Intraoperative Facial Nerve Involvement in Parotid Tumours - A Retrospective Analysis in a Tertiary Care Centre.

Purpose: The study aims to provide a comprehensive overview of the various malignant and benign parotid tumours and evaluate the predictive factors for intraoperative nerve involvement leading to facial palsy (FP). Methods: It is a single-centre retrospective analysis for reviewing the involvement of facial nerve in post- parotidectomy patients. The clinical database from January 2012 to December 2020 was included in the study with a follow-up period of a minimum of 2 years. To maintain homogeneity, all squamous cell carcinomas of level 2 nodes involving parotid or residual/recurrent disease of the oral cavity requiring parotid dissection were excluded. Results: A total of 248 patients (171 benign; 77 malignant) were evaluated with a mean age of 46.48 ± 10.76 years. The presence of malignancy increases the risk of FP (p = 0.027). 37 (14.92%) patients with FP were detected which included 34 with partial [32.35% in malignant; 62.16% in recurrent pleomorphic adenoma (RPA)] and 3 with total paralysis (66.67% in malignant; 33.33% in RPA). The recurrence of pleomorphic adenoma increases FP. While old age, larger size, hard fixed swelling with masseteric space (MS) infiltration appeared as risk factors for FP in malignant tumours (p = 0.047; p = 0.004; p < 0.00001 respectively). Conclusion: Tumour size, malignancy, hard fixed mass, masseteric space infiltration, recurrence, and age > 45yrs have been statistically significant predictive factors for intraoperative facial nerve involvement leading to FP. The study also revealed that FP occurred more commonly when there was concurrent involvement of both superficial and deep lobes but was not statistically significant.

Opportunistic assessment of ischemic heart disease risk using abdominopelvic computed tomography and medical record data: a multimodal explainable artificial intelligence approach.

Current risk scores using clinical risk factors for predicting ischemic heart disease (IHD) events-the leading cause of global mortality-have known limitations and may be improved by imaging biomarkers. While body composition (BC) imaging biomarkers derived from abdominopelvic computed tomography (CT) correlate with IHD risk, they are impractical to measure manually. Here, in a retrospective cohort of 8139 contrast-enhanced abdominopelvic CT examinations undergoing up to 5 years of follow-up, we developed multimodal opportunistic risk assessment models for IHD by automatically extracting BC features from abdominal CT images and integrating these with features from each patient's electronic medical record (EMR). Our predictive methods match and, in some cases, outperform clinical risk scores currently used in IHD risk assessment. We provide clinical interpretability of our model using a new method of determining tissue-level contributions from CT along with weightings of EMR features contributing to IHD risk. We conclude that such a multimodal approach, which automatically integrates BC biomarkers and EMR data, can enhance IHD risk assessment and aid primary prevention efforts for IHD. To further promote research, we release the Opportunistic L3 Ischemic heart disease (OL3I) dataset, the first public multimodal dataset for opportunistic CT prediction of IHD.

Using Surface-Enhanced Raman Spectroscopy to Unravel the Wingtip-Dependent Orientation of N-Heterocyclic Carbenes on Gold Nanoparticles.

N-Heterocyclic carbenes (NHCs) are an attractive alternative to thiol ligands when forming self-assembled monolayers on noble-metal surfaces; however, relative to the well-studied thiol monolayers, comparatively little is known about the binding, orientation, and packing of NHC monolayers. Herein, we combine surface-enhanced Raman spectroscopy (SERS) and first-principles theory to investigate how the alkyl "wingtip" groups, i.e., those attached to the nitrogens of N-heterocyclic carbenes, affect the NHC orientation on gold nanoparticles. Consistent with previous literature, smaller wingtip groups lead to stable flat configurations; surprisingly, bulkier wingtips also have stable flat configurations likely due to the presence of an adatom. Comparison of experimental SERS results with the theoretically calculated spectra for flat and vertical configurations shows that we are simultaneously detecting both NHC configurations. In addition to providing information on the adsorbate geometry, this study highlights the extreme SERS enhancement of vibrational modes perpendicular to the surface.

Giving Gold Wings: Ultrabright and Fragmentation Free Mass Spectrometry Reporters for Barcoding, Bioconjugation Monitoring, and Data Storage.

The widespread application of laser desorption/ionization mass spectrometry (LDI-MS) highlights the need for a bright and multiplexable labeling platform. While ligand-capped Au nanoparticles (AuNPs) have emerged as a promising LDI-MS contrast agent, the predominant thiol ligands suffer from low ion yields and extensive fragmentation. In this work, we develop a N-heterocyclic carbene (NHC) ligand platform that enhances AuNP LDI-MS performance. NHC scaffolds are tuned to generate barcoded AuNPs which, when benchmarked against thiol-AuNPs, are bright mass tags and form unfragmented ions in high yield. To illustrate the transformative potential of NHC ligands, the mass tags were employed in three orthogonal applications: monitoring a bioconjugation reaction, performing multiplexed imaging, and storing and reading encoded information. These results demonstrate that NHC-nanoparticle systems are an ideal platform for LDI-MS and greatly broaden the scope of nanoparticle contrast agents.

Fundamentals and applications of N-heterocyclic carbene functionalized gold surfaces and nanoparticles.

The discovery of N-heterocyclic carbenes (NHCs) revolutionized organometallic chemistry due to their strong metal-ligand bonds. These strong bonds also lend enhanced stability to gold surfaces and nanoparticles. This stability and high degree of synthetic tunability has allowed NHCs to supplant thiols as the ligand of choice when functionalizing gold surfaces. This review article summarizes the basic science and applications of NHCs on gold surfaces and gold nanoparticles. Additionally, scientific questions that are unique to gold-NHC systems are discussed, such as the NHC adatom binding motif and the NHC surface mobility. Finally, new applications for NHCs on gold are covered with particular attention to biomedicine, catalysis, and microelectronics.

Detection of a weaker subgroup of A in ABO blood group system.

Testing to detect ABO incompatibility between a donor and potential transfusion recipient is the foundation on which all other pretransfusion testing is based. Sometimes, weak agglutination reactions may be obtained with reagent antibodies due to weak expression of A and B antigens on red blood cell (RBC) surface which may cause a discrepancy in blood group typing. Here, we report a patient showing discrepancy between RBCs (forward) and serum (reverse) typing. After doing detailed analysis, the blood type as a variant of blood Group A revealed. Subgroups of A are very rare phenotype of blood. Weaker subgroups of A blood group reported so far are mainly A3, Aend, Ax, Am, Ay, and Ael. We are reporting a case of a 35-year-old patient whose RBCs showed a discrepancy between cell and serum grouping during initial testing. Serological investigation included absorption elution tests and saliva tests after performing initial blood grouping. The serological characteristics of the patient's red cells were similar to A3 subtype. The patient was a secretor and A and H substance was present in the saliva. Serum did not show any presence of anti-A1. The weak A phenotype identified had serological characteristics similar to A3.

An Unusual Case of a Pediatric Nasal Septal Abscess with Life-Threatening Complications in COVID-19 Pandemic.

In this modern era, when access to healthcare services is improved, and awareness among the general population is enhanced, the presentation of mere septal abscess of the nose as a fatal complication is less common. Due to various lockdown restrictions in the COVID-19 scenario and fear to contract an infection, patients are presenting late to the health care setting for proper management. We treated an 11-year old child of complicated nasal septal abscess who responded well to aspiration of pus and medical treatment. Our patient is a rare case report who progressed from vestibulitis to septal abscess and further leading to sinusitis, orbital, and intracranial complications.

Knowledge and practices of recording and maintaining patients 'dental records among private dental practitioners of Delhi, India

Proper recording and keeping dental records are an important part of any dental practice. It helps in improving patient care, has medico-legal importance and play significant role in human identification during mass disasters or criminal offences. Aim: To assess the knowledge and practices of recording and maintaining patients 'records among private dental practitioners of Delhi, India. Methods: Data for this cross-sectional study was collected from 160 dentists of Delhi using a self-administered questionnaire. The face and content validity as well as reliability of questionnaire was tested before the final data collection. A single trained examiner collected all the necessary information via personal visits or google forms. Chi-square test was applied to check the statistically significant difference between the dichotomous independent variables with respect to study participants' responses to the questionnaire. Results: The mean age of the study participants was 34.5 (SD 7.2) years.Digital method of recording patient's data and x-ray storage was more prevalent than manual method among the study participants. Slightly more than 40% of the dentists were keeping patient's records safe for a period of 6 to 10 years. Younger dentists with lesser years of practice were more explicit in recording and correcting patient records. Conclusion: Results of this study shows that private dental practitioners of Delhi are aware of medico-legal importance of dental records. Most of them were recording important findings and history of their patients. Dentists must be educated in two aspects namely correct method of recording and the ideal duration of storing their patients' dental records

Use of Glass Ionomer Cement for Incudostapedial Rebridging Ossiculoplasty.

INTRODUCTION: The ossicles of the middle ear are affected by the erosive effect of pathology in chronic otitis media. Ossicular reparation can be done via autologous incus or with alloplastic materials. Glass ionomer cement (GIC) is simple to use and saves considerable operative time and expenses especially in developing countries where costly ossicular prosthesis are not affordable for the majority of the patients. MATERIALS AND METHODS: Twenty-five chronic otitis media patients who underwent surgery were included in this study. The reconstruction material used in this study was glass ionomer cement. All patients had erosion of the long process of incus and a normal stapes. RESULTS: Pure tone average in pre-operative and post-operative period of study patients were 50.09 & 29.92 dB respectively (P=0.01) and the air-bone gap was 24.85 dB preoperatively and 14.05 dB postoperatively. The closure of the air-bone gap was statistically significant (P= 0.01). CONCLUSION: The study showed that the use of GIC ossiculoplasty is an efficient method for the reparation of the long process of the incus. The results are encouraging and indicate that it is worthwhile to conduct more trials using this method.

A Review of the Importance of Atypical Otorhinolaryngological Symptoms in the Screening of COVID-19 Patients.

While the world is fighting against the newly emerged highly contagious coronavirus strain, new evolving ideas regarding symptoms and investigations are reverberating among health care professionals to combat the public health emergency. The study aims to review various presenting symptoms of COVID-19 especially the unusual one and analyzing the importance of olfactory and taste disturbances. 20 studies published recently in the last 1 year were analyzed and discussed for insights into the unusual presentation of symptoms in COVID-19 patients. All the findings and statements in this review regarding the pandemic are based on published information as listed in the references. Most research articles initially focused on fever and respiratory symptoms. Later gastrointestinal symptoms were also taken into consideration. Only 5 studies from the literature have mentioned any smell and taste disturbances after SARS-CoV-2 infection to date. So changing trends can be seen in publications and recognizing these symptoms has important to timely combat this disease. The majority of corona virus-infected patients suffer from mild to moderate severity of the disease. Much hyped up symptoms of the respiratory tract may not be shown by a greater number of patients. So the need of the hour especially in developing and densely populated nations is to recognize unusual symptoms of COVID-19 especially its influence over smell and taste sensation to prevent any delay or misdiagnosis.

Knowledge and awareness of oral cancer patients regarding its etiology, prevention, and treatment.

INTRODUCTION: Assumption on part of healthcare workers that individuals suffering from oral cancer are usually aware of the reasons why they got the disease can lead to creation of a knowledge deficit group and may increase chances of relapse and complications in future. METHODOLOGY: An interview-based questionnaire study was conducted on 218 patients with oral cancer admitted for treatment at a Regional Cancer Centre (RCC) in north India. Questions were designed to assess their knowledge and awareness regarding etiology, treatment, and prevention of oral cancer. RESULTS: The majority of the study participants were from lower and lower middle socioeconomic class. Most of them were not aware about early signs of oral cancer. Some of them were still continuing with the habit of tobacco consumption. CONCLUSION: There is an urgent need to improve the knowledge level of oral cancer patients for its primary and secondary prevention.

Acid Mine Drainage Treatment Using Bayer Precipitates Obtained from Seawater Neutralization of Bayer Liquor.

Bayer precipitates from the seawater neutralization of Bayer liquor waste from the alumina industry are shown to be a prospective solution for the remediation of acid mine drainage (AMD) water. Precipitates are varied in composition, albeit they are generally comprised of hydrotalcite (Mg6Al2(OH)16CO3∙xH2O), calcite (CaCO3), aragonite (CaCO3), mixed metal hydroxides (Mg2Al(OH)7), and halite (NaCl). Brucite (Mg(OH)2) is detected for lower Bayer liquor concentrations (1-3 g L-1 Al2O3) when the concentrations of aluminum and hydroxyl species are insufficient to promote hydrotalcite formation. The neutralizing capacity of the precipitates also varies with Bayer liquor composition. Treatment of AMD water with Bayer precipitates met discharge pH guidelines. The dissolution of hydrotalcite and brucite (1-3 g L-1 Bayer precipitates only) is responsible for the Bayer precipitate's neutralizing capacity, while calcium carbonate has a buffering affect at around pH 7. Manganese ions are the most challenging species to remove because high pH values are required (pH > 9), which is not possible with all precipitates tested. One caveat is that increasing the degree of manganese removal generates issues with excessive dissolved aluminum which exceeds discharge limits. Future research should address this latter problem and facilitate implementation of this approach to AMD remediation.

Effect of strong acids on red mud structural and fluoride adsorption properties.

The removal of fluoride using red mud has been improved by acidifying red mud with hydrochloric, nitric and sulphuric acid. The acidification of red mud causes sodalite and cancrinite phases to dissociate, confirmed by the release of sodium and aluminium into solution as well as the disappearance of sodalite bands and peaks in infrared and X-ray diffraction data. The dissolution of these mineral phases increases the amount of available iron and aluminium oxide/hydroxide sites that are accessible for the adsorption of fluoride. However, concentrated acids have a negative effect on adsorption due to the dissolution of these iron and aluminium oxide/hydroxide sites. The removal of fluoride is dependent on the charge of iron and aluminium oxide/hydroxides on the surface of red mud. Acidifying red mud with hydrochloric, nitric and sulphuric acid resulted in surface sites of the form ≡SOH2(+) and ≡SOH. Optimum removal is obtained when the majority of surface sites are in the form ≡SOH2(+) as the substitution of a fluoride ion does not cause a significant increase in pH. This investigation shows the importance of having a low and consistent pH for the removal of fluoride from aqueous solutions using red mud.

Potential role of melatonin in prevention and treatment of oral carcinoma.

Melatonin, a hormone secreted mainly by pineal gland has been found to have antioxidant and anti-inflammatory properties in the oral cavity where it reaches through saliva. These properties have been found to be beneficial in certain oral pathologies including periodontal diseases, herpes viral infections and Candida, local inflammatory processes, xerostomia, oral ulcers and oral cancer. The objective of this review is to discuss the mechanism of action and potential role of melatonin as a preventive and curative agent for oral cancer. an extensive review of databases like pubmed, medline, science direct and Cochrane reviews was conducted to find articles related to beneficial actions of melatonin in human body with focus on cancers. Numerous studies both in-vitro and in-vivo had shown promising results regarding role of melatonin as anti-carcinogenic agent. Melatonin may play a role in protecting the oral cavity from tissue damage caused by oxidative stress. The experimental evidence suggests that melatonin may have utility in the treatment of several common cancers of the body. However, more specific studies are necessary to extend the therapeutic possibilities to oral carcinoma.

Aggressive adenomatoid odontogenic tumor of mandible showing root resorption: A histological case report.

Adenomatoid odontogenic tumor (AOT) is a benign odontogenic tumor with slow but progressive growth. The three variants: Follicular, extra follicular (both central type), and peripheral present with identical histologic findings. This case report describes a patient with a large AOT in the mandible of the extra follicular type which is the less common of the two central types. It also strikes as an unusual case as it shows significant root resorption of the involved displaced teeth which is not generally reported in AOT's.

Oral health-related knowledge, attitude, and practices among 12-year-old schoolchildren studying in rural areas of Panchkula, India.

UNLABELLED: Oral health is fundamental to general health and well being. Schools can provide a supportive environment for promoting oral health. School policies and education on health-related matters are imperative for the attainment of good oral health and control of related risk behaviors. AIM: This study was conducted to assess oral health-related knowledge, attitude, and practices among 12-year-old schoolchildren studying in rural areas of Panchkula, India. The ultimate goal was to implement an oral health-promotion program in this area. MATERIALS AND METHODS: A total of 440 children (216 males and 224 females) from 12 schools were included in this study. All the participants were requested to complete a 13-question closed-ended questionnaire. The statistical significance of any difference between the two genders was determined using the Chi-square test. RESULTS: Only 25% of the participants said that they cleaned their teeth more than once in a day. Thirty-two percent did not clean their teeth daily. Over the preceding 1 year, 45.5% of the childern had had some problem with their teeth and/or gums, but only 35.9% visited the dentist. Among these children, 8.2% used tobacco in some form. Oral health-related knowledge of girls was significantly better than that of boys. CONCLUSION: Based upon the findings of the present study, the knowledge, attitude, and practices of the surveyed children with regard to oral health is poor. Hence, there is a need for regular oral health education of the children, as well as their parents and school teachers.

Tobacco cessation: what role can dental professionals play?

Introduction: Tobacco dependence is classified as a disease by the International Classification of Diseases (ICD-10), but, medical and dental professionals have neither seriously taken this fact nor made any serious attempt to tackle this disease. Apart from supporting wider tobacco control measures, oral health professionals can help patients to stop using tobacco. This may be the single most important service dentists can provide for their patients’ overall health. Objective:This review is prepared with the object to help both clinicians and oral health professionals to scale up their involvement in tobacco control activities, including advocacy and smoking cessation programs. Literature review:Studies have shown that 70% smokers indicate that they want to quit, but a meagre 2% succeed. The dental practice setting provides a unique opportunity to assist tobacco users in achieving tobacco abstinence. Still, More than 40% of dentists do not routinely ask about tobacco use and 60% do not routinely advise tobacco users to quit, while 61.5% of dentists believe their patients do not expect tobacco cessation services. Conclusion: Interventions by dentist has been found to be effective in helping people to quit tobacco consumption. A step-wise approach and patience must be adopted while dealing with such patients.

An erupted odontoma associated with pigmentation: a histogenetic and histological perspective.

Odontomas are hamartomatous malformations of odontogenic origin composed of all the structures that form the tooth. Pigmentation associated with odontomas is rare, with only two cases reported in the literature. The genesis of this composite malformation is attributable to the organizational failure of the developing odontogenic apparatus leading to abnormal morphodifferentiation. Although some odontomas erupt into the oral cavity, it defies the existing views of normal physiologic tooth movement thus raising questions over the use of this term. Here, we review a case of large odontoma in a 23-year-old male surfacing into the oral cavity from its intraosseous location. The unusual occurrence of melanotic pigmentation in the odontogenic epithelial rests was demonstrated by Mason Fontana special stain. The histogenesis of this unusual entity and explanation to its possible occurrence is discussed.

Oral leiomyoma.

Oral leiomyoma is a benign smooth muscle tumor with a low incidence. Oral leiomyomas present as slow growing, asymptomatic sub mucosal masses, usually in the tongue, hard palate or buccal mucosa. They may be seen at any age and are usually discovered when they are 1 to 2 cm in diameter. The diagnosis is mainly determined by histological studies and special stains that confirm the smooth muscle origin. Surgical excision appears to be the best line of treatment and recurrence is unexpected. The purpose of this article is to present a case of a 32-year old male with a 1 month history of a leiomyoma on his right submandibular region.

Expression of E-cadherin in primary oral squamous cell carcinoma and metastatic lymph nodes: an immunohistochemical study.

BACKGROUND: E-cadherin plays an important role in cell-to-cell adhesion and cell motility and its loss is associated with oral squamous cell carcinoma (OSCC) progression. The aim of this study was to determine the expression of E-cadherin in various grades of OSCC and to correlate changes in the expression between these various grades and metastatic lymph nodes. MATERIALS AND METHODS: Immunohistochemistry (IHC) was used to detect E-cadherin expression in normal oral mucosa, primary OSCC (n = 37), and metastatic lymph nodes (n = 10). E-cadherin immunoreactivity was correlated with grades of differentiation and with clinicopathological features. RESULTS: E-cadherin immunoreactivity was found to inversely correlate with the loss of cell differentiation. The expression of E-cadherin decreased significantly in advanced cases of OSCC. However, increase in E-cadherin immunoreactivity was seen in early lesions, that is, in well differentiated (n = 9) and moderately differentiated OSCC (n = 13). Furthermore, E-cadherin was negative in majority of metastatic lymph nodes (7/10). CONCLUSIONS: Loss of the cell adhesion and E-cadherin plays an important role in progression of OSCC, that is, down regulation of its expression is associated with de-differentiation and metastasis.