Bursting of Underwater Oil Drops.

For decades, two main facets of underwater oil spills have been explored extensively-the rise of oil drops and resulting evolution of the oil slick at the air-water interface. We report on the bursting of rising oil drops at an air-liquid interface which precedes slick formation and reveal a counterintuitive bulge reversal that releases a daughter oil droplet inside the bulk as opposed to upward-shooting jets observed in bursting air bubbles. By unraveling the underlying physics we show that daughter droplet size and bulk liquid properties are correlated and their formation can be suppressed by an increase in the bulk viscosity.

Incidental Discovery of a Phrygian Cap During Whipple's Procedure: A Case Report.

Obstructive jaundice, characterised by yellow discolouration of the skin and mucous membranes due to reduced bile flow, often necessitates surgical intervention for resolution. This article provides a comprehensive literature review to contextualise the management of obstructive jaundice, focusing on common treatment modalities such as common bile duct (CBD) stenting and Whipple's procedure for pancreatic head cancer. Additionally, the incidental finding of a Phrygian cap of the gallbladder during surgical intervention for pancreatic head cancer is described in detail. A case presentation of a 48-year-old female with obstructive jaundice and pancreatic head cancer is outlined, detailing the diagnostic process, treatment decisions, and surgical interventions. The patient underwent CBD stenting followed by Whipple's procedure to address the pancreatic head cancer, during which the incidental discovery of a Phrygian cap of the gallbladder was noted. The discussion of the incidental finding highlights the complexity it adds to surgical interventions and emphasises the importance of adaptability and precision in managing anatomical variations. A comparison with similar cases underscores varying approaches to managing incidental findings, ranging from conservative observation to surgical excision based on clinical indications. This case underscores the significance of thorough diagnostic evaluation and surgical intervention in managing incidental findings such as the Phrygian cap, ensuring appropriate patient management and favourable clinical outcomes in complex surgical scenarios.

Complex Hernia Presentation: A Case Study of Concurrent Spigelian and Pantaloon Hernias in a 49-Year-Old Female.

A 49-year-old woman with a complicated hernia presentation, including direct and indirect inguinal hernias, Spigelian hernias, and Pantaloon hernias, is presented in the case report. The diagnosis was verified by a comprehensive physical examination and imaging, which resulted in a Lichtenstein operation for repair. The surgical procedure for hernia comprised of painstaking dissection, reduction of the hernia sac, and implantation of a prosthetic mesh. The instance emphasizes the value of individualized treatment programs and draws attention to the intricate anatomical details of hernia surgery. Analyzing situations that are similar to one another highlights the necessity of customized strategies to improve patient outcomes.

Adenocarcinoma of the Stomach With Situs Inversus Totalis: A Rare Case.

Situs inversus is a scarce congenital anomaly. Situs inversus totalis (SIT) is a mirroring of the normal. Thoracic and abdominal viscera transposition is a characteristic feature of situs inversus. It is considered to be a premalignant condition. This uncommon genetic disorder is often identified incidentally during thoracic and abdominal imaging. The coexistence of SIT and gastric cancer is rare. Because this anomaly is known to have associated anatomical and vascular anomalies, due care is required to identify it preoperatively and during the surgical procedure. At centers with prior experience, consistent with oncological practices, open surgeries, laparoscopic surgeries, and robotic surgeries can be done. We present a patient with a stomach adenocarcinoma with SIT who underwent distal gastrectomy with gastrojejunostomy along with resection and anastomosis of the transverse colon and capecitabin-oxaliplatin chemotherapy. The postoperative course was favorable. To our knowledge, only 13 cases of diffuse-type gastric cancer in a patient with SIT have been reported in the English-language literature.

Importance of Second-Look Surgery in a Newborn Presenting With Early Malrotation.

Intestinal malrotation refers to the abnormal positioning of the intestines due to a deviation from normal developmental stages. Volvulus is seen in 60%-70% of neonates diagnosed with intestinal malrotation. We are reporting a case of s six-day-old male who presented with multiple episodes of bilious vomiting and constipation and had malrotation of intestines with midgut volvulus. After a contrast upper GI study, the patient was taken for exploratory laparotomy, and extensive patches of an early stage of bowel ischemia were observed; resection was avoided at this stage. In the second-look surgery, all the gangrenous bowel loops were resected, and anastomosis was done.

A Rare Case of a Mesenteric Cyst.

A mesenteric cyst is an uncommon ailment that can affect practically any abdominal quadrant in its presentation. They may turn up as an accidental discovery. Although there are a number of hypotheses explaining the genesis of these cysts, the exact etiology is unknown. A 70-year-old female patient came to see us complaining of abdominal pain for a month and had trouble passing stools for 15 days. Contrast-enhanced computed tomography was done for the patient, which revealed a heterogeneously enhancing mass lesion in the abdominal cavity. The patient was then taken for an exploratory laparotomy procedure. To make the procedure thorough and easy, intraoperative partial drainage of the cyst fluid was carried out. We were able to observe the margins of the mesenteric cyst more easily as the partial drainage was carried out. The partial drainage decreased the volume and size of the mesenteric cyst, reducing the pressure effect on the surrounding structures and allowing easy mobilization of the intraabdominal structures during intraoperative examinations. The partial drainage of the cystic fluid also made the dissection process safer. After releasing all adhesions, the cyst was delivered outside and sent for histopathological analysis. The histopathological reports confirmed it to be a mesenteric cyst. The aim of this article is to educate the readers and to make fellow surgeons well aware of this condition. This will not only help fellow clinicians in better diagnosis and treatment but also help in the reduction of the overall burden of the healthcare society by reducing mortality and morbidity.

In-depth morphological evaluation of tooth anatomic lengths with root canal configurations using cone beam computed tomography in North American population

Abstract Objective This study aimed to assess the association between tooth size and root canal morphology by using CBCT analysis. Methodology In this retrospective study, tooth anatomic lengths (crown and root lengths, buccolingual and mesiodistal dimensions) of 384 patients were assessed and correlated with Vertucci's root canal morphology classification. Data was analyzed for gender-related differences using the independent sample t-test, ANOVA, and the Pearson's correlation for a possible relation between anatomic lengths and canal morphology. Results The maxillary first and second premolars showed a greater predilection for Type IV and II variants, respectively, while the mandibular first premolar showed a greater predilection for Type II canal system. The root canal system of the mandibular second premolar showed maximal diversity (47% Type I, 30% Type II, and 20% Type III). The dimensions were greater in men regardless of tooth type. The most significant relation (p<0.05) between the anatomic size and canal morphology was observed in the maxillary first premolars, followed by the mandibular canines (buccolingual dimension) and the lower second premolars (crown length). Negative correlations existed between the crown length and the patient's age for the anterior teeth and mandibular second premolar (r=−0.2, p<0.01). Conclusions The most common canal formation for anterior teeth was the Type I. The anatomic lengths had the strongest influence on the canal configuration of the maxillary first premolar, with Type IV being the most common root canal system. The mandibular second premolars showed maximal diversity in the canal classification terms and had a significant correlation with their crown lengths. Clinical Relevance The complex relationship between the canal morphology and anatomic tooth sizes need meticulous awareness and recognition during endodontic procedures, in conjunction with the demographic variabilities.

Radio-Morphometric Evaluation of Greater Palatine Canal and Pterygopalatine Fossa Component: Maxillary Anesthetic Implications.

This is a retrospective analytical cross-sectional study involving 131 cone-beam computed tomography (CBCT) scans of adult (18-99 years) that assessed greater palatine canal (GPC) attributes (length, curvature angle, diameter of curvature) and the type of the trajectory of GPC-pterygopalatine fossa (PPF) component. The GPC is an important landmark that connects the oral cavity and PPF. It contains greater and lesser palatine nerves, along-with descending palatine artery and vein by extending from the inferior part of the PPF to the hard palate. The GPC acts as a pathway for infiltration of local anesthesia. The inferior orbital fissure (IOF) is in close proximity to these vital anatomic structures and hence accurate identification of its location during regional block anesthesia is crucial. This is one of the very few studies investigating these important structures on CBCT scans highlighting the importance of preoperative scans for the anatomic determination. The images were analyzed for the lengths and anatomic paths of the right and left GPC-PPF in sagittal plane. The diameters of the upper (higher bony aspect of PPF) and lower openings (GPC opening) displayed statistically significant differences in the comparison between males and females (P < 0.05). Overestimation or underestimation of the GPC length can cause a lack of anesthesia and undesirable diffusion of the anesthetic solution into the orbit thorough the IOF causing diplopia, or into the cranial cavity. A thorough understanding of GPC length and pathway types is obligatory for proper anesthetic administration and performing any maxillofacial procedures.

MicroRNA: Dynamic Regulators of Macrophage Polarization and Plasticity.

The ability of a healthy immune system to clear the plethora of antigens it encounters incessantly relies on the enormous plasticity displayed by the comprising cell types. Macrophages (MΦs) are crucial member of the mononuclear phagocyte system (MPS) that constantly patrol the peripheral tissues and are actively recruited to the sites of injury and infection. In tissues, infiltrating monocytes replenish MΦ. Under the guidance of the local micro-milieu, MΦ can be activated to acquire specialized functional phenotypes. Similar to T cells, functional polarization of macrophage phenotype viz., inflammatory (M1) and reparative (M2) is proposed. Equipped with diverse toll-like receptors (TLRs), these cells of the innate arm of immunity recognize and phagocytize antigens and secrete cytokines that activate the adaptive arm of the immune system and perform key roles in wound repair. Dysregulation of MΦ plasticity has been associated with various diseases and infection. MicroRNAs (miRNAs) have emerged as critical regulators of transcriptome output. Their importance in maintaining health, and their contribution toward disease, encompasses virtually all aspects of human biology. Our understanding of miRNA-mediated regulation of MΦ plasticity and polarization can be utilized to modulate functional phenotypes to counter their role in the pathogenesis of numerous disease, including cancer, autoimmunity, periodontitis, etc. Here, we provide an overview of current knowledge regarding the role of miRNA in shaping MΦ polarization and plasticity through targeting of various pathways and genes. Identification of miRNA biomarkers of diagnostic/prognostic value and their therapeutic potential by delivery of miRNA mimics or inhibitors to dynamically alter gene expression profiles in vivo is highlighted.

microRNAs: Emerging players in oral cancers and inflammatory disorders.

Association of oral diseases and disorders with altered microRNA profiles is firmly recognized. These evidences support the potential use of microRNAs as therapeutic tools for diagnosis, prognosis, and treatment of various diseases. In this review, we highlight the association of altered microRNA signatures in oral cancers and oral inflammatory diseases. Advances in our ability to detect microRNAs in human sera and saliva further highlight their clinical value as potential biomarkers. We have discussed key mechanisms underlying microRNA dysregulation in pathological conditions. The use of microRNAs in diagnostics and their potential therapeutic value in the treatment of oral diseases are reviewed.

MiRNA-Target Interaction Reveals Cell-Specific Post-Transcriptional Regulation in Mammalian Cell Lines.

MicroRNAs are 18-22 nucleotides long, non-coding RNAs that bind transcripts with complementary sequences leading to either mRNA degradation or translational suppression. However, the inherent differences in preferred mode of miRNA regulation among cells of different origin have not been examined. In our previous transcriptome profiling studies, we observed that post-transcriptional regulation can differ substantially depending on the cell in context. Here we examined mechanistic differences in the regulation of a let-7a targeted (wild type) or resistant (mutant) engineered renilla transcript across various mammalian cell lines of diverse origin. Dual luciferase assays show that compared to mutant (mut), the reporter gene containing wild type (wt) let-7a binding sites was efficiently suppressed upon transfection in various cell lines. Importantly, the strength of miRNA regulation varied across the cell lines. Total RNA analysis demonstrates that wt renilla mRNA was expressed to similar or higher levels compared to mut suggesting that translation repression is a predominant mode of miRNA regulation. Nonetheless, transcript degradation was observed in some cell lines. Ago-2 immunoprecipitation show that miRNA repressed renilla mRNA are associated with functional mi-RISC (miRNA-RNA induced silencing complex). Given the immense potential of miRNA as a therapeutic option, these findings highlight the necessity to thoroughly examine the mode of mRNA regulation in order to achieve the beneficial effects in targeting cells.

Comparison of clinical periodontal status among habitual smokeless-tobacco users and cigarette smokers.

AIM: Investigating the comparative effect of cigarette smoking and smokeless-tobacco use on periodontal health. BACKGROUND: There is a dearth of studies comparing the effects of smoking and smokeless tobacco on periodontal health. Smokeless tobacco is emerging as a major public health hazard, but is often neglected as a risk factor by many clinicians. MATERIALS AND METHODS: A cross-sectional study of 286 subjects was conducted. The participants were divided into mutually exclusive groups (i.e. any subject who had the habit of both smoking as well as smokeless tobacco usage was excluded from the study), as follows: a smoking group (SG; n=121); a smokeless-tobacco group (ST; n=81); and a non-tobacco-consuming group (NT; n=84). Data were obtained using a questionnaire and by clinical examination. The Periodontal Disease Index (PDI) and Oral Hygiene Index-Simplified (OHI-S) were used to clinically evaluate the periodontal and dental health status of the subjects. Multivariate analysis was performed to identify statistical correlations. RESULTS: The Plaque Index was higher in the ST group than in the SG group and was statistically significantly higher in the ST group than in the NT group. Probing depth and gingival inflammation (components of the PDI) were also higher in the ST group than in the SG and NT groups, but this was not statistically significant. CONCLUSIONS: Within the limits of the study, and for this study population, the impact on the periodontium as a result of smokeless tobacco use appeared to be comparable with that of smoking tobacco. The results of this study affirm the need to consider smokeless tobacco as a possible contributory factor to periodontal disease, in addition to smoking, and to counsel patients accordingly. Further randomised clinical trials are necessary to validate the long-term impact of smokeless tobacco on periodontal disease.