(1) Mesenchymal stem cells (MSCs) are adult stem cells that can differentiate only in one lineage (mesodermal). (2) They were first discovered in the bone marrow and this remains a common source, followed by adipose tissue. There are other sources: Synovial fluid, umbilical cord blood, amniotic fluid, placenta, fetal liver. (3) MSCs are immunosuppressive, the mechanism of which is not fully elucidated, but involves action on other cells mainly through soluble mediators, like TGFβ, IDO, IL-1, NO, etc. (4) MSCs have shown efficacy in various animal models of autoimmune diseases. There have been small human studies, some of which showed benefit, however, a single randomized controlled trial has been done. (5) MSCs may have a role in autoimmune diseases refractory to treatment or as an add onto prevent treatment side effects.

Dhir V. Mesenchymal Stem Cells: The New Immunosuppressants? J Postgrad Med Edu Res 2012;46(2):63-68.

Hematopoietic stem cells possess the characteristics of self renewal, differentiation, mobilization and apoptosis.

Lad DP, Malhotra P, Varma S. Hematopoietic Stem Cell Applications: Past, Present and Future. J Postgrad Med Edu Res 2012;46(2):69-74.

Bhattacharyya S. Advances and Applications in Stem Cell Biology. J Postgrad Med Edu Res 2012;46(2):75-80.

Bhat S, Kumar A. Biomaterials in Regenerative Medicine. J Postgrad Med Edu Res 2012;46(2):81-89.

Xerostomia, sialoadenitis, taste dysfunction and nausea are well known toxicities following high dose radioactive iodine (RAI) treatment for well-differentiated thyroid cancer. This prospective study sought to determine the incidence rates for RAI adverse effects and to determine, whether the radioprotector, amifostine could decrease the duration of the adverse effects in single treatment patients.

Patients with differentiated thyroid cancer received 150 mCi RAI after total thyroidectomy. All patients were pretreated with 1 mg granisetron and 4 mg dexamethasone. Patients in the amifostine arm (n = 27) were prospectively enrolled and received 500 mg amifostine subcutaneously. Adverse effects were scored based on the CTCAE at 1 month, 6 months, and yearly intervals using a physician administered questionnaire. The results were compared with a retrospective no amifostine cohort (n = 22) for whom data was collected with the identical questionnaire.

The overall incidence of xerostomia, sialadenitis, taste dysfunction and nausea in the treatment group was 26, 22, 52 and 26% respectively. Only grades 1 and 2 adverse effects were observed. The mean duration (days) of xerostomia (control vs treatment)—37.3 vs 21.9 (F test, p = 0.016), taste dysfunction—45.5 vs 23.5 (F test, p = 0.001), sialadenitis— 16.8 vs 7.5 and nausea—18.7 vs 5.1.

In patients treated once with high dose RAI, who develop xerostomia, sialoadenitis, taste dysfunction, and/or nausea, the duration of symptoms appears to be reduced by pretreatment with 500 mg of subcutaneous amifostine without significant treatment related adverse effects.

Sandhu A, Ioffe V, Karakla D, Wadsworth JT, Mendoza A, Rao N, Dignan K, Mason E, Goffman TE. Prospective Single-Arm Study of Radioprotection by Amifostine in High Dose Radioactive Iodine Therapy for Thyroid Cancer. J Postgrad Med Edu Res 2012;46(2):90-94.

To report opacification of hydrophilic acrylic and silicone foldable intraocular lenses (IOL).

Case series.

Five patients with IOL opacification.

We report five eyes of five patients with late opacification of the intraocular lens (IOL). Three patients had hydrophilic acrylic (SC60B-OUV-MDR, Inc), two had silicone IOL (Allergan SI30NB). Two out of the three patients with opacified hydrophilic acrylic IOLs had diabetes mellitus. Three eyes with opacified acrylic IOL underwent IOL exchange with hydrophobic acrylic IOL. Two silicone IOL patients had no visually significant opacification and were managed conservatively.

IOL optic opacification in hydrophilic acrylic and silicone IOL may be due to defective material, manufacturing process, storage.

Ram J, Gupta N, Chaudhary M, Sukhija JS, Gupta A, Kumar J. Late Opacification of Foldable Intraocular Lenses. J Postgrad Med Edu Res 2012;46(2):95-97.

To test the hypothesis that there is no association between the nasal septum deviation and the sagittal growth discrepancy of maxilla.

Total 80 subjects in the age range of 7 to 51 years were divided into four groups of 20 each. Group I included subjects with normally positioned maxilla, group II included subjects with protruded maxilla, and group III included subjects with retruded maxilla in relation to the anterior cranial base. Subjects who already had a deviated nasal septum were included in group IV. All the subjects were clinically examined for the evaluation of nasal septum deviation. The deviation of nasal septum was categorized into anterior and posterior deviation. The sagittal maxillary growth discrepancy in all subjects was evaluated from lateral cephalograms. The association between the deviation of nasal septum and the discrepancy of maxillary growth in the sagittal plane was tested by Chi-square test.

Deviated nasal septum was more common among subjects with normal and retruded maxilla than subjects with protruded maxilla. Subjects in whom nasal septum was already deviated, various sagittal maxillary growth discrepancies were equally distributed. There was no association between the nasal septum deviation and sagittal growth discrepancy of the maxilla (χ² = 2.143 and p = 0.342).

There was no association between nasal septum deviation and the sagittal growth discrepancy of the maxilla.

Bansal A, Utreja AK, Singh SP, Panda NK, Jena AK. The Association between Nasal Septum Deviation and Sagittal Maxillary Growth Discrepancy. J Postgrad Med Edu Res 2012;46(2):98-101.

Angiomyxoma is a rare tumor arising from the pelvis. Preoperative diagnosis and treatment may be difficult.

We report a rare case of aggressive angiomyxoma pelvis that presented as vault prolapse and was misdiagnosed as ovarian tumor.

As surgery is the main treatment, preoperative diagnosis and assessment of extent of the tumor for planning surgery cannot be overemphasized.

Angiomyxoma is a rare pelvic tumor with varied presentation. Preoperative diagnosis and assessment of extent of the tumor are important for its management.

Siwatch S, Saha SC, Aggarwal N, Dhaliwal L, Nijhawan R. Aggressive Angiomyxoma Pelvis Presenting as an Ovarian Tumor with Vault Prolapse. J Postgrad Med Edu Res 2012;46(2):102-103.

Panigrahi M, Padhy SK, Behere PB. Understanding and Managing Complete form of Sporadic Koro Syndrome associated with Depression. J Postgrad Med Edu Res 2012;46(2):104-105.