Search

Abstract. Background: Alopecia areata (AA) is among the most common immunological conditions. Although AA is considered to be a medically benign condition, those living with AA often report comorbid psychiatric conditions, high levels of functional impairment, and diminished quality of life. These consequences are largely due to the unique psychological turmoil associated with the condition. Unfortunately, little research has considered how to improve quality of life outcomes for this group. Aims: The purpose of this study was to evaluate how the PERMA framework of well-being is associated with the individual subjective experience of AA. A greater understanding of how PERMA applies to this group holds promise for assisting clinicians with devising psychosocial coping strategies for this population. Method: 274 individuals were recruited for participation. Hierarchical regression analyses were used to evaluate associations between the PERMA variables and AA-related (a) subjective symptoms (e.g., self-consciousness, sadness) and (b) relationship impact (e.g., perceived attractiveness). Each analysis controlled for demographic and condition-specific variables. Results: Demographic and PERMA variables were found to be significantly associated with positive experiences of each quality of life outcome. Limitations: The male to female ratio of participants was biased toward females. Furthermore, the nature of cross-sectional survey research has inherent limitations. Conclusion: The findings provide support for a relationship between PERMA variables and quality of life outcomes among people with AA. Clinical implications and future research directions are discussed.

Background Medical emergency team (MET) calls allow unstable patients to be identified earlier and enables clinicians to institute timely management to ameliorate physiological stress. Sinus tachycardia is a common cause for triggering MET calls. In this study, outcome measures relating to patients who have a MET call for sinus tachycardia were analysed. Methods Two hundred and ninety-three consecutive patients who had MET calls as a result of sinus tachycardia were included in the study. Outcome measures assessed included inpatient mortality, duration of hospital stay, change in disposition of patient care, change in goals of care, and underlying aetiology. Comparison between medical and procedural patients was also performed. Results There were 154 patients in the medical group compared to 139 patients in the procedural group. Inpatient mortality was 13% and 6% respectively (p-value= 0.065). The duration of hospital stay was longer in the medical group (11 vs. 8 days, p-value= 0.295). Sepsis accounted for about 50% of MET call diagnoses in both groups. Around 20% of patients in both groups did not have a clear cause identified for the sinus tachycardia. About one-fifth of the patients in both groups were transferred to intensive care following the MET call (17% vs. 16%; p-value= 0.823). Conclusions Sinus tachycardia triggering MET call is not a benign condition. It not infrequently requires escalation of care and is associated with significant inpatient mortality. Clinicians should have a high index of suspicion for sepsis as the underlying cause. This article is protected by copyright. All rights reserved.

Kikuchi disease is a rare, benign condition of unknown aetiology, which usually involves young women and is characterised by cervical lymphadenopathy and fever. Herein, we are reporting a case of a young Asian woman, who presented with fever and lymphadenopathy raising possibility of either infection or malignancy but after appropriate clinical investigations including lymph node biopsy, it turned out to be Kikuchi disease. She made an uneventful complete recovery with only symptomatic treatment.

Primary Bartholin gland carcinoma (BGC) is an extremely rare disease. It typically presents in elderly women. It can be confused with Bartholin gland cyst, which is a benign condition leading to a delay in diagnosis and treatment. We are presenting a case report of BGC in a 35-year-old woman, which has created a diagnostic as well as therapeutic dilemma.

PURPOSE OF REVIEW Sulcus vocalis is a benign condition of the vocal folds that, according to its severity, can affect the quality of the voice of those who have it. Voice symptoms can range from mild to severe, affecting the quality of life of patients with this condition. Although different surgical and no surgical options have been described, no gold standard treatment has been described. RECENT FINDINGS New evidence supports congenital, inflammatory, and acquired theories for sulcus vocalis. Also, recent literature demonstrated the role of the epithelium in the pathogenesis, which makes the absence of superficial lamina propria no longer the only accepted hypothesis. Technological developments improved the in-office diagnostics capabilities for this condition, but vocal fold palpation remains the gold standard. Different benign laryngeal conditions are associated with sulcus vocalis and knowing when to treat those is very important. Different treatment options are available for sulcus vocalis, however, results are diverse and no strong recommendations for one over the other can be made. SUMMARY Progress continues to be made in our understanding of sulcus vocalis from diagnosis to treatment. Novel and promising therapeutic strategies have been recently developed for this condition; however, more data and investigations are needed to improve their accuracy and reproducibility.

Penile melanosis is an uncommon but benign condition. Its appearance, however, can cause significant distress to patients. We report a case of a patient presenting with hyperpigmented annular penile macules, with a fibrillar pattern seen on dermoscopy. Histopathological examination revealed basal keratinocyte hyperpigmentation with no melanocytic proliferation or atypia, confirming our diagnosis of penile melanosis. The patient was managed conservatively. We also reviewed the literature surrounding the clinical assessment and management of penile melanosis. Future reports on this topic with clinical-dermoscopic-pathological correlations will aid further understanding of this seldom reported condition.

Chest wall syndrome is the most frequent cause of chest pain complained by patients admitted to the physician’s office, in outward as well as in emergency department. It may affect all ages with sex ratio of 1:1 between man and woman. History of illness and sensibility to palpation or tenderness were the keys to the diagnostic approach. Pain was generally moderate, well localized, continuous or intermittent over a number of hours to days or weeks and was amplified by position or movement that was commonly located on the left side of the chest. Chest wall syndrome is usually a common and benign condition, but it leads to anxiety and frequent recurrence. Definitive treatment is not yet confirmed and treatment for the different condition causing isolated musculoskeletal chest pain is poor. Therefore, some options to avoid aggravating physical activities, stretching, and simple analgesics as needed are the best choices of current management.

The association of mitral valve prolapse (MVP) with ventricular arrhythmias has long been known and has generally been considered a benign condition. In recent years, however, a small but not negligible risk of malignant ventricular arrhythmias and sudden cardiac death has been documented in the large population of subjects with MVP. The main predictors of major arrhythmic risk identified so far include history of syncope, ventricular repolarization abnormalities in the inferior-lateral electrocardiogram leads, right bundle branch block morphology of ventricular ectopic beats, finding of areas of myocardial fibrosis on cardiac magnetic resonance, and mitral annular disjunction (MAD) on echocardiogram, as well as a possible pro-arrhythmic genetic substrate. The stratification of arrhythmic risk, with the active search for red flags and in particular of MAD, is important to identify patients with the malignant arrhythmic variant of MVP in whom to implement closer surveillance and possible therapeutic interventions.

Introduction: The most common lesions of jugular vein dilatation are aneurysms and ectasia. A jugular vein aneurysm is less common compare to an arterial aneurysm in adults. Because of the rare incidence, treatment guidelines primarily associated with the timing of surgery are not clearly established. Proper treatment can reduce patient complaints without excessive intervention. Case report: A 54 years old woman complained of swelling in the right neck that started three years ago and cephalgia for two years. From CT angiography, we obtained a jugular vein dilatation of 2.3 cm. During periodic evaluation from ultrasonography doppler, there is no increase in the size of the jugular vein. Conclusion: Jugular vein aneurysm presenting in adults is an infrequent phenomenon. It is a benign condition, and conservative observation is advised. It should be operated only if symptomatic or progressive enlarging. A periodic examination must be done to evaluate the size of the jugular vein before a surgical decision

Granuloma annulare (GA) is an inflammatory granulomatous skin disease that can be localized (localized GA) or disseminated (generalized GA), with patch, perforating, and subcutaneous subtypes being less common variants of this benign condition. Recently, new research has emerged that further elucidates GA epidemiology and etiopathogenesis; importantly, new therapeutic options for GA have also been described, although there remains a paucity of randomized controlled studies. In this review, we summarize recent updates on GA epidemiology and etiopathogenesis and offer an updated review of the therapeutic options for GA currently reported in the literature. We hope that the current review galvanizes randomized controlled studies that will in turn help lead to the recommendation of evidence-based treatments for GA.

PURPOSE To describe four cases of varix of the vortex vein ampulla imaged with dynamic echography. METHODS Observational case series of four patients with varix of the vortex vein ampulla diagnosed with ocular examination maneuvers such as digital pressure or Valsalva. Dynamic echography was used to confirm the diagnosis. RESULTS Dynamic echography can quickly and noninvasively show the varix of the vortex vein ampulla disappear with external pressure, or engorge with a Valsalva maneuver or altered gaze directions. CONCLUSION Dynamic echography is very helpful in the establishment of the diagnosis of varix of the vortex vein ampulla and differentiating this benign condition from other retinal or choroidal abnormalities.

Barrett’s esophagus (BE) is a benign condition of the distal esophagus that initiates a multistage pathway to esophageal adenocarcinoma (EAC). Short of frequent intrusive (and costly) surveillance, effective screening for neoplasia in BE populations is yet to be established since progressors are rare and virtually undetectable without routine biopsies, which often sample only a small portion of the BE tissue. As a result, reliable estimation of the true prevalence of dysplasia in a BE population and evidence-based optimization of screening for at-risk individuals is challenging. Data-driven microsimulations, i.e., model-generated instances of disease history in a predefined virtual population, have found utility in the EAC screening literature as low-overhead alternatives to real-world hypothesis testing of optimal interventions for dysplasia. Despite the successes, computational limitations, paucity of knowledge and data on Barrett’s dysplasia, and the complexities of disease progression as a multiscale multiphysics process have hindered the treatment of disease progression in BE as a spatial process. Agent-based modeling of nucleation and proliferation processes in dysplasia warrants exploration in this context as an approximation that operates at a trade-off between computational tractability and precise representation of the composition and physics of the substrate (tissue). In this study, we describe spatially resolved simulations of premalignant progression toward EAC in a coarse-grained model of Barrett’s tissue that resolves the metaplastic tissue at a length scale of 0.42 mm (~3300 crypts/mm2). The model is calibrated to reproduce historical high-grade dysplasia prevalence when model-generated patients are screened using the Seattle protocol.

A novel 1-glycyl-3-methyl imidazolium chloride-copper(II) complex [[Gmim]Cl–Cu(II)] was found to be a heterogeneous catalyst for an efficient Heck reaction with good to excellent yield under solvent free condition. This protocol provides a simple strategy for the generation of a variety of new C–C bonds under environmentally benign condition. The catalyst was reused up to nine consecutive cycles without any significance loss in its activity.

Breath-holding spells (BHS) are commonly observed in children as a result of an autonomic nervous system disorder triggered by crying, emotional distress, or pain. There are several types of BHS and cyanotic type is one of them. We encountered a case of 3-year-old girl who presented with a delayed adaptation period and BHS 2 weeks after an endoscopic third ventriculostomy (ETV). She experienced severe headache due to increased intracranial pressure (ICP) during the delayed adaptation period, which may have contributed to the onset of BHS. Management of BHS warrants treatment of the symptoms and removal of the causative factors; in our case, intensive pain control and resolution of the increased ICP after the adaptation period were effective. While BHS are usually described as a benign condition that improves spontaneously, we highlighted the importance of recognizing and monitoring atypical symptoms such as BHS in pediatric cases.

Objective: Left anterior descending Myocardial Bridge (LADMB) is considered a benign condition and actually becomes a forgotten cause of serious cardiac events. This study was conducted to estimate the prevalence of LADMB and its association to atherosclerosis. Methods: An observational retrospective study was conducted on patients referred for coronary angiography between June 2012 and June 2020. Coronary angiography database was revisedand studied population was divided into 2 groups: LADMB group versus Non-LADMB group. Results: LADMB was detected in 510 patients out of 35813 included in the study resulting in a prevalence at 1.42%. The mean age was 66.5 years. Male gender was more common than female (70vs30%). The prevalence of significant atherosclerotic LAD disease was more than two times higher in the non-LADMB group compared to the LADMB group. Statistical analysis revealed a significant negative association between LADMB and atherosclerosis (p

Fibro adipose vascular anomaly (FAVA) is a rare type of vascular malformation with distinct clinical features. The authors here discussed the clinical, imaging, differential diagnosis, histopathological features, and treatment options of FAVA along with an illustrative case. It is important to know about this uncommon entity as this can be misdiagnosed due to the overlapping clinical features with other common entities. It is a benign condition with no proven malignant potential. There are no guidelines regarding the best treatment option.

Eyes are the most precious gift of the god to the living beings. Good vision is crucial for social and intellectual development of person. So to protect this organ is not only a necessity but also a responsibility of every individual. India is having the highest rate of head injury in RTA in the world. Out of which 60% suffer from Subconjunctival hemorrhage. Subconjunctival hemorrhage or Ecchymosis is of very common occurrence. Subconjunctival hemorrhage” is a common benign condition of the eye that has characteristic features, such as the painless acute appearance of a sharply circumscribed redness of bleeding underneath the conjunctiva in the absence of discharge, and inflammation in contagious areas. While searching solution for Subconjunctival hemorrhage in ayurveda, its signs and symptoms match very much with Arjuna” described in “Shuklagata roga”. Which is having symptom painless red spot over white surface of eye. So taking these things into consideration “Vasadi Ghrita Aschyotana” was selected for treating the disease Arjuna. The ghrita contain “Vasa” and “Yashtimadhu” having pittashamaka, Shonitasthapan properties.

Epidermoid cyst is a type of cutaneous cyst commonly found in daily practice. The facial area is the most common area for emergence of this benign condition. Simple extirpation is usually performed to remove epidermoid cysts. However, in rare cases, epidermoid cysts can evolve into malignancies such as basal cell carcinoma (BCC) or can mimic them, which adds difficulty when making a proper diagnosis. In cases of doubt, histopathology plays a key role in aiding diagnosis. This case report is about a 33-year-old woman with suspected nodular lesion that mimicked BCC, but after histopathological analysis was confirmed to be epidermoid cyst.

Introduction Rhinolith is a calcic deposition formed by mineralization of salts in an impacted nasal foreign body. It is a benign condition that can be troublesome owing to its size and extent of impact. Case Report A 35-year-old man with a history of right nasal obstruction with occasional foul-smelling discharge and right eye pain since ten years was diagnosed with rhinolith. During its removal, it was three times bigger than what could be visualized in nasal endoscopy. Conclusion Proper history, examination, and a high suspicion can clinch the diagnosis in almost all cases. A rigid diagnostic nasendoscopy is an important tool in the diagnosis. The treatment of choice is endoscopic removal under local or general anaesthesia.

Background The incidence of a bifid electrophoretic pattern in the albumin region on serum protein electrophoresis is an infrequent phenomenon. The availability of literature from India is scarce and is limited to case reports. Objective The aim of the study is to analyze the frequency of bisalbuminemia in an Indian referral facility. The study delved into their clinical associations. Material and Methods The retrospective case records of the patient from the departmental database were scrutinized. The study subjects were for an 8-year study period. Results There were about 39,900 serum electrophoresis performed in an 8-year study period. A total of 40 cases of bisalbuminemia were detected. The incidence in our cohort was 0.01%. Conclusion Bisalbuminemia, an overtly benign condition, is infrequent in Indian population although not rare. It is associated with several clinical disorders; however, the association seems to be plausibly coincidental.

Background Fetus-in-fetu (FIF) is a rare congenital soft tissue mass that resembles a fetus, occurring in approximately one in 500,000 births. It is typically a benign condition, with only one reported case of malignant recurrence in literature. FIF typically occurs in neonates under 18 months of age, and have largely been described as occurring in the retroperitoneum. In this case, we present a 13-year-old female with initial occurrence and subsequent residual re-growth of FIF following resection, within her right ovary. Case A 13-year-old female presented with abdominal pain and was found to have a 19-centimeter, complex right adnexal mass. Pre-operative tumor markers were normal and pre-operative risk assessment favored a benign process. She underwent an open, right ovarian cystectomy and was diagnosed with FIF on final pathology. Nine months after her procedure, during post-operative surveillance, she complained of intermittent abdominal pain and was found to have a recurrence of her complex right ovarian mass. Pre-operative tumor markers were normal and again pre-operative risk assessment favored a benign process. Intraoperatively there was no normal appearing ovarian tissue and she therefore underwent a right oophorectomy. Pathology noted tissue similar to her initial mass, indicative of growth of residual FIF tissue. Comments In rare cases where FIF is found within the ovary, consider post-operative surveillance, as there is a risk of recurrence or residual disease. Pre-operative assessment using imaging, tumor markers, and a multidisciplinary team is crucial for management of pediatric and adolescent ovarian masses.

Fibrous dysplasia is a benign condition characterized by replacement of bone by a fibro-osseous tissue. This article describes the aetiology, diagnosis and classification of the condition. We discuss the clinical presentation of fibrous dysplasia along with its craniofacial effects. The presentation of fibrous dysplasia in the dental setting is described, along with specific implications for dental and orthodontic management of these patients. CPD/Clinical Relevance: Given the wide array of conditions that can present to GDPs, it is important to be aware of fibrous dysplasia as a possible cause of some signs and symptoms. The presentation, diagnosis and dental management of this group of patients is presented from a clinical perspective.

A 33-year-old male suffered from a dry socket following extraction of a lower molar tooth which was treated with a cocktail of autologous concentrated growth factor (CGF). The healing socket responded with hypergranulation phenomena that is unusual in dry socket condition. Local healing potential of poorly vascularized dry socket usually demonstrate a dragging recovery period instead of a quick granulation tissue response. The reddish sprout of granulation tissue in this case extended over the upper edge of the wound. The over-healing tissue was observed closely and confirmed to be a benign condition. The excess tissue was trimmed to avoid trauma from occlusion following which the socket healed within two weeks. This case suggests the likelihood of a potent cocktail of growth factors could potentiate angiogenesis and vascularization in the dry socket, providing the opportunity towards hypergranulation state. An over-healing state may point towards a remote possibility of malignancy development that need to be alerted. The use of autologous growth factors for dry socket and wound healing would continue in this era of regenerative medicine therapy. However, the inability to precisely control its molecular potential to the required individual need remain a challenge in surgical practice.

Superficial venous thrombosis (SVT) of the upper and lower extremities has long been considered a relatively benign condition. But in recent years, the literature has suggested a benefit to anticoagulation in patients with certain thrombus characteristics (size, location, and distance to deep venous system) resulting in updates to clinical guidelines for the treatment of lower extremity SVT. Despite these now well-established guidelines, there remains a paucity of guidance from national and international societies regarding the imaging of superficial veins when evaluating for venous thrombosis. We recommend potential strategies to close this gap.

Introduction: Transient Hyperphosphatasia (TH) is a benign condition in which serum Alkaline Phosphatase is elevated without any underlying pathology. This is mainly seen in children compared to adults and it is usually an incidental finding. The hallmark of the condition is that normalization of ALP level will with time. However, not knowing the entity would lead to unnecessary investigations and referrals. Here we report a child with TH who presents with a mild degree of bow legs.Case report: A 1year and 8 months old boy was brought by his mother with a concern of bow legs. He was the first child born to non-consanguineous healthy parents following normal antenatal and perinatal periods. His birth weight was 3.5kg and he was growing in his birth centile. He had age-appropriate development and parents had been having a concern about bow legs after he started walking. He is getting an average Sri Lankan diet with animal food and he gets adequate sun exposure as well. There was no history to suggest the liver of renal diseases. On examination, he had a mild degree of bow legs without any features to suggest rickets. His cardiovascular, respiratory, abdominal, and neurology exams were normal. His bone profile showed a high value of ALP (3782 U/L) with normal calcium, phosphate, and vitamin D levels. Due to high ALP levels, he underwent liver and renal functions and that was within the normal range. The diagnosis was made as TH and he was followed up monthly with ALP values. He had a downward trend of ALP levels and in 3 months the ALP value dropped to (580 U/L). Parents were reassured about the condition and the diagnosis was confirmed as TH.Conclusion: It is important to rule out, bone, kidney, or a liver pathology if a child has markedly elevated ALP levels. However, it is important to recognize this entity to avoid unnecessary procedures and concerns.

Sinus pericranii (SP) is a rare venous anomaly consisting of an aberrant communication between the intra- and extra-cranial venous systems forming a venous malformation in the scalp. It is usually defined as midline frontal or parietal fluctuating bluish tumour that increases in size with Valsalva manoeuvre. The gold standard for its diagnosis is digital subtraction angiography, but initial test of choice is magnetic angio-resonance imaging. Although being a benign condition it usually poses aesthetic concerns and fear of complications. This is the reason why, although conservative management is accepted, treatment is usually considered, either endovascular or surgical. We herein review the current management of these rare vascular lesions and illustrate it with a case of a large frontal SP in which surgical excision was decided and performed with an excellent long-term result. We underline the importance of careful haemostasis and multidisciplinary work for the safe management of complex vascular anomalies. Level of evidence: Level V, therapeutic study.

Favre-Racouchot disease (FRD) is an occupational disorder characterized by solar elastosis with open and cystically dilated comedones that tend to appear on the periorbital and temporal face of elderly light-complexioned men. It is a benign condition caused by chronic excessive ultraviolet exposure, as well as ionizing radiation and/or smoking. However, malignant skin neoplasms are uncommonly observed arising in FRD, which suggests a protective role of some element of FRD against carcinogenesis. We explore elastosis as a possibly beneficial tissue response. The clinical manifestations, pathogenesis, and recommended treatment options of this disorder are reviewed.

Ear lidding is a cosmetic outer ear shape deformity commonly observed in newborns. Although lidding is considered a benign condition, psychological concerns such as bullying and depression have been observed in older children supporting correction of the condition. Nonsurgical correction of lidding using molding and splinting techniques has become increasingly popular, achieving successful outcomes in the majority of cases. Spontaneous resolution of the condition has also been reported in the literature however there is minimal prospective data available on the natural progression of ear lidding. In our case series of 11 closely followed newborns, we aimed to characterize the natural progression and resolution of lidding. Ten consecutive newborns participated in the observation plan and all 10 had complete spontaneous resolution of lidding within an average of 40 days. One other newborn's parents self-selected to have molding and splinting treatment. These results suggest that cosmetic treatment for less severe cases of ear lidding may be unnecessary as they have the potential to resolve on their own. Future research in this area could include controlled study designs and more work is needed to identify, which infants will require treatment. Our study may provide helpful reassurance to families and physicians that many newborns may see complete resolution of lidding without intervention.

Nevoid hyperkeratosis of the nipple and/or areola (NHNA) is a rare and benign condition first described by Tauber in 1923. NHNA mostly reported in female patients of child bearing age affecting both the nipples. The aetiology is not well defined and similarly the treatment is empirical. Usually the patient seeks treatment for the cosmetic appearance. Here we report a case of 17-year-old male presented with hyperpigmented to skin coloured verrucous plaques on either side of the right nipple which are asymptomatic and gradually increasing in size since six years. The histopathological features are consistent with nevoid hyperplasia of areola. Till now NHNA has not been reported in young males hence, we report a case of Nevoid hyperkeratosis of the areola in a young male.

Naevus lipomatosus cutaneous superficialis (NLCS) of Hoffman-Zurhelle is a rare hamartomatous benign condition first described in 1921. Two clinical variants have been described: a classical form of multiple yellow papules that coalesce to form larger plaques with segmental distribution, and a solitary form also known as pedunculated lipofibroma. We present a case of early-stage NLCS with characteristic histopathological and dermoscopic features.

Background: Haemorrhoidal disease (HD) is a benign condition affecting a considerable part of adult population. HD can be considered a social and economic burden with high impact on patients’ lifestyle. Several new techniques and devices have been proposed for HD treatment; however, preoperative assessment is essential and the use of classification system is recommended. Methods:: In the last two decades many studies described the preoperative assessment and several attempts of classification for HD. This review focuses on the most relevant studies found in literature where classification systems and clinical evaluation with differential diagnosis have been evaluated. Results: The knowledge of classification systems and differential diagnosis for HD has been shown to play a central role in the clinical assessment and the best treatment choice. Although there are new challenging techniques and devices for HD treatment, a preoperative assessment is always mandatory. Conclusion: Preoperative clinical evaluation is essential for HD patient treatment and outcome. Classification systems are useful for the therapeutic choice and researches on new medical or surgical treatments. In fact, the international guidelines advise several therapeutic options depending on the severity of the HD.

Giant cell tumor of the wrist is a rare, benign and usually symptomatic condition. The discovery is sometimes made following a medical imaging examination or a painful symptomatology or more often a visible or palpable swelling with or without vascular and/or nerve compression. At an advanced stage, the X-ray is of paramount importance. The well codified complete surgical resection is part of the therapeutic arsenal. We present a clinical case report of a young woman with a giant cell tumor localized in the wrist in N’Djamena, Chad. This case concerns a 25-year-old patient who presented in July 2020 of a painful swelling lateral to her left wrist bone and whose X-ray radiography showed lysis of the cortical bone in the lower third of the ulna. After the operative resection of the tumor mass, the pathological examination of the operative specimen revealed the diagnosis of a giant cell tumor. A giant cell tumor is a benign condition, with a few symptoms and the location at the ulna is exceptional. Complete surgical resection is a viable treatment option.

Idiopathic gingival fibromatosis, also called idiopathic gingival overgrowth (IGO), is a rare benign condition that occurs either in isolation or as a part of a syndrome. The overgrowth, if excess, impedes oral functions such as mastication and speech and causes cosmetic disfigurement. Diagnosis and treatment becomes challenging if the overgrowth is massive and accompanies other associated pathologies. This case reports concurrent occurrence of three pathologies, i.e., IGO, aggressive periodontitis, and candidal infection in a 20-year-old healthy male patient. The surgical procedure performed involved internal bevel gingivectomy combined with open-flap surgery. Seven-year follow-up revealed no recurrence of overgrowth and stable periodontal condition.

Introduction.Transient toe walking is a common benign condition in young children. Nevertheless, it leads to parents concern and becomes a frequent reason for visits to orthopaedists. Aim:apreliminary assessment of the effectiveness of squeakers shoes for optimizing of gait in children with transient idiopathic toe walking. Material and methods.A prospective study of 24 children (mean age: 21.4 months) which are under surveillance in outpatient clinics for toe walking as the main complaint. Children supplied free of charge with squeakers shoes. Parents filled questionnaires 1 month after the usage of these shoes. Results.Positive changes in gait (normalization or improvements) were reported in the majority (22 from 24) children. More than half of parents noticed normal gait in regular shoes and one third barefoot. No deterioration has been observed. Discussion.We conducted a preliminary study assessing the effectiveness of modified shoes (squeakers) in children with transient idiopathic toe walking. Most of the parents reported improvements in walking. As a potential mechanism, we suggest positive biofeedback with the recruiting of the sensory (audial) pathway. Conclusion.Based on our study we can recommend squeakers for children with transient idiopathic toe walking demonstrating delayed spontaneous improvement.

Benign transient hyperphosphatasemia (BTH) is a condition which occurs in children younger than five years, characterized by a complete absence of specific clinical and laboratory findings of bone or liver diseases and a five or even 20–70-fold increase in serum of alkaline phosphatase levels(ALP). The aim of this case report was to point out that elevated levels of ALP are not always related to serious bone and liver diseases. We described three healthy patients, which were referred to our out-patient clinic by their primary care physicians because of markedly elevated levels of ALP. The diagnosis of BTH was based on a thorough physical exam, a wide range of laboratory and imaging tests, which excluded liver or bone disease as a cause for elevated ALP. BTH is not very well-known and managed in daily clinical practice. Primary care physicians should consider this diagnosis in cases with elevated ALP in otherwise healthy infants and toddlers, refrain from unnecessary tests, prescribing higher doses of vitamin D3 or referral to tertiary level pediatric institutions.

Cutaneous warts are a common dermatological condition caused by the human papillomavirus (HPV) strains 1,2,4 and rarely 57. Although it is a benign condition, it causes disfigurement, pain, discomfort, has a tendency to koebnerize, and can be transmitted to others. This makes adequate and timely treatment important. There are several conventional treatments available which include electrosurgery, cryotherapy and topical medications like imiquimod which show variable responses. Our study evaluated the effectiveness and associated side effects of intralesional PPD for the treatment of multiple warts in a group of 20 patients. This is done as a form of immunotherapy. It was administered at a dosage of 0.1ml into each lesional site every two weeks until the clearance of lesions or up to a maximum of 6 injections. We observed a marked response in 5%, moderate response in 75% and no response in 20 % of our study population with no complications. On comparison to previous similar studies, the accuracy of our observed results for efficacy and observed side effects was reinforced. Hence proves to be a modality of treatment that should be more widely used for the treatment of warts as it is cheap, safe, less stressful and comparatively more effective.

Background The long-term consequences of tibial torsion remain unclear. This study evaluated whether syndesmotic injuries are associated with tibial torsion. Methods A collection of over 3000 cadaveric skeletons was screened for irregular bony prominence along the lateral distal tibia, consistent with previous syndesmosis injury. Tibial torsion was measured and compared to 1034 control cadaveric tibiae. Results Mean torsion of 236 specimens with syndesmotic injury was 6.2 ± 8.9 degrees, while that of control specimens was 7.9 ± 8.8 degrees (P = 0.008). Multiple regression analysis showed a non-statistically significant trend toward internal torsion and syndesmotic injury (standardized beta = −0.051, P = 0.059). Syndesmosis injury was present in 48/200 specimens (24.0%) with internal torsion and 31/199 specimens (15.6%) with external torsion (P = 0.035). Conclusion This association between internal tibial torsion and syndesmotic injury suggests that internal tibial torsion might not be an entirely benign condition and merits further study.

Endometriosis is common in premenopausal women and affects about 10% of women of reproductive age. It is a benign condition but demonstrates malignant behaviour with recurrences and metastases. Its tendency to increase the risk of specific subtypes of ovarian cancer is being discussed, because they exhibit specific clinical features that distinguish them from classical ovarian cancer. Malignant transformation of endometriosis goes through its transition to atypical endometriosis. Although endometriosis-associated ovarian carcinomas have a good prognosis, adequate follow-up and monitoring after treatment of endometriosis are recommended.

Disseminated pyogenic granuloma is a rare entity. Patients need reassurance for this benign condition and are advised about the risk of recurrence and the risk of scarring with a total surgical excision. Red‐flag diagnoses should be ruled out.

Epiploic appendices are small pouches filled with projection-like fat structure adjacent to the antimesenteric side of the colon wall; they range in size from 0.5 to 5 cm and provide vascularization from small arterioles. Epiploic appendagitis is a benign condition of the epiploic appendices which leads to ischemia of the structure. Ischemia, therefore, causes localized sharp abdominal pain. Though uncommon, its symptoms can be diagnosed as acute lower abdominal pain since the symptoms could mimic diverticulitis and appendicitis. Thus, to diagnose epiploic appendagitis in this case, a CT scan was conducted to detect a fat-dense lesion of ovoid-like structure close to the colon. Given the good response to conservative management, establishing a correct diagnosis could help to minimize inappropriate invasive management.