The risk of secondary solid malignancies is increased after allogeneic hematopoietic stem cell transplantation (HSCT). The risk starts at about 10 years after HSCT and continues even 20 years later. The most common secondary malignancies include squamous cell carcinoma of skin, genitourinary tract and oral cavity; lung and breast cancers. The use of total body irradiation or conditioning chemotherapy, chronic graft-versus-host disease and duration since HSCT can influence the risk of secondary solid malignancies. Secondary solid malignancies are common causes of nonrelapse mortality in long-term survivors and may account for up to 10% of late deaths. Avoiding smoking, alcohol use and excess sun exposure may reduce the risk. Cancer prevention guidelines are largely consensus-driven and follow the recommendations for general population.
Research on medicinal plants are important to Nepal because most of its rural population relies on it as mode of medicine. Medicinal plants namely Swertia chirayita and Dendrobium amoenum were collected from mid hills of Nepal. The present study was undertaken to find the antimicrobial activity, phytochemical presence and their cytotoxicity in different extraction medium. The percentage yield from the plants were highest in warm methanol extraction with 12.6%, followed by ethyl acetate and lowest was for cold methanol. Plant extract showed the presence of antioxidants like alkaloid, terpenoids, flavonoids, tannin, glycosides. The Brine Shrimp Bioassay of methanol and ethyl acetate extract showed cytotoxicity. Chiraito extract showed LC50 of 199 ppm for Dhunche sample, 128.82 ppm for Daman sample and 131.82 ppm of Illam sample. The antibacterial activity of methanol extract of Chiraito and Dendrobium amoenum showed significant bioactivity by inhibiting growth of microbial species selected for the test. The zone of inhibition shown by the extracts was comparable to the standard antibiotics. Similarly, methanol extract of Chiraito also showed significant antifungal activity with the zone of inhibition comparable to amphotericin.Nepal Journal of Biotechnology. Dec. 2015 Vol. 3, No. 1: 48-54
Statins are widely prescribed medications to prevent cardiovascular events. While self-limited statin myopathy is relatively common, statin-induced necrotizing autoimmune myopathy (SINAM) is extremely uncommon, with incidence of two cases per million per year. We present a case of SINAM after a decade of atorvastatin use, leading to debilitating weakness. A 71-year-old male presented with recurrent falls due to extreme bilateral lower-extremity weakness without pain or sensory changes. No fever, chills, rash, joint pain, recent infection or medication changes were reported. Reported taking atorvastatin 80 mg daily for 10 years. Physical examination revealed significant muscle wasting on right deltoid and proximal muscle weakness in all extremities. Lab tests included elevated creatinine kinase, aldolase, ESR, CRP and transaminases. Anti-HMGCR antibody was significantly elevated. TSH, serum protein electrophoresis and RPR were unremarkable. ANA, Anti-Jo-1, anti-Mi2, anti-SRP, anti-ds-DNA, anti-SSA and anti-SSB antibodies were negative. MRI of thigh revealed diffuse myositis. Electromyogram revealed an acute myopathic process. Muscle biopsy showed muscle necrosis and C5b-9 sarcolemmal deposits on non-necrotic fibers without rimmed vacuoles. He was diagnosed with SINAM. Statin was discontinued, and steroid, immunoglobulins and azathioprine were started with gradual improvement. Unlike the self-limiting statin myopathy, SINAM is more severe and is associated with significant proximal muscle weakness, markedly elevated CK and persistent symptoms despite statin discontinuation. Anti-HMGCR antibodies are present in 100% of cases. Immunosuppressants are the mainstay of treatment, and statin rechallenge should never be done in these cases. Although relatively rare, physicians should be cognizant of SINAM.
Background:Cervical cancer is the third most common cancer worldwide. Accurate information about cervical cancer to general public can lower the burden of the disease including its mortality.Aims:We aimed to look at the quality of information available in YouTube for cervical cancer.Materials and Methods:We searched YouTube (http://www.youtube.com) for videos using the keyword Cervical cancer on November 12, 2015. Videos were then analyzed for their source and content of information.Results:We studied 172 videos using the keyword Cervical cancer on November 12, 2015. We found that there were videos describing the personal stories, risk factors, and the importance of screening. However, videos discussing all the aspects of cancers were lacking. Likewise, videos from the reputed organization were also lacking.Conclusion:Although there were numerous videos available in cervical cancer, videos from reputed organizations including Center for Disease Control and Prevention, American Cancer Society, and World Health Organization were lacking. We strongly believe that quality videos from such organizations via YouTube can help lower the burden of disease.
Background: Foreign body (FB) ingestion and impaction in the esophagus constitute an important cause of morbidity and mortality worldwide. One-third of foreign bodies retained in the gastrointestinal tract are present in the esophagus and mostly in children require endoscopic removal with rigid esophagoscopy. Aims and objectives: This study seeks to highlight the challenges in the management of esophageal FB using rigid esophagoscopy. It will also evaluate the outcome of management. Their management depends on the anatomic location, shape, size of the foreign body, and duration of impaction. Materials and methods: This was a retrospective study of 60 patients with confirmed esophageal foreign bodies that were managed in the ENT department of SCL Hospital, NHL Medical College, Ahmedabad, from January 2016 to June 2018. Demographic and clinical data were documented, and simple statistical tables were used to illustrate the data. Results: The data of 60 patients were retrieved from ENT emergencies. Fifty (83.33%) patients had radiologic confirmation of foreign bodies in their esophagus, and 10 (16.67%) were further confirmed during esophagoscopy. There were 35 (58.33%) males and 25 (41.67%) females with male:female ratio of 1:1.4. The age range was 1-70 years with a mean of 35 ± 6.88 years. Majority of the foreign bodies, 50 (83.33%), were impacted in the cricopharyngeal sphincter of the esophagus. Dentures ranked highest among the adult population, 15 (25%) cases, while coins ranked highest in the pediatric populations, 20(33.33%) cases. Six (10%) cases presented to the hospital after 72 hours. Complications occurred in 5 (8.33%) cases. Conclusion:The management of impacted esophageal foreign bodies with rigid esophagoscopy was safe, reliable, and an effective procedure despite its challenges.
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