Cervical Necrotizing Fasciitis: An Uncommon Fulminant Disease Entity

Cervical necrotizing fasciitis is an uncommon fulminant disease of single or polymicrobial infectious origin characterized by rapid necrosis of the subcutaneous tissue and fasciae. The disease has high mortality rate. Early identification, timely surgical debridement, broad spectrum antibiotic therapy, aggressive wound care and intensive medical care of the patient are of paramount importance for better prognosis. We present a case report and review of literature of cervical necrotizing fasciitis with a thorough insight into its epidemiology, etiology, pathogenesis, diagnosis and management.

Abnormal Exacerbation of Moderately Differentiated Gastric Adenocarcinoma in a Patient with TAFRO Syndrome: An Impaired Tumor Immunity?

TAFRO syndrome is a relatively new disease entity first reported in 2010. We report a case of TAFRO syndrome accommodated by abnormal exacerbation of moderately differentiated gastric adenocarcinoma. The pathophysiology of TAFRO syndrome is largely unknown, but because the disease often responds to immunosuppressive therapy and also because T follicular helper (Tfh) cells are reported to be drastically decreased in TAFRO syndrome, involvement of a dysregulated immune system can be speculated. Growing evidence points toward a pivotal role of Tfh cells in tumor immunity through supporting ectopic lymphoid structures, which are recruitment sites for cells directly engaging in antitumor activity such as CD8⁺ T cells, NK cells, and macrophages. In fact, Tfh cells are reported to positively correlate with longer survival in human colorectal and breast cancer. Combined with our observations of hyperprogressive gastric cancer in the presented patient, an impaired tumor immunity is strongly indicated in TAFRO syndrome.

A CRITICAL REVIEW OF VATIKA HRIDROGA WITH SPECIAL REFERENCE TO ISCHEMIC HEART DISEASE

Given increasing evidence, most deaths are due to non-communicable diseases; half of them are the cardiovascular disease. Hridaya is moolasthana of pranvavaha and rasavaha strotas. According to Acharya Sushruta, any condition that produces disturbance in the heart is Hridroga. It is classified into five types. Vataja Hridroga is characterized by Ruja in Urah Pradesha (Pain in the chest region). Vatika type seems to have conceived the disease entity correlated with ischemic heart disease. None of the other Cardiac afflictions appears to have been described under Hridroga. The prevalence rate in the younger age group is increasing day by day so, we need to know the detailed knowledge of vatika hridroga

AMA FROM AYURVEDIC AND MODERN PERSPECTIVE

Agni is one of most powerful transformative principles of Ayurveda. Deranged Agni leads to the formation of Ama. Ama is responsible for causing most of the diseases in human beings. The disease produced, clinically mani- fests itself in form of various signs and symptoms. These signs and symptoms are the principal tools for a physi- cian to diagnose the disease and treat it promptly. On the basis of these symptoms, all diseases can be classified in Samavastha and Niramavastha. If an objective Parameter that could measure the severity of Ama is searched, it will prove to be an advantage for the physician, who could then catch the cause (Ama) and save patients from this harmful disease entity. A definite line of treatment of Ama can be planned after considering the symptoms and severity of the condition. Keeping this approach, the review is carried out to understand Ama from Ayurvedic and Modern perspectives. After reviewing it can be concluded that Ama has no direct correlation in modern science but can best be equated to 'toxins'. They may be endotoxins like enzymes, hormones, catalysts, etc. when these are unable to function properly or entirely, different metabolites are formed which are not acquired by the body. On further process these go on accumulating in different systems, affecting the normal mechanism of that respective system or exotoxins produced by some bacteria or micro-organism when they enter into the body. Keyword: Agni, Ama, Toxin

Retroperitoneal Angiomyolipoma in A Woman of Childbearing Age: A Case Report

Introduction: Extrarenal angiomyolipoma is an uncommon disease entity and is rare in the retroperitoneum. This lesion shows three benign components, including mature adipose tissue, thick-walled blood vessels, and smooth muscles. Case Report: This report describes a 37-year-old woman who presented with incidental right retroperitoneal mass in prenatal checkup. The patient underwent excisional surgery. Histological examinations and the immunohistochemical study revealed angiomyolipoma. Based on the diagnosis, the patient received no more treatment. After 3 years of close followup examinations, no recurrence was observed. Conclusion: This diagnosis is often confused with many other entities in retroperitoneum. Thus, imaging and histologic correlation are required. Proper diagnosis is essential for further patient management and avoids unnecessary treatment.

The difference of the retinal structural and microvascular characteristics in patients with MOGAD-ON and AQP4-ON

Background Antibodies against myelin-oligodendrocyte-glycoprotein (MOG-Abs) associated disorders (MOGAD) have been recognized as a disease entity in their own right. Optic neuritis (ON) is the most common symptom in MOGAD. Objective To demonstrate the differences in retinal microvascular characteristics between patients with MOGAD-ON and aquaporin-4 antibody (AQP4-Ab) positive ON. Methods A prospective study in which optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) were used to measure retinal and microvascular parameters. Results 22 MOGAD-ON eyes, 32 AQP4-ON eyes and 60 control eyes were included in the study. The thickness of RNFL and GCC in MOGAD-ON eyes is significantly lower than that of HC (p <0.001, respectively), but comparable to AQP4-ON eyes. The vessel density in retina capillary plexus (RCP) reduced significantly in MOGAD-ON than that in AQP4-ON (p < 0.05, respectively). Unlike AQP4-ON, the visual accuracy in MOGAD-ON was positivitly correlated with vessel density of superficial RCP (P = 0.010) and ON relaspe times (P = 0.038). Conclusion The retinal neuro-axonal damages between MOGAD-ON and AQP4-ON were comparable. Unlike AQP4-ON eyes, microvascular densities were significantly reduced in MOGAD-ON, and was positively correlated with the deterioration of visual acuity in MOGAD-ON.

Eosinophilic, polymorphic and pruritic eruption associated with radiotherapy (EPPER) in patient with tongue cancer

Eosinophilic polymorphic and pruritic eruption associated with radiotherapy (EPPER) is a rare disease entity that appears in cancer patients after radiotherapy. We describe patient with tonsil cancer who presented with EPPER in an area that had been irradiated. The patient responded to the application of topical corticosteroids and systemic antihistamines.

CRITICAL ANALYSIS OF NIDANA AND SAMPRAPTHI OF AMAVATA WITH SPECIAL REFERENCE TO AUTOIMMUNITY

The human body is a conglomeration of dosha, dhatu and mala. Even though doshas are having opposite gunas they do not harm the body when in equilibrium state and it maintains the integrity of dushyas. Ama is a unique concept in Ayurveda which can be considered as improperly digested food or accumulated metabolic waste which is not expelled out of the body has a tremendous capacity to vitiate the dosha, dhatu and mala and is capable of producing various diseases. Amavata is a disease entity where ama and vata plays important role in the samprapthi of disease and viruddha ahara and chesta are considered to be the main causative factors. Autoimmunity is the system of immune responses of an organism against its healthy cells and tissues. Any disease that results from such an aberrant immune response is termed an autoimmune disease. Keywords: Amavata, Ama, virudhahara, cheshta, autoimmunity