Undifferentiated pleomorphic sarcoma presenting as a gingival mass: A rare case

Malignant fibrous histiocytoma which was once considered as a tumor of adults, is now being re-classified and subtyped either as a pleomorphic undifferentiated sarcoma or pleomorphic variant of other spindle cell tumors. Only less than 5% of these cases are reported in the head and neck, and its presentation intra-orally is still rarer. Herein, we report a case of gingival swelling in relation to the 16 region, which on microscopic examination showed a histomorphometric pattern of storiform pleomorphic-malignant fibrous histiocytoma. Immunohistochemical studies were done to exclude similar appearing spindle cell neoplasms. The tumor showed focal positivity for pan histiocytic marker, CD68. Based on the histopathological and immunohistochemical profiles, the tumor was diagnosed as undifferentiated pleomorphic sarcoma

A challenging male patient with retroviral infection on highly active antiretroviral therapy issues with re-transplantation

A 44-year-old African male with chronic kidney disease Stage V due to hypertension underwent a live related renal transplant in 2005. He was on triple immunosuppression postoperatively. Subsequently, he developed metastatic Kaposi sarcoma requiring reduction in immunosuppression and switching over to rapamycin. He was found to be retrovirus positive on a follow-up visit. His graft function progressively deteriorated requiring dialysis while continuing on highly active antiretroviral therapy. He had multiple infective episodes including acute bacterial endocarditis. He received a second renal transplant from a live-related donor in 2017. Despite repeated dosage adjustments, tacrolimus levels were persistently elevated due to drug-drug interaction with diltiazem and anti-retroviral drugs, despite good allograft function

Early recurrence of IgA nephropathy in a young adult: Transplant recipient

A 20-year-old male with hypothyroidism, chronic kidney disease Stage V due to hypertension, and Henoch–Schonlein purpura (IgA vasculitis) underwent a live-related renal transplant in 2015 with mother as a donor. He was inducted with single dose thymoglobulin 75 mg following which he was initiated on triple immunosuppressive therapy – prednisolone 25 mg once a day, tacrolimus 2.5 mg in the morning and 3 mg in the night, and mycophenolate mofetil 750 mg BID. On the 5th day of transplantation, he noticed purpuric rashes in the forearm and thigh associated with hematuria. He had good graft function. Renal allograft biopsy on sixth post operative day showed recurrence of IgA nephropathy (IgAN)

Experimental and numerical investigation of heat dissipation from an electronic component in a closed enclosure

Intensifying electronic component power dissipation levels, shortening product design cycle times, and greater than before requirement for more compact and reliable electronic systems with greater functionality, has heightened the need for thermal design tools that enable accurate solutions to be generated and quickly assessed. The present numerical study aims at developing a computational tool in OpenFOAM that can predict the heat dissipation rate and temperature profile of any electronic component in operation. A suitable computational domain with defined aspect ratio is chosen. For analyzing, “buoyant Boussinesq Simple Foam“ solver available with OpenFOAM is used. It was modified for adapting to the investigation with specified initial and boundary conditions. The experimental setup was made with the dimensions taken up for numerical study. Thermocouples were calibrated and placed in specified locations. For different heat input, the temperatures are noted down at steady state and compared with results from the numerical study

Experimental and numerical investigation of heat dissipation from an electronic component in a closed enclosure

Intensifying electronic component power dissipation levels, shortening product design cycle times, and greater than before requirement for more compact and reliable electronic systems with greater functionality, has heightened the need for thermal design tools that enable accurate solutions to be generated and quickly assessed. The present numerical study aims at developing a computational tool in OpenFOAM that can predict the heat dissipation rate and temperature profile of any electronic component in operation. A suitable computational domain with defined aspect ratio is chosen. For analyzing, “buoyant Boussinesq Simple Foam“ solver available with OpenFOAM is used. It was modified for adapting to the investigation with specified initial and boundary conditions. The experimental setup was made with the dimensions taken up for numerical study. Thermocouples were calibrated and placed in specified locations. For different heat input, the temperatures are noted down at steady state and compared with results from the numerical study

Oral field cancerization and its clinical implications in the management in potentially malignant disorders

Oral cancer is one of the common malignancies reported in India. Most of these cancers are preceded by potentially malignant disorders. Despite improvements in the management strategies of these cancers the posttreatment prognosis has remained poor. The 5-year survival rates of oral cancers in most countries are still below 50%. The poor outcomes in oral cancer prevention and treatment can be due to nature of the spread of genetically altered cells as fields within the epithelial compartment. The conventional management protocols need to be modified taking into consideration the field spread of genetically altered cells

Anti-Granulocyte–Macrophage Colony–Stimulating Factor Monoclonal Antibody Gimsilumab for COVID-19 Pneumonia: A Randomized, Double-Blind, Placebo-controlled Trial

RATIONALE: GM-CSF (granulocyte-macrophage colony-stimulating factor) has emerged as a promising target against the hyperactive host immune response associated with coronavirus disease (COVID-19). OBJECTIVES: We sought to investigate the efficacy and safety of gimsilumab, an anti-GM-CSF monoclonal antibody, for the treatment of hospitalized patients with elevated inflammatory markers and hypoxemia secondary to COVID-19. METHODS: We conducted a 24-week randomized, double-blind, placebo-controlled trial, BREATHE (Better Respiratory Education and Treatment Help Empower), at 21 locations in the United States. Patients were randomized 1:1 to receive two doses of intravenous gimsilumab or placebo 1 week apart. The primary endpoint was all-cause mortality rate at Day 43. Key secondary outcomes were ventilator-free survival rate, ventilator-free days, and time to hospital discharge. Enrollment was halted early for futility based on an interim analysis. MEASUREMENTS AND MAIN RESULTS: Of the planned 270 patients, 225 were randomized and dosed; 44.9% of patients were Hispanic or Latino. The gimsilumab and placebo groups experienced an all-cause mortality rate at Day 43 of 28.3% and 23.2%, respectively (adjusted difference = 5% vs. placebo; 95% confidence interval [26 to 17]; P = 0.377). Overall mortality rates at 24 weeks were similar across the treatment arms. The key secondary endpoints demonstrated no significant differences between groups. Despite the high background use of corticosteroids and anticoagulants, adverse events were generally balanced between treatment groups. CONCLUSIONS: Gimsilumab did not improve mortality or other key clinical outcomes in patients with COVID-19 pneumonia and evidence of systemic inflammation. The utility of anti-GM-CSF therapy for COVID-19 remains unclear. CLINICAL TRIAL registered with www.clinicaltrials.gov (NCT 04351243