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Background & objectives: Multinodular goitre is probably the most common endocrine problem in the world today. Neither a well formulated nor a simple procedure is available for the management of MNG, hence the need for the present study. The aim was to study the various modes of presentation, the distribution with respect to age and sex and the usefulness of histological evaluation. Methods: This was a retrospective study of 100 cases of thyroid lesions during the period of April 2009 to October 2010. Results: Adenomatous goiter was found to be the commonest lesion with a frequency of 52 cases (52%).Most of the patients were female accounting for 90.39%. Most of the cases (53.85%) were noted in 21-40 years age group. Commonest presentation was swelling in front of the neck noted in 98% of cases. Conclusion: Commonest histological observation in the present study was adenomatous goitre in 52%. Majority of the patients were females with a M:F ratio of 1:9.4, with the commonest age group being 31-40 yrs. Almost all patients presented with swelling in front of the neck, with other complaints being that of pain, discomfort, dysphagia, dyspnoea and features of hyperthyroidism. [ABSTRACT FROM AUTHOR]

Background: Suicide is a psychiatric emergency. Stressors in life and social variables (like marital status, family, and social support) are among the determinants of suicide. Hopelessness and suicidal intent are among the psychological variables that have shown promise in the prediction of suicide. Aims and Objectives: To assess stressful life events, hopelessness, suicidal intent, and sociodemographic variables in patients of attempted suicide. Materials and Methods: Fifty consecutive patients admitted with attempted suicide were interviewed. Presumptive Stressful Life Event Scale, Beck Hopelessness Scale, and Beck Suicidal Intent Scale were used along with a semistructured pro forma for interview. Data were analyzed with statistical tests. Results: Sixty-six percent of the participants were females, 72% were less than 30 years of age. Sixty-six percent of the patients had stressful life event score between 101 and 200 with the mean score of 127. The stressful life event score in those who considered they are in need of psychiatric help was significantly high. Most of the patients had mild (34%) and moderate (40%) degrees of hopelessness, and the mean score was 9.64. The mean suicidal intent in the participants was 25.14, when correlated with hopelessness score significant positive correlation was found. Conclusion: Lethality of the attempt increases with the increase in hopelessness. [ABSTRACT FROM AUTHOR]

AimsTo investigate the cytotoxicity of beta-lapachone, a potent agent that may selectively target tumour cells, in retinoblastoma (RB) cell lines.MethodsGrowth inhibitory effects of beta-lapachone were evaluated in Y79, WERI-RB1, and RBM human retinoblastoma cell lines. Pro-apoptotic effects of beta-lapachone were evaluated in Y79 cells by detection of caspase 3/7 activity, by enzyme-linked immunosorbent assay for nucleosome fragments, and by cellular morphological analysis.ResultsBeta-lapachone induced significant dose-dependent growth inhibitory effects in all three retinoblastoma cell lines. The 50% growth inhibitory concentration (IC50) of this agent was 1.9 μM in Y79 cells, 1.3 μM in WERI-RB1 cells, and 0.9 μM in RBM cells. Beta-lapachone also induced proapoptotic effects in RB cells. Treatment of Y79 cells with 1.9 μM beta-lapachone (IC50) resulted in a peak, fourfold induction of caspase 3/7 activity at 72 h post-treatment; a peak, 5.6-fold increase in nucleosome fragments at 96 h post-treatment; and a peak, 1.7-fold increase in the frequency of apoptotic cells at 48 h post-treatment, relative to vehicle-treated controls.ConclusionBeta-lapachone induced potent cytotoxic effects in RB cell lines at low micromolar concentrations, suggesting this agent could be useful in the clinical management of RB.Eye (2008) 22, 454–460; doi:10.1038/sj.eye.6702764; published online 16 March 2007 [ABSTRACT FROM AUTHOR]

A case of type I (type A) aortic dissection proved by postmortem examination could not be fully delineated relative to the type of dissection by dynamic CT as well as three positive contrast aortograms. Small tears in the ascending aorta and their strategic locations can escape even intensive radiologic evaluation. We present a case in which medical therapy was provided and, inappropriately, surgery was not performed. [ABSTRACT FROM AUTHOR]

Lymphomatoid granulomatosis (LYG) is a rare angiodestructive lymphoproliferative disorder (LPD) of uncertain etiology, with prominent pulmonary involvement. Recent studies indicate that LYG is an Epstein–Barr virus (EBV)-associated B cell LPD with large numbers of background reactive T lymphocytes (T cell-rich B cell lymphoma). Although the disease frequently, but not exclusively, occurs in various immunodeficiency states, it has not been reported in association with the transient immunosuppression following autologous bone marrow/peripheral stem cell transplantation (ABM/PSCT). We describe a patient who developed lymphomatoid granulomatosis of the lung approximately 2 weeks after high-dose chemotherapy and autologous peripheral stem cell transplantation for multiple myeloma. Although molecular studies showed no evidence of EBV genome in the biopsy material, the serologic profile with high IgM titers was suggestive of primary EBV infection. Complete radiologic remission occurred following reconstitution of the patient’s immune response after a 2-week course of ganciclovir treatment. Despite the apparently low frequency of LPD (both LYG and EBV-associated post-transplant lymphoma) in the ABMT setting, we believe that it should be considered in the differential diagnosis of patients whose clinical course following ABMT is complicated by fevers, in the absence of an identifiable infectious process. [ABSTRACT FROM AUTHOR]

The atypical appearance of a gas-containing, noninfected, popliteal synovial cyst has been presented. The case again demonstrates the value of plain radiographs, in this instance in distinguishing gas bubbles and calcification, which may not be apparent by MRI and ultrasound. The uniqueness of this case is stressed. The cause of the gas bubbles was not ascertained. [ABSTRACT FROM AUTHOR]

The development of a right hemothorax as the result of a ruptured thoracoabdominal aneurysm is an uncommon and usually fatal event. Survival depends upon an accurate diagnosis and prompt surgical intervention. We present a case of a ruptured thoracoabdominal aneurysm into the right chest that presented as opacification of the right hemithorax and hypotension. An early CT scan provided the correct preoperative diagnosis, although the patient did not survive. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 58-year-old woman suffering from drowsiness, altered sensorium and irritability. The patient was examined to have herpetic skin lesions on the right abdomen indicating a chronic kidney disease (CKD) managed through dialysis and medication. Furthermore, a 500 mg dose of valacyclovir was also administered once per day.

Background: Over recent years, the field of medicine has been challenged by the twin epidemic of heart failure and renal insufficiency. The coexistence of the two problems in the same patient, referred to as cardiorenal syndrome (CRS), is defined as 'disorders of the heart and kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other. The mechanisms underlying this interaction are complex and multifactorial in nature., Objective of Study: Identify and classify patients admitted with cardiorenal syndrome into various subtypes and assess clinical outcome at discharge and at three months., Methods: Ours was a longitudinal study of 50 patients admitted in ICU with CRS. They were classified as per RONCO classification (2008) into various subtypes. Outcomes was addressed as favourable for patients stable at discharge and at 3 months follow up, whereas outcome was termed non-favourable for patients who expired or initiated on hemodialysis., Results: Of 50 patients, two-third patients were males (66%), with mean age of males and females being 64.18 years and 64.64 years respectively. Majority of the patients had Type-1 CRS (46%) followed by twenty two percent Type-2, twenty six percent type-4 and six percent Type-5. There were no patients with type-3 CRS. At the end of the study, 24 (48%) patients were stable, 12 (24%) required dialysis and 14 (28%) patients had expired. The total non-favourable outcomes (dialysis / death) were higher with subtypes CRS-4 (n-11, 22%) and CRS-1 (n-8, 16%). Anemia, raised serum creatinine, low eGFR values, low ejection fraction were significant predictors of non-favourable outcome in our study., Conclusions: CRS occurs in all age groups, more commonly in elderlies with a male preponderance. Prevalence of CRS-1 was higher followed by CRS-4. Prognosis was unfavourable in CRS-1, CRS-4 and CRS-5. Sepsis was predominant cause of death in patients with CRS-5 with hundred percent mortality during hospital stay. Risk factors like pre-existing renal impairment, anemia, reduced e GFR and low ejection fraction were significantly associated with worse outcomes. There is need for large scale population / community based studies to chart the prevalence of cardiorenal subtypes and prognosticate each individually.

We present a case of a middle-aged patient presenting with acute onset abdominal pain and distension who had signs of bowel obstruction on physical exam. He was afebrile, hemodynamically stable with no peritoneal signs. Abdominal radiograph and CT scan were pathognomic for sigmoid volvulus. Through this case report we want to discuss the presentation, diagnosis, management options for sigmoid volvulus and importance of features suggestive of ischemic bowel that necessitates different management options.