A Tibetan Inscription by lHa Bla-ma Ye-shes-'od from dKor (sPu) Rediscovered

1994 ◽  
Vol 4 (3) ◽  
pp. 369-375
Author(s):  
Laxman S. Thakur
Keyword(s):  
First Line ◽  
The Right ◽  
River Sutlej

dKor and sPu are twin villages, separated by a rivulet, situated on the right bank of the river Sutlej in Kinnaur. A stēle inscription in question was first noticed from dKor by A. H. Francke in 1909, and subsequently by Giuseppe Tucci, in 1933 (Fig. i). Unfortunately neither Francke nor Tucci translated it in extenso. Francke, however, has published its main contents and Tucci relied on Francke's translation. Fragmentary it may be, but it contains invaluable information about the activities of Ye-shes-'od, a well-known monk-king of Western Tibet (formerly of the Gu-ge kingdom). To our knowledge, this seems to be the only Tibetan inscription which can definitely be dated to Ye-shes-'od's times. Fortunately, it mentions a specific date, i.e. the dragon's year (‘brug gi lo). In the year A.D. 1042 his grand-nephew Byang-chub-'od indirectly recalls Ye-shes-'od's deeds in the very first line of an inscription at rTa-pho. Thus it runs: spre'u'i lo la sngon mes byang chub sons dpas/gtsug lag khang ‘di bzhengs … [before, in the monkey year this temple (vihāra) was constructed by the grandfather the bodhisattva]. It is quite clear that the grandfather referred to in the line is none other than Ye-shes-'od. Another inscription also at rTa-pho, belonging to a somewhat later period, again records his name along with Byang-chub-'od and Zhi-ba-'od.

Anaphylactic shock: are we doing enough and with the right timing and order?

2015 ◽  
Vol 53 (3) ◽  
pp. 191-198
Author(s):  
H. Bălan ◽  
Adriana Gurghean
Keyword(s):  
Anaphylactic Shock ◽  
Good Practice ◽  
Fluid Replacement ◽  
First Line ◽  
Good Opportunity ◽  
First Line Therapy ◽  
Line Therapy ◽  
Practice Parameters ◽  
Golden Standard ◽  
The Right

Abstract Anaphylactic shock became, unfortunately, a common presence in Romanian mass-media, due to some fatal cases in the last months. The coincidence that in December 2014 the American Academy of Allergy, Asthma and Immunology, the American College of Allergy, Asthma and Immunology, and the Joint Council of Allergy Asthma and Immunology released Practice parameters offers a good opportunity to renew for all practitioners what is now considered the “golden standard” of good practice. Epinephrine must be considered the cornerstone and the most urgent measure to be applied in these cases, immediately after the diagnosis. A very important notice is to forget the administration of antihistamines or corticosteroids as first line therapy instead of epinephrine. Proper positioning of the subjects and quick fluid replacement (1-2 l of normal saline in a few minutes) are also mandatory.

scholarly journals Giant acquired acral fibrokeratoma: A case report

2019 ◽  
Vol 11 (2) ◽  
Author(s):  
Hend M. Al-Atif
Keyword(s):  
Dorsal Surface ◽  
Surgical Excision ◽  
Skin Lesions ◽  
Skin Tumor ◽  
Central Hospital ◽  
First Line ◽  
Fibrous Tumor ◽  
The Right ◽  
Histopathology Examination ◽  
Saudi Male

Acquired acral fibrokeratoma (AAF) is a rare benign fibrous tumor. Its size is usually small (i.e., <0.5 cm). However, few cases with giant lesions (i.e., >1 cm) have been reported. A 17-year-old Saudi male presented to the Dermatology Outpatient Clinic of Aseer Central Hospital, Aseer Region, Saudi Arabia, with a painless rounded skin-colored exophytic nodule arising from the dorsal surface of the right middle toe, 1.7 cm in diameter. The tumor was surgically excised. Histopathology examination revealed a giant polyploid lesion, composed of massive hyperkeratosis, acanthosis, a core of thick collagen bundles and vertically oriented small dermal blood vessels. The diagnosis was giant AAF. There was no evidence of recurrence after surgical excision. AAF is a rare benign skin tumor which should be differentiated from other similar skin lesions. Surgical excision is the first line for treatment.

scholarly journals Kesehatan hidung di Sekolah Polisi Negara Karombasan Manado

e-CliniC ◽  
2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Lyon Lalita ◽  
Ora I. Palandeng ◽  
Olivia C.P. Pelealu
Keyword(s):  
Health Status ◽  
Nasal Cavity ◽  
Public Attention ◽  
First Line ◽  
Cross Sectional ◽  
Negative Impacts ◽  
Cross Sectional Design ◽  
The Right ◽  
Observational Descriptive Study

Abstract: Physiologically, nose has several functions such as a filter and the first-line defence as well as protectve organ against the negative impacts of the environment. The nose is also useful to clean the air from dust, bacteria, and viruses through a mucociliary transport mechanism. Generally, the important role of smell has lack of public attention until eventually disorders or injuries that can disturb the ability and physiological function of the nose occur. This was an observational descriptive study with a cross sectional design. Respondents were 30 students in Sekolah Polisi Negara (State police school) Karombasan Manado; all were males. Nose health status of every respondent was determined by examination of the nasal cavity, conchae, mucous layer, secretion, septum, and post nasal drips. The results showed that from the 30 respondents, there was edema at the right conchae and left conchae each as many as 6.7%. Examination of septum showed that septum deviation of the right nose. Examination of nasal cavity, mucosa layer, secretion and post nasal drips overall resulted in normal category. Conclusion: Nose health status at Sekolah Polisi Negara Karombasan Manado was categorized as good.Keywords: nose health, physical examination of nose Abstrak: Secara fisiologis hidung mempunyai beberapa fungsi antara lain sebagai penyaring dan pertahanan lini pertama serta pelindung tubuh terpenting terhadap lingkungan yang tidak menguntungkan. Hidung juga berguna membersihkan udara inspirasi dari debu, bakteri dan virus melalui mekanisme transpor mukosiliar. Umumnya, peran penting dari indera penghiduan kurang mendapat perhatian khusus dari masyarakat sendiri hingga terjadi gangguan atau cidera yang dapat menghilangkan kemampuan dan fungsi fisiologis dari organ hidung. Penelitian ini bertujuan untuk mendapatkangambaran kesehatan hidung di Sekolah Polisi Negara Karombasan Manado. Jenis penelitian ialah deskriptif observasional dengan desain potong lintang. Sampel penelitian ialah 30 orang mahasiswa Sekolah Polisi Negara Karombasan Manado, seluruhnya berjenis kelamin laki-laki. Status kesehatan hidung setiap responden dinilai dengan memeriksa kavum nasi, konka, mukosa, sekret, septum, dan post nasal drip. Hasil pemeriksaan menunjukkan dari 30 mahasiswa, terdapat edema pada konka sebelah kanan dan kiri masing-masing sebesar 6,7%. Hasil pemeriksaan septum, ditemukan deviasi septum pada hidung kanan sebesar 3,3%. Pada pemeriksaan kavum nasi, mukosa, sekret, dan post nasal drips didapatkan hasil yang normal. Simpulan: Secara keseluruhan kesehatan hidung di Sekolah Polisi Negara Karombasan tergolong baik. Kata kunci: kesehatan hidung, pemeriksaan fisik hidung

scholarly journals Choosing the Right Treatment Option for the Right R/M HNSCC Patient: Should We Adhere to PFE for First-Line Therapy?

2021 ◽  
Vol 11 ◽  
Author(s):  
Katharina Lübbers ◽  
Mykola Pavlychenko ◽  
Theresa Wald ◽  
Susanne Wiegand ◽  
Andreas Dietz ◽  
...  
Keyword(s):  
Cox Regression ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy ◽  
Kaplan Meier ◽  
Real World Evidence ◽  
Consumption Benefit ◽  
Outcome Differences ◽  
The Right ◽  
High Level

BackgroundThe landmark EXTREME trial established cisplatin, 5-fluorouracil and cetuximab (PFE) as first-line chemotherapy (1L-ChT) for recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC). We were interested in outcome differences of R/M HNSCC in 1L-ChT and factors influencing outcome in certain subgroups, especially patients receiving PFE, and the value of PFE compared to other 1L-ChT regimens to provide real world evidence (RWE).MethodsFor this retrospective monocentric study, 124 R/M HNSCC patients without curative surgical or radiotherapy options receiving at least one cycle of 1L-ChT were eligible. We analyzed their outcome using Kaplan-Meier plot and Cox regression to identify predictors for prolonged survival.ResultsSubgroups benefiting significantly from PFE were patients suffering from an index HNSCC outside the oropharynx. The PFE regimen proved to be superior to all other 1L-ChT regimens in clinical routine. Significant outcome differences between PFE treatment within or outside controlled trials were not seen.ConclusionThis retrospective analysis provides RWE for factors linked to improved outcome. Subgroup analyses highlight the lasting value of PFE among the growing spectrum of 1L-ChT. Importantly, fit smokers with high level alcohol consumption benefit from PFE; considering the patient’s lifestyle factors, PFE should not be ignored in decision-making.

scholarly journals Treatment of unresectable cutaneous squamous cell carcinoma with pembrolizumab

2019 ◽  
Vol 12 (8) ◽  
pp. e229915
Author(s):  
Samantha Venkatesh ◽  
Ali Al-Haseni ◽  
Debjani Sahni
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Locally Advanced ◽  
Cutaneous Squamous Cell Carcinoma ◽  
First Line ◽  
Mutation Burden ◽  
The Right ◽  
Cell Death Protein ◽  
Potential Use

Currently, there are few effective therapies for locally advanced and metastatic cutaneous squamous cell carcinoma (cSCC); however, there is recent evidence supporting the use of immunological therapies in cSCC given the typically high mutation burden and association with immunosuppressed states. This report describes a 56-year-old man presenting with synchronous, invasive cSCC on the right temple and right dorsum of the hand deemed unfavourable for surgical resection. The patient was treated with nine infusions of programmed cell death protein 1 (PD-1) inhibitor therapy, pembrolizumab, with clinical and radiographical resolution of his lesions. This case illustrates the potential use of anti-PD-1 antibody as a first-line treatment in the setting of advanced, unresectable cSCC.

Rupture of lenticulostriate artery aneurysms

2014 ◽  
Vol 120 (2) ◽  
pp. 426-433 ◽  
Author(s):  
Olivier Heck ◽  
René Anxionnat ◽  
Jean-Christophe Lacour ◽  
Anne-Laure Derelle ◽  
Xavier Ducrocq ◽  
...  
Keyword(s):  
Therapeutic Strategy ◽  
First Line ◽  
Ischemic Event ◽  
Bilateral Case ◽  
History Of ◽  
Lenticulostriate Artery ◽  
The Right ◽  
The Brain ◽  
Deep Location

The authors report on 3 rare cases of ruptured lenticulostriate artery (LSA) aneurysms that were heralded by deep cerebral hematomas. The hematomas were unilateral in 2 cases and bilateral in 1; in the bilateral case, only a single LSA aneurysm could be identified on the right side of the brain. Because of their small size (≤ 2 mm), fusiform aspect, and deep location within the brain, all of the aneurysms were treated conservatively. There was no hemorrhage recurrence, and follow-up angiography demonstrated spontaneous thrombosis in 2 of the 3 cases. The clinical course was favorable in 2 of the 3 patients. The course in the patient with the bilateral hematoma was marked by an ischemic event after the initial episode, resulting in an aggravation of deficits. The cause of this second event was uncertain. Because our knowledge about the natural history of LSA aneurysms is incomplete, there is no consensus concerning a therapeutic strategy. The authors' experience in 3 reported cases leads them to think that a conservative approach involving close angiographic monitoring may be proposed as first-line treatment. If the monitored aneurysm then persists or grows in size, its occlusion should be considered. Nonetheless, other studies are needed to further strengthen the legitimacy of this strategy.

Continence aids in the management of urinary incontinence

2012 ◽  
Vol 22 (2) ◽  
pp. 85-98 ◽  
Author(s):  
J Browning ◽  
Z Zaheer ◽  
A Orzechowska ◽  
A Mistri
Keyword(s):  
Urinary Incontinence ◽  
Nursing Homes ◽  
Older People ◽  
Urge Incontinence ◽  
Individual Characteristics ◽  
First Line ◽  
Anticholinergic Medications ◽  
Surgical Measures ◽  
The Right

SummaryUrinary incontinence is a common problem, more so in older people and those in residential or nursing homes. Guidelines promote a structure to the management of incontinence, recommending non-pharmacological measures (including continence aids) as first-line options. Anticholinergic medications are used widely for urge incontinence, and surgical measures employed in selective cases.Whilst other treatments are being tried, or where incontinence is refractory to treatment (about 30% of cases), it is important to promote continence or contain incontinence with continence aids in order to minimize psychological complications. What can be a bewildering array of aids is available and choosing the right type of aid requires knowledge of these. Here, we suggest a classification of continence aids, describing individual characteristics and appropriate situations for use.

scholarly journals Desmopressin 120 mcg, 180 mcg, 240 mcg: The right treatment for the right patient

2018 ◽  
Vol 90 (2) ◽  
pp. 127 ◽  
Author(s):  
Pietro Ferrara ◽  
Ester Del Vescovo ◽  
Francesca Ianniello ◽  
Giulia Franceschini ◽  
Luciana Romaniello ◽  
...  
Keyword(s):  
Drug Therapy ◽  
Nocturnal Enuresis ◽  
Bladder Function ◽  
Efficacy And Safety ◽  
Nocturnal Polyuria ◽  
First Line ◽  
Normal Bladder ◽  
Increased Risk ◽  
The Right ◽  
Line Drug

Background: The first-line drug therapy for patients with nocturnal enuresis (NE) associated with nocturnal polyuria and normal bladder function is desmopressin (dDAVP). Objective: To evaluate if increasing dose of oral desmopressin lyophilisate (MELT) can improve response rates to dDAVP and is useful in enuretic children. Materials and methods: We enrolled a total of 260 children all diagnosed with NE. Enuretic children were treated with increasing MELT at a dose of 120, 180 and 240 mcg a day.Results. We included in our study a total of 237 children, 164 males (69.2%) and 73 females (30.8%) aged between 5 and 18 years (mean age 10.32 ± 2.52 years). Of the 237 patients enrolled in the study and treated with MELT 120 mcg, a full response was achieved in 135 (56.9%). A partial response was achieved in 21 (8.9%) patients, therefore the dose was increased up to 180 mcg, with further improving symptoms (14.3%) or full response (9.5%), and up to 240 mcg, without usefulness. Conclusions: MELT at the dose of 120 mcg resulted efficacy and safety; the increased dose up to 180 mcg resulted poorly efficacy; finally, the further increase up to 240 mcg did not improve the symptoms with the increased risk of side effects.

A case of delusional disorder

2017 ◽  
Vol 41 (S1) ◽  
pp. s828-s828
Author(s):  
O. Porta Olivares ◽  
M. Juncal Ruiz ◽  
B. Fernández Abascal Puente ◽  
M. Gómez Revuelta ◽  
M. Pérez Herrera ◽  
...  
Keyword(s):  
Therapeutic Relationship ◽  
Psychiatric Treatment ◽  
Delusional Disorder ◽  
Psychotic Symptoms ◽  
First Line ◽  
Behavioral Disturbances ◽  
Competing Interest ◽  
Long Acting ◽  
The Right ◽  
First Line Treatment

IntroductionFunctioning of patients with delusional disorder may be impaired, particularly if the delusional thinking is chronic rather than episodic. They refuse to characterize their beliefs as false and view opposing views with surprise, if not hostility and disdain, dismissing or ignoring them, and continuing their struggle to find resolution or restitution for the wrongs they have endured or the illnesses from which they suffer. They typically reject and often resent the suggestion that they are mentally compromised. They are a difficult group to engage clinically, often refusing to meet with a clinician about their delusions and/or to take medication. The first-line treatment of delusional disorder is antipsychotic medication rather than other clinical interventions. Patients with the disorder often reject psychiatric treatment, it is particularly important that medication be prescribed in the context of a therapeutic relationship that includes support, education, encouragement of healthier pursuits, and discouragement of damaging, delusion-inspired actions.MethodsWe describe a case of a 55-year-old woman with a delusional disorder that was diagnosed 4 years before. The supervision of the right take of the treatment was not possible and the intensity of behavioral disturbances increased. Then we started the treatment with long-acting injectable aripiprazole.ResultsWithin the 4 months following the start of treatment, her mental state improved by attenuation of psychotic symptoms.ConclusionsLong-acting aripiprazole could be an effective tool for treatment of psychotic symptoms in patients with no insight and difficulties to check the proper treatment take.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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