In this preliminary report, we explore the uptake pattern of fluorodeoxyglucose (FDG) in fibromatosis and hypothesize the potential clinical role of FDG-positron emission tomography (PET) in the management of this benign but locally aggressive heterogeneous group of soft-tissue tumours. Five patients were studied (two men and three women, age range 23-35 years), among whom were three cases of deep musculoskeletal fibromatosis, one of abdominal fibromatosis (abdominal desmoid) associated with familial adenomatous polyposis (Gardner's syndrome) and one case of both deep musculoskeletal fibromatosis and abdominal desmoid. The FDG uptake in the lesions was heterogeneous in four cases and relatively homogeneous in one case. The uptake ranged from low to moderate grade with areas or foci of relatively avid FDG uptake. The maximum standardized uptake value (SUV(max)) observed was up to 4.7; the avidity probably related to the biological aggressiveness and tendency for recurrence, characteristic of fibromatosis. A dual-point FDG-PET carried out over four active foci in two cases registered an increase in SUV ranging from 6.93% to 25.85% (mean 19.28%). Treatment monitoring with chemotherapy was carried out in two cases: the reduction in FDG uptake was consistent with the histological evidence of fibrosis and reduction in mitosis. Hence, a baseline FDG-PET can serve a valuable role in monitoring the effect of systemic pharmacotherapy in patients with recurrent progressive disease after unsuccessful local-regional treatment. The findings in this report can be extrapolated and have implications for studying the utility of FDG-PET in defining aggressiveness, guiding biopsy and defining excision site in a large tumour and in monitoring therapy in fibromatosis.
Müllerianosis of the urinary bladder is a rare condition that encompasses 3 histological entities (endometriosis, endocervicosis, and endosalpingiosis). The authors report 2 patients with bladder müllerianosis, one of whom had endometriosis and the other a history of past pelvic surgery, describe the histological and cystoscopic features, and review the literature on this condition. Mucosal hyperemia and submucosal nodules or cysts with associated fibrosis and distortion of the bladder wall may mimic malignancy on cystoscopy, as may the infiltrative growth pattern sometimes evident histologically. Recognition of this complex diagnostic entity is important to avoid misdiagnosis and inappropriate investigation. There is a clinical association with endometriosis and past pelvic surgery.
Introduction Chronic suppurative otitis media is a common ailment in developing countries, and it generally presents with otorrhea and hearing loss. Different surgical procedures have been used to treat otitis media; among them is myringoplasty, which is a procedure that includes repair of the tympanic membrane. Platelet concentrates have been used widely in different types of wounds and are found to improve wound healing. Hence, the use of platelet-rich fibrin in myringoplasty will also improve the tympanic membrane healing. Objectives To assess the safety and efficacy of autologous platelet-rich fibrin on graft uptake in myringoplasty. Methods Eighty-six patients were observed during the study period of two years. Forty-three patients in the study group underwent myringoplasty aided with platelet-rich fibrin, and 43 patients in the control group went through the same procedure but without the platelet-rich fibrin. The patients were observed for three months postoperatively by a blinded observer. Results A total of 4.7% of the patients in the study group had postoperative infection, compared with a rate of 19% in the control group ( p = 0.039). The graft uptake success rate was found to be 97.7% in the study group as compared with 81% in control group ( p = 0.012). The results were found to be statistically significant. Conclusion Being autologous in nature, and by comparing the groups, platelet-rich fibrin is safe for patients. The postoperative graft uptake rate is better in cases in which platelet-rich fibrin was used. The postoperative infection rate was also lower in the same group.
BACKGROUND: Evidence-based practice (EBP) is the integration of clinical expertise, patient values, and best research evidence into the decision-making process for patient care. Identification of barriers that refutes the use of EBP in day-to-day practice will go a long way in designing programs for inculcating EBP among physiotherapy students. Therefore, the aim of this study was to identify perceived barriers to EBP among physiotherapy students. METHODS: A convenience sample of 429 participants were recruited from physiotherapy colleges affiliated to a State Health Science University as per the inclusion criteria. Participants were asked to fill the self-reported questionnaire that was developed by researchers based on possible items from previously developed surveys. Data collected were tabulated and analyzed by descriptive statistics. Response frequencies for the survey questions were determined and displayed in graphical formats. RESULTS: The study comprised of 182 final year students, 112 interns, and 135 postgraduate students having a mean age of 21.29 (0.85), 22.30 (0.77), and 24.34 (1.45) years, respectively. Majority of participants reported insufficient time, poor understanding of statistical analysis, lack of research skills, lack of formal training, lack of access to paid article, poor ability to critically appraise articles, and inadequate infrastructure facilities as barriers towards practicing EBP. CONCLUSION: Physiotherapy students perceived various organizational, training-related, and personal barriers toward the use of EBP. Effective education could prove to be the most powerful tool to overcome these barriers toward the use of EBP.
Venous ectasias are benign conditions of the neck, in which focal dilatations of veins occur. Internal jugular, external jugular or superficial veins are usually the affected ones in the neck. They are often ignored or misdiagnosed. Here we are reporting a patient with venous ectasia of the retromandibular vein and the common facial vein. A 25-year-old male presented to our out-patient department with an intermittent swelling over the right side of the neck that he had for one year. The swelling was more prominent on lying down and on Valsalva maneuver. Radiologic imaging was suggestive of venous ectasia of the retromandibu-lar vein and the common facial vein. Surgical excision was done for aesthetic reasons and in fear of thrombosis. Intraoperatively, we noticed that it was arising from the retromandibular and the common facial veins. Venous ectasias of superficial veins are rare. We can consider these patients for surgical excision in view of the risk of thrombosis, thromboembolic events, rupture, and aesthetic reasons.
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