Pediatric head and neck squamous cell carcinoma: A retrospective observational study

BACKGROUND

Pediatric head and neck squamous cell carcinoma is very rare. Limited data are available in English literature on this issue due to paucity of cases. Hence, we retrieved data of pediatric head and neck cancer in younger age group (≤20 years of age) for evaluation of clinicopathological characteristics, treatment, and outcome of this emerging issue.

MATERIALS AND METHODS

A retrospective observational study was conducted from January 2011 to December 2015 in our Department of Radiotherapy. A total of nine patients of age 20 years or younger were identified during this period for analysis in this study. Various parameters such as age, clinical features, clinical stage, and the treatment received by the patients were recorded and analyzed for outcome.

RESULTS AND DISCUSSION

Median age of presentation was 19 years with male:female ratio 8:1. The most common subsite involved was tongue > buccal mucosa > tonsil > retromolar trigone. Surgery was preferred treatment modality followed by adjuvant therapy (radiotherapy/chemotherapy). Complete response was shown in 62% cases. Disease progression was found in 25% of cases. On median follow-up of 8 months, 25% of patients had developed local recurrence, none showed metastatic disease.

CONCLUSION

The rarity of these tumors inevitably results in a paucity of high-level evidence to guide treatment. It has a high impact on the quality of life, cosmetic outcomes, and secondary malignancies may develop with increased survival. More clinical studies to be conducted to establish etiopathological characteristic and treatment guidelines in this issue.

Spectrum of cancer in adolescents and young adult: An epidemiological and clinicopathological evaluation

INTRODUCTION

Changing scenario of cancer in adolescents and young adult (AYA) age group becomes an emerging and alarming problem. The age span that falls under the AYA umbrella, i.e., 15-29 years, is broad and having unique characteristic as compared to older and pediatric cohort. Only a few data are available in English literature about this age group where the spectrum of cancer varies accordingly as the function of age.

OBJECTIVE

The aim of this study was to evaluate the incidence and pattern of tumor in adolescents and young age group.

MATERIALS AND METHODS

A retrospective observational study was done at a tertiary care center. Medical records of patients aged 15-29 years registered from 2011 to 2015 were retrieved for analysis.

RESULTS

Incidence rate of malignancy in AYA age is 5.71% in this observational study. Male:female ratio was 1.81:1. Most common cancer in this age group was head and neck cancer > central nervous system > gastrointestinal tract in the entire cohort.

CONCLUSION

The malignancy spectrum, their subtypes, and demographic distribution in the AYA cohort have diversity among different cancer centers within India as well as in different countries across the world.

Squamous cell carcinoma of the oral cavity and oropharynx in young adults

BACKGROUND

Head and neck squamous cell carcinoma (SCC) is a disease of older age group predominately in the sixth and eighth decades of life. The incidence of oral SCC (young age <40 years) varies between 0.4% and 3.9%. There has been increasing trend in younger age group worldwide as well as in India as reported by many studies.

AIM

The aim of the present study was to compare the clinicopathological profile, treatment, and outcomes of SCC of oral cavity and oropharyngeal cancer in the young age group of <40 years old.

MATERIALS AND METHODS

This retrospective observational study was done by retriving data of selected cohort from 2013 to 2015. Patients were divided into 2 groups: Group 1 (10-30 years) and Group 2 (31-40 years) for comparison. SPSS Version 16 software was used for statistical analysis.

RESULTS

Cohort of 217 patients was analyzed. The male:female ratio was 11:1. The most frequent site of primary tumor was tongue > buccal mucosa. The primary site of cancer as oropharynx was present in 3 (5.17%) and 22 (13.83%) patients, respectively, in two groups. Mean overall survival (OS) in two groups was 22.53 and 25.14 months, respectively (P = 0.119). The median disease-free survival (DFS) in two groups was 7 and 8 months, respectively.

CONCLUSION

The present study showed that the incidence of oropharyngeal cancer increases with age, but the behavior is more aggressive in a younger age group in spite of aggressive treatment, the DFS and OS were not improved in under 30 years group.

Size control synthesis and characterization of ZnO nanoparticles and its application as ZnO-water based nanofluid in heat transfer enhancement in light water nuclear reactor

A novel and facile approach for size-tunable synthesis of ZnO nanoparticle (NPs) is reported. Size-tuning was attained by using PEG (polyethylene glycol) of molecular weights 400 and 4 000. ZnO NPs was synthesized using homogeneous chemical precipitation followed by hydrothermal. Here triethylamine (TEA) was used as a hydroxylating agent. As-synthesized ZnO NPs were characterized by powder X-ray diffraction (XRD), transmission electron microscopy (TEM) and Energy Dispersive Spectroscopy (EDS) analysis. Synthesized ZnO nanoparticle was used for the preparation of ZnO-water based nanofluid and its application in heat transfer enhancement in light water nuclear reactor. In this work, ZnO-water based nanofluid of different volume concentration (1 percnt;, 2 percnt; and 3 percnt;) and particle size of 10 nm and 20 nm is used for enhancement in heat transfer in annular channel by using two phase approach. The particle size of 10 nm gives better result for enhancing the heat transfer rate in comparison to 20 nm particle size in nuclear reactor.

Abstract P4-14-01: POWER-remote: A randomized study evaluating the effect of a remote-based weight loss program in women with early stage breast cancer

Background: The majority of women diagnosed with breast cancer are overweight or obese, and gain weight after diagnosis. The Practice-based Opportunities for Weight Reduction (POWER) study reported that, in an obese population with cardiovascular risk factors, a scalable remote weight loss intervention with web support was equally effective to an in-person intervention (Appel NEJM 2011). We adapted the remote intervention for breast cancer survivors.

Methods: We conducted a phase II single-blind trial in which women with stage 0-III breast cancer and a BMI ≥25 were randomized to a remotely-delivered weight loss intervention with a study specific website (POWER-remote) or to self-directed weight loss. Participants were stratified by menopausal status and concomitant hormone therapy use. Weight was assessed at baseline, 6 and 12 months. The primary objective was to compare the proportion of women who lost ≥5% of their baseline body weight after 6 months in the POWER-remote and the self-directed arms. A sample size of 80 patients yielded approximately 93.6% power to detect a difference in weight loss response of 19.0% in the self-directed arm and 38.2% in the POWER-remote arm with a one-sided type I error of 10%. We obtained blood samples for correlative studies including inflammatory biomarkers and assessment of telomere length at baseline and 6 months.

Results: From 2013-2015 we enrolled 96 women; 84 were evaluable for the primary analysis. Both cohorts had similar baseline characteristics including menopausal status, race (77% Caucasian and 20% African American in entire cohort), and BMI (average mean 32 kg/m2). The majority (93%) of patients received endocrine therapy, and 55% had completed chemotherapy. At 6 months 43.1% (95% CI 29.3–57.8) of women randomized to POWER-remote had lost ≥5% of their baseline body weight, compared to 11.1% (95% CI 3.7–24.1) in the self-directed arm, p&lt;0.001. A significant difference continued at 12 months, and was observed in all subgroups (Table 1). Biomarker analysis will be presented at the meeting.

Table 1. Proportion of patients achieving ≥5% weight loss after 6 and 12 months POWER-remotePOWER-remoteSelf-DirectedSelf-Directed   n% [95% CI]n% [95% CI]p-valueInteraction p-value for heterogeneity of treatment effectLost &gt;=5% of baseline weight at 6 months      All patients4343.1 [29.3, 57.8]4111.1 [3.7, 24.1]&lt;0.001 Endocrine therapy3545 [29.3, 61.5]3211.1 [3.1, 26.1]&lt; 0.0010.96No endocrine therapy836.4 [10.9, 69.2]911.1 [0.3, 48.2]0.11 Chemotherapy2126.9 [11.6, 47.8]253.7 [0.1, 19]0.010.64No chemotherapy2260 [38.7, 78.9]1622.2 [6.4, 47.6]0.01 Lost &gt;=5% of baseline weight at 12 months      All patients3031.4 [19.1, 45.9]3113.3 [5.1, 26.8]0.006 Endocrine therapy2632.5 [18.6, 49.1]2616.7 [6.4, 32.8]0.040.99No endocrine therapy427.3 [6, 61]50 [0, 33.6]0.05 Chemotherapy1119.2 [6.6, 39.4]167.4 [0.9, 24.3]0.070.72No chemotherapy1944 [24.4, 65.1]1522.2 [6.4, 47.6]0.07 

Conclusions: Sustained weight loss over 1 year is feasible in breast cancer survivors who undergo a remotely delivered weight loss intervention. Weight loss was observed irrespective of endocrine therapy or chemotherapy. These data will be used to design a new trial with a physical activity component.

Citation Format: Santa-Maria CA, Coughlin J, Blackford A, Carpenter A, Dalcin A, Huang C-Y, Luber B, Schreyer C, Armanios M, Sharma D, Chaudhry M, Jerome GJ, Snyder C, Appel L, Stearns V. POWER-remote: A randomized study evaluating the effect of a remote-based weight loss program in women with early stage breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-14-01.

Development and characterization of morin hydrate loaded microemulsion for the management of Alzheimer's disease

The aim of this study is to prepare and characterize intranasal delivery of morin hydrate loaded microemulsion for the management of Alzheimer's diseases. After intranasal delivery, brain and blood drug concentrations were found to be higher for optimized morin hydrate loaded microemulsion as compared to plain morin hydrate. Significant (P < 0.05) reduction in assessed pharmacodynamic parameters was observed after intranasal administration of morin hydrate loaded microemulsion as compared to sham control group. Daily chronic treatment with morin loaded microemulsion till the 21st day significantly increased the memory in wistar rats with STZ-induced dementia.

Pharmacophore modelling, atom-based 3D-QSAR generation and virtual screening of molecules projected for mPGES-1 inhibitory activity

COX-2 inhibitors exhibit anticancer effects in various cancer models but due to the adverse side effects associated with these inhibitors, targeting molecules downstream of COX-2 (such as mPGES-1) has been suggested. Even after calls for mPGES-1 inhibitor design, to date there are only a few published inhibitors targeting the enzyme and displaying anticancer activity. In the present study, we have deployed both ligand and structure-based drug design approaches to hunt novel drug-like candidates as mPGES-1 inhibitors. Fifty-four compounds with tested mPGES-1 inhibitory value were used to develop a model with four pharmacophoric features. 3D-QSAR studies were undertaken to check the robustness of the model. Statistical parameters such as r² = 0.9924, q² = 0.5761 and F test = 1139.7 indicated significant predictive ability of the proposed model. Our QSAR model exhibits sites where a hydrogen bond donor, hydrophobic group and the aromatic ring can be substituted so as to enhance the efficacy of the inhibitor. Furthermore, we used our validated pharmacophore model as a three-dimensional query to screen the FDA-approved Lopac database. Finally, five compounds were selected as potent mPGES-1 inhibitors on the basis of their docking energy and pharmacokinetic properties such as ADME and Lipinski rule of five.

Immunization with r-Lactococcus lactis expressing outer membrane protein A of Shigella dysenteriae type-1: evaluation of oral and intranasal route of administration

AIMS

To evaluate the comparative immunogenic potential of food grade Lactococcus lactis expressing outer membrane protein A (OmpA) of Shigella dysenteriae type-1 (SD-1) when administered either orally or intranasally.

METHODS AND RESULTS

OmpA of SD-1 was cloned and expressed first in Escherichia coli and then in L. lactis. Presence of recombinant gene was confirmed by restriction enzyme digestion and immunoblot analysis. Using immobilized metal affinity chromatography, OmpA was purified from recombinant E. coliBL21 (DE3) and subcutaneously administered in BALB/c mice. Detection of OmpA-specific IgG antibodies by enzyme-linked immunosorbent assay (ELISA) confirmed the immunogenicity of OmpA. In order to establish r-L. lactis as a mucosal delivery vehicle, it was administered orally and nasally in BALB/c mice. Serum IgG and faecal IgA were assessed through ELISA to compare the relative potential of immunization routes and immunogenic potential of r-L. lactis. Immunization via the oral route proved superior to intranasal exposure.

CONCLUSION

Recombinant L. lactis expressing OmpA of SD-1 was found to be immunogenic. Oral administration of r-L. lactis elicited higher systemic and mucosal immune response when compared with the nasal route.

SIGNIFICANCE AND IMPACT OF THE STUDY

Using food grade recombinant L. lactis has implications in the development of a prophylactic against multidrug-resistant Shigella, which can be used as a prospective vaccine candidate. Evaluating mucosal routes of immunization demonstrated that the oral route of administration elicited better immune response against OmpA of Shigella.

Co-delivery of indoleamine 2,3-dioxygenase prevents loss of expression of an antigenic transgene in dystrophic mouse muscles

A significant problem affecting gene therapy approaches aiming at achieving long-term transgene expression is the immune response against the protein product of the therapeutic gene, which can reduce or eliminate the therapeutic effect. The problem is further exacerbated when therapy involves targeting an immunogenic tissue and/or one with a pre-existing inflammatory phenotype, such as dystrophic muscles. In this proof-of-principle study, we co-expressed a model antigen, bacterial β-galactosidase, with an immunosuppressive factor, indoleamine 2,3-dioxygenase 1 (IDO1), in muscles of the mdx mouse model of Duchenne muscular dystrophy. This treatment prevented loss of expression of the transgene concomitant with significantly elevated expression of T-regulatory (Treg) markers in the IDO1-expressing muscles. Moreover, co-expression of IDO1 resulted in reduced serum levels of anti-β-gal antibodies. These data indicate that co-expression of genes encoding immunomodulatory enzymes controlling kynurenine pathways provide a viable strategy for preventing loss of transgenes targeted into dystrophic muscles with pre-existing inflammation.

Effect of TENS on stimulation of saliva in postmenopausal women with or without oral dryness - An interventional study

BACKGROUND

Decreased estrogen levels in postmenopausal women may cause an increase in oral symptoms including dry mouth, burning sensation of the mouth, and taste alterations. Management of salivary gland hypofunction by various modalities had been tried with variable results and associated side effects or discomfort.

AIM

To evaluate the effects of transcutaneous electric nerve stimulation (TENS) on whole salivary flow rate in postmenopausal females with and without oral dryness.

METHODS

Fifty postmenopausal women, based on their response to Xerostomia Inventory, were divided into 2 groups of 25 each; group 1 were postmenopausal women with oral dryness (PMD + OD) and group 2 were postmenopausal women without oral dryness (PMD - OD). Unstimulated whole saliva collection was done by low forced spitting method. External salivary stimulation of parotid gland by electrodes of TENS unit was done and sialometry was repeated. The salivary flow rates were compared within both groups before and after stimulation and between the two groups.

RESULTS

The mean salivary flow rates at baseline were statistically significantly lower in the PMD + OD group than the PMD - OD group. There was a mean increase of 0.33 ml and 0.46 ml with TENS stimulation in PMD + OD and PMD - OD groups, respectively.

CONCLUSION

Postmenopausal women with perception of oral dryness had lower salivary flow rates. 90% of the subjects, irrespective of oral dryness status, responded to TENS therapy. TENS stimulation resulted in a statistically significant increase in the quantity of whole saliva flow rate in postmenopausal women with or without oral dryness.

Impact of post-operative radiation on coronary arteries in patients of early breast cancer: A pilot dosimetric study from a tertiary cancer care center from India

BACKGROUND

The significant impact of postoperative radiotherapy (PORT) on cardiac morbidity in patients of early breast cancer (EBC) undergoing breast-conserving surgery has been shown in different studies. The present study was conducted to assess the impact of surgery and the side of involvement on radiation dose to left anterior descending artery (LAD) and Left circumflex coronary artery (LCx).

MATERIALS AND METHODS

Totally, 58 patients of EBC were randomly chosen for this dosimetric study and planned with tangential field technique without intensity modulation (IM). Heart, LAD, and LCx (n = 55) were contoured. Dose volume histograms were analyzed to determine the Dmax (maximum dose) and Dmean (mean dose) of LAD and LCx. Student's t-test was used for comparative analysis of the means.

RESULTS

The mean Dmax of LAD for left (L) EBC was 3.17 Gray (Gy) while for right (R) EBC it was 0.86 Gy (P = 0.007; 95% C.I, 1.14-3.48). The mean Dmean of LAD for L-EBC and R-EBC were 1.97 Gy and 0.79 Gy, respectively (P = 0.029; 95% C.I, 0.77-1.60). The mean-Dmax of LCx for patients with L-EBC (2.9 Gy; range: 1.2-4.35 Gy) was statistically higher than that for R-EBC (1.3 Gy; range: 0.7-3.2 Gy) (P = 0.045). The mean-Dmean of LCx for L-EBC (2.1 Gy; range: 0.6-3.6 Gy) was also significantly higher than that of L-EBC (0.9 Gy; range: 0.7-2.1 Gy) (P = 0.03). There was no significant impact of the pattern of surgery on LAD dose, but significance was noted for LCx dose parameters (P = 0.04 and 0.08 for m-Dmax and m-Dmean of LCx).

CONCLUSION

This pilot dosimetric study confirms the assumption that patients with left-sided EBC are at higher risk of developing long-term cardiac morbidity when treated with PORT due to increased dose to LAD.

Ochromobactrum intermedium: an emerging opportunistic pathogen-case of recurrent bacteraemia associated with infective endocarditis in a haemodialysis patient

We describe the first clinical case report of infective endocarditis related to Ochrobactrum intermedium infection. The case involved a 23-year-old man receiving dialysis via an internal jugular long-term haemodialysis catheter. He improved with a prolonged course of meropenem and minocycline. Ochrobactrum spp. are recognized as rare emerging opportunistic pathogens.

[Evaluation of a teaching tool for learning the surgical technique of inguinal orchidopexy]

INTRODUCTION

Practical training of the surgery resident is based on the companionship currently hampered in particular by the increase of the number of residents in training. We created a teaching tool to promote learning and validation of a technique of classic urologic surgery, inguinal orchidopexy. The objective is to evaluate the applicability and the relevance of this tool.

MATERIAL AND METHODS

The tool is a technical evaluation sheet made from reference documentation. The trainers evaluated the residents at 3 times of the semester (hetero-evaluation at 0, 3 and 6 months). Residents evaluated themselves monthly on the same items.

RESULTS

Three trainers and 6 residents in surgery participated in the study between May and November 2013. The initial evaluation confirmed that the theoretical knowledge was acquired prior to the practical learning. The level of residents was very uneven at the beginning of the study but not at the end of the semester. The monthly evaluations gave a progressive and significant increase of notes. The notes of the intermediate and final hetero-evaluations rose gradually and they were always superior to those previous self-assessments (P<0.05). The tool was considered simple and useful for the participants.

CONCLUSION

This tool is applicable and relevant to the technical teaching of inguinal orchidopexy in this population. A larger study would be helpful to confirm it. This type of tool could be applied to the simple and common surgery techniques to enrich the educational tools used in the training.

LEVEL OF EVIDENCE

4.

In Vitro Effects of Pioglitazone on the Expression of Components of Wnt Signaling Pathway and Markers of Bone Mineralization

Pioglitazone is an insulin-sensitizing thiazolidinedione (TZD) whose use is associated with bone loss. We examined the effects of pioglitazone on components of the Wnt signaling pathway (Wnt1, β-catenin) and markers of bone mineralization [osteoprotegerin (OPG), bone sialoprotein (BSP), fibroblast growth factor (FGF)23] as well as mineral content in human osteoblast hFOB 1.19 cells. hFOB 1.19 cells were cultured in K12/DMD medium with or without pioglitazone. PPARγ Wnt1, OPG, BSP, or FGF23 mRNA expression was measured using qRT-PCR; β-catenin, OPG, BSP, or FGF23 using ELISA; and calcium or phosphate content using colorimetry. Treatment with pioglitazone resulted in increased expression of PPARγ mRNA in hFOB 1.19 osteoblasts. Pioglitazone decreased Wnt1 mRNA levels and suppressed components of Wnt signaling pathway as evidenced by a decrease in β-catenin gene expression and secretion as well as β-catenin specific activity. The expression and the activity of OPG, BSP, and FGF23 were also reduced by pioglitazone together with total (but not specific) calcium and phosphate content. Pioglitazone affects Wnt1 signaling pathway and mineral matrix regulation components in human osteoblasts.

Spatio-temporal changes in glutathione and thioredoxin redox couples during ionizing radiation-induced oxidative stress regulate tumor radio-resistance

Ionizing radiation (IR)-induced oxidative stress in tumor cells is effectively managed by constitutive and inducible antioxidant defense systems. This study was initiated to understand the relative contribution of different redox regulatory systems in determining the tumor radio-resistance. In this study, human T-cell lymphoma (Jurkat) cells were exposed to IR (4 Gy) and monitored for the spatio-temporal changes in cellular redox regulatory parameters. We monitored the changes in the levels of reactive oxygen species (ROS) (total, mitochondrial, primary, and secondary), thiols (total, surface, and intracellular), GSH/GSSG ratio, antioxidant enzyme activity viz. thioredoxin (Trx), Trx reductase (TrxR), glutathione peroxidase, and glutathione reductase with respect to time. We have also measured protein glutathionylation. We observed that tumor cells mount a biphasic response after IR exposure which can be divided into early (0-6 h) and late (16-48 h) responses in terms of changes in cellular redox parameters. During early response, constitutively active GSH and Trx systems respond to restore cellular redox balance to pre-exposure levels and help in activation of redox-sensitive transcription factor Nrf-2. During late response, increase in the levels of antioxidants GSH and Trx rescue cells against IR-mediated damage. We observed that disruption of either glutathione or thioredoxin metabolism led to partial impairment of ability of cells to survive against IR-induced damage. But simultaneous disruption of both the pathways significantly increased radio sensitivity of Jurkat cells. This highlighted the importance of these two antioxidant pathways in regulating redox homeostasis under conditions of IR-induced oxidative stress.

Centrality-Dependent Modification of Jet-Production Rates in Deuteron-Gold Collisions at √[s(NN)]=200 GeV

Jet production rates are measured in p+p and d+Au collisions at sqrt[s_{NN}]=200  GeV recorded in 2008 with the PHENIX detector at the Relativistic Heavy Ion Collider. Jets are reconstructed using the R=0.3 anti-k_{t} algorithm from energy deposits in the electromagnetic calorimeter and charged tracks in multiwire proportional chambers, and the jet transverse momentum (p_{T}) spectra are corrected for the detector response. Spectra are reported for jets with 12<p_{T}<50  GeV/c, within a pseudorapidity acceptance of |η|<0.3. The nuclear-modification factor (R_{dAu}) values for 0%-100% d+Au events are found to be consistent with unity, constraining the role of initial state effects on jet production. However, the centrality-selected R_{dAu} values and central-to-peripheral ratios (R_{CP}) show large, p_{T}-dependent deviations from unity, challenging the conventional models that relate hard-process rates and soft-particle production in collisions involving nuclei.

Antenatal Health Care Service Utilization in Slum Areas of Pokhara Sub-Metropolitan City, Nepal

BACKGROUND

Half a million women die every year due to pregnancy and childbirth in the world. Among these death, 99% occur in the low and middle income countries. Antenatal care (ANC) provides an opportunity to deliver different services which are important in improving maternal survival.

METHODS

A descriptive cross sectional study was conducted from September 2012 - February 2013 among 400 married women of reproductive age group. A pre-tested structured questionnaire were used and data were analyzed using Statistical Package for Social Science(SPSS) for windows version 18.0. Frequency, crude and adjusted odds ratios and confidence intervals were performed.

RESULTS

Nearly 27% had four or more antenatal health care utilization(ANC) visits on appropriate time according to schedule of World Health Organization(WHO). In logistic regression, ANC users were found to be more/less likely to be in age group 20 - 35 years (AOR =2.825, 95% CI: 1.166-6.843), education of spouse (AOR 0.361, 95% CI : 0.130-1.000), occupation of spouse (AOR = 0.261, 95% CI: 0.093 -0.739), monthly income of family > 20,000Nrs (AOR = 2.190, 95% CI: 1.041-4.606), planned pregnancy (AOR = 2.417, 95% CI: 1.047 -5.609), death of child (AOR = 3.153, 95% CI: 1.112 -8.944).

CONCLUSIONS

This study demonstrated low antenatal care service utilization. Hence, there is a need to increase the availability and accessibility of antenatal care to all women.

A rare case of onychomycosis caused by Emericella quadrilineata (Aspergillus tetrazonus)

Onychomycosis is a common chronic nail disorder where dermatophytes are the predominant pathogens. However, non-dermatophytic moulds like Aspergillus can also be implicated as the causative agents. Herein, we report a rare case of onychomycosis due to Emericella quadrilineata ( Aspergillus tetrazonus) in an apparently immunocompetent host.

Oral gingival myiasis: A rare case report and literature review

Myiasis is a universal term for extreme infection by the parasitic fly larvae that feed on their host living/dead tissue. Gingival myiasis is a rare disease in the humans associated with poor oral hygiene, suppurative oral lesions, alcoholism, and senility, among other conditions. We present a case of gingival myiasis in the maxillary anterior region on the palatal surface in a 21-year-old mentally challenged male with moderate periodontitis and neurologic deficit. The diagnosis was made on the presence of larvae in the lesion. Treatment done was a manual removal of the larvae, one by one, with the help of the clinical forceps, surgical debridement of the oral wound, and subsequent management of the periodontal disease.

Measurements of Elliptic and Triangular Flow in High-Multiplicity 3He+Au Collisions at √(s(NN))=200 GeV

We present the first measurement of elliptic (v(2)) and triangular (v(3)) flow in high-multiplicity (3)He+Au collisions at √(s(NN))=200  GeV. Two-particle correlations, where the particles have a large separation in pseudorapidity, are compared in (3)He+Au and in p+p collisions and indicate that collective effects dominate the second and third Fourier components for the correlations observed in the (3)He+Au system. The collective behavior is quantified in terms of elliptic v(2) and triangular v(3) anisotropy coefficients measured with respect to their corresponding event planes. The v(2) values are comparable to those previously measured in d+Au collisions at the same nucleon-nucleon center-of-mass energy. Comparisons with various theoretical predictions are made, including to models where the hot spots created by the impact of the three (3)He nucleons on the Au nucleus expand hydrodynamically to generate the triangular flow. The agreement of these models with data may indicate the formation of low-viscosity quark-gluon plasma even in these small collision systems.

Prevalence of Gall Stones in Liver Cirrhosis

INTRODUCTION

Increased incidence and prevalence of gallstones in liver cirrhosis has already been reported by many studies. This study aimed to investigate the prevalence of gallstone disease in Nepali patients with LC and to identify risk factors for gallstone formation.

METHOD

Consecutive patients of LC presenting to liver clinic from January, 2010 to December, 2012 were evaluated for GS by ultrasonography at their first visit. Liver cirrhosis was diagnosed on the basis of clinical features, laboratory parameters, ultrasonography, and/or histopathology.

RESULT

Two hundred and twenty four LC patients were studied. Male to female ratio was 2.3:1. Alcohol was the major etiological factor for LC followed by hepatitis B, alone or in conjunction with alcohol. Seventy-four patients (33%) were found to have GS. Incidence of GS was more in advance stage of cirrhosis. There was no significant correlation between formation of GS and etiology of LC, except for the HCV related liver cirrhosis, in which it was present in 39% of the patients. More the advance disease,more was the incidence as 57% of Child-C patients had GS. Portal vein diameter was also associated with GS formation. When portal vein diameter was more than 13 mm, there was more GS formation.

CONCLUSIONS

One third of the patients of LC showed GS at the presentation. Patients with HCV related cirrhosis are more prone to develop GS than other. Severity of the disease and portal vein diameter was found to be associated with GS formation.