No abstract

F, Mielants H et al. Randomized double-blind comparison of chimeric monoclonal antibody to tumor necrosis factor alpha (infliximab) versus placebo in active spondyloarthropathy.

Ovarian cancer (OC) is a relatively fatal female reproductive malignancy. Since the underlying causes are uncertain, it brings us to believe that both genetic and external factors contribute toward development of this lethal disorder. Exposure to endocrine-disrupting chemicals (EDCs) in the form of occupational usage of pesticides, fungicides, herbicides, plasticizers, cosmetics, and so on is potentially carcinogenic and their ability to cause epigenetic modifications has led us to hypothesize that they may play a catalytic role in OC progression. In response to synthetic chemicals, animal models have demonstrated disturbances in the development of ovaries and steroid hormonal levels but in humans, more research is required. The present review is an attempt to address the impact of EDCs on the hormonal system and gene methylation levels that may lead to malfunctioning of the ovaries which may consequently develop in the form of cancer. It can be concluded that endocrine disruptors do have a potential carcinogenicity and their high proportions in human body may cause epigenetic modifications, prompting ovarian surface epithelium to grow in an abnormal manner.

EditordAnaesthetic-induced hepatic dysfunction is a complex diagnostic problem. Because of the use of multiple drugs that can cause liver dysfunction, it is often difficult to pinpoint the culprit. Diagnosis of inhalation anaesthetic-related hepatic injury is usually made after other causes have been excluded. Unlike other drugs of this class, sevoflurane has the least hepatotoxic potential as it is not metabolised to reactive intermediates that lead to the formation of hepatotoxic proteins. 1 Using a case of acute hepatitis after general anaesthesia as an example, we review the mechanisms of liver injury and suggest measures to avoid recurrence. We obtained written consent from the patient for publication and have reported this adverse event to our hospital pharmacy and the US Food and Drug Administration.A 58-yr-old male with a BMI of 23.5 kg m À2 was undergoing L5-S1 laminectomy under general anaesthesia. His anaesthetic history was significant for acute hepatitis after two previous spine surgeries. In both cases, his postoperative course was marked by elevated liver enzymes accompanied by nausea and anorexia. His medical history was significant for hypertension, hyperlipidaemia, exercise-induced asthma, and Factor V Leiden. His medications included enalapril, atorvastatin, enoxaparin, warfarin, pregabalin, ibuprofen, tramadol, and paracetamol. He had no history of jaundice, blood transfusions, tattoo, high risk sexual activity, injected drug use, or alcohol use.He had previously received propofol, fentanyl, rocuronium, and sevoflurane for anaesthesia. He had been diagnosed as being allergic to propofol which had been incriminated as the offending agent during his previous admissions. Hence, we planned to use alternate anaesthetics such as etomidate for induction along with opioids and a neuromuscular blocking agent, with sevoflurane for maintenance.His preoperative evaluation was unremarkable with all investigations, including liver enzymes, within normal limits. Preoperative vital signs were normal. On the day of surgery,

Background: The diminishing hormonal concentrations in women after menopause may trap them into a number of reproductive health deficits. Their lifestyle, occupation, dietary constituents, etc., affect the overall health. Unfortunately, women belonging to rural areas lack basic amenities and cultural aspects give them a backseat to pay heed to personal health. Therefore, it is important to take into consideration the demographic profile of rural women. Objective: The objective of the study is to evaluate postmenopausal women of rural Punjab for sociodemographic, reproductive parameters and health issues. Results: This study analyzed 425 women showing a high rate of illiteracy (74.6%), agricultural occupancy (85.2%), and consumption of vegetarian food (94.4%). The mean age at menarche and menopause was observed as 14.04 ± 1.12 and 47.97 ± 3.4 years, respectively. The most frequent complaints were fatigue (70.4%), backache (69.4), breathing problems (52.2%), and abdominal discomfort (43.1%). Conclusion: Later age at menopause in women was found concurrent with involvement in agriculture and exposure to pesticides. Delayed menopause may indicate a risk of reproductive cancers while protection in cardiovascular diseases. Therefore, age at menopause and dependent sociodemographic parameters should be considered important tools in determining the reproductive health of aging women. Large-scale studies dealing with this health aspect are warranted at village level.

<h4>ABSTRACT</h4> <p>A 13-year-old boy had right periocular pain, upgaze vertical diplopia, and lid swelling. Right extorsion and hypodense cystic swelling in the right superior oblique involving the muscle and tendon behind the trochlea existed. Oral treatment was prescribed. MRI revealed a collapsed cyst. Ocular motility improved, but levoelevation diplopia persisted.</p> <p><cite>J Pediatr Ophthalmol Strabismus</cite> 2006;43:185-187.</p> <h4>AUTHORS</h4> <p>The authors are from the Strabismus Service, Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi-110002, India.</p> <p>Originally submitted January 30, 2005.</p> <p>Accepted for publication March 5, 2005.</p> <p>Address reprint requests to Dr. Amit Bhatia, C-140/IV, Ground Floor, Dayanand Colony, Lajpat Nagar IV, New Delhi-110024, India.</p>

Eventration of diaphragm is usually asymptomatic, but can present with symptoms ranging from mild dyspnea to a life-threatening emergency. It can pose a management dilemma when diagnosed incidentally especially during the pregnancy. We report a case of eventration of diaphragm diagnosed during pregnancy and managed conservatively with a favorable feto-maternal outcome.

The major concern that has confronted surgeons during the COVID-19 pandemic is the risk of infection during surgery. So far, no studies have found SARS-CoV-2 in surgical smoke, and if it was found, whether it was infectious or not is unknown. To date, no evidence shows that respiratory viruses can be transmitted through a surgical plume or an aerosolized gas. There are various advantages of laparoscopy over laparotomy that must be kept in mind in the COVID-19 era, such as early recovery and shorter hospital stay, which can greatly help to conserve valuable hospital resources, and reduced risk of spillage of blood and body fluids, which can help to reduce transmission risk; most importantly, the distances between surgeons and between surgeons and patients are greater. Certain precautionary measures can be taken to reduce SARS-CoV-2 transmission during laparoscopy. Whenever possible, it should be the surgical option of choice.