Zosteriform cutaneous leiomyoma: a case report

<p class="abstract">Cutaneous leiomyomas are rare, benign soft tissue tumors arising from smooth muscles of the skin and comprise of three distinct subtypes, namely piloleiomyoma, angioleiomyoma and genital leiomyoma. Piloleiomyomas can present as solitary form, multiple disseminated and zosteriform or segmental forms. Cutaneous leiomyomas are rare, of which zosteriform leiomyoma is not commonly encountered. Here we report an uncommon case of Type I zosteriform cutaneous leiomyoma in a middle-aged individual which was confirmed on histopathology. Patient was further started on nifedipine with significant symptomatic improvement. The patient is planned for surgical excision and long-term follow in view of its association with aggressive renal malignancy.</p>

Chronic Primary Tinnitus: A Management Dilemma

Tinnitus often described as sound in the ear in absence of any external stimulus. It poses a challenge to the psychological and mental wellbeing of the patient and professional unsatisfaction to the clinician. The patient often an old aged individual usually approaches the outpatient department with various sounds in the ear, making him feel ill or unable to have a sound sleep. The middle-aged patient often complains of professional incapability and lack of concentration due to tinnitus. Despite vast academic research and advances, the efficiency of available treatment is debatable, often compelling the clinician to convey the message that “you may have to learn to live with it”. In the present overview of reviews, we tend to look into the management of tinnitus and present a comprehensive outlook of various evidence-based reviews from Cochrane and augmented with various studies from PubMed.

Acute intestinal obstruction due to gastrointestinal stromal tumours: case report

Gastrointestinal stromal tumours (GIST) as such is a rare disease, but according to some study it may end up to malignant type in approximately 10-30%. Herein we present a 2 cases of GIST who presented with acute intestinal obstruction in emergency department. In imaging studies (X-ray erect abdomen, ultrasonography abdomen), it showed a features of intestinal obstruction but could not rule out the exact mechanism or pathology behind the obstruction. As commonly adhesions is a main culprit behind the cause of acute intestinal obstruction in case of any post-operative patient. So, we try to highlight that in case of any old aged individual and in virgin abdomen GIST should be keep in mind as a cause of intestinal obstruction.

RELATIONSHIP BETWEEN ALZHEIMER’S DISEASE & PERIODONTITIS - A LITERATURE REVIEW

Periodontitis is the microbial infection often causing inflammation of the gingiva, bone loss and tooth mobility. Apart from periodontitis, periodontal bacteria like Porphyromonas gingivalis, Spirochetes, Treponema denticola are known to cause systemic diseases such as cardiovascular diseases, preterm low birth weight infants, Alzheimer’s diseases etc. Alzheimer’s disease is a progressive mental deterioration of the brain that can occur in middle or old aged individual due to generalized regeneration of neurons in the brain. Literature has shown that inflammation plays a vital role in the progression of Alzheimer’s disease where periodontitis is a risk factor proving the focal infection theory. This article reviews the relationship of periodontitis in Alzheimer’s disease and its role in modifying the disease. Keywords: Alzheimer’s Disease, Chronic Periodontitis, Periomedicine, Inflammation

Typ-2-Diabetes im Alter: Beispiel für eine Patienten-zentrierte medikamentöse Therapie

Diabetes in older adults has a high prevalence and is frequently associated with comorbidities of the cardiovascular system, dysfunction of cognition as well as depression and impaired mobility or increased frailty. Furthermore, impaired renal function, heart failure, risk for hypoglycemia and polypharmacy has to be considered in the decision about the diabetes treatment strategy. The goal of blood glucose management is driven by patient relevant issues and patient self-esteem, quality of life defined by the patient, preservation of physical and social mobility rather than potential long-term effects on reduction of cardio- and microvascular events in the future, which is limited by patient-inherent reduced life expectancy of the aged individual. Therefore, long-term diabetes medication should avoid hypoglycemia and prevent acute hyperglycemia or short-term complications on morbidity and clinical course of geriatric syndromes associated with regular blood glucose levels above 200 mg/dl (11.1 mmol/l). The therapy should be safe, easy to handle for the patient and possibly affect co-morbidities positively. However, there are limited data available about efficacy, safety and pharmacokinetics of drugs in patients over 75 years of age or older. Since more than 5 % of the population in Germany is older than 80 years means that more than 1 million of these individuals suffer from diabetes. It is time to ask for data in these elderly subpopulations by policy makers in health care.

Grace of God: A Phenomenological Inquiry

Grace, in the Christian understanding, is the unconditional love, the free, and undeserved favor of God. Grace, in this context, is not of man, but of the Divine through which the knowledge of truth is gained— truth that surpasses man’s natural knowledge and experience; by which the soul is likened to the Divine. In this paper, an attempt is made to decipher (through phenomenological inquiry) the experience of grace in the life of a middle-aged individual and how it provide resilience in the functioning of ones’ everyday life. The paper also discusses the possibility of the essential nature of the experience of Gods’ grace as it look into the subjective experience of the individual.

Bimodal video laryngoscope assisted management of retropharyngeal abscess: a case report

A retropharyngeal abscess is a suppurative collection of the deep spaces of the neck. Mostly at presentation they are massive and are a dilemma for the surgeon and the anesthetist alike, vying for space, one for therapeutic intervention and the other for airway access. Video laryngoscopic assisted evacuation of such a collection, adopting the nasopharyngeal and the transoral route was undertaken in a middle aged individual which is being reported.

Investigation of aged Asian dust particles by the combined use of quantitative ED-EPMA and ATR-FTIR imaging

In our previous works, it was demonstrated that the combined use of quantitative energy-dispersive electron probe X-ray microanalysis (ED-EPMA), which is also known as low-Z particle EPMA, and attenuated total reflectance Fourier transform infrared spectroscopy (ATR-FTIR) imaging has great potential for a detailed characterization of individual aerosol particles. In this study, extensively chemically modified (aged) individual Asian dust particles collected during an Asian dust storm event on 11 November 2002 in Korea were characterized by the combined use of low-Z particle EPMA and ATR-FTIR imaging. Overall, 109 individual particles were classified into four particle types based on their morphology, elemental concentrations, and molecular species and/or functional groups of individual particles available from the two analytical techniques: Ca-containing (38%), NaNO3-containing (30%), silicate (22%), and miscellaneous particles (10%). Among the 41 Ca-containing particles, 10, 8, and 14 particles contained nitrate, sulfate, and both, respectively, whereas only two particles contained unreacted CaCO3. Airborne amorphous calcium carbonate (ACC) particles were observed in this Asian dust sample for the first time, where their IR peaks for the insufficient symmetric environment of CO32− ions of ACC were clearly differentiated from those of crystalline CaCO3. This paper also reports the first inland field observation of CaCl2 particles probably converted from CaCO3 through the reaction with HCl(g). HCl(g) was likely released from the reaction of sea salt with NOx/HNO3, as all 33 particles of marine origin contained NaNO3 (no genuine sea salt particle was encountered). Some silicate particles with minor amounts of calcium were observed to be mixed with nitrate, sulfate, and water. Among 24 silicate particles, 10 particles are mixed with water, the presence of which could facilitate atmospheric heterogeneous reactions of silicate particles including swelling minerals, such as montmorillonite and vermiculite, and nonswelling ones, such as feldspar and quartz. This paper provides detailed information on the physicochemical characteristics of these aged individual Asia dust particles through the combined use of the two single-particle analytical techniques, and using this analytical methodology it is clearly shown that internal mixing states of the aged particles are highly complicated.