The influence of the COVID-19 pandemic on the psychological well-being of college students: a cross-sectional study

OBJECTIVE

Even before the outbreak of the COVID-19 pandemic, concerns regarding college students' mental health were on the rise due to the increasing number of students afflicted with mental health issues. Exposure to numerous pandemic-related measures exacerbated existing issues with anxiety, depression, and stress. This study aimed to assess depression, anxiety, and stress levels among university students in the Aseer region in Saudi Arabia.

SUBJECTS AND METHODS

Data were collected from eligible individuals using a web-based, self-administered DASS-21 questionnaire. This questionnaire consists of 21 questions with a rating scale of 0-3. Each of the psychological factors of depression, anxiety, and stress was categorized as normal, mild, moderate, severe, and extremely severe. Results were expressed using descriptive statistics as proportions, and the Mann-Whitney/Kruskal-Wallis' test was used to evaluate the presence of a significant difference between each of the socio-demographic factors of the respondents and the psychological outcomes.

RESULTS

Respondents aged between 18-24 years reported higher rates of extremely severe depression than other age groups. Females had higher rates of depression, especially severe and extremely severe forms. Extremely severe anxiety had a relatively high prevalence across all age groups. Extremely severe stress was more common among respondents aged between 18-24 years, while respondents older than 34 years reported the highest prevalence of severe stress. The Mann-Whitney/Kruskal-Wallis' tests showed statistically significant differences between participants in the different groups.

CONCLUSIONS

The COVID-19 pandemic had a high psychological impact on university students, which indicates that a psychological support program should be implemented to reduce this impact.

Detection and analysis of potential drug-drug interactions among patients admitted to the cardiac care unit in a tertiary care hospital

OBJECTIVE

This study aimed to estimate how prevalent potential drug-drug interactions (pDDIs) were in patients with cardiovascular diseases who were hospitalized for more than 24 hours, and to determine the risk factors associated with these pDDIs.

PATIENTS AND METHODS

A prospective observational study was conducted on patients admitted to the cardiac care unit in a tertiary care hospital. We included two hundred medical records of cardiovascular disease patients who were prescribed more than one drug. These medical records were analyzed for pDDIs using the Micromedex drug interaction checker database. Data were analyzed using Descriptive statistics. Chi-square test and the Pearson correlation coefficient were applied.

RESULTS

PDDIs were prevalent in 95% of the analyzed medical records, with at least one detected pDDI per record. Within the 200 medical records, 430 potentially interacting drug pairs were identified, with the majority resulting in moderate and major interactions. Aspirin/clopidogrel (111), furosemide/aspirin (89), enoxaparin/clopidogrel (89) and Lisinopril/aspirin (60) were the most common interacting pairs. Whereas, aspirin, heparin, clopidogrel, furosemide, ranitidine and Lisinopril were the most frequently implicated drugs in DDIs.

CONCLUSIONS

PDDIs were common among hospitalized cardiovascular patients. PDDIs were associated with age and number of drugs prescribed. The routine integration of an online drug interactions screening tool may improve the ability of pharmacists to identify cardiac patients at higher risk of potential drug interactions and conduct appropriate interventions thereafter.

Behavior of right atrial strain in patients with advanced idiopathic pulmonary arterial hypertension after initiation of specific combined therapy

Background

Right atrial (RA) function has emerged as an important determinant of outcome in pulmonary arterial hypertension (PAH). However, studies exploring RA function and assessing its behavior in response to specific PAH combination therapy, independent of RA size in patients with PAH is not adequately investigated.

Purpose

Assess the behavior of strain based measures of RA in response to combined PAH therapy, independent of RA size in patients with PAH.

Methods

RA peak longitudinal strain (PLS) and peak active contraction strain (PACS) were retrospectively assessed in 38 patients with advanced idiopathic pulmonary arterial hypertension (IPAH) who were referred to Aswan heart Centre and not receiving proper GDMT; at baseline and during follow-up after initiation of specific PAH combination therapy in the form of either Sildenafil/Bosentan or Sildenafil/Macitentan.

Results

Most of the patients were females with median (IR) age 34 (27–39) years. All patients presented with dyspnea WHO-FC III. At baseline, all patients were receiving only monotherapy in the form of sildenafil. Median (IR) time to echocardiographic follow-up was 11 (8–18) months. Patients presented with markedly right ventricle (RV) and RA enlargement, depressed RV systolic function, and reduced RA strain parameters compared with values previously reported in healthy controls. Among various baseline associations of the RA PLS, the strongest were with baseline RA area (rho: −0.659; p<0.001) and RVEF by CMR (rho: 0.570; p<0.001). At follow up; RA PLS and PACS significantly increased (16.6 vs 24 and 7.06 vs 11.42, respectively: p<0.001); however, RA area did not show significant decrease. Only RV TDI & FAC showed significant improvement among different RV function parameters measured by echocardiography. During the follow up period, 11 out of 38 patients (28.9%) were hospitalized. RA PLS change was significantly lower in the hospitalized group than the non-hospitalized group (4.40 vs 10.2; p=0.014). RA PLS change was independently associated with hospitalization in the multivariate regression analysis (95% CI: −0.061 to −0.010; p=0.008).

Conclusion

Initiation of specific PAH combination therapy in undertreated patients with IPAH showed improvement in RA strain parameters despite no change in RA area during follow up.

Funding Acknowledgement

Type of funding sources: None.

Molecular Detection and Differentiation of Mycobacterium Tuberculosis Complex and Non-tuberculous Mycobacterium in the Clinical Specimens by Real Time PCR

Mycobacteria are subdivided into three groups: the Mycobacterium tuberculosis complex, the non-tuberculous mycobacteria called NTM or MOTT (Mycobacteria Other Than Tuberculosis) and Mycobacterium leprae. Over the past few decades, the incidence of infections caused by NTM has increased world wide. The differentiation of Mycobacterium tuberculosis complex from NTM is of primary importance for infection control and choice of antimicrobial therapy. However, there is so far no report in Bangladesh about the detection of NTM and hence differentiation of MTB and NTM. Neither acid-fast bacilli (AFB) staining nor histopathology can discriminate MTB and NTM. In order to detect and differentiate Mycobacterium tuberculosis complex and NTM we used commercially available LyteStar TB/NTM Real Time PCR kit (Altona Diagnostics, Germany) and analyzed 782 clinical specimens from tuberculosis suspected patients. We have found 49 MTB and 74 NTM positive samples from variety of clinical specimens such as sputum, bronchial lavages, body fluids, tissues, needle aspirates and swabs. Many of the PCR positive specimens were AFB negative on direct microscopic examination thus, indicating strong sensitivity of PCR than AFB staining. This is the first report in the country about detection of NTM and it warrants further elaborate investigation. Moreover, our results showed that multiplex real-time PCR assay is an effective sensitive tool for the rapid identification and differentiation of MTB and NTM directly from clinical specimens.

Clinical Profile and Outcome of Intracranial Meningioma in Apollo Hospitals Dhaka

Background: A meningioma is a tumor that arises from the meninges- the membranes that surround the brain and spinal cord.Objective: This is a retrospective analysis of the recorded data of patients managed for intracranial meningiomas between January 2007 and June 2015 at Apollo Hospital, Dhaka.Methodology: Demographic data was analyzed for all but only patients who had surgery and histological diagnosis were analyzed for outcome.Results: This study shows that meningiomas had female preponderance. Majority cases were above 50 years of age. Convexity is the most common anatomical location of meningioma. Most common symptoms were headache (70%) followed by seizure in 34.3% of patients. 90% of the cases were benign. Malignant meningioma was 1.4% and recurrence was found in 1.4% of cases. Six patients with histological grades I, II and III meningi- omas were sent for stereotactic radiotherapy after incomplete tumor resection or for residual tumour. Total removal was done in 80% cases and the mortality was 1.4%, in patient who had poor GCS score on admission.Pulse Vol.9 January-December 2016 p.22-26

Detection of Nontuberculous Mycobacterium by Real Time PCR from Variety of Clinical Specimens

Aim: Nontuberculous mycobacterium (NTM) causes many types of infections including respiratory and non-respiratory infections such as skin and soft tissue infections, lymphadenitis, meningitis, gastro-intestinal infections, disseminated infections and even intravenous catheter-related infections. Increasing incidence of NTM is reported worldwide in last decade. However, incidence of NTM in Bangladesh is not known as detection of NTM is not undergoing in Bangladesh which is necessary to know as these NTM species are resistant to first-line anti-TB drugs and, when mistaken for M. tuberculosis, give rise to erroneous identification of multidrug-resistant TB (MDR-TB). We wanted to know the existence of NTM from various clinical specimens including tissues from tuberculosis suspected patients visited in Apollo Hospitals Dhaka in 2013 to 2015.Material and Method: Sample processing, DNA extraction and real time PCR (polymerase chain reaction) were done according to the commercial LyteStar TB/NTM PCR kit developed by Altona Diagnostics, Germany. The target DNA sequences are amplified with IS61 10-specific primers for MTB complex and ITS-specific primers for NTM. Probes specific for MTB complex and NTM DNA are labeled with fluorophore dye FAM and HEX, respectively. We have analyzed 579 clinical specimens from tuberculosis suspected patient.Result: Among 579 specimen different types of tissues were 201 and histopathology data were available for 166 cases. In tissues NTM was detected by PCR in 3 1(19%) cases, 8 of which were compatible with histopathology findings and rest 23 cases showed no evidence of granulomatous lesion. We analyzed 378 different varieties of clinical specimens such as sputum, bronchial lavages, body fluids, pus and swabs. Among 378 samples 215 samples were requested for AFB staining. NTM was detected by PCR in 19(8.8%) samples and out of 19 NTM positive specimens only one was AFB positive.Conclusion: This is the first report in the country about detection of NTM in variety of clinical specimens and warrants further elaborate investigation. Our results showed that PCR is an effective tool for the rapid identification of NTM from tissues and AFB negative clinical specimens having suspicion for mycobacterial infection.Pulse Vol.9 January-December 2016 p.15-21

Abstract P5-03-02: The dynamic duo: A breast cancer-targeting nanoparticle loaded with a cytotoxic peptide as a treatment for metastatic disease

Metastatic breast cancer is a uniformly fatal disease with a 5-year survival rate of 15 percent. To date there are no effective approaches for targeted therapy. To develop a treatment for metastatic cancer, our group discovered a novel cytotoxic peptide, CT20p, and developed a nanotechnology-based platform to deliver and concentrate CT20p in breast tumors. CT20p was derived from Bax, a member of the Bcl-2 family. Unlike the parent protein, CT20p does not cause apoptosis and its cytotoxicity is independent of caspases and Bcl-2 overexpression. Rather, the intracellular target of CT20p is a protein called chaperonin-containing T-complex (CCT), which is required for the folding of actin and tubulin into their native forms. Inhibition of CCT activity by CT20p, indicated by decreased F-actin and tubulin, impaired the polymerization of microfilaments and microtubules, causing loss of cell migration and adhesion that promoted breast cancer cell death. In contrast, normal, non-transformed cells were resistant to the cytotoxicity of CT20p. On its own, CT20p is not membrane-permeable. To deliver the peptide to cells, we used nanoparticles formed with a novel aliphatic hyperbranched polyester polymer (HBPE-NPs). The surface of HBPE-NPs retains carboxylic acid groups for labeling of targeting ligands to enable accumulation in tumors. To concentrate on breast cancer, we functionalized the HBPE-NPs with either folate (FOL) or glutamate (GLU), which target the folate receptor (FR) or the metabotropic glutamate receptor (GRM-1) respectively. FR and GRM-2 are essential metabolic components that are highly expressed in solid tumors like breast cancer. In vitro targeting studies using triple negative breast cancer cell (TNBC) lines established that folate FOL or GLU-HBPE-NPs loaded with fluorescent dyes were readily up taken at high efficiency by TNBC cells. HBPE-NPs also contain unique hydrophobic cavities especially suited for encapsulating CT20p. We found that once the CT20p-HBPE-NPs were taken up by cancer cells, the peptide was released inside cells under acidic conditions (e.g. endosomes) and directly interacted with its intracellular target, CCT. Studies using primary cells derived from human breast tumors confirmed the targeted uptake of HBPE-NPs as well as demonstrated the cancer-specific cytotoxicity of CT20p. We treated a murine TNBC xenograft model with nanomolar amounts of FOL-CT20p-HBPE-NPs and achieved 100% regression of established tumors as well as prevented tumor growth. These studies indicated that CT20p is a potent and specific anti-cancer agent due to its inhibition of CCT, an essential molecular complex highly expressed in cancer cells, and that the peptide can be efficiently delivered to tumor sites using HBPE-NPs decorated with ligands to receptors, such FR or GRM-1, found on tumor cells.

Citation Format: Vishnubhotla P, Khaled AR, Khaled AS, Perez JM, Bassiouni R, Flores O, Nierenberg D. The dynamic duo: A breast cancer-targeting nanoparticle loaded with a cytotoxic peptide as a treatment for metastatic disease. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-03-02.

Abstract P5-04-04: Cutting the ties that bind: Targeting chaperonin-containing T-complex (CCT) for therapeutic intervention in the treatment of advanced stage breast cancer

Metastatic disease is a principal cause of death from breast cancer. This is due in part to the development of resistance to current therapeutics and the often debilitating side effects that impair quality of life. The challenge is to therapeutically target an essential physiological function of cancer cells not found in normal, non-transformed cells. To this end, we discovered CT20p, a therapeutic peptide that causes cancer-specific death in human breast tumor cells and tumor regression in xenograft models of breast cancer. Using a proteomics approach, we found that CT20p directly binds to multiple subunits of a type II chaperonin called chaperonin containing T-complex or CCT. CCT forms a large macromolecular complex composed of 8 subunits (CCTα, CCTβ, CCTγ, CCTδ, CCTϵ, CCTζ, CCTη, CCTω). Each subunit contains an ATP binding site as well as substrate binding sites. Inhibition of CCT by CT20p depletes the pool of native actin and tubulin (obligate clients of CCT), impairing the polymerization of cytoskeletal elements needed to support cell adhesion and motility. As a result cancer cells lose the ability to migrate and die from loss of substrate survival signals. We found that expression levels of CCT varied among different triple negative breast cancer (TNBC) cell lines, with the highest expression occurring in those of the mesenchymal stem-like (MSL) subtype with metastatic potential. Lowest levels of CCT were found in normal breast epithelial cells. Sensitivity to killing by CT20p thus correlated with levels of CCT, with cancer cells expressing high amounts of CCT being the most susceptible. Using tissue microarrays (TMAs) of breast cancer progression, we developed an immunohistochemistry staining procedure for CCTβ. Results were interpreted on a scale of 1 to 4 (with 4 being the strongest staining). CCTβ expression was statistically higher in invasive ductal carcinoma (IDC) as compared to normal and cancer adjacent tissue (CAT) (p<0.0001). Within the types of IDC, CCTβ was highest in tumors that exceeded 5 cm across (T3), grew in chest wall or skin and in inflammatory breast cancer (T4) (p<0.05). Examining CCTβ levels in different molecular types showed little correlation with estrogen receptor (ER) positivity but strong correlation with ER and progesterone receptor (PR) positivity or PR alone (p>0.001). Statistical correlations were also observed with Her2 positivity (p>0.05). However, no statistically significant correlations were observed with TNBC tissues, with CCTβ staining ranging from the strongest staining (4) to lowest (1). These results are similar to that observed with the TNBC cell lines and indicate that CCT expression may reflect the heterogeneity of TNBC. These results suggest that CCT is a promising target for therapeutic intervention due to its increased expression in advanced stage breast cancer, independence of molecular identity and dependence by cancer cells to support essential cytoskeletal changes associated with the metastatic stem-like phenotype.

Citation Format: Khaled AS, Vishnubhotla P, Khaled AR, Bassiouni R. Cutting the ties that bind: Targeting chaperonin-containing T-complex (CCT) for therapeutic intervention in the treatment of advanced stage breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-04-04.

Central Neurocytoma: a Case Report

Central neurocytoma is a tumour showing neuronal differentiation. This tumour usually located in ventricles occurs at young age and carries favorable prognosis. For this, accurate diagnosis is essential. There is no published case report of central neurocytoma in Bangladesh. With these objectives, we have presented a case report of central neurocytoma in a 37 years old female. DOI: http://dx.doi.org/10.3329/pulse.v6i1-2.20351 Pulse Vol.6 January-December 2013 p.51-52

Correlation of Intra-Operative Frozen Section Consultation With the Final Diagnosis At a Tertiary Referral Center in Dhaka

Abstract not available DOI: http://dx.doi.org/10.3329/pulse.v5i2.20261 Pulse Vol.5 July 2011 p.22-25

A Clinical and Histopathological study of Lichenoid Eruption of Skin in Two Tertiary Care Hospitals of Dhaka

Abstract not available DOI: http://dx.doi.org/10.3329/pulse.v5i1.20184 Pulse Vol.5 January 2011 p.12-18

Abstract P6-04-13: Preclinical testing using a novel CT20p peptide-nanoparticle combination in breast cancer

BACKGROUND: The marked difference in metabolism observed between tumor and normal cells could contribute to the development of invasive and metastatic forms of breast cancer. The problem is that while patients diagnosed with invasive forms of breast cancer may be initially responsive to treatment, a significant number develop relapsing and even metastatic disease. There is a critical unmet need to develop new therapeutic approaches for patients diagnosed with invasive forms of breast cancer that are effective given the unique metabolism of tumor cells. METHODS: We examined the cytotoxic properties of a novel peptide, CT20p, derived from the C-terminus of Bax. For delivery to cells, the amphipathic nature of CT20p allowed it to be encapsulated in polymeric nanoparticles (NPs). NPs were made using aliphatic hyperbranched polyester (HBPE) that incorporated surface carboxylic groups and interior hydrophobic cavities for encapsulation of CT20p. To examine the cytotoxic potential and targeting capacity of CT20p-HBPE-NPs, we treated MDA-MB-231 breast cancer cells and MCF-10A breast epithelial cells with the peptide-nanoparticle combination and measured changes in mitochondrial function, cell metabolism and induction of apoptotic and non-apoptotic cell death. The ability of CT20p-NP-HBPE to cause tumor regression was examined by subcutaneously implanting MDA-MB-231 cells in nude mice. RESULTS: Initial studies showed that CT20p caused the release of calcein from mitochondrial-like lipid vesicles, without disrupting vesicle integrity, and, when expressed as a fusion protein in cells, localized to mitochondria. While the peptide alone had little effect upon intact cells, likely not penetrating the plasma membrane, when encapsulated and delivered by nanoparticles, CT20p-HBPE-NPs proved an effective killer of breast cancer cells. CT20p-HBPE-NPs initiated non-apoptotic cell death within 3 hours of treatment by targeting mitochondria and deregulating cellular metabolism. Nanoparticles alone or nanoparticles encapsulating a control peptide had minimal effects. The cytotoxicity of CT20p-HPBE-NPs was most pronounced in breast cancer cells, sparing normal, epithelial cells. In implanted breast tumors, CT20p-HBPE-NPs accumulated in tumors within 24 hours and reduced tumor burden by 50-80%. CONCLUSION: These results reveal the innovative features of CT20p that allow nanoparticle-mediated delivery to tumors and the potential application in combination therapies that target the unique metabolism of cancer cells.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P6-04-13.

A comparison of DXA and CT based methods for estimating the strength of the femoral neck in post-menopausal women

The study goal was to compare simple two-dimensional (2D) analyses of bone strength using dual energy x-ray absorptiometry (DXA) data to more sophisticated three-dimensional (3D) finite element analyses using quantitative computed tomography (QCT) data. DXA- and QCT-derived femoral neck geometry, simple strength indices, and strength estimates were well correlated.

INTRODUCTION

Simple 2D analyses of bone strength can be done with DXA data and applied to large data sets. We compared 2D analyses to 3D finite element analyses (FEA) based on QCT data.

METHODS

Two hundred thirteen women participating in the Study of Women's Health Across the Nation (SWAN) received hip DXA and QCT scans. DXA BMD and femoral neck diameter and axis length were used to estimate geometry for composite bending (BSI) and compressive strength (CSI) indices. These and comparable indices computed by Hip Structure Analysis (HSA) on the same DXA data were compared to indices using QCT geometry. Simple 2D engineering simulations of a fall impacting on the greater trochanter were generated using HSA and QCT femoral neck geometry; these estimates were benchmarked to a 3D FEA of fall impact.

RESULTS

DXA-derived CSI and BSI computed from BMD and by HSA correlated well with each other (R=0.92 and 0.70) and with QCT-derived indices (R=0.83-0.85 and 0.65-0.72). The 2D strength estimate using HSA geometry correlated well with that from QCT (R=0.76) and with the 3D FEA estimate (R=0.56).

CONCLUSIONS

Femoral neck geometry computed by HSA from DXA data corresponds well enough to that from QCT for an analysis of load stress in the larger SWAN data set. Geometry derived from BMD data performed nearly as well. Proximal femur breaking strength estimated from 2D DXA data is not as well correlated with that derived by a 3D FEA using QCT data.

[Autoimmune progesterone dermatitis]

BACKGROUND

Autoimmune progesterone dermatitis (AIPD) is caused by an immune reaction to endogenous progesterone following exposure to exogenous progesterone, especially in oral contraceptives and intrauterine devices. Skin eruption develops cyclically during the luteal phase of the menstrual cycle when progesterone levels are elevated. The resultant clinical symptoms are frequently confused with other forms of dermatosis. We describe a young woman presenting AIPD.

PATIENTS AND METHODS

A 23-year-old woman had a history of a chronic pruritic papular-vesicular eruption on the trunk, present since the onset of puberty and unsuccessfully treated with antihistamines and topical steroids. Skin lesions normally began a few days before menstruation and resolved a few days afterwards. Intradermal testing using progesterone was positive, thereby confirming the diagnosis. The patient's skin lesions improved under oral contraceptives designed to inhibit ovulation and there was no relapse during subsequent menstrual cycles.

DISCUSSION

AIPD is a rare autoimmune disorder. The diagnostic criteria of AIPD include recurrent cyclical worsening of skin lesions and symptomatic improvement after inhibition of progesterone secretion by suppression of ovulation. The pathogenesis is unclear. Positive response to various tests with progesterone suggests involvement of various mechanisms such as antibodies and/or cell-mediated immune reactions.

CONCLUSION

AIPD is a rare disease that can seriously affect patients' quality of life and which may even be life-threatening in certain cases.

Malignant proliferating trichilemmal cyst of the scalp: histological aspects and nosology

BACKGROUND

Malignant proliferating trichilemmal cyst is a rare tumour usually located on the scalp of elderly women. About 40 cases of malignant proliferating trichilemmal tumour have been documented.

CASE REPORT

We report a case of a malignant proliferating trichilemmal cyst of the scalp in a 57-year-old woman. On the vertex she had a voluminous vegetated and multinodular tumour measuring 7 x 5 cm with spontaneous and abundant bleeding, and another lesion of the scalp corresponding to a trichilemmal cyst. Based on histopathological findings, the case was diagnosed as malignant proliferating trichilemmal cyst.

CONCLUSION

Diagnostic, clinicoprognostic and histological features of this tumour are discussed. Treatment is not yet standardized given its rarity.

Astroblastoma

Aims and Objectives: Astroblastoma is one of the very unusual type of brain tumours, whose histogenesis has not been clarified. It occurs mainly among children and young adults. Astroblastoma has characteristic histological picture and varied biological behavioural. We report a 10-year old girl diagnosed as a case of astroblastoma.Clinical presentation: A 10-year old girl was examined for intermittent frontal headache and convulsion for two years. MRI revealed brain tumour which was later confirmed as astroblastoma by histopathological examination.Conclusion: Astroblastoma is rare because of its varied biological behaviour.DOI: http://dx.doi.org/10.3329/pulse.v4i1.6966Pulse Vol.4 January 2010 p.38-39

Dysembryoplastic neuroepithelial tumour: A case report

Aim and Objective: Dysembryoplastic neuroepithelial tumour is an unusual brain tumour with varied incidence commonly occured in younger age group. We report a 16-year old female diagnosed as a case of dysembryoplastic neuroepithelial tumour. Clinical presentation: A 16 year old female was examined for headache and convulsion for two months. MRI revealed a brain tumour which was later confirmed as dysembyroplastic neuroepithelial tumour by histopathological examination.DOI: http://dx.doi.org/10.3329/pulse.v4i1.6968Pulse Vol.4 January 2010 p.43-44

Bilateral renal angiomyolipoma not assocated with tuberous sclerosis: A case report

Angiomyolipoma is a tumour composed of varying admixtures of bloodvessels, smooth muscles and adipose tissue.Renal angiomyolipoma can be unilateral or bilateral. Bilateral angiomyolipoma has a very strong association with tuberous sclerosis. In non tuberous sclerosis patient, bilateral renal angiomyolipoma is relatively rare. We have described a 49 year old non tuberous sclerosis female presented with bilateral renal angiomyolipoma. Renal angiomyolipoma commonly behaved in a benign way and resection is curative in most of the cases.DOI: http://dx.doi.org/10.3329/pulse.v4i1.6965Pulse Vol.4 January 2010 p.36-37

Primary malignant CNS lymphoma in an immunocompetent patient: A case report

Aim and Objective: Primary malignant CNS lymphoma in otherwise healthy immunocompetent subject is relatively uncommon.They occur more frequently in immunocompromised patients. In this case report, we presented a report of an immunocompetent 48 year old male with primary CNS lymphoma.Clinical presentation: A 48 year old male was admitted in the neurosurgery department of Apollo hospital Dhaka because of continuous headache and vomiting for 15 days. There was no history of any illness, medication or head trauma. He was tested negative for HIV test. MRI revealed a periventricular mass which was confirmed as primary CNS lymphoma, diffuse large cell type by histopathology and immunohistochemical examination.Conclusion: We presented this case because of relatively uncommon occurrence and raising incidence of primary CNS lymphoma in immunocompetent subjects in last one or two decades.DOI: http://dx.doi.org/10.3329/pulse.v4i1.6960Pulse Vol.4 January 2010 p.26-27