RESUMEN
Primary tuberculous parotitis is an extremely rare entity presenting with nonspecific symptoms, variable clinical signs, and imaging features mimicking parotid neoplasm. It is a clinical and diagnostic challenge, and a confirmed histological diagnosis would indicate nonoperative management, thus avoiding unwarranted surgery and associated morbidity. Tuberculosis of the salivary gland is a relatively rare extrapulmonary manifestation of tuberculosis, with the incidence of tuberculous parotitis being 2%-9%. The prevalence of disseminated tuberculosis has increased in recent times because of the use of immunosuppressive therapy for organ transplantation and chemotherapy. However, the incidence of concurrent pulmonary tuberculosis in patients with tuberculous parotitis is a rarer scenario. Fine-needle aspiration cytology (FNAC) can confirm the diagnosis of tuberculous parotitis with a high sensitivity (84%-100%) and specificity (94%-100%). The utility of FNAC is also enhanced as the aspirate can be utilized for cartridge-based nucleic acid amplification test (CBNAAT) testing for mycobacterium and drug sensitivity testing, thereby further increasing its sensitivity and specificity. This translates to a lesser chance of unnecessary surgical intervention and the potential surgical morbidity. Here, we report a case of parotid swelling in a 72-year-old male, with no evidence of any pulmonary or systemic tuberculosis, with clinical and imaging features suggestive of parotid neoplasm but diagnosed as tubercular parotitis on FNAC. He was started on antitubercular therapy, which resulted in the progressive diminution of the size of the lesion. Primary tuberculous parotitis should be considered a possibility while managing the parotid neoplasm.
RESUMEN
BACKGROUND: Depression is the most common mental disorder in community settings, and is a major cause of disability across the world. Antidepressants such as SSRI (Selective Serotonin Reuptake Inhibitor) and TCA (Tricyclic antidepressants) are used. These drugs affect the adrenergic and serotonergic pathways. These drugs have an unfavorable side effect profile, take longer time to act and are not very effective in resistant cases. Alternate pathways involving the glutamate receptors have also been linked with depression, hence Ketamine an NMDA antagonist was evaluated for the antidepressant effect. AIM: To study the antidepressant effect of ketamine in subanaesthetic doses in male albino mice. STUDY DESIGN, MATERIALS AND METHODS: The study was a randomized controlled animal study done on 30 male albino BALB/c mice divided into five groups with Imipramine (10mg/kg) as the standard drug and Ketamine in varying doses (5, 7.5, 10 mg/kg) as the test drug. The animal model used was the forced swim test. The reduction in immobility time was taken as the index of the antidepressant effect. STATISTICAL ANALYSIS: The data were analysed with the one way ANOVA test using SPSS version 12. RESULTS AND CONCLUSION: The data analysis showed that Ketamine at a dose lower dose of Ketamine (5mg/kg) did not show a significant antidepressant effect in contrast to the higher doses (7.5 and 10mg/kg) which showed significant antidepressant effect ('p' > 0.05). The inference of this study is that Ketamine has significant antidepressant property at variable dose ranges and further studies can be done on these lines.
