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Byline: Y. Siddiqui, MKA. Sherwani, A. Khan, M. Zahid, M. Abbas, N. Asif Background: Management of malignant bone and soft tissue tumors remains an overwhelming confront to orthopedic surgeons. The [...]

Byline: Y. Siddiqui, M. Zahid, A. Sabir, G. Kumar Sir, Osteosarcoma in association with skip metastasis is of rare occurrence. [sup][1] When multiple bone lesions are simultaneously present at diagnosis, [...]

Abstract: Aim: Lignolytic (lignin degrading) enzyme, from oil palm pathogen Ganoderma boninense Pat. (Syn G. orbiforme (Ryvarden)), is involved in the detoxification and the degradation of lignin in the oil palm and is the rate‐limiting step in the infection process of this fungus. Active inhibition of lignin‐degrading enzymes secreted by G. boninense by various naturally occurring phenolic compounds and estimation of efficiency on pathogen suppression was aimed at. Methods and Results: In our work, 10 naturally occurring phenolic compounds were evaluated for their inhibitory potential towards the lignolytic enzymes of G. boninense. Additionally, the lignin‐degrading enzymes were characterized. Most of the peholic compounds exhibited an uncompetitive inhibition towards the lignin‐degrading enzymes. Benzoic acid was the superior inhibitor to the production of lignin‐degrading enzymes, when compared between the 10 phenolic compounds. The inhibitory potential of the phenolic compounds towards the lignin‐degrading enzymes are higher than that of the conventional metal ion inhibitor. The lignin‐degrading enzymes were stable in a wide range of pH but were sensitive to higher temperature. Conclusion: The study demonstrated the inhibitor potential of 10 naturally occurring phenolic compounds towards the lignin‐degrading enzymes of G. boninense with different efficacies. Significance and Impact of the Study: The study has shed a light towards a new management strategy to control basal stem rot disease in oil palm. It serves as a replacement for the existing chemical control. [ABSTRACT FROM AUTHOR]

Abstract: Aim: Ganoderma sp, the causal pathogen of the basal stem rot (BSR) disease of oil palm, secretes extracellular hydrolytic enzymes. These play an important role in the pathogenesis of BSR by nourishing the pathogen through the digestion of cellulose and hemicellulose of the host tissue. Active suppression of hydrolytic enzymes secreted by Ganoderma boninense by various naturally occurring phenolic compounds and estimation of their efficacy on pathogen suppression is focused in this study. Methods and Results: Ten naturally occurring phenolic compounds were assessed for their inhibitory effect on the hydrolytic enzymes of G. boninense. The enzyme kinetics (Vmax and Km) and the stability of the hydrolytic enzymes were also characterized. The selected compounds had shown inhibitory effect at various concentrations. Two types of inhibitions namely uncompetitive and noncompetitive were observed in the presence of phenolic compounds. Among all the phenolic compounds tested, benzoic acid was the most effective compound suppressive to the growth and production of hydrolytic enzymes secreted by G. boninense. The phenolic compounds as inhibitory agents can be a better replacement for the metal ions which are known as conventional inhibitors till date. The three hydrolytic enzymes were stable in a wide range of pH and temperature. Conclusion: These findings highlight the efficacy of the applications of phenolic compounds to control Ganoderma. Significance and Impact of the study: The study has proved a replacement for chemical controls of G. boninense with naturally occurring phenolic compounds. [ABSTRACT FROM AUTHOR]

The antagonistic and enzymatic activities of non-pathogenic hymenomycetes naturally occurring on oil palm (Elaeis guineensis) trunks were assessed to determine their potential as biocontrol agents against G. boninense. Twenty-five Basidiomycota were isolated on a Ganodermaselective medium and identified using internal transcribed spacer (ITS) sequencing. The three fungi with potentially higher antagonistic activity against G. boninense, based on the percentage inhibition of radial mycelial growth (PIRG) in dual culture, were Pycnoporus sanguineus (84%), Trametes lactinea (82%) and Grammothele fuligo (81%). In addition to these three isolates, Lentinus tigrinus and a Rigidoporus sp. were also able to invade sterilized oil palm blocks previously colonized by G. boninense despite having lower PIRG values. Colonization of oil palm blocks by G. fuligo, P. sanguineus, Rigidoporus sp., T. lactinea and L. tigrinus resulted in mass losses of 32.50, 30.78, 27.64, 25.20 and 19.33%, respectively, probably due to an ability to produce one or more lignocellulolytic enzyme. Further work is needed to determine the enzymatic degradation potential of these fungi under natural conditions and their possible use in the prevention of colonization of oil palm by G. boninense. [ABSTRACT FROM AUTHOR]

Inferior glenohumeral dislocation is the least common type of glenohumeral dislocations. It may be associated with fractures of the adjacent bones and neurovascular compromise. It should be treated immediately by close reduction. The associated neuropraxia usually recovers with time. Traction-counter traction method is commonly used for reduction followed by immobilization of the shoulder for three weeks. Here, we report a case of inferior glenohumeral joint dislocation with greater tuberosity fracture with transient neurovascular compromise and present a brief review of the literature. [ABSTRACT FROM AUTHOR]

Introduction: Patients with diabetes require healthcare and information that are accurate and extensive. Large language models (LLMs) like ChatGPT herald the capacity to provide such exhaustive data. To determine (a) the comprehensiveness of ChatGPT's responses in Urdu to diabetes-related questions and (b) the accuracy of ChatGPT's Urdu responses when compared to its English responses., Methods: A cross-sectional observational study was conducted. Two reviewers experienced in internal medicine and endocrinology graded 53 Urdu and English responses on diabetes knowledge, lifestyle, and prevention. A senior reviewer resolved discrepancies. Responses were assessed for comprehension and accuracy, then compared to English., Results: Among the Urdu responses generated, only two of 53 (3.8%) questions were graded as comprehensive, and five of 53 (9.4%) were graded as correct but inadequate. We found that 25 of 53 (47.2%) questions were graded as mixed with correct and incorrect/outdated data, the most significant proportion of responses being graded as such. When considering the comparison of response scale grading the comparative accuracy of Urdu and English responses, no Urdu response (0.0%) was considered to have more accuracy than English. Most of the Urdu responses were found to have an accuracy less than that of English, an overwhelming majority of 49 of 53 (92.5%) responses., Conclusion: We found that although the ability to retrieve such information about diabetes is impressive, it can merely be used as an adjunct instead of a solitary source of information. Further work must be done to optimize Urdu responses in medical contexts to approximate the boundless potential it heralds., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Benign recurrent intrahepatic cholestasis is an autosomal recessive disorder presenting with intermittent episodes of cholestatic jaundice. The initial episode of benign recurrent intrahepatic cholestasis tends to occur within the first two decades of a patient's life. Episodes can occur unprompted but can often be precipitated by infections or pregnancy. We report an interesting case of a 13-year-old girl presented with recurrent intrahepatic cholestasis. The patient has a unique homozygous USP53 genetic mutation, the first patient to present with this mutation within the South Asian region. The patient was initially misdiagnosed as a case of autoimmune hepatitis, and when presenting to our set-up was diagnosed as a case of benign recurrent intrahepatic cholestasis. The patient has since been managed on medication and remains regular in follow-up, responding well to treatment., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article., (© The Author(s) 2024.)

Introduction The unique nature of a lack of good oral health, coupled with the lack of discussion and recognition surrounding the associated stigma, highlights it as a distinct issue. This stigma causes discomfort, devalues individuals, and necessitates urgent care and intervention. In Pakistan, a variety of reasons, including cultural beliefs, socioeconomic gaps, and poor access to dental care services, tend to exacerbate the stigma that is associated with dental care. This study aimed to determine the impact of stigma on oral health-seeking behaviours amongst the population of South Punjab in Pakistan. Methodology The study employed a qualitative design with a phenomenological approach, and the data collection was preceded by the administration of semi-structured interview guides and discussion guides to the patients and the consultant group, respectively. The targeted population was composed of patients who had reported stigmatization and a focus group of 10 dental consultants from various specialisations in dentistry. Data was collected until saturation from 16 patients who were recruited through the purposive convenience sampling technique. Results The study identified three themes, including perceived stigma impact on health-seeking behaviours and coping mechanisms; 10 subthemes emerged. Results showed social attitudes and unhealthy perceptions of oral conditions that lead to shame, loss of self-esteem, and lack of confidence among affected individuals. Behavioural reactions like mockery and discrimination further made it difficult for the participants who sought dental care and treatment. The study highlighted that stigma resulted in the avoidance of dental care, deterioration of oral health, and a tendency towards self-medication. People also used coping strategies such as hiding dental issues by avoiding social gatherings and seeking help from close friends to manage oral health stigma. Dental consultants had the strong opinion that care quality could be enhanced by utilising compassionate communication and patient education campaigns. Conclusions The experiences of patients and consultants related to dental stigma highlighted the complex interplay of sociocultural norms and healthcare practices. The study demonstrated that perceived stigma impacted the health-seeking behaviours of patients. Social support and education about oral health helped patients overcome this stigma. The study revealed that patients avoided dental treatments due to stigmatised behaviour from health professionals, a lack of affordability, and a feeling of shame to show and discuss the condition of their teeth, which got even worse due to self-remedy. The experiences of patients and consultants highlighted the need for increased advocacy, educational campaigns, and policies that can reduce inequalities in oral health and improve health equity. The study recommends specific intervention strategies and policy formulation to address oral health inequalities and contribute to advancing oral health equity in Pakistan., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Review Board of Bakhtawar Amin Dental College and Hospital issued approval COD 341/23. The Institutional Review Board of Bakhtawar Amin Dental College and Hospital, Multan, Pakistan, considered the ethical and technical aspects of the research proposal "Unveiling the Veil of Stigma: Exploring its Impact on Oral Health Seeking Behaviours". After a comprehensive discussion, the members of the committee approved the proposed research project. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Zain Ul Abideen et al.)

Background/purpose: To describe the clinical, optical coherence tomography (OCT), fundus autofluorescence and ultrasound findings of a patient with a choroidal nevus actively exuding vitelliform material in the setting of autosomal dominant Best dystrophy (BD)., Methods: The patient's clinical course was followed over time with ophthalmic examinations and multimodal imaging., Results: A 71-year-old male patient with BD was referred for evaluation of a choroidal nevus in the right eye. Dilated fundoscopic examination showed a small pigmented choroidal nevus in the temporal periphery. Over a 3-year period, the nevus developed progressive deposition of vitelliform material along its inferior border. Meanwhile, OCT and fundus photography showed only slight growth. Ultrasound showed no change in height; basal measurements were confounded by the increased vitelliform deposits. Genetic testing confirmed a heterozygous mutation in the BEST1 gene and electrophysiology was consistent with BD., Conclusions: Dysfunction of the retinal pigment epithelium associated with BD may cause novel presentations of other conditions such as choroidal nevi. The implication for malignant transformation of a choroidal nevus associated with vitelliform deposit accumulation in this context is unknown.