A comparative prospective observational study on the use of ulipristal acetate versus mifepristone in reduction of the size of uterine leiomyoma

Background: Fibroid or uterine leiomyoma is the most common benign tumor of the uterus in the reproductive age group and found in one out of every four women. They are symptomatic in 50% of women, with the peak incidence occurring among women in their 30s or 40s. Fibroid can cause a variety of symptoms which include menstrual disturbances commonly menorrhagia and dysmenorrhea. It is a common indication of hysterectomy in Indians. An effective medical treatment option may reduce hysterectomy-associated morbidity and mortality. This study is undertaken to evaluate the efficacy and safety of medical management of myoma and contribution in the reduction of myoma size comparing the two drugs ulipristal and mifepristone. Aims and Objectives: The study was conducted to compare reduction of menorrhagia (By pictorial blood loss assessment chart score), reduction of fibroid size (using transvaginal ultrasonography), and improvement of hemoglobin (Hb) level. We are also evaluating safety or side effects using these drugs. Materials and Methods: The study includes 210 patients who are divided into two groups. Group A includes 105 patients who are treated with tablet Ulipristal Acetate 5 mg daily for 3 months and Group B includes 105 patients who are treated with tablet mifepristone 25 mg daily for 3 months. Results: Ulipristal and mifepristone both are effective in reduction of menorrhagia and improvement of Hb levels, but Ulipristal is more effective in reduction of size of uterine myoma than mifepristone after 3 months of treatment. Conclusion: Multicentric study over a larger population is required to reach a valid conclusion.

Bilateral symmetrical lipoma of the buccal fat pad as an incidental finding in a woman with weight gain after tamoxifen: a case report

Although lipoma is a common benign tumor, it occurs relatively infrequently in the oral and maxillofacial areas, and only 31 cases of lipoma in the buccal fat pad have been reported. Herein, we present an extremely rare case of symmetric lipomas in both buccal fat pads. These masses were incidentally discovered during a facelift procedure in a 50-year-old woman with a 4-year history of tamoxifen use. during which she had gained 10 kg. The patient stated that cheek protrusion had developed concomitantly with weight gain and was exacerbated by an injection lipolysis procedure she had received 1 year previously. This case underscores the importance of paying careful attention to the patient’s medication use and surgical history when evaluating suspected cases of lipoma, and sheds light on tamoxifen use and subcutaneous injections of phosphatidylcholine and deoxycholate as potential risk factors for lipoma development.

Clinical Application of Low-Temperature Plasma Radiofrequency in the Treatment of Hemangioma in Nasal Cavity, Pharynx and Larynx

Objective Hemangioma is a common benign tumor in the head and neck. The therapeutic effect by conventional treatment was not very satisfactory. The purpose of this study is to explore the surgical strategy of low-temperature plasma radiofrequency in the treatment of hemangioma located in the nasal cavity, pharynx, and larynx. Methods The clinical data of 29 cases with hemangioma in nasal cavity, pharynx, and larynx treated by low-temperature plasma radiofrequency ablation were retrospectively analyzed. The strategy of ablation before resection was performed for 16 cases of nasal capillary hemangioma. The other 13 cases of cavernous hemangioma in the pharynx and larynx were treated by the strategy of direct ablation. Results All 29 patients underwent a successful operation with minimal intraoperative bleeding and no postoperative bleeding complications. There was no nasal septum perforation, dyspnea, dysphagia, dysphonia, or other complications. The patients were followed up for more than 3 years without recurrence. Conclusion Low-temperature plasma radiofrequency is a practical, minimally invasive, and accurate method for treating hemangiomas in the nasal cavity, pharynx, and larynx. For capillary hemangiomas, the strategy of ablation before resection may be an effective way to reduce bleeding, and for cavernous hemangiomas, the strategy of direct ablation is a simple and efficient method.

Physiotherapy Rehabilitation in Subject with Scapular Osteochondroma: A Case Report

Introduction: The most prevalent benign tumour affecting the metaphysis of long bone is osteochondroma, a form of cartilaginous tumour. Solitary or multiple osteochondromas can prevail.Hereditary multiple exostosis (HME) or familial osteochondromatosis is the multiple variant, which is an autosomal dominant syndrome. Case Presentation: A 35-year old female with right-hand dominance was referred todepartment of physiotherapy. On palpation small nodular swelling of marble size was present in left axilla. X-rays findings showed increased scapular mass and ribs were compressed laterally. Discussion: The most widespread benign tumour is osteochondroma. In 3.0-6.4 percent of all instances, the scapula is implicated. The osteochondroma normally develops on the scapula's anterior aspect. The scapula osteochondroma induces pain and a grating sound when the scapula is moved. Mechanic irritation of muscle, tendon, or soft tissue, emergence of a pseudoaneurysm or bursa, fracture, or malignant transformation are all causes of symptoms. Conclusion: Osteochondroma is a common benign tumor. Management of osteochondroma is important to improve the quality of life. Physiotherapy plays an important role in managing Scapular osteochondroma.

Effect of Two Different Doses of Vitamin D Supplementation on Uterine Myoma on South East Iranian Population; A Clinical Trial

Objective: Uterine myoma is the most common benign tumor however with significant distress and reduced quality of life in affected women. Besides, vitamin D deficiency may be a risk factor for uterine myoma. This study aimed to evaluate the effect of vitamin D supplements on the size of myoma in women with vitamin D insufficiency or deficiency. Materials and methods: This clinical trial was conducted in a teaching hospital from 2019 to 2020. According to baseline vitamin D level, participants were assigned into two interventional equal groups (vitamin D deficiency or insufficiency) to receive either 1000 IU daily or 50000 IU weekly vitamin D for 12 weeks. The size and location of the uterine myoma were compared before and after the intervention. Results: Totally, 137 women with uterine myoma were enrolled. Based on baseline vitamin D level, 52 cases had vitamin D insufficiency and 85 cases had vitamin D deficiency. No significant difference was observed in age and BMI in both groups. The location of the subserosal and intramural myoma did not differ, otherwise, the percent of the submucosal myomas were increased significantly (p=0.020) after the intervention. In both groups decreased myoma size otherwise not significant was seen after the intervention (p=0.148 and p=0.664 respectively). Conclusion: Vitamin D supplementation may not be effective in women with vitamin D insufficiency or deficiency in the short term to reduce myoma size.

Milan system in salivary gland lesions: Its diagnostic and clinical relevance

Background: The salivary gland lesions constitute around 3–6% of all head-and-neck lesions and have always posed a diagnostic riddle for the cytopathologists around the world. Since the majority of these lesions need surgical excision, it is, therefore, important to diagnose these lesions with utmost precision to prevent over or under stage procedures. The recent adaption of Milan system of reporting aims to establish a uniform, accurate, and consensual reporting system which bridges the communication between the pathologists and the clinicians. Aims and Objectives: The current study aims to assess the diagnostic application of Milan system and aims to reclassify the lesions according to it. Materials and Methods: The current study was conducted at our institute during 1 year period. All salivary gland swellings presenting to the fine-needle aspiration cytology (FNAC) section during this period were included in the study. Along with this, records and slides of cases of salivary gland lesions were retrospectively assessed. All relevant data and radiologic findings were retrieved from the case records. FNAC was done using 23 G needle. The slides were stained with both Leishman and Papanicolaou stain wherever possible. Quantitative data were expressed as mean and standard deviation and percentages. All the 83 lesions were reclassified as per the Milan system. Histopathology was available in 42 cases. Inclusion criteria: All the samples of the patient having salivary gland lesion(s) whose FNAC were performed in the department of pathology. Statistical Analysis: Data were be entered into Microsoft Excel spreadsheets. For quantitative data, mean and standard deviation were calculated. For qualitative data, percentage and proportion were calculated. Sensitivity, specificity, and spearman correlation between FNAC and histopathology were calculated. P<0.05 was considered statistically significant. Results: The total of 83 cases was included in our study. The cytological analysis was done and all cases were classified as per Milan system. The age of patients ranged from 4 years to 77 years with a mean age of 43 years. Parotid was the most frequently involved gland in which a total of 51 cases (61.4%) were reported. The most common benign tumor reported on cytology was pleomorphic adenoma and the most common malignant tumor reported was adenoid cystic carcinoma. On recategorization of lesions as per Milan system, the category IVA, that is, benign salivary gland neoplasm had the maximum number of lesions (40) accounting for 48.1% of all the lesions. Histopathology was available in 42 cases. The predominant lesion on histopathology was pleomorphic adenoma (22). On statistical analysis of the data, the sensitivity was 71.4%, specificity was 96.1%, diagnostic accuracy as 62.1%, and positive and negative predictive value as 83.3 and 92.5%, respectively. Conclusion: Risk stratification approach in classifying salivary gland cytology aspirate as per Milan system provides a standardized reporting and better communication to clinician.

Clinicopathological Study of Benign Neoplastic Lesions of the Oral Cavity

Oral benign tumors are common in the Indian subcontinent. These benign neoplastic lesions may mimic other tumors like lesions or malignant tumors of the oral cavity. Aim: The current study's goal is to investigate the demographical distribution of benign tumors of the oral cavity and to study their histopathological and site-wise distribution. Materials and method: It's a retrograde observational study of 30 patients. In the Indian subcontinent, benign tumors and tumor-like lesions are prevalent. Data is collected from the otorhinolaryngology department of a referral center and medical college in the Maharashtra state of India. Data was collected from previous histopathological reports of excision biopsies done in the Otorhinolaryngology Department. Result: papilloma is the most common benign tumor found in the present study is a retrospective observational study. This research was carried out at tertiary care referring facility and health college in the Indian state of Maharashtra. Data were collected from 30 patients from the department of otorhinolaryngology and histopathology reports of benign neoplastic lesions.

Sinonasal Inverted Papilloma Associated with Adenoid Cystic Carcinoma

Inverted papilloma is the most common benign tumor of the paranasal sinuses with the possibility of malignant transformation. On the one hand, adenoid cystic carcinoma (ACC) is a rare malignant neoplasm that arises from the secretory glands. Sinonasal ACC accounts for 10%–25% of all head and neck ACC. This neoplasm is defined by its distinctive histologic appearance. Surgical resection, whenever possible, is the mainstay therapy. An association between inverted papilloma and malignancy is controversial. A synchronous carcinoma has been established at diagnosis in 3.3%–11% of cases, and the risk of metachronous carcinoma is &#x3c;3%. We report a case of an 84-year-old female affected with sinonasal inverted papilloma associated with synchronous ACC. She had right nasal obstruction due to the rapid growth of the tumor. She was referred to our department for further workup. A frozen biopsy revealed part of the tumor as ACC. The tumor was consistent with preoperative imaging, and surgical findings also showed infiltration into the orbit. There was no consent for radical surgery with orbital exenteration and adjuvant chemoradiotherapy in consideration of her advanced age. This is the first case report of the association between sinonasal inverted papilloma and ACC within our retrieval capability.

LncRNA-MCM3AP-AS1 Promotes the Progression of Infantile Hemangiomas by Increasing miR-138-5p/HIF-1α Axis-Regulated Glycolysis

Infantile hemangioma (IH) is a common benign tumor of endothelial cells in infants. Most hemangiomas are self-limited, but a few may develop and lead to serious complications that affect the normal life of children. Therefore, finding an effective treatment strategy for IH is a pressing need. Recent studies have demonstrated that non-coding RNAs affect the progression of multiple tumors. This study aims to investigate the mechanism by which LncRNA-MCM3AP-AS1 promotes glycolysis in the pathogenesis of IH. We first documented that the expression of LncRNA MCM3AP-AS1 was significantly upregulated in IH. Furthermore, we demonstrated that MCM3AP-AS1 bound to miR-106b-3p which promotes glycolysis in IH. In addition, we found that inhibition of HIF-1α contributed to the transformation of glycolysis to normal aerobic oxidation, partially reversed the promoting effect on glycolysis by the up-regulation of LncRNA MCM3AP-AS1 in IH disease. More importantly, we demonstrated this phenomenon existed in IH patients. Taken together, we demonstrate that LncRNA-MCM3AP-AS1 promotes the progression of infantile hemangiomas by increasing the glycolysis via regulating miR-138-5p/HIF-1α axis.

Pulmonary Hamatroma

Pulmonary hamartoma are common benign tumor of lung. These are composed of variable components of cartilage, fat, smooth muscles and respiratory epithelium. Most patients are asymptomatic with few present with pulmonary symptoms. The neoplasm is less common in young with surgical excision being the treatment of choice. Histopathology revealed the true pathological nature of the tumor.