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Prostate cancer remains a significant global health concern, necessitating continuous research and innovation in treatment modalities. This review explores the currently employed techniques in radiation dose planning and tumor irradiation in the context of prostate cancer management. In addition, we delve into the nuances of expected posttreatment magnetic resonance imaging (MRI) appearances within the gland or in the prostate bed, postradiation tumor recurrence, and its mimics. Radiation therapy (RT) has evolved as a cornerstone in prostate cancer treatment, offering both curative and palliative solutions. Recent developments have seen the emergence of advanced techniques such as intensity-modulated radiation therapy (IMRT) and stereotactic body radiation therapy (SBRT), allowing for precise targeting of cancer cells while minimizing damage to surrounding healthy tissue. The avoidance of normal tissue dose through more conformal dose distribution as in IMRT or proton therapy, improved imaging modalities as in multiparametric magnetic resonance imaging (mpMRI) and prostate positron emission tomography (PET), interventional separation of critical structures from the prostate target, and many other techniques can greatly reduce the side effects of RT. These advancements enhance treatment efficacy and reduce the risk of side effects, promoting improved patient outcomes. [ABSTRACT FROM AUTHOR]

The use of Prostate Imaging Reporting and Data System (PI-RADS) with multiparametric magnetic resonance imaging (MRI) has significantly improved the detection of clinically significant prostate cancer (csPCa), but there are certain challenges that the reader may face. This review provides an overview of the pitfalls associated with the PI-RADS system for multiparametric prostate MRI (mpMRI), with suggestions/pearls to help overcome these pitfalls. PI-RADS assessment is hindered by several causes of false positives (FPs) and false negatives (FNs). In addition, there is wide variability in the positive predictive value (PPV) of the PI-RADS system across different centers, highlighting the need for improvement. While the negative predictive value (NPV) for csPCa is generally high, variations exist. This review discusses the pitfalls contributing to FNs, including MRI artifacts, such as susceptibility and motion artifacts. Techniques to optimize image acquisition, such as switching the phase encoding direction and reducing bowel peristalsis, are suggested to mitigate these artifacts. Improper b -value selection for diffusion-weighted imaging (DWI) is another pitfall, emphasizing the importance of using high b -values (≥1,400 s/mm 2) to optimize neoplasm detection. Similarly, optimizing window settings to visualize csPCa, correctly positioning the endorectal coil, awareness of rare variants like mucinous adenocarcinoma and cribriform adenocarcinoma, and distinguishing central zone tumors from normal central zone are discussed. This article highlights the common pitfalls causing FPs, such as benign pathologies like prostatitis, granulomatous prostatitis, prostatic abscess, stromal BPH nodules, extruded BPH nodules, and prostatic calcifications. It also discusses the pitfalls related to normal anatomical structures, including the central zone, anterior fibromuscular stroma, thickened surgical capsule, neurovascular bundle, and periprostatic venous plexus. Techniques for carefully evaluating these entities' morphology and distribution of signal abnormalities are described to avoid overdiagnosing these as PCa. The article also addresses the pitfalls related to postintervention changes, including postbiopsy hemorrhage and artifacts caused by the UroLift procedure, while providing recommendations for managing these challenges. Finally, the pitfalls that may be encountered during staging, including evaluation for extraprostatic extension, and pelvic nodal and osseous metastases, are highlighted. [ABSTRACT FROM AUTHOR]

Mandibular canines typically have a single root and a single canal, but variations can occur. This case report presents a 43-year-old man who complained of dull, intermittent, and spontaneous pain in the lower front tooth region for the past 2 weeks. Clinical findings indicated a mandibular canine with a rare anatomical configuration: three canals within a single root that merge to form one, corresponding to the Sert and Bayirli Type XVIII canal configuration. A diagnosis of previously initiated root canal therapy with symptomatic apical periodontitis was made. The patient's diagnosis was confirmed through careful clinical and radiographic examination, including the use of cone-beam computed tomography for detailed morphology. Given the intricate root canal anatomy, a specialized endodontic approach was employed, leading to a successful resolution of the patient's symptoms. [ABSTRACT FROM AUTHOR]

Endodontic management of internal root resorption is challenging due to difficulty in debridement of the entire canal contents, disinfection, and control of the resorptive process. Often, there is no barrier to stop the repair material from being pushed into the periradicular tissues. In these case reports, we discuss the clinical management of internal root resorption, use of two forms of collagen used as a barrier material with mineral trioxide aggregate. – One-year follow-up of these cases reveals complete healing. [ABSTRACT FROM AUTHOR]

We report, herein, a rare case of vertebral bone marrow necrosis in a patient at 1-month post–novel coronavirus disease 2019 (COVID-19) pneumonia complicated with disseminated intravascular coagulation (DIC). The commonly observed radiological features on the imaging modalities like computed tomography (CT), magnetic resonance imaging (MRI), and 18-F fluorodeoxyglucose positron emission tomography (FDG PET) have been discussed here followed by a brief discussion on the role of in-phase and opposed-phase imaging in differentiating the disease from malignant infiltrative pathologies. Histopathological findings on bone marrow smear that confirm the diagnosis have also been illustrated. [ABSTRACT FROM AUTHOR]

Introduction: Metformin, the preferred first line oral hypoglycaemic agent used in type 2 diabetes mellitus, is notorious to cause vitamin B12 deficiency which can lead to reversible macrocytic anaemia and/or neurological dysfunction. A simple and inexpensive test like complete blood count could go a long way in timely diagnosis and treatment of anaemia. Aims and objectives: To observe the haematological abnormalities in patients using Metformin for 5years or more and to note the effects of age, sex, residence of the subjects, drug dose, duration and combination with other oral hypoglycaemic agents on such changes. Methodology: In this observational and cross-sectional study, 100 patients aged 18-60 years with type 2 Diabetes Mellitus using Metformin for 5years or more were recruited after exclusion of use of drugs (vitamin or iron supplements, antiplatelets etc.). and alcohol, hypothyroidism, end-organ disease. They were subjected to complete blood count with RBC indices. Serum iron profile was sent for the microcytic group and serum vitamin B12 and folate estimation were done in the macrocytic group. Results: 66 out of 100 were having anaemia of following types- 44 normocytic normochromic, 19 microcytic hypochromic (84.2% are iron-deficient) and 3 macrocytic (66.7% B12 deficient). Anaemia is more frequent in females aged 18-50y (71.8%), rural individuals (76.6%), people using increased daily dosage or insulin in combination with Metformin (p<0.05). Nevertheless no such relation could be elicited between duration of Metformin use and anaemia nor does Metformin show any effect on leukocyte or platelet counts. Conclusion: Regular screening is imperative by physicians in such cases for timely detection of different types of anaemia and prompt treatment. [ABSTRACT FROM AUTHOR]

Background & objectives: Methicillin resistant Staphylococcus aureus (MRSA) isolates with inducible clindamycin resistance (iCR) are resistant to erythromycin and sensitive to clindamycin on routine testing and inducible clindamycin resistance can only be identified by D-test. This study was aimed to detect methicillin resistance and iCR among S. aureus isolates, effectiveness of some commonly used antibiotics and correlation between methicillin resistance and iCR. Methods: The present cross-sectional study included 46 S. aureus isolates subjected to Kirby-Bauer's disk diffusion method for antibiotic susceptibility testing (AST) to estimate MRSA and resistance to some commonly used antibiotics. D-test was employed to detect iCR. Results: Eleven of the 46 (23.9%) isolates tested were MRSA. Overall, 19 (41.3%) isolates showed of iCR. Vancomycin and linezolid were found to be 100 per cent effective. A positive Karl-Pearson's coefficient of correlation (0.89) between methicillin resistance and iCR was obtained. Interpretation & conclusions: Detection of iCR is important for the use of clindamycin in MRSA infections. Methicillin resistance and iCR appear to be clinically unrelated. [ABSTRACT FROM AUTHOR]

Intrinsically disordered regions (IDRs) are structurally flexible protein segments with regulatory functions in multiple contexts, such as in the assembly of biomolecular condensates. Since IDRs undergo more rapid evolution than ordered regions, identifying homology of such poorly conserved regions remains challenging for state-of-the-art alignment-based methods that rely on position-specific conservation of residues. Thus, systematic functional annotation and evolutionary analysis of IDRs have been limited, despite them comprising ~21% of proteins. To accurately assess homology between unalignable sequences, we developed an alignment-free sequence comparison algorithm, SHARK (Similarity/Homology Assessment by Relating K-mers). We trained SHARK-dive, a machine learning homology classifier, which achieved superior performance to standard alignment-based approaches in assessing evolutionary homology in unalignable sequences. Furthermore, it correctly identified dissimilar but functionally analogous IDRs in IDR-replacement experiments reported in the literature, whereas alignment-based tools were incapable of detecting such functional relationships. SHARK-dive not only predicts functionally similar IDRs at a proteome-wide scale but also identifies cryptic sequence properties and motifs that drive remote homology and analogy, thereby providing interpretable and experimentally verifiable hypotheses of the sequence determinants that underlie such relationships. SHARK-dive acts as an alternative to alignment to facilitate systematic analysis and functional annotation of the unalignable protein universe., Competing Interests: Competing interests statement:The authors declare no competing interest.

Background: 'Regenerative endodontics' using host-derived scaffolds and biomaterials (MTA) is popular in the management of teeth with open apex. Alkaline pH and bioactivity contribute to tissue healing and remineralization. We assessed the influence of PRF and Blood Clot on the pH and Ca + ion release from MTA. Methods: A total of 15 single-rooted human extracted teeth were sectioned at the level of the cementoenamel junction. Based on the type of scaffolds used, samples were divided into three groups. Group 1 (MTA+ PRF), Group 2 (MTA + Blood Clot), Group 3 (control MTA). The prepared specimens were transferred to a fresh falcon tube containing 10mL of distilled water and the collected solutions were analysed for pH and Ca + ion release at 3h, seventh day and 14 th day. Results: It was observed that the mean pH and Ca + ion release were significantly lower in the experimental groups as compared to the control group. Though there was an increase in the pH recorded in Group 1 and 2 at all time periods, the difference was not significant. Ca + ion release peaked at Day 7 (Group3 > Group2 > Group1) and reduced significantly on the 14 th day for all groups. Conclusions: Within the limitations of the study, it can be concluded that PRF and blood clot influence the pH and Ca + ion release from MTA., Competing Interests: No competing interests were disclosed., (Copyright: © 2023 Khatri S et al.)