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IntroductionOsteomyelitis of the elbow may be a complex clinical problem. Treatment goals include the eradication of infection and preservation of maximal joint function. Bony debridement may be necessary in addition to elbow joint arthroplasty. The use of synthetic material or allograft as the arthroplasty material may be contraindicated in the setting of infection. The use of free muscle transfer as an arthroplasty medium has not been well described.MethodsA 22-year-old paraplegic man developed recurrent osteomyelitis of the right elbow, necessitating extensive bony debridement by the orthopedic surgery team. Reconstruction arthroplasty was performed using a free rectus abdominis muscle flap as the arthroplasty material to serve as a source of biologically active, well-vascularized arthroplasty medium in the presence of ongoing infection.ResultsA successful free muscle flap arthroplasty was performed. External fixation and physical therapy were implemented postoperatively. The patient had resolution of osteomyelitis and excellent functional use of the elbow for activities of daily living and wheelchair motion.ConclusionsElbow arthroplasty in the setting of active infection may be accomplished by means of free tissue muscle transfer. Elimination of infection and acceptable joint function may be possible with this form of reconstruction.

Background: Oral squamous cell carcinoma (OSCC) poses a significant global health burden, particularly prevalent in regions like India. Despite advancements in diagnostics, early detection of OSCC remains challenging, necessitating novel diagnostic modalities. Toll-like receptors (TLRs) and their polymorphisms have emerged as potential contributors to OSCC pathogenesis. Methods: This retrospective case-control study examined 120 individuals, including 60 OSCC cases and 60 healthy controls. Genotyping of TLR3 single-nucleotide polymorphisms (SNPs) rs3775290 and rs3775291 was conducted using TaqMan allelic discrimination real-time polymerase chain reaction. Functional consequence analysis and TLR3 expression profiling were performed to elucidate their role in OSCC pathogenesis. Results: Significant associations were observed between TLR3 SNPs and OSCC susceptibility, particularly at loci rs3775290 and rs3775291. Functional consequence analysis revealed pathogenic mutations in TLR3 genes, potentially affecting protein structure and function. TLR3 overexpression was detected in OSCC lesions, implicating its involvement in disease progression. Conclusion: TLR3 polymorphisms play a pivotal role in OSCC pathogenesis, offering potential biomarkers for diagnosis and prognosis. Targeting TLR3-mediated pathways may hold promise in personalised OSCC management. Further research is warranted to elucidate the precise mechanisms underlying TLR3-mediated carcinogenesis in OSCC, facilitating the development of tailored therapeutic strategies. [ABSTRACT FROM AUTHOR]

The study was conducted during 2022-23 to assess the level of food insecurity and income status among farm households. Data from 474 farmers through personal interview method were collected. Agriculture was the primary occupation for most households followed by off-farm activities. Average per capita annual income (Rs. 1,00,073) was lower than the national average. The per capita annual income was Rs. 73,303, Rs. 93,256 and Rs. 1,44,456 for marginal, small, and medium farmers, respectively. About 47 per cent of the expenditure was made on consumption. A comparison of calorie intake to recommended calorie intake indicated that food insecurity was prevailing among 26 percent of the farmers. The major contribution to calorie intake was from cereals, the consumption of vegetables and fruits was low. A decision tree model using machine learning algorithms was used to identify the factors influencing food security. Per capita income, family size, consumption expenditure, social participation, and land holdings had significant importance in classifying the households as food secure and insecure. Diversifying farm activities and creating additional opportunities in rural areas, teaching households about balanced diets, promoting home gardening, and institutional policies to improve food security may be the strategic points. [ABSTRACT FROM AUTHOR]

The study was conducted during 2022 in Lucknow district of Uttar Pradesh to analyze the livelihood security of rural households. Data was collected from 515 households through personal interview method using kobo collect. Landless and marginal farmers were more food insecure in the region. Forty four % of the households were food insecure. Composite livelihood security index was constructed using six domain indicators viz., habitat, health, economic, food, nutrition and social participation security. The weight for each domain indicator was derived from principal component analysis. The composite livelihood security index was 0.44 among the respondents. The livelihood security was high for medium farmers (0.46) followed by small farmers (0.45). Farming experience, social participation, livestock possession, income, calorie intake, body mass index and wealth significantly influenced the livelihood security. Lack of awareness on pest and disease control and poor price realization were the major constraints faced by the farmers. Technological, institutional and policy interventions are necessary to enhance their livelihood status. [ABSTRACT FROM AUTHOR]

Background: Epithelial membrane antigen (EMA) has been used as a marker for the expression of tumour margins in various glandular neoplastic lesions. Histopathologically, oral squamous cell carcinoma (OSCC) may exhibit several features within the same tumour cells, portraying that these cells at the invasive margins commonly display certain features that differ from those of the superficial part of the tumour. Aim: To identify and study the invasive tumour front and also to recognise any micrometastases in an OSCC lesion. Materials and Method: A retrospective study of 30 OSCC cases with superficial and most invasive parts were sectioned at 4 µm. Routine H&E staining and immunohistochemical staining with mouse antihuman EMA were done. The OSCC cases were graded into well differentiated squamous cell carcinoma (WDSCC), moderately differentiated squamous cell carcinoma (MDSCC) and poorly differentiated squamous cell carcinoma (PDSCC). The EMA-stained slides were observed and analysed under higher magnification to identify the individual EMA-stained cells. Results: Analysis of Variance (ANOVA) analysis revealed that when comparing the superficial and invasive fronts of OSCC, it was evident that the P values were significant across the groups. In WDSCC, positive predictive value was 70.6% and sensitivity was 100% when the same slide was analysed for large and small islands to individual cells in an EMA-stained section, while MDSCC and PDSCC showed both sensitivity and positive predictive value to be 100%. Conclusion: EMA could be considered a useful prognostic marker for describing the nature of the neoplastic epithelium as well as recognising the typical anaplastic cells in cases of OSCC. [ABSTRACT FROM AUTHOR]

Fibrolipoma, a subtype of lipoma, is a painless, well-circumscribed, slow-growing, submucosal benign adipocyte tumour. It is uncommon in the oral cavity and oropharyngeal region. It accounts for 1.6% of all facial lipomas. Fibrolipomas mostly affect the buccal mucosa and buccal vestibule and cause functional and cosmetic disabilities. The diagnosis and differentiation of fibrolipoma with clinically similar lesions such as fibroma and pleomorphic adenoma are very essential for a correct treatment plan and complete follow-up. Here, we present fibrolipoma, a very rare subtype of lipoma involving the buccal mucosa of the left premolar region in a 44-year-old male patient. [ABSTRACT FROM AUTHOR]

Mucosal malignant melanoma arising from the head and neck region is a rare entity, and it is more aggressive than cutaneous melanoma. Furthermore, the complexity of the oral cavity makes surgical excision more difficult. Oral malignant melanoma is a rare tumour of melanocytic origin, accounting for 20–30% of malignant melanomas at the mucosal surface and 16% intra-orally. Hard palate and maxillary gingiva are the most common involved sites. The age of reported patients ranges from 20 years to 80 years. Hence, we do hereby present a case of malignant melanoma of mandibular gingiva with review of the literature in a 42-year-old female patient. [ABSTRACT FROM AUTHOR]

ABSTRACT Treatment of patients with moderate-severe psoriasis and/or psoriatic arthritis includes systemic biologic, antimetabolite, and immunosuppressive therapy. However, adverse events such as serious infectious complications must be considered before starting [...]