End-to-Side Versus End-to-End Venous Anastomosis Using Couplers in Mandibular Reconstruction: A Comparative Study.

Purpose: This study compares the advantages of end-to-side technique over end-to-end technique for venous anastomosis using couplers. Methods: Patients were divided into group I and group II based on end-to-side and end-to-end techniques, respectively. Intraoperative anastomotic time, flap ischemic time, and postoperatively flap vitality were the parameters evaluated. Results: Thirty-eight patients were randomly allocated to two groups with 19 patients in each group. The mean anastomotic time with standard deviation in group I was 391.84 ± 49.052 s and in group II was 354.47 ± 46.365 s with p value 0.021. The mean flap ischemic time with standard deviation in group I was 180.68 ± 35.773 min and in group II was 161.21 ± 32.418 min with p value 0.087. All the flaps in group I were vital, whereas 78.9% of flap vitality was observed in group II with p value 0.105. Conclusion: Based on this study, end-to-side venous anastomosis using couplers is a better technique over end-to-end venous anastomosis.

Identification of Novel Cytochrome C1 (CYC1) Gene Expression in Oral Squamous Cell Carcinoma- An Evaluative Study.

Introduction: Cytochrome C1 (CYC1) is an important subunit of mitochondrial complex III and plays a vital role in oxidative phosphorylation (OXPHOS) and reactive oxygen species generation. Overexpression of the CYC1 gene has been implicated in cancer development and its prognosis previously, but unexplored in head-and-neck squamous cell carcinomas (HNSCC), especially oral squamous cell carcinoma (OSCC). Materials and Methods: CYC1 m-RNA expression and gene alterations were assessed using the Cancer Genome Atlas dataset in HNSCC and validated in OSCC tissues using real-time polymerase chain reaction (RT-PCR). The protein-protein interaction (PPI) network and functional enrichment pathways were also analysed. Results: A thorough analysis of the TCGA (The Cancer Genome Atlas) database revealed that CYC1 was overexpressed in the HNSCC cases and the increased expression correlated with several parameters which involve the prediction of advanced diseases such as histopathological grade, tumour-node-metastasis staging, and nodal metastases (P < 0.05). The expression of CYC1 was validated using RT-PCR showing significant upregulation (P < 0.05) in OSCC tissue samples compared to the normal tissue counterparts. PPI network and functional analysis show the prominent role of CYC1 in OXPHOS, especially in electron transport chain III complex regulation. Discussion: The study revealed that CYC1 is highly expressed in HNSCC, and is validated in the OSCC patient tissue samples compared to the normal counterparts and associated with advanced disease stages and grade of the tumour. CYC1 could be a novel promising therapeutic and prognostic marker in HNSCC, especially in OSCC.

Epidemiology of carbapenem-resistant Escherichia coli and first report of blaVIM carbapenemases gene in calves from India.

A cross-sectional study on six dairy farms was conducted to ascertain the occurrence of carbapenem-resistant Escherichia coli in calves. Two-hundred and seventy-nine isolates of E. coli were recovered from 90 faecal samples from apparently healthy (45) and diarrhoeal (45) calves. The isolates were screened for phenotypic susceptibility to carbapenems and production of metallo ß-lactamase, as well as five carbapenemase resistance genes by PCR, and overexpression of efflux pumps. Eighty-one isolates (29.03%) were resistant to at least one of three carbapenem antibiotics [meropenem (23.30%), imipenem (2.15%) and ertapenem (1.43%)], and one isolate was positive for the blaVIM gene which was located on an Incl1 plasmid of a novel sequence type (ST 297) by multilocus sequence typing. The majority (83.95%) of isolates had an active efflux pump. Calves housed on concrete floors were approximately seven times more likely to acquire meropenem-resistant isolates than those housed on earthen floors (95% CI 1.27-41.54). In India, carbapenem drugs are not used in food animal treatment, hence carbapenem-resistant strains in calves possibly originate from the natural environment or human contact and is of public health importance. To our knowledge, this is the first report of blaVIM carbapenemases gene in calves from India.

Molecular characterisation of blaOXA-48 carbapenemase-, extended-spectrum ß-lactamase- and Shiga toxin-producing Escherichia coli isolated from farm piglets in India.

OBJECTIVES: The aim of this study was to characterise carbapenemase-, extended-spectrum ß-lactamase (ESBL)- and Shiga toxin-producing Escherichia coli isolated from farm piglets in India. METHODS: Faecal samples (n=741) from 10 organised pig farms, including non-diarrhoeic (n=546) and diarrhoeic (n=195) piglets, were processed for isolation of carbapenem-resistant and ESBL-producing E. coli. RESULTS: A total of 27 and 243 isolates were phenotypically confirmed as carbapenem-resistant and ESBL-producers, respectively. The meropenem minimum inhibitory concentration (MIC) of carbapenem-resistant isolates ranged from 8-128µg/mL. On genotypic screening of the 27 carbapenem-resistant isolates, 3 isolates were positive for the blaOXA-48 carbapenemase gene; no other carbapenemase genes were detected. The 243 ESBL-producing isolates were positive for blaCTX-M-1 (n=135), qnrA (n=92), qnrB (n=112), qnrS (n=49), tetA (n=42), tetB (n=45) and sul1 (n=43). The Shiga toxin virulence markers stx1 and stx2 were detected in 41 and 38 of the 243 phenotypic ESBL-producing isolates, respectively. Multilocus sequence typing (MLST) of blaOXA-48-positive E. coli isolates showed ST10- and ST5053-like sequence types. CONCLUSION: This is the first report on the presence of blaOXA-48-carrying E. coli in piglets in India, which pose a potential risk to public health.

Clinical Significance of an Unusual Variation: Anomalous additional belly of the sternothyroid muscle.

The infrahyoid muscles are involved in vocalisation and swallowing; among these, the sternothyroid muscle is derived from the common primitive sheet. The improper differentiation of this muscle may therefore result in morphological variations. We report an unusual variation found during the dissection of a 65-year-old male cadaver at the Sri Manakula Vinayagar Medical College, Madagadipet, Pondicherry, India, in 2015. An anomalous belly of the right sternothyroid muscle was observed between the internal jugular (IJ) vein and the internal carotid artery with an additional insertion into the tympanic plate and petrous part of the temporal bone and the presence of a levator glandulae thyroideae muscle. The anomalous muscle may compress the IJ vein if it is related to the neurovascular structures of neck; hence, knowledge of variations of the infrahyoid muscles can aid in the evaluation of IJ vein compression among patients with idiopathic symptoms resulting from venous congestion.