A coincidence of renal cell carcinoma and hematological malignancies

Hematological malignancies with renal cell carcinoma (RCC) are rarely seen. We reported here two cases of coincidence of RCC with multiple myeloma (MM) and Hodgkin??s disease (HD). A 69-year-old male patient with tumor that was located at the upper pole of left kidney was admitted to our clinic. Partial tumoral resection was perfomed and stage-I RCC was diagnosed after the histopathological examination of tumor. Moreover, he was diagnosed with IgG kappa stage-IIA MM as a result of bone marrow examination and serum immunofixation electrophoresis. Radiotherapy, combination chemotherapy, and autologous stem cell transplantation (ASCT) were performed. The patient is still alive who achieve a complete remission. A 53-year-old male patient suffered from cervival lymphadenopathy. He has a story of right radical nefrectomy that has been performed 4?years ago. Stage II-B lymphocyte-predominant HD was diagnosed. Combination chemotherapy was started, but relapse occurred 25?months later. ASCT was not planned due to cardiovascular problems and the patient died. Clinicans should keep in mind the coincidence of RCC with MM and HD.     

Cytotoxicity screening of Bangladeshi medicinal plant extracts on pancreatic cancer cells

Background  

There has been a long standing interest in the identification of medicinal plants and derived natural products for developing cancer therapeutics. Our study focuses upon pancreatic cancer, due to its high mortality rate, that is attributed in part to the lack of an effective chemotherapeutic agent. Previous reports on the use of medicinal plant extracts either alone or alongside conventional anticancer agents in the treatment of this cancer have shown promising results. This work aims to investigate the therapeutic properties of a library of medicinal plants from Bangladesh.     

Vaginal Yolk Sac Tumor Causing Infantile Hydrometra: Use of Multidetector-Row Computed Tomography

BackgroundA case of vaginal endodermal sinus (yolk sac) tumor resulting in hydrometra in a 9-month-old female infant is reported.CaseThe patient presented with an intermittent bloody discharge on her diapers and a lower abdominal mass on palpation. Multidetector-row computed tomography showed an irregular, dense soft-tissue mass with heterogeneous enhancement within the vagina, obstructing it. On reformatted computed tomography images, there was upstream dilatation of the cervical and uterine cavities, with fluid attenuation contents called hydrometra, resulting from the vaginal obstruction. The histopathological features of the vaginal mass were identical to those of the endodermal sinus tumor (yolk sac tumor). The patient was treated exclusively by means of chemotherapy.ConclusionExamination of the alpha-fetoprotein levels was useful in the diagnosis of the patient and in assessing the patient's response to treatment by chemotherapy.     

A preliminary study on the effect of pharmacist counseling on awareness of and willingness to quit smoking in Malaysian population

Objectives This paper presents an outcome of pharmacist counseling among Malaysian smokers for their awareness of and willingness to quit smoking. Method It was a cross-sectional study during a 3-day public health campaign at a shopping complex. Each self-referred participant was asked to complete a questionnaire apart from the question regarding improvement, and if any in their awareness and willingness to quit smoking, were asked to respond after counseling. Pharmacists counseled each participant about smoking cessation strategies and smoking related diseases. The data were analyzed by χ ² test. Results Among respondents, 25.5% had been smoking for more than 10 years, 31% for 5–10 years, 25.4% for 2–5 years and 18.3% for 1–2 years. The participants declaring no awareness about smoking were 22.9%, with little awareness 44.3%, having moderate awareness 25.7% and with considerable awareness were 7.1%. After counseling, 4.1% revealed unawareness, 17.8% little awareness, 43.8% moderate and 34.2% had considerable awareness on the above aspects. The post counseling awareness on smoking was observed to be significantly higher (P< 0.01). Among smokers studied, 67% showed willingness to quit smoking. Conclusion Increase in awareness of and willingness to quit smoking reflects that pharmacist counseling seems to be helpful in cessation of smoking.     

A life-threatening infection: Fournier's gangrene

Fournier's gangrene is a life-threateningdisorder in which infection of the perineum andscrotum spreads along fascial planes, causingsoft tissue necrosis. If urgent surgery isdelayed, the disease will soon result in septicshock, multiorgan failure, and death. In thisstudy, we present 21 patients with Fournier'sgangrene who were treated in period between1994 and 2001. Patients' charts were reviewedretrospectively and are discussed in the lightof literature.All patients received aggressive surgicaldebridment. Penicillin or Ceftriaxone,aminoglicoside and metronidazole wereadministered intravenously. Of the 21 patients,5 had scrotal carbuncle, 1 had urethralstricture, 1 had chronic indwelling urethralcatheterization, 2 had perirectal abscess, and1 had hemorrhoidectomy. In eleven patients wecouldn't identify any cause. Twelve patientshad diabetes mellitus, and two had chronicalcoholism. Escherichia coli was isolatedin 12 purulent tissue cultures, and Bacteroides fragilis in eight. Seventeenpatients survived, whereas four died.Fournier's gangrene is considered a surgicalemergency. Early surgical intervention isessential, as the gangrene can spread rapidlyat rates reaching 2 mm per hour. So thatFournier's gangrene is an abrupt, rapidlyprogressive, gangrenous infection of theexternal genitalia and perineum and is a realurologic emergency.     

The effects of methidathion on lipid peroxidation and some liver enzymes: role of vitamins E and C

Methidathion (MD) [ O, O-dimethyl S-(2,3-dihydro-5-methoxy-2-oxo-1,3,4-thiadiazol-3-ylmethyl) phosphorodithioate] is one of the most widely used organophosphate insecticides (OPIs) in agriculture and public health programmes. We have, therefore, examined the in vivo and in vitro effects of MD on the serum activities of cholinesterase (ChE), enzymes concerning liver damage and lipid peroxidation (LPO; only in vivo), and have evaluated the ameliorating effects of a combination of vitamins E and C against MD toxicity. The in vivo experimental groups were: control group, MD-treated group (MD), and a group treated with MD plus vitamin E plus vitamin C (MD+Vit). The MD and MD+Vit groups were treated orally with a single dose of 8 mg MD/kg body weight at 0 h. Vitamin E and vitamin C were injected at doses of 150 mg/kg body weight i.m. and 200 mg/kg body weight i.p., respectively, 30 min after the treatment with MD in the MD+Vit group. Blood samples were taken 24 h after the MD administration. For in vitro study, venous blood samples were obtained from volunteers, and serum recovered. The activities of serum enzymes were determined in each sample and these served as 0 h values. Each sample was divided into four portions, each of which served as one of the experimental groups, as follows: control group, vitamin E plus vitamin C group (Vit), MD-treated group (MD) and MD plus vitamin E plus vitamin C group (MD+Vit). Vitamin E and vitamin C were added at doses of 7.5 and 10 micro g/ml, respectively, into the Vit and MD+Vit groups. MD was added at doses of 0.4 mg/ml into the MD and MD+Vit groups. The activities of serum enzymes were determined in each sample at 24 h. The results of the in vivo experiment demonstrated that thiobarbituric acid reactive substances were increased in the MD group compared with the control group, and decreased in the MD+Vit group compared with MD group. ChE activity was decreased in both MD and MD+Vit groups compared with controls and increased in the MD+Vit group compared with the MD group. The activities of aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyltransferase (GGT) and lactate dehydrogenase (LDH) were increased in both the MD and MD+Vit groups compared with the control group. AST activity was decreased in MD+Vit group compared with the MD group. Alanine aminotransferase (ALT) activity was decreased in both the MD and MD+Vit groups compared with control group. The results of in vitro experiment showed that all enzyme activities remained unchanged in both the control and Vit groups compared with values at 0 h. The activities of ChE, ALT and LDH were decreased in both the MD and MD+Vit groups compared with 0 h values. There was no significant difference between the MD and MD+Vit groups. The activities of AST, ALP and GGT remained unchanged in all groups. From these results, it can be concluded that MD caused liver damage, and LPO may be one of the molecular mechanisms involved in MD-induced toxicity. Single-dose treatment with a combination of vitamins E and C after the administration of MD can reduce LPO caused by MD.     

Rare variants of Cutaneous Leishmaniasis: whitlow, paronychia, and sporotrichoid

Cutaneous Leishmaniasis is endemic in certain areas of Pakistan, with the wet form of the disease being the most prevalent. It has a number of morphological variants, which are dependent on the immune status of the host, the subspecies of the Leishmania, and also, to some extent, on the site of involvement. We describe here a case of Leishmaniasis showing two very rare variants, whitlow and paronychial lesions, occurring concurrently with sporotrichoid spread. The patient responded to intramuscular sodium stibogluconate with resolution of the skin lesions.     

Prolidase deficiency

A 32‐year‐old mentally retarded woman was admitted to hospital with recurrent ulcers on her legs, which appeared for the first time at 8 years of age. Apart from recurrent lower respiratory tract infections and chronic otitis media, her personal history was unremarkable. Her parents were second‐degree relatives. The family history showed no similar disease or mental retardation. Physical examination revealed that the patient had an unusual facial appearance, with a high‐arched palate; she had multiple tooth caries ( Fig. 1 ).

Figure Figure 1  Open in figure viewer PowerPoint Facial appearance of the patient