A Massive Growth in the Palate: A Case Report.

This case report describes a 67-year-old woman who developed an extensive, slow-growing lesion occupying the whole of the palate in 10 years. Considering clinical and radiographic features, calcifying neoplasms were considered. Correlating microscopic features with clinical features, the lesion was diagnosed as peripheral ossifying fibroma, which seldom presents as an extensive lesion on the palate amongst the elderly age group. This case report will highlight clinicians and pathologists about a rare presentation of a commonly encountered lesion with a comprehensive view of the differential diagnosis of other comparable lesions.

Microplastics in oral healthcare products (OHPs) and their environmental health risks and mitigation measures.

The environmental input of microplastics from personal care products has received significant attention; however, less focus has been paid to oral healthcare products. The present study assessed the occurrence of microplastics in commercially available oral healthcare products such as toothbrushes, toothpastes, toothpowder, mouthwash, dental floss, and mouth freshener spray that have a pan-India distribution. The extracted microplastics were quantified and characterised using a microscope and ATR-FTIR. All products showed microplastic contamination, where toothbrushes showed the maximum particles (30-120 particles/brush) and mouth freshener sprays (0.2-3.5 particles/ml) had the least abundance. Fragments, fibres, beads, and films were the various shapes of microplastics observed, where fragments (60%) were dominant. Various colours such as pink, green, blue, yellow, black, and colourless were observed, where colourless (40%) particles were dominant. Microplastics were categorized into three sizes: <0.1 mm (63%), 0.1-0.3 mm (35%), and >0.3 mm (2%). Four major types of polymers, such as polyethylene (52%), polyamide (30%), polyethylene terephthalate (15%), and polybutylene terephthalate (3%), were identified. Risk assessment studies such as Daily Microplastics Emission (DME), Annual Microplastics Exposure (AME), and Polymer Hazard Index (PHI) were carried out. The DME projection for India was the highest for mouthwash (74 billion particles/day) and the least for mouth freshener sprays (0.36 billion particles/day). The AME projection for an individual was the highest in toothbrushes (48,910 particles ind.-1 yr.-1) and the least in mouth freshener sprays (111 particles ind.-1 yr.-1). PHI shows that the identified polymers fall under the low-to high-risk categories. This study forecasts the community health risks linked to microplastics in oral healthcare products and suggests mitigation strategies. It has the potential to shape environmental policy development in response.

Accidental finding of COVID-associated mucormycosis (CAM) in a patient presenting as toothache: A case report and review of literature.

Mucormycosis is an angio-invasive rapidly progressing fungal infection, usually reported in immunocompromised individuals. We present a case of COVID-associated mucormycosis in a patient with a presenting symptom of toothache in the maxilla with a possible mild case of COVID-19. Abstract: Coronavirus-associated mucormycosis (CAM) had reached epidemic status, especially during the second wave of COVID-19. It was especially prevalent in India with a large mortality rate. Mucormycosis, particularly the rhinocerebral type is seen to be greatly associated with COVID-19, especially in patients with altered immunity. Uncontrolled diabetes, chronic kidney disease, immunocompromised patients, malignant hematological diseases, etc. are the major risk factors of CAM, precipitated by the injudicious use of corticosteroids for the treatment of COVID-19. CAM may often present in the maxillofacial region which warrants that dental clinicians be aware of the clinical presentation, diagnostic guidelines, and appropriate management measures for the disease. This report is one such case of CAM involving the posterior maxilla in a middle-aged individual with mild COVID-19 symptoms.

Prediction of muscular paralysis disease based on hybrid feature extraction with machine learning technique for COVID-19 and post-COVID-19 patients.

Many Coronavirus disease 2019 (COVID-19) and post-COVID-19 patients experience muscle fatigues. Early detection of muscle fatigue and muscular paralysis helps in the diagnosis, prediction, and prevention of COVID-19 and post-COVID-19 patients. Nowadays, the biomedical and clinical domains widely used the electromyography (EMG) signal due to its ability to differentiate various neuromuscular diseases. In general, nerves or muscles and the spinal cord influence numerous neuromuscular disorders. The clinical examination plays a major role in early finding and diagnosis of these diseases; this research study focused on the prediction of muscular paralysis using EMG signals. Machine learning-based diagnosis of the diseases has been widely used due to its efficiency and the hybrid feature extraction (FE) methods with deep learning classifier are used for the muscular paralysis disease prediction. The discrete wavelet transform (DWT) method is applied to decompose the EMG signal and reduce feature degradation. The proposed hybrid FE method consists of Yule-Walker, Burg's method, Renyi entropy, mean absolute value, min-max voltage FE, and other 17 conventional features for prediction of muscular paralysis disease. The hybrid FE method has the advantage of extract the relevant features from the signals and the Relief-F feature selection (FS) method is applied to select the optimal relevant feature for the deep learning classifier. The University of California, Irvine (UCI), EMG-Lower Limb Dataset is used to determine the performance of the proposed classifier. The evaluation shows that the proposed hybrid FE method achieved 88% of precision, while the existing neural network (NN) achieved 65% of precision and the support vector machine (SVM) achieved 35% of precision on whole EMG signal.

Effects of bilateral superficial cervical plexus block on sevoflurane consumption during thyroid surgery under entropy-guided general anesthesia: a prospective randomized study.

BACKGROUND: Bilateral superficial cervical plexus block (BSCPB) provides good postoperative analgesia, but its effect on anesthetic consumption is unknown. This study evaluated the effects of BSCPB on sevoflurane consumption during thyroid surgery. METHODS: Fifty patients were randomly allocated into groups A and B of 25 each in this prospective double-blind study. Group A received BSCPB with 20 ml 0.25% bupivacaine, whereas group B received 20 ml saline immediately before entropy-guided general anesthesia. Intraoperative hemodynamic parameters, end-tidal sevoflurane concentration, minimum alveolar concentration, and sevoflurane consumption were recorded. Postoperative pain was assessed using a visual analog scale, and the time of the first request for analgesia was noted. All side effects were recorded. RESULTS: Demographics were comparable. Mean sevoflurane consumption [for 30 min: group A = 7.2 (1.1) ml, group B = 8.8 (2.0) ml, P = 0.001; for 60 min: group A = 13.5 (1.7) ml, group B = 16.5 (3.9) ml, P = 0.002] and mean end-tidal sevoflurane concentration [for 30 min: group A = 1.2% (0.2%), group B = 1.4% (0.2%), P = 0.008; for 60 min: group A = 1.2% (0.1%), group B = 1.4% (0.2%), P = 0.010] were significantly lower in group A. Patients in group A had a longer duration of analgesia [361.6 (79.5) min vs. 151.0 (60.2) min, P < 0.001] compared to those in group B. CONCLUSIONS: Preinduction BSCPB during thyroid surgery significantly reduced sevoflurane consumption and increased the duration of postoperative analgesia.

Ascaridia galli infection in a checkered keelback (Xenochrophis piscator) snake.

The checkered keelback is also known as Asiatic water snake and is common species of non-venomous snake known to occur in India. The present study report the occurrence of Ascaridia galli infection in a checkered keelback snake, which was found dead near Veterinary College hostel premises. The post-mortem examination of the snake revealed catarrhal exudate without ingesta in the stomach and showed gastric ulcerations with edema. Large numbers of round worms were packed in the lumen of small intestine with petechial haemorrhages and necrotic enteritis. The nematode parasites were recovered and processed for identification. Based on morphological characters, the worms were identified as A. galli and the intestinal contents of the snake showed A. galli eggs.

Dual Cystic Arteries in Association with Caterpillar Hump of Right Hepatic Artery- A Case Report and its Surgical Relevance.

A rare variation was seen in the arterial supply of liver and gall bladder during dissection of an adult female cadaver. The right hepatic artery was having a tortuous course with double loops and cystic artery was arising from the distal loop within the hepatobiliary triangle. There was an accessory cystic artery arising from the superior pancreaticoduodenal artery outside the hepatobiliary triangle which ascended anterior to the common bile duct and cystic duct towards the gall bladder. The knowledge of these vascular variations is very much essential owing to increase in surgical interventions involving the biliary tract. Recognition of such vascular variations is essential for laparoscopic surgeons to reduce complications like uncontrolled intraoperative bleeding, iatrogenic extrahepatic biliary injuries and conversion to open cholecystectomy. This report emphasizes the necessity of all surgeons being well aware of vascular variations and anomalies to be able to accomplish safe and uneventful hepatobiliary surgeries.

Anatomical Study of Pterygospinous and Pterygoalar Bar in Human Skulls with their Phylogeny and Clinical Significance.

BACKGROUND: Pterygospinous and pterygoalar ligaments present at the cranial base may sometimes get ossified leading to the formation of complete or incomplete bony bars in relation to foramen ovale. These are of clinical importance because these may obliterate the foramen ovale causing mandibular neuralgia. They may cause trouble in performing thermocoagulation and anaesthesia for trigeminal neuralgia. They may pose surgical difficulty in approaching the retro and parapharyngeal spaces and hence the anatomy of these bony bars is very important. MATERIALS AND METHODS: The present study was conducted in 100 dry human skulls of unknown sex to know the incidence, side, degree of ossification (complete/ incomplete) and relation of the pterygospinous and pterygoalar bars to the foramen ovale. RESULTS: Pterygospinous and pterygoalar bars were seen in 41 skulls which were classified into Type I (26.83%), Type II (58.54%) and Type III (14.63%) based on the presence of pterygospinous bar, pterygoalar bar or both together. Pterygospinous bars were seen in 17 skulls of which, one skull (5.88%) had complete and 16 skulls (94.12%) showed incomplete bars. Out of the 30 skulls with pterygoalar bars, complete bar was seen in one (3.33%) and incomplete in 29 skulls (96.67%). These bars were seen more on the left side of the skull than on the right. They were in close relation to the foramen ovale; the pterygospinous bar was inferior or medial to foramen ovale and pterygoalar bar was lateral, inferior or medial to the foramen ovale. CONCLUSION: The presence of the pterygospinous and pterygoalar bars cause variety of symptoms due to neurovascular entrapment and also obstruct surgical approaches to the base of skull. Hence the anatomical knowledge of these osseous bars is essential for anaesthetists, radiologists, dentists and neurosurgeons to increase the success of diagnostic evaluation and surgical approaches to the cranial base.