Objective: In this study, Objective was to assess the social support, quality of life and mental health status in breast cancer patients. Different literatures have highlighted the breast cancer's impact on mental health, quality of life, financial status etc., but very few studies have been done particularly in Nepal to assess impact of social support and quality of life on the mental health of a breast cancer patient. Methods:The design of the study was cross-sectional. The study was conducted from December 2015 to August 2016. A total of 149 patients diagnosed with breast cancer who met eligibility were enrolled. We included only patients who were reachable, diagnosed with breast cancer at least for 6 months and consented to participate in the study. They were interviewed using EORTC, mMOSS-SS and HADS questionnaires through telephone interview. Statistical analysis was carried out with SPSS (version 16).Results: For QOL, mean linear scores for the global health and functioning scale were 82.08 and 69.06 (on a scale of 0-100; higher the score, better the global health and physical function). For social support, mean linear score was 85.03 (on a scale of 0-100; higher the score, better the social support). For mental health, mean anxiety and depression score were 7.01 and 4.85 respectively (on a scale of 0-21, 8 being cut off for borderline and 11 being the cutoff for abnormal condition). Out of 149 respondents, 40.93% (61) were screened positive for depression either borderline or abnormal mood, whereas 52.34% (78) women were screened positive for anxiety either borderline or abnormal mood. Significantly less number of married woman currently living with husband had borderline plus abnormal mood. Similarly significantly higher number of woman living in nuclear family had depression. Global health scores of above mean, Social support scores of above mean and Anxiety scores of below mean had significant association with normal mood (p<0.05). Conclusion:From our study, we concluded that there was a high prevalence of undiagnosed depression in breast cancer patients. Good social support, better quality of life and absence of anxiety had significant association with the better mental health status. So, regular psychiatric screening and follow up should be recommended. To improve social support; counseling of spouse, family members and friends could be done along with the patient. For the quality of life; better pain control and rehabilitation measures should be tried.

Objective: To review and analyze the clinical and imaging features of central giant cell granuloma patients and to review the relevant literatures for the diagnosis and clinical manifestation of central giant cell granuloma. Methods: Seven cases of central giant cell granuloma were retrospectively selected for the study, all of which were confirmed by pathology and had relevant imaging investigations. All seven cases had undergone CT scan, three cases had undergone MRI scan. Detailed clinical features were compared along with the imaging findings and analysis was done on the basis of their presentation and imaging features. Results: The clinical features, radiologic features were varied according to the site of the lesion. CT features include unevenly dense expansile mass causing bone destruction and cortical thinning. While MRI features with low to iso-intensity in T1- and T2 weighted images. There may be presence of cystic degeneration, hemorrhage or hemosiderin deposits or osteoid formation, which can cause T1 and T2 signal changes. On contrast study, the lesion doesn’t enhance but periphery may enhance mildly. Conclusion: Unevenly dense expansile mass with bone destruction and cortical thinning with low to iso-intensity in T1 weighted and T2 weighted images and mildly enhance peripherally, Central giant cell granuloma should be considered.

Sweet's syndrome and eosinophilic folliculitis are aseptic inflammatory dermatitis mainly because of infiltrated neutrophils and eosinophils on skin, respectively. These diseases rarely overlap or coexist in the same patient, especially co-occur in HIV infected patient. Here, we report a rare case of an AIDS patient who developed eosinophilic folliculitis and Sweet's syndrome within 1 month of initial antiretroviral therapy, presumably due to immune reconstitution inflammatory syndrome. The CD4 + T cell counts increased dramatically from 70 to 249 cells/µL within a period of 1 month. Interestingly, the patient was rapidly and strikingly responsive to thalidomide, which has anti-inflammatory, immune regulation, inhibition of neutrophil chemotaxis etc. Moreover, we focused our attention on discussing the clinical, pathological, and possible pathogenic aspects of the rare overlap of HIV complicated with neutrophilic and eosinophilic dermatosis.

Background: The clinical and laboratory characteristics of AIDS-associated Talaromyces marneffei infection, a rare but a fatal mycosis disease of the central nervous system, remain unclear. Case presentation: Herein, we conducted a retrospective study of ten AIDS patients with cerebrospinal fluid culture-confirmed central nervous system infection caused by Talaromyces marneffei. All 10 patients were promptly treated with antifungal treatment for a prolonged duration and early antiviral therapy (ART). Among them, seven patients were farmers. Nine patients were discharged after full recovery, while one patient died during hospitalization, resulting in a mortality rate of 10%. All patients initially presented symptoms and signs of an increase in intracranial pressure, mainly manifesting as headache, dizziness, vomiting, fever, decreased muscle strength, diplopia or even altered consciousness with seizures in severe patients. Nine patients (90%) showed lateral ventricle dilatation or intracranial infectious lesions on brain CT. Cerebrospinal fluid findings included elevated intracranial pressure, increased leukocyte count, low glucose, low chloride and high cerebrospinal fluid protein. The median CD4 + T count of patients was 104 cells/μL (IQR, 36-224 cells/μL) at the onset of the disease. The CD4 + T cell counts of three patients who eventually died were significantly lower (W = 6.00, p = 0.020) than those of the patients who survived. Conclusions: The common clinical symptoms of T. marneffei central nervous system infection are associated with high intracranial pressure and intracranial infectious lesions. Earlier recognition and diagnosis and a prolonged course of amphotericin B treatment followed by itraconazole combined with early ART might reduce the mortality rate.

Background: To review and analyze the clinical and imaging features of central giant cell granuloma patients and to review the relevant literatures for the diagnosis and clinical manifestation of central giant cell granuloma.Methods: 7 cases of central giant cell granuloma were retrospectively selected for the study all of which were confirmed by pathology and had relevant imaging investigations. All 7 cases had undergone CT scan, 3 cases had undergone MRI scan. Detailed clinical features were compared along with the imaging findings and analysis was done on the basis of their presentation and imaging features.Results: The clinical features, radiologic features were varied according to the site of the lesion. CT features include unevenly dense expansile mass causing bone destruction and cortical thinning. While MRI features with low to iso-intensity in T1 weighted and T2 weighted images. There may be presence of cystic degeneration, hemorrhage or hemosiderin deposits or osteoid formation, which can cause T1 and T2 signal changes. On contrast study, the lesion doesn’t enhance but periphery may enhance mildly. Conclusion: Unevenly dense expansile mass with bone destruction and cortical thinning with low to iso-intensity in T1 weighted and T2 weighted images and mildly enhance peripherally, CGCG should be considered.