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ObjectiveTo evaluate differences based on intrauterine device (IUD) frame geometry in force, and stress, and strain at the stem/arms junction during simulated IUD removal.Study designWe manufactured injection-molded frame models for three Nova-T IUDs (Mirena [model M]; Liletta [model L]; Kyleena [model K]) and a Tatum-T IUD (Paragard [model P]) at two-times scaling. We created a custom fixture to simulate the uterus and used a screw-driven machine to pull models at various displacement rates through the 10 cm fixture cavity to measure force and strain and calculate stress at the IUD stem/arms junction. We tested models at 30 mm/min and higher displacement rates for exploratory analyses. We used Mann-Whitney U test for statistical testing.ResultsWe completed testing at 30 mm/min using five of each Nova-T model and nine model P samples. Resistance against the cavity walls created significantly more force on model P (11.83, interquartile range [IQR] 11.61-12.31) than any Nova-T model samples (p

Research misconduct refers to deliberate or accidental manipulation or misrepresentation of research data, findings, or processes. It can take many forms, such as fabricating data, plagiarism, or failing to disclose conflicts of interest. Data falsification is a serious problem in the field of medical research, as it can lead to the promotion of false or misleading information. Researchers might engage in p-hacking - the practice of using someone else's research results or ideas without giving them proper attribution. Conflict of interest (COI) occurs when an individual's personal, financial, or professional interests could potentially influence their judgment or actions in relation to their research. Nondisclosure of COI can be considered research misconduct and can damage the reputation of the authors and institutions. Hypothesis after results are known can lead to the promotion of false or misleading information. Cherry-picking data is the practice of focusing attention on certain data points or results that support a particular hypothesis, while ignoring or downplaying results that do not. Researchers should be transparent about their methods and report their findings honestly and accurately. Research institutions should have clear and stringent policies in place to address scientific misconduct. This knowledge must become widespread, so that researchers and readers understand what approaches to statistical analysis and reporting amount to scientific misconduct. It is imperative that readers and researchers alike are aware of the methods of statistical analysis and reporting that constitute scientific misconduct. Keywords: Conflict of interest, data fabrication, misconduct, p-hacking, plagiarism, Author(s): Karthik N. Rao (corresponding author) [1]; Manish Mair [2]; Ripu D. Arora [3]; Prajwal Dange [3]; Nitin M. Nagarkar [4] Introduction Research misconduct refers to the deliberate or accidental [...]

Background: The second wave of the COVID-19 pandemic led to a very dreaded complication of mucormycosis. Immunosuppressive action of the COVID-19 virus, co-morbidities, for example, diabetes mellitus (DM), hypertension, use of steroids, and humidified oxygen, are among the important factors that make the patients susceptible to developing mucormycosis. Objective: The present study was conducted to identify and understand all the significant histological changes including the type and extent of tissue involvement, the pattern of inflammation, the volume of fungal hyphae, hemorrhage, etc., in patients with COVID-19 associated mucormycosis (CAM) and correlate with clinical outcome. Method: It was a retrospective cross-sectional observational study involving all the patients of CAM, who underwent debridement or biopsy over a period of 5 months, from April 01, 2021, to August 31, 2021. CAM was classified based on the radiological evaluation, clinical features, and organs involved. Different demographic, clinical, laboratory, and histologic parameters were recorded. The variables were assessed for their association with poor clinical outcomes using multiple logistic regression. P < 0.05 was considered statistically significant. Results: A total of 146 patients were included in the study with a mean age of 49.4 years and 71.2% were male. Sino-naso-palatal was the most common type of CAM (32.9%), while sino-naso-cerebral was the least common (14.3%). DM was present in 54.1% of patients, out of which 26.6% were recently diagnosed. The death occurred in 21.9% of patients. Maximum mortality was observed in CAM of sino-naso-cerebral involvement (42.9%). Total leucocyte count (TLC) [OR = 0.87; 95%CI: 0.76-0.97; P = 0.02] and C-reactive protein (CRP) [OR = 0.97; 95%CI: 0.96-0.99; P = 0.008] were significantly associated with poor outcomes. Other factors, that is, high prothrombin time, DM, ferritin, and the involvement of muscle, skin, and cartilage, were also associated with poor clinical outcomes but were not statistically significant. Similarly, high fungal volume and the presence of thrombosis were also associated with poor outcomes but were not statistically significant. Conclusion: CAM more commonly affects males with co-morbidities. TLC and CRP were significantly associated with poor outcomes. Histologically, the involvement of skin, muscle, and cartilage and the presence of excessive fungal hyphae and thrombosis were also associated with poor outcomes.

DYRK1A, a ubiquitously expressed kinase, is linked to the dominant intellectual developmental disorder, microcephaly, and Down syndrome in humans. It regulates numerous cellular processes such as cell cycle, vesicle trafficking, and microtubule assembly. DYRK1A is a critical regulator of organ growth; however, how it regulates organ growth is not fully understood. Here, we show that the knockdown of DYRK1A in mammalian cells results in reduced cell size, which depends on mTORC1. Using proteomic approaches, we found that DYRK1A interacts with the tuberous sclerosis complex (TSC) proteins, namely TSC1 and TSC2, which negatively regulate mTORC1 activation. Furthermore, we show that DYRK1A phosphorylates TSC2 at T1462, a modification known to inhibit TSC activity and promote mTORC1 activity. We also found that the reduced cell growth upon knockdown of DYRK1A can be rescued by overexpression of RHEB, an activator of mTORC1. Our findings suggest that DYRK1A inhibits TSC complex activity through inhibitory phosphorylation on TSC2, thereby promoting mTORC1 activity. Furthermore, using the Drosophila neuromuscular junction as a model, we show that the mnb, the fly homologs of DYRK1A, is rescued by RHEB overexpression, suggesting a conserved role of DYRK1A in TORC1 regulation.

Predictability of the various financial instruments can lead to more trust and investment. The study examines the long-term and causal relationship between various Nifty indices and the Ethereum cryptocurrency. This study considers the data from April 2015 to December 2022 in two phases, pre-covid and post-covid. Johansen’s cointegration test was used to determine if the vectors in the data set are cointegrated, using the Max-Eigen and Trace tests for evaluation. The Granger causality test was also used to explore the short-term causal relationship between Ethereum and the five Nifty indices. The study found that post-pandemic daily returns of stock market indices have developed a significant cointegration with the cryptocurrency over time. The Granger causality test results showed bi-directional relationships of Nifty 50, Nifty 200 and Nifty Next 50 with Ethereum and a unidirectional relationship between Nifty Auto and Ethereum. The non-linear results reveal a one-way relationship pre-covid and a bi-directional relationship post-covid except for Nifty Banks. Johansen’s cointegration test, both in the pre-and post-covid-era, indicated that these indices had a substantial long-term cointegration with cryptocurrencies. This study also offers guidance to investors in making long-term investment decisions and to regulatory authorities. This implied that the investing decisions resulted in developing a causal relationship between the equity market and cryptocurrencies, which seemed very unlikely before 2020. This indicates that a new and young investor also considered cryptocurrencies a viable alternate investment option compared to traditional options such as fixed deposits, gold, and other fixed-income instruments.

The basic concepts of research are learned through systematic literature searches which form the basis of a research statement and research topic. Then the research question, hypothesis, aim, and objectives, as well as the experimental design, are developed. Given the context provided, the primary focus is on the importance of adequately training postgraduates and young research investigators in research methodology and project development. It is evident that there is a lack of proper training in these areas, and the rapid expansion of colleges in India exacerbates this issue. To address this, research students must receive comprehensive instruction in scientific research methodology, experimental design, statistics, scientific writing, publishing, and research ethics. Our team has been conducting workshops and symposia for more than two decades to improve the current teaching methods in these areas. Most recently, we organized a series of national and international workshops and seminars in multiple states across India to fortify the core concepts of scientific research for students and faculty members. This report highlights the key aspects of these workshops and the positive outcomes experienced by participants.

ObjectiveThe primary aim of this study was to compare non-invasive blood pressure (NIBP) measurement using the automated oscillometric method with invasive blood pressure (IBP) measurement using peripheral arterial line insertion in critically ill children receiving vasoactive agents.DesignSingle-centre, prospective cohort study.SettingTertiary care 15 bedded Pediatric ICU in Urban Indian city.SubjectsAll critically ill children between the ages of 1 month to 16 years with shock on vasoactive medications and with IBP monitoring.ResultsForty children with 1,072 paired BP measurements were incorporated in the final analysis. Among all normotensive children (Total number of paired measurements = 623) receiving vasoactive agents, Bland–Altman analysis revealed an acceptable agreement between Invasive mean blood pressure (MBP) and non-invasive MBP with a bias of −2.10 mmHg (SD 11.35). The 95% limits of agreement were from −24.34 to 20.14 mmHg. In children with hypotension (Total number of paired measurements = 449), Bland–Altman analysis showed disagreement between Invasive MBP and non-invasive MBP i.e., a bias of −8.44 mmHg (SD 9.62). The 95% limits of agreement were from −27.29 to 10.41 mmHg.ConclusionA limited agreement exists between invasive blood pressure (IBP) and non-invasive blood pressure (NIBP) measurements in critically ill children requiring vasoactive agents. This discrepancy can lead to either an underestimation or an overestimation of blood pressure. While NIBP can serve as a screening tool for hemodynamically stable children, those who are hemodynamically unstable and necessitate the initiation of vasoactive agents should undergo IBP monitoring.

Abstract Background Airborne environmental and engineered nanoparticles (NPs) are inhaled and deposited in the respiratory system. The inhaled dose of such NPs and their deposition location in the lung determines their impact on health. When calculating NP deposition using particle inhalation models, a common approach is to use the bulk material density, ρ b , rather than the effective density, ρ eff . This neglects though the porous agglomerate structure of NPs and may result in a significant error of their lung-deposited dose and location. Results Here, the deposition of various environmental NPs (aircraft and diesel black carbon, wood smoke) and engineered NPs (silica, zirconia) in the respiratory system of humans and mice is calculated using the Multiple-Path Particle Dosimetry model accounting for their realistic structure and effective density. This is done by measuring the NP ρ eff which was found to be up to one order of magnitude smaller than ρ b . Accounting for the realistic ρ eff of NPs reduces their deposited mass in the pulmonary region of the respiratory system up to a factor of two in both human and mouse models. Neglecting the ρ eff of NPs does not alter significantly the distribution of the deposited mass fractions in the human or mouse respiratory tract that are obtained by normalizing the mass deposited at the head, tracheobronchial and pulmonary regions by the total deposited mass. Finally, the total deposited mass fraction derived this way is in excellent agreement with those measured in human studies for diesel black carbon. Conclusions The doses of inhaled NPs are overestimated by inhalation particle deposition models when the ρ b is used instead of the real-world effective density which can vary significantly due to the porous agglomerate structure of NPs. So the use of realistic ρ eff , which can be measured as described here, is essential to determine the lung deposition and dosimetry of inhaled NPs and their impact on public health. Graphical abstract

In India, the incidence of mucormycosis reached high levels during 2021–2022, coinciding with the COVID-19 pandemic. In response to this, we established a multicentric ambispective cohort of patients hospitalised with mucormycosis across India. In this paper, we report their baseline profile, clinical characteristics and outcomes at discharge. Patients hospitalized for mucormycosis during March–July 2021 were included. Mucormycosis was diagnosed based on mycological confirmation on direct microscopy (KOH/Calcofluor white stain), culture, histopathology, or supportive evidence from endoscopy or imaging. After consent, trained data collectors used medical records and telephonic interviews to capture data in a pre-tested structured questionnaire. At baseline, we recruited 686 patients from 26 study hospitals, of whom 72.3% were males, 78% had a prior history of diabetes, 53.2% had a history of corticosteroid treatment, and 80% were associated with COVID-19. Pain, numbness or swelling of the face were the commonest symptoms (73.3%). Liposomal Amphotericin B was the commonest drug formulation used (67.1%), and endoscopic sinus surgery was the most common surgical procedure (73.6%). At discharge, the disease was stable in 43.3%, in regression for 29.9% but 9.6% died during hospitalization. Among survivors, commonly reported disabilities included facial disfigurement (18.4%) and difficulties in chewing/swallowing (17.8%). Though the risk of mortality was only 1 in 10, the disability due to the disease was very high. This cohort study could enhance our understanding of the disease’s clinical progression and help frame standard treatment guidelines.

Background: Mycobacterium w (Mw), an immunomodulator, resulted in better clinical status in severe coronavirus infectious disease 19 (COVID-19) but no survival benefit in a previous study. Herein, we investigate whether Mw could improve clinical outcomes and survival in COVID-19. Materials and Methods: In a multicentric, randomized, double-blind, parallel-group, placebo-controlled trial, we randomized hospitalized subjects with severe COVID-19 to receive either 0.3 mL/day of Mw intradermally or a matching placebo for three consecutive days. The primary outcome was 28-day mortality. The co-primary outcome was the distribution of clinical status assessed on a seven-point ordinal scale ranging from discharged (category 1) to death (category 7) on study days 14, 21, and 28. The key secondary outcomes were the change in sequential organ failure assessment (SOFA) score on days 7 and 14 compared to the baseline, treatment-emergent adverse events, and others. Results: We included 273 subjects (136 Mw, 137 placebo). The use of Mw did not improve 28-day survival (Mw vs. placebo, 18 [13.2%] vs. 12 [8.8%], P = 0.259) or the clinical status on days 14 (odds ratio [OR], 1.33; 95% confidence intervals [CI], 0.79-2.3), 21 (OR, 1.49; 95% CI, 0.83-2.7) or 28 (OR, 1.49; 95% CI, 0.79-2.8) between the two study arms. There was no difference in the delta SOFA score or other secondary outcomes between the two groups. We observed higher injection site reactions with Mw. Conclusion: Mw did not reduce 28-day mortality or improve clinical status on days 14, 21 and 28 compared to placebo in patients with severe COVID-19. [Trial identifier: CTRI/2020/04/024846]

Rajnish Nagarkar,1 Mamillapalli Gopichand,2 Suparna Kanti Pal,3 Ankur Gupta,4,5 Najmuddin Mohd Saquib,4,5 Ganga Sagar,4 Kanury VS Rao,4,5 Zaved Siddiqui,4,5 Imliwati Longkumer6 1Surgical Oncology, HCG Manavta Cancer Centre, Nashik, Maharashtra, India; 2Surgical Oncology, HealthCare Global Enterprises Limited, Vijayawada, India; 3Radiotherapy, Indoriv Clinical, Kolkata, India; 4Research and Development Section, PredOmix Technologies Private Limited, Gurugram, India; 5Research and Development Section, PredOmix Health Sciences Private Limited, Singapore; 6Biochemistry, North East Cancer Hospital and Research Institute, Guwahati, Assam, IndiaCorrespondence: Imliwati Longkumer; Zaved Siddiqui, Email ilongkumer@yahoo.co.in; zaved@predomix.comAbstract: We evaluated the potential relevance of our multi-cancer detection test, OncoVeryx-F, for ovarian cancer screening. For this, we compared its accuracy with that of CA125-based screening. We demonstrate here that, in contrast to CA125-based detection, OncoVeryx-F detected ovarian cancer with very high sensitivity and specificity. Importantly here, Stage I cancers too could be detected with an accuracy of > 98%. Furthermore, again unlike CA 125, the detection accuracy of OncoVeryx-F remained comparable in both Caucasian and South Asian/Indian women. Thus, the robustness and accuracy of OncoVeryx-F, particularly for early-stage detection, underscores its potential utility for ovarian cancer screening.Keywords: CA 125, Oncoveryx-F, OvC, NoC, LC-MS/MS

Introduction Reconstruction with free flaps becomes a challenge in recurrent cases having previously treated necks, in patients who have received prior radiation therapy or chemotherapy or both, and where the patient has already undergone free flap reconstruction in a prior surgery. Depleted cervical recipient vessels can increase the complexity of reconstruction in achieving successful free flap prefusion and thereby increasing flap thrombosis and eventually failure.

Mycosis fungoides (MF) is the most common subtype of Cutaneous T-Cell Lymphoma (CTCL). Patients with Skin of Color (SOC) may be disproportionately impacted by MF due to delayed diagnoses, limited research, and treatment differences. In this graphical review, we provide an overview of MF immunopathogenesis and demonstrate how it manifests differently in SOC patients. We also provide our hypothesis for why the disease process can result in a myriad of clinical presentations in SOC patients. Last, we provide a summary of current treatment options, highlighting ongoing clinical trials and opportunities to include SOC patients to promote health equity.

Cutaneous T-cell lymphoma (CTCL) serves as an umbrella term for numerous lymphomas that reside in or recirculate through the skin. One such systemic lymphoma is Sézary Syndrome (SS). Although SS is not as common in Skin of Color (SOC), minority patients presenting with the condition do have a different presentation than their White counterparts. In this graphical review, we provide an overview of SS immunopathogenesis and varying presentations. Additionally, a summary of current treatment options is provided, highlighting ongoing clinical trials and opportunities to include SOC patients to promote health equity. SOC patients often have poorer prognosis due to biological differences and health disparities resulting in delayed diagnosis. This exemplifies the potential advantages and promising solutions of precision medicine implementation. To this end, the impact and benefits of precision medicine are summarized.

Background: A novel nanosomal paclitaxel lipid suspension (NPLS), free from Cremophor EL (CrEL) and ethanol, was developed to address the solvent-related toxicities associated with conventional paclitaxel formulation. Objective: To evaluate the efficacy and safety of NPLS versus CrEL-based paclitaxel (conventional paclitaxel) in patients with metastatic breast cancer (MBC). Design: A prospective, open-label, randomized, multiple-dose, parallel, phase II/III study. Methods: Adult (18–65 years) female patients with MBC who had previously failed at least one line of chemotherapy were randomized (2:2:1) to NPLS 175 mg/m 2 every 3 weeks (Q3W, n = 48, arm A), NPLS 80 mg/m 2 every week (QW, n = 45, arm B) without premedication or conventional paclitaxel (Taxol ® , manufactured by Bristol-Myers Squibb, Princeton, NJ, USA) 175 mg/m 2 Q3W ( n = 27, arm C) with premedication. In the extension study, an additional 54 patients were randomized (2:1) to arm A ( n = 37) or arm C ( n = 17). Results: Pooled data from the primary study and its extension phase included 174 patients. The primary endpoint was the overall response rate (ORR). As per intent-to-treat analysis, ORR was significantly better in the NPLS QW arm as compared to conventional paclitaxel [44.4% (20/45) versus 22.7% (10/44), ( p = 0.04)]. An improvement in ORR with NPLS Q3W versus conventional paclitaxel arm [29.4% (25/85) versus 22.7% (10/44)] ( p = 0.53) was observed. Disease control rates observed were improved with NPLS Q3W versus conventional paclitaxel Q3W (77.7% versus 72.7%, p = 0.66) and with NPLS QW versus conventional paclitaxel Q3W (84.4% versus 72.7%, p = 0.20), although not significant. A lower incidence of grade III/IV peripheral sensory neuropathy, vomiting, and dyspnea was reported with NPLS Q3W versus conventional paclitaxel Q3W arms. Conclusion: NPLS demonstrated an improved tumor response rate and a favorable safety profile versus conventional paclitaxel. NPLS 80 mg/m 2 QW demonstrated a significantly better response versus conventional paclitaxel 175 mg/m 2 Q3W. Trial registration: Clinical Trial Registry-India (CTRI), CTRI/2010/091/001344 Registered on: 18 October 2010 (https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=MjEzNQ==&Enc=&userName=CTRI/2010/091/001344), CTRI/2015/07/006062 Registered on: 31 July 2015 (https://ctri.nic.in/Clinicaltrials/pmaindet2.php?EncHid=MTE2Mjc=&Enc=&userName=CTRI/2015/07/006062)

Abstract Background Osteosarcoma usually arises from primitive bone-forming mesenchymal cells. Metaphyseal growth plates of long bones are the usually affected site. Though it is the most common primary bone malignancy, only 6–10% of osteosarcomas are craniofacial. In the sinonasal region, the commonly involved sites reported in the literature are maxillary and ethmoid sinus. Sphenoid sinus has been the least commonly involved site among the paranasal sinuses and only a handful of cases have been reported. Methods A rare case of osteosarcoma involving the sphenoid and ethmoid sinus was presented to our institute and he was managed surgically and with postoperative chemotherapy. Further, an internet-based literature search was conducted to detect cases of osteosarcoma involving sphenoid sinus only as well as combined sphenoid and ethmoid sinus. Results About 13 articles (13 patients), which fulfilled our inclusion and exclusion criteria were included in our study. Out of the 14 patients (including the present case), 5 patients (100%) who underwent both modes of adjuvant therapy were alive during the final follow-up. On the other hand, among those who received single adjuvant therapy, only one patient was alive (33.3%) and two patients died (66.6%). Conclusion Osteosarcomas are highly malignant primary bone neoplasms with rare occurrence in the head and neck region. It constitutes a therapeutic challenge because of its anatomical location and the known side effects of chemotherapy. Timely intervention with a multidisciplinary approach is necessary to avoid death in these patients.

Abstract Objective To determine the overall surgical outcomes of infranotch T4b oral cancers and compare them with T4a oral cancers. Methods PubMed, EMBASE and Cochrane databases from 2000 to 2022 were systematically searched. Clinical studies reporting at least one outcome following curative surgery and adjuvant therapy for comparison of patients with either infranotch T4b (IN–T4b) or T4a tumour. The heterogeneity of the included studies was determined using Tau-squared, Chi-squared, and the Higgins I 2 test. The random effects model was used to determine the log odds ratio (logOR). Results The systematic review comprised 11,790 patients from 16 included studies. Seven studies were included in the meta-analysis (n = 11,381). For IN–T4b patients, the pooled 2 and 5 year overall survival (OS) were 59.3% and 53.2%, 2 and 5 year disease-free survival (DFS) 57.9% and 48.4%, 2 and 5 year disease-specific survival (DSS) 72% and 68%, and 2 and 5 year local control (LC), 47% and 56%, respectively. There was no statistically significant difference in 2 year OS [logOR = 0.28 (−0.47, 1.03), p = 0.46, confidence interval (CI) = 95%], 5 year OS [logOR = 0.7 (−0.4, 1.8), p = 0.54, CI = 95%], 2 year DFS [logOR = 0.22 (−0.35, 0.79), p = 0.45, CI = 95%], 5 year DFS [logOR = 0.17 (−0.42, 0.77), p = 0.57, CI = 95%], 2 year LC [logOR = 0.47 (−0.33, 1.26), p = 0.25, CI = 95%] and 5 year LC [logOR = 0.34 (−0.31, 0.99), p = 0.31, CI = 95%] between IN–T4b and T4a oral cancers. Conclusion Results of this meta-analysis suggest that IN–T4b oral cancers have similar outcomes to T4a oral cancers, which supports down-staging IN–T4b cancers to T4a cancers.

Introduction: Rhinosporidiosis is an enigmatic disease with many unsolved queries right from taxonomy to treatment. This study has been done to understand the disease characteristics with a peek into the lesser known immunological aspects of it by studying the changes in levels of certain primarily cell-mediated immunity (CMI)-specific cytokines in rhinosporidiosis patients.Materials and Methods:A prospective observational study was performed. Detailed epidemiological and clinicoradiological assessment was done along with selected inflammatory and immunological markers. The tests for immunological parameters were done by ELISA and CLIA and data were compiled and analyzed using appropriate statistics.Results:Disease showed male predominance and all patients gave a universal pond bathing history. Majority patients had O+ve blood group. Right side was affected most with nasal obstruction being commonest symptom. Nasal cavity was involved in majority of cases with inferior turbinate and meatus being sites of maximum occurrence and attachment. Nasopharynx, oropharynx were other involved sites. Extra-nasal sites included skin and parotid gland. Endoscopic and CECT findings were similar and confirmed intraoperatively. Tests for inflammatory markers showed no significant change in patients. Immunological markers -IL-6, TNF-beta- levels showed significant increase though no such increase was found with IFN-gamma levels.Conclusion:Rhinosporidiosis has a definite epidemiological and clinical-radiological profile. A clear association with exposure to contaminated water is present which could not be further associated with disease duration or recurrence. The immunological profile needs to be further investigated upon since it remains quite elusive.

Abstract Background A mandibulotomy approach has been introduced for removal of posteriorly-based tumors of the oral cavity, oropharynx, and certain parapharyngeal tumors with minimum morbidity. Case presentation A middle-aged male presented with a left-sided upper neck mass for last year and difficulty in swallowing for the past six months. A previous history of sclerotherapy and incision and drainage was present and a histopathological examination report from the incision and drainage-derived tissue was suggestive of lymphangioma. On examination, a single soft globular swelling measuring approximately 6 × 4 cm in the left infra-auricular region and a scar of previous incision and drainage measuring approximately 1 × 0.5 cm was present. Oropharynx: tonsillar bulge was present and reaching up to the uvula. Contrast-enhanced MRI revealed an enhancing lesion suggesting a vascular tumour affecting the pre and post-styloid compartment. The patient underwent surgical excision of the lymphangioma by a modified mandibulotomy approach to improve bony stability, avoiding lip split incision and tooth extraction for medically resistant lymphangioma. So, we introduced our modified technique of mandibulotomy in cases of medically resistant parapharyngeal space tumors with a modified lifting step osteotomy with a thin saw blade. Conclusion The modified mandibulotomy approach provides a safe and effective means of tumor resection and this technique not only ensures complete tumour resection but also maintains the integrity and functionality of the mandible.

The purpose of the study was to analyze the effectiveness of technical trading strategies in trading stocks of selected Indian companies represented in the Nifty 50 Index. The research was done using secondary data from January 2022 to August 2022. Hourly share prices of 14 largest companies as per market capitalization from 14 different sectors from the Nifty 50 Index were considered as a part of the study. Simple Moving Average, Exponential Moving Average – Relative Strength Index and Bollinger Bands – Relative Strength Index – strategies considered in the study. It was found that strategy based on Bollinger Bands and Relative Strength Index performed the best. Performance was considered with respect to both the number of stocks having a net profit and the number of stocks that were able to outperform the buy-and-hold strategy for the time period considered. The study considered several combined strategies and performance indicators, whereas previous studies used limited indicators. Out of the 14 stocks considered, the Simple Moving Average strategy was able to generate net profit for 8 stocks and it outperformed the buy-and-hold strategy for 6 stocks, Exponential Moving Average – Relative Strength Index strategy generated net profit for 6 stocks and it outperformed the buy-and-hold strategy for 5 stocks, and the Bollinger Bands – Relative Strength Index generated net profit for 11 stocks and it outperformed the buy-and-hold strategy for 10 stocks. The Bollinger Bands – Relative Strength Index strategy was able to outperform as it was more dynamic and entered and exited positions actively.

The solid pseudopapillary epithelial neoplasm (SPEN) of the pancreas is a relatively uncommon entity. The aim of the present study was to summarize our experiences with regard to diagnostic dilemma, surgery, postoperative follow-up, and management. This retrospective data were collected during the period from January 1, 2018 to December 31, 2020. A total of four patients (three females and one male) were identified within an age range of 13 to 25 years. All the patients were presented with nonspecific symptoms such as abdomen lumps, swelling in the abdomen, and abdominal pain. To reach a definite diagnosis, imaging studies were conducted along with endoscopic ultrasound fine-needle aspiration (EUS-FNA) and biopsy. After confirmation of SPEN on biopsy, all the patients underwent surgery without any complications. Patients are on follow-up, and to date, no metastasis has been detected. SPEN is a rare pancreatic tumor with unusual pathological features leading to a diagnostic dilemma. The pathologist should be familiar with SPEN and its salient histological characteristics that differentiate it from other look-alike pancreatic tumors and can help in timely surgery and management.

Cutaneous T-cell lymphoma (CTCL) is an uncommon type of lymphoma involving malignant skin-resident or skin-homing T cells. Canine epitheliotropic lymphoma (EL) is the most common form of CTCL in dogs, and it also spontaneously arises from T lymphocytes in the mucosa and skin. Clinically, it can be difficult to distinguish early-stage CTCLs apart from other forms of benign interface dermatitis (ID) in both dogs and people. Our objective was to identify novel biomarkers that can distinguish EL from other forms of ID, and perform comparative transcriptomics of human CTCL and canine EL. Here, we present a retrospective gene expression study that employed archival tissue from biorepositories. We analyzed a discovery cohort of 6 canines and a validation cohort of 8 canines with EL which occurred spontaneously in client-owned companion dogs. We performed comparative targeted transcriptomics studies using NanoString to assess 160 genes from lesional skin biopsies from the discovery cohort and 800 genes from the validation cohort to identify any significant differences that may reflect oncogenesis and immunopathogenesis. We further sought to determine if gene expression in EL and CTCL are conserved across humans and canines by comparing our data to previously published human datasets. Similar chemokine profiles were observed in dog EL and human CTCL, and analyses were performed to validate potential biomarkers and drivers of disease. In dogs, we found enrichment of T cell gene signatures, with upregulation of IFNG, TNF, PRF1, IL15, CD244, CXCL10, and CCL5 in EL in dogs compared to healthy controls. Importantly, CTSW, TRAT1 and KLRK1 distinguished EL from all other forms of interface dermatitis we studied, providing much-needed biomarkers for the veterinary field. XCL1/XCL2 were also highly specific of EL in our validation cohort. Future studies exploring the oncogenesis of spontaneous lymphomas in companion animals will expand our understanding of these disorders. Biomarkers may be useful for predicting disease prognosis and treatment responses. We plan to use our data to inform future development of targeted therapies, as well as for repurposing drugs for both veterinary and human medicine.