Sinonasal organising haematoma – a little known entity

IntroductionSinonasal organising haematoma is a recently described, rare, benign inflammatory condition, which closely resembles malignancy in its clinical presentation.ObjectiveTo describe the clinical features of organising haematoma and to review the evolution of surgical options successfully used.MethodsA retrospective review of charts of all patients with a histopathological diagnosis of sinonasal organising haematoma was performed.ResultsSix (60%) of the 10 patients were male with a mean age of 47.4 years. All patients had unilateral disease with recurrent epistaxis as the presenting symptom. Maxillary sinus was the most commonly involved sinus. There was no history of trauma in any of the patients. Hypertension (80%) was the most commonly associated comorbidity. Contrast-enhanced CT scan of the paranasal sinuses showed heterogeneous sinus opacification with/without bone erosion. Histopathological examination was diagnostic. Complete endoscopic excision was done in all patients resulting in resolution of the disease.ConclusionAwareness of this relatively new clinical entity and its evaluation and treatment is important for otolaryngologists, maxillofacial surgeons and pathologists alike. Despite the clinical picture of malignancy, histopathological features of benign disease can safely dispel such a diagnosis.     

BAFF blockade for systemic lupus erythematosus: will the promise be fulfilled?

Summary: Systemic lupus erythematosus (SLE) is a complex immune disorder in which loss of tolerance to nucleic acid antigens and other cross-reactive antigens is associated with the development of pathogenic autoantibodies that damage target organs including the skin, joints, brain, and kidney. B cells are essential to lupus pathogenesis, not only because they produce pathogenic autoantibodies but also because they have multiple effector functions in the immune system. There has been much recent interest therefore in targeting of B cells for the treatment of SLE and other autoimmune diseases. BAFF (B-cell activation factor belonging to the tumor necrosis factor family) is a crucial homeostatic cytokine for B cells that is upregulated during inflammation and links adaptive with innate immunity. Excessive levels of BAFF may alter selection of autoreactive B cells and contribute to perpetuation of SLE by a variety of mechanisms. BAFF antagonists have been effective in the prevention and treatment of SLE in several different murine models. Three classes of BAFF antagonists have been developed for clinical use, and initial clinical trials have begun. However, immune modulation in SLE is complicated by differences in the immune defects between patients and at different disease stages. Further work will be needed both in animal models and humans to determine the most appropriate clinical applications for BAFF blockade.     

Sterilisation for girls and women with mental handicaps: SOME ETHICAL AND MORAL CONSIDERATIONS

The issues that come into play when young women and girls with mental handicaps are referred for sterilisation are discussed in the light of ethical arguments. The story of sterilisation is traced over the century. An attempt is made to understand the evolution of the legal aspects of sterilisation, from a rather paternalistic/eugenic standpoint in the early 1900's to a more humanistic one in the present day, as evidenced in contemporary court decisions. A comprehensive system of analysing the various components of sterilisation referral is suggested.     

Morbidity and mortality among “big” babies who develop necrotizing enterocolitis: A prospective multicenter cohort analysis

Background

Necrotizing enterocolitis (NEC) is classically a disease of prematurity, with less reported regarding morbidity and mortality of this disease among other infants.

Longer average blood storage duration is associated with increased risk of infection and overall morbidity following radical cystectomy

Background

Patients with bladder cancer undergoing radical cystectomy (RC) experience high rates of perioperative blood transfusions (PBTs) and morbidity. The aim of this study was to evaluate the effect of blood storage duration on the risk of adverse perioperative outcomes in this high-risk patient population.

Synovial sarcoma of anterior abdominal wall

Sarcomas are connective tissue tumours, and can arise in any part of the body, more commonly in the extremities. Histological types and clinical presentation of truncal sarcomas are similar to those seen in any other anatomic locations. Radiological investigations may be contributory, but biopsy is conclusive. Surgical resection with wide margins is the initial standard treatment, however a multimodal approach including radiotherapy and chemotherapy is often favoured. Because of the high recurrence rate regardless of therapy, close follow-up is imperative. We present a case of synovial sarcoma of the anterior abdominal wall.     

Illustration of anti-rheumatic mechanism of rheumavedic capsule

The present study was taken up to illustrate the mechanism of anti-rheumatic activity of ‘Rheumavedic capsule’, a polyherbal formulation of Vedic-bio Labs, Bangalore, in adjuvant induced arthritic rats. Anti-inflammatory mechanism is illustrated using phlogistic agents induced paw edema in rats. Analgesic mechanism is illustrated using Eddy’s hot plate and acetic acid (0.6%v/v) induced writhing in mice. Histopathology of knee joint was studied.Rheumavedic showed inhibition of inflammation mediated through Histamine, 5-Hydroxy tryptamine, and Bradykinin. Rheumavedic showed protection in both acetic acid and Eddy’s hot plate induced pain. Histopathology of knee joint of rat pre-treated with rheumavedic showed significant reduction in the mononuclear infiltration, pannus formation and adhesion molecules.The anti-rheumatic mechanism of rheumavedic is due to; inhibition of inflammatory mediators i.e., Histamine, 5-Hydroxy tryptamine and Bradykinin., protection against prostaglandins mediated pain, by inhibiting cyclo-oxygenase synthesis and reduction in pannus formation, by inhibiting mononuclear infiltration.