Splenic artery pseudoaneurysm secondary to necrotizing pancreatitis – A rare lethal complication

CLINICAL HISTORY: A 35-year-old male patient presented with history of massive hemoptysis associated with pain abdomen and breathlessness since the past 3 days. Patient had no prior co-morbidities; however was a chronic alcoholic and smoker since the past 15 years. No hospital admissions in the past

Telescopic Overdenture Rehabilitation Following Hemimandibulectomy: Case Report

Oral squamous cell carcinoma (OSCC) warrants extensive surgical resection of the affected areas of the oral cavity which takes a tremendous toll on the patient’s functioning, aesthetic as well as social confidence. Replacement of such a large number of teeth along with portions of the alveolar ridge and mucosa warrants exuberant planning to ensure a satisfactory outcome in terms of function and patient comfort. The present case report describes one such case of OSCC that was treated with partial mandibular resection and had a large mandibular defect that was rehabilitated by means of a prosthesis using an interdisciplinary approach.&nbsp

IMMUNOHISTOCHEMICAL EXPRESSION OF CD44 IN COLORECTAL CARCINOMA IN RELATION TO HISTOMORPHOLOGIC PARAMETERS AND CLINICO-PATHOLOGICAL FACTORS: A CROSS-SECTIONAL STUDY.

Background Cancer stem cells (CSC) have proven to play a vital role in cell invasion, metastasis, and treatment resistance in colorectal carcinoma (CRC), which subsequently led to poor outcomes. Cluster of differentiation 44 (CD44) is usually expressed in stem cells in CRCs and can be detected by immunohistochemistry (IHC). Aims The present study aimed to evaluate the role of immunohistochemical expression of CD44 in CRC cases of this region and its relationship with clinicopathological parameters and patient outcomes. Methods A cross-sectional study included 52 patients with primary CRC who were analyzed for CD44 expression by IHC on paraffin-embedded blocks. Data were collected, tabulated, and statistically analyzed by using SPSS Version 23.0. Results The study had a male predominance (70%) with most participants aged above 45 years (82%). Tumors were predominantly left-sided (69%) and larger than 5 cm (73%). CD44 membranous positivity was found in 78.8% of tumor cells and 59.6% of stromal cells. Signet ring cells showed weak CD44 positivity. CD44 expression correlated with higher tumor stages (T3, T4) and larger tumor sizes (>5 cm), but not with nodal stage, perineural, or lymphovascular invasion. Stromal CD44 positivity was found in 59.6% of cases and showed no significant correlation with tumor stage, size, lymphovascular invasion, perineural invasion, or nodal stage (e.g., T stage: T3 - 14 positive, 16 negative; N stage: N0 - 18 positive, 14 negative; tumor size >5 cm - 21 positive, 17 negative). Conclusions CRC prognosis is independently correlated with CD44 expression, a stem cell marker. They are linked to epithelial-mesenchymal transition (EMT) and tumor budding, with increased expression in high-burden instances. Recommendation Further research should be conducted on the role of CD44 expression in colorectal cancer, particularly focusing on post-neoadjuvant chemotherapy cases, to better understand its prognostic implications and potential as a therapeutic target

Efficient Online Timed Pattern Matching by Automata-Based Skipping

The timed pattern matching problem is an actively studied topic because of its relevance in monitoring of real-time systems. There one is given a log $w$ and a specification $\mathcal{A}$ (given by a timed word and a timed automaton in this paper), and one wishes to return the set of intervals for which the log $w$, when restricted to the interval, satisfies the specification $\mathcal{A}$. In our previous work we presented an efficient timed pattern matching algorithm: it adopts a skipping mechanism inspired by the classic Boyer--Moore (BM) string matching algorithm. In this work we tackle the problem of online timed pattern matching, towards embedded applications where it is vital to process a vast amount of incoming data in a timely manner. Specifically, we start with the Franek-Jennings-Smyth (FJS) string matching algorithm---a recent variant of the BM algorithm---and extend it to timed pattern matching. Our experiments indicate the efficiency of our FJS-type algorithm in online and offline timed pattern matching

The Indian cobra reference genome and transcriptome enables comprehensive identification of venom toxins

Snakebite envenoming is a serious and neglected tropical disease that kills ~100,000 people annually. High-quality, genome-enabled comprehensive characterization of toxin genes will facilitate development of effective humanized recombinant antivenom. We report a de novo near-chromosomal genome assembly of Naja naja, the Indian cobra, a highly venomous, medically important snake. Our assembly has a scaffold N50 of 223.35 Mb, with 19 scaffolds containing 95% of the genome. Of the 23,248 predicted protein-coding genes, 12,346 venom-gland-expressed genes constitute the \u27venom-ome\u27 and this included 139 genes from 33 toxin families. Among the 139 toxin genes were 19 \u27venom-ome-specific toxins\u27 (VSTs) that showed venom-gland-specific expression, and these probably encode the minimal core venom effector proteins. Synthetic venom reconstituted through recombinant VST expression will aid in the rapid development of safe and effective synthetic antivenom. Additionally, our genome could serve as a reference for snake genomes, support evolutionary studies and enable venom-driven drug discovery

Seizure prediction : ready for a new era

Acknowledgements: The authors acknowledge colleagues in the international seizure prediction group for valuable discussions. L.K. acknowledges funding support from the National Health and Medical Research Council (APP1130468) and the James S. McDonnell Foundation (220020419) and acknowledges the contribution of Dean R. Freestone at the University of Melbourne, Australia, to the creation of Fig. 3.Peer reviewedPostprin

Finding Diagnostically Useful Patterns in Quantitative Phenotypic Data.

Trio-based whole-exome sequence (WES) data have established confident genetic diagnoses in ∼40% of previously undiagnosed individuals recruited to the Deciphering Developmental Disorders (DDD) study. Here we aim to use the breadth of phenotypic information recorded in DDD to augment diagnosis and disease variant discovery in probands. Median Euclidean distances (mEuD) were employed as a simple measure of similarity of quantitative phenotypic data within sets of ≥10 individuals with plausibly causative de novo mutations (DNM) in 28 different developmental disorder genes. 13/28 (46.4%) showed significant similarity for growth or developmental milestone metrics, 10/28 (35.7%) showed similarity in HPO term usage, and 12/28 (43%) showed no phenotypic similarity. Pairwise comparisons of individuals with high-impact inherited variants to the 32 individuals with causative DNM in ANKRD11 using only growth z-scores highlighted 5 likely causative inherited variants and two unrecognized DNM resulting in an 18% diagnostic uplift for this gene. Using an independent approach, naive Bayes classification of growth and developmental data produced reasonably discriminative models for the 24 DNM genes with sufficiently complete data. An unsupervised naive Bayes classification of 6,993 probands with WES data and sufficient phenotypic information defined 23 in silico syndromes (ISSs) and was used to test a "phenotype first" approach to the discovery of causative genotypes using WES variants strictly filtered on allele frequency, mutation consequence, and evidence of constraint in humans. This highlighted heterozygous de novo nonsynonymous variants in SPTBN2 as causative in three DDD probands

Clinical and molecular consequences of disease-associated de novo mutations in SATB2

Purpose: To characterize features associated with de novo mutations affecting SATB2 function in individuals ascertained on the basis of intellectual disability. Methods: Twenty previously unreported individuals with 19 different SATB2 mutations (11 loss-of-function and 8 missense variants) were studied. Fibroblasts were used to measure mutant protein production. Subcellular localization and mobility of wild-type and mutant SATB2 were assessed using fluorescently tagged protein. Results: Recurrent clinical features included neurodevelopmental impairment (19/19), absent/near absent speech (16/19), normal somatic growth (17/19), cleft palate (9/19), drooling (12/19), and dental anomalies (8/19). Six of eight missense variants clustered in the first CUT domain. Sibling recurrence due to gonadal mosaicism was seen in one family. A nonsense mutation in the last exon resulted in production of a truncated protein retaining all three DNA-binding domains. SATB2 nuclear mobility was mutation-dependent; p.Arg389Cys in CUT1 increased mobility and both p.Gly515Ser in CUT2 and p.Gln566Lys between CUT2 and HOX reduced mobility. The clinical features in individuals with missense variants were indistinguishable from those with loss of function. Conclusion: SATB2 haploinsufficiency is a common cause of syndromic intellectual disability. When mutant SATB2 protein is produced, the protein appears functionally inactive with a disrupted pattern of chromatin or matrix association

Prevalence, phenotype and architecture of developmental disorders caused by de novo mutation: The Deciphering Developmental Disorders Study

Individuals with severe, undiagnosed developmental disorders (DDs) are enriched for damaging de novo mutations (DNMs) in developmentally important genes. We exome sequenced 4,293 families with individuals with DDs, and meta-analysed these data with published data on 3,287 individuals with similar disorders. We show that the most significant factors influencing the diagnostic yield of de novo mutations are the sex of the affected individual, the relatedness of their parents and the age of both father and mother. We identified 94 genes enriched for damaging de novo mutation at genome-wide significance (P < 7 × 10−7), including 14 genes for which compelling data for causation was previously lacking. We have characterised the phenotypic diversity among these genetic disorders. We demonstrate that, at current cost differentials, exome sequencing has much greater power than genome sequencing for novel gene discovery in genetically heterogeneous disorders. We estimate that 42% of our cohort carry pathogenic DNMs (single nucleotide variants and indels) in coding sequences, with approximately half operating by a loss-of-function mechanism, and the remainder resulting in altered-function (e.g. activating, dominant negative). We established that most haplo insufficient developmental disorders have already been identified, but that many altered-function disorders remain to be discovered. Extrapolating from the DDD cohort to the general population, we estimate that developmental disorders caused by DNMs have an average birth prevalence of 1 in 213 to 1 in 448 (0.22-0.47% of live births), depending on parental age

Splenic artery pseudo-aneurysm secondary to necrotizing pancreatitis – A rare lethal complication.

CLINICAL HISTORY: A 35-year-old male patient presented with history of massive hemoptysis associated with pain abdomen and breathlessness since the past 3 days. Patient had no prior co-morbidities; however was a chronic alcoholic and smoker since the past 15 years. No hospital admissions in the pas