Mucormycosis in a surgical defect masquerading as osteomyelitis: a case report and review of literature

Mucormycosis is a rare, highly lethal opportunistic fungal disease affecting immune compromised and diabetic patients. Mucormycosis is considered as the 3rd most common invasive mycosis after candidiasis and  aspergillosis in debilitating patients. It is caused by the filamentous fungi of the class zygomycetes. The infection usually begins in the nose due to inhalation of fungal spores. This fatal fungal disease needs a prompt and early definitive diagnosis, aggressive surgical therapy and high dose anti-fungal therapy. Here, we present a case report of Mucormycosis in a 64 year elderly diabetic male patient who was previously operated for myiasis and also the extensive review of the literature of the mucormycosis.Key words: Diabetes mellitus hyphae, myiasis, PAS stain, zygomycosi

Effect of surgical experience and spine subspecialty on the reliability of the {AO} Spine Upper Cervical Injury Classification System

OBJECTIVE The objective of this paper was to determine the interobserver reliability and intraobserver reproducibility of the AO Spine Upper Cervical Injury Classification System based on surgeon experience (< 5 years, 5–10 years, 10–20 years, and > 20 years) and surgical subspecialty (orthopedic spine surgery, neurosurgery, and "other" surgery). METHODS A total of 11,601 assessments of upper cervical spine injuries were evaluated based on the AO Spine Upper Cervical Injury Classification System. Reliability and reproducibility scores were obtained twice, with a 3-week time interval. Descriptive statistics were utilized to examine the percentage of accurately classified injuries, and Pearson’s chi-square or Fisher’s exact test was used to screen for potentially relevant differences between study participants. Kappa coefficients (κ) determined the interobserver reliability and intraobserver reproducibility. RESULTS The intraobserver reproducibility was substantial for surgeon experience level (< 5 years: 0.74 vs 5–10 years: 0.69 vs 10–20 years: 0.69 vs > 20 years: 0.70) and surgical subspecialty (orthopedic spine: 0.71 vs neurosurgery: 0.69 vs other: 0.68). Furthermore, the interobserver reliability was substantial for all surgical experience groups on assessment 1 (< 5 years: 0.67 vs 5–10 years: 0.62 vs 10–20 years: 0.61 vs > 20 years: 0.62), and only surgeons with > 20 years of experience did not have substantial reliability on assessment 2 (< 5 years: 0.62 vs 5–10 years: 0.61 vs 10–20 years: 0.61 vs > 20 years: 0.59). Orthopedic spine surgeons and neurosurgeons had substantial intraobserver reproducibility on both assessment 1 (0.64 vs 0.63) and assessment 2 (0.62 vs 0.63), while other surgeons had moderate reliability on assessment 1 (0.43) and fair reliability on assessment 2 (0.36). CONCLUSIONS The international reliability and reproducibility scores for the AO Spine Upper Cervical Injury Classification System demonstrated substantial intraobserver reproducibility and interobserver reliability regardless of surgical experience and spine subspecialty. These results support the global application of this classification system

Cellular Automata as an Example for Advanced Beginners’ Level Coding Exercises in a MOOC on Test Driven Development

Programming tasks are an important part of teaching computer programming as they foster students to develop essential programming skills and techniques through practice.  The design of educational problems plays a crucial role in the extent to which the experiential knowledge is imparted to the learner both in terms of quality and quantity. Badly designed tasks have been known to put-off students from practicing programming. Hence, there is a need for carefully designed problems. Cellular Automata programming lends itself as a very suitable candidate among problems designed for programming practice. In this paper, we describe how various types of problems can be designed using concepts from Cellular Automata and discuss the features which make them good practice problems with regard to instructional pedagogy. We also present a case study on a Cellular Automata programming exercise used in a MOOC on Test Driven Development using JUnit, and discuss the automated evaluation of code submissions and the feedback about the reception of this exercise by participants in this course. Finally, we suggest two ideas to facilitate an easier approach of creating such programming exercises

Cellular Automata as an Example for Advanced Beginners’ Level Coding Exercises in a MOOC on Test Driven Development

Programming tasks are an important part of teaching computer programming as they foster students to develop essential programming skills and techniques through practice.  The design of educational problems plays a crucial role in the extent to which the experiential knowledge is imparted to the learner both in terms of quality and quantity. Badly designed tasks have been known to put-off students from practicing programming. Hence, there is a need for carefully designed problems. Cellular Automata programming lends itself as a very suitable candidate among problems designed for programming practice. In this paper, we describe how various types of problems can be designed using concepts from Cellular Automata and discuss the features which make them good practice problems with regard to instructional pedagogy. We also present a case study on a Cellular Automata programming exercise used in a MOOC on Test Driven Development using JUnit, and discuss the automated evaluation of code submissions and the feedback about the reception of this exercise by participants in this course. Finally, we suggest two ideas to facilitate an easier approach of creating such programming exercises

Central cemento-ossifying fibroma of posterior maxilla

Cemento-ossifying fibromas (COFs) are relatively rare, benign lesions affecting the jaws and other craniofacial bones and are included in the group of mesodermal odontogenic tumors by Gorlin. They have a predilection for females between the third and fourth decades of life, and about 60% of the lesions are seen most often in the mandibular arch, predominantly occurring in the premolar/molar region of the mandible. This report describes a case of central COF in a 49-year-old male involving the maxillary posterior region. The current case is reported because of the rarity of such lesions and the paucity of information concerning them in the dental literature. We believe that this case illustrates many of the clinical, radiographic, and histologic features associated with cemento-ossifying tumors

Adenoid cystic carcinoma of the palate: case report and review of literature

Adenoid Cystic Carcinoma (ACC) is a rare tumor constitutes for less than 1% of head and neck malignancies and 10% of all salivary gland tumors. Palate is the most common site to be involved in the oral cavity followed by parotid gland and submandibular gland. They are usually asymptomatic, slow growing, characteristically shows infiltrative growth and perineural invasion. This paper reports a case of Adenoid Cystic Carcinoma in a 35 year old female man reported with a swelling on the left side of palate involving the hard and soft palate since 8 months which was diagnosed histopathologically and review of literature of the peculiar clinical, and histopathological features.Pan African Medical Journal 2016; 2

Diagnostic and prognostic role of magnetic resonance imaging in cases of moderate to severe traumatic brain injury

Moderate to severe traumatic brain injury (TBI) remains a leading cause of death and disability worldwide. Timely diagnosis and accurate prognostication play a key role in informed clinical decision-making. Though magnetic resonance imaging (MRI) is a superior anatomical scan compared to computerized tomography (CT), the latter remains the current investigation of choice in the clinical setting of TBI due to some of the former’s inherent deficiencies in imaging bone/blood, limited access, cost, etc. Nevertheless, the fact that MRI is a valuable adjunct in evaluating the TBI patients with clinical findings disproportionate to the CT scan substantiates its possible complementary/supplementary diagnostic and prognostic role in TBI. MRI scan is ideally placed on demonstrating the shear/diffuse axonal injury (DAI), non-haemorrhagic intraparenchymal lesions, and brain stem lesions poorly delineated by a CT scan. The currently available literature demonstrates that DAI and caudal brainstem lesions are indicators of poorer outcomes. However, the prognostic value of MRI, in addition to that of CT, remains an area of active investigation. We have tried to present the evidence-based use of MRI in moderate to severe TBI. Advances in newer MRI sequences like susceptibility-weighted imaging (SWI), diffusion tensor imaging (DTI), functional MRI (fMRI), and magnetic encephalography (MEG) have the potential to revolutionize the current role of MRI in TBI.