Analysis of non-metric dental traits for ethnicity identification in a mixed population of Uttar Pradesh.

BACKGROUND: Forensic odontology involves the identification of individuals through dental records, making it a crucial tool in legal investigations. Non-metric dental traits (NMDT), which are variations in dental morphology play a key role as these traits are inherited characteristics that can help establish biological relationships or ancestry. Thus, we aim to assess the frequency and variability of NMDT in the human dentition of four ethnically mixed populations in Uttar Pradesh. This study can aid in the future by maintaining records of ethnic groups and their variability, which can be crucial for disaster victim management and forensic odontology. METHODS: The study was conducted on a total of 100 patients coming to the OPD of Oral Medicine and Oral Pathology and Microbiology of King George's Medical University from January 2022 to July 2023. Impressions of both arches were made for participants using irreversible hydrocolloid (alginate), and casts were examined under a stereomicroscope to assess 15 different morphological characteristics. RESULTS: NMDTs such as winging, shoveling, double-shoveling interruption groove, canine mesial ridge, hypocone, metacone, carabelli's trait, peg-shaped incisors, peg-shaped molar, premolar lingual cusp variation, deflecting wrinkle, protostylid, metaconulid, entoconulid was evaluated. The NMDTS were evaluated in four different ethnics Nordics, Mediterranean, Oriental Mediterranean, and Protoaustraloid amongst which various traits showed a statistically significant variation among the population of Uttar Pradesh. CONCLUSION: The sample studied presented confirmed supernumerary traits like metacone, protostylid, carabellis trait, metaconulid, premolar lingual cusp variation, and deflecting wrinkle were seen highest in Nordic, Mediterranean, Oriental Mediterranean, and Protoaustraloid ethnicity have a significant association with the Uttar Pradesh population.

Giant Cell Lesions of the Jaws: A Work on Current Concepts and Making Through a Working Classification.

INTRODUCTION: Giant cell-rich lesions are a diverse group of lesions that usually occur in bone and contain varying numbers of reactive osteoclastic-type multinucleate giant cells. These lesions present a challenge in pathologic diagnosis, often requiring a combination of clinical, radiographic, and histopathological assessments. The present retrospective observational study aims to provide a concise diagnostic criterion by combining all these parameters, which will aid in effective diagnosis and targeted treatment planning in the future. MATERIAL AND METHOD: Previously diagnosed cases of these lesions were taken from the archives and categorized as Central Giant Cell Granuloma (CGCG), CGCG with secondary Aneurysmal Bone Cyst (ABC), primary ABC, and Brown's Tumour. Their demographic characteristics along with clinical, radiological, and histological data were retrieved and compiled into the table. The data was then analyzed and classified into aggressive and non-aggressive CGCG according to the criteria set in the study. RESULT: 10 reported cases were of isolated CGCG, 5 were CGCG with secondary ABC, 5 of Brown's tumor and 3 were that of conventional ABC. Out of these, the lesions showing extensive size along with an increased number of giant cells were categorized under aggressive CGCG, whereas those with less aggressive characteristics were categorized under non-aggressive CGCG. The aggressive category comprised 5 cases of isolated CGCG, 2 cases of CGCG with secondary ABC, 3 cases of primary ABC, and 5 of brown tumor, whilst the rest of the cases were categorized under non-aggressive CGCG. CONCLUSION: Since all these share overlapping features, thereby this type of concise categorization is the dire need so that the lesions can have a precise diagnosis with treatment and follow-up intervals for aggressive lesions.

Idiopathic Lympho-Plasma Cellular Mucositis; A Diagnostic Predicament.

The term "idiopathic lymphoplasmacellular mucositis" (ILPM) refers to a set of conditions marked by extensive lymphocyte and plasma cell infiltrates in the submucosa which can involve the oral cavity, upper respiratory tract and the genital epithelium. There is no recognized cause of ILPM, and the diagnosis is mostly done on an exclusion basis. Herein, we report a 32-year-old man presented with an erosive ulcerated lesion on the hard palate and review the literature regarding the possible differential diagnosis including squamous cell carcinoma. We also reviewed the previously reported cases of ILPM with palatal involvement to summarise clinical presentation, treatment, and outcome of the entity to date.

Calcifying odontogenic cysts: A novel outlook on classification, diagnosis and management.

BACKGROUND: The Calcifying Odontogenic Cysts (COC) displays a wide range of clinical and histopathological variations as well as diverse biological behaviors. This diversity has led to confusion and disagreement regarding the terminology and classification of this lesion. The previous classification attempts to categorize COC into two concepts. The first concept, termed "monistic," suggests that all COCs are neoplastic despite the majority being cystic in structure and seemingly non-neoplastic. The second concept, known as "dualistic," posits that COC comprises two distinct entities: a cyst and a neoplasm. This research discusses various previous classifications of COC found in the literature and proposes a new, straightforward universal classification based solely on histopathology, aiming to facilitate understanding for surgeons. MATERIAL AND METHODS: Fifteen cases of COC have been collected with clinicopathological parameters including detailed information regarding patient demographics, symptoms, anatomical site, radiological characteristics, duration of evolution, recurrence, and types of histopathology according to the proposed classification. RESULT: A total of fifteen cases of COC were analyzed. According to the histological analysis of the proposed classification Type 1: 5 (33.3), Type II: 4 (26.6), Type III: 3(20), and Type IV:3(20) and recurrence in 3 (20 %) of cases. CONCLUSION: It simplifies the complexities arising from variations in the cystic linings of type IV of COC, which can be overlooked and have caused recurrence in the current research. Therefore, the key requirement for arriving at a validated and practical conclusion lies in the accurate histological classification of calcifying odontogenic cysts and their impact on treatment.

How predominant cell and stroma types harmonize to predict head and neck adenoid cystic carcinoma outcomes?

Adenoid cystic carcinoma (ACC) is an uncommon tumor that usually appears in the major salivary glands of the head and neck region, including the minor glands in the oral cavity, sinonasal tract, and other sites. ACC of the head and neck may have a low-grade histological appearance. This malignant tumor has unusual clinical characteristics such as occasional regional lymph node metastases and a prolonged yet continuously advancing clinical course. Additionally, it is an invasive tumor with perineural invasion, difficult-to-clear margins, metastasis, and localized recurrence. The cribriform and tubular proliferation of basaloid cells, which mostly display a myoepithelial cellular phenotype, are ACC's distinct histologic characteristics. The degree of genetic alterations and aneuploidy observed in tumor genomes are linked to the severity of histologic grade, which correlates with clinical prognosis. The three predominant cell types (PCTs) i.e., conventional ACC (C-ACC), myoepithelial-predominant ACC (M-ACC), and epithelial-predominant ACC (E-ACC)-and their respective applications will be reviewed. The function of extracellular matrix (ECM) components such as laminin, type IV collagen, fibronectin, and tenascin are also emphasized. An attempt has been made to explore the recent molecular diversity, regulatory pathways prevalent in PCT, ECM with its genetic changes, and translational utility with targeted therapies for ACC.

Advancing Pain Management Protocols for Intrauterine Device Insertion: Integrating Evidence-Based Strategies Into Clinical Practice.

The discomfort and anxiety associated with the intrauterine device (IUD) insertion process is a significant barrier to its adoption as a form of contraception despite its high efficacy. This study aimed to classify and identify methods for minimizing pain and anxiety in IUD implantation in women below the age of 49. A search of publications from online databases, PubMed and Google Scholar, revealed 14 articles that met the inclusion criteria. An analysis of the selected studies showed that several pharmacological and non-pharmacological measures effectively minimized patient discomfort associated with IUD insertion. Of the 14 studies, 12 evaluated pharmacological methods for pain management in IUD insertion, while two studies assessed non-pharmacological methods. The results showed that although the IUD is more effective than other forms of contraceptives, fear of pain related to the insertion process is one of the most significant barriers to the use of an IUD among women. Most studies identified pharmacological methods of pain management for IUD insertion, highlighting a need for more research on non-pharmacological methods to improve patient experiences and reduce associated fears.

Colonic Metastasis in a Patient With Hereditary Diffuse Gastric Cancer: A Case Report.

Metastasis of gastric carcinoma to atypical locations can complicate management, often leading clinicians to rely heavily on chemotherapy. While instances of gastric carcinoma spreading to the liver, peritoneum, and lymphatics are well documented in the literature, there is limited evidence of its spread to intraintestinal organs, particularly the colon. This scarcity of reports complicates diagnosis, given the variations in histopathology. This case report highlights a 35-year-old patient diagnosed with colonic metastasis from hereditary diffuse gastric cancer (HDGC) while being evaluated for potential causes of iron deficiency anemia. A mutation in the E-cadherin (CDH1) tumor suppressor gene is associated with HDGC. Dysregulation of CDH1 leads to tumor proliferation, invasion, migration, and metastasis. Treatment options for gastric cancer include surgical resection with neoadjuvant or adjuvant chemotherapy or palliative care with chemotherapy in metastatic disease. Although colonic metastasis from gastric cancer is rare, documented incidents can offer valuable insights that avoid misdiagnosing primary tumors and help guide further management.

Metamorphosis of Dentigerous cyst: A case Series with Insight into Molecular Profiling.

The objective of this study was to review the clinical, radiologic, and histologic aspects of cases of dentigerous cysts metamorphosing into different entities along with comments on the molecular factors involved in the process. A series comprising 8 cases of dentigerous cysts was performed retrospectively along with a comprehensive literature review. Two cases of dentigerous cyst converting into mucous metaplasia were included, out of which one case was transformed into ameloblastoma after a year. The other two cases were reported as acanthomatous and unicystic ameloblastoma, whereas four transitioned to AOT. The complete review of cases and literature with molecular profiling concluded that the lining of dentigerous cysts has the potential for transforming into benign odontogenic tumors. Therefore, a careful clinical and histopathological examination is crucial for the correct diagnosis. Also, a thorough molecular understanding of the cystic lining is required.

B-cell Follicular Lymphoid Hyperplasia (Pseudolymphoma) of the Oral Cavity: A Diagnostic Quandary.

Pseudolymphoma is a reactive process involving lymphadenopathy, polyclonal proliferation of B or T-cells, simulating oral lymphoma. With its incidence being very rare, only four cases have been reported in oral cavity with the detailed immunocytochemical examination, which can be due to this entity's unawareness, underdiagnosis or overdiagnosis. It is prerogative to perform immunocytochemical investigations to prevent overdiagnosis as lymphoma, which can be debilitating to the patient. Wherein the treatment of pseudolymphoma initially includes topical or intralesional corticosteroid, antibiotics to surgical and radiotherapy based on its etiology. Herein, we discuss B-cell follicular lymphoid hyperplasia previously diagnosed as small round cell tumor.

Clear and Spindle Cell Dedifferentiation in Ameloblastic Carcinoma: A Case Report on a Uncommon Phenomenon.

Ameloblastic carcinoma is a rare malignant neoplasm with characteristic histopathological features that are directed towards an aggressive surgical approach than benign odontogenic lesions. It affects people of all ages, mostly in the posterior mandible, without a preference for race or gender. De novo cancer is one of its primary types, while the second type is defined as a malignant change from an antecedent case of benign ameloblastoma. The rapid progression of molecular biology led to the revelation that ameloblastoma contains a BRAF-V600E genetic mutation over 60%. Besides conventional ameloblastic carcinomas, rare histologic variants have also been described in the literature, including clear and spindle cells. These variants pose diagnostic challenges as to whether it is a dedifferentiation or a distinct entity. The dearth of data lends credence to the notion that these histologic variations are related to high-grade neoplasms and more aggressive outcomes. As a result, the current report intends to analyze a series of patients diagnosed with conventional ameloblastic carcinoma of the head and neck region with spindle and clear cell types along with a brief assessment of the literature.

A serious warning: A case report on localized amyloidosis of the oral cavity.

ABSTRACT: Amyloidosis is a relatively rare condition with an array of complex pathophysiology. Localized amyloidosis is a rare and benign condition that practically never results in any clinical repercussions in the head and neck area. Multiple soft nodules of the tongue, lip, and cheek are the most commonly described defining characteristics of localized oral amyloidosis. These nodules originate due to the proliferation of abnormally folded protein aggregates in the body's extracellular tissue compartments, which destroy organ structure and function. Herein, we address the case of a female infant aged one with a smooth nodule in the labial mucosa who was diagnosed with primary localized amyloidosis. When a patient is diagnosed with amyloidosis of the oral mucosa, the possibility of systemic amyloidosis or an underlying plasma cell dyscrasia must be ruled out. Surgical treatment may be beneficial for eliminating any functional impairment if primary localized amyloidosis is established.

Enigma of Acantholytic and Clear Cell Changes in Oral Squamous Cell Carcinoma.

Only limited cases have been reported about the clear cell variant of squamous cell carcinoma occurring in the oral cavity. The present study regards the case showing the histopathological features of both the clear cell and acantholytic variants of oral squamous cell carcinoma. A review of the literature has been done to understand the pathogenesis of those changes. Also, a hypothesis has been given that the clear cell changes could be the consequences of the cascades of the acantholytic process and not a separate entity. Therefore, more research is required to confirm this hypothesis and understand the prognosis of the lesion.

Electrocatalytic on-site oxygenation for transplanted cell-based-therapies.

Implantable cell therapies and tissue transplants require sufficient oxygen supply to function and are limited by a delay or lack of vascularization from the transplant host. Previous exogenous oxygenation strategies have been bulky and had limited oxygen production or regulation. Here, we show an electrocatalytic approach that enables bioelectronic control of oxygen generation in complex cellular environments to sustain engineered cell viability and therapy under hypoxic stress and at high cell densities. We find that nanostructured sputtered iridium oxide serves as an ideal catalyst for oxygen evolution reaction at neutral pH. We demonstrate that this approach exhibits a lower oxygenation onset and selective oxygen production without evolution of toxic byproducts. We show that this electrocatalytic on site oxygenator can sustain high cell loadings (>60k cells/mm3) in hypoxic conditions in vitro and in vivo. Our results showcase that exogenous oxygen production devices can be readily integrated into bioelectronic platforms, enabling high cell loadings in smaller devices with broad applicability.

Gene Expression Analysis of Environmental Temperature and High-Fat Diet-Induced Changes in Mouse Supraclavicular Brown Adipose Tissue.

Obesity, a dysregulation of adipose tissue, is a major health risk factor associated with many diseases. Brown adipose tissue (BAT)-mediated thermogenesis can potentially regulate energy expenditure, making it an attractive therapeutic target to combat obesity. Here, we characterize the effects of cold exposure, thermoneutrality, and high-fat diet (HFD) feeding on mouse supraclavicular BAT (scBAT) morphology and BAT-associated gene expression compared to other adipose depots, including the interscapular BAT (iBAT). scBAT was as sensitive to cold induced thermogenesis as iBAT and showed reduced thermogenic effect under thermoneutrality. While both scBAT and iBAT are sensitive to cold, the expression of genes involved in nutrient processing is different. The scBAT also showed less depot weight gain and more single-lipid adipocytes, while the expression of BAT thermogenic genes, such as Ucp1, remained similar or increased more under our HFD feeding regime at ambient and thermoneutral temperatures than iBAT. Together, these findings show that, in addition to its anatomical resemblance to human scBAT, mouse scBAT possesses thermogenic features distinct from those of other adipose depots. Lastly, this study also characterizes a previously unknown mouse deep neck BAT (dnBAT) depot that exhibits similar thermogenic characteristics as scBAT under cold exposure and thermoneutrality.

Drug-induced liver injury and prospect of cytokine based therapy; A focus on IL-2 based therapies.

Drug-induced liver injury (DILI) is one of the most frequent sources of liver failure and the leading cause of liver transplant. Common non-prescription medications such as non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen, and other prescription drugs when taken at more than the recommended doses may lead to DILI. The severity of DILI is affected by factors such as age, ethnicity, race, gender, nutritional status, on-going liver diseases, renal function, pregnancy, alcohol consumption, and drug-drug interactions. Characteristics of DILI-associated inflammation include apoptosis and necrosis of hepatocytes and hepatic infiltration of pro-inflammatory immune cells. If untreated or if the inflammation continues, DILI and associated hepatic inflammation may lead to development of hepatocarcinoma. The therapeutic approach for DILI-associated hepatic inflammation depends on whether the inflammation is acute or chronic. Discontinuing the causative medication, vaccination, and special dietary supplementation are some of the conventional approaches to treat DILI. In this review, we discuss a concise overview of DILI-associated liver complications, and current therapeutic options with special emphasis on biologics including the scope of cytokine therapy in hepatic repair and resolution of inflammation caused by over- the-counter (OTC) or prescription drugs.

ESD with double-balloon endoluminal intervention platform versus standard ESD for management of colon polyps.

Background and study aims Endoscopic submucosal dissection (ESD) with the double-balloon endoluminal intervention platform (DEIP) is a novel technique for removal of complex colon polyps (> 2 cm) or those located in anatomically difficult positions. DEIP helps create a therapeutic zone with improved visualization and stability, facilitating polyp removal. We aimed to compare the outcomes of DEIP with the conventional cap-assisted ESD (standard ESD) technique for colon polyp resection, in particular, the ability to complete the ESD procedure without resorting to hybrid ESD or piecemeal resection. Patients and methods This was a retrospective cohort of all patients who underwent colon ESD in a single large tertiary referral center between September 2016 and October 2019. Information was collected on patient demographics and study outcomes including procedure time, rates of en bloc and curative resection, operative and postoperative complications. All patients were followed up for 1 month after the procedure. Results 111 patients were included in the study (DEIP 60, standard ESD 51). There was no statistically significant difference between mean procedures time (±â€ŠSD) in the two groups, mean (81.9 ±â€Š35.4 min standard vs. 96.4 ±â€Š42.2 min in DEIP). Mean polyp size (±â€ŠSD) was similar between the two groups (7.6 ±â€Š6.0 cm 2 vs. 6.2 ±â€Š5.5 cm 2 , P  = .2). There were no significant differences in en bloc and curative resection rates or operative and postoperative complications between the two techniques. Conclusion Procedure time was similar using both techniques. However, DEIP enabled the entire procedure to be performed using the ESD technique without resorting to snare resection, which may affect the en bloc and curative resection rate. There were no significant differences in en bloc and curative resection rates between the two groups, probably due to the small sample size.

Complication in diabetic nephropathy.

BACKGROUND: Diabetic kidney disease is the most common cause of chronic kidney disease, leading to end-stage renal disease (ESRD) and premature death. In addition, it negatively affects a patient's quality of life and social environment, and poses a burden on national health care budgets. Although various therapeutic approaches, such as hypoglycemic agents, antihypertensive drugs, and renin-angiotensin system inhibitors, have been tried to slow the progression of nephropathy, the number of patients with diabetic kidney disease continues to rise with the prevalence of type 2 diabetes mellitus. Thus, early identification of patients at risk of developing diabetic nephropathy and initiation of appropriate therapy is important to improve patient outcomes. In end stage renal disease (ESRD), diabetic nephropathy is the main cause considered from other diseases.

Impact of antidepressants use on risk of myocardial infarction: A systematic review and meta-analysis.

AIMS: The aim of the study was to perform a systematic review and meta-analysis to determine the association between antidepressants use and risk of myocardial infarction (MI), and whether this association differs between tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs). METHODS: A PubMed/MEDLINE search was conducted for studies published up to December 2013. Included studies were evaluated for publication bias and heterogeneity. Depending on the presence of heterogeneity, a random or fixed effects model was used to identify the pooled relative risk (RR) with 95% confidence intervals (CIs). Cumulative meta-analysis, subgroup and sensitivity analyses were also performed. All analyses were performed using comprehensive meta-analysis software. RESULTS: Fourteen (five cohort and nine case-control) studies were included. There was heterogeneity among the studies (P heterogeneity = 0.02; I (2) = 68%) but no publication bias (Begg's P = 0.30 and Egger's P = 0.45). Antidepressants use significantly increases the risk of myocardial infarction (MI) (RR = 2.03; 95% CI = 1.30-3.18; P < 0.01). On subgroup analysis by study design, cohort studies show significant positive association (RR = 2.16; 95% CI = 1.42-3.29; P < 0.01), but not case-control studies (RR = 2.47; 95% CI = 0.69-8.90; P = 0.17). Sensitivity analysis and cumulative meta-analysis confirmed the stability of results. TCAs users are having 36% increased risk of MI after excluding one outlier (RR = 1.36; 95% CI = 1.10-1.67; P < 0.01), but SSRIs showing no association (RR = 0.84; 95% CI = 0.57-1.22; P = 0.35). CONCLUSIONS: We found evidence that the use of antidepressants was associated with elevated risk of MI. Further research is needed to identify the underlying biological mechanisms.