Equal Sex Predilection Research Articles

Epidemiology of benign paroxysomal positional vertigo (BPPV) and risk factors for secondary BPPV: a population-based study

BackgroundBPPV (benign paroxysmal positional vertigo) is a disorder that causes sudden, spinning sensation for few seconds with specific head movements. Of all disorders of inner ear that causes dizziness, BPPP is the most common one. To understand this disorder, we conducted a retrospective study at a tertiary care ENT hospital in Eastern India.Aims and objectives1. To know the incidence of BPPV among all vertigo patients.2. To know the age-sex distribution of BPPV.3. To identify secondary causes of BPPV and their prevalence.4. To know the incidence of different canal BPPVs.5. To ascertain the treatment outcome of different particle repositioning maneuvers in BPPV.MethodsTotal 575 patients presented to the vertigo clinic from 15 September 2018 to 21 March 2022. Out of them 151 patients (26.6%) were diagnosed with BPPV by proper history taking, clinical examination including provocative tests. They were treated with appropriate particle repositioning maneuvers (PRM). Patients were followed for mean 6 months and results were analyzed.Results and analysisOf all vertigo patients, BPPV constitutes 26.6% of cases, making it most common cause of peripheral vertigo. It commonly affects 40–60 years of age group with equal sex predilection. Eighty-three percent of cases were idiopathic, secondary causes include vestibular migraine, Meniere’s disease, labyrinthitis, and orthostatic hypotension. Posterior canal was most commonly affected (74%), followed by lateral and anterior canal. Particle repositioning maneuver (PRM) cures 96% of all BPPV patients (75% needs only one PRM, 15% requires the second one) with overall success rate of 96% after 6 months of follow-up.ConclusionBPPV is the most common cause of peripheral vertigo. One has to understand the anatomy, physiology and pathophysiology of vestibular system to provide better patient care in these patients. Particle repositioning maneuver (PRM) is the treatment for BPPV.

Oral Steatocystoma Simplex—A Rare Tumor

Abstract Steatocystoma is a benign adnexal tumor that originates from sebaceous glands or ducts. Steatocystoma simplex presents as a solitary, noninherited tumor that affects adults with equal sex predilection. It can affect any part of the body and is seen most commonly on the skin of the face and neck. Involvement of the oral mucosa is extremely rare. To the best of our knowledge, only 3 intraoral cases have ever been reported. We report a rare case of steatocystoma simplex presented in a 17-year-old male patient involving the buccal mucosa.

Prevalence of oral anomalies in schoolchildren between the age group of 5 and 14 years of vadodara district

Introduction: Anomalies of the oral and dental structures can be isolated or represent a manifestation of a general disorder or a syndrome. Oral anomalies may lead to functional and aesthetic disorders, and their recognition contributes to early diagnosis and treatment planning. Hence, their recognition is of great significance for a timely and accurate diagnosis. Hence, the present study aimed to know the prevalence of oral anomalies in school-going children. Aim: The aim of this study was to know the prevalence of oral anomalies in schoolchildren between the age group of 5 and 14 years located in Vadodara city. Methodology: The study was comprised of 7533 schoolchildren (male – 4211 and female – 3322) aged between 5 years and 14 years. All of the study participants underwent an oral screening examination for oral health and developmental anomalies. Results: Out of 7533 children, 65 (42 – male and 22 – female) had oral anomalies, with a prevalence of 0.86%. The prevalence of supernumerary teeth and fusion was 0.37% and 0.07%, respectively. Ankyloglossia showed an equal frequency in both sexes, with a prevalence value of 0.02%. The prevalence value of 0.10% and 0.06% was noted in talon's cusp and cleft lip and palate, respectively. With 0.03% prevalence, microdontia showed an equal sex predilection. With a prevalence value of 0.01%, the least common anomalies found here were geographic tongue, microdontia and temporomandibular joint ankylosis. Conclusion: Oral anomalies occur with different frequencies in many countries of the world amongst different ethnic or regional groups. Early identification of these anomalies is noteworthy in planning comprehensive management of the young child.

Death Due to Obstruction of Airways by a Hyperplastic Polyp: An Unusual Complication of Treated Desmoid Fibromatosis.

Desmoid fibromatosis (DF) is a rare, locally aggressive but benign clonal fibroblastic lesion of deep soft tissue. It can occur at any age. Extra-abdominal lesions are more common in the pediatric population, with equal sex predilection. Desmoid fibromatosis of the head and neck, particularly the anterior neck, is more difficult to manage because of the proximity to vital structures and may eventually require definitive airway management with insertion of a tracheostomy tube. Indwelling tracheostomy tubes carry their own set of complications. This is the case of a 21-month-old boy who died suddenly due to tracheal obstruction by a hyperplastic polyp. He was diagnosed with DF of the neck before he was 1 month old and required an indwelling tracheostomy tube as a result. Chronic tracheostomy intubation can be complicated by granulation tissue polyp or, less commonly, fibroepithelial polyp formation that can become large enough to cause airway obstruction. To the authors' knowledge, this is the first case of hyperplastic polyp causing fatal airway obstruction.

Cemento-osseous dysplasia: Clinicopathological spectrum of 10 cases analyzed in a tertiary dental institute.

Background:Cemento-osseous dysplasia (COD) is a distinct entity, which is confined to the tooth-bearing areas of the jaws or edentulous alveolar processes.Aims:This study analyzes the demographic, clinical, radiographic and histopathological features of COD.Materials and Methods:Archival data from 2013 to 2017 present in the Department of Oral Pathology were retrieved. Clinicopathological and radiological features of all the cases which had been previously diagnosed as COD were analyzed in detail.Results:In the present study, 10 cases of COD were analyzed (1 periapical, 6 florid and 3 focal). Equal sex predilection was observed. The mean age in females and males was 42.6 years (22–64 years) and 28.6 years (17–36 years), respectively. Bony expansion was seen frequently, but pain was not a common feature. Mandible was affected almost twice as frequently as maxilla and posterior region was affected more than anterior region. Most cases showed mixed radiopaque and radiolucent lesion (5/10) and peripheral radiolucent rim (9/10) on radiographic examination. Histopathological features included the presence of curvilinear trabeculae (4/10), sheets of compact bone (3/10) or both (3/10). Foci of mineralization in form of ossicles or cementicles were noted in 5 out of 10 cases.Conclusion:COD is a nonneoplastic process usually confined to the tooth-bearing areas of the jaws or edentulous alveolar processes. Depending on the location and extent, it can be either focal/periapical/florid variant. Histopathological features of COD can overlap with other fibro-osseous lesions. Hence, the correlation of clinical, radiological and histopathological features is of paramount importance in the accurate diagnosis of COD.

INTRAPULMONARY TERATOMA: A CAUSE OF SHORTNESS OF BREATH IN A YOUNG WOMAN

SESSION TITLE: Tuesday Medical Student/Resident Case Report Posters SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: 10/22/2019 01:00 PM - 02:00 PM INTRODUCTION: Intrapulmonary Teratoma (IPT) is a rare benign cystic lesion with fewer than 100 cases reported in medical literature(1). We report a case of an 18-year-old female with symptoms of shortness of breath, recurrent pulmonary effusions which, following thoracotomy, was attributed to a mature cystic teratoma containing respiratory and pancreatic tissue. CASE PRESENTATION: An 18-year-old female presented to the emergency room short of breath with right-sided chest pain. Notably, she had a month-long history of intermittent shortness of breath treated with antibiotics for presumed pneumonia only with marginal improvement in her symptoms. Initial vital signs and physical exam were unremarkable. Chest X-Ray showed a large right-sided pleural effusion, chest CT reported a large right-sided loculated pleural effusion with compressive atelectasis for which thoracentesis was done and a chest tube placed. She was given Ceftriaxone, Doxycycline along with tissue plasminogen activator (tPA) and dornase alpha (DNase), essentially managed as empyema. After clinical and radiographic improvement, she was discharged home on a 4-week course of Levofloxacin. 3 weeks from discharge, shortness of breath persisted with imaging notable for worsening right-sided pleural effusion(Figure 1). Subsequently, right thoracoscopy which was converted to right thoracotomy revealed a large complex multi-loculated cystic structure containing greenish material. Histology diagnosis was a mature cystic teratoma composed of respiratory and pancreatic tissue. Two-month follow up after removal of the teratoma in toto resulted in the patient having a complete clinical recovery. DISCUSSION: Since they were first described by Mohr, as few as 65 IPTs have been reported in literature between 1839 and 1996 (2).Patients age between 10 months and 68 years(3) with equal sex predilection and presenting complaints are often non-specific - chest pain (52%), hemoptysis (42%), cough (39%) and trichoptysis (13%), which is rare but pathognomonic. IPTs can appear as lobulated masses, cavitary lesions or as areas of consolidation on imaging. CT helps in estimating different elements that compose the teratoma (soft tissue/fluid/fat/calcification), differentiating ruptured from unruptured teratoma and, delineating degree of mediastinal invasion and/or proximity to vascular structures. Histopathologically, IPTs can demonstrate endo-, meso- or ectodermal elements like in our patient whose histology was impressive for respiratory epithelium and pancreatic tissue. There are reports of rupture of cysts containing pancreatic tissue owing to the production of proteolytic or digestive enzymes (2). For this reason and the possibility of being malignant, surgical excision is advised. CONCLUSIONS: IPTs are a rare entity and may present with non-specific symptoms. Radiographic imaging often assists in diagnosis and surgery is the mainstay of treatment. Reference #1: Ditah C, Templin T, Mandal R, Pinchot JW, Macke RA. Isolated intrapulmonary teratoma. J Thorac Cardiovasc Surg. 2016 Dec;152(6):e129–31. Reference #2: Asano S, Hoshikawa Y, Yamane Y, Ikeda M, Wakasa H. An intrapulmonary teratoma associated with bronchiectasia containing various kinds of primordium: a case report and review of the literature. Virchows Arch. 2000 Apr 10;436(4):384–8. Reference #3: Carter D, Eggleston JC. Teratoma. In: Hartmann WH, ed. Tumor of the Lower Respiratory Tract. Washington: Armed Forces Institute of Pathology, 1980: 325-6 DISCLOSURES: No relevant relationships by Rohit Aloor, source=Web Response no disclosure on file for Daniel Harley; No relevant relationships by ARJUN KANWAL, source=Web Response No relevant relationships by Vaishnavi Raman, source=Web Response No relevant relationships by Himanshu Rawal, source=Web Response

Nonfunctioning Parathyroid Carcinoma

Parathyroid carcinoma (PC) is a rare endocrine malignancy accounting for less than 1% of cases of primary hyperparathyroidism (PHPT) [1,2]. There is an equal sex predilection, whereas adenomas are most commonly seen in females. Patients with PC are younger than those with adenoma (50 vs. 60 years) and usually present with marked hypercalcemia and/or systemic manifestations, related to either hypercalcemia or increased PTH levels.

Myxoinflammatory Fibroblastic Sarcoma: A Radiographical, Pathological, and Immunohistochemical Report of Rare Malignancy.

Myxoinflammatory fibroblastic sarcoma (MIFS) is a rare, painless, and intermediate (rarely metastasizing) fibroblastic tumor, which commonly occurs in the extremities, with an equal sex predilection. This sarcoma is composed of a mixed inflammatory infiltrate along with spindled, epithelioid, and bizarre tumor cells in a background of hyaline and myxoid areas. In spite of such a distinctive morphology, the tumor can be a diagnostic challenge, simulating inflammatory conditions as well as neoplastic nature. For accurate diagnosis, the tumor requires extensive clinical, radiological, and pathological investigations. We present a case of MIFS in a 19-year-old female who presented with a mass in the left ankle. After appropriate excision and postoperative radiation therapy, she is free of disease, including recurrence and metastasis, at 12 years postoperatively.

Gnathic Osteosarcoma: A Retrospective Analysis over a 20 Year Period

Osteosarcomas are very rare malignant mesenchymal neoplasms affecting jaw bones. Only few studies are reported about this lesion in this particular region. We wanted to assess the demography and tumor behaviour and histopathological pattern, retrospectively in the available cases. A retrospective analysis of hospital records for 20 years was carried out. Clinical features, radiographic findings, histopathological details and treatment aspect of each of the lesions was considered. Findings of this study revealed only 13 cases of gnathic osteosarcomas, usually occurring in middle age, with equal sex predilection and predominantly seen in maxilla. Histopathologically, most of them belonged to osteogenic variant. Only few cases of gnathic osteosarcomas are reported in this region mainly in the young males. Interestingly many of them has history of dental extraction before the onset of disease.

Myxoinflammatory fibroblastic sarcoma: an uncommon tumour at an unusual site.

Myxoinflammatory fibroblastic sarcoma is a low grade sarcoma that is composed of a mixed inflammatory infiltrate along with spindled, epithelioid and bizarre appearing cells in a background of hyaline and myxoid zones. Seen affecting the distal extremities commonly, with an equal sex predilection, these tumors are rare and require an extensive immunohistochemical work up for proper diagnosis. They have a tendency to recur.

Xeroderma Pigmentosum: A Case Report of Two Siblings

Xeroderma Pigmentosum: A Case Report of Two Siblings Xeroderma Pigmentosum (literally means dry pigmented skin) is defined by extreme sensitivity to sunlight, resulting in sunburn, pigment changes in the skin and greatly elevated incidence of skin cancers (Alan R Lehman et al.). Herba and Kaposi first described Xeroderma Pigmentosum in 1974. Kramer et al. found an equal sex predilection and significant parental consanguinity, confirming an autosomal recessive inheritance pattern. The incidence of XP seems to vary across the globe. The incidence reported in US and Europe is 1:250000 and in Japan and other countries at a higher frequency 1:40000. Its incidence is not that significant in context to the other part of the world. The basic defect underlying the clinical manifestations is a nucleotide excision repair (NER) defect leading to a defective repair of DNA damaged by ultra violet (UV) radiation. Historically, the disease was classifies as classical XP with only skin abnormalities and the De-Sanctis-Cacchione syndrome with skin abnormalities and extreme neurological degeneration was evident.

Plexiform Ameloblastoma of the Mandible

Ameloblastoma is a common and aggressive odontogenic epithelial tumor. It has an aggressive behavior and recurrent course, and is rarely metastatic. Ameloblastoma represents 1% of all tumors and cysts that involve the maxillomandibular area and about 10% of the odontogenic tumors. It is primarily seen in adults in the third to fifth decade of life, with equal sex predilection. Radiographically, it appears as an expansile radiolucent, with thinned and perforated cortices, and is known to cause root resorption. As it shares common radiographic features with other lesions such as the giant cell tumor, aneurismal bone cyst, and renal cell carcinoma metastasis, a definitive diagnosis can only be made with histopathology. We present an extensive case of plexiform ameloblastoma of the mandible in a 42-year-old female patient.

Sialolipoma: case report and review of 27 cases

This article presents a patient with sialolipoma of the submandibular gland, a rare neoplasm, and reviews related literatures. A MEDLINE literature and articles published in the Korean language in KMbase (kmbase.medric.or.kr) search was performed and the literatures were reviewed. We presented a sialolipoma of the submandibular gland and other 27 cases from published literatures. Our case was shown in 62-year-old female. It was the second case of submandibular gland sialolipoma reported in the English literature. Unlike other lipomatous lesion in the oral cavity, definite male predilection was not observed in the sialolipoma. The most common site for the tumor was the parotid gland (17 cases, 60.7%), followed by the palate (four cases, 14.2%). Histopathologically, a tumor was a benign lesion with proliferating lipocytes including scattered foci with a normal salivary gland tissue. Our treatment of choice was surgical excision and recurrent case has not been reported. Sialolipoma is a rare benign neoplasm in the head and neck and it shows equal sex predilection.

Benign Fibro-Osseous Lesions of the Jaws: A Study of 127 Chinese Patients and Review of the Literature

The aim of this study is to analyze all the cases of benign fibro-osseous lesions treated at School and Hospital of Stomatology, Wuhan University, to compare the results obtained in this study with those previously documented by other authors. The 127 cases diagnosed as a fibro-osseous lesion were retrieved, and information about these lesions was documented. In all, 127 cases of benign fibro-osseous lesions were surgically treated. Of these, 55 were cemento-ossifying fibroma, 43 ossifying fibroma, and 29 fibrous dysplasia. Cemento-ossifying fibromas mostly occur in men of the second decades, mostly in the mandible. Ossifying fibromas had almost equal sex predilection and age distribution peaked in the second decades, mostly in the mandible. Fibrous dysplasia also had equal sex predilection, and age distribution peaked in the second and third decades, with equal occurrence in both jaws. The tumors needed to have a regular follow-up after the surgery.

Eccrine acrospiroma of neck in a 3-year-old female child

Eccrine acrospiromas are tumours derived from eccrine sweat gland epithelium. They are usually found in middle-aged people with equal sex predilection. Most of such tumours are found on extremities. We present a case of 3-year-old female child who presented to our institute with a swelling in neck just above the medial end of right clavicle. Thorough clinical, laboratory and radiological investigations were carried out. Taking into consideration the age of the patient and other clinical features a diagnosis of sebaceous cyst of neck was arrived at. The mass was excised under general anaesthesia and sent for histopathological examination. The pathological report established a diagnosis of benign eccrine acrospiroma. The patient has no complaint postoperatively and has been advised to be on regular follow up due to reported cases of recurrence and malignant transformation. Such case of eccrine acrospiroma is rare and has never been reported in the literature and thus should be kept in mind while dealing with neck swellings especially in children taking into consideration its malignant potential.

Role of IL-12B Promoter Polymorphism in Adamantiades–Behcet's Disease Susceptibility: An Involvement of Th1 Immunoreactivity against Streptococcus Sanguinis Antigen

Adamantiades-Behcet's disease (ABD) is a chronic inflammatory multisystem disorder. Although the precise etiology is unclear, high prevalence of human leukocyte antigen (HLA)-B51 predisposition and predominantly involved T-helper type 1 cells (Th1)-type proinflammatory cytokines and extrinsic Streptococcal infection suggest a substantial association with an immunogenetic basis and strengthens the hypothesis that IL-12, a potent inducer of Th-1 immune reaction, is a putative candidate in its pathogenesis. These clinicopathological findings led us to examine interleukin 12 p40 (IL-12B) promoter polymorphism, for which the 4-base pair (bp) heterozygous insertion has been shown to affect the gene transcription and subsequent protein production. We analyzed IL-12B promoter genotypes in 194 Japanese subjects (92 with ABD and 102 normal controls) by PCR-based restriction enzyme digestion. The frequency of the insertion heterozygosity was significantly higher in patients than in controls (49/92, 53.3% vs 39/102, 38.2%, respectively). Comparing these with HLA haplotype data, this trend was more significant in HLA-B51-negative patients (29/42, 69.0% vs 20/50, 40.0%; P = 0.005). As assessed by semiquantitative reverse transcription-PCR and ELISA, stimulation with Streptococcal antigens specifically increased expression of IL-12 p40 mRNA and protein, in conjunction with IL-12 p70 induction, in peripheral blood mononuclear cells from heterozygous patients. Our results provide evidence for anti-bacterial host response toward Th1-immunity mediated by IL-12 in patients with ABD, and the possible insight into the genetic susceptibility that is independent of HLA background.

Conjunctival Melanoma: The Role of Conservative Surgery and Radiotherapy in Regional Metastatic Disease

To evaluate prognostic factors and determine the role of conservative surgery and radiotherapy in managing metastatic conjunctival malignant melanoma (MM) involving preauricular/submandibular lymph nodes. A retrospective analysis (1990-2003) of clinical and histopathologic data from 12 patients presenting with regional metastases after failed local treatment for conjunctival MM. Patients received a common, multispecialty, conservative management approach: wide local excision, topical cryotherapy or radiotherapy to conjunctival MM (orbital exenteration for more advanced local disease), lumpectomy, and adjuvant "ring" radiotherapy of regional metastases, with chemotherapy for distant metastases. Median age at primary diagnosis was 51 (range 28-86) years with equal sex predilection. Six of the 12 patients had primary tumors of the bulbar conjunctiva; the remainder arose in the palpebral conjunctiva, the caruncle, or the fornix. Of 11 originating in primary acquired melanosis (PAM), 2 were amelanotic. Epithelioid tumor cells were noted histologically in seven of eight specimens in which cell type could be determined. Eight tumors metastasised to preauricular nodes, three to submandibular and one to both, with a median interval of 23 (range 12-108) months after primary diagnosis. After conservative surgery and "ring irradiation," 7 of 12 patients remained free of regional nodal relapse at median interval of 16 (range 3-126) months. Five patients developed regional nodal recurrence at median interval of 11 (range 6-13) months, 3 of whom were within radiotherapy portals. Eight patients developed distant metastasis at median interval of 44 (range 22-138) months. Eleven patients had tumor-related death. The mean Kaplan-Meier adjusted survival time after primary diagnosis was 76 months with death ensuing postregional metastasis within a median 18 (range 4-127) months. The sole survivor's follow-up duration was 56 months. Locoregional metastasis after treatment for conjunctival MM is associated with a poor prognosis. Both epithelioid tumor cells and PAM are associated with disseminating disease and poorer outcome. Literature review has failed to demonstrate advantages of mutilating radical surgery over a conservative approach in this rare disease.

Nonalcoholic steatohepatitis: what we know in the new millennium.

Nonalcoholic steatohepatitis (NASH) is a liver disease characterized by diffuse fatty infiltration and inflammation. The exact prevalence of NASH is unclear, but it is becoming more evident that the disease is much more common than previously thought. Although generally a benign, indolent process, it can progress to advanced liver disease in approximately 15-20% of patients. Clinical characteristics associated with NASH include obesity, hyperlipidemia, diabetes mellitus, and hypertension, all of which have been associated with underlying insulin resistance. Typically, this disease becomes evident in the fourth or fifth decade of life with an equal sex predilection. NASH is thought to be caused, in part, by impaired insulin signaling, leading to elevated circulating insulin levels and subsequent altered lipid homeostasis. This process is likely multifactorial and includes both genetic and environmental factors. Treatment options to date are limited and are based on very small clinical trials. Current investigations are focusing on improving the underlying insulin resistance that has been associated with NASH as well as other therapies that decrease oxidative stress or improve hepatocyte survival.