Rare association of eventration of left hemidiaphragm with ipsilateral thyroid agenesis

Eventration is a well-known congenital malformation of the diaphragm, usually asymptomatic and diagnosed incidentally on chest radiography. It is sometimes associated with a number of other congenital syndromes and anomalies. We report a rare case of eventration of left hemidiaphragm associated with gastric volvulus, ipsilateral thyroid agenesis and microphthalmia.     

Proposed guidelines for the management of nodding syndrome

Nodding Syndrome is a poorly understood neurologic disorder of unknown aetiology that affects children and adolescents in Africa. Recent studies have suggested that the head nods are due to atonic seizures and Nodding Syndrome may be classified as probably symptomatic generalised epilepsy. As part of the Ugandan Ministry of Health clinical management response, a multidisciplinary team developed a manual to guide the training of health workers with knowledge and skills to manage the patients. In the absence of a known cause, it was decided to offer symptomatic care. The objective is to relieve symptoms, offer primary and secondary prevention for disability and rehabilitation to improve function. Initial management focuses on the most urgent needs of the patient and the immediate family until ‘stability’ is achieved. The most important needs were considered as seizure control, management of behavioural and psychiatric difficulties, nursing care, nutritional and subsequently, physical and cognitive rehabilitation. This paper summarises the processes by which the proposed guidelines were developed and provides an outline of the specific treatments currently being provided for the patients.     

Comparison of periodontal open flap debridement versus closed debridement with Er,Cr:YSGG laser

Background

Traditional periodontal open flap debridement (OFD) results in reduced pocket depth (PD), clinical attachment loss (CAL), gingival recession (GR) and postoperative pain and discomfort. The quest to overcome these shortcomings has led to research into Er,Cr:YSGG laser assisted pocket therapy (ELAPT). This study was designed to compare the clinical outcomes of ELAPT versus OFD.

Methods

Fifteen patients with a PD of ≥5 mm and ≤8 mm at two sites were selected. Test sites (Group 1) were treated by ELAPT and the control (Group 2) by OFD. Clinical parameters were recorded at baseline, 3 and 6 months and included Plaque Index (PI), Gingival Index (GI), modified Sulcular Bleeding Index (mSBI), PD, CAL and GR.

Results

Both treatments produced a reduction in PI, GI, mSBI and PD, an increase in GR, and a gain in CAL at 3 and 6 months. The mean gain of CAL in Group 1 at 3 and 6 months (1.60 ± 0.78 and 1.80 ± 0.63) was similar (p > 0.05) to the value of Group 2 (1.93 ± 0.88 and 2.00 ± 0.54). GR increased significantly (p < 0.05) only in Group 2 at 3 and 6 months (1.80 ± 0.56 and 1.87 ± 0.64) compared to Group 1 (0.50 ± 0.68 and 0.60 ± 0.74).

Conclusions

ELAPT compared with OFD results in similar CAL gains with less GR and significant reductions in PD, GI and mSBI, and may be considered as an alternative to surgical therapy.     

Morphometric and Histological Study of Breast Lesions with Special Reference to Proliferative Activity and Invasiveness

Breast carcinoma is the most common cause of carcinoma death in women. Sometimes, difficulty arises to differentiate between premalignant lesions and carcinoma by routine histopathology. Our study was done to establish the role of morphometry and immunohistochemistry to solve this problem. In this study, total 60 cases of different breast lesions were included and 10 controls were also included to compare the results with the normal findings. They were studied by hematoxylin and eosin-stained sections for morphometry and routine histological study; as well as by proliferative markers such as proliferating cell nuclear antigen and p53. Invasiveness was studied using immunohistochemical staining with 34 βE12 monoclonal antibody. Statistically significant differences were found in morphometric parameters and in expression of proliferative markers between most of them. Morphometry and immunohistochemistry help in the proper diagnosis of different breast lesions that lie in the gray zone on routine histopathology.     

Barriers and Facilitators of Addiction Treatment: a Qualitative Study

International Journal of Mental Health and Addiction - Addictive disorders affect a considerable proportion of the population worldwide and in India. Treatment-related barriers and facilitators...     

Received social support, self-efficacy, and finding benefits in disease as predictors of physical functioning and adherence to antiretroviral therapy

OBJECTIVE: The study investigated whether received social support, self-efficacy, and finding benefits in disease are related to physical functioning and adherence to antiretroviral medication among men and women infected with HIV. METHODS: Data were collected among 104 patients of three HIV clinics in India. The measures included general self-efficacy scale, Berlin social support scales, questionnaire on taking antiretroviral medication, and SF-20 (physical functioning). RESULTS: The results of path analysis and mediation analysis revealed that finding benefits and self-efficacy were directly related to both adherence and physical functioning. Additionally, finding benefits mediated the relation between patients' self-efficacy and adherence as well as physical functioning. Although received support was unrelated to adherence directly, effects of received support on adherence were mediated by self-efficacy. CONCLUSIONS: Besides personal and social resources, benefit finding was related to better adherence to antiretroviral medication. PRACTICE IMPLICATIONS: Identifying patients receiving low social support, with weak general self-efficacy and finding no benefits in being diagnosed with HIV may help to elicit those people who are at risk for poorer adherence and physical functioning.     

Letter to the editor concerning “A systematic review and meta-analysis on the management of accidental dural tears in spinal surgery: drowning in information but thirsty for a clear message” by Alshameeri ZAF,et al. [Eur Spine J (2020); DOI 10.1007/s00586-020-06401-y]

European Spine Journal -