Archives-August 2022

Brown tumor or fibrocystic osteitis is a rare benign bone lesion secondary to exposure to excessive parathyroid hormone secretion in hyperparathyroidism. It can affect the entire skeleton; mandibular localization remains exceptional. We report a case of a 28-year-old female patient, who presented a swelling of the chin evolving for 1 year. Radiological examination revealed the presence of two mandibular lytic lesions. Histological examination after biopsy revealed a giant cell tumor, on which the diagnosis of brown tumor was evoked and confirmed by the discovery of primary hyperparathyroidism profile on parathyroid adenoma whose surgical treatment allowed a spectacular regression of the mandibular tumor. Our patient's case illustrates how the Brown tumors should be considered in the differential diagnosis of osteolytic lesions to avoid unnecessary and harmful interventions.

The bioecological study of Harithalodes derogata in northern Kerala is scanty. The larval instars of Harithalodes derogata feeds on many crops in northern Kerala, especially in okra. It also causes severe damage in Hibiscus sp. The study was conducted in the monsoon and post monsoon seasons of 2019 to 2020. Leaf roll was up to 80- 85 % in okra and 35-40 % in hibiscus and the defoliation was observed 70-75 % in okra and 30-35 % in hibiscus under heavy infestation. The field population of larvae was highest in August and December, while it was lowest in June and July.

The occupational radiation doses for medical staff at the Sheri Kashmir Institute of Medical Sciences (SKIMS) Hospital's departments of diagnostic radiology, nuclear medicine, radiotherapy, cardiology, gastroenterology, radiological physics, and bioengineering were monitored and evaluated. To ascertain the status of their average yearly effective dosage and average cumulative lifetime exposure, 250 medical radiation employees were observed. The Radiation Safety Lab of the Department of Radiological Physics and Bioengineering at SKIMS was where the analysis for this study was completed. Based on their clinical responsibilities and expertise, the observed personnel were divided into two subgroups: technical professionals and physicians. Thermo luminescent dosimeters (TLD-BARC (CaSo4:Dy)) were used to measure the whole body doses in all categories of workers, with the exception of those in the cardiology lab and gastroenterology, for whom the TLD was worn under the lead apron (0.5millimeter lead thickness). Additionally, an extremities dosimeter was given to each of the three departments—nuclear medicine, cardiology, and gastroenterology. Radiological physics, nuclear medicine, radiation, cardiology, gastroenterology, BE, and SKIMS Medical College employees' annual average effective doses were found to be 0.26, 0.60, 0.18, 0.35, 1.37, 0.17, and 0.25 mSv, respectively. The average hand/extremity dose recorded by the department of nuclear medicine utilising the unsealed radioisotopes was 1.06mSv. Cardiology and gastroenterology, two departments that use fluoroscopic guidance for a variety of procedures, were also given an extra extremity dosimeter, and the average dosages were discovered to be 0.42 and 5.57 mSv, respectively. The measured annual dosage resulted in levels that were significantly lower than the international recommended occupational dose limit.

The presence of pathogens in drinking water may result from source water contamination by human and animal activities, followed by improper or insufficient treatment. The study was conducted to assess the bacteriological quality of water produced at the Kwanyako Water Treatment Plant in the Central the Region of Ghana. Triplicate water samples of Raw and Final water were collected in sterile 500ml polypropylene bottles, and analysed for thermotolerant coliform (TTC) using the Most Probable Number (MPN) method to determine the bacteriological quality of water before and after treatment. The study was carried out for a period of 6 months (September, 2013 to February 2014). TTC was positive for all Raw water samples but negative for all Final water samples. This implied that, the water produced at the Treatment plant is efficiently treated and poses no health threat.

Acoustic neuromas represent 6-7% of all intracranial tumors and develop slowly in the internal auditory canal, in the cerebellopontine angle. It is usually unilateral. The bilateral forms are exceptional and suggest neurofibromatosis type 2 "NF2". It can cause neurological disorders because of its development but also because of its volume and the compression caused on adjacent neurological structures. Magnetic resonance imaging (MRI) is the standard imaging modality for the diagnosis of the disease. which shows a mass of the cerebellopontine angle of intermediate signal in the T2-weighted sequence, heterogeneous, strongly enhanced after injection, with the famous sign of the ice cream cone aspect testifying to damage of the VIII nerve in the internal auditory canal, these tumors are classified according to their extent and size, which conditions the therapeutic management, the treatment is based on microsurgery, radiosurgery or therapeutic abstinence, depending on the tumor stage.

The electronic cigarette is a product of common consumption which has known a remarkable commercial success. Its use is controversed by the doctors because of its toxicity, especially in the long term. A lesser toxicity of vaping compared to cigarettes is also an established fact. We report the case of a young electronic cigarette smoker, who arrived at the emergency department with a myocardial infarction. In the literature, a significant impact of electronic cigarette use on intermediate endpoints or markers of cardiovascular but it is not clear whether these changes have medium- and long-term clinical consequences. Few clinical studies have been conducted to specifically evaluate the cardiovascular effects of vaping. Thus, the electronic cigarette should never be used on a non-smoker or ex-smoker. Ideally, its use should be limited in time necessary for smoking cessation.

Left ventricular (LV) aneurysm or pseudoaneurysm are most often secondary to myocardial infarction. They predispose to heart failure, rhythm disorders and thrombus formation. Their diagnosis can be difficult, requiring a high performance imaging. The purpose of our study is to demonstrate the important role of cardiac MRI in the study of the left ventricular aneurysms. We performed a retrospective study, which collected 68 patients referred for cardiac MRI, between 2007 and 2021, and for whom the final diagnosis of left ventricular aneurysms or pseudoaneurysms was retained. We evaluated the incidence of this pathology, the underlying heart disease, the myocardial morphology, perfusion and viability, as well as those of aneurysms with search for thrombus. The mean age was 64.4 years, with a male predominance. Cardiac MRI was performed mostly to search for myocardial viability (61.8 %). The underlying heart disease was exclusively ischemic heart disease. In 58.8% of the cases, the diagnosis was that of a true aneurysm without thrombus and in 38.2% of cases with thrombus. LV pseudoaneurysm was present in only 2 patients. These aneurysms were mainly located apically (84.8%). Perfusion defect perfusion was noted in the necrotic coronary territories, with the presence of viability in 11.8% of cases. The mean of the LV end-diastolic diameter was at 66.3+/- 8.2 mm (i.e. 39 mm/m2) and the mean volumes were at 264.1± 101.5 ml (155.3 ml/m2). The mean LV ejection fraction was at 29.8 ±10%. Thus, cardiac MRI is the "gold standard" in post-infarction studies for an exhaustive study, not only for the diagnosis of LV aneurysms, but also on the complete myocardial study.

Small lymphocytic lymphoma (SLL) is a low-grade B-cell non-Hodgkin lymphoma (NHL) characterized by a monoclonal population of mature B-cell lymphocytes. It is rarely associated with cardiac involvement. Pericardial effusion is one of the most common incidental findings in cancer patients, which significantly worsens morbidity and mortality. Thus, early detection, adequate treatment, and understanding of pericardial diseases are necessary to help improve the quality of life of cancer patients. An individual treatment plan should be established, taking into account cancer stage, the patient's prognosis, local availability and experience. We report the case of a SLL involving the pericardium.

Table of contents for the month of August 2022