Atypical teratoid rhabdoid tumour (ATRT) is a rare and highly aggressive malignant neoplasm of the central nervous system (CNS), which occurs predominantly in children less than 2 years of age. There are less than 50 cases described in adult. We report a case of primary spinal ATRT in a 65-year-old male who presented to us with cauda equina syndrome. To the best of our knowledge, our patient is the (1) second oldest patient to be diagnosed with ATRT and only the third case of adult spinal ATRT report in the literature; (2) first reported case of CNS ATRT occurring in a patient with non-rhabdoid renal cancer; (3) first adult patient of ATRT to present with cauda equina syndrome.

Development of incisional hernia (IH) is multifactorial but in ammation and abdominal wall ECM (extracellular matrix) disorganization are key pathological events. We investigated if the differential expression of broblast biomarkers re ects the cellular milieu and the dysregulated ECM in IH tissues.Expression of broblast biomarkers, including connective tissue growth factor, alpha-smooth muscle actin (α-SMA), CD34 (cluster of differentiation 34), cadherin-11 and broblast speci c protein 1 (FSP1), was examined by histology and immuno uorescence in the hernial-fascial ring/neck tissue (HRT) and hernia sack tissue (HST) harvested from the patients undergoing hernia surgery and compared with normal fascia (FT) and peritoneum (PT) harvested from brain-dead healthy subjects undergoing organ procurement for transplantation. The H&E staining revealed alterations in tissue architecture, broblast morphology, and ECM organization in the IH tissues compared to control. The biomarker for undifferentiated broblasts, CD34, was signi cantly higher in HST and decreased in HRT than the respective FT and PT controls. Also, the ndings revealed an increased level of CTGF (connective tissue growth factor) with decrease in α-SMA in both HRT and HST compared to the controls. In addition, an increased level of FSP1 ( broblast speci c protein 1) and cadherin-11 in HRT with decreased level in HST were observed relative to the respective controls (FT and PT). Hence, these ndings support the heterogeneity of broblast population at the laparotomy site that could contribute to the development of IH. Understanding the mechanisms causing the phenotype switch of these broblasts would open novel strategies to prevent the development of IH following laparotomy.

Internal carotid artery [ICA] dissection is a rare cause of vocal cord palsy. This cause is not always considered in the initial differential diagnosis and such cases often get classed as idiopathic. We report a case of right ICA dissection, where the patient had presented with symptoms of right vocal cord palsy. This was a 52-year-old woman who presented to ENT department with a 3 week history of hoarse voice, sore throat and dysphagia. She was found to have a right vocal cord palsy and oropharyngeal dysphagia. Her neurological examination at the time of assessment was normal except for a mild reduced elevation of right side of her palate. At that time, the aetiology was thought to be idiopathic. Due to an incidental sphenoid wing meningioma on the CT head and neck, she underwent an MRI head, which demonstrated a thrombosed right ICA. Subsequently, her CT images were reconstructed to demonstrate a rat-tail stenosis of the lower right ICA consistent with dissection, for which she was started on clopidogrel. Therefore an internal carotid artery dissection should be considered in a case of ‘idiopathic’ vocal cord palsy, as they may not necessarily be idiopathic.

<p class="abstract"><strong>Background:</strong> Adenoidectomy is one of the most commonly performed paediatric surgical procedure by otorhinolaryngologists. Over the past few decades, adenoidectomy has evolved and different techniques have been proposed to reduce morbidity and surgical risk. Controlled ablation or Coblation® is capable of low temperature molecular disintegration within soft tissue causing its dissolution. In this study, we report our experience of adenoidectomy using Coblation®, and its role in reducing pain, morbidity and its significant outcomes are discussed.</p><p class="abstract"><strong>Methods:</strong> A total number of 25 children aged 3-15 years, who underwent coblation adenoidectomy between March 2017 and April 2018 were included in this study.</p><p class="abstract"><strong>Results:</strong> The mean age was 7.8 years (males 7.79 years and females 7.81 years). Pre operatively 100% patients had sleep disturbance and after coblation adenoidectomy only 12% patients have disturbed sleep and the rest 88% patients have comfortable sleep. 80% patients did not have pain in immediate post-operative period and 88% had no pain when they visited hospital for first review. 76% patients had less than one day of hospital stay and 24% patients had more than one day of hospital stay. 68% patients had no episode of upper respiratory tract infection (URTI) within the first one year after surgery.</p><p class="abstract"><strong>Conclusions:</strong> Over the years, many different adenoidectomy techniques have evolved and is surgeon specific or centre specific. Endoscopic-assisted coblation adenoidectomy is a safe and effective method of adenoidectomy.</p><p> </p>