Oral Verrucous Hyperplasia: A Case Report

Oral verrucous hyperplasia is a whitish or pinkinsh elevated pre malignant lesion which occurs rarely. Its is also considered to be an early form of verrucous carcinoma. We have reported a case of verrucous hyperplasia which was diagnosed and treated with buccal fat pad as graft.     

Lipoma of the Floor of the Mouth: Report of an Unusually Large Lesion

Lipomas are among the most common benign tumors affecting the human body. However, they are relatively uncommon in the oral cavity. Oral lipomas are likely to affect cheek, tongue, lips, gingiva and rarely the floor of the mouth. We report a case of huge lipoma of the floor of the mouth, associated with difficulty in speech and mastication in a 72-year-old male. The tumor was completely excised and sent for histopathological examination, which confirmed the tumor to be a simple classical lipoma.     

Clinico-Epidemiological Profile of Breakthrough COVID-19 Infection among Vaccinated Beneficiaries from a COVID-19 Vaccination Centre in Bihar,India

BackgroundWhen the whole world is fighting in an unprecedented pace against COVID-19 pandemic, the breakthrough COVID infections poise to dampen the rapid control of the same. We carried out this project with two objectives; first, to estimate the proportion of breakthrough COVID-19 infection among completely vaccinated individuals and second, to study the clinico-epidemiological profile of breakthrough COVID-19 infections among them.MethodsThis cross-sectional analytical study was conducted among 2703 fully vaccinated individuals from AIIMS, Patna COVID Vaccination Centre (CVC), Bihar, India. The participants were selected randomly using a systematic sampling technique from the list of beneficiaries maintained at the CVC. Telephonic interviews were made to collect the information by trained data collectors.ResultsA total of 274 fully vaccinated beneficiaries [10.1% (95% CI: 9.1%, 11.4%)] were diagnosed with breakthrough COVID-19 infection. The infections were more among males (10.4%) and the individuals aged ≤29 years (12.5%). The beneficiary categories, the healthcare-worker and the frontline-worker, were identified as predictors of the breakthrough COVID infections. Only one in three participants had adopted adequate COVID appropriate behaviour following the full vaccination. The majority of the breakthrough infections occurred during the second wave of COVID-19. The majority of the individuals with breakthrough infections were asymptomatic and no death was reported among them.ConclusionOne in every ten fully vaccinated individuals can get the breakthrough COVID infections. The healthcare-worker and the frontline-worker had independent risk of getting the breakthrough infections. Very few with breakthrough infections were serious and no death was reported among them.     

Understanding liquid–liquid equilibria in binary mixtures of hydrocarbons with a thermally robust perarylphosphonium-based ionic liquid

Binary mixtures of hydrocarbons and a thermally robust ionic liquid (IL) incorporating a perarylphosphonium-based cation are investigated experimentally and computationally. Experimentally, it is seen that excess toluene added to the IL forms two distinct liquid phases, an “ion-rich” phase of fixed composition and a phase that is nearly pure toluene. Conversely, n-heptane is observed to be essentially immiscible in the neat IL. Molecular dynamics simulations capture both of these behaviours. Furthermore, the simulated composition of the toluene-rich IL phase is within 10% of the experimentally determined composition. Additional simulations are performed on the binary mixtures of the IL and ten other small hydrocarbons having mixed aromatic/aliphatic character. It is found that hydrocarbons with a predominant aliphatic character are largely immiscible with the IL, while those with a predominant aromatic character readily mix with the IL. A detailed analysis of the structure and energetic changes that occur on mixing reveals the nature of the ion-rich phase. The simulations show a bicontinuous phase with hydrocarbon uptake akin to absorption and swelling by a porous absorbent. Aromatic hydrocarbons are driven into the neat IL via dispersion forces with the IL cations and, to a lesser extent, the IL anions. The ion–ion network expands to accommodate the hydrocarbons, yet maintains a core connective structure. At a certain loading, this network becomes stretched to its limit. The energetic penalty associated with breaking the core connective network outweighs the gain from new hydrocarbon–IL interactions, leaving additional hydrocarbons in the neat phase. The spatially alternating charge of the expanded IL network is shown to interact favourably with the stacked aromatic subphase, something not possible for aliphatic hydrocarbons.

Binary mixtures of hydrocarbons and a thermally robust ionic liquid (IL) incorporating a perarylphosphonium-based cation are investigated experimentally and computationally.     

Transition as a topic in psychiatry training throughout Europe: trainees’ perspectives

European Child & Adolescent Psychiatry - The majority of adolescents with mental health problems do not experience continuity of care when they reach the transition boundary of their child and...     

Development and psychometric properties of the “Suicidality: Treatment Occurring in Paediatrics (STOP) Risk and Resilience Factors Scales” in adolescents

European Child & Adolescent Psychiatry - Suicidality in the child and adolescent population is a major public health concern. There is, however, a lack of developmentally sensitive valid and...     

Synthesis of methanediol [CH2(OH)2]: The simplest geminal diol

Geminal diols—organic molecules carrying two hydroxyl groups at the same carbon atom—have been recognized as key reactive intermediates by the physical (organic) chemistry and atmospheric science communities as fundamental transients in the aerosol cycle and in the atmospheric ozonolysis reaction sequence. Anticipating short lifetimes and their tendency to fragment to water plus the aldehyde or ketone, free geminal diols represent one of the most elusive classes of organic reactive intermediates. Here, we afford an exceptional glance into the preparation of the previously elusive methanediol [CH₂(OH)₂] transient—the simplest geminal diol—via energetic processing of low-temperature methanol–oxygen ices. Methanediol was identified in the gas phase upon sublimation via isomer-selective photoionization reflectron time-of-flight mass spectrometry combined with isotopic substitution studies. Electronic structure calculations reveal that methanediol is formed via excited state dynamics through insertion of electronically excited atomic oxygen into a carbon–hydrogen bond of the methyl group of methanol followed by stabilization in the icy matrix. The first preparation and detection of methanediol demonstrates its gas-phase stability as supported by a significant barrier hindering unimolecular decomposition to formaldehyde and water. These findings advance our perception of the fundamental chemistry and chemical bonding of geminal diols and signify their role as an efficient sink of aldehydes and ketones in atmospheric environments eventually coupling the atmospheric chemistry of geminal diols and Criegee intermediates.

Since the turn of the century, geminal diols—defined as organic molecules carrying two hydroxyl groups (OH) at the same carbon atom—have been recognized as key reactive intermediates by the physical (organic) chemistry and atmospheric science communities as fundamental transients in the aerosol cycle (1–3). However, even the simplest representative of a geminal diol—methanediol [CH₂(OH)₂] (1′, 1″)—has not been isolated yet and is conjectured only to exist as short-lived intermediates in the troposphere and in aqueous solutions of formaldehyde (H₂CO) as a transient driven by the inherent dehydration tendency and instability of the two adjacent hydroxyl groups at the same carbon atom (4–7). This classifies geminal diols as one of the least-explored classes of organic reactive intermediates.Gas-phase electronic structure calculations predict that two conformers of methanediol [CH₂(OH)₂] (1′, 1″) are thermodynamically favorable compared to the well-known methyl peroxide isomer (CH₃OOH, 2) by 267 kJ ⋅ mol⁻¹ and 257 kJ ⋅ mol⁻¹, respectively; these conformers are also thermodynamically and kinetically stable toward unimolecular decomposition via dehydration to the formaldehyde–water complex (3), as the 1′ to 3 and 1″ to 3 reactions are endoergic by 21 and 11 kJ ⋅ mol⁻¹ and have barriers of 181 and 191 kJ ⋅ mol⁻¹, respectively (8–11) (Fig. 1). A second decomposition mechanism of 1′/1″ to formic acid (HCOOH) and molecular hydrogen (H₂) involves a transition state predicted to be even 159 kJ ⋅ mol⁻¹ higher than the barrier of the dehydration mechanism (12). Consequently, methanediol [CH₂(OH)₂] (1′, 1″) is expected to be thermodynamically and kinetically stable and hence should be detectable in the gas phase once prepared. However, envisaging the complexities of a directed gas-phase synthesis and short lifetimes of these reactive intermediates, free geminal diols signify one of the most elusive groups of organic transient molecules. This system is also attractive from the viewpoint of electronic structure theory and chemical bonding to benchmark the chemical reactivity and fundamental bond-breaking processes leading to geminal diols in extreme environments.Open in a separate windowFig. 1.Molecular structures of CH₄O₂ isomers. Relative energies, point groups, electronic ground states, and adiabatic ionization energies (blue) of CH₄O₂ isomers are also compiled. The energies were computed at the coupled cluster singles, doubles, and perturbative triples level with a complete basis set extrapolation [CCSD(T)/CBS] and include zero-point vibrational energy corrections. The atoms are color coded in gray (carbon), white (hydrogen), and red (oxygen). The formation of methanediol [(CH₂(OH)₂], 1’ and 1’’) and methyl peroxide (CH₃OOH, 2) via excited-state oxygen atom [O(¹D)] insertion into a carbon–hydrogen and carbon–oxygen/oxygen–hydrogen bonds of methanol (CH₃OH), respectively, are barrierless. The transition state of the decomposition of methanediol [(CH₂(OH)₂], 1’ and 1’’) to a formaldehyde (H₂CO) and water (H₂O) complex (H₂CO···H₂O, 3) is also shown.Here, we report the very first preparation of the previously elusive methanediol [CH₂(OH)₂] molecule (1’), along with its isomer methyl peroxide isomer (CH₃OOH) (2), through exposure of low-temperature (5 K) methanol (CH₃OH)–oxygen (O₂) ices to energetic electrons (SI Appendix, Tables S1–S4). The isomers were unambiguously identified in the gas phase upon sublimation in the temperature-programmed desorption (TPD) phase and discriminated through isomer-selective photoionization–reflectron time-of-flight mass spectrometry together with mass shifts of their isotopically substituted counterparts. The identification of the simplest geminal diol 1’ may have far-reaching consequences for the atmospheric chemistry. Thermodynamically and kinetically stable geminal diols may “lock up” aldehydes and ketones—formed as byproducts of the Criegee-intermediate formation reaction—as geminal diols and hence would remove carbonyl compounds from the atmospheric ozonolysis reaction sequence (1, 13, 14). The Criegee-intermediate formation reaction is a process in which ozone reacts with alkenes forming a carbonyl oxide with two charge centers (Criegee intermediate) (14). Therefore, the existence of geminal diols and Criegee intermediates couples the chemistries of geminal diols, carbonyl compounds, and Criegee intermediates, thus helping to provide a better understanding of the atmospheric chemistry upon which all terrestrial life depends.     

Merits of multicolor imaging for tractional retinal detachment

Purpose:To compare multicolor imaging (MCI) with Optos color fundus photography (OCFP) for the evaluation of morphology and extent of preretinal membranes in diabetic tractional retinal detachments (TRD).Methods:In this retrospective study, 30 eyes with diabetic TRDs were imaged using the MCI feature of the Heidelberg Spectralis Spectral-domain optical coherence tomography (SD-OCT) and color photo using the Optos Daytona ultra-widefield fundus camera. Two investigators independently graded and determined the agreeability between the two modalities with respect to the extent of the TRD and preretinal membranes on the SD-OCT B-scan images.Results:The MCI provided better visualization of the attachments and traction points of the posterior hyaloid face and preretinal membranes and is comparable to the SD-OCT B-scan images. The inter-rater agreeability rates for OCFP had a Kappa (κ) value of 0.37, while the MCI had a κ value of 0.46. When comparing between images of different wavelengths, grading using infrared reflectance (IR) had a poor agreement (−0.04 ± 0.04) while green reflectance (GR) (0.46 ± 0.32) and blue reflectance (BR) (0.53 ± 0.19) had a moderate agreement. The composite MCI and GR images also had comparatively higher intraclass coefficient when compared to the OCFP (0.25 [−0.09–0.55]) and IR (−0.03 [−0.39–0.34]) images.Conclusion:MCI is more sensitive for determining the extent of TRDs and for the detection of secondary membranes when compared to OCFP, thus, aiding in better surgical planning.     

Orbital dermoid cyst

Background:Dermoid cyst, a developmental benign choristoma, is the most common orbital tumor of childhood, arising from ectodermal sequestration along the lines of embryonic fusion of mesodermal processes, lined by keratinized stratified squamous epithelium and expanding slowly due to constant desquamation and dermal glandular elements. Approximately 80% are found in the head and neck region and comprise 3-9% all orbital masses.Purpose:It is mandatory to know about the variable presentations of orbital dermoids and the surgical techniques that can be adopted based on the site, extent, age and aesthetic needs, presence of inflammation and possibility of intraoperative rupture.Synopsis:Orbital dermoids can be classified as juxta-sutural, sutural or soft tissue cysts; superficial or deep; intraosseous or extraosseous, and intraorbital or extraorbital. These smooth, painless, mobile or partially mobile lesions mostly present at the fronto-zygomatic suture with proptosis, displacement, ptosis or diplopia, depending on depth and extent. Therefore, it is important to understand the various presentations and the appropriate surgical techniques.Highlights:We describe the embryological origin, types and clinical features of dermoids in this video and demonstrate the surgical and minimally invasive techniques for their management.Video link: https://youtu.be/-q3xD2igjcQ     

Subarachnoid spread of germinoma mimicking tuberculous meningitis

A case of pineal germinaoma spreading along the basal subarachnoid space, clinically and macroscopically at autopsy, resembling tuberculous basal arachnoiditis is reported. Need to carry out CSF cytology of even hemorrhagic CSF is stressed, to diagnose the condition.