Outcome Study of Mandibular Fractures Treated by Surgical Stabilization With Plates and Screws.

This study aims to assess the outcomes of mandibular fractures treated through surgical stabilization using plates and screws, focusing on factors such as postoperative complications, patient satisfaction, and functional recovery. A total of 42 patients were included in the study. Surgical interventions involved the application of plates and screws at the fracture sites. Postoperative complications, including infection, hardware failure, and malocclusion, were recorded. Surgical stabilization of mandibular fractures using plates and screws demonstrates favorable outcomes in terms of stability, occlusal alignment, and patient satisfaction. The findings of this study contribute valuable insights into the efficacy of this surgical approach, highlighting its role in achieving successful outcomes for mandibular fracture management. Further prospective studies and randomized controlled trials are recommended to strengthen the evidence base and refine treatment protocols.

Evaluating seismic risk by MCDM and machine learning for the eastern coast of India.

Natural disasters such as earthquakes endanger human lives and infrastructure, particularly in urban areas. With the advancements in science and technology in understanding natural hazards, recent studies have attempted to mitigate them by mapping the risks using geospatial technology. In this paper, we attempt to integrate the multi-criteria decision-making (MCDM) models, namely the Analytical Hierarchy Process (AHP) and the Criteria Importance Through Inter-criteria Correlation (CRITIC), besides using the artificial neural network (ANN) to assess the seismic risk in the eastern coast of India. The AHP-CRITIC technique is used to evaluate the earthquake coping capacity and vulnerability and has been further used to generate a training base for earthquake probability mapping by ANN. The earthquake probability and spatial intensity information are used to develop the hazard map. Following that, integrating vulnerability, hazard and coping capacity spatial information assessed earthquake risk. Our results indicate that approximately 5% of the study area is at high risk, whilst more than 11% of the population is at high risk due to seismic induced hazards. The area under the curve of the receiver operating characteristic curve is 0.85, which indicates reliable results. The results of this study may help various agencies involved in planning, development and disaster mitigation to develop seismic hazard mitigation methods by better understanding their impacts on the eastern coastal region of India.

Osteoblastoma of the frontal sinus: A rare case presenting with seizures and pneumocephalus.

Key Clinical Message: Osteoblastoma of the frontal sinus, although rare, can manifest with seizures and pneumocephalus, underscoring the importance of thorough evaluation and complete surgical excision to prevent serious complications and ensure optimal patient outcomes. Abstract: Osteoblastoma is an infrequent bone tumor, with origins typically in the vertebrae and long bones. While craniofacial involvement is rare, it may occur in regions such as the paranasal sinuses. We present a case of osteoblastoma located in the frontal sinus, an exceptionally uncommon site, resulting in seizures secondary to pneumocephalus. A 21-year-old male presented with a generalized tonic-clonic seizure and postictal confusion. Imaging studies revealed a well-defined lesion in the left frontal sinus causing cortical breach, destruction of the posterior wall, and pneumocephalus. A total surgical excision was performed through bifrontal craniotomy. Histopathological analysis confirmed the diagnosis of osteoblastoma. Postoperative recovery was uneventful, with a follow-up CT scan showing complete lesion excision. Osteoblastomas, especially in the cranial sinuses, are rare entities that may present asymptomatically but can lead to severe complications. The risk of recurrence underscores the importance of complete surgical resection for optimal patient outcomes.

Unifocal Tubercular Osteomyelitis of Ulna Diaphysis in a Child: A Case Report.

Introduction: Osteoarticular tuberculosis (OATB) contributes to around 10% of extrapulmonary tuberculosis of which the spine is the most common site. Isolated involvement of ulna diaphysis is extremely rare. We present a case of unifocal tuberculous osteomyelitis of ulna diaphysis in a 3 -year-old male child and highlight its resemblance with musculoskeletal tumors and stress the importance of GeneXpert mycobacterium tuberculosis (MTB)/resistance to rifampicin (RIF) in the diagnosis of OATB. Case Report: A mother of a 2-year-old male child incidentally noticed that her son complained of left forearm pain. She was not sure of any fall or trauma to the forearm. No history of fever or other constitutional symptoms was present. Clinical examination was uneventful except for local tenderness in over the dorsomedial aspect of the left mid forearm. A plain radiograph revealed an oval solitary lytic lesion over distal one-third ulna diaphysis. A needle biopsy was done after clinical, hematological, and radiological evaluation, and finally, GeneXpert detected tuberculosis without RIF. No further tests were required and the child was started on antitubercular therapy (ATT) which resulted in complete healing without any symptoms. Conclusion: The authors conclude that it is therefore essential to consider tuberculosis in the differential diagnosis while evaluating a lytic bone lesion. Where possible, all patients should have a biopsy of the lesion and provide a specimen for GeneXpert MTB/RIF to confirm the diagnosis and drug susceptibility testing.

Perioperative Management Conundrum for a Case With Multiple Commonly Used Drug Hypersensitivity.

Perioperative hypersensitivity reactions vary from mild to potentially fatal anaphylaxis, resulting in significant morbidity and mortality. Most of the perioperative hypersensitivity and allergic reactions are attributed to antibiotics, antiseptic solutions, latex, and opioids. In the current thrust for opioid-free anesthesia, owing to its multiple advantages, paracetamol and nonsteroidal antiinflammatory agents play a significant role in multi-modal pain and inflammatory response management. Nearly nine out of ten individuals experience postoperative pain, one-third experience postoperative nausea and vomiting, and one-fourth experience fever, irrespective of surgery and type of anesthesia, often as an inflammatory response. While perioperative hypersensitivity reactions are common, a patient allergic to multiple commonly used drugs for the treatment of pain, fever, acid-peptic disorder, and nausea and vomiting is scarce. Such cases pose a great challenge in perioperative management. A 14-year-old male child with a traumatic foot drop planned for tibialis posterior tendon transfer developed an allergic reaction with mild fever following an injection of Ranitidine and Ondansetron in the preoperative area. Surgery was deferred and was investigated for allergy profile testing for commonly used drugs, which showed high IgE levels and moderate to severe hypersensitivity for diclofenac and paracetamol. The patient was operated on after one month under spinal anesthesia, avoiding ranitidine, ondansetron, diclofenac, and paracetamol. The following morning, he developed a high-grade fever (102.3° F), which did not resolve with conservative measures. Hypersensitivity and allergic reactions to NSAIDs are reported in the literature. While there are multiple drugs available as NSAIDs, cross-sensitivity or allergy to other drugs within the same group, and even chemically related groups, is also another possibility that needs to be considered while managing such patients. Mefenamic acid controlled the fever, and the child was discharged home after 48 hours of observation. However, the case posed a great perioperative management dilemma; the present report intends to highlight and discuss it.

Impairments in pulmonary functions in paediatric spinal tuberculosis: a cross-sectional study.

PURPOSE: This study aimed to investigate the impact of vertebral column destruction and kyphotic deformity due to spinal tuberculosis on pulmonary functions in paediatric patients. METHODS: A cross-sectional study was conducted, involving 30 patients diagnosed with healed spinal tuberculosis, aged 7-18 years. Detailed radiographic measurements, including the level of involvement, kyphosis angle, Spinal Deformity Index (SDI), and drug-resistance status, were compared with various pulmonary function parameters. RESULTS: The mean age of the study group was 12.8 ± 2.7 years (range 7-17 years), consisting of 11 males and 19 females. Fourteen patients were managed conservatively and 16 were managed operatively. The mean SDI was 5.2 ± 4.7. The mean kyphotic angle was 31.3° ± 25.3. The average number of involved vertebrae was 2.6 ± 1.5. Pulmonary functions were classified as restrictive in 24 patients, normal in 4 patients, obstructive in 1 patient, and mixed in 1 patient. Multidrug-resistant tuberculosis (MDR-TB) was detected in 5 (16.7%) patients, while the remaining 25 (83.3%) patients were sensitive to conventional antitubercular drugs. The correlation coefficients between the percentage reduction in forced vital capacity (FVC) and kyphosis angle, SDI, and number of vertebrae were 0.4 (p = 0.026), 0.4 (p = 0.028), and 0.19 (p = 0.295), respectively. The mean percentage reduction in FVC and total lung capacity (TLC) were 35.8 ± 15.7 and 6.2 ± 2.3, respectively. No significant association was observed between pulmonary functions and drug sensitivity status (p = 0.074). CONCLUSIONS: Paediatric spinal tuberculosis can lead to thoracic insufficiency due to progressive destruction and shortening of the spinal column, spinal growth inhibition, and kyphotic deformity. Management of these cases should focus on promoting normal lung development while ensuring disease resolution and deformity correction. Further research should explore growth conserving or growth guiding systems to address or prevent growth retardation and simultaneously provide spinal stabilization.

Tibial lengthening for massive distal femoral bone loss.

A man in his 30s was involved in a road traffic accident (RTA) and sustained a grade-IIIA distal femur fracture with acute loss of distal two-third of the femur. Initially, damage control surgery was done by an external fixator application. Later, staged limb reconstruction surgery was undertaken as a definitive procedure that involved bifocal distraction osteogenesis involving the proximal tibia and femur along with docking of the corticotomised femoral fragment onto the tibial plateau to achieve knee arthrodesis. The tibial and femoral regenerate together measured 25.8 cm at the end of distraction phase leaving behind a limb length discrepancy of 5 cm. Acute traumatic large bone loss is a rare presentation and is beset with unique management challenges. Limb reconstruction surgery (LRS) with LRS system provides flexibility to tackle individual case-based scenarios and helps achieve limb length, maintain alignment and restore function.

Rapid metabolic fingerprinting with the aid of chemometric models to identify authenticity of natural medicines: Turmeric, Ocimum, and Withania somnifera study.

Herbal medicines are popular natural medicines that have been used for decades. The use of alternative medicines continues to expand rapidly across the world. The World Health Organization suggests that quality assessment of natural medicines is essential for any therapeutic or health care applications, as their therapeutic potential varies between different geographic origins, plant species, and varieties. Classification of herbal medicines based on a limited number of secondary metabolites is not an ideal approach. Their quality should be considered based on a complete metabolic profile, as their pharmacological activity is not due to a few specific secondary metabolites but rather a larger group of bioactive compounds. A holistic and integrative approach using rapid and nondestructive analytical strategies for the screening of herbal medicines is required for robust characterization. In this study, a rapid and effective quality assessment system for geographical traceability, species, and variety-specific authenticity of the widely used natural medicines turmeric, Ocimum, and Withania somnifera was investigated using Fourier transform near-infrared (FT-NIR) spectroscopy-based metabolic fingerprinting. Four different geographical origins of turmeric, five different Ocimum species, and three different varieties of roots and leaves of Withania somnifera were studied with the aid of machine learning approaches. Extremely good discrimination (R2 > 0.98, Q2 > 0.97, and accuracy = 1.0) with sensitivity and specificity of 100% was achieved using this metabolic fingerprinting strategy. Our study demonstrated that FT-NIR-based rapid metabolic fingerprinting can be used as a robust analytical method to authenticate several important medicinal herbs.

A Novel Rhodamine Probe Acting as Chemosensor for Selective Recognition of Cu2+ and Hg2+ Ions: An Experimental and First Principle Studies.

Copper and Mercury ions have vital role to play in biological world as their excess or deficiency can cause different type of diseases in human being as well as biological species including plants and animals. Therefore, their detection at trace level becomes very important in term of biological. The current studies embody the fabrication, structural characterization and recognition behavior of a novel rhodamine B hydrazone formed when hydrazide of rhodamine B was condensed with 5-Allyl-3-methoxy salicylaldehyde (RBMA). RBMA was found to be responsive towards the very trace level of Cu2+ and Hg2+ among other tested cations so far. The sensing procedure is based on the classical opening of the spiroatom ring of rhodamine. The limit of detection (LOD) and binding constant is 5.35 ppm, 2.06 × 104 M-1 and 5.16 ppm, 1.26 × 104 M-1 for Cu2+ and Hg2+ ions respectively. The probable mechanism correlates the specific binding of RBMA with Cu2+ and Hg2+ ions. The 1:1 stoichiometry of RBMA with Cu2+ and Hg2+ ions have been supported by HRMS, FT-IR data, Job's plot, and binding constant data. Reversibility is well exhibited by RBMA by the involvement of CO32- ions via demetallation process. The real time application is well demonstrated by the use of paper strip test. The DFT study also carried out which agrees well with the experimental findings. The results displayed the novelty of this current work towards the trace level analysis of the Cu2+ and Hg2+ of the cations which are play the crucial role in industry.

Impact of anthropogenic and land use pattern change on spatio-temporal variations of groundwater quality in Odisha, India.

The groundwater physicochemical parameters were studied to understand their spatiotemporal variations and groundwater quality, using the statistical and entropy weights methods. Out of ten parameters that were considered, F-, TDS, and Cl- appear to be the major contributors influencing the quality of groundwater. The Principal Component Analysis (PC1, PC2) indicates that the majority of ions are derived from both natural and anthropogenic sources. Studies of saturation indices of gypsum, Halite, dolomite, and calcite indicate that dissolution of these salts also affects groundwater salinization. In coastal areas, a few of the water samples also appear to be contaminated by the mixing of seawater. The entropy weights, which are free from subjective biases were used to estimate the water quality index. The entropy-based water quality index (EWQI) varies from excellent to good quality for the year 2012-13, and appears to degrade after 2015 onwards. For the year 2018-19 and 2021-22, 71.42% and 68.42% of the study areas show excellent water quality, followed by 25.33% and 24.33% (good), 2.54% and 3.54% (average), 0.7% and 3.7% study area shows as poor quality respectively. The groundwater quality, particularly in the western, central, northern, and eastern parts of the region, appears to be average, poor, and very poor in several small patches, respectively. Industrial developments, mining activities, irrigation, changing land use patterns, agricultural activities, and increased anthropogenic activities may be contributing to the degradation of the water quality.

Mycorrhizae set the stage for plants to produce a higher production of biomolecules and stress-related metabolites: a sustainable alternative of agrochemicals to enhance the quality and yield of beetroot (Beta vulgaris L.).

Population explosions, environmental deprivation, and industrial expansion led to an imbalanced agricultural system. Non-judicial uses of agrochemicals have decreased agrodiversity, degraded agroecosystems, and increased the cost of farming. In this scenario, a sustainable agriculture system could play a crucial role; however, it needs rigorous study to understand the biological interfaces within agroecosystems. Among the various biological components with respect to agriculture, mycorrhizae could be a potential candidate. Most agricultural crops are symbiotic with arbuscular mycorrhizal fungi (AMF). In this study, beetroot has been chose to study the effect of different AMFs on various parameters such as morphological traits, biochemical attributes, and gene expression analysis (ALDH7B4 and ALDH3I1). The AMF Gm-Funneliformis mosseae (Glomus mosseae), Acaulospora laevis, and GG-Gigaspora gigantean were taken as treatments to study the effect on the above-mentioned parameters in beetroot. We observed that among all the possible combinations of mycorrhizae, Gm+Al+GG performed best, and the Al-alone treatment was found to be a poor performer with respect to all the studied parameters. This study concluded that the more the combinations of mycorrhizae, the better the results will be. However, the phenomenon depends on the receptivity, infectivity, and past nutrient profile of the soil.

An assessment of the impact of structure and type of microplastics on ultrafiltration technology for microplastic remediation.

Microplastic, which is of size less than 5 mm, is gaining a lot of attention as it has become a new arising contaminant because of its ecophysiology impact on the aquatic environment. These microplastics are found in freshwater or drinking water and are the major carriers of pollutants. Removal of this microplastic can be done through the primary treatment process, secondary treatment process, and tertiary treatment process. One approach for microplastic remediation is ultrafiltration technology, which involves passing water through a membrane with small pores to filter out the microplastics. However, the efficiency of this technology can be affected by the structure and type of microplastics present in the water. New strategies can be created to improve the technology and increase its efficacy in removing microplastics from water by knowing how various types and shapes of microplastics react during ultrafiltration. The filter-based technique, that is, ultrafiltration has achieved the best performance for the removal of microplastic. But with the ultrafiltration, too some microplastic that are of sizes less than of ultrafiltration membrane passes through the filter and enters the food chain. Accumulation of this microplastic on the membrane also leads to membrane fouling. Through this review article, we have assessed the impact of the structure, size, and type of MPs on ultrafiltration technology for microplastic remediation, with that how these factors affect the efficiency of the filtration process and challenges occur during filtration.

A dual channel rhodamine appended smart probe for selective recognition of Cu2+ and Hg2+ via "turn on" optical readout.

A new rhodamine-6G hydrazone RHMA has been synthesized using rhodamine-6G hydrazide and 5-Allyl-3-methoxysalicylaldehyde. RHMA has been fully characterized with different spectroscopic methods and single crystal XRD. RHMA can selectively recognize Cu2+ and Hg2+ in aqueous media amongst other common competitive metal ions. A significant change in absorbance was observed with Cu2+ and Hg2+ ions with emergence of a new peak at λmax 524 nm and 531 nm respectively. Hg2+ ions lead to "turn-on" fluorescence enhancement at λmax 555 nm. This event of absorbance and fluorescence marks the opening of spirolactum ring causing visual color change from colorless to magenta and light pink.RHMA-Cu2+ and RHMA- Hg2+complexes are found to be reversible in presence of EDTA2-ions. RHMA has real application in form of test strip. Additionally, the probe exhibits turn-on readout-based sequential logic gate-based monitoring of Cu2+ and Hg2+ at ppm levels, which may be able to address real-world challenges through simple synthesis, quick recovery, response in water, "by-eye" detection, reversible response, great selectivity, and a variety of output for accurate investigation.

Comprehensive Metabolomic Fingerprinting Combined with Chemometrics Identifies Species- and Variety-Specific Variation of Medicinal Herbs: An Ocimum Study.

Identification of plant species is a crucial process in natural products. Ocimum, often referred to as the queen of herbs, is one of the most versatile and globally used medicinal herbs for various health benefits due to it having a wide variety of pharmacological activities. Despite there being significant global demand for this medicinal herb, rapid and comprehensive metabolomic fingerprinting approaches for species- and variety-specific classification are limited. In this study, metabolomic fingerprinting of five Ocimum species (Ocimum basilicum L., Ocimum sanctum L., Ocimum africanum Lour., Ocimum kilimandscharicum Gurke., and Hybrid Tulsi) and their varieties was performed using LC-MS, GC-MS, and the rapid fingerprinting approach FT-NIR combined with chemometrics. The aim was to distinguish the species- and variety-specific variation with a view toward developing a quality assessment of Ocimum species. Discrimination of species and varieties was achieved using principal component analysis (PCA), partial least squares discriminate analysis (PLS-DA), data-driven soft independent modelling of class analogy (DD-SIMCA), random forest, and K-nearest neighbours with specificity of 98% and sensitivity of 99%. Phenolics and flavonoids were found to be major contributing markers for species-specific variation. The present study established comprehensive metabolomic fingerprinting consisting of rapid screening and confirmatory approaches as a highly efficient means to identify the species and variety of Ocimum, being able to be applied for the quality assessment of other natural medicinal herbs.

Suitability of the Lower Ganga basin groundwater for irrigation, using hydrogeochemical parameters and land-use dynamics.

The northern Ganga basin is one of the most densely populated basins in the world. Most agricultural and industrial contaminants drained in the river length are likely to be accumulated in the lower part of the Ganga basin. In this study, we have used ten parameters obtained from 495 sampling locations, besides using long-term climate data (GLDAS_NOAH025_M) to understand the irrigation suitability using the TOPSIS model. Multi-criteria decision making (MCDM) model using TOPSIS has been used to make the best choices from the available finite number of alternatives based on their ranking. The entropy weights for the irrigation suitability parameters such as electrical conductivity (Ec), sodium adsorption ratio (SAR), magnesium hardness (MH), sodium percent (Na%), total hardness (TH), Kelly's ratio (KR), permeability index (PI), chloride concentration (Cl-), groundwater level fluctuation (GWLF), and the Lang factor (Df) are found to be 0.08, 0.14, 0.02, 0.02, 0.04, 0.08, 0.01, 0.32, 0.29, and 0.01, respectively. We find that SAR, Cl-, and GWLF control the water quality for irrigation in the Lower Ganga basin since these parameters have relatively higher entropy weights (more than 0.10). The results obtained from the computed performance index or the closeness coefficient show that the area percent having very good and good groundwater quality for irrigation in the Lower Ganga basin is 77.03% and 22.97% respectively. The land-use change dynamics for the between 2000 and 2015 estimated using the transition matrix shows a positive percentage change for settlement (133.50%), wetland (35.04%), and bare area (0.98%); however, several other classes such as the agriculture (- 0.85%), forest (- 0.49%), grassland (- 14.38%), sparse vegetation (- 11.39%), and water (- 4.12%) show a decreasing trend. The highest amount of percentage change was observed in settlement areas which were contributed by other land-use classes such as agriculture (694.43 km2), water (41.61 km2), forest (16.77 km2), and grassland (1.86 km2). The results may be useful to the concerned organization for the proper planning and management of water resource for sustainable development.

An Unusual Presentation of a Rare Disease: Eosinophilic Fasciitis.

Eosinophilic fasciitis is an uncommon disorder presenting with diffuse fasciitis and peripheral eosinophilia. Due to the rarity of this disorder and limited literature, its diagnosis and treatment are often delayed. We present the case of a young male wherein the diagnosis of eosinophilic fasciitis was initially delayed due to an atypical presentation. However, after the diagnosis was confirmed, the patient was successfully managed with oral corticosteroids. A well-written informed consent was obtained from the patient prior to the preparation of this manuscript. An 18-year-old right-hand dominant male presented with a sudden onset, progressive, non-traumatic, left forearm swelling associated with a weak hand grip. The swelling was tender on examination with a local rise in temperature. Radiographs taken at the time of presentation revealed no osseous pathology. As the initial blood investigations were suggestive of a localized inflammatory pathology involving the forearm, the patient was managed with non-steroidal anti-inflammatory drugs and analgesics. He returned 6 months later with a recurrence of the symptoms. A magnetic resonance imaging scan of the left forearm was performed to further investigate the pathology and it was suggestive of a diffuse plaque-like thickening involving the myofascial layer of the muscles. Blood investigations showed peripheral eosinophilia, raised immunoglobulin G count, and raised inflammatory markers. A full-thickness forearm biopsy showed the presence of lymphocytic infiltration. A diagnosis of eosinophilic fasciitis was suspected and the patient was managed with oral corticosteroids, given as a tapering dose. Following this, the patient had symptomatic improvement with the resolution of the deranged blood parameters. He was asymptomatic at the latest follow-up of 4 years.

Outcome of Joint Aspiration in Acute Knee Haemarthrosis in a Haemophilic Joint: A Prospective Randomised Controlled Trial in 120 Patients in a Tertiary Haemophilia Care Centre.

Background: Bleeding into the joints cause major morbidity in haemophilia patients. The clinical hallmark of haemophilia is haemarthrosis especially in knee, ankle and elbow joint. Current literature suggests that aspiration of an acute haemarthrosis in haemophilia may lead to further bleeding and prevent tamponade effect. But the rehabilitation gets delayed, leading to joint stiffness and the function gets deteriorated. This study was done to evaluate the efficacy of joint aspiration in the management of acute knee haemarthrosis, with regard to pain relief and functional outcome. Materials and Methods: This is a prospective, randomised controlled trial in a tertiary care haemophilia treatment centre comprising 120 haemophilic patients with unilateral acute knee haemarthrosis. Factor level was checked and appropriate factor replacement [40%] was done. The patients were randomly allocated in two groups: Group A and Group B, each consisting of 60 patients. All patients received ice application, limb immobilisation, analgesics, physiotherapy and compression bandage as the routine primary management. In addition, study Group A also received therapeutic aspiration of the knee joint at initial presentation, after the first factor infusion. All patients were clinically evaluated for pain in terms of Visual Analogue Scale (VAS score) and function in terms of Haemophilic Joint Health Score [HJHS], before and at 4 h, 48 h and 7 days after initial factor administration. Results: All patients showed therapeutic improvement in terms of a declining trend in VAS and HJHS scores. Pain relief (VAS Score) in Group A, was found to be significantly better compared to Group B at the end of 4 h [4.80 ± 0.49 vs 6.54 ± 1.05; p < 0.001], 48 h [2.48 ± 0.50 vs 3.30 ± 0.46; p < 0.001] and 7 days [1.16 ± 0.37 vs 1.70 ± 0.46; p < 0.001]. Functional improvement (HJHS Score) in Group A, was found to be significantly better compared to Group B as well at the end of 4 h [11.24 ± 0.77 vs 14.52 ± 0.61; p < 0.001], 48 h [7.24 ± 0.65 vs 11.28 ± 0.64; p < 0.001] and 7 days [2.36 ± 0.48 vs 5.52 ± 0.67; p < 0.001]. Conclusion: Our study recommends the use of joint aspiration as a therapeutic tool in the holistic management of acute knee haemarthrosis in addition to usual treatment of ice application, immobilization and oral tranexamic acid. Early factor replacement along with therapeutic joint aspiration is a key for better pain relief and a better functional outcome.

Diagnosis of Intraosseous Hibernoma of an Appendicular Skeleton in an Adult - A Rare Case Report.

Introduction: Hibernoma is an uncommon benign tumor composed of multivacuolated brown adipocytes described in the literature a decade back. Intraosseous hibernomas are extremely rare with propensity to affect axial skeleton. Involvement of appendicular skeleton has been reported only twice in the literature till date. Case Report: We present a case of solitary, painless mass in the left proximal tibia mimicking neoplasm in a 35-year-old male. The plain radiographs revealed a lytic lesion with well-defined margin at the junction of metaphyseal-diaphyseal region of the left proximal tibia. The lesion was hyperintense on T2 and hypointense on T1 with heterogenous enhancement on contrast imaging. FDG-PET showed high uptake of fluorodeoxyglucose. Histopathological examination revealed the presence of multivacuolated cytoplasm with abundant mitochondria suggestive of hibernoma. On immunohistochemistry, the cells were positive for S-100. Conclusion: The findings of imaging modalities are non-specific and histopathological examination is required to confirm the diagnosis of hibernoma. Intraosseous hibernoma needs to be considered as a differential diagnosis of sclerotic bone lesion. Further, evaluation with regular follow-up with imaging will be required if the mass undergoes any clinical changes. Both radiologists and pathologists, need to be aware of this rare entity to avoid misdiagnosis of the uncommon lesion.

Linalool reduces the virulence of Pseudomonas syringae pv. tomato DC 3000 by modulating the PsyI/PsyR quorum-sensing system.

Quorum sensing modulatory effect of linalool was tested for the first time against Pseudomonas syringae pv. tomato DC 3000, a bacterial plant pathogen responsible for causing huge losses worldwide. DC 3000 extensively regulates its virulence traits through quorum sensing mechanism involving expression of psyI, an acyl-homoserine lactone (AHL) synthase gene and psyR, a luxR-type regulator. In this study, exposure of DC 3000 to 80 ppm linalool concentration resulted in reduced biofilm formation, hampered motility, decreased AHL production, and reduced secretion of plant cell wall-degrading enzymes followed by negligible effect on the bacterial count and its metabolic activity. Extracellular polymeric substances (EPS), which play a crucial role in the development of biofilm and subsequent infection was significantly reduced which was further confirmed by Fourier Transform Infrared Spectroscopy. The qRT PCR analysis of the gene expression analysis of virulence genes (syringafactin production gene syfA, type III secretion system gene hrpA, flagellar genes fleQ and fliC, and coronatine production gene cfl unveiled significant downregulation of the same under Lin 80 ppm concentration. To further confirm the aforementioned possibilities, docking simulations run between PsyR and linalool suggested a strong interaction with the developed protein model. Overall, the treatment of DC 3000 with Lin 80 ppm affected the phenotypic and genotypic expressions associated with quorum sensing, thereby significantly reducing the infection rate as observed in in-vivo plant assay.

Rare Case of Gaucher's Disease Presenting as a Solitary Swelling of the Proximal Tibia Mimicking a Musculoskeletal Tumor in an Adult: A Case Report.

Introduction: Gaucher's disease is a congenital lysosomal storage disorder caused by an autosomal recessive mutation in B-glucocerebrosidase. It is a multi-system disease, wherein patients present with hematological abnormalities, joint pain, osteonecrosis, and developmental delay. We present a case of 38-year-old male with a painless solitary soft-tissue swelling over the left proximal tibia, eventually diagnosed it to be a case of Gaucher's disease. This case is unique in the literature, because this subcutaneous Gaucher mass was not associated with a significant past history and was being evaluated as a standard approach to a bone tumor. Case Presentation: A 38-year-old man presented to our outpatient department with a solitary, painless soft-tissue swelling of the left proximal tibia noticed 6 months back, which has gradually progressed to a present size of 9x5 cm over a period of 6 months. General physical examination revealed moderate splenomegaly. Radiographs showed an osteolytic lesion in the left proximal tibia without cortical erosion. Radiographs for skeletal survey revealed similar osteolytic lesions elsewhere. Hematological investigations revealed thrombocytopenia. A serum protein electrophoresis was found to be normal and the urine was negative for myeloma proteins. Blood workup for endocrine abnormalities was within normal limits. MRI of the lesion suggests bone infarct. Biopsy from the lesion showed a giant binucleate storage cell filled with glucocerebrosides suggestive of Gaucher's disease. The diagnosis was confirmed by elevated plasma levels of glucocerebrosidases. Conclusion: Gaucher's disease is a rare metabolic disease of the bone which may mimic a primary bone tumor or metastasis. A step-wise meticulous approach with biopsy and elevated plasma levels of glucocerebrosidase helps establish the diagnosis. Once must have a high index of suspicion for Gaucher's disease in an adult with multiple osteolytic lesions without any significant past medical and surgical history.