Inflammatory Hyperplasia Research Articles

Diode laser excision of pyogenic granuloma

Pyogenic granuloma is a commonly occurring inflammatory hyperplasia of the skin and oral mucosa in females. It is a misnomer that is characterized histologically by angiomatous proliferation rather than a granulomatous lesion. This tumor-like growth is considered to be nonneoplastic in nature and has a varied clinical presentation. We present one such case of pyogenic granuloma, which was excised with a diode laser along with a relevant review of the literature.

Atypical Oral Fibrous Histiocytoma - An Uncommon Histiocytic Lesion Presenting as Inflammatory Fibrous Hyperplasia

Fibrous histiocytoma, as the name suggests, is a lesion which is prominently composed of a combination of fibroblastic & histiocytic cells. Fibrous histiocytoma can usually be seen as either cutaneous types or involving deep tissues. The diagnosis of fibrous histiocytoma is only confirmed after surgical excision. It is imperative to differentiate this lesion from the other aggressive forms of fibrohistiocytic neoplasms. Atypical Fibrous Histiocytoma (AFH) comes in the spectrum of fibrous histiocytic lesion ranging from benign to malignant lesions. Atypical Fibrous Histiocytoma in oral cavity is distinctly uncommon. This uncommon occurrence of the lesion needs to be made known of, to prevent inappropriate treatment. Hence, here we present an uncommon case report of Atypical oral fibrous histiocytoma which presented clinically as epulis fissuratum/ Inflammatory fibrous hyperplasia

Effect of Buyi Pishen acupuncture on inflammatory factor and cartilage matrix in adjuvant arthritis rats

To observe the effect of Buyi Pishen acupuncture (acupuncture for invigorating spleen and kidney) on inflammatory factor and synovial cartilage matrix in adjuvant arthritis (AA) rats, and to explore the mechanism of acupuncture for rheumatoid arthritis (RA). A total of 60 clean male Wistar rats were randomized into a normal group, a model group, a tripterygium wilfordii polyglycoside tablet (TWP) group and an acupuncture group, 15 rats in each group. Rats in the model group, the TWP group and the acupuncture group received intradermal injection of Freund's complete adjuvant (FCA) at right hind foot pad to induce the AA model. TWP suspension of 8 mg/kg was given by gavage in the TWP group. Acupuncture was applied at "Shenshu" (BL 23), "Pishu" (BL 20) and right "Housanli" (ST 36), "Sanyinjiao" (SP 6), "Yanglingquan" (GB 34) in the acupuncture group, 15 min a time, once a day. The intervention was given 15 days in both TWP group and acupuncture group. The foot-pad swelling degree before modeling, before and after intervention and the arthritis index (AI) score before and after intervention were calculated; the serum levels of interleukin (IL)-1β, IL-4, IL-10 and tumor necrosis factor-α (TNF-α) were detected by ELISA method; the ultrastructure and histomorphological changes of synovium issue were observed by transmission electron microscope and HE staining; the positive expression of matrix metalloproteinase (MMP)-3 and MMP-9 in synovium issue was detected by immunohistochemistry method. Before intervention, foot-pad swelling degree of the model group, the TWP group and the acupuncture group was increased compared with the normal group (P<0.01). After intervention, foot-pad swelling degree and AI score were increased compared with the normal group (P<0.01), foot-pad swelling degree and AI scores in the TWP group and the acupuncture group were lower than the model group (P<0.05), and those in the acupuncture group were decreased compared with the TWP group (P<0.05). The model group exhibited unclear nuclear membrane of synovial cells, chromatin pyknosis, massive inflammatory cell infiltration and hyperplasia in synovial tissue; the TWP group and the acupuncture group exhibited clear and smooth nuclear membrane of synovial cells, inapparent chromatin pyknosis, less inflammatory cell infiltration and hyperplasia in synovial tissue, the acupuncture group exhibited less matrix destruction as well. Compared with the normal group, serum levels of IL-1β and TNF-α and positive expression of MMP-3 and MMP-9 in synovium issue were increased (P<0.01), while serum levels of IL-4 and IL-10 were decreased (P<0.01) in the model group. Compared with the model group, serum levels of IL-1β and TNF-α and positive expression of MMP-3 and MMP-9 in synovium issue were decreased (P<0.05, P<0.01), while serum levels of IL-4 and IL-10 were increased (P<0.05) in the TWP group and the acupuncture group; compared with the TWP group, serum level of TNF-α and positive expression of MMP-3 and MMP-9 in synovium issue were decreased (P<0.05), while serum levels of IL-4 and IL-10 were increased (P<0.05) in the acupuncture group. Buyi Pishen acupuncture can effectively improve the injury of articular cartilage in AA rats, its mechanism maybe related to reducing the inflammatory reaction in synovium and inhibiting the degradation of articular cartilage matrix.

Evaluation of the Mechanism of Jiedu Huazhuo Quyu Formula in Treating Wilson’s Disease-Associated Liver Fibrosis by Network Pharmacology Analysis and Molecular Dynamics Simulation

The Jiedu Huazhuo Quyu formula (JHQ) shows significant beneficial effects against liver fibrosis caused by Wilson's disease (WD). Hence, this study aimed to clarify the mechanisms of the JHQ treatment in WD-associated liver fibrosis. First, we collected 103 active compounds and 527 related targets of JHQ and 1187 targets related to WD-associated liver fibrosis from multiple databases. Next, 113 overlapping genes (OGEs) were obtained. Then, we built a protein-protein interaction (PPI) network with Cytoscape 3.7.2 software and performed the Gene Ontology (GO) term and Kyoto Encyclopedia of Gene and Genome (KEGG) pathway enrichment analyses with GENE DENOVO online sites. Furthermore, module analysis was performed, and the core target genes in the JHQ treatment of WD-associated liver fibrosis were obtained. Pathway and functional enrichment analyses, molecular docking studies, molecular dynamic (MD) simulation, and Western blot (WB) were then performed. The results indicated that 8 key active compounds including quercetin, luteolin, and obacunone in JHQ might affect the 6 core proteins including CXCL8, MAPK1, and AKT1 and 107 related signaling pathways including EGFR tyrosine kinase inhibitor resistance, Kaposi sarcoma-associated herpesvirus infection, and human cytomegalovirus infection signaling pathways to exhibit curative effects on WD-associated liver fibrosis. Mechanistically, JHQ might inhibit liver inflammatory processes and vascular hyperplasia, regulate the cell cycle, and suppress both the activation and proliferation of hepatic stellate cells (HSCs). This study provides novel insights for researchers to systematically explore the mechanism of JHQ in treating WD-associated liver fibrosis.

Juvenile Spongiotic Epithelial Hyperplasia: Case Report

Localized juvenile spongiotic gingival hyperplasia (LJSGH) is a rare gingival lesion that has a distinctive form of inflammatory hyperplasia. The lesion has specific features both clinically and pathologically and it may or may not involve multiple sites. In this paper we present a case with lesion that clinically in harmony with LJSGH in upper central incisor area, confirmed by biopsy. A 13-year-old boy was referred to our Assalam Dental Center in Zliten, Libya, presented with circumscribed, erythematous overgrowth on the right maxillary incisor gingiva. With the provisional diagnosis of LJSGH, total excision of the lesion was performed. Clinical, microscopic and histopathogical examination confirmed the diagnosis of LJSGH in maxillary incisor site. The excised lesion showed no recurrence after 18 months of follow up appointments.

Degradation of internal fixation materials based on antibacterial and absorbable silk containing different gentamicin concentrations.

Adding gentamicin to silk fibroin enhances both the antibacterial performance and degradation rate of silk-based materials. The increased material degradation rate can affect the strength of early internal fixation, resulting in internal fixation failure. This study sought to adjust the gentamicin concentration to control the material degradation rate, thereby better meeting clinical application requirements. The in vitro degradation, water absorption rate, and expansion rate of silk-based materials containing different gentamicin concentrations were studied. A gentamicin-loaded silk-based screw was implanted into the femurs of New Zealand rabbits. Micro-computed tomography was used to measure the screw diameter, which was then used to calculate the degradation rate. The specimens were stained with hematoxylin and eosin and Masson's trichrome. The in vitro results revealed increasing material degradation rates with increasing gentamicin concentration but no significant differences in water absorption rates with different gentamicin concentrations. The degradation rates of gentamicin-loaded (4mg/g) silk-based rod-like materials were approximately 11.08% at three months in vitro and 9.4% in the animal experiment. The time for complete degradation was predicted from the fitting curve to be approximately 16months. No inflammatory hyperplasia was observed in bone or soft tissue. The degradation and biocompatibility of the material containing 4mg/g gentamicin meet clinical application requirements, and previous experimental results demonstrate good antibacterial performance of materials containing this gentamicin concentration.

Euphorbia factor L3 ameliorates rheumatoid arthritis by suppressing the inflammatory response by targeting Rac family small GTPase 1

ABSTRACT Euphorbia factor L3 (EFL3) is extracted from Euphorbia lathyris and is known for its anti-inflammatory properties. This study focused on the potential anti-inflammatory and therapeutic effects of EFL3 on rheumatoid arthritis (RA) using fibroblast-like synoviocytes (FLSs) and arthritis animal models. Functional analysis showed that EFL3 could ameliorate the inflammatory phenotype of FLSs derived from RA patients, as evidenced by the decreases in cell viability, migration, invasion and cytokine production. Luciferase activity, Western blotting and immunofluorescence assays demonstrated that EFL3 inhibited the nuclear translocation of the p65 subunit and the subsequent activation of the nuclear factor kappa-Β (NF-κB) pathway. Furthermore, the therapeutic effects of EFL3 against arthritic progression were evidenced by decreases in joint swelling, arthritis scores, inflammatory factor production, synovial hyperplasia, and bone destruction in collagen-induced arthritis (CIA) and tumor necrosis factor-α (TNF-α) transgenic (TNF-tg) mouse models. Molecular analysis identified Rac family small GTPase 1 (Rac1) as the potential target that was required for EFL3-mediated suppression of the inflammatory RA FLS phenotype. In summary, this study uncovered the therapeutic potential of EFL3 in RA, which suggests its future clinical use.

Role of cryosurgery in maxillofacial lesions: A literature review

Cryosurgery has the ability to produce very low temperatures which causes tissue destruction. It has been found to be effective for oral cavity lesions of the infants, elderly patients and also of the immunocompromised patients. Cryosurgery is a very safe, easy to perform, and relatively inexpensive technique for treating various oral injuries on an outpatient basis. It is an atraumatic form of therapy compared to conventional surgery. Liquid nitrogen spray or cryoprobe has been used alone or in combination with other surgical methods in various types of oral lesions. According to various studies and literature, cryosurgery has been found to be effective for the treatment of refractory trigeminal neuralgia and TMJ pain, as it provides longer pain free interval than the other treatment modalities. It has been utilized as an effective method for the treatment of benign conditions like gingival pigmentation, inflammatory papillary hyperplasia, mucocele; premalignant conditions like leukoplakia, lichen planus and as a palliative therapy for malignant conditions like erythroplakia, squamous cell carcinoma. In hypertrophic scars, as an adjuvant therapy after enucleation for odontogenic lesions like ameloblastomas, keratocysts and for vascular lesions like capillary hemangiomas it has been found to be beneficial.

Oral myiasis in humans.

Myiasis is a parasitic infestation resulting from flies laying eggs in the host tissues. It is common in animals, but can also occur in humans, including in the oral cavity. The diagnosis is usually quite clear in endemic regions such as Brazil, but it can be challenging to clinicians in nonendemic counties when faced with a patient who has acquired the infection elsewhere. We report two clinical cases of human intraoral myiasis and discuss the diagnosis and treatment of this condition. Two men, both of whom were insituations of vulnerability presented with myiasis: the first patient had larvae infesting the alveolar ridge region after tooth extraction, while the second was diagnosed with inflammatory fibrous hyperplasia associated with larvae along the edges of the lesion. Both were treated with ivermectin and antibiotics, and given guidance on preventative care. Such infestations are often a clear sign of neglect, and clinicians need to pay attention to the general health of patients affected by oral myiasis.

Effects of Chemical Composition of Cholesterol and Pigment Stones on the Gallbladder Mucosa

Objective: To compare the effect of chemical composition of cholesterol and pigment stones on gallbladder mucosa. Study design &amp; setting: This comparative cross-sectional study was conducted in the Department of Anatomy, BMSI, JPMC, Karachi, Pakistan, from April to September 2021. Methodology: Total n= 120 gallbladder specimens were collected after cholecystectomies in 10% formalin. Gross morphological features of gallbladder and stones were observed. Specimens were processed and 5µm sections from fundus, body &amp; neck of gallbladder were stained and examined for microscopic changes. Chemical analysis of stones was carried out to differentiate between cholesterol &amp; pigment stones. Results: We evaluated different histomorphological alterations in gallbladder with reference to both type of gallstones. Muscular wall thickness in pigment stone group was noted to be (143.89±78.66) and in cholesterol group (158.37±83.95). Both pigment and cholesterol stone showed increased tendency of muscular hypertrophy. Mucosal ulceration, chronic inflammatory cell infiltration, capillary congestion and hyperplasia (p-value: 0.04) were observed in both type of stones. Statistical analysis showed that large cholesterol stones produce significant histopathological changes (p-value: 0.004); greater the size of stone, more profound was the mucosal hyperplasia. Rokitansky-Ashcoff sinuses were predominant in gallbladders with cholesterol stone. Conclusion: Gallstones cause series of histopathological changes ranging from chronic cholecystitis to pre-malignant and malignant changes. Hyperplasia was observed to be more frequent with long standing, large cholesterol stones

Subungual melanoma with blue naevus-like morphological features: a clinicopathological retrospective analysis of nine cases

Melanocytic lesions in the nail apparatus are often challenging. Both subungual melanomas (SUM) and blue naevus of the nail are very rare. Occasionally, melanomas may mimic blue naevus histologically. Benign and malignant blue melanocytic lesions are commonly associated with G protein mutations, a distinct abnormality not associated with conventional subungual melanomas. We describe the clinical, histological and immunohistochemical features of nine cases of SUM with blue naevus-like morphological features. Mutations in exon 4 and 5 of GNAQ and GNA11 were investigated in two cases, which showed no mutations. RNA-seq of one case revealed unknown mutations along with mutations in ATM, METK and ARID1A. Our study delineates a variant of SUM that mimics blue naevus. Awareness of this pitfall is important when evaluating heavily pigmented lesions around the nail in order to avoid misdiagnosis. Appropriate sampling of subungual lesions and clinicopathological correlation are paramount to reach the correct diagnosis.

Effect of silk fibroin microcarrier loaded with clematis total saponins and chondrocytes on promoting rabbit knee articular cartilage defects repair

To prepare the silk fibroin microcarrier loaded with clematis total saponins (CTS) (CTS-silk fibroin microcarrier), and to investigate the effect of microcarrier combined with chondrocytes on promoting rabbit knee articular cartilage defects repair. CTS-silk fibroin microcarrier was prepared by high voltage electrostatic combined with freeze drying method using the mixture of 5% silk fibroin solution, 10 mg/mL CTS solution, and glycerin. The samples were characterized by scanning electron microscope and the cumulative release amount of CTS was detected. Meanwhile, unloaded silk fibroin microcarrier was also prepared. Chondrocytes were isolated from knee cartilage of 4-week-old New Zealand rabbits and cultured. The 3rd generation of chondrocytes were co-cultured with the two microcarriers respectively for 7 days in microgravity environment. During this period, the adhesion of chondrocytes to microcarriers was observed by inverted phase contrast microscope and scanning electron microscope, and the proliferation activity of cells was detected by cell counting kit 8 (CCK-8), and compared with normal cells. Thirty 3-month-old New Zealand rabbits were selected to make bilateral knee cartilage defects models and randomly divided into 3 groups ( n=20). Knee cartilage defects in group A were not treated, and in groups B and C were filled with the unloaded silk fibroin microcarrier-chondrocyte complexes and CTS-silk fibroin microcarrier-chondrocyte complexes, respectively. At 12 weeks after operation, the levels of matrix metalloproteinase 9 (MMP-9), MMP-13, and tissue inhibitor of MMP 1 (TIMP-1) in articular fluid were detected by ELISA. The cartilage defects were collected for gross observation and histological observation (HE staining and toluidine blue staining). Western blot was used to detect the expressions of collagen type Ⅱ and proteoglycan. The inflammatory of joint synovium was observed by histological staining and inducible nitric oxide synthase (iNOS) immunohistochemical staining. The CTS-silk fibroin microcarrier was spherical, with a diameter between 300 and 500 μm, a porous surface, and a porosity of 35.63%±3.51%. CTS could be released slowly in microcarrier for a long time. Under microgravity, the chondrocytes attached to the surface of the two microcarriers increased gradually with the extension of culture time, and the proliferation activity of chondrocytes at 24 hours after co-culture was significantly higher than that of normal chondrocytes ( P<0.05). There was no significant difference in proliferation activity of chondrocytes between the two microcarriers ( P>0.05). In vivo experiment in animals showed that the levels of MMP-9 and MMP-13 in group C were significantly lower than those in groups A and B ( P<0.05), and the level of TIMP-1 in group C was significantly higher ( P<0.05). Compared with group A, the cartilage defects in groups B and C were filled with repaired tissue, and the repaired surface of group C was more complete and better combined with the surrounding cartilage. Histological observation and Western blot analysis showed that the International Cartilage Repair Scoring (ICRS) and the relative expression levels of collagen type Ⅱ and proteoglycan in groups B and C were significantly better than those in group A, and group C was significantly better than group B ( P<0.05). The histological observation showed that the infiltration of synovial inflammatory cells and hyperplasia of small vessels significantly reduced in group C compared with groups A and B. iNOS immunohistochemical staining showed that the expression of iNOS in group C was significantly lower than that in groups A and B ( P<0.05). CTS-silk fibroin microcarrier has good CTS sustained release effect and biocompatibility, and can promote the repair of rabbit cartilage defect by carrying chondrocyte proliferation in microgravity environment.

Speech and swallowing function following microsurgical reconstruction of palatal defects in a series of six pediatric patients.

Reconstruction of extensive palatal defects in growing patients aims to restore speech intelligibility and swallowing function while avoiding excessive scarring formation that may cause growth disturbances in the palate and midface region. Free flaps transfer healthy, well-vascularized tissue to the defect area, and their combination with pharyngeal flaps allow for restoration of the velopharyngeal function. We examined speech and swallowing after microsurgical palate reconstruction in a series of six pediatric patients. Radial forearm free flaps were used in all cases, in combination with a superiorly based pharyngeal flap in five cases. Mean age at surgery was 10.7 years. Etiologies included recurrent oronasal fistula due to failed primary cleft palate repair (n=4), embryonal rhabdomyosarcoma of the maxilla (n=1), and inflammatory fibrous hyperplasia (n=1). Speech evaluations (with the Hirose standard and listener ratings) and swallowing assessments (based on videofluoroscopy swallowing studies and patient-reported swallowing and diet) were performed in average 44 months postoperatively. All flaps survived without major postoperative complications. Speech intelligibility was graded as "excellent" in four patients and "moderate" in two. Hypernasality and nasal obstruction were each judged as "none/minimal" in five cases and "moderate" in one case. All patients tolerated oral diet without significant nasal regurgitation. In five of six patients, the swallowing assessment showed good motion and velopharyngeal closure. Microsurgical reconstruction of extensive palatal defects using radial forearm free flap, with or without a superiorly based pharyngeal flap, is a reliable technique that can deliver substantial improvement of speech and swallowing in pediatric patients.

Anti-inflammatory effect of Eucommia Chlorogenic Acid (ECA) on adjuvant-induced arthritis rats and its effect on autophagy related pathway

Observation ECA’s treatment effects in Adjuvant arthritis rats and relative mechanisms. The rat model of arthritis was established by subcutaneous injection of 0.2 mL Freund’s complete adjuvant. After model success, giving different ECA concentrations (25 mg/kg, 50 mg/kg and 100 mg/kg) to rats by ig methods and continued to 28 days. Measuring thymus and spleen index; observation histopathological morphology of rat joint by HE and Masson staining, and Inflammatory cells, synovial hyperplasia, oochas score and degree of fibrosis were detected semi quantitatively. The relative gene and protein expressions were measured by RT-PCR and Western blot. Compared with Normal group, Inflammatory cells, synovial hyperplasia, fibrosis and oochas score increased significantly in Model group (P<0.01, respectively); COX-1, COX-2, TNF-α, IL-1β, IL-6 and IL-17 mRNA expression were significantly up-regulation (P<0.01); AMPK, Beclin1 and ATG12 mRNA and protein expressions were significantly down-regulation (P<0.01, respectively). Compared with Model group, The inflammatory cells, the degree of fibrosis, the proliferation of synovial tissue and OOCHAS score decreased significantly in Middle and High groups (P<0.01, respectively); Thymus index significantly depressed in Low, Middle and High groups (P<0.01, respectively); spleen index were significantly down-regulation in Middle and High groups (P<0.05 or P<0.01); COX-2, TNF-α and IL-17 mRNA expression was significantly down-regulation (P<0.05), IL-1βand IL-6 mRNA expression were significantly depressed in Middle and High groups (P<0.05 or P<0.01); AMPK, Beclin1, LC3-II, ATG5 and ATG7 mRNA expressions were significantly up-regulation in Middle and High groups (P<0.05 or P<0.01); mTOR gene expression was significantly down-regulation (P<0.05), ATG12 mRNA expression was significantly up-regulation (P<0.01) in High group; AMPK, Beclin1, LC3-II, ATG5 and ATG7 protein expressions were significantly increased in High group (P<0.05 or P<0.01), mTOR protein expression were significantly down-regulation and ATG12 protein expression were significantly up-regulation in Low, Middle and High groups (P<0.05 or P<0.01, respectively). ECA can inhibit the inflammatory response in adjuvant arthritis rats, and its mechanism may be related to promoting autophagy of synovial cells.

Cedrol from ginger alleviates rheumatoid arthritis through dynamic regulation of intestinal microenvironment.

The imbalance of intestinal flora would induce immune inflammation. Cedrol (CE), found from ginger by our group earlier, has been proven to play an excellent role in ameliorating rheumatoid arthritis (RA) via acting on JAK3, MAPK, and NF-κB. However, there have been no studies on CE ameliorating RA through the regulation of the micro-environment. In this study, the adjuvant arthritis model (AIA) is established to evaluate the weight, arthritis score, paw swelling, bone destruction, immune organ index, inflammatory cell infiltration, cartilage erosion, and metabolic enzymes of kidneys in AIA rats after CE intervention. The results indicated CE could alleviate paw swelling, reduce arthritis score, decrease the secretion of TNF-α, IL-6, and IL-1β in serum in a dose-dependent manner, and inhibit the immune organ index of the spleen while having no significant effect on metabolic enzymes of the kidney. In addition, pathological sections of ankle and knee joints suggested CE might significantly prevent inflammatory cell infiltration, synovial hyperplasia, and joint degeneration and protect articular cartilage. Then, for the first time, 16S rRNA gene was applied to analyze the regulatory effect of CE on intestinal flora. CE could effectively improve the uniformity, diversity, and richness of intestinal flora, reduce the number of pathogenic bacteria, and increase the proportion of beneficial bacteria, and it significantly inhibited the abundance of Prevotella in RA rats, which was 12.43 times smaller than that in methotrexate. The distribution and excretion of CE in vivo were detected by GC-MS. It was found that CE would massively accumulate in the gastrointestinal tract after oral administration, which is then mainly excreted through feces. Interestingly, the research suggested that CE, which plays a role in the dynamic regulation of the intestinal micro-environment, could be used as a potential component to prevent RA.

Presence of a t(12;18)(q14;q21) Chromosome Translocation and Fusion of the Genes for High-mobility Group AT-Hook 2 (HMGA2) and WNT Inhibitory Factor 1 (WIF1) in Infrapatellar Fat Pad Cells from a Patient With Hoffa’s Disease

Hoffa's disease is anterior knee pain presumably stemming from inflammatory fibrous hyperplasia of the infrapatellar fat pad (Hoffa's pad). The etiology and pathogenesis are unclear, however, and no genetic information about the disease has been published. We report the genetic findings in cells from the fat pad of a patient with Hoffa's disease. Infrapatellar fat pad cells from a patient with Hoffa's disease were examined using cytogenetic, RNA sequencing, reverse transcription-polymerase chain reaction, and Sanger sequencing techniques. Cytogenetic examination of short-term cultured cells from the Hoffa's pad revealed a balanced t(12;18)(q14;q21) translocation as the sole chromosomal aberration. RNA sequencing detected an out-of-frame fusion of exon 3 of the gene coding for high mobility group AT-hook 2 (HMGA2) with exon 9 of the gene coding for WNT inhibitory factor 1 (WIF1). The fusion was subsequently verified by reverse transcription-polymerase chain reaction together with Sanger sequencing. Our data indicate that Hoffa's disease is a neoplastic process with acquired genetic aberrations similar to those found in many benign tumors of connective tissues. The genetic aberrations are presumably acquired by mesenchymal stem cells of the infrapatellar fat pad inducing proliferation and differentiation into adipocytes or other mature connective tissue cells.

3% Polidocanol Sclerotherapy for Pyogenic Granuloma: Efficacy and Safety Analysis.

Pyogenic granuloma is a commonly occurring inflammatory hyperplasia involving skin and mucous membranes. Various modalities of treatment have been used to treat pyogenic granuloma. However, there is an increased risk of intraoperative bleeding and recurrence of pyogenic granuloma following surgical treatment of pyogenic granuloma. Therefore, sclerotherapy has evolved as an effective alternative treatment modality in excellent safety and efficacy. The aim of this study was to assess the safety and efficacy of 3% polidocanol in liquid form in pyogenic granuloma as a sclerosant. This was a retrospective study of cases treated between March 2019 and February 2020 at two different private institutes. The study included 30 patients with 30 pyogenic granulomas treated with 3% polidocanol liquid. Individuals with comorbid conditions such as diabetes, hypertension, thyroid disorders, and those who were on medications were excluded from the study. Two units of 3% polidocanol solution were injected with an insulin syringe at the base of the lesion. Changes in lesions and adverse events were recorded and injections were repeated after a gap of 2 weeks if needed. In 28 patients, there was complete resolution of the lesion within 4 weeks and 2 patients received a second injection of polidocanol. All the patients tolerated the procedure and the lesions resolved without any significant sequelae. The advantages of 3% polidocanol sclerotherapy are that it is a safe, easy, effective, and minimally invasive procedure with little discomfort to the patient and very minimal complications as compared with other modalities. Polidocanol 3% solution is an effective sclerosant for the treatment of pyogenic granuloma.The aim of this study was to assess the safety and efficacy of 3% polidocanol in the liquid form in PG as a sclerosant.

A case report on the management of lingual papilitis through Ayurveda

Transient lingual papilitis is a common inflammatory hyperplasia of one or multiple fungiform lingual papillae that has acute onset. It is painful and transient. Based on the clinical features, the condition can be compared with Pittaja jihvakantaka. In the present case report, a 35-year-old male patient presented with a chief complaint of nodular growth on the dorsal surface of his tongue for 4 months. The growth persisted even after intake of systemic steroids and even after avoiding possible mechanical stimuli. Considering the pathology and symptomatology, Triphala guggulu, Kamadudha rasa, Sutashekhara rasa, Ajamodadi churna, and Haridra khanda were prescribed. Anu taila and Yashtyadi taila were given for Pratimarsha nasya (~low-dose medication through nasal route). After about four months of treatment, the associated symptoms subsided to a significant level. No adverse events were noted during the treatment and follow-up period of about three months. This case report sets an example that Ayurveda has an effective and safe treatment for conditions such as lingual papilitis. This case also becomes evidence and base for further research works with a larger sample size.

Pyogenic Granuloma of Lower Lip: An Unusual Presentation

Pyogenic granuloma is a benign inflammatory hyperplasia of connective tissue. It depicts an overzealous tissue response to a known stimulus or injury and is commonly found in the gingiva, especially in the anterior maxilla, and rarely on lips, oral mucosa, and tongue. It is commonly seen during the second, third, and fourth decade in females, with predilection in the third decade. This case report depicts the unusual presentation of pyogenic granuloma of the lower lip in an 11-year-old male child following a positive history of trauma and lip biting, which was successfully managed by excision under local anesthesia.

The effect of iron dextran injection on oral candidiasis symptoms in experimental iron deficiency anemia of laboratory rats

Iron deficiency anemia (IDA) is the most common type of anemia that causes various health problems and is commonly companied by oral symptoms, including oral thrush from Candida infection. The study assessed the role of iron status in the pathogenicity of oral candidiasis in an animal model. IDA in rats was produced by feeding on iron-free diet (five weeks), followed by inducing oral candidiasis by Candida albicans suspension. After the infection, animal subgroups were treated by intramuscular injection (IM) of iron dextran (ID) at 2 and 4 mg/kg once a week for three weeks and normal saline injection for comparison. Blood parameters test and tongue histopathological study were conducted. The IDA parameters and the oral thrush lesions were detected in experimental rats. IM of 2 mg ID diminished oral white patches and improved blood hemoglobin (14.533 g/dl), serum iron (109.177 μg/dl), and serum ferritin (5.276 ng/ml) and decreased total iron-binding capacity (377.000 μg/dl). Tongue sections showed normal tongue papillae, reduced inflammation and regular keratin deposition on papillae. At a 4 mg dose, despite the improvement in the blood parameters, a mild reduction was found in tongue thrush by less normal appearance of tongue papillae sections, mild inflammatory cells and hyperplasia of squamous epithelium. The study findings indicate that iron status plays a critical role in the treatment of oral thrush infection.