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Dematapitiya C, Perera C, Pathmanathan S, Subasinghe V, Anandagoda G, Dissanayaka V, Wijenayake U, Dissanayake P, Gamage K, Wijewickrama P, Sumanatilleke M. Parathyroid carcinoma during pregnancy: a novel pathogenic CDC73 mutation - a case report. BMC Endocr Disord 2022; 22:259. [PMID: 36284286 PMCID: PMC9594882 DOI: 10.1186/s12902-022-01169-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 10/05/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Parathyroid carcinoma is an uncommon cause of PTH-dependent hypercalcemia. Only a handful of cases have been reported of parathyroid carcinoma during pregnancy. CASE PRESENTATION Twenty-four - Year - old female presented with proximal myopathy was found to have hypercalcemia. Her serum corrected total calcium was - 15 mg/dl (8.5 - 10.3), serum phosphate - 2.3 mg/dl (2.5 - 4.5), intact PTH - 118 pg/ml (20 - 80), Vitamin D - 15 ng/ml and Urine Ca/Cr ratio - 2.1 (0.1 - 0.2). Her CECT-neck revealed a well-defined mass lesion posterior to the right lobe of the thyroid - 2.6 cm × 2.5 cm × 2.9 cm in size. She was started on vitamin D supplementation, and she underwent right lower focal parathyroidectomy. Her PTH levels normalized following surgery. Her histology revealed an atypical parathyroid adenoma. She was treated with calcium and vitamin D. Her follow up was uneventful. One year following initial surgery the patient became pregnant and at 16 weeks of POA, the patient presented with a rapidly enhancing neck mass for one week duration. Her biochemical investigations were suggestive of a recurrence of primary hyperparathyroidism. Her ultrasound scan of the neck revealed a well-defined discreate hypoechoic nodule, superior to the thyroid isthmus which was confirmed by a non-contrast MRI scan of the neck. She underwent an uncomplicated second trimester parathyroid tumour excision with normalization of post op PTH. Her histology revealed a parathyroid carcinoma with vascular and capsular invasion. Her genetic studies revealed a novel frameshift mutation of the CDC73 gene. She was treated with calcium and vitamin D supplementation and closely followed up with ionized calcium and PTH levels which were normal throughout the pregnancy. She had an uncomplicated caesarean section at a POA of 37 weeks. Currently she is twelve weeks post-partum, in remission of disease. CONCLUSION This case shows the importance of stringent follow up of atypical parathyroid adenoma patients, the benefit of second trimester surgery in management of hypercalcemia due to parathyroid carcinoma during pregnancy and the importance of identifying the novel CDC73 gene mutation.
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Affiliation(s)
| | - Chiara Perera
- Provincial Directorate of Health Services-Western Province, Colombo, Sri Lanka
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Kalra B, Joshi A, Kalra S, Shanbhag VG, Kunwar J, Singh Balhara YP, Chaudhary S, Khandelwal D, Aggarwal S, Priya G, Verma K, Baruah MP, Sahay R, Bajaj S, Agrawal N, Pathmanathan S, Prasad I, Chakraborty A, Ram N. Coping with Illness: Insight from the Bhagavad Gita. Indian J Endocrinol Metab 2018; 22:560-564. [PMID: 30148107 PMCID: PMC6085948 DOI: 10.4103/ijem.ijem_228_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The Shrimad Bhagavad Gita enlightens everyone on how to cope up with various situations in life. It uses the conversation between Lord Krishna and Arjuna to highlight initial negative coping mechanisms exhibited by the latter. It goes on to showcase positive coping skills suggested by Lord Krishna and implemented by Arjuna. The Bhagavad Gita, through this "case-based methodology," teaches us how to cope with a demanding situation. Diabetes is a lifestyle disease, which warrants a thorough change in one's lifestyle, including changes in basic activities such as diet and exercise. This brief communication utilizes the teachings of Bhagavad Gita to help in coping with illness, especially chronic illness such as diabetes. The article cites verses from the Bhagavad Gita to show how one may cope with the stress of illness such as diabetes.
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Affiliation(s)
- Bharti Kalra
- Department of Gynecology, Bharti Hospital, Karnal, Haryana, India
| | - Ameya Joshi
- Department of Endocrinology, Bhaktivedanta Hospital and Research Institute, Mumbai, Maharashtra, India
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, Haryana, India
| | - Vivekanand G. Shanbhag
- Deputy Director, Bhaktivedanta Hospital and Research Institute, Mumbai, Maharashtra, India
| | - Jyoti Kunwar
- Department of Psychiatry, AIIMS, New Delhi, India
| | | | | | | | | | - Gagan Priya
- Department of Endocrinology, Fortis Hospital, Mohali, Punjab, India
| | - Komal Verma
- Department of Behavioural and Allied Sciences, Amity University, Jaipur, Rajasthan, India
| | - Manash P. Baruah
- Department of Endocrinology, Excel Center, Guwahati, Assam, India
| | - Rakesh Sahay
- Deaprtment of Endocrinology, Osmania Hospital, Hyderabad, Telangana, India
| | - Sarita Bajaj
- Department of medicine, MLN Medical College, Allahabad, Uttar Pradesh, India
| | - Navneet Agrawal
- Department of Medicine, Diabetes Obesity And Thyroid Clinic, Gwalior, Madhya Pradesh, India
| | | | - Inderjit Prasad
- Department of Endocrinology, Dhaka Medical College Hospital, Dhaka, Bangladesh
| | | | - Nanik Ram
- Department of Endocrinology, Aga Khan University Hospital, Karachi, Pakistan
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Chowdhury F, Pathmanathan S, Aslam I, Hogg J, Kastelik J. P69 The use of assessment in the delivery of bronchoscopy simulation- Are skills retained at assessment? Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Chowdhury F, Chaudhuri N, Renshaw S, Pathmanathan S, Hogg J, Hill J, Blaxill P, Rogers T, Kastelik J. P73 The creation of a simulated pan-deanery medical thoracoscopy and indwelling pleural catheter course: Abstract P73 Table 1. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Pathmanathan S, Burgher B, Sabesan S. Is intensive chemotherapy safe for rural cancer patients? Intern Med J 2013; 43:643-9. [DOI: 10.1111/imj.12083] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Accepted: 01/16/2013] [Indexed: 11/29/2022]
Affiliation(s)
- S. Pathmanathan
- School of Medicine and Dentistry; James Cook University; Australia
| | - B. Burgher
- Department of Medical Oncology; Townsville Cancer Centre; The Townsville Hospital; Townsville; Queensland; Australia
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Pathmanathan S, Krishna MT, Blomberg A, Helleday R, Kelly FJ, Sandström T, Holgate ST, Wilson SJ, Frew AJ. Repeated daily exposure to 2 ppm nitrogen dioxide upregulates the expression of IL-5, IL-10, IL-13, and ICAM-1 in the bronchial epithelium of healthy human airways. Occup Environ Med 2003; 60:892-6. [PMID: 14573722 PMCID: PMC1740417 DOI: 10.1136/oem.60.11.892] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Repeated daily exposure of healthy human subjects to NO2 induces an acute airway inflammatory response characterised by neutrophil influx in the bronchial mucosa AIMS To assess the expression of NF-kappaB, cytokines, and ICAM-1 in the bronchial epithelium. METHODS Twelve healthy, young non-smoking volunteers were exposed to 2 ppm of NO2/filtered air (four hours/day) for four successive days on separate occasions. Fibreoptic bronchoscopy was performed one hour after air and final NO2 exposures. Bronchial biopsy specimens were immunostained for NF-kappaB, TNF-alpha, eotaxin, Gro-alpha, GM-CSF, IL-5, -6, -8, -10, -13, and ICAM-1 and their expression was quantified using computerised image analysis. RESULTS Expression of IL-5, IL-10, IL-13, and ICAM-1 increased following NO2 exposure. CONCLUSION Upregulation of the Th2 cytokines suggests that repeated exposure to NO2 has the potential to exert a "pro-allergic" effect on the bronchial epithelium. Upregulation of ICAM-1 highlights an underlying mechanism for leucocyte influx, and could also explain the predisposition to respiratory tract viral infections following NO2 exposure since ICAM-1 is a major receptor for rhino and respiratory syncytial viruses.
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Samarawickrema WA, Jayasekera N, Jansen CG, Chelliah RV, Karandawala FR, Pathmanathan S. Significance of coconut husk pits as larval habitats of Culex quinquefasciatus (Say) in the filariasis endemic coastal belt of Sri Lanka. Southeast Asian J Trop Med Public Health 1982; 13:590-5. [PMID: 7170641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Extended surveys of coconut husk pits in three districts in a study of vectors of Japanese encephalitis showed that Cx. gelidus constituted 50.9% of the larval material in Panadurra, 77.7% in Allutgama and 75.2% in Talalla. Correspondingly, Cx. quinquefasciatus was 0, 4.1 and 0 percent respectively. A similar survey in Polhena, Matara, a well known filariasis endemic village showed 72.2% Cx. gelidus and 21.2% Cx. quinquefasciatus. Analysis of past records of husk pit surveys from seven other districts gave similar results. The reason for relatively higher breeding of Cx. quinquefasciatus in the husk pits at Polhena, Matara and a suggested vector control strategy are discussed.
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