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The giant cell tumor of tendon sheath (GCTTS) or nodular tenosynovitis arises as discrete solitary nodule in the tendon sheath near joints of toes and fingers. Multifocal giant cell tumor of tendon sheath is a rare entity, of which the etiology is not yet fully understood and it is different from diffuse type of GCTTS. Diffuse type of GCTTS occurs around large joints having a main mass from which a small satellite nodule may arise. Multifocal GCTTS along a single tendon is a more rare entity. Herein, we describe a case of multifocal GCTTS along the tendon sheath of flexor digitorum profundus tendon of index finger. The patient was managed by surgical excision of the tumor swellings with no recurrence at two years follow up. [ABSTRACT FROM AUTHOR]

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Purpose: A review study on the biochemistry of epilepsy showed that in epileptic patients, serum glucose and cholesterol concentrations are low, sodium is unaffected, potassium increases, glucose is high and mild hypocalcemia. We have conducted a biochemical study on sudden unexpected death in epilepsy (SUDEP) cases in an attempt to establish the characteristic biochemical values to diagnose these deaths.Methods: This was a hospital based case-control study done at All India Institute of Medical Sciences, New Delhi for one year. Twenty SUDEP cases and 20 age- and sex-matched controls were included in the study. Femoral blood, cerebrospinal fluid, vitreous humor, and pericardial fluid were biochemically analyzed for sodium, potassium, calcium, glucose, N-acetyl- cysteine activated creatine kinase (CK-NAC) and isoenzyme CK-MB.Result: Serum sodium, CK-MB and CK-NAC level was found significantly increased and potassium level was found decreased in SUDEP cases in comparison to non-epileptic deaths. Likewise, in CSF, sodium and CK-NAC was found increased and potassium level was found decreased in SUDEP cases. In vitreous humor, sodium and CK-MB level was found increased and potassium level was found decreased in SUDEP cases in comparison to non-epileptic deaths. In pericardial fluid, sodium, CK-NAC and CK-MB level was found increased and potassium level was found decreased in SUDEP cases in comparison to non-epileptic deaths.Conclusion: It concludes that high sodium level and low potassium level could be associated with SUDEP. However, this is a small size study, a larger study is needed to verify the findings. Furthermore, it is difficult to conclude whether these findings are exclusive to SUDEP. [ABSTRACT FROM AUTHOR]

• Novel operation theatre compatible machine was developed which works on principle of rotary ultrasonic bone drilling (RUBD) process. • RUBD produced comparatively lesser temperature rise (from 13.1 °C to 25.8 °C) than CSBD (34 °C to 45 °C) during drilling of hard tibia bones. • Design of experiment based response surface methodology was used to plan the set of experiments to study the effect of drilling parameters on temperature rise in RUBD process. • Regression equation has been used to develop the statistical model to predict the temperature rise at the bone tool interface, and the drilling parameters (rotational speed, feed rate, drill tool diameter and abrasive size) are determined for minimum temperature rise. Temperature rise in surgical bone drilling is an important factor that leads to death of the bone cells, known as Osteonecrosis, and results into poor osteosynthesis i.e. implant failure. The present work aims to study the temperature rise during bone drilling by a recently developed operation theatre (OT) compatible machine. The temperature during the drilling process was recorded from K-type thermocouple devices, which were embedded in the human tibial bone at four different positions (at 0.5 mm, 1.0 mm, 1.5 mm, and 2.0 mm) from the drilling site. Comparative study revealed that rotary ultrasonic bone drilling (RUBD) technique produced lesser temperature (40 – 50%) than conventional drilling on human tibia. Statistical model was developed to predict the temperature rise in RUBD process using response surface methodology (RSM), and the optimum parameters were determined using Genetic Algorithm. Analysis of variance (ANOVA) was carried out at a confidence interval of 95 percent (α = 0.05) to determine the influence of various drilling parameters such as rotational speed, feed rate, drill diameter and abrasive particle size on temperature rise. It was observed that the rotational speed was responsible for the maximum temperature rise (51.8%) followed by drill diameter (18.8%), and abrasive particle size (14.3%); whereas, the feed rate contributed minimal (4%) temperature rise. [ABSTRACT FROM AUTHOR]

Abstract: Splenic infarction is rare in inflammatory diseases of the pancreas, although the spleen and its vessels have an intimate relation with the pancreas. Most reported cases are of focal infarction, and treatment is mostly conservative. The authors report a case of diffuse splenic infarction in a 17-year-old boy with severe acute pancreatitis who presented with massive upper gastrointestinal bleeding and was treated with splenectomy. [Copyright &y& Elsevier]

Vitamin D deficiency is common and linked to poor prognosis in pulmonary arterial hypertension (PAH). We investigated the differential effect of basal vitamin D levels in monocrotaline (MCT) induced PAH in normal and vitamin D deficient (VDD) rats. Rats were fed a VDD diet and exposed to filtered fluorescent light to deplete vitamin D. Normal rats were pretreated with vitamin D 100 IU/d and treated with vitamin D 100 and 200 IU/d, while VDD rats received vitamin D 100 IU/d. Vitamin D receptor (VDR) silencing was done in human umbilical vein endothelial cells (HUVECs) using VDR siRNA. Calcitriol (50 nM/mL) was added to human pulmonary artery smooth muscle cells (HPASMCs) and HUVECs before and after the exposure to TGF-β (10 ng/mL). Vitamin D 100 IU/d pretreatment in normal rats up-regulated the expression of eNOS and inhibited endothelial to mesenchymal transition significantly and maximally. Vitamin D 100 IU/d treatment in VDD rats was comparable to vitamin D 200 IU/d treated normal rats. These effects were significantly attenuated by L-NAME (20 mg/kg), a potent eNOS inhibitor. Exposure to TGF- β significantly reduced the expression of eNOS and increased the mesenchymal marker expression in normal and VDR-silenced HUVECs and HPASMCs, which were averted by treatment and maximally inhibited by pretreatment with calcitriol (50 nM). To conclude, this study provided novel evidence suggesting the beneficial role of higher basal vitamin D levels, which are inversely linked with PAH severity. [ABSTRACT FROM AUTHOR]

Abstract: Neurofibroma of the common bile duct is extremely rare. Fewer than 20 cases have been reported in the literature. We report a case of neurofibroma in a 47-year-old female presented with obstructive jaundice. Preoperative imaging failed to diagnose the case. The patient was treated with en-bloc excision of the extrahepatic biliary tree and Roux-en-Y hepaticojejunostomy. [Copyright &y& Elsevier]

Abstract: Extrahepatic biliary cystadenoma is a rare benign lesion with malignant potential. Fewer than 100 cases have been reported in the literature. The most common clinical presentation is obstructive jaundice. Frank cholangitis is extremely rare. The authors report a case of extrahepatic biliary cystadenoma in a 55-year-old woman who presented with recurrent episodes of cholangitis. [Copyright &y& Elsevier]

Abstract: Eumycetoma in the cerebellopontine angle region is extremely uncommon with no case being reported as per an extensive review of the literature by the authors. The authors report a case of cerebellopontine angle eumycetoma in a young female managed by subtotal decompression and antifungal treatment. The pre-operative diagnosis of eumycetoma in this location is extremely difficult and the role of histopathology is very important to characterize this uncommon lesion. The prognosis of this bizarre pathology is dismal despite all treatment modalities as compared to the usual tumors of the cerebellopontine angle that generally have a favorable outcome. [Copyright &y& Elsevier]