Carotid Body Tumor ; diagnosis ; Humans ; Male

Cholangiocarcinoma ; pathology ; Female ; Fluorodeoxyglucose F18 ; pharmacology ; Humans ; Positron-Emission Tomography ; methods ; Soft Tissue Neoplasms ; pathology ; Tomography, X-Ray Computed ; methods

Proliferating trichilemmal cyst is a rapidly growing large cutaneous adnexal neoplasm occurring on the head and neck region of elderly women. Malignant transformation has rarely been reported in these lesions. We describe here a 85-year-old lady who presented with a large ulcerated growth over the scalp for one year duration. Incisional biopsy revealed proliferating trichilemmal cyst with malignant transformation. She underwent wide local excision of this growth. She is alive and without evidence of disease after 14 months of follow up. Because of limited number of cases reported in literature, management of malignant proliferating trichilemmal cyst is controversial. Treatment mainly entails wide local surgical excision. Many other adjuvant modalities have been tried. This paper presents the diagnosis and management of one case of malignant proliferating trichilemmal cyst followed by review of the literature.
Cysts ; Literature ; Review [Publication Type] ; Malignant - descriptor ; Malignant Neoplasms

Objective: In an effort to etablish new candidates with improved antineoplastic activity, 4-cycloalkylidineamino 1,2-naphthoquinone semicarbazones were synthesized, characterized and evaluated for anticancer activity. Method: The desired compounds were synthesized by condensation of 4- amino1, 2-naphthoquinone with cyclic ketones and further subsequent reaction of this product with semicarbazide hydrochloride. Compounds were characterized by FT-IR, 1H NMR, 13C NMR, elemental analysis and screened for antiproliferative activity against three human cancer cell lines (HepG2, MG-63 and MCF-7) by MTT assay using doxorubicin as standard. Docking was performed by using the Glide 5.7 integrated with Maestro 9.2 (Schr?dinger, LLC, 2011) to understand the binding preference of synthesized compounds with target enzyme topoisomerase-II. Results: 4-(cyclohexylideneamino) [1, 2] naphthoquinone 2-semicarbazone was found to be most active cytotoxic agent against all cancer cell lines with IC50 values in the range of 5.58–6.31 μM. Results of molecular docking were also well correlated in vitro cytotoxicity assay. Insilico ADME studies revealed the drug likeliness of compounds. Conclusions: The synthesized compounds were found to have significant anticancer activity and able to enter in higher phases of the drug development process due to favorable pharmacokinetic properties.

Castleman disease (CD) is a rare lymphoproliferative disorder of unknown aetiology. It manifests in two distinct clinical presentations: unicentric and multicentric. Unicentric CD is rare and may present as an isolated neck mass. A 22-year-old man presented with a 6-month history of right neck swelling that occupied the posterior triangle of the right neck region. After surgical exploration, a solitary, well defined, and hyper vascular mass was excise. A histopathological examination confirmed the lesion as CD, hyaline-vascular variant. CD of the neck is a diagnosis that is usually not taken into consideration while evaluating neck masses due to its rarity and unassuming presentation. It should be keep in the differential diagnosis of neck masses as the clinical and radiological features evade a firm diagnosis. The treatment of unicentric CD is complete surgical excision, which cures the patient.

Objective: This study aimed to determine the prevalence of epilepsy in prisoners suffering from substance dependence and the relationship between onset of epilepsy and substance dependence in a prison population. Methods: The present cross-sectional study in a prison population was conducted in Central Jail (CJ), New Delhi, India over a period of 3 months. The convenience sample consisted of 900 subjects. The study group consisted of 450 prisoners taken from the deaddiction ward and the rest were placed in the control group. Physical examination and Mini Mental State Examination (MMSE) of subjects were done to make necessary exclusion. Assessment tools were applied in the order starting from MMSE, Basic Socio-demographic Performa, Present State Examination (PSE), and Addiction Severity Index (ASI). Results: The average ages of study and control subjects were 34.5 + 2.3 years (mean + standard deviation) and 35.6 + 3.6 years respectively. Prevalence of epilepsy among substance using prisoners was 1.4 times higher than in non-substance using prisoners. Alcohol, opioid, and cannabis, either alone or in various combinations, were the most commonly used substances. Subjects suffering from epilepsy were likely to have higher chances of consuming three or more substances than those without problem of epilepsy. Study subjects suffering from epilepsy compared with those without epilepsy performed worse in all parameters. This is indicative of higher severity of psychoactive substance dependence. Conclusion: Findings of high prevalence rate of epilepsy and co-morbid substance dependence highlight the need for better screening among epileptic subjects for substance abuse at entry into prison for effective treatment while in custody, and at follow-up on release. Specialist addiction services for prisoners have a considerable impact in a wellplanned intervention programme for prisoners with substance use and comorbid epilepsy. ASEAN Journal of Psychiatry, Vol. 15 (2): July – December 2014: 153-163.

Simultaneous non-traumatic perforation of the extrahepatic bile duct and the gallbladder is an uncommon occurrence that has been infrequently reported. We describe a patient with a spontaneous perforation of both the extrahepatic bile duct and the gallbladder. A contrast-enhanced computed tomography (CECT) scan of the abdomen and endoscopic retrograde cholangiopancreatography (ERCP) demonstrated a perforation of the gallbladder and a free leak from the right hepatic duct, respectively. Endoscopic biliary drainage following a sphincterotomy and biliary stent placement led to a dramatic improvement in the patient’s general condition. He was subsequently scheduled to undergo an elective cholecystectomy. Repeat ERCP performed at 4 weeks after the initial stenting showed a normal cholangiogram and a distally migrated stent, which was there after removed. However, early stent removal led to re-perforation of hepatic duct and gallbladder. A repeat endoscopic biliary drainage did not help, and the patient developed biliary peritonitis. Surgical exploration revealed a perforation at the fundus of the gallbladder, 400 ml of biliopurulent collection and a frozen Calot’s triangle. A subtotal cholecystectomy, gall stone removal, and a thorough peritoneal lavage were undertaken. The patient improved postoperatively. The second biliary stent was removed after 4 months. This case report highlights the role of endoscopic biliary drainage in the management of an extrahepatic bile duct perforation and warns against the early removal of a biliary stent.

Objectives: The aims of the study were to investigate whether Sudarshan Kriya (SK), a form of Yoga and related practices can lead to increased Global Assessment of Functioning (GAF) and increased feeling of wellness in patients with substance dependence. Method: This was a 3-month single blind parallel randomized controlled study with sample size of 111 patients which were allocated by simple randomization to two groups. Study subjects were involved in an intensive program of Sudarshan Kriya and practices (SK&P) which they practised daily for 6 weeks. The control subjects were instructed to sit in an armchair with their eyes closed and pay gentle attention to their breath. A period sample of three months consisting of all patients admitted in De-addiction (DAC) ward fulfilling study criteria was taken. Only male patients diagnosed to be suffering from Substance Dependence by ICD-10 (DCR) criteria, aged between 18-65 years were included in this study. The assessment tools were the Basic Socio-demographic Performa, Mini Mental State Examination (MMSE), Severity of Dependence Scale (SDS), Schedule for Clinical Assessment in Neuropsychiatry (SCAN) based clinical interview, Global Assessment of Functioning (GAF) and Psychological General Well Being (PGWB). These assessments were conducted before starting the intervention and six weeks thereafter. Results: In the final analysis, number of participants analyzed in the study group was 55 and in the control group was 56. Majority of subjects were unemployed, married individuals who did not have occupational skills of more than skilled labour level. After six weeks of SK&P, statistically significant improvement in study subject dimensional scores of GAF (48.43+/- 0.08 to 66.77+/-0.14), Anxiety (ANX) (9.64+/-0.52 to 15.66+/-0.38), Depressed Mood (DEP)(7.19+/-0.2 to 9.18+/-0.37), Positive Well Being (PWB)(10.28+/-0.61 to 12.92+/-0.73), General Health (GH)(7.74+/-0.18 to 9.75+/-0.22) and Total PGWB(41.46+/-0.35 to 59.28+/-0.63) were noticed. However, when compared with control subjects, improvement was statistically significant in the case of GAF (p=0.000158), Anxiety (ANX)(p=0.011), Positive Well Being (PWB)(p=0.02), General Health (GH)(p=0.02) and Total PGWB(p=0.05); but not in the case of Depressed Mood (DEP), Self Control (SC) and Vitality. Conclusion: Practicing SK&P helps in improving Global Assessment of Functioning, Psychological General Well Being, General Health (GH) and positive well being of an individual. SK&P also causes significant reduction in anxiety levels of an individual.

This systematic review aimed to assess the effect of premedication on postoperative pain after root canal treatment in vital teeth. Five electronic databases were searched for randomized clinical trials, and two independent reviewers selected eligible studies, extracted data, and assessed the quality of studies using the Cochrane Risk of Bias tool. Meta-analysis was conducted using the random-effects model, and the pooled effect estimate of the standardized mean difference (SMD) between premedication and placebo was calculated. Subgroup analysis was conducted based on the class and route of the drug. Studies with a high risk of bias were excluded from the sensitivity analysis. Ten trials satisfied the inclusion criteria, of which eight were included in the meta-analysis. Premedication was more effective in reducing postoperative pain than placebo at 6 hours (SMD = -1.00; 95% confidence interval [CI] = -1.33 to -0.66), 12 hours (SMD = -0.80; 95% CI = -1.05 to -0.56), and 24 hours (SMD = -0.72; 95% CI = -1.02 to -0.43). The results of the sensitivity analysis confirmed the findings of the primary analysis. Based on these results, it can be concluded that premedication is effective in reducing postoperative pain in teeth with irreversible pulpitis. However, additional quality studies are required for further validation.

This systematic review aimed to assess the effect of premedication on postoperative pain after root canal treatment in vital teeth. Five electronic databases were searched for randomized clinical trials, and two independent reviewers selected eligible studies, extracted data, and assessed the quality of studies using the Cochrane Risk of Bias tool. Meta-analysis was conducted using the random-effects model, and the pooled effect estimate of the standardized mean difference (SMD) between premedication and placebo was calculated. Subgroup analysis was conducted based on the class and route of the drug. Studies with a high risk of bias were excluded from the sensitivity analysis. Ten trials satisfied the inclusion criteria, of which eight were included in the meta-analysis. Premedication was more effective in reducing postoperative pain than placebo at 6 hours (SMD = -1.00; 95% confidence interval [CI] = -1.33 to -0.66), 12 hours (SMD = -0.80; 95% CI = -1.05 to -0.56), and 24 hours (SMD = -0.72; 95% CI = -1.02 to -0.43). The results of the sensitivity analysis confirmed the findings of the primary analysis. Based on these results, it can be concluded that premedication is effective in reducing postoperative pain in teeth with irreversible pulpitis. However, additional quality studies are required for further validation.