Pilomatricoma: A Case Report.

Pilomatricoma is one of the rare skin benign neoplasms arising from the matrix cells of hair follicles. We report the case of a 17-year-old female who had a swelling over the medial surface of the right ear lobule, which was determined to be an epidermal inclusion cyst by radiological and clinical examination. Over the period of eight days, it grew to 2 × 2 cm. A well-defined encapsulated lesion with thick cellular debris was found on an ultrasonography of the local region. Under local anesthesia, the patient had a cyst excision. Early detection by ultrasonography is beneficial in skin lesions to confirm if they are benign or malignant. Complete excision of the cyst is the treatment in order to limit the morbidity and lower the aggressive behavior. In this case, we came to a diagnosis after a histopathological examination, confirming it as a pilomatricoma. Due to its rarity, it is often misdiagnosed.

Multifocal tuberculosis revealed by a sternal swelling in an immunocompetent child.

Tuberculosis (TB) is one of the most common pathogens of bacterial lung infections, especially in underdeveloped nations like Morocco, where the incidence of TB was 97 cases per 100 000 persons in 2019. Thanks to its national TB prevention and control plan, Morocco was able to achieve remarkable progress in the management of TB with an 80% reduction in the total number of patients diagnosed with TB between 1980 and 2018. The national plan also allowed us to reach and maintain a therapeutic rate above 86% since 2002. Sternal TB is a rare clinical condition accounting for 1% of all musculoskeletal TB cases. Due to its rarity and the lack of awareness of clinical presentations, the diagnosis of sternal TB can be quite complex. We describe the case of a 14-year-old Moroccan patient consulting in the Military Hospital Mohammed V-Rabat with central chest pain for 4 months which was not associated with breathing, physical exercise or eating. The patient also had a history of asthenia, fever and weight loss. A computed tomography scan of the chest showed a destructive lesion of the sternum. Afterward, a chirurgical biopsy was performed and enabled to confirm the microbiological diagnosis of TB with the realization of the real-time PCR. The antitubercular therapy was given to the patient who had complete resolution of symptoms. This condition should be included in the differential diagnosis of chronic chest pain that mimics costochondritis particularly in patients from endemic areas.

Case Report: Atypical visual presentation caused by a large convexity meningioma-a nerve stretching and stalk indentation effect.

Visual field defects are commonly present in patients with brain tumors, particularly due to direct compression on the optic apparatus. However, there are instances where brain tumors, despite not directly compressing the optic pathway, can still cause visual symptoms, albeit rarely reported but not uncommonly observed. These mechanisms are thought to be associated with increased intracranial pressure (IICP). We report a case of a 32-year-old man who presented with right blurred vision and was diagnosed with a right convexity meningioma. Upon reviewing his magnetic resonance images, we hypothesized that the indentation of the pituitary stalk on the optic chiasm and the stretching of the optic nerve, combined with a focal effect of IICP, could be responsible for his atypical visual field defect.

Inguinal Lipoblastoma Masquerading as Obstructed Omentocele in a Girl.

Lipoblastoma in the inguinal regional is a rare occurrence in children and can present as a surgical surprise during pediatric herniotomies. Irreducible inguinal hernia is one of the most common surgical problems dealt by pediatric surgery residents in emergency. We report a case of inguinal lipoblastoma presenting as irreducible groin swelling. Complete excision of the mass was done with no recurrence till date.

Massive scrotal elephantiasis: A case report.

The condition known as scrotal elephantiasis is a debilitating rarity where the scrotum undergoes significant swelling, typically arising from chronic obstructive lymphedema. A case is presented of a 60-year-old man who had suffered severe and persistent enlargement of his scrotum for multiple years. This affliction greatly affected both his ability to function effectively and caused detrimental psychosocial consequences. After a clinical evaluation, the patient was diagnosed with scrotal elephantiasis. A comprehensive strategy was adopted, utilizing scrotal volume reduction surgery to yield a significant enhancement in the quality of life following the operation.

Decoding Femoral Vein Leiomyosarcoma: A Rare Vascular Malignancy Revealed Through Imaging.

Lumps are commonly found in the femoral triangle. Femoral hernias and lymphadenopathy are included in the differential diagnosis. One of the rare possibilities of femoral triangle swellings is leiomyosarcoma. Leiomyosarcoma originating from the walls of blood vessels is very rare, and only a few cases are reported. We present a case of a 50-year-old male patient complaining of swelling over the left thigh. Ultrasonography showed a highly vascular soft tissue tumour in the anteromedial compartment of the thigh. Magnetic resonance imaging (MRI) was done later. It showed a well-defined, heterogeneously enhancing solid cystic lesion along the femoral vein with intravenous extension, and the femoral artery was seen encasing along its length. A surgical exploration of the lesion suggested a mass originating from the femoral vein, obstructing the vein itself. The mass was excised, and the defect in the vein was repaired. Histopathological examination revealed the mass to be leiomyosarcoma of vascular origin.

Management of Cheilitis Granulomatosa with Pica Disorder: A Rare Case Report.

Aim: To report a rare case of cheilitis granulomatosa (CG) with pica disorder presented as chronic persistent lip swelling with an unusual eating disorder. Background: Cheilitis granulomatosa or Miescher's cheilitis is a rare, persistent, or recurring nontender chronic painless swelling of one or both the lips due to granulomatous inflammation, which was first described by Miescher in 1945. It can present as a monosymptomatic form or as a part of other entities of Melkersson-Rosenthal syndrome (MRS). Case description: A 14-year-old female patient presented with persistent diffuse swelling of the upper lip for 1 year. She also had an unusual habit of eating clay, mud, and potentially harmful items like flakes of paint for 1.5 years. Clinically, chronic persistent lip swelling involving upper lip and gingival enlargements were present along with systemic manifestations. Patient counseling with combination therapy showed excellent response with no signs of relapse at 6 months of follow-up. Conclusion: Cheilitis granulomatosa is a unique rare inflammatory disorder with many possible contributory factors and exact etiology is poorly understood. Clinical significance: This case report draws attention to constant exposure to an allergen that could be one of the possible etiological factors to CG secondary to pica eating disorder. Though it is a rare disease, research on the pathogenesis of CG and clinical trials evaluating the efficacy of the various treatments are needed to enhance our understanding of this disease, to improve the quality of life, as patients are very disturbed by the unsightly and distressing nature of macrocheilitis. How to cite this article: Dayanarayana U, Shastry SP, Kempegowda RT, et al. Management of Cheilitis Granulomatosa with Pica Disorder: A Rare Case Report. Int J Clin Pediatr Dent 2024;17(4):483-489.

Ledderhose's Disease.

Ledderhose disease, also known as plantar fibromatosis, is a rare fibroproliferative disorder characterized by the development of fibrous nodules within the plantar fascia of the foot. These nodules cause discomfort, pain, and impaired mobility, particularly during activities like walking, and are often associated with other fibromatoses, such as Dupuytren's disease. In this case, a 60-year-old woman presented with significant plantar pain exacerbated by walking, along with swelling in the arch of her foot. The diagnosis involved a clinical examination that revealed nodules and tenderness in the plantar fascia, and ultrasound imaging confirmed the presence of fibrotic tissue. Due to the patient's preference for non-surgical management, a conservative approach was adopted. This included the use of medications, orthotic devices, and physical therapy. This case underscores the effectiveness of non-surgical interventions in managing Ledderhose disease, highlighting the importance of personalized treatment plans tailored to patient preferences.

Crosslinking and Swelling Properties of pH-Responsive Poly(Ethylene Glycol)/Poly(Acrylic Acid) Interpenetrating Polymer Network Hydrogels.

This study investigates the crosslinking dynamics and swelling properties of pH-responsive poly(ethylene glycol) (PEG)/poly(acrylic acid) (PAA) interpenetrating polymer network (IPN) hydrogels. These hydrogels feature denser crosslinked networks compared to PEG single network (SN) hydrogels. Fabrication involved a two-step UV curing process: First, forming PEG-SN hydrogels using poly(ethylene glycol) diacrylate (PEGDA) through UV-induced free radical polymerization and crosslinking reactions, then immersing them in PAA solutions with two different molar ratios of acrylic acid (AA) monomer and poly(ethylene glycol) dimethacrylate (PEGDMA) crosslinker. A subsequent UV curing step created PAA networks within the pre-fabricated PEG hydrogels. The incorporation of AA with ionizable functional groups imparted pH sensitivity to the hydrogels, allowing the swelling ratio to respond to environmental pH changes. Rheological analysis showed that PEG/PAA IPN hydrogels had a higher storage modulus (G') than PEG-SN hydrogels, with PEG/PAA-IPN5 exhibiting the highest modulus. Thermal analysis via thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC) indicated increased thermal stability for PEG/PAA-IPN5 compared to PEG/PAA-IPN1, due to higher crosslinking density from increased PEGDMA content. Consistent with the storage modulus trend, PEG/PAA-IPN hydrogels demonstrated superior mechanical properties compared to PEG-SN hydrogels. The tighter network structure led to reduced water uptake and a higher gel modulus in swollen IPN hydrogels, attributed to the increased density of active network strands. Below the pKa (4.3) of acrylic acid, hydrogen bonds between PEG and PAA chains caused the IPN hydrogels to contract. Above the pKa, ionization of PAA chains induced electrostatic repulsion and osmotic forces, increasing water absorption. Adjusting the crosslinking density of the PAA network enabled fine-tuning of the IPN hydrogels' properties, allowing comprehensive comparison of single network and IPN characteristics.

Dercum's Disease: The Clinical Presentation, Diagnosis, Radiological Findings, and Treatment of a Rare, Debilitating Inflammatory Disorder.

Introduction: Dercum's disease, also known as adiposis dolorosa, is a rare syndrome characterized by the growth of multiple, and painful, subcutaneous adipose tissues that commonly present in the abdomen and extremities. The scientific community hypothesizes that Dercum's disease is a combination of neurologic and endocrine disorders. Patients commonly describe it as chronic adipose pain, which manifests as sporadic painful flares throughout their history with the disease. Case Presentation: We share the case of a 32-year-old woman who presented to the emergency department for an acute episode of left lower extremity pain and swelling associated with a previously diagnosed history of Dercum's disease. The patient had similar events in the past, with her last episode being 3 months earlier. A diagnosis is based on clinical presentation, findings on imaging, and the exclusion of other diseases that are associated with lipomas. While there is no standard approach to treatment, healthcare professionals focus on pain management. Conclusion: Dercum's disease is a chronic debilitating disorder, with multiple types that are diagnosed through imaging. The treatment of Dercum's disease is predicated on the patient's symptoms and the effectiveness of medications that vary based on the patient's needs.

Enhancing the properties of swelling soils with lime, fly ash, and expanded polystyrene -A review.

This paper discusses efforts made by past researchers to steady the expansive (problematic) soils using mechanical and chemical techniques - specifically with EPS beads, lime and fly ash. Administering swelling of problematic soils is critical for civil engineers to prevent structural distress. This paper summarizes studies on reduction of swelling potential using EPS, lime and fly ash individually. Chemical stabilization with lime and fly ash are conventional methods for expansive soil stabilization, with known merits and demerits. This paper explores the suitability of different materials under various conditions and stabilization mechanisms, including cation exchange, flocculation, and pozzolanic reactions. The degree of stabilization is influenced by various factors such as the type and amount of additives, soil mineralogy, curing temperature, moisture content during molding, and the presence of nano-silica, organic matter, and sulfates. Additionally, expanded polystyrene (EPS) improves structural integrity by compressing when surrounded clay swells, reducing overall swelling. Thus, EPS addresses limitations of chemicals by mechanical means. Combining EPS, lime and fly ash creates a customized system promoting efficient, long-lasting, cost-effective and eco-friendly soil stabilization. Chemicals address EPS limitations like poor stabilization. This paper benefits civil engineers seeking to control expansive soil swelling and prevent structural distress. It indicates potential of an EPS-lime-fly ash system and concludes by identifying research gaps for further work on such combinatorial stabilizer systems.

Myopericytoma of the Right Middle Finger: A Case Report of an Uncommon Perivascular Neoplasm.

This report describes the case of a 29-year-old male who presented with painless swelling on the volar aspect of his right middle finger. The initial clinical impression was consistent with an epidermal inclusion cyst. A plain radiograph of the lesion revealed a circumscribed superficial nodular soft tissue mass confined to the dermis of the affected finger. Following surgical excision and subsequent histopathologic examination, the lesion was ultimately identified as a myopericytoma (MPC). The occurrence of MPCs in the finger is uncommon; thus, a high level of suspicion is required to consider it as one of the differential diagnoses for painless nodules in this anatomical location. Surgery serves as the primary method for treatment, and histopathologic evaluation plays a crucial role in confirming the diagnosis and ruling out malignancy.

A case report of genital Crohn's disease with a brief review of Indian cases reported.

Crohn's disease (CD) is a type of inflammatory bowel disease, which presents with extraintestinal manifestations in some cases, skin being one of the organs involved. Vulvar and perianal involvement leads to significant morbidity and has an adverse effect on the quality of life. We report a case of genital CD affecting the vulva, perianal region, and oral cavity, due to its rarity and diagnostic difficulty.

A scoping review on intraoperative and postoperative surgical castration complications in domesticated equids.

BACKGROUND: Castration is the most common surgical procedure in domesticated equids; surgical techniques used and perioperative management vary considerably. OBJECTIVES: To identify and chart the current evidence on perioperative complications associated with different methods of surgical castration in domesticated equids. STUDY DESIGN: Joanna Briggs Institute systematic scoping review. METHOD: CAB Abstracts, Medline and Embase databases were searched using terms related to equine castration complications. Two authors independently and blindly screened publications against eligibility criteria. Data on study methods, perioperative management, surgical techniques, and perioperative complications were extracted. Surgical techniques were grouped into categories depending on technique; open, closed or half-closed, and whether the parietal tunic was open or closed at the end of surgery. RESULTS: The search identified 1871 publications; 71 studies met the final inclusion criteria. The data reported 76 734 castrations, most of which were open or closed, with the vaginal tunic remaining open at the end of surgery. Twenty-five studies reported information regarding surgical techniques and perioperative management, allowing detailed charting and comparisons, of which analgesia and antimicrobial usage varied notably. Eighteen different complications were reported, with swelling or oedema being the most common. Evisceration was most commonly reported in draught breeds and Standardbreds, and the risk appeared low if the parietal tunic was closed at the end of surgery. MAIN LIMITATIONS: Grey literature and studies not available in English were not included. Existing studies varied greatly in perioperative management, surgical techniques and reporting of outcomes, making evidence consolidation problematic. CONCLUSION: A lack of consensus regarding complication definitions creates uncertainty and discrepancies between complication rates associated with different surgical techniques and perioperative management. The implementation of standardised systems for describing surgical techniques and complications is recommended for future studies. A number of studies did not follow current recommendations for perioperative analgesia and use of antimicrobials.

Mechanical Characterization, Water Absorption, and Thickness Swelling of Lightweight Pineapple Leaf/Ramie Fabric-Reinforced Polypropylene Hybrid Composites.

Fiber-reinforced composites are among the recognized competing materials in various engineering applications. Ramie and pineapple leaf fibers are fascinating natural fibers due to their remarkable material properties. This research study aims to unveil the viability of hybridizing two kinds of lignocellulosic plant fiber fabrics in polymer composites. In this work, the hybrid composites were prepared with the aid of the hot compression technique. The mechanical, water-absorbing, and thickness swelling properties of ramie and pineapple leaf fiber fabric-reinforced polypropylene hybrid composites were identified. A comparison was made between non-hybrid and hybrid composites to demonstrate the hybridization effect. According to the findings, hybrid composites, particularly those containing ramie fiber as a skin layer, showed a prominent increase in mechanical strength. In comparison with non-hybrid pineapple leaf fabric-reinforced composites, the tensile, flexural, and Charpy impact strengths were enhanced by 52.10%, 18.78%, and 166.60%, respectively, when the outermost pineapple leaf fiber layers were superseded with ramie fabric. However, increasing the pineapple leaf fiber content reduced the water absorption and thickness swelling of the hybrid composites. Undeniably, these findings highlight the potential of hybrid composites to reach a balance in mechanical properties and water absorption while possessing eco-friendly characteristics.

Chronic Expanding Hematoma in the Upper Extremity: A Case Report on Diagnostic and Management Challenges.

Hematomas are a common occurrence in clinical practice, often resulting from trauma or underlying bleeding disorders. They can manifest with various symptoms depending on their location and size. While hematomas are typically straightforward to diagnose and manage, specific presentations can pose diagnostic challenges. We present the case of a growing post-traumatic right upper extremity mass in a 67-year-old male on anticoagulant medication, Xarelto (rivaroxaban) 20mg, with no history of bleeding disorders. Differential diagnoses include a benign lipoma or possible soft-tissue malignancy. The mass was surgically excised and sent to pathology, which confirmed it was a hematoma and led to a diagnosis of a chronic expanding hematoma. Ultrasonography, computed tomography, and magnetic resonance imaging are diagnostic modalities that can help distinguish different presentations. Despite the commonality of hematomas in clinical practice, atypical hematomas may also present unique challenges in diagnosis and management due to their varied clinical presentations and locations. This report underlines the importance of understanding hematomas' diverse etiologies, presentations, and imaging characteristics for appropriate treatment and diagnosis.

A Rare Case of Calcinosis Cutis Presenting to a Tertiary Care Hospital in Rural Maharashtra.

Calcinosis cutis is a common ailment of the skin, caused by the accumulation of calcium salts in the subcutaneous regions, though there are rare case reports from rural Maharashtra region. This condition is usually asymptomatic and might manifest as a single growth or several different-sized growths. Its clinical presentation is observed as nodules or plaques without causing injury to underlying tissues. The condition is reported to be a secondary presentation to trauma, malignancies, and connective tissue diseases and has multifactorial underlying etiologies. Recommendation for treatments including both medical and surgical procedures is contingent upon the manifestation and severity of the condition. The final decision can be based on the results obtained from diagnostic modalities like fine needle aspiration and radiological imaging. This is the case of a 35-year-old male with a swelling on his left foot for the past two years without any associated medical history. The patient was managed by surgical incision and had a good recovery.

Long-term 23-year Global Post-marketing Safety Surveillance Review of Delayed Complications with a Supportive Hyaluronic Acid Filler for Infraorbital Hollow Rejuvenation.

HARES is a supportive (high G') HA filler with a low degree of water affinity (gel swelling) and modification (<1% BDDE) that has a well-established safety and efficacy profile in the literature, especially for infraorbital hollow (IOH) rejuvenation. To further support the safety of this product, a long-term review of delayed-onset adverse events of interest (DAEIs) related to HARES was conducted using reports from a global post-marketing safety surveillance database over the past 23 years. This review demonstrated low reporting frequencies of delayed-onset nodules and inflammatory events, establishing a long-term safety profile for HARES that supports its continued use in clinical practice, especially for IOH rejuvenation.

Effect of Carbon on Void Nucleation in Iron.

The study reports the significance of carbon presence in affecting void nucleation in Fe. Without carbon, void nucleation rates decrease gradually at high temperatures but remain significantly high and almost saturated at low temperatures. With carbon present, even at 1 atomic parts per million, void nucleation rates show a low-temperature cutoff. With higher carbon levels, the nucleation temperature window becomes narrower, the maximum nucleation rate becomes lower, and the temperature of maximum void nucleation shifts to a higher temperature. Fundamentally, this is caused by the change in effective vacancy diffusivity due to the formation of carbon-vacancy complexes. The high sensitivity of void nucleation to carbon comes from the high sensitivity of void nucleation to the vacancy arrival rate in a void. The void nucleation is calculated by first obtaining the effective vacancy diffusivity considering the carbon effect, then calculating the defect concentration and defect flux change considering both carbon effects and pre-existing dislocations, and finally calculating the void nucleation rate based on the recently corrected homogeneous void nucleation theory. The study is important not only in the fundamental understanding of impurity effects in ion/neutron irradiation but also in alloy engineering for judiciously introducing impurities to increase swelling resistance, as well as in the development of simulation and modeling methodologies applicable to other metals.

A flexible glucose biosensor modified by reduced-swelling and conductive zwitterionic hydrogel enzyme membrane.

This paper reports a flexible glucose biosensor which is modified by a reduced-swelling and conductive zwitterionic hydrogel enzyme membrane that contains two forms of chemical cross-links. One chemical cross-linking is induced by thermal initiators and forms the basal network of the hydrogel. Another cross-linking is achieved by the coordination interactions between the multivalent metal ion Al3+ and anionic group -COO- of zwitterionic poly-carboxy betaine (pCBMA), which significantly increase the cross-linking density of the zwitterionic hydrogel, improving the reduced-swelling property and reducing the pore size. The better reduced-swelling property and reduced diameters of pores within the zwitterionic hydrogel make less glucose oxidase (GOx) leakage, thus significantly improving the enzyme membrane's service life. By introducing the Al3+ and Cl-, the conductivity of the zwitterionic hydrogel is enhanced approximately 10.4-fold. According to the enhanced conductivity, the reduced-swelling property, and the high GOx loading capacity of the zwitterionic hydrogel, the sensitivity of the biosensor with GOx/pCBMA-Al3+ is significantly improved by 5 times and has a long service life. Finally, the proposed GOx/pCBMA-Al3+ biosensor was applied in non-invasive blood glucose detection on the human body, verifying the capability in practice.