50 +/- 38.85 and 39.98 +/- 16.69 pg mL(-1) respectively). However, OSM was detected in GCF of healthy subjects (66.15 +/- 28.10 pg mL(-1)) and gingivitis-suffering subjects (128.33 +/- 22.96 pg mL(-1)) and was found as below the detectable limit (approximately equal 0.0 pg mL(-1)) in the serum of same subjects. Significant correlation has been found between clinical parameters and GCF-serum levels of OSM.

CONCLUSIONIncreased OSM level both in the GCF and serum, and the decreased levels after initial periodontal therapy (SRP) may suggest a use as an inflammatory biomarker in the periodontal disease.

Adult ; Analysis of Variance ; Case-Control Studies ; Chronic Periodontitis ; blood ; metabolism ; therapy ; Dental Scaling ; Female ; Gingival Crevicular Fluid ; chemistry ; Gingivitis ; blood ; metabolism ; therapy ; Humans ; Male ; Middle Aged ; Oncostatin M ; analysis ; blood ; metabolism ; Periodontal Index ; Statistics, Nonparametric

Neuropathic pain is a common and very prevalent disorder affecting the citizens of both developed and developing countries. The approved and licensed drugs for neuropathic pain are reported to have associated side effects. Traditional plant treatments have been used throughout the world for the treatment of neuropathic pain. Among the many medications and other alternative medicines, several herbs are known to cure and control neuropathic pain with no side effects. The present paper discusses the plants with neuropathic pain and related beneficial effects originating from different parts of world that are of current interest.
Animals ; Humans ; Neuralgia ; drug therapy ; Phytotherapy ; Plant Extracts ; therapeutic use ; Plants, Medicinal ; chemistry

Objective: Laparoscopy has now become a state-of-the-art technique for many diagnostic and therapeutic procedures with known advantages over laparotomy. There is scarce literature from India regarding minilaparoscopy, as per our literature review. Therefore, we performed this study with a 2.9-mm laparoscope to determine its feasibility and efficacy for diagnostic purposes and level II surgeries with the aim of reducing postoperative pain and better cosmesis. Methods: This was a prospective study conducted from June 2019 to March 2020. Diagnostic modern minilaparoscopy with a 2.9-mm telescope was performed under general anesthesia by a single surgeon. Operative intervention was performed depending on the intraoperative findings. Results: The mean age was 29.3 years. The most common indication for laparoscopy was infertility (98%). Only diagnostic laparoscopy was performed in 76% of patients, while 24% underwent operative laparoscopy. The various operative procedures performed were cystectomy, salpingectomy, ovarian drilling, and adhesiolysis. The mean visual analog scale scores at 1 hour and 2 hours postoperatively and discharge were 1.57±0.59, 1.41±0.51, and 1.29±0.47, respectively. Mild pain was present in 70 (72.2%) patients at the time of discharge, and only one patient had severe pain. Five or more analgesic tablets were required in only 16.5% of patients in the postoperative period. There was no wound infection or port-site hernia at follow-up. Conclusion Modern minilaparoscopy with a 2.9-mm laparoscope is a feasible and safe option for diagnostic laparoscopy and level II gynecological procedures with minimal postoperative morbidity, such as pain and wound infection, and provides good cosmetic outcomes.

Objective: Laparoscopy has now become a state-of-the-art technique for many diagnostic and therapeutic procedures with known advantages over laparotomy. There is scarce literature from India regarding minilaparoscopy, as per our literature review. Therefore, we performed this study with a 2.9-mm laparoscope to determine its feasibility and efficacy for diagnostic purposes and level II surgeries with the aim of reducing postoperative pain and better cosmesis. Methods: This was a prospective study conducted from June 2019 to March 2020. Diagnostic modern minilaparoscopy with a 2.9-mm telescope was performed under general anesthesia by a single surgeon. Operative intervention was performed depending on the intraoperative findings. Results: The mean age was 29.3 years. The most common indication for laparoscopy was infertility (98%). Only diagnostic laparoscopy was performed in 76% of patients, while 24% underwent operative laparoscopy. The various operative procedures performed were cystectomy, salpingectomy, ovarian drilling, and adhesiolysis. The mean visual analog scale scores at 1 hour and 2 hours postoperatively and discharge were 1.57±0.59, 1.41±0.51, and 1.29±0.47, respectively. Mild pain was present in 70 (72.2%) patients at the time of discharge, and only one patient had severe pain. Five or more analgesic tablets were required in only 16.5% of patients in the postoperative period. There was no wound infection or port-site hernia at follow-up. Conclusion Modern minilaparoscopy with a 2.9-mm laparoscope is a feasible and safe option for diagnostic laparoscopy and level II gynecological procedures with minimal postoperative morbidity, such as pain and wound infection, and provides good cosmetic outcomes.

Background: This study aimed to determine whether ultrasound-guided transversus abdominis plane (TAP) block is more effective in reducing postoperative pain and analgesic consumption than local anesthetic infiltration (LAI) at the port site for elective laparoscopic gynecological surgeries. Methods: Eighty patients with the American Society of Anesthesiologists status I/II undergoing laparoscopic gynecology surgery were enrolled for this randomized control trial. After general anesthesia was administered, patients in group C received LAI at each port site, and patients in group T received bilateral ultrasound-guided TAP. Postoperative pain was assessed at time intervals of 1/2, 2, 4, 6, 8, and 24 h using the numeric pain scale (NPS). Clinical metrics such as postoperative analgesic diclofenac consumption, need for rescue fentanyl, nausea-vomiting scores, and antiemetic requirements were also recorded. Results: Seventy-four patients were included in the final analysis. Postoperatively, patients in group T had significantly lower NPS than those in group C (P < 0.05). The highest difference in the postoperative NPS was observed at 2 h (median [1Q, 3Q]; group C = 3 [2, 4]; group T = 1 [0, 2]; P < 0.001). A statistically significant difference was observed in the frequency of diclofenac (75 mg intravenous) requirement between the groups (P = 0.010). No significant difference was observed between the groups in need of rescue fentanyl or antiemetic and the nausea-vomiting scores. Conclusions In patients undergoing laparoscopic gynecological surgery, ultrasound-guided TAP block provided greater postoperative analgesic benefits in terms of lower NPS and reduced analgesic requirements than port site LAI.

Methods: Hospital records of spinal tuberculosis patients treated at a single center over a period of 5 years were retrospectively reviewed. A diagnosis of spinal tuberculosis was based on standard clinical, radiological, microbiological, and histopathological evidence. Patients were treated in accordance with the “middle-path” regimen; surgery was reserved for selective indications. Results: A total of 1,652 patients were included. Their median age was 32.4 years, with 53% being male. Axial pain (98%) was the most common presenting symptom; 19% of patients had neurological deficit. Lumbar spine (37%) was the most common site of involvement, with a paradiscal pattern (82%) of involvement predominating. Multi-level involvement was seen in 19% of patients; skip lesions were noted in 2.8%. Transpedicular biopsy was performed in 667 patients; at least one tissue test was diagnostic of tuberculosis in 65% of patients. Forty-four patients had drug resistance to rifampicin. Surgery was required in 10.5% of patients. The “middle-path” regimen was associated with high compliance and significant improvements in pain (Visual Analog Scale score) and function (36-Item Short Form Health Survey). Conclusions Our findings confirm the widespread prevalence of spinal tuberculosis and describe various epidemiological characteristics of a large sample of spinal tuberculosis patients. Adoption of the “middle-path” regimen is associated with high compliance and favorable outcomes in spinal tuberculosis.