A Study on Quality of Life in Post-tracheostomised Patients

IntroductionTracheostomy is a complex procedure which includes special care and attention with respect to the stoma and wound. But apart from surgical pitfalls certain qualities of life are also affected which needs due consideration for positive prognostic outcomes.ObjectiveTo assess the quality of life in post tracheostomised patients.Materials and MethodsThis study was a hospital based observational study conducted for a period of one year and included 97 patients. All patients underwent tracheostomy in ENT department and Central ICU. Nineteen post tracheostomy quality of life parameters were evaluated in 1st, 4th and 12th week interval.Results83.51% were male belonging to 6th and 7th decade. Most of them were tracheostomised on emergency basis (90.72%) for malignant causes (82.47%) and 95.88% of them had it for temporary period of time. Aryepiglottic folds were the most common site of malignant lesion. In the 1st week post tracheostomy, all parameters were affected except taste, smell and aesthetic state whereas in the following weeks it was employment, anxiety and voice production which were the affected quality of life.ConclusionMost people had upper airway malignant growth and due to late presentation, they had to be put under emergency tracheostomy. Thus, leading to less time in pre-operative counselling that is a must in improving post-operative period quality of life. Awareness is required for timely screening of patients from 5th decade onwards so that adequate and timely treatment can be provided.     

The effects of graphene nanostructures on mesenchymal stem cells

We report the effects of two-dimensional graphene nanostructures; graphene nano-onions (GNOs), graphene oxide nanoribbons (GONRs), and graphene oxide nanoplatelets (GONPs) on viability, and differentiation of human mesenchymal stem cells (MSCs). Cytotoxicity of GNOs, GONRs, and GONPs dispersed in distearoyl-sn-glycero-3-phosphoethanolamine-N-[amino(polyethylene glycol)] (DSPE-PEG), on adipose derived mesenchymal stem cells (adMSCs), and bone marrow-derived mesenchymal stem cells (bmMSCs) was assessed by AlamarBlue and Calcein AM viability assays at concentrations ranging from 5 to 300 μg/ml for 24 or 72 h. Cytotoxicity of the 2D graphene nanostructures was found to be dose dependent, not time dependent, with concentrations less than 50 μg/ml showing no significant differences compared to untreated controls. Differentiation potential of adMSCs to adipocytes and osteoblasts, – characterized by Oil Red O staining and elution, alkaline phosphatase activity, calcium matrix deposition and Alizarin Red S staining – did not change significantly when treated with the three graphene nanoparticles at a low (10 μg/ml) and high (50 μg/ml) concentration for 24 h. Transmission electron microscopy (TEM) and confocal Raman spectroscopy indicated cellular uptake of only GNOs and GONPs. The results lay the foundation for the use of these nanoparticles at potentially safe doses as ex vivo labels for MSC-based imaging and therapy.     

Is This Phantom Pain?

Right upper quadrant abdominal pain may be due to many causes, and at times may give rise to diagnostic dilemma. We present here a young lady with biliary type of pain who was eventually found to have gall bladder agenesis with aerobilia, in the absence of prior biliary intervention.     

Synthetically important ring opening reactions by alkoxybenzenes and alkoxynaphthalenes

Alkoxybenzenes and alkoxynaphthalenes, as nucleophiles, have drawn great attention from organic chemists over the decades. Due to their high ring strain, those particular classes of molecules are often used in synthesis by utilizing their properties to undergo facile Friedel–Crafts alkylations. Different isomeric and low or densely substituted alkoxybenzenes are used for synthesis according to the structure of the target molecule. Isomeric methoxybenzenes, are the most commonly used molecule in this regard. This review aims to comprehensively cover the instances of different alkoxy-benzenes/naphthalenes used as nucleophiles for ring opening.

This concise review reports the ring opening functionalizations of small sized molecular rings with alkoxybenzenes/alkoxynaphthalenes in Friedel–Crafts fashion.     

Solitary sacral osteochondroma without neurological symptoms: a case report and review of the literature

Purpose

To report a case of solitary sacral osteochondroma without neurological symptoms and describe the en bloc excision of the tumour, as well as review the literature on osteochondroma involving the sacrum.

Methods

Summary of the background data: although osteochondromas are among the most common benign tumours of the bone, they uncommonly involve the spine. Its occurence in the sacrum is rare, accounting for only 0.5 % of the osteochondromas involving spine. All previous cases of sacral osteochondroma have reported neurological symptoms on presentation.

Case report

A 21-year-old male presented with a palpable, painless mass in the left side of the sacral region of 1 year duration, without neurological symptoms. Radiological studies showed a well-circumscribed lesion with bony osteoid within arising from the sacrum at S3–S4 level left to midline, with features suggestive of osteochondroma. The tumour was excised en bloc through posterior approach. A literature review of sacral osteochondroma was conducted using MEDLINE search of English Literature and bibliographies.

Results

Histopathological studies showed the lesion to consist mature bone trabeculae with active enchondral ossification with cap of normal hyaline cartilage. Literature review yielded only 8 cases of sacral osteochondroma reported earlier.

Conclusion

This is the 9th case of solitary osteochondroma of the sacrum to be reported, the first to be reported without any neurological symptoms, and third case reported for which en bloc excision was performed.

     

An unusual case of vaccine-associated paralytic poliomyelitis

The present article reports a case involving an immunocompetent, previously well child who, despite two previous doses of inactivated poliovirus vaccine, developed severe flaccid paralysis consistent with polio after receiving oral polio vaccine.