Physiology and Anatomy

We report the case of a 86-year-old man with previously diagnosed an adenocarcinoma of the right colon with metastasis to the penis. The patient underwent right hemicolectomy with negative margins and completed 12 cycles of adjuvant chemotherapy with Oxaliplatin and a fluoropyrimidine (FOLFOX IV). Two years later after the surgery, the patient presented tumoral progression and apparition of multiple metastases on liver and peritoneal carcinosis, the patient is since on supportive and palliative care. Few months later the clinical examination showed an indurated lesion of glans penis, whose resection was consistent with metastatic colon adenocarcinoma.

Streptococcus mutans (s. mutans) and Streptococcus sanguis(S.sanguis) are two important bacteria of the oral microflora. S. mutans is the most important cause of dental caries and S. sanguis is one of the major bacteria that play an important role in formation of microbial plaque. The aim of this study is to determine the effect of cigar and cigarette smoke on the growth of streptococcus mutans and streptococcus sanguis. The standard strains of s.mutans (ATCC25175) and sanguis(ATCC10550) were cultured on blood agar and incubated for 48h in different environments: atmospheric air, microaerophillic, carbon dioxide, cigar and three type of cigarette smoke (Winston ,ultralight Winston and kent). Then digital photographs of the colonies were taken and the diameter of the colonies was measured. Data were analyzed using post hoc and general linear model statistical tests. Both cigar and cigarette smoke significantly increased the growth of s.mutans and s.snguis (p=0/000). In almost all environments except cigar smoke, the growth of s.mutans was more than s.sanguis. The diameter of s.mutans colonies in dioxide ,microaerophilic, cigar and cigarette smoke (Winston,ultra light wniston and kent) showed in order: 82%, 65%, 69%, 106%, 92% increase and the diameter of s.sanguis showed in order: 45%, 53%, 137%, 89%, 40%, 55% increase. These findings indicate that cigarette smoke increases the s.mutans/s.sanguis ratio but cigar smoke decreases this ratio.

Pulmonary embolism and aortic dissection are serious and life-threatening conditions which seldom occur concomitantly. We present a rare case of uncomplicated type B aortic dissection associated at the same time to deep vein thrombosis and pulmonary embolism, in our case, the question arises on the therapeutic decision, since the anticoagulant treatment of venous thromboembolic disease presents a risk of complication of the aortic dissection.

The observation that mother-to-child transmission of HIV can occur through breastfeeding has resulted in policies that recommend avoidance of breastfeeding by HIV infected women under specific circumstances in developing countries. We aim to estimate the present rate of HIV infected mothers who practice exclusive breast feeding in a tertiary level hospital in India. This cross sectional study examined practices of 82 counseled HIV mothers by using structured and open ended questionnaire. Data analysis was conducted using SPSS 18.0 .Our results showed that 58.6% (n=48) of mothers practiced exclusive breast feeding. 24.6% (n =12) of women were concerned about the social repercussions if they did not breast-feed, whereas 16.3% (n=8) stated they could not ensure hygienic food preparation. Breast feeding is the most community accepted feeding practice in India. Due to the lack of hygienic conditions, poor economic status and the risk of social repercussions breast-feeding should be promoted for HIV women.

Chronic non-communicable diseases are the major threat to the health of population in developing countries. Tobacco smoking is one of the preventable underlying factors responsible for this group of diseases. Pakistan faces a higher prevalence of smoking despite the fact that masses are well aware about the ill health effects arising from smoking, thus leading to high unmet need for cessation of smoking. The current community based study on three hundred & twenty subjects looked into the situation unmet need & determinants for higher level of unmet need. The overall prevalence of current smoking in both genders was 49%. There was however no significant relation between gender & smoking (p=0.28). The met need to quit smoking was 21.5% while unmet need to quit smoking was computed as 26.15%. The reasons for not being able to quit smoking were that smokers were of the opinion that they could fully control their smoking habits in future (28.6%; p=0.08), smokers were unaware about smoking cessation services (54.4%; p=0.02), lack of training to health care providers for imparting counseling services (37.2%; p=0.05), the subjects expressed need to establish locally based services with community based smoking cessation advisors (78.6%; p=0.01). The study concluded that in presence of high motivation among smokers to quit smoking, there is urgent need to provide appropriate smoking cessation services to the target population.

Disease progression is a complex process which involves multiple sequential steps leading to cellular changes, altered signaling pathways and metabolic events. Cancer is a very wide spread disease in the world. Among the various types of cancers, ovarian cancer is the leading cause of death in gynecological malignancies. Biomarkers are cellular, biochemical, molecular or genetic alterations by which a normal, abnormal or simply biological process can be predicted or monitored. Various Biomarkers like Cancer Antigen 125, HCG, Human Kallikreins, Membrane Tyrosine Kinase Receptors, HE 4 and Mesothelin etc. are used to identify pathological processes before individuals become symptomatic or to identify individuals who are susceptible to cancer.

The implantable port chamber catheters are useful for repeated intravenous treatment, they are placed surgically, percutaneously or radio-guided, they can cause variable complications (infection, thrombosis, malposition, product leakage ...). The occurrence of malposition of the distal portion of the catheter is a rare complication. We report a case of malposition (intra-dural and extra medullary position) whose mechanism have not been determined.

Mucoperidone carcinoma of the parotid is a very rare tumor and represents 1 to 4% of all parotid tumors. It can be observed at any age, especially in the adult to the 5th decade, but very rarely in the child, nineteen cases have been reported in the world literature, with an equality between the two sexes. We report the case of a 9-year-old girl admitted to consultations for a left lateral-cervical swelling that gradually increases in volume, and has evolved for 3 years. Cervical ultrasounds with an MRI were performed objectifying a tumor of the parotid gland. Total parotidectomy was performed. The extemporaneous biopsy was in favor of a low grade mucoepidemic carcinoma. The surgical procedure was completed by functional lymph node dissection. This is a slow-growing tumor with a non-specific symptomatology. The treatment is essentially surgical. Its prognosis depends on the histological features of the tumor.

The Previous studies have shown evidence for the presence the quality factor of otoacoustic emissions models and it's role, in this work we study the effect by using different values of the quality factor, so we take the values of the quality factor (Q=5, 10, 20, 30, 40 and 50) The results suggest that reflections generation of the otoacoustic emissions from roughness are behaved two parts with respect to the value of the quality factor (Q), we found with low value (Q=5 and 10) the generation of the reflectivity is less than with high values of the quality factor ( Q = 20, 30, 40 and 50) therefore the reflectivity is depend on the value of quality factor.

Tacrolimus has become an important cornerstone in the prevention of rejection after kidney transplantation. However, its use has been complicated by several side effects, including chronic allograft nephropathy, diabetes mellitus, arterial hypertension, and neurotoxicity. Tacrolimus-induced neutropenia is a less recognized, but potentially life-threatening complication. We describe one patient with leukopenia developing within 49 days after renal transplant. After excluding other potential causes, tacrolimus was considered the most probable culprit. Definitive proof of this hypothesis was obtained by discontinuation of tacrolimus and switching to cyclosporine, which led to recovery of white blood cell count. With this case report, we aim to make others aware of the potential neutropenia induction by tacrolimus.