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Metalloid pollution, including arsenic poisoning, is a serious environmental issue, plaguing plant productivity and quality of life worldwide. Biochar, a carbon-rich material, has been known to alleviate the negative effects of environmental pollutants on plants. However, the specific role of biochar in mitigating arsenic stress in maize remains relatively unexplored. Here, we elucidated the functions of biochar in improving maize growth under the elevated level of sodium arsenate (Na2AsO4, AsV). Maize plants were grown in pot-soils amended with two doses of biochar (2.5% (B1) and 5.0% (B2) biochar Kg−1 of soil) for 5 days, followed by exposure to Na2AsO4 ('B1 + AsV'and 'B2 + AsV') for 9 days. Maize plants exposed to AsV only accumulated substantial amount of arsenic in both roots and leaves, triggering severe phytotoxic effects, including stunted growth, leaf-yellowing, chlorosis, reduced photosynthesis, and nutritional imbalance, when compared with control plants. Contrariwise, biochar addition improved the phenotype and growth of AsV-stressed maize plants by reducing root-to-leaf AsV translocation (by 46.56 and 57.46% in 'B1 + AsV' and 'B2 + AsV' plants), improving gas-exchange attributes, and elevating chlorophylls and mineral levels beyond AsV-stressed plants. Biochar pretreatment also substantially counteracted AsV-induced oxidative stress by lowering reactive oxygen species accumulation, lipoxygenase activity, malondialdehyde level, and electrolyte leakage. Less oxidative stress in 'B1 + AsV' and 'B2 + AsV' plants likely supported by a strong antioxidant system powered by biochar-mediated increased activities of superoxide dismutase (by 25.12 and 46.55%), catalase (51.78 and 82.82%), and glutathione S-transferase (61.48 and 153.83%), and improved flavonoid levels (41.48 and 75.37%, respectively). Furthermore, increased levels of soluble sugars and free amino acids also correlated with improved leaf relative water content, suggesting a better osmotic acclimatization mechanism in biochar-pretreated AsV-exposed plants. Overall, our findings provided mechanistic insight into how biochar facilitates maize's active recovery from AsV-stress, implying that biochar application may be a viable technique for mitigating negative effects of arsenic in maize, and perhaps, in other important cereal crops. Highlights: Maize developed significant growth defects under excessive arsenate (AsV) stress. Biochar addition decreased root AsV uptake and root-to-leaf AsV translocation. Biochar protected photosynthetic rate and pigment levels from AsV -stress. Biochar reduced AsV-caused oxidative damage by strengthening antioxidant defense. Biochar boosted osmoprotectant levels and nutrient uptake in AsV-stressed maize. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 40-year-old male with jaundice who was admitted to the hospital in March 2007. It states that his jaundice was accompanied with pruritus in which the he took a complementary/alternative medication (CAM) for 15 days. It adds that the patient's physical examination discovered a dilated abdomen with free fluid but without organ enlargement and a liver span of 11 centimeters.

The detection of the primary site in Carcinoma of Unknown Primary (CUP) is a challenging task which can significantly alter the course of management and also prognosis. Various modalities have been assessed with varying sensitivity and specificity. Imaging and cytological diagnosis have formed a key part of the diagnostic algorithm of CUP. Trans Oral Robotic Surgery offers the advantage of being both diagnostic as well as therapeutic with promising sensitivity and specificity and can form an integral part in the management of CUP. A prospective study was carried out at a tertiary care centre over a period of one year. Patients with unilateral neck swelling which was histopathologically proven squamous cell carcinoma neck metastasis were included in the study. They were evaluated with endoscopy and radiology according to the standard algorithm. When these failed to detect the primary, the patients underwent ipsilateral radical tonsillectomy and tongue base mucosal wedge biopsy via TORS. Post-operative histopathological examination was done on the resected specimens to detect the primary site. Transoral Robotic Surgery was able to localise primary in 50% of the patients enrolled in the study. Out of the primary site identified by TORS; 55.56% were located in the tonsil and 44.4% in the tongue base. TORS can offer promising detection rates of the occult primary in CUP and should form an integral part of the diagnostic algorithm. [ABSTRACT FROM AUTHOR]

To find if an association could be established between Human Papilloma Virus (HPV) infection and oropharyngeal cancers (OPCs) in a group of patients known to be regular users of tobacco, and to determine the impact of HPV status on clinical outcomes.Case records of 212 patients with AJCC-7 (The American Joint Committee on Cancer 7th edition) stages II–IVB non metastatic squamous cell carcinoma of the oropharynx treated using radical radiotherapy with or without chemotherapy during the years 2015–2018 were retrieved. Formalin-fixed, paraffin-embedded blocks from oropharyngeal biopsies were available for 177 patients and were evaluated for p16 expression by immunohistochemical (IHC) staining. More than 50% nuclear staining with or without cytoplasmic staining was considered HPV+. The association between tobacco use and HPV, as well as the influence of HPV status on survival outcomes were assessed. p16 expression was found to be positive in 23(13%) patients. Significant association was found between chewable tobacco usage and HPV positivity (p = 0.051). The median follow up was 20.5 months (range: 3–80). 5-year Overall Survival was 43.4% and 29.8% (p = 0.044) in HPV+ and HPV− patients, respectively. Local control was significantly better in HPV+ patients (38.6% vs. 25.3%, p = 0.049). There was also a trend towards improved Disease-free Survival in HPV+ patients (31 months vs. 15 months, p = 0.078). Though less in prevalence among the Indian population, improved outcomes in HPV+ OPC patients and widely available IHC HPV assays signifies the routine implementation of p16 testing in day-to-day clinical practice. [ABSTRACT FROM AUTHOR]

To assess the exact role of high-risk HPV testing in patients of carcinoma unknown primary with secondary metastasis to the neck who underwent TORS and neck dissection for identification of the primary site.A prospective study was carried out at a tertiary care centre over one year. Patients with unilateral neck swelling, which was cytologically proven squamous cell carcinoma neck metastasis, were included in the study. After clinicopathological evaluation, they underwent TORS-assisted ipsilateral radical tonsillectomy, tongue base mucosal wedge biopsy for primary site identification, and ipsilateral neck dissection. They underwent HPV RNA ISH from the tonsil, the base of the tongue and blood. They also underwent HPV DNA testing from the blood. P16 was done in the base of tongue, tonsil, and lymph node specimens.In the study cohort of 18 patients who underwent ipsilateral radical tonsillectomy, mucosal tongue base wedge biopsy and neck dissection, p16 positivity was isolated in 5.56%, 0% and 2.78% of patients, respectively. (n = 1/18, 0/18, 5/18). Interestingly, HPV E7 mRNA expression was absent in the tonsil /base of tongue specimens, but metastatic lymph nodes displayed expression in 11.11%. HPV DNA was undetected in all analysed tissues and patients’ blood.In the Indian subcontinent, it is not essential to do detailed high-risk HPV analysis in cases of carcinoma unknown primary with secondary metastasis to the neck. [ABSTRACT FROM AUTHOR]

Positron emission tomography (PET) has been used for the characterization of pancreatic and periampullary lesions. Pancreatitis-associated inflammation affecting only a portion of the pancreas gives the appearance of a mass lesion on imaging. Consequently, the differential diagnosis between cancer and pancreatitis becomes a commonly encountered problem. Traditionally, PET was interpreted as positive (to denote malignancy) if fluorodeoxyglucose (FDG) activity in the pancreas exceeded background activity and as negative (to denote benign) if activity was less than or equal to background activity. However, the specificity was limited with this method of interpretation. A relatively wide overlap has been reported between semiquantitative uptake values obtained in cancers and those in inflammatory lesions. Also, the qualitative (metabolic patterns) and quantitative variables (standardized uptake values) have been complementary and at sometimes controversial to each other in various clinical situations. There is paucity of data in the literature highlighting the role of FDG PET/CT in characterization of such mass lesions. The primary aim of this pictorial review is to list the various pathologic processes of pancreas and periampulla that could be studied with FDG PET/CT and recognize the different FDG uptake patterns and apply this information to characterize the different lesions affecting the pancreas and periampulla. We have also discussed the limitations of conventional imaging and advantages of FDG PET/CT for the evaluation mass-forming lesions of the pancreas and periampulla. [ABSTRACT FROM AUTHOR]

Sarcoidosis bone is uncommon, and involvement of the skull is exceptionally rare. We present a 65-year-old obese female who presented with a 2-month history of dryness of mouth, polyuria, fatigue, and anorexia. She had generalized lymphadenopathy, organomegaly, and hypercalcemia, and a skeletal survey revealed extensive osteolytic lesions in the skull and phalanges. Both lymph node biopsy from the cervical lymph node and bone marrow examination revealed non-caseating granulomas, suggesting sarcoidosis. She was started on 1 mg/kg oral corticosteroids; during a follow-up of 6 months, she achieved normocalcemia; however, the punched-out lesions in the skull remained unchanged. This case reiterates several important issues that all lymphadenopathy in emerging nations may not be tubercular, and presence of osteolytic lesions in skull are unusual for sarcoid, at an elderly age, necessitates evaluation for more common etiologies like metastases and myeloma. Finally, patients with osseous sarcoid should be on a close follow-up since due to the rarity of this presentation, no definite consensus on the management of such cases exists in the literature. [ABSTRACT FROM AUTHOR]

Esthesioneuroblastoma (ENB) constitutes 3 % of all malignant intranasal tumors. As the tumor is very rare, the number of patients of ENB treated in individual departments is small. We present our institute's experience in combined modality management of 15 successive patients of ENB treated from 2006 to 2010. Clinical characteristics and treatment modality in form of surgery, radiotherapy and chemotherapy were noted. Kadish stage C was the most common stage (12 patients) followed by stage B (3 patients). Fourteen patients underwent primary surgery, of which nine had total excision and five had subtotal excision. One patient was treated with combination of chemotherapy (CT) and radiotherapy (RT). Median RT dose delivered was 54 Gy. Twelve patients received CT with cisplatin and etoposide. Overall, eight patients had complete response, five had partial response, while one had static disease and progressive disease each. Two patients had distant metastases. Four-year loco-regional control (LRC) was 25 % and 4-year overall survival (OS) was 45 %. Most common presentation in our series was locally advanced tumors. Most of these patients require adjuvant RT, which helps in significant LRC. Systemic CT benefits in inoperable, advanced and high risk tumors. Risk-adapted and multimodality approach is the need of hour to achieve good control rates while minimizing treatment related toxicity. [ABSTRACT FROM AUTHOR]

Purpose: Data on genotypes, basal core promoter (BCP) and precore mutants of hepatitis B virus and their association with different HBV related liver disease have been studied inadequately and are controversial. Thus, the aim of this study was to determine the incidence of BCP and precore HBV mutants and their relationship with HBV genotype and different stages of HBV related liver disease in North Indian patients.Methods: A total 273 patients with different stages of HBV related liver diseases were enrolled. Nested polymerase chain reaction (PCR) was used to amplify the BCP/PC regions. RFLP and direct sequencing were performed to validate the mutations identified in these regions. HBV genotyping was accomplished by multiplex PCR.Results: Genotype D was the predominant genotype found in each of the various HBV related liver diseases. The BCP mutation was found significantly more often in inactive carriers and compensated cirrhosis as compared to the other groups. The BCP mutation was present in 29.1% of patients with genotype D versus 17.1% with genotype A (P = 0.001). The precore mutation was also more frequently observed with genotype D compared with genotype A (36.9 vs. 4.8%, P = 0.0007).Conclusion: Genotype D is predominant in North Indian patients. The BCP and precore mutations occur in one-third of HBV positive patients in association with the genotype D. We did not find any correlation with severity of liver disease with genotypes and mutations. [ABSTRACT FROM AUTHOR]

Hepatitis C virus (HCV) infection has been associated with insulin resistance or diabetes mellitus, but data are controversial on the role of different HCV genotypes in causing insulin resistance. We have designed a study aimed at determining insulin resistance in patients with chronic hepatitis C with predominant genotype 3. Insulin resistance was measured using a homeostasis model of assessment for insulin resistance in 85 non-diabetic, non-cirrhotic patients with chronic hepatitis C (genotype 3 = 54). The results were compared with 38 biopsy-proven patients with non-alcoholic fatty liver disease and 25 age- and body mass index-matched healthy volunteers. Patients with chronic hepatitis C had a higher fasting insulin and homeostasis model of assessment for insulin resistance values than healthy volunteers (P = 0.0001). A large number of patients with chronic hepatitis C showed evidence of insulin resistance than healthy controls [53 (62.3%) vs. 4 (16%), respectively] (P < 0.0001). Of the various risk factors studied for insulin resistance in patients with chronic hepatitis C, higher waist (P = 0.010) and higher serum triglycerides (P = 0.002) were found to correlate with HOMA-insulin resistance. There was no difference in insulin resistance amongst patients with genotype 1 or 3, respectively. Based on these results, we conclude that insulin resistance is common among non-diabetic, non-cirrhotic patients with chronic hepatitis C. A majority of these patients had genotype 3, but there was no difference in insulin resistance between genotype 1 and genotype 3 patients. [ABSTRACT FROM AUTHOR]

Rosai Dorfman disease or sinus histiocytosis is a rare, idiopathic, benign and self-limiting histiocytic proliferative disorder, usually seen in younger patients. It most commonly involves the cervical lymph nodes, with a predominant infiltration of sinusoidal histiocytes and classically presents with massive cervical lymhadenopathy. Extranodal disease occurs in about 43% of cases and produces different signs and symptoms depending upon its location. We report a case of this disorder in 22-year-old male with initial isolated involvement of bilateral nasal cavity and paranasal sinuses with subsequent involvement of cervical lymph nodes and skin. The clinical presentation, histologic characteristics, radiographic findings and treatment of the disease are discussed. [ABSTRACT FROM AUTHOR]

First described as a pleural neoplasm, the solitary fibrous tumor (fibrous mesothelioma) has been reported in a number of extrapulmonary sites, including the Head-Neck region. In the Head-Neck region, it has been described in the sinonasal tract, epiglottis, parapharyngeal, retropharyngeal spaces, parotid and infratemporal fossa. We present the second case of solitary fibrous tumor of infratemporal fossa described in world literature. A complete excision was achieved by transmaxillary approach. [ABSTRACT FROM AUTHOR]

The current study sought the effective mitigation measure of seawater-induced damage to mung bean plants by exploring the potential roles of acetic acid (AA). Principal component analysis (PCA) revealed that foliar application of AA under control conditions improved mung bean growth, which was interlinked to enhanced levels of photosynthetic rate and pigments, improved water status and increased uptake of K+, in comparison with water-sprayed control. Mung bean plants exposed to salinity exhibited reduced growth and biomass production, which was emphatically correlated with increased accumulations of Na+, reactive oxygen species and malondialdehyde, and impaired photosynthesis, as evidenced by PCA and heatmap clustering. AA supplementation ameliorated the toxic effects of seawater, and improved the growth performance of salinity-exposed mung bean. AA potentiated several physio-biochemical mechanisms that were connected to increased uptake of Ca2+ and Mg2+, reduced accumulation of toxic Na+, improved water use efficiency, enhanced accumulations of proline, total free amino acids and soluble sugars, increased catalase activity, and heightened levels of phenolics and flavonoids. Collectively, our results provided new insights into AA-mediated protective mechanisms against salinity in mung bean, thereby proposing AA as a potential and cost-effective chemical for the management of salt-induced toxicity in mung bean, and perhaps in other cash crops. [ABSTRACT FROM AUTHOR]