Congenital brachial artery true aneurysms are exceedingly rare. Most are pseudoaneurysms secondary to trauma or infection. We report a boy aged 2 years who presented with painless, pulsatile swelling on the medial aspect of the right arm, 4 cm above the elbow joint that had been present since birth. Spiral CT angiography showed a fusiform aneurysm of the distal right brachial artery with a peripheral crescent-shaped thrombus. Distal arteries were normally opacified. There was no evidence of abnormal dilation or stenosis in any other artery. The aneurysm was surgically resected, with vascularisation re-established using a reversed great saphenous vein graft. His postoperative course was uneventful. Early surgery should be performed for moderately sized to large aneurysms that recently increased in size, exhibited luminal thrombus formation or caused neurovascular distal limb compromise. Early surgery could prevent complications such as a ruptured aneurysm, thromboembolism or limb ischaemia or loss.
Glomangiopericytoma is a rare vascular neoplasm characterised by a pattern of prominent perivascular growth with myoid phenotype. It is categorised as a borderline low-malignancy tumour by WHO and accounts for less than 0.5% of all sinonasal tumours. After curative resection, patients of glomangiopericytoma need long-term endoscopic follow-up due to high risk of recurrence.We report a case of a 23-year-old man complaining of nasal obstruction off and on and frequent epistaxis. A reddish mass in the right nasal cavity was observed on endoscopy and treated with endoscopic excision.Biopsy revealed this to be glomangiopericytoma arising from the septum of right nasal cavity, which was excised in toto with endonasal endoscopic approach using diode laser.
PurposeUnder the tenets of conservation of resources and role theories, this study has aimed to draw up and test a moderated-mediation model. The model postulates job burnout (JB) as a mediator between role stress (RS) and organizational commitment (OC) while transformational leadership (TFL) as a moderator to such mediation.Design/methodology/approachFor this cross-sectional study, multisource field data from the service industry was collected using a convenient sampling procedure. A total of 354 employees participated in the anonymous survey. The proposed model of the study was tested with a hierarchical regression approach using Hayes PROCESS macro.FindingsThe data fitted best for the four-factor measurement model of the study. Afterward, the authors found that RS directly affected employees’ perception of OC. The relationship between RS and OC was partially mediated by JB. The authors ascertained the transformational leader’s buffering role between the RS-JB relationship and the transformational leader’s contingent indirect effect as well.Originality/valueThis research is a first-of-its-kind investigation into enlightening the direct and indirect link via JB between RS and OC and the moderating effect of TFL on such indirect effect in a rarely studied organizational setting of a developing country.
Tuberculosis (TC) is very common and significant cause of morbidity and mortality worldwide. Isolated cystic duct lymph node TC cases without involvement of gallbladder are exceedingly rare. It is difficult to diagnose preoperatively because of lack of characteristic signs and symptoms of TC. We report a man aged 45 years who presented with right upper abdominal pain since 1week. It was associated with nausea and postprandial fullness. There was no evidence of jaundice and lymphadenopathy. Abdominal examination showed moderate right upper quadrant tenderness with positive Murphy's sign and splenomegaly but no signs of peritonism. Abdomen ultrasound revealed sludge in gallbladder, dilated pancreatic duct, coarse exotexture of liver, splenomegaly and no lymphadenopathy. He underwent laparoscopic cholecystectomy; histological report showed chronic caseating granulomatous lymphadenitis with Langhans type of giant cells in lymph node near cystic duct with chronic cholecystitis of gallbladder. Standard antituberculosis therapy was given for 12 months.
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