Embalming with honey: Quest for an eco-friendly and non-toxic museum.

According to Codex Alimentarius, 'Honey is the natural sweet substance, produced by honeybees from the nectar of plants or from secretions of living parts of plants, or excretions of plant-sucking insects on the living parts of plants, which the bees collect, transform by combining with specific substances of their own, deposit, dehydrate, store and leave in honeycombs to ripen and mature'. It can also penetrate deep into the tissue and can prevent autolysis and putrefaction. This paper highlights the usefulness of honey as an embalming agent.

Awareness of Adverse Drug Reactions and its Reporting among Third-year Undergraduate Medical Students.

BACKGROUND: Drug is a double-edged sword. Though important, Adverse Drug Reactions under-reporting is real and is mainly due to lack of awareness. No published research has ever evaluated the perspective of third year medical students towards Adverse Drug Reactions reporting. The objective of the study was to evaluate awareness of Adverse Drug Reactions and its reporting among Third-year Medical Students of BP Koirala Institute of Health Science. METHODS: It was a descriptive cross-sectional questionnaire-based survey using google form conducted between 09/01/2020 to 09/28/2020. Any consenting third-year medical student of BP Koirala Institute of Health Science was eligible. Descriptive analysis of the data was performed using Microsoft Excel. Ethical clearance was obtained from Departmental-Research-Unit which is under IRC. RESULTS: Out of 80 eligible students, 79(98.75%) participated in the survey. 31.6(25%) had reported Adverse Drug Reactions. 36.7(29%) were aware of National Adverse Drug Reactions monitoring service. 12.7(10%) were aware of BPKIHS ADR monitoring. Again, 35(49.30%) were familiar with Adverse Drug Reactions to a particular drug whereas 29(40.85%) and 28(39.44%) were even familiar with Adverse Drug Reactions to a new product and Adverse Drug Reactions of serious (life or organ threatening) nature respectively. Regarding barriers to Adverse Drug Reactions reporting, 64(83.12%) were uncertain how to report; 39(50.65%) were unaware of existing National ADR system and 33(42.86) could not decide if it was an Adverse Drug Reactions. Regarding recommendations to improve Adverse Drug Reactions reporting, 73(94.81%) recommended education and training, 57(74.03%) stressed on collaboration among health professionals; 52(67.53%) said Adverse Drug Reactions reporting should be professional obligation whereas 51(66.23%) highlighted feedback from Monitoring Centers. CONCLUSIONS: We evaluated the awareness of Adverse Drug Reactions and its reporting among third-year medical Students of the institute which was relatively poor compared to other study population like doctors and pharmacists.

Probing natural substitute for formalin: Comparing honey, sugar, and jaggery syrup as fixatives.

BACKGROUND: Since its discovery in 1859, formalin has been considered as the "gold standard" in tissue fixation. As formalin is highly toxic and carcinogenic, the quest for its substitute has started recently. Literature search reveals very sparse studies on natural substitute for formalin. Here, it is an attempt to explore eco-friendly, economical, and readily available natural substance for formalin substitute. AIM: The aim of our study was to evaluate the efficacy of natural fixatives such as honey, sugar, jaggery, and water in comparison to the standard fixative used like formalin. MATERIALS AND METHODS: Fresh goat tissues (tongue) were fixed separately with buffered 10% formalin (positive control), honey, sugar syrup, jaggery syrup, and distilled water (negative control). 24 h fixation was done at room temperature followed by conventional processing and routine H and E staining. The stained sections were assessed for cytoplasmic and nuclear detail by three pathologists under light microscope and were graded accordingly. RESULTS: The results showed statistically significant differences between jaggery with other natural fixatives for both nuclear details and cytoplasmic staining. CONCLUSION: The preservation of tissue by honey, sugar, and jaggery syrup was comparable to that of formalin. Among the three natural fixatives, jaggery syrup excelled. Hence, it can be considered as an equally effective formalin substitute.

Basaloid squamous cell carcinoma - A rare and aggressive variant of squamous cell carcinoma: A case report and review of literature.

Basaloid squamous cell carcinoma (BSCC) is a rare and aggressive variant of oral squamous cell carcinoma with a predilection for the tongue and in other locations, such as floor of the mouth, palate, retromolar trigone, and gingival mucosa. Here, we present a case of BSCC of oropharynx in a 60-year-old male patient.

Eosinophilic ulcer of the tongue masquerading as malignant ulcer: An unexplored distinct pathology.

Eosinophilic ulcer (EU) is a rare self-limiting chronic benign ulcerative lesion of the oral mucosa often misdiagnosed as oral malignancy. Its etiopathogenesis is ambiguous, but trauma plays an important role in the development. Microscopically, it is characterized by a polymorphic inflammatory infiltrate with a prominent eosinophilic component and large mononuclear cells extending deep into the submucosa, underlying muscle and salivary glands. We discuss a case of EU in a 55-year-old male, which presented with a symptomatic nonhealing ulcer on the right lateral border of the tongue and was further clinically misdiagnosed as malignant ulcer.

The role of vascular endothelial growth factor in proliferation of odontogenic cysts and tumors: An immunohistochemical study.

BACKGROUND: Vascular endothelial growth factor (VEGF) is capable of initiating angiogenesis in blood vessels and may act as mitogenic agent for epithelium of odontogenic cysts and tumors. This study was conducted to evaluate the role of epithelial VEGF expression in odontogenic cysts and ameloblastoma and its correlation with argyrophilic nucleolar organizer region counts to assess its role in their biological behavior. MATERIALS AND METHODS: In this retrospective cross-sectional study, 45 histologically confirmed cases, 15 cases of each of keratocystic odontogenic tumors (KCOTs), dentigerous cysts, and ameloblastomas were examined for immunohistochemical expression for epithelial VEGF, and argyrophilic nucleolar organizer regions (AgNORs) (used as secondary marker in this study) staining was done for comparing the proliferative capacity with VEGF. RESULTS: KCOT shows mild expression within the basal layers and strong expression in the suprabasal layer whereas, in dentigerous cysts, a majority showed no VEGF expression whereas ameloblastomas showed strong expression in all cases by stellate reticulum-like cells at the center of the follicles and suprabasal layers of epithelium. The results of AgNOR counts were higher in KCOTs as compared to ameloblastoma and least in dentigerous cysts. CONCLUSION: VEGF expression by the epithelium of odontogenic cysts and tumors may play a role in epithelial proliferation via autocrine mechanism as reflected by increased AgNOR counts. The angiogenic activity via paracrine pathway may be responsible for the difference in growth rate and neoplastic behavior of the lesions.

Maxillary Glandular Odontogenic Cyst: An Uncommon Entity at an Unusual Site.

The glandular odontogenic cyst (GOC) is a rare developmental cyst that was described in 1988 by Gardner, et al. This lesion demonstrates non-specific clinical course and radiological findings. Hence, often confused with other lesions, but specific histopathlogical features help in establishing its correct diagnosis. This article presents a rare case of a maxillary glandular odontogenic cyst in a 70-year-old female patient.

Application of modified reverse panoramic radiograph on lambdoid suture for age estimation.

BACKGROUND: Cranial suture closure has long been recognized as a character of human development related to aging. For this reason, it has been utilized for various forensic and archaeological studies to determine the age of an unidentified/or skeletonized individuals. Various cadaveric studies have established the role of lambdoid suture in age estimation, but not routinely practiced. The objective is to establish if any correlation exists between individual's age and lambdoid sutures closure status (ectocranially) in mortals through modified reverse panoramic radiograph (RPRg). METHODS: Total number of 85 subjects, 25 years and beyond were included in the study, and divided into four groups with an age interval of 10 years. Assessment of lambdoid suture closure was done according to Frederic Rating Scale on modified RPRg. Data obtained was subjected to statistical analysis using Spearman's correlation test. RESULTS: A significant difference was observed between the age group and suture closure. Correlation coefficient of 0.570 was obtained, and was interpreted as a good correlation between the age and suture closure status with a P value of <0.001. CONCLUSIONS: Lambdoid suture can be very effective and practical tool for age assessment in mortals through modified RPRg (ectocranially).

Keratoameloblastoma or Kerato-odontoameloblastoma: report of its soft tissue recurrence with literature review.

Keratoameloblastoma (KA) is a rare histological variant of the ameloblastoma with extensive keratin production within the odontogenic islands as well as in the fibrous stroma. Pindborg first reported it in 1970, since then only 18 cases have been reported in the literature. We report a soft tissue recurrence of KA, involving right posterior region of the lower jaw in a 27-year-old female.

Chondrolipoma: Report of a rare intra oral variant with review of histiogenetic concepts.

Chondrolipomas are benign mesenchymal tumors characterized by the proliferation of mature adipocytes associated with variable amounts of mature cartilaginous tissue. Herein, we describe a case of chondrolipoma of the tongue in a 35-year-old Indian male. The lesion presented as a nodular, sessile, pink mass on posterio-dorsal surface of left side of the tongue since approximately 20 years. Histopathologically, the mass revealed a well circumscribed, encapsulated proliferation of mature adipocytes with islands of well formed mature cartilaginous tissue. Chondrolipomas are uncommon in the oral cavity, with only 14 cases being reported in the English literature.

Traumatic ulcerative granuloma with stromal eosinophilia.

Chronic ulcers of the oral mucosa are the lesions which a physician comes across frequently. "Eosinophilic Ulcer" is a rare variety of that. Eosinophilic ulcer or traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) is a chronic benign lesion of the oral mucosa and is a relatively recent delineated entity. Its etiopathogenesis is still uncertain but trauma seems to play a fundamental role. Clinically the lesion manifests as an isolated ulcer, showing a raised and indurated border in addition to a white or yellowish bed. Microscopically, it is characterized by diffuse polymorphic inflammatory infiltrate, rich in eosinophils, involving the superficial mucosa and the deeper muscle layer with epitheliod cells. Hereby, reporting a case of a 60-year-old female patient who presented with a chief complaint of non-healing painful ulcer on the tongue.

Odontogenic myxoma.

Odontogenic myxoma is a rare intraosseous neoplasm, which is benign but locally aggressive. It rarely appears in any bone other than the jaws. It is considered to be derived from the mesenchymal portion of the tooth germ. Clinically, it is a slow-growing, expansile, painless, non-metastasizing, central tumor of jaws, chiefly the mandible. Here we report the case of a typical odontogenic myxoma in a 26-year-old female patient, which had acquired large dimensions and involved the entire left half of the mandible including the ramus, resulting in a gross facial deformity, within a span of one and a half years.

Extraosseous calcifying cystic odontogenic tumor: An uncommon variant.

Odontogenic cysts comprise a diverse group of exceptional lesions derived from epithelial elements of the tooth-forming apparatus. Calcifying cystic odontogenic tumor is a rare odontogenic lesion, which represents about 2% of all odontogenic tumors and cysts. It may occur in a central (intraosseous) or peripheral (extraosseous calcifying cystic odontogenic tumor [ECCOT]) location. ECCOT in contrast to central, tends to affect the older patients, commonly located in the anterior lower jaw, is less aggressive and the recurrence is rare. Here, we report clinico-pathological and radiographic features of ECCOT located in relation to 48 (posterior lower jaw) measuring about 1 cm in the greatest diameter in a 17-year-old male.

Granular cell ameloblastoma showing desmoplasia.

Our case of ameloblastoma had a surprisingly long 25 year history, with abnormally large dimensions, a multilocular diffuse-mixed radiographic picture, and was histopathologically diagnosed as granular cell ameloblastoma with desmoplasia. To the best of our knowledge, this is the first ameloblastoma ever reported, that has shown combined features of granular cells, desmoplasia, ameloblastic follicles, plexiform, and acanthomatous patterns. The nature of granular cells in this type of tumor and the significance of their presence have also been reviewed. From the studies on ameloblastomas to date, it seems that the old belief that granular cell ameloblastoma is the most aggressive variant of ameloblastoma is a myth, and in all probability, granular cells are just a transitional or matured phase in the life cycle of ameloblastomas, starting with normal stellate reticulum-like cells, leading to a production of granules and finally leading to degeneration and formation of cystic areas.

Peripheral cemento-ossifying fibroma: Report of a recurrence case.

Peripheral cemento-ossifying fibroma [PCOF] is a reactive gingival overgrowth occurring frequently in the maxillary anterior region in teenagers and young adults. Here, we report a case of POCF in a 13-year-old male, which was previously surgically excised and had recurred after a period of 9 months. PCOF should be considered in differential diagnosis of such reactive hyperplastic lesions originating from the gingiva. Hence, early diagnosis with proper surgical excision and aggressive curettage of the adjacent tissues are essential for prevention of recurrence.

Non-infiltrating angiolipoma of the upper lip: A rare entity.

Angiolipoma is a variant of lipoma with a prominent vascular component. It is the most common tumor of the forearm followed by trunk and extremities of young individuals. It's occurrence in head and neck region is rare. In this report, we present clinical and histopathologic features of non-infiltrating angiolipoma occurring on the upper lip in a 9-year-old female. Toluidine blue stain is used to demonstrate increased mast cell density around blood vessels, speculating its role in vasculogenesis.