The world is suffering from the COVID-19 pandemic. Nature has thrown a new challenge towards the healthcare professionals in the form of this new virus. As if that was not enough, we found an extremely rare, interesting and challenging case of mesenteric immature teratoma in this pandemic. Teratomas take origin from totipotent cells and may give rise to neoplasms that contain, in a helter-skelter fashion, bits of bone, epithelium, muscles, fat, nerves and other tissues. They are usually smaller than 10 cm, with cystic space, which is filled with a thick sebaceous secretion containing matted hair and sometimes teeth protruding from a nodular projection, which are unbrushed and may be carious. Though the usual sites are ovaries, occasionally testes, extragonadal sites may be affected. Classically the teratoma originates in the midline position. But in the abdomen, it usually takes the position of one of the paravertebral gutters, as in the present case, perhaps due to its size and weight of the solid part of the constituent elements. Due to its rarity it deserves the attention of the world and therefore we present to u this interesting case.
INTRODUCTIONHepatic abscesses are classified as those of bacterial origin or by Entamoeba-histolytica but modern times have seen a major shift in etiology of pyogenic abscesses in the liver.1 This remains a serious condition with high morbidity and mortality, despite advances in diagnostic and therapeutic modalities. Liver abscesses commonly occur secondary to biliary or intestinal tract infections, haematogenous seeding or extension of contiguous infection, and carry a mortality rate of 20-60% even with appropriate medical-surgical management. The most common presenting clinical symptoms are abdominal pain, fever, nausea, vomiting, loss of appetite and jaundice. These symptoms are variable depending upon size of abscess, general health of the patient, associated chronic diseases and complications, poor hygiene, contaminated drinking water, malnutrition, hepatic dysfunction, low host resistance, alcohol intake, delayed or inadequate treatment are all responsible for the disease in the low socio economic group. Liver abscesses usually occur in older, more debilitated patients, often in the setting of malignancy. The incidence of pyogenic liver abscess is on the rise. The majority of large series published over the past 20 years cite biliary disorders as the most common identifiable source of the hepatic ABSTRACT Background: Liver abscesses commonly occur secondary to biliary or intestinal tract infections, haematogenous seeding or extension of contiguous infection, and carry a mortality rate of 20-60% even with appropriate medicalsurgical management. The aims of the study were to study the current prevelence of etiological factors in cases of liver abscess, to study clinical presentations in cases of liver abscess and study outcomes of the current trend in investigations and outcomes of the modes of treatment in cases of liver abscess. Methods: 50 patients with the diagnosis of liver abscess belonging to various age groups and socio-economic status are included in the study. Written consent and a pre designed proforma was taken from all the patients and to collect relevant data form the patients included in the study. Results: In our study of 50 cases of liver abscess age ranges from 16 to 65, with majority of patients being in young age group (14-34 years). The median age for our study of liver abscess is 31. In our study, there were number of males 41 (82%) greater than females 9 (18%). In our study, right hypochondrium pain 12 cases (24%) was the most common presenting symptom among all liver abscess. Conclusions: Percutaneous aspiration along with medical management yields far better results. Ultrasonography is the most important recommended tool for the initial diagnostic investigation in liver abscess cases with percutaneous aspiration and pigtailing. Hence the prognosis of liver abscess has been improved with different advanced modalities in the management of liver abscess with less or no mortality except in patients with malignant disease.
Background: Interleukin (IL) 33 is a pleiotropic cytokine involved in numerous diseases including asthma and induces a novel subtype of innate cells called nuocytes. The signalling pathway of IL-33 resembles other IL-1 cytokines, but the role of the serine-threonine kinase mammalian target of rapamycin (mTOR) in IL-33 function in vitro and in vivo is unknown. Rapamycin is a specific mTOR inhibitor that acts as an immunosuppressant. Methods: Model 1: BALB/c mice were treated with IL-33 intranasally for five consecutive days +rapamycin. Model 2: wild-type nuocytes were transferred into IL-33 receptor knockout (ST2-/-) mice and treated with IL-33 + rapamycin for five days. On day 6 bronchoalveolar lavage (BAL) and lungs were assayed for cell infiltration and cytokine levels. Ex vivo wild-type nuocytes were sorted using fluorescence activated cell sorting and treated in vitro with IL-33+rapamycin. Results: Intranasal IL-33 induces airway inflammation and nuocytes in the lung that produce type-2 cytokines (IL-5 and IL-13), which are inhibited by rapamycin. Ex vivo nuocytes treated with IL-33 produce type-2 cytokines in an mTOR-dependent manner. Adoptive transfers of wild-type nuocytes were sufficient to restore IL-33-driven airway inflammation in ST2-/mice in an mTOR-dependent manner. Conclusion: IL-33-induced airway inflammation and cytokine production is inhibited by rapamycin. Nuocytes produce type-2 cytokines in response to IL-33 in an mTOR-dependent manner. Nuocytes are sufficient to drive IL-33-induced, mTOR-dependent airway inflammation.
Renal stones is a common condition affecting human beings of both genders and all age groups worldwide. Their presentation vary from unilateral loin region pain to nausea vomiting, to burning micturation or even haematuria. Patient profile of renal stone disease differs from one geographical region to another. Therefore this prospective observational study was conducted in Dr. D.Y. Patil Medical College and Hospital, Nerul, Navi Mumbai to find out patient characteristics of this region. 100 patients were included in the study. 82% patients were females most of whom were housewives. 48% patients belonged to the age group 41-60 years. Most common presentation was left sided flank pain. CT scan and USG abdomen were equally accurate in determining the size of the renal stone. Most of the females were managed conservatively whereas most males required intervention like URS or PCNL for their treatment.
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