Lepromatous Leprosy Manifesting As Chronic Macrocheilia: Report of a Rare Case.

Leprosy is a chronic debilitating disorder caused by the acid-fast bacilli Mycobacterium leprae (M. leprae) and Mycobacterium lepromatosis. These bacilli exhibit a distinctive predilection for the skin and peripheral nerves, although they can potentially impact any system in the body. Lately, there has been a notable reduction in mucosal symptoms, largely attributed to the timely diagnosis and treatment of leprosy. Nonetheless, oral lesions continue to hold significant epidemiological importance due to their crucial role in disease transmission. Oral manifestations, although rare, are frequently encountered in individuals afflicted with multi-bacillary leprosy. Chronic macrocheilia is an exceedingly rare manifestation of the disease, with only a few documented case reports and case studies. This article aims to document an exceptionally uncommon case of lepromatous leprosy with chronic macrocheilia as the sole presenting feature.

A systematic review of Pilomatrix carcinoma arising from the previous scar site of Pilomatrixoma.

Pilomatrix carcinoma is a rare tumor arising from the hair follicle matrix cells most commonly seen in the head and neck region. Also known as "calcified epithelial carcinoma of Melherbe," it was first reported in 1980 by Lopansri and Mihm. Since then till date to the best of our knowledge only around 125 cases were reported in literature, of which only 11 cases were reported to arise from histologically proven areas of previous pilomatrixoma which is the benign variant. One such case is being reported here along with the review of literature. A 50-year-old man presented with a swelling in the nape of his neck since 6 months, which was gradually increasing in size. He had a history of similar swelling at the same site 18 months back for which he underwent a surgery at a center outside. Final histopathology report was suggestive of pilomatrixoma with negative margin. Wide local excision of the tumor with 3 cm margin, placement of surgical clips followed by a primary closure was done. The final histopathology report is suggestive of pilomatrix carcinoma. The patient has no recurrence in 6 months follow-up. The differential diagnosis of pilomatrix carcinoma should be considered in cases of recurrent skin tumors. Wide local excision is the preferred treatment. Re-excision should be done in margin positive cases and cases where simple excision was done due to improper preoperative diagnosis. Due to the rarity of the disease, adjuvant treatment is not properly defined.

Compressive Strength Evaluation of Three Distinct Implant Design Approaches.

Objectives: The study was done to assess the implant-abutment interface static compressive. strength of three design types and implant-abutment connection failure style. Materials and Methods: The implants at 306 with respect to the y-axis were aligned using a stainless steel holding device. Twenty specimens from each system totaled 60 total. A unidirectional vertical piston in a computer-controlled universal testing machine (MTS 810) generated static compression loading until failure. Specimens were macroscopically examined for fracture of the screw and implant, abutment looseness, and longitudinal displacement. Analysis of variance was used to analyze the data (ANOVA). Result: The screw-vent system had a mean compressive strength of 335.6 22.7 psi for the Unipost system, 384.3 37.1 psi for the screw-vent system, and 245.3 25.4 psi for the ITI-1 piece abutment connection. Conclusion: The connection between the Unipost implant and abutment showed a statistically significant variation.

Evolution of treatment in gastric cancer- a systematic review.

Multimodality is the standard of care in gastric cancer but surgery remains the mainstay of curative treatment. As we are heading towards a more conservative approach for functional preservation without compromising oncological outcomes in all malignancies, the guidelines keeps changing based on various studies.The extent of surgery used to vary between the east and west, with the east performing more radical surgery and the west more reliant on multimodality therapy. This practice has been changing in the recent times.In this article we have reviewed how the treatment protocols of gastric cancer has evolved and modified, highlighting the practice changing trials.

Bisphenol A exposure induces neurobehavioral deficits and neurodegeneration through induction of oxidative stress and activated caspase-3 expression in zebrafish brain.

Bisphenol A (BPA) is noted for its adversative effects by inducing oxidative stress, carcinogenicity, neurotoxicity, inflammation, etc. However, the likely act of BPA in inducing neurodegenerative phenotypes remains elusive in the available literature. Hence, the present study was conducted to decipher the neurodegenerative potential of BPA in inducing Parkinson's disease like phenotypes in zebrafish. Zebrafish were subjected to chronic waterborne exposure to BPA for 56 days. Locomotor activities and neurobehavioral response were assessed by the NTDT (novel tank diving test), OFT (open field test), and LDPT (light-dark preference test). The oxidative stress markers and histopathological observation for pyknosis and chromatin condensation were carried out. Immunohistochemistry for activated caspase-3 and targeted proteins expression study was performed. The basic findings reveal that chronic BPA exposure significantly induces locomotor dysfunction through a significant decline in mean velocity and total distance traveled. As a measure of pyknosis and chromatin condensation, pyknotic and Hoechst positive neurons in telencephalon and diencephalon significantly increased by BPA exposure. A higher concentration of BPA adversely affects the neurobehavioral response, antioxidant status, and neuromorphology in zebrafish. Parkinson-relevant targeted protein expression viz. alpha-synuclein and LRRK2, were significantly upregulated, whereas tyrosine hydroxylase, NeuN, and Nurr1 were significantly downregulated in the zebrafish brain. As an indicator of cell death by apoptosis, the expression of activated caspase-3 was significantly increased in the BPA-exposed zebrafish brain. These basic results of the current study indicate that chronic waterborne exposure to BPA induces neuropathological manifestation leading to the development of motor dysfunction and Parkinsonism-like neurodegenerative phenotypes in zebrafish.

Qualitative and morphological evaluation of the mandibular bone using computed tomography.

CONTEXT: Determining the amount of cortical and cancellous bone present in the mandible is an important criterion for the selection of proper implant size and reduction of post implant placement complications. It becomes difficult to manage the presence of lingual undercuts when there is perforation of either the buccal or lingual cortical plates. Computed tomography (CT) images of the mandible can reduce the risk of complications by evaluating the thickness of cortical and cancellous bone in the mandible. AIMS: Evaluate thickness of the buccal and lingual cortical plates and cancellous bone. Gender variation in the cancellous bone and cortical bone thickness. Determine the shape of the mandible. SETTINGS AND DESIGN: A retrospective study was conducted using the CT scan images of pathologies pertaining to the Head and Neck region. METHODS AND MATERIAL: CT scan images of 30 patients, comprising of 22 males and 8 females. The mental foramen was considered as the anatomical landmark and the vertical marking was considered at a height of 20 mm from basal bone. The thickness of both cortical and cancellous bone was noted 6 mm anterior to it and 18 mm posterior. The shape of the buccal and lingual cortical bone was also considered. STATISTICAL ANALYSIS: Statistical analysis was done using Student's t-test or Chi-square test. RESULTS: The mean thickness of cortical bone was more in anterior mandible than posterior mandible and cortical bone density was thickest at height of 20 mm, whereas for cancellous bone, it was highest at 5 mm from the basal bone, thickness. Buccal concavity, type A (68.2%), was the most common in the anterior region for males, followed by round shape, type C (56-58%) in the posterior region. For females, type C (25-31%) in the posterior region and lingual concavity, type B (18-30%) were the most common types in the anterior region. CONCLUSIONS: Lingual concavity may pose serious problems in cases of perforations during implant placement. Lingual cortical plates were thicker than the buccal cortical plates and it is concave anterior mandible. Thus, CT imaging can help in characterizing the quantity and morphology of the mandible.

Primary primitive neuroectodermal tumor of the breast: a rare case presentation.

A primitive neuroectodermal tumor (PNET) in the breast developed in a 36-year-old Indian woman who initially underwent lumpectomy and was diagnosed as the malignant phyllodes tumor of the right breast. Within 2 months it recurred, clinicoradiologically appearing like organized collection. Incision and drainage along with biopsy was done. The tissue diagnosis was reported as PNET. The histopathology report showed the tumor cells as malignant round cells, immunohistochemically positive for CD99, vimentin and neuron-specific enolase (NSE) (patchy) and negative for CD45, cytokeratin, S100, and desmin. Extended simple mastectomy was carried out. She came after another interval with recurrence. Chemotherapy as well as radiotherapy was given. After 18 months of surgery, the patient is having persistent stable disease without distant metastasis. PNET in adults is rare and has been reported in the chest wall (Askin tumor) and other visceral sites. To our knowledge, only a few cases have been reported of a primary PNET of the breast.