Rejected

Vincristine-induced peripheral neuropathy (VIPN) is the main side effect and major reason for neuropathic pain in cancer survivors treated with vincristine. Vincristine, a chemotherapeutic antimitotic drug, is used frequently in combination chemotherapy. The primary purpose of the current study was to assess the protective effect of sodium selenite (SSe) on VIPN in vitro. Cytotoxicity effects of vincristine were evaluated using PC12 cells as a neuronal model. The cell culture studies were conducted in three groups based on the various treatments, including vincristine, SSe, and co-exposure to both compositions. Cell viability and cell cycle analyses were performed using MTT assay and flow cytometry, respectively. The level of mRNA expression of and was determined using qRT-PCR. According to the results, vincristine decreased the survival rate of PC12 cells. After 24 and 48 h exposure to different concentrations of vincristine (0.1-20 μΜ), the survival rate of PC12 cells decreased as compared to the control group. The results showed that treatment with 5 μΜ of vincristine resulted in apoptosis of PC12 cells. Interestingly,co-incubation of these cells with SSe significantly reduced the cell damage induced by vincristine. Furthermore, vincristine induced the inhibition of the G2 phase in PC 12 cells, and using SSe in combination with vincristine eliminated the inhibition of the cell cycle in the G2 phase. Briefly, our in vitro preliminary study showed that SSe might protect PC12 cells from vincristine-induced peripheral neuropathy during chemotherapy.

Two patients with delayed presentations of neck pain and fixed kyphotic deformity after trauma were found to have atlantoaxial spondyloptosis (AAS) with type II dens fractures. Owing to the rarity of AAS, outcomes and optimal treatment are not well understood. In both cases, closed reduction was achieved with a dynamic overhead traction setup, followed by posterior surgical stabilization with C1-2 screw fixation.

Chronic cough lasting for > 8 weeks is a common medical condition that burdens patients. This study aimed to qualitatively describe knowledge, awareness, experiences, and subtypes of burdens (physical, social, psychological) among Japanese patients with refractory chronic cough (refractory to treatment of underlying relevant medical conditions) and unexplained chronic cough (symptoms of unexplained origin).

Chronic Neck Pain is a major disease leading to disability in individuals around the world. Various rehabilitative approaches are being used worldwide to treat neck pain. This literature review highlights efficacy of those techniques used in correcting posture in chronic neck pain. In total 17 articles are included in this review (10 articles on exercises, Pilates 3, global postural re-education (GPR) 1, patient education 2, proprioceptive neuromuscular facilitation 1). The effects of the techniques were examined on individual outcomes (pain, disability), quality of life (QoL), and psychological aspects and the targeted aspects of physical function (muscle strength, mobility and endurance). Most of the techniques are effective compared to control group and few techniques in combination with other interventions like exercise and education had better improvements in outcomes, few techniques compared to one another found to be equally significant on reducing pain and disability. To date, it was challenging to affirm superiority of one technique over other. Further high quality research is needed to confirm the effect of these techniques with appropriate evaluation methods.

Oral squamous cell carcinoma is considered a rare complication of post-haematopoietic stem cell transplantation (HSCT). Early detection of these lesions is further complicated by the overlapping clinical appearance and presentation of lesions associated with chronic graft versus host disease (cGVHD). We report a case of oral squamous cell carcinoma in a 33 year-old man who presented with severe intraoral pain on the lower left side of the cheek and jaw 19 months after undergoing HSCT for the treatment of underlying acute lymphoblastic leukaemia. He was previously treated with intravenous cyclophosphamide as a conditioning regimen for HSCT and later developed cGVHD of the liver, eyes, and gut, which resolved with treatment. Intraoral examination revealed two separate lesions. The first lesion presented as a raised oval nodular swelling with a well-circumscribed margin and irregular surface on the left buccal mucosa. A similar, but more extensive, lesion was noted on the left lingual gingiva and was associated with spontaneous bleeding. Biopsy revealed that both lesions were well-differentiated squamous cell carcinomas and were p16 positive. He underwent palliative radiotherapy but succumbed to his disease 3 months after initiation of treatment.

Otogenic brain abscess is a severe infection that must be treated as early as possible. Rare cases with a high mortality rate can be reduced by recognizing the red flags of a brain abscess, such as headaches, mental status changes, fever, and focal neurological deficits. Those could be supported by modern diagnostic management and adequate antibiotic therapy that was able to penetrate the central nervous system and abscesses. We report a case of a cerebellar abscess of the 49-year-old man with the chief complaint of vertigo. It was accompanied by chronic progressive headache, fever, bidirectional nystagmus, abnormal Romberg test, and abnormal cerebellar signs. Magnetic resonance imaging (MRI) of the head with contrast showed a right cerebellar abscess with an infectious source of otitis media and mastoiditis. The MRI evaluation showed improvement after admistered metronidazole 500 mg every 6 hours (week 22) and cefixime 200 mg every 12 hours (week 13). Long-term antibiotic treatment can be an alternative if surgery cannot be performed. However, surgery is still considered if there is no good clinical response during medical therapy.

A mucocele is a slowly progressive cystic lesion of paranasal sinuses secondary to obstruction of the sinus ostium. It is an extremely rare condition in the pediatrics age group. The symptoms usually result from lesion expansion, inflammation, or compression of the adjacent structures. We report a case of an 11-year-old boy who presented with a right-side ethmoid mucocele with no known etiology and no history of cystic fibrosis. The patient underwent endoscopic sinus surgery for mucocele excision and abscess drainage. Clinicians are recommended to suspect paranasal mucoceles in patients presenting with progressive non-specific headache and orbital manifestations.

Acute proptosis is a very rare condition presenting to the emergency department. As there are very few case reports of patients with acute onset proptosis, it is important to report each new case. This case report is of a 38-year-old lady who presented to our emergency department with a headache for three days, altered sensorium for eight hours, and acute proptosis of the left eye for 40 minutes. She was diagnosed to have a venous hemorrhagic infarct in the left parietal-occipital-temporal region with thrombosis of the left transverse and sigmoid sinuses. To the best of our knowledge, there is no documented case report or study which featured acute proptosis as a clinical sign in a patient with venous hemorrhagic infarct or where acute proptosis was associated with thrombosis of a cerebral venous sinus other than cavernous sinus. This study shows that acute proptosis can be a presenting sign even in venous hemorrhagic infarct and acute proptosis can be associated with cerebral sinus venous thrombosis even without the involvement of cavernous sinus. So although rare, venous hemorrhagic infarct and cerebral venous sinus thrombosis irrespective of the venous sinus involved should be considered in any patient presenting to the emergency department with acute onset proptosis.

Glossopharyngeal Neuralgia is often difficult to diagnose in view of its symptoms that overlap with many other regional causes. This subset of patients commonly visits otolaryngologists, dentists, oncologists only to be referred to the other and finally to the psychiatrist when the diagnosis is overlooked. We hereby present a prospective observation study of 26 cases of Glossopharyngeal neuralgia. In our observation we found a prevalence of 0.2% for glossopharyngeal neuralgia in our patients with facial pain, however amongst the neuropathic pain the GPN was more prevalent with about 35% of all the cases. Amongst the cases diagnosed with GPN we had 73.1% female predilection as compared to only 26.9% male. 53.8% of cases had left sided and 46.2% on the right sided making it non-significant in sidewise predilection.

Dermographism is the most common form of chronic inducible urticaria. However, the natural history and clinical course of patients with dermographism in tropical countries has not fully been described.