An Unusual Presentation of Nodular Hidradenoma.

Benign adnexal neoplasms are quite a common occurrence in adults, especially in the head and neck region. They raise suspicion for malignancy if there are red flag signs like rapid increase in size, pain, ulceration or recurrence. We hereby report a case of a middle-aged gentleman who consulted our surgical OPD with right-sided neck swelling, which was initially thought to be a dermoid cyst; on further evaluation, found to be a dermal sweat gland tumour with features of nodular hidradenoma. The point that is of interest but coincidence to note is that this swelling was preceded by a minor trauma. Characterising these swellings using simple imaging and pathological investigation modalities is important to study their behavioural pattern and add the same to our existing database. This will also help the treating surgeons to keep in mind the possibility of occurrence of such histologies in soft tissue swellings when they present with uncommon clinical features, instead of brushing them aside as the common epidermal or dermoid cysts. Incidence of malignancy is almost nil in nodular hidradenoma, which when found, is attributed to poor surgical clearance; hence the prudence to operate with adequate clearance is extremely significant in preventing the transformation of a mole into a mountain.

Caecal Volvulus Presenting as an Obstructed Inguinal Hernia: A Case Report.

Caecal volvulus (CV) is an uncommon cause of large intestinal obstruction due to the axial torsion of the caecum, ascending colon, and terminal ileum. We describe the case of a 37-year-old man who presented with bilateral inguinal hernias (the left larger than the right), diffuse abdominal pain, vomiting, difficulty passing stool, and flatus that were comparable to those of an obstructed hernia. Imaging tests revealed a collapsed ascending colon, free fluid collection, and a significantly dilated proximal ileum. An urgent laparotomy showed a perforated, clockwise-twisted caecum that required a right hemicolectomy. Postoperatively, the patient had a good recovery. CV is uncommon, and its symptoms are vague, making diagnosis difficult. For an accurate diagnosis and prompt action, imaging tools and a high index of suspicion are essential. This case serves as a reminder of the significance of taking rare entities into consideration in developing a differential diagnosis of complex abdominal presentations and the necessity for a differential diagnostic approach to choose the most suitable surgical course of action.

A New Silver Nano-Formulation of Cassia auriculata Flower Extract and its Anti-Diabetic Effects.

BACKGROUND: Treatment of diabetes mellitus (DM) using plant based drugs is advancing and getting much attention in recent years. Cassia auriculata L. is widely used in Indian folk medicine for the treatment of DM. Site-specific targeted plant drug delivery by metallic nanoparticles carriers is a new emerging procedure under research due to its enhanced bioavailability and reduced toxicity. This study was therefore aimed at biosynthesizing a new silver nanoparticle of Cassia auriculata L. flower extract and study its anti-diabetic efficiency in rats. METHODS: The silver nanoparticles were biosynthesized using AgNO3 solution and characterized by spectroscopy, SEM and EDAX analyses. The acute toxicity of this nano-preparation (up to 2000 mg/kg b. wt) was analyzed in rats and the anti-diabetic efficiency (for 50 mg/kg.b.wt and 200 mg/kg.b.wt) was studied in Streptozotocin induced diabetic rats. The diabetic parameters such as; blood glucose, serum protein, liver glycogen, serum lipid profile, serum levels of creatinine, urea, ALT, AST and ALP were analyzed. The histology of the liver, kidney and pancreas was evaluated after staining with Haematoxylin and Eosin. RESULTS: The increased blood glucose in Streptozotocin induced diabetic rats was found to be significantly reduced (p<0.01) in the treated group of rats. The characteristic damage and disorganization in the cells of Streptozotocin induced DM was found to be recovered in the treated group of rats. The alterations in the lipid profile, hyperglycaemia, reduced serum protein and liver glycogen, enhanced liver function and kidney function markers observed in the rats of DM control group were normalized in the treated group of rats. CONCLUSION: The results of this study, proving an efficient anti-diabetic activity of the biosynthesized silver nanoparticles of Cassia auriculata L. flower extract, implies that this nano-preparation may be exploited as an alternative biopharmaceutical agent for treating DM.

Non-toxic and non teratogenic extract of Thuja orientalis L. inhibited angiogenesis in zebra fish and suppressed the growth of human lung cancer cell line.

Lung cancer is a malignant tumour with minimal survival rate and the current treatments are not showing complete remission of tumour and have many side effects. Thus a natural herbal medicine with good anti-cancer properties is highly demanded. Thuja orientalis L. is a traditionally used medicine to cure cough, bronchitis, excessive menstruation, asthma, skin infection and premature baldness. In addition, recent studies have revealed that it has anti-proliferative and anti-cancer activity. Angiogenesis is the main reason for the propagation and metastasis of cancers. We therefore intended to study the effects of the leaf extract of Thuja orientalis L. on angiogenesis as well as lung cancer cell growth. We have tested the anti-angiogenesis efficiency by alkaline phosphatase assay and also analysed the in vivo toxicity and teratogenic effects of various concentration of Thuja orientalis L. extract by establishing an in vivo zebra fish (Danio rerio), a promising model for cancer research which share genetic structure similarity to that of human beings. Also we demonstrated an anti-cancer effect of leaf extract from Thuja orientalis L. on human lung cancer cell line (A549) by MTT and trypan blue assay. The results revealed that the Thuja orientalis L. extract is efficient in repressing lung tumour cell growth significantly (p ≤ 0.01) in all treatments (2.4 mg/ml to 0.3 mg/ml) except 0.15 mg/ml compared to the control. The in vivo toxicity assay has proven that it is non-toxic at concentrations 0.6 mg/ml, 0.3 mg/ml and 0.15 mg/ml in zebrafish. The teratogenic assays revealed the therapeutic index (TI) as 0.808 with 0.7029 mg/ml as LC50 concentration at 24 h which is within the desirable value (below 1) for drug administration. Noticeable inhibition of angiogenesis also was observed in treatment with 2.4 mg/ml to 0.3 mg/ml. Overall we found that Thuja orientalis L. plant leaf extract exhibits better anti-cancer properties as we have validated by in vitro and in vivo analysis.