Thoracoplasty with acrylic plate-marlex mesh combination following near total resection of sternum: a case of chondrosarcoma of sternum

Removal of the whole sternum for malignant tumours results in a large defect, causing severe deformity and possible paradoxical movements of the chest wall. The reconstruction of the resultant large defect of the chest wall is often complex and difficult. Commonly used materials include rib autograft, steel strus acrylic plate and various synthetic meshes such as Goretex or Marlex mesh, with a myocutaneous flap for coverage. A case of a 48-year-old man with sternal chondrosarcoma successfully treated with thoracoplasty using acrylic plate-marlex mesh combination following near total resection of sternum is reported.     

Pitfall in diagnostic trauma laparoscopy

The resurging interest in diagnostic laparoscopy has witnessed its increasing application in trauma surgery. Such unbridled enthusiasm has at times overlooked its shortcoming in the diagnosis and management of certain in abdominal injuries. We report and discuss one such conspicuous limitation and advocate that the use laparoscopy in abdominal trauma should be tempered with caution.     

Pulmonary resection for metastatic breast cancer

The management of pulmonary metastasis from breast carcinoma is challenging and often consists of palliation of symptoms. Surgical resection of pulmonary metastasis is considered inappropriate in view of the disseminated nature of the disease and limited life expectancy. It can however be a worthwhile option if imaging, including bone scans rule out metastatic disease in other part of the body. We report a patient with pulmonary metastasis from breast carcinoma who was successfully treated with pulmonary wedge resection of the metastatic lesion.     

Primary squamous cell carcinoma of caecum

Proximal to the anal canal, carcinomas composed in whole or in part of squamous epithelium are distinctly uncommon, accounting for 0.1 per cent of all colorectal carcinomas. Pure squamous cell carcinoma of the colorectum are extremely rare. Here we report a case of primary squamous cell carcinoma of the caecum in a 55 year old lady from South India.     

Assessment of the referral system for surgical removal of third molars at the Dental Faculty,King Saud University

Introduction: There is compelling evidence that prophylactic extraction of third molars is a health problem that needs to be addressed. In particular, the vast amount of evidence demonstrating complications after removal of third molars, rather than supporting the necessity of removal or the negative effects of retention, raise this concern. Objective: The aim of this study was to investigate the referral system for third molar extraction at our institution by assessing patient opinions and the experience of the oral surgeons and the referring dentists. The main outcome measures of concern were the reasons for third molar extraction, patient awareness about the surgery and the comorbidities that may accompany the surgery. Methods: Pilot cross-sectional survey questionnaires were distributed at the Dental Faculty Clinic at King Saud University, from 15 March 2015 to 30 June 2016 by the staff in charge of the patient waiting area, oral surgery clinic, primary care clinic and specialist clinic. Results: Of 400 potential respondents, 226 completed the survey (response rate: 54%). Of these patients, 91% knew why they had been referred to the oral surgery department, but 73.5% did not understand the surgical extraction procedure or its complications. In total, 45.2% of the patients referred had no signs or symptoms, and 36% were referred for prophylactic reasons. In conclusion, our system needs reassessment. To combat the subjective health practice of routinely referring patients for prophylactic extraction, the role of primary care should be emphasised by implementing a system for regular patient check-ups, and public awareness should be increased.Key words: Wisdom tooth, removal, retention, surgery     

ACI/EG eutectic mixture mediated synthesis,characterization and in vitro osteoblast differentiation assessment of spiropyrrolo[1,2-b]isoquinoline analogues

An eco-friendly acetylcholine iodide–ethylene glycol (ACI/EG) deep eutectic mixture mediated green protocol has been developed for the synthesis of hitherto unexplored multi-functionalized linear tricyclic spiropyrrolo[1,2-b]isoquinoline analogues. The effects of the synthesized compounds on the osteoblast differentiation of hBMSC-TERT cell lines were investigated and promising results were observed with significant IC₅₀ values. In addition, molecular modeling simulations were also performed with the 3D structure of BMP-2 to reveal binding interactions and orientations of highly potent spiropyrrolo[1,2-b]isoquinoline analogues.

An eco-friendly acetylcholine iodide–ethylene glycol (ACI/EG) deep eutectic mixture mediated green protocol has been developed for the synthesis of unexplored multi-functionalized linear tricyclic spiropyrrolo[1,2-b]isoquinoline analogues.     

The role of concomitant immunosuppressants in impeding the progression of diabetic retinopathy: A pilot study

Purpose:Hallmark of Diabetic Retinopathy (DR) is blood-retinal barrier alteration. Vascular endothelial growth factor (VEGF) and inflammation are involved in the pathogenesis of DR. Anti-VEGFs and lasers are effective in treating DR but have numerous drawbacks, hence the need to develop alternative therapies that may delay the onset or progression of DR.Methods:Fifteen patients were recruited in each group; the study group was on immunosuppressants for some other coexisting disease and the control group was not on them. Each subject underwent detailed history, ophthalmic examination, and glycosylated hemoglobin (HbA1c) and renal function tests at the time of recruitment and the end of one year. Primary outcome measure was to compare the progression of DR in diabetics on immunosuppressant versus those not on it.Results:Median age in the study and control group was 57 years and 60 years, respectively (P = 0.6). Median duration of diabetes was 11 and 12 years in the study and control group, respectively (P = 0.7). HbA1c for the study and control group for first visit was 7.6% and 8.0%, respectively (P = 0.26) and for second visit was 7.5% and 8.1%, respectively (P = 0.11). Hypertensives in the study and control groups were 9 and 4, respectively (P = 0.065); renal disease in the study and control groups was 4 and 2, respectively (P = 0.361). The control group showed 33.3% progression of DR, and no progression was seen in the study group (P = 0.014).Conclusion:Immunosuppressants seemed to delay the onset and progression of DR in the earlier stages.