KKR ENT Hospital and Research Institute

Objectives: The objective of this study was to study the clinicopathological profile of multiple myeloma (MM) presenting to Jawaharlal Nehru Hospital and Research Center (JLNH&RC) Bhilai and document the disease in central India. Material and Methods: This was a retrospective observational study using patient data from January 2013 to December 2019. The clinical and radiological findings, laboratory parameters, and bone marrow examination were analyzed. Results: About 35.38% of patients presented in the 6th decade of life with a male-to-female ratio of 1.3:1. About 91.93% of patients had low backache and bone pain, and 96.92% of patients had Anemia. About 63.01% of patients had serum creatinine >2 mg/dL, and 92.30% of patients had A/G ratio reversal. About 64.70% of patients had serum beta-2 microglobulin (≥3.5 μg/mL). About 80.7% had osteolytic lesions, predominantly in the skull and pelvis. About 46.15% of patients had >50% plasma cells on bone marrow aspirate. About 85.71% exhibited hypercellularity, and 8.92% of patients had grade 2 marrow fibrosis. About 76.92% of patients presented with Durie Salmon stage III disease, and 58.82% presented with international staging system (ISS) stage II disease. Conclusion: MM has an inconsistent clinical presentation with multiple system involvement. It should be considered as a differential in patients above 50 years of age presenting with normocytic normochromic Anemia and bony pain. Bone marrow study is important in resource-poor settings where specialized laboratory testing is limited. The Durie and Salmon staging and the ISS can be used for the prognosis with equal efficacy.

BackgroundInvasive Papillary Carcinomas (IPC) are rare and account for approximately 0.5% of all invasive breast carcinomas. Most of them are seen in post-menopausal women and have a good prognosis. These tumors lack the myoepithelial cell layer (MCL) within the papillae or at the periphery of the tumor with areas showing stromal invasion or invasion into lymphovascular spaces. Immunohistochemistry (IHC) for myoepithelial cells and basement membrane is essential for the diagnosis of invasive cancer.Case presentationWe present a rare case of IPC in a 74-year-old woman who presented with complaints of gradually increasing painless retroaerolar mass in the left breast of two months duration. The mass was irregular, having an oblong as well an adjacent high density mass lesion on mammography. Ultrasound (US), and Magnetic Resonance Imaging (MRI) helped in the diagnosis of the possibility of a malignant breast lesion. Left-sided modified radical mastectomy was performed and the specimen was histopathologically diagnosed as Invasive Papillary carcinoma. Immunohistochemistry confirmed the diagnosis.ConclusionsInvasive Papillary Carcinomas of the breast are rare cancers in post-menopausal women. We have highlighted the role of Mammography, US, and MRI in early diagnosis so that timely management is possible.

<p class="abstract"><strong>Background:</strong> Snoring is a sleep disorder which often causes cognitive dysfunction, due to inadequate rhythms of sleep cycle. Commonly evaluated with polysomnography. P300 is an electrophysiological method to measure the cognitive dysfunction. Usefulness of P300 audiological test in snoring for cognitive ability is studied here.</p><p class="abstract"><strong>Methods:</strong> Prospective study with 20 cases and 30 controls. Cases were selected with simple sleep apnoea questionnaires and snoring people were selected as cases. Healthy non snoring people were selected as controls. </p><p class="abstract"><strong>Results:</strong> Significant increase in latency of P300 in snoring people (50%); more in males and in the middle aged group.</p><p class="abstract"><strong>Conclusions:</strong> P300 is an electrophysiological method to measure the cognitive dysfunction in snoring people.</p>

Introduction:Osteoarthritis (OA) is the most common age-related joint disease affecting >80% people beyond 55 years of age. It is a leading cause of elderly visit to outpatient departments and accounts for almost half of all nonsteroidal anti-inflammatory drug prescriptions. The burden and impact of knee OA in Indian population and extent of public health services usage by people with OA are not known.Methods:We performed a prospective blinded multicenter screening and therapeutic study from June 2013 to June 2014 at 3 centers to screen patients >55 years with knee OA to assess quality of life, functional disability, and limitation of functions and to compare the effectiveness of hip and leg strengthening exercise programs in these patients. Functional disability was assessed by Western Ontario and McMaster’s Universities OA index (WOMAC), Friedman, and Wyman Scores; locomotor function was assessed by walking status, Visual Analog Scale (VAS), and 30-second timed chair stand tests; and quality of life was assessed by Short Form-36 (SF-36).Results:Of 2854 patients screened, 2054 (72%) patients had OA (male:female-1.9:1) with mean age of 63 years and standard deviation of 8. Of 2054 patients, 226 patients were randomly selected for therapeutic study. In remaining 1828 patients, baseline 10-meter walk test (10MWT) was 0.3 m/s, mean SF-36 Physical Component Score (PCS) was 31.3, and Mental Component Score (MCS) was 34.2. At 3 months, 79% patients were comfortable with significant VAS, WOMAC, Friedman-Wyman Scores, 10MWT, and timed chair test improvements in patients who performed lifestyle modifications and exercises (P = .04). Short Form-36 improved, mean PCS was 43.6, and MCS was 54.2. At 3 months, 274 (15%) patients were unsatisfied among whom 26% and 74% were treated with arthroscopic procedures and arthroplasty, respectively. Isolated hip and leg strengthening exercise programs similarly improved knee pain, function, and quality of life.Conclusion:Motivation and counseling with hip and leg strengthening exercises should be incorporated with pharmacotherapy in each OA prescription. Physical fitness and weight reduction should be promoted as first-line management of OA.

© 2006. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Pseudocyst of the auricle is a rare condition and is hardly encountered in routine ENT practice. There have been only about 200 of these cases reported in world literature. The etiology remains obscure and the treatment modalities uncertain. The authors present their series of 15 cases and review the available literature on this condition. A new and completely successful method of treatment is also presented.

In order to observe the pattern of behaviour, the underlying stressors and possible association with psychosocial factors in Pediatric Non-Epileptic Seizure (NES); 22 children with unusual feature of poor control of their symptoms were studied. Detailed historical account, examination including psychiatric evaluation, EEG and CT Scan in all and video recording with provocative procedures were done wherever feasible. Ten males (45.5%) and 12 females (55.5%) were in the age range from 5 through 18 years. Ten children (45.5%) had uncontrolled symptoms while 12 (55.5%) had unusual symptoms. History and eye witness account was accurate in 15 (68.1%). Separate video recording could be done in 6 (27.3%) while induction with provocative procedures was possible in 7 (31.8%) older children. Pointers to NES were: stress induced events 13 (59.4%), persistence of symptom despite adequate treatment 10 (45%), lack of physical injury 20 (90.0%), symptoms when some one was around 12 (54.5%), lack of postictal phenomenon 12 (54.5%), lack of incontinence 22 (100%), positive gains 6 (27.0%) and gradual onset and offset 12 (54.5%). Nine children (40.0%) had coexisting epilepsy and NES. The present study addresses the need of awareness, provocative procedure, video recording of the event and individualised management of NES in our circumstances where video EEG facility is not available.

A 22‐year‐old woman was referred to dermatology from oncology for an opinion regarding the sudden matting of scalp hair of 10 days duration. A case of primary infertility for 7 years, this patient was undergoing chemotherapy with doxorubicin, cyclophosphamide, and cisplatin after operative removal of a papillary cystadenoma (clear ceil type) from her left ovary 40 days previously.She had noticed a sudden matting of her hair 3 to 4 hours after using a soap containing Acacia concinna for washing her hair. All efforts to disentangle the matted hairs were futile. She was feeling very uncomfortable because of the heavy solid mass of tangled hair. She told of rubbing her wet hair and using a wet towel to cover her hair after use of the soap. She denied earlier use of the soap, shampoo, setting lotions, bleaches, or hair dye. She had not cut her hair since early childhood.Examination showed a huge, firm almost stony mass of severely tangled hair on her scalp, which was more marked over the vertex and occipital areas (Figs. 1 and 2). The hairs in the frontal area were free, thin, and straight. The skin over the entire scalp was normal. On light microscopy, a few hairs showed features of trichorrhexis nodosa. Routine hematology was normal. The patient was unable to tolerate the pain and discomfort because of the stony hard mass. She shaved her head and offered her hair in a temple, as is a common custom in parts of South India.

Movement DisordersVolume 6, Issue 2 p. 183-183 Brief Communication Action myoclonus (lance-adam syndrome) secondary to strangulation with dramatic response to alcohol Shailendra Jain, Shailendra Jain JLN Hospital and Research Centre, Bhilai, IndiaSearch for more papers by this authorMeena Jain, Meena Jain JLN Hospital and Research Centre, Bhilai, IndiaSearch for more papers by this author Shailendra Jain, Shailendra Jain JLN Hospital and Research Centre, Bhilai, IndiaSearch for more papers by this authorMeena Jain, Meena Jain JLN Hospital and Research Centre, Bhilai, IndiaSearch for more papers by this author First published: 1991 https://doi.org/10.1002/mds.870060219Citations: 15AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume6, Issue21991Pages 183-183 RelatedInformation