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Abstract The immunogenicity and effectiveness of oral rotavirus vaccines (ORVs) against severe rotavirus-associated gastroenteritis are impaired in low- and middle-income countries (LMICs) where the burden of disease is highest. Determining risk factors for impaired ORV response may help identify strategies to enhance vaccine effectiveness. In this study, we use metagenomic sequencing to provide a high-resolution taxonomic analysis of stool samples collected at 6 weeks of age (coinciding with the first ORV dose) during a prospective study of ORV immunogenicity in India and Malawi. We then analyse the functional capacity of the developing microbiome in these cohorts. Microbiome composition differed significantly between countries, although functional capacity was more similar than taxonomic composition. Our results confirm previously reported findings that the developing microbiome is more diverse in taxonomic composition in ORV non-seroconverters compared with seroconverters, and we additionally demonstrate a similar pattern in functional capacity. Although taxonomic or functional feature abundances are poor predictors of ORV response, we show that skews in the direction of associations within these microbiome data can be used to identify consistent markers of ORV response across LMIC infant cohorts. We also highlight the systemic under-representation of reference genes from LMICs that limit functional annotation in our study (7% and 13% annotation at pathway and enzyme commission level, respectively). Overall, higher microbiome diversity in early life may act as marker for impaired ORV response in India and Malawi, whilst a holistic perspective of functional capacity may be hidden in the “dark matter” of the microbiome.

Oral rotavirus vaccine (ORV) efficacy varies between countries, but underlying reasons aren’t fully understood. In this prospective cohort study, authors show that maternal rotavirus-specific antibodies in serum and breastmilk and pre-vaccination microbiota diversity are negatively correlated with ORV response in India and Malawi but not in the UK.

Radiolucent lesions of Temporomandibular Joint (TMJ) represent a diagnostic challenge and a treatment conundrum. Biopsy of the lesions is technically difficult owing to their complex anatomy. The Differential Diagnosis (DD) includes a wide array of lesions including Simple Bone Cyst, Ameloblastoma, Central Giant Cell Granuloma, Hemangioma, Osteoblastoma, Osteochondroma, Chondroblastoma, Chondrosarcoma, Neurofibroma and metastatic malignant lesions though none has a specific predilection for TMJ. Here we present a case report of a large expansile radiolucent lesion of right TMJ in a 22 year old male patient with difficulties involved in diagnosis and management. Though cystic lesion of TMJ is uncommon it is incumbent on the Maxillofacial Surgeon for an early diagnosis and prompt management.