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Characteristic clinical picture of Nocardia is dependant on early presentation. It could be mistaken for fungal keratitis. Microbiological confirmation is important. Drug of choice for Nocardia keratitis is amikacin.

BackgroundKikuchi–Fujimoto disease is so named because Kikuchi and Fujimoto were the first scientists to describe it in Japan in 1972. Although the disease has been reported from all over the world and more so from Asia, it is rare. To date only eight cases have been reported from Nepal. Cervical lymphadenopathy, fever and raised Erythrocyte Sedimentation Rate are usual presenting features of this disease. We describe a case which presented with thrombocytopenia and axillary lymphadenopathy in addition to the usual features. Out of the total eight cases that have been reported from Nepal so far, no patients had thrombocytopenia and only one patient had axillary lymphadenopathy.Case presentationA 24-year-old Nepali female presented with a 3-week history of low-grade fever, headache, and painful, discrete, unilateral left-sided cervical and axillary lymphadenopathy. Among the multitude of tests that were carried out, Erythrocyte Sedimentation Rate was raised and there was thrombocytopenia while other tests were normal. Painful lymphadenopathy pointed to bacterial lymphadenitis while chronic low-grade fever suggested tuberculosis. A cervical lymph node was excised for histopathological examination to reach an accurate diagnosis. On the basis of pathognomonic features viz., paracortical foci composed of various types of histiocytes including crescentic type in the background of abundant apoptotic karyorrhectic debris, a diagnosis of Kikuchi–Fujimoto disease was made. On follow-up evaluation after 6 weeks, the patient had no systemic symptoms, enlarged lymph nodes had regressed in size significantly, and Erythrocyte Sedimentation Rate and platelet count had become normal.ConclusionKikuchi–Fujimoto disease should be kept in the differential diagnosis of lymphadenopathy in young patients, female or male even in tuberculosis-endemic countries and even in patients who have unusual features; for example thrombocytopenia and involvement of axillary lymph nodes in addition to cervical lymph nodes as in this case.

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Vincristine is a chemotherapeutic agent that is a component of many combination regimens for a variety of malignancies, including several common pediatric tumors.78% of patients with advanced malignant disease were treated with vincristine, an alkaloid derived from vinca rosea Linn, 59% of these survived from the beginning of treatment and could be evaluated. Favourable responses were seen in patients with Hodking's disease, reticulum cell sarcoma, lymphosarcoma, carcinoma of the breast, acute leukemia and choriocarcinoma. Toxic include a high incidence of alopecia and neurologic complications. Vincristine treatment is limited by a progressive sensorimotor peripheral neuropathy. Vincristine-induced peripheral neuropathy (VIPN) is particularly challenging to detect and monitor in pediatric patients, in whom the side effect can diminish long term quality of life. Further research is needed to predict, prevent, and treat disease to maximize therapeutic benefit and avoid unnecessary toxicity from vincristine treatment.

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Background:To assess changes in oral microflora in dental plaque from cancer patients within 7 days of the first course of chemotherapy and the relationship of the changes with mucositis.Materials and Methods:Thirty cancer patients, divided into a test group undergoing chemotherapy and a control group not undergoing chemotherapy, were enrolled in this pilot study. Oral microflora was cultured from three samples of dental plaque at t0 (before chemotherapy), t1 (1 day after chemotherapy), and t2 (7 days after chemotherapy). Single and crossed descriptive analyses were used to establish prevalence, and the Chi-square test was used to establish the statistical significance of the differences observed in distributions (significance level: P < 0.05).Results:In most patients (55%), oral microflora consisted mainly of Gram-positive cocci, while the remaining 45% of the bacterial flora also had periodontal-pathogenic species. No Porphyromonas gingivalis appeared in the test group. Actinobacillus was the least frequently found bacterium among periodontal pathogens in the test group, while Fusobacterium nucleatum was the most frequently found. No significant differences were found in quantitative bacterial changes between t0, t1, and t2 in either the test or control groups, or between the two groups. According to World Health Organization scores, oral mucositis developed in 10 patients (66.6%) in the test group.Conclusions:The results of this pilot study indicate that there were no changes in microflora in dental plaque in cancer patients within 7 days of the first course of chemotherapy. No correlations between oral mucositis and specific microorganisms were assessed.

Cissus quadrangularis L. is a member of succulent climber of family Vitaceae and it is also called as bone setter because of its bone healing property. The present study focused to assess the in vitro antioxidant and in vivo anti-inflammatory activity of the plant stem extracts in different solvents namely petroleum ether, chloroform, ethyl acetate and methanol. Among all these extracts; ethyl extract showed highest phenolic and flavonoid content (19.35±0.29mg GA/g, 8.68±0.06 RE/g dry wt. respectively). In DPPH free radical scavenging assay all mentioned extracts exhibited free radical scavenging activity but the highest free radical scavenging activity was showed by ethyl acetate extract in increasing dose dependent manner. On the basis of highest phenolic, flavonoid content and free radical scavenging activity ethyl acetate extract was selected for anti- inflammatory activity. The anti-inflammatory activity of Cissus quadrangularis Lin. was investigated in carageenan induced inflammation in Wistar albino rats. Two different doses 250mg/kg and 500mg/kg were administered to the animals. The results showed that both doses had significant reduction in inflammatory condition but dose 500mg/kg showed maximum inflammatory reduction on comparing with control and standard treated groups.