Abstract Osteoarthritis (OA) refers to articular cartilage breakdown that causes pain and loss of function in joints. Articular cartilage is essential to joint movement because it lubricates and relieves stress in joints. Articular cartilage lesions and cartilage matrix deterioration are caused by imbalances in cartilage synthesis and catabolism, extracellular matrix composition, and cartilage synthesis. Platelet-rich plasma (PRP) is an autologous blood product containing higher-than-normal amounts of platelets. Platelet concentrates are useful in the treatment of OA because they clearly have anti-inflammatory properties that promote tissue healing. A thorough search of all materials related to the topic was carried out on PubMed and Google Scholar. Articles were narrowed down based on relevance, inclusion criteria, and exclusion criteria. Fifteen articles were selected based on these factors and analyzed. The studies show that PRP is a useful therapy option for knee OA, with data indicating that it can improve quality of life, increase function, and lessen pain in a variety of patient demographics with varying degrees of OA severity. However, the efficacy is dependent on patient features, the PRP formulation, and the concentration; some studies suggest that repeated injections or larger concentrations may be necessary to get the best outcomes.
Oral cancer imposes a disproportionate global health burden, with persistently poor survival rates primarily attributable to late-stage diagnosis. oral potentially malignant disorders (OPMDs) are identifiable and clinically actionable precursors to the development of most oral squamous cell carcinomas (OSCCs). However, accurate risk stratification in routine dental practice remains a challenge. Toluidine blue (TB) vital staining, a cationic, acidophilic, metachromatic dye with selective affinity for nucleic acid-rich dysplastic and malignant epithelium, has been employed as a chairside adjunctive diagnostic tool for more than four decades. This narrative review synthesizes the current evidence on the mechanism of TB staining, its diagnostic accuracy, and its utility within the broader landscape of adjunctive tools available to dental practitioners. TB demonstrates a pooled sensitivity of 71% to 95% and specificity of 68% to 81%, with its diagnostic odds ratio consistently exceeding that of clinical visual examination. Compared with light-based adjunctive tools, TB exhibits superior specificity to chemiluminescence and autofluorescence, although its sensitivity is lower than that of both techniques. The integration of TB into a multimodal diagnostic protocol, combining clinical examination, staining, and, where indicated, histopathological confirmation, optimizes the detection of high-risk lesions, guides biopsy site selection, and supports surgical-margin assessment. Known limitations include false positives from inflammatory conditions, false negatives in hyperkeratotic lesions, and operator-dependent interpretation. Emerging technologies, such as reflection spectroscopy, artificial intelligence-assisted image analysis, and combined multimodal platforms, offer potential solutions to address these constraints. Dental practitioners who incorporate TB into a structured clinical workflow, interpreted alongside the full clinical picture, are well positioned to improve early detection and reduce diagnostic delay, which remains a major determinant of oral cancer mortality.
Multiple familial trichoepithelioma (MFT) is an uncommon, benign, adnexal tumor with an autosomal dominant inheritance pattern. It manifests as multiple, tiny, firm, skin-colored papules typically on the face. This case series describes five affected individuals across three generations, highlighting the clinical features, diagnostic challenges, and management considerations. Despite its benign nature, the condition carries significant cosmetic and psychological implications. Histopathology remains the gold standard for diagnosis, distinguishing it from malignant mimickers. Various treatment options have been explored, including surgical excision, laser therapy, radiofrequency ablation, topical agents like imiquimod, and electrosurgical techniques, with varying degrees of success. However, recurrence remains a challenge, and treatment depends on the degree of the disease and patient preference. Given the rarity of MFT, increasing awareness among clinicians is crucial for early recognition and appropriate management. This report emphasizes the importance of differentiating trichoepithelioma from other cutaneous neoplasms to prevent unnecessary interventions and optimize patient outcomes.
Cholecystitis, an acute inflammation of the gallbladder, is one of the most important surgical diseases. In most cases, the cystic duct becomes obstructed by a gallstone, causing the inflammation, and laparoscopic cholecystectomy is the gold standard for treatment. However, the timing of surgery is still up for debate; the traditional approach is to delay laparoscopic cholecystectomy until after conservative medical management has been completed because of concerns about inflammation and operating on a previously inflamed organ with a lot of scar tissue forming around it. However, the trend is toward early laparoscopic cholecystectomy, typically performed within 72 hours after the onset of acute cholecystitis or during the initial hospitalization. The purpose of this article is to summarize the evidence from the literature comparing early vs. delayed laparoscopic cholecystectomy in patients with acute cholecystitis, with a focus on clinical outcomes, safety, and cost-effectiveness. To evaluate the evidence, we conducted a systematic review of the published literature, including randomised controlled trials, observational studies and meta-analyses, to determine what the outcomes of the patients were related to operative difficulty, complication rates, conversion to open cholecystectomy, length of stay in the hospital, recurrence of biliary events, and total costs of providing healthcare for the patient. The literature demonstrates a consistent advantage to an early laparoscopic cholecystectomy; safety and efficacy, shorter hospital stays, lower cost, less risk of recurrent complications, and comparable or lower complication and conversion rates. In addition to the benefits, the use of delayed laparoscopic cholecystectomy may still be appropriate for some high-risk patients and for hospitals with limited capacity to operate on inflamed gallbladders; however, delayed laparoscopic cholecystectomy is associated with a higher rate of recurrent symptoms and hospitalizations. Early Laparoscopic Cholecystectomy is the procedure of choice for the average patient with acute cholecystitis and should be pursued whenever possible, considering the patient's particular clinical situation and the available resources of the hospital.
Interstitial pregnancy is a rare and life-threatening form of ectopic pregnancy, accounting for 1-3% of all ectopic pregnancies. It occurs when the gestational sac implants in the interstitial portion of the fallopian tube, which traverses the myometrial wall. Due to the rich vascular supply and distensibility of the myometrium, these pregnancies can progress to a larger gestational age before rupture, often resulting in catastrophic hemorrhage with significant maternal morbidity and mortality. Early diagnosis is challenging due to nonspecific clinical presentation, and rupture can occur suddenly with rapid hemodynamic deterioration. This case report describes the clinical presentation, diagnostic challenges, and successful surgical management of a ruptured interstitial pregnancy. A high index of suspicion, prompt imaging, and urgent surgical intervention are crucial for favorable maternal outcomes.
