Comprehensive analysis of radiological and surgical predictors in cervical sympathetic schwannomas: a novel staging approach and its implications.

BACKGROUND: Vagal schwannomas are well-documented, but cervical sympathetic chain schwannomas (CSCS) are rare, with most knowledge from case reports. This study aims to identify radiological predictors of misdiagnosis and factors guiding surgical approaches based on tumor size and extent. METHODS: An ambispective analysis was conducted on 21 cases of CSCS, examining preoperative data, intraoperative findings and the questionnaire to identify the potential predictors. Tumors were classified into three types based on their relationship with the carotid sheath, and this classification was correlated with vessel ligation and postoperative neural outcomes. RESULTS: An excellent agreement was found between radiologist on new classification system(Kappa:0.89). Tumor classification revealed a diverse distribution, with 6 cases identified as Type 1, 6 as Type 2, 5 as Type 3, and 4 as Type 3S. The necessity of external carotid artery (ECA) ligation correlated with the tumor type. Type 3 tumors required ECA ligation in 50% of cases, while Type 1 and Type 2 tumors predominantly involved vascular preservation. Postoperative complications included vagal palsy in 28.5% of cases and first bite syndrome in 71.4%. CONCLUSION: Accurate preoperative planning and a novel staging system can enhance surgical outcomes and reduce postoperative complications as validated by our study.

Exploring the Interrelationship Between Diabetes Mellitus and Chronic Lung Diseases: A Comprehensive Review.

Diabetes mellitus (DM) is a chronic metabolic disorder that affects millions of individuals worldwide. With an increasing prevalence, understanding its implications for respiratory health is essential. Chronic lung diseases, such as asthma and chronic obstructive pulmonary disease (COPD), significantly impact morbidity and healthcare costs, with COPD alone accounting for substantial economic burdens. This comprehensive review investigates the intricate relationship between DM and chronic lung diseases. A systematic search across multiple databases yielded 1,078 articles, from which 10 studies were selected for detailed examination. The findings reveal a bidirectional relationship: diabetes increases the risk of developing chronic lung conditions, while chronic lung diseases can exacerbate glycemic control. Shared inflammatory pathways and comorbidities complicate patient outcomes, underscoring the urgent need for integrated treatment approaches. By elucidating the mechanisms linking these conditions, this review provides valuable insights for healthcare professionals, emphasizing the importance of interdisciplinary care to enhance the quality of life for individuals affected by both diabetes and chronic lung diseases. The results highlight the necessity for further research to explore targeted therapies and preventive measures addressing these interconnected health issues.

Assessing the Impact of a Gluten-Free Diet on Celiac Disease Symptoms in Children: A Comprehensive Review.

Celiac disease, a serious autoimmune disease, is triggered by the ingestion of gluten. It is associated with many gastrointestinal and extraintestinal symptoms. The cornerstone of treatment is a strict gluten-free diet (GFD). This paper collected studies that were screened between the 15th and 25th of June 2024 and were searched for from many databases and registers, including PubMed, Medline, ClinicalTrials.gov, Cochrane Library, Europe PMC, and EBSCO Open Dissertations. We have included the 12 most relevant studies that examined the effects of GFD adherence among pediatric patients with celiac disease. Evidence suggests that a GFD caused notable improvements in liver function, growth metrics, and quality of life indices. Extraintestinal symptoms such as cardiac dysfunctions and obstructive sleep apnea also showed compelling improvement. We conclude that there are substantial advantages of a GFD in children with celiac disease and call for the need for personal nutritional support to address nutritional deficiencies and long-term studies and comprehensive strategies to optimize treatment outcomes and improve the quality of life for affected children.

Perplexing First Branchialcleft Anomalies-A Case Series with Review of Literature.

Incomplete obliteration of the branchial apparatus results in the formation of branchial cleft anomalies. First branchial cleft anomalies may persist anywhere in the first branchial arch, from the external auditory canal at the level of the bony cartilaginous junction to the submandibular triangle. The majority of cases present in childhood as an opening in the skin though they may present as cysts or neck masses, mostly mistaken for neck abscesses which leads to inadequate treatment and complications. Here different cases of first branchial cleft anomalies with variable presentation and treatment are illustrated. The need for proper diagnosis and adequate treatment cannot be overemphasized to avoid mismanagement and complications.

Outcome of Concurrent Septorhinoplasty and Functional Endoscopic Sinus Surgery (FESS) in Patients with Sinusitis and Nasal Deformity: A Retrospective Study and Review of Literature.

Patients with deformed external noses and deviated nasal septum also have lateral wall deformities compromising the osteomeatal complex leading on to sinusitis. These patients will need septorhinoplasty along with functional endoscopic sinus surgery (FESS) to facilitate proper drainage of sinuses. The two main risks of combined procedure are firstly the risk of infection if done in infected sinusitis and secondly, the fear of collapse of nasal bone and the frontal process of the maxilla if medial and lateral osteotomies are done after extensive ethmoidectomy for extensive sinus disease. Our objective was to study the outcomes of combined septorhinoplasty with functional endoscopic sinus surgery in patients having sinusitis along with nasal deformity. In this retrospective study we describe the outcomes of patients who have undergone combined FESS + Rhinoplasty. We controlled the sinus infection and avoided extensive polyposis for combined procedure. We found that nasal block, facial pain, anosmia, rhinorrhea improved in all the patients There was a complete resolution of symptoms in the group. Thus, in combined surgery, we could simultaneously get a good functional airway, solve the sinus complaints and improve the nasal aesthetics satisfactorily. The patients were subjected to SNOT scale in 2023 and average score of SNOT score was found as 11 at an average postop followup period of 14 Years post op. We found that combined Rhinoplasty and Functional Endoscopic Sinus Surgery for patients having nasal deformity with chronic Rhinosinusitis can be performed safely and effectively. Simultaneously harvested septal cartilage could be used judiciously for meticulous reconstruction. It, avoided the extra cost and patient's time of two staged partial surgery.

Reconstructive Rhinoplasty-Our Experiences at a Rural Medical College in Gujarat.

Introductions: Interpolated flaps remain the mainstay of nasal reconstruction. In this regard Paramedian forehead flap has been combined and modified variously by different surgeons. However, still multiple stages are required to give shape to the nose and ensure that skin and cartilaginous vault of nose are aesthetically and functionally reconstructed. However, we describe a technique in which cartilage is reconstructed at the same stage as harvesting the flap without risk of vascular compromise. Materials and Methods: We describe a retrospective chart review of reconstructive nasal procedure in 2 stages with reconstruction in the first sitting itself using Paramedian forehead flap and ipsilateral septal perichrondium and septal cartilage in 4 patients of lower nasal vault deficiency between Jan 2018 to Dec 2018. The patients age ranged from 10 to 67 Years. 2 of the patients needed surgery due to dog bite injury 1 due to excision of basal cell carcinoma and another due to road traffic accident. The technique involved harvesting an ipsilateral paramedian forehead flap along with ipsilateral septal perichondrial flap anteriorly based and using septal cartilage to make the skeleton. The flap was divided after 3 weeks and thinned suitably. Results: All the patients reported complete uptake of flap without any cartilage necrosis. Functionally none of the patient reported more nasal block than that seen preoperatively. The average NOSE VAS score remained 17.5 reported 1 month after the second stage. Conclusions: Planning is the key for appropriate and cosmetically feasible nasal con-struction. Emphasis must be given to nasal subunit being reconstructed and the choice of flap must be robust. Our forehead flap uses 2 stage design with septal flap to allow for cartilage reconstruction in situ. We utilized post op small vessel dilators along with BACTIGRAS dressings to prevent infection. Our technique in both cases allowed for a greater nasal airway and greater nasal valve suppor.t.

Study of Outcome of an Implanted Autologous Auricular Cartilage: A Preliminary Experimental Research in Rabbits.

To investigate the viability of the implanted crushed and uncrushed auricular cartilage graft with intact perichondrium with respect to macroscopic and microscopic parameters. Cartilage grafts from 8 white New Zealand rabbits were harvested from the right auricle, with intact perichondrial layers. There were two categories Pre implant and Post-implant and two types, mildly crushed and uncrushed cartilage graft. The cartilage grafts were implanted into the subcutaneous pockets over the right upper paraspinal area. At the end of 2 months, implanted grafts were retrieved and examined histopathologically. There was a difference among the both types of cartilages in both the categories with respect to chronic inflammation, fibrosis, cartilage mass viability and vascularization. The mildly crushed auricular autologous cartilage with intact perichondrium does not lose the viability and maintains the structural integrity and thus increasing the clinical predictability for cosmetic correction of nose in rhinoplasty.

Development of SSR markers and construction of a linkage map in jute.

Jute is an important natural fibre crop, which is only second to cotton in its importance at the global level. It is mostly grown in Indian subcontinent and has been recently used for the development of genomics resources.We recently initiated a programme to develop simple sequence repeat markers and reported a set of 2469 SSR that were developed using four SSR-enriched libraries (Mir et al. 2009). In this communication, we report an additional set of 607 novel SSR in 393 SSR containing sequences. However, primers could be designed for only 417 potentially useful SSR. Polymorphism survey was carried out for 374 primer pairs using two parental genotypes (JRO 524 and PPO4) of a mapping population developed for fibre fineness; only 66 SSR were polymorphic. Owing to a low level of polymorphism between the parental genotypes and a high degree of segregation distortion in recombinant inbred lines, genotypic data of only 53 polymorphic SSR on the mapping population consisting of 120 RIL could be used for the construction of a linkage map; 36 SSR loci were mapped on six linkage groups that covered a total genetic distance of 784.3 cM. Hopefully, this map will be enriched with more SSR loci in future and will prove useful for identification of quantitative trait loci/genes for molecular breeding involving improvement of fibre fineness and other related traits in jute.

Arsenic-induced myocardial injury: protective role of Corchorus olitorius leaves.

Groundwater arsenic contamination in Bangladesh and its adjoining part of West Bengal (India) is reported to be the biggest arsenic calamity in the world in terms of the affected population. Tossa jute, Corchorus olitorius is a popular crop of this arsenic prone population. The present study was undertaken to evaluate the protective effect of aqueous extract of C. olitorius leaves (AECO) against sodium arsenite (NaAsO(2)) induced cardiotoxicity in experimental rats. The animals exposed to NaAsO(2) (10mg/kg, p.o.) for 10days exhibited a significant inhibition (p<0.01) of superoxide dismutase, catalase, glutathione-S-transferase, glutathione peroxidase, glutathione reductase and reduced glutathione level in myocardial tissues of rats. In addition, it significantly increased (p<0.01) oxidized glutathione, malondialdehyde and protein carbonyl content in myocardial tissue. Treatment with AECO (50 and 100mg/kg, p.o.) for 15days prior to NaAsO(2)-intoxication significantly protected cardiac tissue against arsenic-induced oxidative impairment. In addition, AECO pretreatment significantly prevented NaAsO(2) induced hyperlipidemia, cardiac arsenic content and DNA fragmentation in experimental rats. Histological studies of myocardial tissue supported the protective activity of the AECO. The results concluded that the treatment with AECO prior to arsenic intoxication has significant protecting effect against arsenic-induced myocardial injury.

Protective effect of Corchorus olitorius leaves on sodium arsenite-induced toxicity in experimental rats.

The present study was undertaken to evaluate the protective effect of aqueous extract of Corchorus olitorius leaves (AECO) against sodium arsenite-induced toxicity in experimental rats. The animals exposed to sodium arsenite at a dose of 10mg/kg body weight p.o. for 10days exhibited a significant inhibition (p<0.01) of hepatic and renal antioxidant enzymes namely superoxide dismutase, catalase, glutathione-S-transferase, glutathione peroxidase and glutathione reductase. In addition, arsenic intoxication significantly decreased (p<0.01) the level of reduced glutathione and increased (p<0.01) the levels of oxidized glutathione and thiobarbituric acid reactive substances in selected tissues. Treatment with AECO at doses of 50 and 100mg/kg body weight p.o. for 15days prior to arsenic intoxication significantly improved hepatic and renal antioxidant markers in a dose dependant manner. AECO treatment also significantly reduced the arsenic-induced DNA fragmentation of hepatic and renal tissues. Histological studies on the ultrastructural changes of liver and kidney supported the protective activity of the AECO. The results concluded that the treatment with AECO prior to arsenic intoxication has significant role in protecting animals from arsenic-induced hepatic and renal toxicity.

Protective effect of Corchorus olitorius leaves against arsenic-induced oxidative stress in rat brain.

The present study was undertaken to evaluate the protective effect of an aqueous extract of Corchorus olitorius leaves (AECO) against NaAsO(2) induced brain toxicity in experimental rats. The animals exposed to NaAsO(2) (10mg/kg, p.o.) for 10 days exhibited a significant inhibition (p<0.01) of superoxide dismutase, catalase, glutathione-S-transferase, glutathione peroxidase, glutathione reductase and reduced glutathione levels in rat brain. In addition, the toxin increased (p<0.01) the levels of oxidized glutathione and thiobarbituric acid reactive substances in the brain tissue of experimental rats. Treatment with AECO (50 and 100mg/kg, p.o.) for 15 days prior to arsenic intoxication significantly improved antioxidant markers in a dose dependant manner. Histological studies on the ultrastructural changes of brain tissue supported the protective activity of the AECO. The results suggest that treatment with AECO prior to arsenic intoxication has a significant role in protecting animals from arsenic-induced toxicity.

A simple ethanol wash of the tissue homogenates recovers high-quality genomic DNA from Corchorus species characterized by highly acidic and proteinaceous mucilages

A simple miniprep based on early elimination of highly acidic and proteinaceous mucilages through ethanol washing of the tissue homogenates has been developed for the extraction of genomic DNA from mature leaves and seeds of Corchorus spp. As compared to high cetyltrimethylammonium bromide (CTAB)-NaCl DNA extraction followed by ethanol-based removal of remnant mucilages from the DNA pellet, this simple miniprep consistently and reproducibly recovers high amounts of DNA with good spectral qualities at A260/A280 and A260/A230. The purified DNA is efficiently digested by restriction endonucleases, and is suitable for PCR amplification of nuclear microsatellites with expected allele sizes.