Ameoblastic carcinoma of mandible: a rare case report with review of literature

Ameloblastic carcinoma is a rare malignant lesion with characteristic histologic features and behavior that dictates more aggressive surgical approach than that of a simple ameloblastoma. However, reliable evidence of its biologic activity is currently unavailable due to the scarcity of well-documented cases. It occurs primarily in the mandible in a wide range of age groups; no sex or race predilection has been noted. It may present as a cystic lesion with benign clinical features or as a large tissue mass with ulceration, significant bone resorption and tooth mobility. Because the lesion is usually found unexpectedly after an incisional biopsy or the removal of a cyst, a guide to differential diagnosis is not usually useful. The identifying features of ameloblastic carcinoma must be known and recognized by dental practitioners. The tumour cells resemble the cells seen in ameloblastoma, but they show cytologic atypia. Moreover, they lack the characteristic arrangement seen in ameloblastoma. Direct extensions of the tumour, lymph node involvement and metastasis to various sites (frequently the lung) have been reported. We present a case of ameloblastic carcinoma of the mandible with a clinical course of typical aggressiveness and extensive local des- truction in a 27 year old male patient

Establishment of the mechanism of purification and levigation of green chemistry-assisted biocomposites of red ochre (Gairika): synthesis, characterization, and antibacterial, prebiotic, antioxidant, and antacid activities of the traditional Ayurvedic medicine Laghu Sutashekhara Rasa

Gairika (red ochre) has a long history of influencing human civilization. Gairika is a rich source of nutrients used for reproductive and brain health. Gairika is mentioned as an antacid drug in Indian Ayurvedic medicine under Laghu Sutashekhara Rasa (LSR). However, a detailed study on LSR has not been reported to date. In the present study, LSR was prepared, and a pharmaceutical SOP (standardization procedure) was reported to obtain batch-to-batch reproducibility. LSR was characterized using FTIR, XRD, SEM-EDX, and TGA analyses. LSR was tested in vitro for its antacid activity. Advanced instrumentation revealed that LSR formation produced symmetrical particles (5–8 µm) with kaolin, kaolinite, quartz, goethite, and hematite, along with the phytoconstituents of Goghrita (clarified cow’s butter), Shunthi, and Nagawalli, as confirmed by GC-MS/MS analysis. The FTIR study revealed the formation of a chelating complex of goethite and hematite along with their phytoconstituents. XRD analysis confirmed the presence of kaolin, kaolinite, quartz, goethite, and hematite. Using in vitro antacid experiments, LSR and Shunthi demonstrated significant antacid activity as compared to antacid drugs and standards in the market, such as CaCO3. The DPPH assay revealed IC50 values of 12.16 ± 1.23 mg/mL, which is 0.0029 of Trolox-equivalent antioxidant activity. The inhibition (18 ± 4 mm) against pathogens (S. aureus, E. coli, P. aeruginosa, and B. subtilis) and the prominent growth of gut microbiota-supported strains (S. boulardii, L. paracasei, and L. plantarum) observed on LSR formulation were indicative of LSR application as a prebiotic. Here, the mechanism of purification and levigation mentioned in the classical literature of LSR was established. Overall, purification of Gairika with cow ghee and levigation with Nagawalli may enhance the solubility, bioavailability, and shelf-life of LSR through hydration and co-crystallization mechanisms. This is the first comprehensive report on the pharmaceutical validation of LSR and its characterization. The results of the present study could contribute to the development and reliable reproduction of LSR and the utility of environmental red ochre as a medicine in combination with Shunthi (Zingiber officinale Roxb.), as prescribed under Indian Ayurvedic medicine

Scholars Journal of Medical Case Reports ISSN 2347-9507 (Print) Solitary Oral Mucosal Neuromas: A Rare Case Report

Abstract: Mucosal neuromas are a form of neurogenic tumour that arises in the oral cavity as a component of multiple endocrine neoplasia type 2b (MEN 2b). The syndrome is characterized with other features like tumors of the endocrine glands and skeletal abnormalities. Mutation at codon 918 of the RET protooncogene is a consistent feature among people affected with MEN 2. There are few reports describing pure mucosal neuromas without characteristics of MEN 2B . Analysis of the RET protooncogene among these cases have demonstrated no point mutation in the MEN 2B region (M918T). Hence, it is a subject of debate whether such anomalies should be considered as a different entity or a milder form of the MEN 2B syndrome. We report a case of 25 year old male patient who presented with multiple neuromas over the labial mucosa, tongue and floor of the mouth with no other features of MEN 2B. Keywords: Mucosal Neuromas, Neurogenic tumor, Multiple Endocrine Neoplasia type 2B, RET protooncogene, Point mutations INTRODUCTION Multiple endocrine neoplasia type 2B (MEN 2B or MEN 3) also known as multiple neuroma syndrome is a rare autosomal dominant disorder characterized by medullary thyroid carcinoma, pheochromocytoma, and mucosal neuroma

Oral myiasis in brain hemorrhage

Myiasis is a rare condition which arises from the invasion of body tissues or cavities of living animals or humans by maggots or larvae of certain species of flies. Oral myiasis is seen especially in individuals with neurologic deficit, secondary to oral wounds, suppurative lesions, and extraction wounds. The halitosis and neglected oral hygiene attracts flies to lay eggs in oral wounds which results in oral myiasis. We present a case of oral myiasis in a 63-year-old female patient who was medically compromised since 6 months

Desmoplastic ameloblastoma of maxilla: Radiologic–Pathologic correlation

Desmoplastic ameloblastoma (DA) is a rare variant of ameloblastoma, and less than 170 patients have been reported in the literature. The present case deserves special importance because of its rare occurrence, unfamiliar appearance, potentially aggressive nature, and high chances of misdiagnosis. Moreover, the radiographic features of this lesion rarely point towards ameloblastoma. Desmoplastic variant of ameloblastoma tends to infiltrate between bone trabeculae. The risk of recurrence is high. This report is an attempt to help the dental community in developing familiarity with the clinical presentation and at the same time advocating to develop a high index of suspicion in recognizing such cases

Basal Cell Ameloblastoma of Mandible: A Rare Case Report with Review

Ameloblastoma is a slow-growing benign neoplasm that has a strong tendency to local invasion and that can grow to be quite large without metastasizing. Rare examples of distant metastasis of an ameloblastoma in lungs or regional lymph nodes do exist. It has an aggressive and recurrent course and is rarely metastatic. Radiographically it shares common features with other lesions such as the giant cell tumor, aneurysmal bone cyst, and renal cell carcinoma metastasis; a definitive diagnosis can only be made with histopathology. Basal cell ameloblastoma is believed to be the rarest histologic subtype in which the tumor is composed of more primitive cells and has even fewer features of peripheral palisading. Till date, only few cases of basal cell ameloblastoma have been reported in the literature. Considering the rarity of the lesion, we report here an interesting and unique case of basal cell ameloblastoma of the mandible occurring in a very old patient

Therapeutic potential of evergreen maiden hair fern Adiantum venustum D. Don: A comprehensive review

Adiantum venustum D. Don (Himalayan or Evergreen maiden hair fern), also known as ‘Hansraj’ in India, is a pteridophytes that grows extensively in tropical and temperate areas. It has been used in traditional medicines to treatment cough, cold, fever, and headache. However, the information available is scarce and scattered. So, the primary goal of this review is to provide complete and updated knowledge about the distribution, morphology, pharmacognostic characteristics, chemistry and biological activities of A. venustum to assess its therapeutic potential and future research opportunities. Different parts of this fern have been extensively used in traditional medicines to treatment diseases from time immemorial. It is a reservoir of active chemical compounds like terpenoids, flavonoids, fatty acids, sterol, carotenoids and others, which possesses antimicrobial, antiviral, antitumor, and anti-analgesic properties. The current review has been designed to provide the upto-date knowledge and perspectives about A. venustum and its potential use as a therapeutic plant. So, researchers should take a keen interest in exploring and isolating new active components, bio-assay their pharmaceutical values and mode of action, and conducting clinical trials to justify their reported studies on human health benefits

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population.The aim of this study was to inform vaccination prioritization by modelling the impact of vaccination on elective inpatient surgery. The study found that patients aged at least 70 years needing elective surgery should be prioritized alongside other high-risk groups during early vaccination programmes. Once vaccines are rolled out to younger populations, prioritizing surgical patients is advantageous