Most Read

  • CORONA IN INDIAN EPICS

    This corona disease was mentioned in Indian mythology a few thousand years ago, the article are explained the corona virus features, how it spreads, where and how to control it, mentioned Indian epics.

  • Technological dependence, captive market and outsourcing in the Spanish telecommunications equipment industry Angel Calvo (UB)

    This article addresses the complex relations between the expansion of multinationals and economic nationalism in Southern Europe during a period of industrial crisis, growing economic integration and intense technological change, all amidst a notable alteration of the regulatory framework. The paper focuses on the process of global restructuring of the telecommunications industry in the two final decades of the 20th century and the first years of the new millennium. The period encompasses the transition from an industry based on the close linkage, if not strict integration, between the monopoly of the telephone service and the national telecommunication equipment industry. Methodologically, it is based on a case study – that of the International Telecommunication and Electronics Company -, on an interdisciplinary approach and on varied sources. The article reveals the factors behind the transformation of a vertically integrated company into one that outsourced its production before being engulfed by the globalized economy. It also highlights the role of international markets and, more specifically, the Latin American market.

  • Accuracy of Prostate Specific Antigen Density in Predicting Prostate Cancer- A single-centre UK experience

    Introduction and objectives: PSA has been a useful tool in identifying prostate cancer since its discovery. However relying on this alone can lead to unnecessary over investigation as it can be falsely raised in other conditions. PSA density is a possible enhanced marker for prostate biopsy indication, however it is not standard practice or recommended in national guidelines. Previous studies have shown that PSA density is most useful when the PSA is in the range of 4-10. We aim to study the effectiveness of PSA density at detecting prostate cancer within that range as well as outside that range. Methods: Retrospective single centre study at Peterborough City Hospital including 500 patients who had a MRI prior to prostate biopsy between July 2017 to July 2018. Patients undergoing repeat biopsy already on a cancer pathway were excluded. PSA density was calculated by dividing PSA from the prostate volume recorded on the MRI. A cut of value of PSA density was chosen at 0.15 and 0.10. Results: Data from 500 patients with a mean age of 65 and mean PSA of 10.7 (PSA range 0.32 to 99). 251 (50.2%) patients had cancer on histology with 152 having clinically significant cancer. Mean PSA density was 0.11ng/ml/cm3 with benign histology, 0.36ng/ml/cm3 for all cancer and 0.48ng/ml/cm3 for clinically significant cancer. Overall the mean PSA density in prostate cancer was found to be 0.15. Sensitivity of PSAD at detecting all prostate cancer at cutoff of 0.10 with PSA 4-10 was 76% and 88% for clinically significant prostate cancer (Gleason 7>). The negative predictive value was 94% for clinically significant prostate cancer. With PSA of 10 and PSA density of 0.10 the sensitivity was 93% (all cancer) and 96.6% (Gleason 7>) with a negative predictive value of 93.7% for clinically significant prostate cancer. At a cut…

  • Solitary extramedullary plasmacytoma of prostate on the background of treated prostate adenocarcinoma

    Solitary Plasmacytoma is a rare entity which accounts for < 5% of all plasma cell dyscrasias. Most commonly involved sites for solitary extramedullary plasmacytoma are head and neck (90 %) especially upper respiratory tract, followed by Gastrointestinal tract. Rarely it can involve testes, bladder and orbit. PET/CT provides an invaluable imaging support for initial evaluation of additional plasmacytomas and response to treatment. There are no randomized trials regarding the best treatment approach. Generally, radiotherapy remains treatment of choice of solitary plasmacytoma. Our case, with its rare site of occurrence along with patient’s history of radiotherapy treated prostate malignancy and significant history of radiation cystitis provides a unique diagnostic and therapeutic challenge. Treatment can be personalised in cases such as this, where patients can be treated with chemotherapy in contrary to radiotherapy as further exposure to the radiations could exacerbate the bleeding risks.

  • Guidelines for Safe and Effective Use of Hydroxychloroquine in COVID-19 Patients

    The emergent need to treat COVID-19 patient must be tempered with safe use of drugs. The guideline set forth provides parameters for dosing and monitoring hydroxychloroquine in this population, reducing the occurrence of adverse effects and improving overall pharmacotherapy.

  • Mucin-producing papillary thyroidal carcinoma with unusual histology: A rare case report

    Background: Although mucinous carcinoma or mucoepidermoid carcinoma of the thyroid gland are an extremely rare but an established entity, papillary thyroidal carcinoma (PTC) with mucin production is also exceedingly rare. Case report: We reported one rare case of mucin producing PTC with unusual histology. The patient was 71 years-old Japanese man. The hemi-thyroidectomy was performed. Histologically, the tumor cells harbored the similar features with conventional PTC, but this case indicated extracellular and intracellular mucin. On the other hand, the tumor showed cystic-papillary or cribriform growth of the columnar tumor cells. Conclusions: We diagnosed it as mucin-producing PTC with columnar cell variant (CCV). We examined it immunohistochemically, and this case expressed TTF-1, thyroglobulin, and cytokeratin (CK)7, but was negative for HBME-1. We discuss on the differential diagnosis.

  • The multifactorial etiology and approach to iron deficiency anemia in adolescent girls

    Iron deficiency anemia (IDA) is a common but underdiagnosed cause of morbidity in adolescent females. Associated thrombocytopenia is rare, but resolves when the anemia is treated with iron supplementation. Menorrhagia is an important cause in the multifactorial etiology and may be familial. This article presents a case of severe anemia and thrombocytopenia in the presence of iron deficiency due to menorrhagia. A holistic approach to IDA is discussed with an approach to the management thereof in adolescent females.

  • Merkel cell polyomavirus on primary Merkel cell carcinoma of the skin with partial regression after biopsy

    Introduction: Merkel cell carcinoma (MCC) is an uncommon primary cutaneous tumour. The majority of these tumour (about 80%) have integration of the polyomavirus DNA into the genome of Merkel cell carcinoma. Reports about at least nine cases of partial regression in primary and or metastatic lesions have been published. It is likely that regression is an immunological response mediated by T cells. Case Report: We report an 81year old woman who presented with a rapidly growing tumor in the left thigh. An incisional biopsy of the lesion was performed. Histopathologic and immunohistochemically diagnosis were consistent with Merkel cell carcinoma. Scant peritumoral lymphocytic infiltrate was CD3+, CD4+, and scant CD8+ was observed. The reporter test polymerase chain reaction (PCR) for Merkel virus yielded a positive result. Twenty days after the initial biopsy the lesion began to regress. Conclusion: Merkel cell carcinoma is a rare and aggressive tumour. At least nine cases of partial regression on primary and or metastatic lesions have been published. It is likely that regression is a T cell-mediated immunological response. A reporter test (PCR) for Merkel virus and both types of lymphocytic infiltrate and distribution (intratumoral and peritumoral) in our case very important as there are several known mechanisms that can contribute to cellular immune escape in MCP y V positive Merkel cell carcinoma. Study of integration and regulation of the immunological system implies future development of individually of different immunological therapies.

  • Individualized approach for Coarctation of the Aorta in a Patient with PHACE syndrome and Extensive Hemangiomas

    PHACE syndrome is a neurocutaneous disorder with large facial segmental hemangiomas associated with anomalies of the brain, eye and heart. We report a case of a 3 years old girl who presented at the age of 6 weeks with severe coarctation of the aorta and aortic arch aneurysm. In addition, she had extensive strawberry hemangiomas over the scalp, neck and chest which, after extensive investigation, led to the diagnosis of PHACE syndrome. After complete evaluation we successfully initiated treatment with propranolol that was pursued without complications over three years with striking success and remarkable regression of her hemangiomas. Meanwhile the coarctation was managed conservatively. This case highlights that propranolol treatment, while effective against hemangiomas, may contribute to slow the progression of aortic arch aneurysm and delay the need for high risk surgical intervention.

  • Surgical Correction of Intra-Areolar Polythelia

    Intra-areolar polythelia (IAP) is an extremely rare congenital malformation with the presence of two or more nipples within a normal sized areola. This is a case report of a 25-year-old gentleman who presented with two nipples on the areola of his left breast since birth. Surgical excision was done under local anesthesia for aesthetic purpose.