Unveiling Enigma: Navigating the Diagnostic Labyrinth of an Atypical Medial Clavicular Enchondroma.

Benign cartilaginous lesions called enchondromas usually appear in the long bones of the limbs. This case report, however, draws attention to an uncommon and unusual appearance of enchondroma near the medial end of clavicle. Because of the unusual location, the diagnostic process was very complex, which presented a challengefor the physicians. We provide the clinical, radiological and histological results that finally allowed for an accurate diagnosis. This example highlights the need of taking into account atypical location for benign lesions and highlights the necessity of a thorough diagnostic approach in unexpected clinical settings. Since the occurrence of clavicular enchondromas is a rare entity and can at times mislead the clinician, healthcare providers must be vigilant enough to guarantee a prompt and accurate diagnosis for timely intervention.

Challenges and Triumphs: Unusual Presentation of Tuberculosis in the Cuboid Bone Successfully Managed Through Surgical and Medical Intervention.

This case report describes the unusual presentation of tuberculosis (TB) affecting the cuboid bone in a 16-year-old male patient. The patient presented with a one-year history of progressive foot pain, a discharging sinus, evening rise of temperature, weight loss, and loss of appetite. Clinical examination revealed soft tissue swelling and the presence of caseous material oozing from the sinus. Emergency debridement and curettage were performed, and bone cementing was carried out. An intraoperative sample was sent for a culture sensitivity test, histological analysis, and cartridge-based nucleic acid amplification test (CBNAAT). Histopathological examination, CBNAAT, and culture and sensitivity tests confirmed the diagnosis of Mycobacterium tuberculosis infection. Post-operatively, anti-tuberculous treatment was started. The patient fully recovered from TB of the cuboid.

A Systematic Review of the Management of Knee Osteoarthritis by Proximal Fibular Osteotomy in the Indian Population.

This systematic review aims to assess the management of knee osteoarthritis through proximal fibular osteotomy (PFO) in the Indian population by synthesizing data from various prospective cohort and interventional studies. We seek to provide an overview of the effectiveness and safety of PFO as a treatment modality and offer insights into its potential implications for clinical practice in India. A systematic search strategy was employed, targeting multiple medical databases to identify relevant studies published from 2018 to 2023. Inclusion criteria encompassed studies involving Indian patients with medial compartment knee osteoarthritis and varus deformity who underwent PFO. Data were extracted and evaluated according to the Newcastle-Ottawa Scale for observational studies. Eight studies were included in this review, each displaying varying designs, patient populations, and follow-up duration. The findings consistently indicated that PFO improved pain, knee function, and radiological outcomes, such as knee joint space and tibio-femoral angles. These improvements were generally sustained over several months to a year. The available evidence underscores the potential of PFO as a promising intervention for managing knee osteoarthritis in the Indian population, particularly in patients with medial compartment involvement and varus deformity. While these results are promising, the limitations inherent in the current literature, including study design variations and small sample sizes, necessitate further research with more extensive and diverse patient populations. This systematic review provides valuable insights for healthcare professionals and researchers, highlighting the need for more rigorous investigations and supporting the consideration of PFO as a viable treatment option for knee osteoarthritis in India.

Reconstructive Surgical Intervention for Malunited Distal End Radius and Ulna Fracture: A Case Report Demonstrating Improved Patient Outcomes.

This case report explores the efficacy of reconstructive surgical intervention in addressing malunited fractures of the distal end of the radius and ulna. The study presents a detailed analysis of a specific case, highlighting the surgical techniques employed and their impact on patient outcomes. The report emphasizes the importance of precision in addressing malunited fractures and showcases how the intervention led to improved patient outcomes. By documenting this case, the study contributes valuable insights into the field of orthopedic surgery, providing a basis for further research and enhancing the understanding of optimal approaches to managing such complex fractures.

CP110 and CEP135 Localize Near the Proximal Centriolar Remnants of Mice Spermatozoa.

Centrioles form centrosomes that organize microtubules, assist in cell structure, and nucleate cilia that provide motility and sensation. Within the sperm, the centrosome consists of two centrioles (proximal and distal centriole) and a pericentriolar material known as the striated column and capitulum. The distal centriole nucleates the flagellum. Mice spermatozoa, unlike other mammal spermatozoa (e.g., human and bovine), have no ultra-structurally recognizable centrioles, but their neck has the centriolar proteins POC1B and FAM161A, suggesting mice spermatozoa have remnant centrioles. Here, we examine whether other centriolar proteins, CP110 and CEP135, found in the human and bovine spermatozoa centrioles are also found in the mouse spermatozoa neck. CP110 is a tip protein controlling ciliogenesis, and CEP135 is a centriole-specific structural protein in the centriole base of canonical centrioles found in most cell types. Here, we report that CP110 and CEP135 were both located in the mice spermatozoa neck around the proximal centriolar remnants labeled by POC1B, increasing the number of centriolar proteins found in the mice spermatozoa neck, further supporting the hypothesis that a remnant proximal centriole is present in mice.

Vasopressin-Induced Gangrene of the Bilateral Foot Digits and Right Index Finger Managed With Platelet-Rich Plasma Treatment.

Bilateral foot digit gangrene generated by vasopressin is a serious complication for which management and treatment choices are extremely difficult. This case report presents a case of vasopressin-induced gangrene that was successfully treated with platelet-rich plasma (PRP) infiltration. A 20-year-old female patient came with a history of vasopressin treatment, causing bilateral foot digit gangrene and increasing necrosis. The patient's health quickly declined, and conventional care techniques had no effect on enhancing tissue perfusion or stopping the gangrene from getting worse. In our study, we have chosen to use PRP infiltration as an experimental therapeutic technique in light of the restricted choices available. This case study demonstrates the possibility of PRP infiltration as a cutting-edge and effective treatment for vasopressin-induced bilateral foot digit gangrene. The potential of PRP to stimulate angiogenesis, tissue regeneration, and wound healing is essential for optimizing the patient's results. For vasopressin-induced gangrene, more studies are required to evaluate the efficacy of PRP infiltration as a common therapy approach. This case study highlights the important role that PRP infiltration plays in enhancing tissue perfusion, stopping the advancement of necrosis, and promoting recovery.

The evolution of centriole degradation in mouse sperm.

Centrioles are subcellular organelles found at the cilia base with an evolutionarily conserved structure and a shock absorber-like function. In sperm, centrioles are found at the flagellum base and are essential for embryo development in basal animals. Yet, sperm centrioles have evolved diverse forms, sometimes acting like a transmission system, as in cattle, and sometimes becoming dispensable, as in house mice. How the essential sperm centriole evolved to become dispensable in some organisms is unclear. Here, we test the hypothesis that this transition occurred through a cascade of evolutionary changes to the proteins, structure, and function of sperm centrioles and was possibly driven by sperm competition. We found that the final steps in this cascade are associated with a change in the primary structure of the centriolar inner scaffold protein FAM161A in rodents. This information provides the first insight into the molecular mechanisms and adaptive evolution underlying a major evolutionary transition within the internal structure of the mammalian sperm neck.

A Rare Encounter: Unravelling the Enigma of a Bilateral Humerus Shaft Fracture With a Unique Mode of Injury.

Humerus bone fractures make up 4-6% of all adult fractures, of which proximal humerus shaft fracture is only six percent. Simultaneous occurrences of bilateral humerus shaft fractures are infrequently encountered in clinical practice. Precise statistics regarding these injuries are lacking, with scant documentation in the existing literature concerning the subject matter. These fractures may arise due to convulsions triggered by incidents like an electric shock, epilepsy, alcohol withdrawal, and hypoglycemia, which typically give rise to sudden and excessive muscular contractions. Such fractures usually coincide with dislocations of the shoulder joint. However, in our case, the bilateral humerus shaft fractures were caused by physical injuries despite the individual remaining conscious throughout the ordeal. We present a clinical scenario wherein a 28-year-old male sustained fractures in both humerus shafts as a consequence of a road traffic collision with a unique mode of injury, i.e., both the arms of the patient hitting the trolley of a stationary truck. Radiographic investigation revealed a mid-arm shaft fracture on the right side and a fracture of the proximal one-third of the humerus shaft on the left side. He was managed with closed reduction and internal fixation with intramedullary (CRIF) nailing on the right side, and open reduction and internal fixation (ORIF) with plate osteosynthesis for the left side were done. So this is a compelling rare case of bilateral humerus shaft fracture following high-velocity trauma with a unique mode of injury, treated operatively with satisfactory results on follow-up.

A Comprehensive Review on Platelet-Rich Plasma Activation: A Key Player in Accelerating Skin Wound Healing.

Platelet-rich plasma (PRP) activation is emerging as a promising and multifaceted tool for accelerating skin wound healing. This review extensively examines PRP's role in wound healing, focusing on its composition, mechanisms of action, activation methods, and clinical applications. PRP's potential to enhance both chronic and acute wound healing and its applications in cosmetic and aesthetic procedures are explored. Furthermore, this review investigates safety concerns, including adverse reactions, infection risks, and long-term safety implications. Looking to the future, emerging technologies, combination therapies, personalized medicine approaches, and regulatory developments are discussed, pointing towards an important and transformative era in wound healing and regenerative medicine. With its wide-ranging implications for healthcare, PRP activation has the potential to become a ubiquitous and essential therapeutic option, improving patient outcomes and reducing healthcare costs.

Activation-induced cytidine deaminase an antibody diversification enzyme interacts with chromatin modifier UBN1 in B-cells.

Activation-induced cytidine deaminase (AID) is the key mediator of antibody diversification in activated B-cells by the process of somatic hypermutation (SHM) and class switch recombination (CSR). Targeting AID to the Ig genes requires transcription (initiation and elongation), enhancers, and its interaction with numerous factors. Furthermore, the HIRA chaperon complex, a regulator of chromatin architecture, is indispensable for SHM. The HIRA chaperon complex consists of UBN1, ASF1a, HIRA, and CABIN1 that deposit H3.3 onto the DNA, the SHM hallmark. We explored whether UBN1 interacts with AID using computational and in-vitro experiments. Interestingly, our in-silico studies, such as molecular docking and molecular dynamics simulation results, predict that AID interacts with UBN1. Subsequently, co-immunoprecipitation and pull-down experiments established interactions between UBN1 and AID inside B-cells. Additionally, a double immunofluorescence assay confirmed that AID and UBN1 were co-localized in the human and chicken B-cell lines. Moreover, proximity ligation assay studies validated that AID interacts with UBN1. Ours is the first report on the interaction of genome mutator enzyme AID with UBN1. Nevertheless, the fate of interaction between UBN1 and AID is yet to be explored in the context of SHM or CSR.

CP110 and CEP135 localize near the proximal and distal centrioles of cattle and human spermatozoa.

Centrosomes play an important role in the microtubule organization of a cell. The sperm's specialized centrosome consists of the canonical barrel-shaped proximal centriole, the funnel-shaped distal centriole, and the pericentriolar material known as striated columns (or segmented columns). Here, we examined the localization of the centriole proteins CEP135 and CP110 in cattle and human spermatozoa. In canonical centrioles, CP110 is a centriole tip protein that controls cilia formation, while CEP135 is a structural protein essential for constructing the centriole. In contrast, we found antibodies recognizing CEP135 and CP110 label near the proximal and distal centrioles at the expected location of the striated columns and capitulum in cattle and humans in an antibody and species-specific way. These findings provide a pathway to understanding the unique functions of spermatozoan centrosome.

Tenosynovial giant cell tumour of the finger: a case report.

Giant cell tumour most commonly occuring in epiphysis of the long bone, present and with pain, tenderness and swelling. It is a solitary lesion with restricted movement and tenderness over the lesion. The tendon sheath is where tenosynovial giant cell tumours typically develop. Because of its remarkably peculiar position, we present a case of giant cell tumour (GCT) tenosynovial of bone in the middle phalaynx in a 33-year-old female with complaints of swelling, pain in ring finger of left hand since 2 months which is rarely seen. After clinical, radiological, pathological investigations tenosynovial giant cell tumour was diagnosed. Following fine needle aspiration cytology, histopathology was utilized to confirm the tumour's diagnosis which was later treated as resection of excision of the tumour with allo/autograft reconstruction. Our case report showed no evidence of recurrence in 2 years of follow-up. Hence our case report proves that early and complete resection of the tumour shows evidence of regain of complete range of motion and decrease recurrence rate.

IgG antibodies label the spermatozoan centriole of Drosophila melanogaster.

Centrioles are microtubule-based, barrel-shaped, subcellular organelles with evolutionarily conserved composition, structure, and function. Yet, in sperm cells, centrioles are remodeled, gaining species-specific composition and structure. The sperm centrioles of Drosophila melanogaster undergo dramatic remodeling, during which most known centriolar proteins are lost. Here, we find that IgG antibodies unexpectedly label Drosophila melanogaster spermatozoan centrioles . This labeling offers a simple method for marking the spermatozoan centriole, though it may interfere with testing new anti-centriolar antibodies using immunofluorescence.

Tubulin posttranslational modifications modify the atypical spermatozoon centriole.

Sperm cells are transcriptionally and translationally silent. Therefore, they may use one of the remaining mechanisms to respond to stimuli in their environment, the post-translational modification of their proteins. Here we examined three post-translational modifications, acetylation, glutamylation, and glycylation of the protein tubulin in human and cattle sperm. Tubulin is the monomer that makes up microtubules, and microtubules constitute the core component of both the sperm centrioles and the axoneme. We found that the sperm of both species were labeled by antibodies against acetylated tubulin and glutamylated tubulin.

Heterologous expression of hAID in E. coli leads to the production of a splice isoform of AID: hAIDδC, a mystery to be explored.

Activation-induced cytidine deaminase (AID) is a key player that initiates antibody diversification in activated B-cell. AID mediates somatic hypermutation (SHM) and class switch recombination (CSR) via the deamination of cytosine to uracil at the Ig locus, resulting in the production of high-affinity antibodies. AID is predominantly restricted to Ig genes, whereas off-targeting of AID leads to lymphocyte-related malignancies. Interestingly, apart from FL-AID other splice isoforms of AID are highly expressed in the lymphocyte malignancies. In our study, we found that the heterologous expression of hAID-FL in E. coli cells produced two induced bands of hAID as demonstrated by SDS-PAGE and western blotting. Remarkably, peptide mapping data predicted that one band is hAID-FL and the other is its splice isoform, hAIDδE4a. To get an insight into why E. coli cells expressed hAID-FL and hAID variant, we mutated the 5' and 3' splice site of a putative intron of hAID, but it failed to produce only hAID-FL. Incidentally, hAID expressed with fusion partners also displayed two bands, and peptide mapping data strongly suggest that besides hAID-FL, the lower band showed a significant number of amino acids missing towards the C-terminal domain (named as hAIDδC). Our results are the first report to show that expression of recombinant hAID alone or irrespective of solubilization tags in E. coli cells produced hAID-FL and hAIDδC. It will be fascinating to explore the potential mechanism underlying the expression of hAIDδC from recombinant hAID plasmid in E. coli cells.

Disease Characteristics, Care-Seeking Behavior, and Outcomes Associated With the Use of AYUSH-64 in COVID-19 Patients in Home Isolation in India: A Community-Based Cross-Sectional Analysis.

Background: During the second wave of the COVID-19 pandemic in India, the Ministry of Ayush conducted a community study to provide therapeutic care to patients with asymptomatic, mild, and moderate COVID-19 in home isolation based on the empirical evidence generated on the efficacy of AYUSH-64 in COVID-19. Objective: To document disease characteristics, care-seeking behavior, and outcomes in patients with asymptomatic, mild, or moderate COVID-19 in home isolation who used AYUSH-64 for COVID-19. Methods: Cross-sectional analysis of the data generated through a community study conducted in India from 08 May to 31 August 2021 was performed to study the disease characteristics, care-seeking behavior during home isolation, clinical outcomes, adverse events, and the association between various risk factors and clinical recovery during the study period. The data were collected through semi-structured questionnaires, available in electronic data collection format at the baseline, 7, 14, and 21 days. A logistic regression was performed to explore the relationship between relevant variables and clinical recovery. Results: Data from 64,642 participants were analyzed for baseline assessment, and final analysis was done for 49,770 participants. The mean age of the enrolled participants was 38.8 ± 11.7 years, and 8.4% had co-morbidities. AYUSH-64 was utilized as an add-on to the standard care by 58.3% of participants. Comparable clinical outcomes were observed in participants utilizing AYUSH-64 either as a standalone or as an add-on to standard care, in terms of clinical recovery, disease progression, the requirement for oxygen supplementation, hospitalization, ICU admission, and need for ventilator support. Younger age, having no co-morbidities or substance abuse, and having been vaccinated were associated with early clinical recovery than those who were older and not vaccinated. Conclusions: The study findings suggest that AYUSH-64 use, either standalone or as an adjunct to standard care, in asymptomatic, mild, or moderate COVID-19 is associated with good clinical outcomes. Ayush services and interventions can be effectively integrated into the mainstream public health architecture to serve public health goals.

Sperm centriole assessment identifies male factor infertility in couples with unexplained infertility - a pilot study.

Unexplained infertility affects about one-third of infertile couples and is defined as the failure to identify the cause of infertility despite extensive evaluation of the male and female partners. Therefore, there is a need for a multiparametric approach to study sperm function. Recently, we developed a Fluorescence-Based Ratiometric Analysis of Sperm Centrioles (FRAC) assay to determine sperm centriole quality. Here, we perform a pilot study of sperm from 10 fertile men and 10 men in couples with unexplained infertility, using three centriolar biomarkers measured at three sperm locations from two sperm fractions, representing high and low sperm quality. We found that FRAC can identify men from couples with unexplained infertility as the likely source of infertility. Higher quality fractions from 10 fertile individuals were the reference population. All 180 studied FRAC values in the 10 fertile individuals fell within the reference population range. Eleven of the 180 studied FRAC values in the 10 infertile patients were outliers beyond the 95% confidence intervals (P = 0.0008). Three men with unexplained infertility had outlier FRAC values in their higher quality sperm fraction, while four had outlier FRAC values in their lower quality sperm fraction (3/10 and 4/10, P = 0.060 and P = 0.025, respectively), suggesting that these four individuals are infertile due, in part, to centriolar defects. We propose that a larger scale study should be performed to determine the ability of FRAC to identify male factor infertility and its potential contribution to sperm multiparametric analysis.

Extreme Lengthening of Tibia Using Bone Transport Technique: A Rare Case Report.

This is a case describing a 13-year-old female student having a history of a fall-developed wound over the anterior aspect of the right leg with discharging sinus treated as chronic osteomyelitis and operated and distal tibia corticotomy and Ilizarov fixation was done. The patient was full of complications, but full limb lengthening was restored with follow-up. The Ilizarov frame's proper installation and the middle segment's efficient transportation are essential variables in reducing the likelihood of the transported segment deviating.

Unfolding the Role of Splicing Factors and RNA Debranching in AID Mediated Antibody Diversification.

Activated B-cells diversify their antibody repertoire via somatic hypermutation (SHM) and class switch recombination (CSR). SHM is restricted to the variable region, whereas, CSR is confined to the constant region of immunoglobulin (Ig) genes. Activation-induced cytidine deaminase (AID) is a crucial player in the diversification of antibodies in the activated B-cell. AID catalyzes the deamination of cytidine (C) into uracil (U) at Ig genes. Subsequently, low fidelity repair of U:G mismatches may lead to mutations. Transcription is essential for the AID action, as it provides a transient single-strand DNA substrate. Since splicing is a co-transcriptional event, various splicing factors or regulators influence the transcription. Numerous splicing factors are known to regulate the AID targeting, function, Ig transcription, and AID splicing, which eventually influence antibody diversification processes. Splicing regulator SRSF1-3, a splicing isoform of serine arginine-rich splicing factor (SRSF1), and CTNNBL1, a spliceosome interacting factor, interact with AID and play a critical role in SHM. Likewise, a splicing regulator polypyrimidine tract binding protein-2 (PTBP2) and the debranching enzyme (DBR1) debranches primary switch transcripts which later forms G-quadruplex structures, and the S region guide RNAs direct AID to S region DNA. Moreover, AID shows several alternate splicing isoforms, like AID devoid of exon-4 (AIDΔE4) that is expressed in various pathological conditions. Interestingly, RBM5, a splicing regulator, is responsible for the skipping of AID exon 4. In this review, we discuss the role and significance of splicing factors in the AID mediated antibody diversification.

G-quadruplex stabilization in the ions and maltose transporters gene inhibit Salmonella enterica growth and virulence.

The G-quadruplex structure is a highly conserved drug target for preventing infection of several human pathogens. We tried to explore G-quadruplex forming motifs as promising drug targets in the genome of Salmonella enterica that causes enteric fever in humans. Herein, we report three highly conserved G-quadruplex motifs (SE-PGQ-1, 2, and 3) in the genome of Salmonella enterica. Bioinformatics analysis inferred the presence of SE-PGQ-1 in the regulatory region of mgtA, SE-PGQ-2 in ORF of entA, and SE-PGQ-3 in the promoter region of malE and malK genes. The G-quadruplex forming sequences were confirmed by biophysical and biomolecular techniques. Cellular studies affirm the inhibitory effect of G-quadruplex specific ligands on Salmonella enterica growth. Further, PCR inhibition, reporter based assay, and RT-qPCR assays emphasize the biological relevance of G-quadruplexes in these genes. Thus, this study confirmed the presence of G-quadruplex motifs in Salmonella enterica and characterized them as a promising drug target.