Cystic Ovarian Mucinous Carcinoma With Carcinosarcomatous Mural Nodules: An Uncommon Entity.

Mural nodules in ovarian mucinous cystic tumors are uncommon, with only 80 cases reported over the last 30 yr. The literature describes only 5 cases of carcinosarcomatous mural nodules with mucinous ovarian neoplasm. We compared and summarized the literature related to mural nodules in mucinous ovarian tumors to elaborate on the clinical and histomorphologic features. A 21-yr-old woman presented with 2 mo history of abdominal distension. Physical examination showed a palpable pelvic mass. Radiologic investigation showed a 31×18.6×25 cm large right ovarian cyst. Few nodular solid masses were also seen, the largest mass measured 3.5×3.1 cm. On histomorphology and immunohistochemistry, it was a mucinous ovarian carcinoma with carcinosarcomatous mural nodules. Carcinosarcomatous mural nodules with ovarian mucinous neoplasm affects younger females. It presents at an early stage and does not carry an adverse prognosis.

Papillary Endothelial Hyperplasia of Scalp with Bone Erosion: A Case Report with Review of Literature.

BACKGROUND: Papillary endothelial hyperplasia (PEH) is a reactive pseudoneoplastic proliferation of endothelial cells. They are typically well-circumscribed, indolent lesions and curable by complete excision. Description: We present a four-year-old girl with post traumatic scalp swelling, clinically considered to be a capillary hemangioma. Computed tomography revealed a 3.3 × 1.5 cm scalp mass with erosion of outer table and diploic space of the occipital calvarial bone, suggesting a vascular or soft tissue tumor. Histologically it was a PEH within a hemangioma. Literature Review: PEH presenting as a scalp swelling with bone erosion has only been reported thrice in the literature. Conclusion: Scalp PEH with skull bone defect can affect the pediatric age group. Bone erosion is not stage dependent; it can occur in the early stages.

Leptin levels in gingival crevicular fluid during canine retraction: in vivo comparative study.

OBJECTIVE: To evaluate and compare the leptin levels in gingival crevicular fluid (GCF) and rate of canine retraction using an elastomeric chain and nickel-titanium (NiTi) closed coil spring. DESIGN: In vivo, clinical study. SETTING: Orthodontic department at ITS Centre for Dental Studies and Research, Ghaziabad, India. PARTICIPANTS: Twenty-seven patients reported to the Department of Orthodontics at ITS Centre for Dental Studies and Research. METHODS: Twenty-seven patients were included in the study in which canine retraction was carried out with an elastomeric chain and NiTi closed coil spring on either side of the arch applying 150 g of force on both sides. GCF samples were collected before the commencement of canine retraction, on the first, seventh and 21st day after application of force and were analysed for leptin levels by the ELISA technique. Impressions for the study model were taken at baseline and after 21 days to measure the rate of tooth movement bilaterally with an electronic digital calliper. RESULTS: The results obtained within both groups showed a significant decrease in leptin levels from baseline to 21 days ( P = 0.0001). There was no significant difference in leptin levels between both groups, but leptin levels decreased more in the NiTi closed coil spring group. The rate of tooth movement is not significantly different between both groups, but space closure is faster in the NiTi closed coil spring group. CONCLUSIONS: Leptin levels in GCF showed a significant decrease during canine retraction using an elastomeric chain and NiTi coil spring; there was no significant difference in the rate of tooth movement between both the groups.

Immediate Placement and Restoration of Implant in Periapical Infected Site in the Maxillary Esthetic Zone: A Case Report.

Immediate placement and restoration of the implant is a widely used protocol, but loading of implants in the site which is periapically infected is still not very popular. Very few studies have been conducted and its still in debate. The conventional protocol of placing implant and waiting for it to osseointegrate is time consuming and compromises patients esthetics and psychological comfort. This report presents a case of immediate placement and restoration of implant in the region with periapical infection.

Pancreatic neuroendocrine tumor with abundant mitochondria.

ABSTRACT: A 40-year-old woman presented with dull, boring periumbilical region pain radiating to the back and vomiting for 1 year. Magnetic resonance cholangiopancreatography detected a polypoid growth in the ampullary region. The patient underwent Whipple's procedure. The specimen revealed a 4.9 × 4.5 × 3.7 cm tumor arising from the pancreas, abutting the posterior pancreatic surface and infiltrating the terminal common bile duct and the ampulla. Microscopic examination showed a pancreatic tumor composed of neuroendocrine cells. In addition, many large foci showing solid sheets of oncocytic cells with abundant granular eosinophilic cytoplasm were observed. Immunohistochemistry studies revealed positivity for synaptophysin, chromogranin, and Ki67 index above 70%. A diagnosis of oncocytic neuroendocrine tumor of Grade 3 was made. In electron microscopy, oncocytic cells showed abundant mitochondria dispersed throughout the cytoplasm. Oncocytic pancreatic neuroendocrine neoplasms are uncommon and can be diagnosed only on histopathological examination. These tumors tend to show a malignant behavior.

Efficacy of sucrose application in minimizing pain perception related to dental injection in children aged 3 to 9 years: a randomized control trial.

Background: Dental fear and anxiety are significant challenges in managing behavior in children. Oral administration of sucrose or sweet-tasting solutions has shown effectiveness in reducing procedural pain in infants and neonates. This study aimed to investigate whether pre-application of sucrose solution had an effect on minimizing pain perception during injection and to assess the potential impact of the child's age and sweet preference. Methods: A randomized control clinical trial was conducted on 60 children aged 3-9 years requiring buccal infiltration injections. Following parental consent, demographic data of the children were recorded. Sweet preferences was assessed using a modified forced-choice test. Children were equally and randomly allocated into study (sucrose) and control groups using a lottery method. Sucrose solution or distilled water, respectively, was applied to the lateral surface of the tongue for 2 min. Topical anesthetic was applied at the site of injection, followed by local anesthesia administration. The children rinsed their mouths thrice with water immediately after anesthetic injection. A video was recorded during injection which was then scored by three blinded examiners on the Sound Eye Motor (SEM) scale. The children also self-evaluated using Wong-Baker Faces Pain Rating Scale (WBFPS). Results: The mean SEM scores and WBFPS scores were analyzed using the Kruskall-Wallis test. The mean SEM score in the study group was 1.37 ± 0.61, compared to 3.17 ± 0.87 in the control group, showing a statistically significant difference (P < 0.001). Mean pain scores assessed by WBFPS in the study group were 0.60 ± 1.4, while in the control group, they were 6.27 ± 2.33, also showing a statistically significant difference (P < 0.001). Children with a sweet preference demonstrated a subjective reduction in pain perception. Conclusion: Application of sucrose before dental injections in children helps to minimize pain upon injection across all age groups.

Air-Abrasion in Dentistry: A Short Review of the Materials and Performance Parameters.

The selection of abrasive material and parameters of the Air-Abrasion device for a particular application is a crucial detail. However, there are no standard recommendations or manuals for choosing these details; the operator must depend on his experience and knowledge of the procedure to select the best possible material and set of parameters. This short review attempts to identify some of the effects that the selection of material and parameters could have on the performance of the Air-Abrasion procedure for a particular application. The material and parameter data are collected from various studies and categorized according to the most popular materials in use right now. These studies are then analyzed to arrive at some inferences on the performance of Air-Abrasion materials and parameters. This review arrives at a few conclusions on the effectiveness of a material and parameter set, and that there is potential for developments in the area of standardizing parameter selection; also, there is scope for further studies on Bio-Active Glass as an alternative to the materials currently used in Air-Abrasion.

4-[(4-Benzyl-oxybenzyl-idene)amino]-1,5-dimethyl-2-phenyl-1H-pyrazol-3(2H)-one.

In the title mol-ecule, C(25)H(23)N(3)O(2), two terminal phenyl rings are twisted by 50.20 (6) and 71.26 (5)° from the mean plane (r.m.s. deviation = 0.032 Å) of the central benzyl-idene-amino-pyrazolone fragment. The N atoms of the pyrazole ring have a pyramidal environment, the sums of the valence angles around them being 353.5 (2) and 347.3 (2)°. The crystal structure is stabilized by C-H⋯O interactions.

N-(3-Chloro-4-fluoro-phen-yl)acetamide.

In the title compound, C(8)H(7)ClFNO, the dihedral angle between the benzene ring and the acetamide side chain is 5.47 (6)°. An S(6) ring motif is formed via an intra-molecular C-H⋯O hydrogen bond. In the crystal, N-H⋯O hydrogen bonds link the mol-ecules into C(4) chains along [001].

N'-(2,6-Difluoro-benzyl-idene)pyridine-4-carbohydrazide.

In the title compound, C(13)H(9)F(2)N(3)O, the pyridine ring forms a dihedral angle of 16.92 (7)° with the benzene ring. In the crystal, mol-ecules are linked via N-H⋯O, C-H⋯O and C-H⋯F, with the same O atom accepting two bonds.

4-Methyl-benzoic acid-N'-[(E)-4-methyl-benzyl-idene]pyridine-4-carbohydrazide-water (1/1/1).

In the title hydrated 1:1 adduct, C(8)H(8)O(2)·C(14)H(13)N(3)O·H(2)O, the Schiff base mol-ecule exists in an E conformation with respect to the N=C bond [1.2843 (13) Å] and the dihedral angle between the pyridine ring and the benzene ring is 1.04 (5)°. In the crystal, mol-ecules are linked by N-H⋯O, C-H⋯O, O-H⋯O and O-H⋯N hydrogen bonds into sheets lying parallel to the ab plane. The crystal structure also features π-π inter-actions with centroid-centroid distances of 3.6224 (6) and 3.7121 (6) Å.

2-Chloro-1-(4-hy-droxy-phen-yl)ethanone.

The asymmetric unit of the title compound, C(8)H(7)ClO(2), consists of two independent mol-ecules, with comparable geometries. Both mol-ecules are approximately planar (r.m.s. deviations = 0.040 and 0.064 Šfor the 11 non-H atoms). In the crystal, mol-ecules are linked via inter-molecular O-H⋯O and C-H⋯O hydrogen bonds into chains two mol-ecules thick along (-101).

N'-[(E)-4-Chloro-benzyl-idene]pyridine-4-carbohydrazide monohydrate.

The asymmetric unit of the title compound, C(13)H(10)ClN(3)O·H(2)O, consists of two crystallographically independent Schiff base mol-ecules which exist in an E conformation with respect to the C=N double bond, and two independent water mol-ecules. In the crystal, the Schiff base and water mol-ecules are linked into a three-dimensional network via N-H⋯O, O-H⋯N, O-H⋯O and C-H⋯O hydrogen bonds. The crystal studied was a pseudo-merohedral twin with twin law (101 0-10 00-1) and a component ratio of 0.792 (2):0.208 (2).

Pediatric Mesenchymal Hamartoma of Liver: A Case Report with Histomorphological Differential Diagnosis and Review of Literature.

Mesenchymal hamartoma of liver (MHL) is a benign liver tumour that occurs mainly in children, especially those under 2 years old. The pathogenesis of this tumor is still unknown. It is believed that MHL is derived from the Ito cells and either a developmental malformation of primitive hepatic mesenchyme; result of toxic or ischemic insult; or a true neoplasm. It is amenable to treatment and has a good prognosis but presents with varied clinical, imaging and histological findings. However, it can be confused with other hepatic tumors and can mimic malignancy. Therefore, it is important to recognize this rare entity to avoid unnecessary over management. We present a case of MHL in a 3-year-old boy with abdominal distension. Based on the clinical presentation, laboratory and radiological findings a diagnosis of complex cyst of liver was made. A final diagnosis of MHL was given after histopathological examination.

An in vitro Investigation of the Sealing Ability of Biodentine and Mineral Trioxide Aggregate as Retrofilling Materials after the use of Various Irrigating Solutions.

Aim: The purpose of this study was to assess the sealing ability of Biodentine (BD) and mineral trioxide aggregate (MTA) as retrograde filling materials after irrigation with 17% ethylenediaminetetraacetic acid (EDTA) and QMix irrigating solutions. Materials and Methods: Decoronation of 48 permanent maxillary central incisors was done. Root canal instrumentation was carried out in the samples. The apical root was resected for about 3 mm and retrocavities were prepared. Teeth were allocated into two groups (n = 24). MTA was used in Group 1. BD was used in Group 2. Depending on irrigation, the groups were subdivided A, B, and C subgroups. Group A - 0.9% saline; Group B - 17% EDTA; and Group C - QMix were used. The resected root end was irrigated with 5 ml of all irrigating solutions for 1 min. After final irrigation, cavities were filled with retrofilling materials in each group. Nail enamel was applied to the surfaces of the roots apart from the resected end. Roots were placed in India ink for 72 h. Teeth were sectioned longitudinally and microleakage was determined with a stereomicroscope. Statistical Analysis: Analysis was done using the one-way analysis of variance, Independent t-test, and post hoc test. Results: Statistically significant difference in the degree of microleakage was observed between irrigating solutions and the retrofilling materials. Conclusion: BD exhibits a better sealing ability compared to MTA as a retro filling material following QMix irrigation.

Orthodontic bond strength with the use of non-aerosol producing bonding primers in lieu of conventional primers: An in vitro evaluation.

OBJECTIVE: To evaluate the efficacy of non-aerosol producing restorative self-etching primers (SEPs) as a substitute for conventional orthodontic bonding primers and to analyze the extent of residual composite on the tooth post-debonding. MATERIALS AND METHODS: Eighty-four extracted human premolars were randomly divided into seven groups based on the adhesive and the bonding protocol used. The study comprised Prime and Bond one select (Dentsply), G-Premio Bond (GC), which were each divided into three subgroups based on the method used for moisture control and the control group (Transbond XT conventional total etch). The three methods for moisture control in study groups were: without drying, air-drying with the use of a three-way syringe, and with the use of blotting paper. Shear bond strength (SBS) was tested using a universal testing machine (UTM), and after debonding, the enamel surface of each tooth was examined under 10× magnification to evaluate adhesive remaining index (ARI) scores. RESULTS: Groups 2A (Prime and Bond; without drying) & 1 (Transbond XT) had the lowest and highest SBS values, respectively (P = 0.001). Comparison of ARI between the control group and group 2b (Prime and Bond; air-drying with 3 in 1) showed a significant difference (P = 0.041). Comparison of ARI between control group and group 2c (Prime and Bond; blotting paper) showed a significant difference (P = 0.017). Rest all other comparisons were non-significant. CONCLUSIONS: Transbond XT had SBS values higher than the self-etch groups. Among the self-etch groups, G-Premio Bond had higher SBS values when the traditional methods of air-drying were followed. Use of blotting paper for drying that produced variable SBS values can be an effective alternative method. G-Premio Bond with its adequate bond strength under manufacturer's instruction seems promising in this regard.

Cytomorphologic analysis of dyshormonogenetic goiter.

Dyshormonogenetic goiter is a rare cause for congenital hypothyroidism because of the lack of enzymes needed for the synthesis of thyroid hormones. They are usually treated with hormonal treatment. Cytomorphological features can lead to misdiagnosis of malignancy. Elaboration on the cytomorphological features of dyshormonogenetic goiter is scarce, with only four case reports in the literature. We present a case of a child with dyshormonogenetic goiter, highlighting its cytological features, and common differential diagnosis. We also compared cytomorphologic features with other cases reported in the literature.

Primary Versus Secondary NAFLD: Perspective on Advanced Fibrosis.

BACKGROUND: The presence of macrovesicular steatosis on liver biopsy is the commonest histopathological finding. Nonalcoholic fatty liver disease (NAFLD) is the presence of ≥5% macrovesicular steatosis without significant alcohol use. It is subdivided into primary and secondary NAFLD; information on their differences is limited. AIM: To determine the histopathological differences between primary and secondary NAFLD and establish whether the prevalence of advanced fibrosis varies between the two types. METHODOLOGY: Three years of retrospective study of 90 liver biopsies with ≥5% macrovesicular steatosis. Age, gender, clinical history, serum transaminase levels were noted. The biopsy was reviewed for steatosis, inflammation, and fibrosis. Differences between primary and secondary NAFLD for age, gender, AST/ALT ratio, histopathological features were determined. Descriptive statistical analysis, 2-tailed Student's t test, Chi-square test, Fisher's exact test were used, where p < 0.05 was considered significant. RESULT: Primary and secondary NAFLD were 42 (46.7%) and 48 (53.3%), respectively. Inflammation was noted in 50 (55.5%) and fibrosis in 31 (34.4%). The prevalence of advanced fibrosis was 24.4%. Primary and secondary NAFLD differed significantly on ballooning degeneration, Mallory Denk bodies (MDBs), glycogenated nuclei, and fibrosis stage (p < 0.05). There were no significant differences among AST/ALT ratio, steatosis, and inflammation grade. CONCLUSION: Primary NAFLD is a more severe type of liver disease. On histopathology, ballooning degeneration, MDBs, glycogenated nuclei, and advanced fibrosis was more prevalent in primary than secondary NAFLD.

Comparison of two different initial archwires for tooth alignment during fixed orthodontic treatment-A randomized clinical trial.

OBJECTIVES: The aim of the study was to clinically evaluate and compare 0.016-inch superelastic nickel-titanium (NiTi) and 0.016-inch heat-activated nickel-titanium (NiTi) archwires in terms of alignment efficiency, root resorption, and pain intensity. METHOD: A total of 20 patients requiring fixed orthodontic treatment, having Little's irregularity index of 5-8, and requiring first premolar extractions were recruited. They were randomly allocated to receive two different archwires (0.016-inch superelastic NiTi or 0.016-inch thermoelastic NiTi). Good-quality impressions were taken of the lower arch before archwire placement (T0) and at every month after that till the alignment was complete. The rate of tooth alignment was measured on casts by determining Little's irregularity index. The pain experienced by the patient was assessed 24 hours and 1 week after the placement of the archwire on a visual analogue scale. Cone beam computed tomographic radiographs of lower anterior teeth were taken before and after alignment to assess root resorption. Data obtained were subjected to statistical analysis using the SPSS software (version 20.0). The level of significance was kept at 5%. RESULTS: The repeated measures ANOVA indicated that there was no significant difference in the aligning efficiency of superelastic and heat-activated NiTi wires. (p = 0.45). The Mann Whitney U test showed that superelastic NiTi wires had statistically significant higher VAS scores than heat-activated NiTi at 24 hours and 1-week interval (p < 0.05). Student's t-test indicated greater root resorption with superelastic NiTi but the difference was not statistically significant. CONCLUSION: Both the wires showed similar aligning efficiency and resulting root resorption. Superelastic NiTi was observed to produce more pain compared to heat-activated NiTi in the aligning phase.

Efficient removal of 2,6-xylidine precipitate using different agitation protocols: An in vitro field emission scanning electron microscopic study.

Background: Any solution of chemical nature when combined will result in the formation of a precipitate, which in the root canal system will interfere with the hermetic seal. In clinical practice presence of any precipitate, especially carcinogenic in nature, should be eliminated. Aim: To evaluate whether final irrigation with different agitation protocols will remove the precipitate formed following lidocaine hydrochloride and sodium hypochlorite combination at the coronal, middle, and apical-root thirds. Materials and Methods: Forty-four uniradicular teeth were standardized at 17 mm. All specimens were injected with 2% lidocaine hydrochloride and 2.5% sodium hypochlorite, followed by mechanical instrumentation using rotary files. Further, specimens were arbitrarily divided into four groups (n = 11) based on the final irrigation protocol: Group 1: No irrigation; Group 2: Manual irrigation; Group 3: Mechanical irrigation; Group 4: Ultrasonic irrigation. Samples were sectioned and Field Field Emission Scanning Electron Microscopic (FESEM) analysis of the canal wall was done at coronal, middle, and apical thirds. Results: FESEM images revealed occluded dentinal tubules with the presence of precipitate seen in all-thirds of each specimen. Conclusion: No irrigation protocol was successful in removing the precipitate formed; but when compared ultrasonic irrigation had the least precipitate seen at-coronal,-middle and apical thirds.