Microcystic serous cystadenoma of the pancreas: a report of two cases with one of diffuse presentation.

Microcystic adenoma or serous cystadenoma is an uncommon tumor and accounts for 1-2% of the exocrine neoplasms of the pancreas. Usually unifocal, they present as single, large, well-demarcated multiloculated cystic tumors, ranging in size from 1 to 25 cm. Multifocal variants or diffuse serous cystadenomas are extremely rare. We present 2 cases of which 1 is a diffuse variant affecting the body, tail and part of the neck of the pancreas. In both the patients the tumors were detected incidentally. We highlight on the diffuse variant in view of its rarity and present a review of literature. In this case the entire body and tail of the pancreas was spongy replaced by multicystic lobules and hyalinized fibrocollagenous stroma. The cysts were lined by low cuboidal glycogen containing bland cells. Such a unique presentation wherein the entire body and tail of the pancreas is replaced with multiple cysts is a diffuse presentation of microcystic adenoma and a search through literature revealed only 7 such cases among the 15 cases with multifocal presentation reported.     

Comparison of the efficacy of liraglutide with pioglitazone on dexamethasone induced hepatic steatosis,dyslipidemia and hyperglycaemia in albino rats

Objectives:To evaluate the efficacy of liraglutide with pioglitazone for prevention of dexamethasone induced hepatic steatosis, dyslipidemia and hyperglycemia in Albino rats.Results:Dexamethasone caused hepatomegaly, dyslipidemia, and hyperglycemia. Both pioglitazone and liraglutide significantly reduced hepatomegaly, dyslipidemia and hyperglycemia (P < 0.01). Reduction of blood sugar levels after glucose load was significant with pioglitazone when compared with liraglutide (P < 0.01).Conclusion:Liraglutide has comparable efficacy to pioglitazone in prevention of dexamethasone induced hepatomegaly, dyslipidemia and fasting hyperglycemia.KEY WORDS: Dexamethasone, hepatomegaly, hyperglycemia, liraglutide, pioglitazone, prevention     

HPV-associated carcinoma of esophagus in the young: a case report and review of literature

Esophageal carcinoma (EC) is rare in the younger age group, with only 15 cases reported in world literature. It is even rarer for an etiological agent to be implicated.A case of a 15-yr-old boy with squamous cell carcinoma of the esophagus is reported. Human papillomavirus (HPV) 16 DNA sequences were detected in the neoplasm and the adjacent mucosa by polymerase chain reaction followed by restriction fragment length polymorphism (PCR-RFLP). The adjacent mucosa also showed virus-induced changes.     

Pathology for the HPB Surgeon

Optimal care of a patient implies a good professional understanding between all the medical personnel involved in that patient’s care. Similarly a basic understanding of the areas where surgery and pathology interact would go a long way, in clarifying the disease process in the patient. This review aims to cover a few topics in liver lesions, FNAC Vs core biopsy, IHC, Margin examination, and frozen sections, in order to improve the communication between these two specialities.     

Thoracic spinal nerve and root conduction: A magnetic stimulation study

We describe a technique of magnetic coil (MC) stimulation of the thoracic spinal nerves and roots in 12 normal subjects and a patient with diabetes mellitus. We kept the MC flat against the vertebral column in the midline over T-7, T-8, and T-9 spinous processes and obtained compound muscle action potentials from the upper rectus abdominis, external oblique, and intercostal muscles. We obtained mean latencies to these muscles after stimulation in the posterior axillary line. We noted that the onset latencies remained fixed despite increasing the intensity of stimulation from 30% to 100% and on moving the coil up to 3 cm lateral to the spinous processes suggesting that the stimulation of the fastest conducting fibers was occurring at a fixed site, most likely at the intervertebral foramina. Prolonged latencies in the diabetic patient confirmed the diagnosis of radiculoneuropathy. © 1995 John Wiley & Sons, Inc.     

Bilateral Adrenal Phaeochromocytoma with Pregnancy

Summary: A case is reported of fatal terminal shock following normal labour; bilateral adrenal phaeochromocytoma and pituitary necrosis was revealed at autopsy.     

Sex difference in cellular retinol- and retinoic acid-binding proteins in human colon adenocarcinomas

Human colon adenocarcinomas and adjacent non-cancerous, normal colon from the same patient were assayed for the presence and amounts of cellular binding proteins for retinol (CRBP) and retinoic acid (CRABP) by sucrose gradient analysis. In male patients, the mean concentrations of both CRBP and CRABP in the colon cancers were statistically significantly higher than in the adjacent normal colon. By contrast, in female colon cancers, the mean levels for both binding proteins were reduced approximately 2-fold, compared to the concentrations in the adjacent normal colon. These findings reveal an unexpected sex difference in the binding proteins for retinol and retinoic acid in human colon malignancies.     

The north Indian dengue outbreak 2006: a retrospective analysis of intensive care unit admissions in a tertiary care hospital

Dengue fever (DF), dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS) have emerged as public health problems of international concern. During a dengue outbreak in north India in October 2006, more than 10000 patients presented to hospital with fever. We retrospectively analysed the presenting features, treatment given and the outcome of patients admitted to the Intensive Care Unit (ICU), All India Institute of Medical Sciences (AIIMS): a tertiary care hospital in New Delhi. A total of 72 critically ill patients were referred for admission to the ICU. The common symptoms were fever (100%), myalgia (40%) and gastrointestinal bleed. Menorrhagia and haematuria were seen as the sole presenting features in many females. Treatment consisted of bed rest, oxygen therapy, intensive monitoring, antipyretics, platelet transfusions, hydration and electrolyte correction. On average, six units of platelets were required per patient. The average duration of stay in the ICU was 3 d. There were eight deaths. Adequate hydration and platelet replacement with transfusions, especially apheresis platelets to a target level above 60000 platelets/mm3, were effective means of combating the disease.