International Journal of Medical and Biomedical Studies

Management of Squamous Cell Papilloma on The Lateral Border of The Tongue Using Excision Surgery: A case report

Sonya Astri — 2026-04-09

Background: Squamous cell papilloma is a benign epithelial proliferation of the oral mucosa, commonly associated with low-risk human papillomavirus infection. It typically presents as a small, solitary, asymptomatic lesion. However, lesions arising on the lateral border of the tongue may raise diagnostic concern due to the high-risk nature of this anatomical site for malignancy.

Case Presentation: A 52-year-old female presented with a six-month history of a thickened and irregular sensation on the right lateral border of the tongue and was not associated with any symptoms. Clinical examination revealed a lobulated exophytic mass measuring approximately 3 × 2 × 2 cm. Given the lesion’s size and location, an incisional biopsy was performed, and histopathological examination demonstrated stratified squamous epithelium with papilomatosis, acanthosis, and hyperkeratosis without dysplasia, consistent with squamous cell papilloma.

Management and Outcome: Definitive surgical excision was performed under general anesthesia due to lesion size, anatomical considerations, and controlled systemic hypertension (ASA II). Complete surgical excision was achieved with preservation of tongue function, minimize the risk of recurrence and promote optimal healing. Postoperative healing was uneventful, and no recurrence was observed at 2 weeks follow-up.

Conclusion: Large squamous cell papillomas of the lateral tongue are uncommon and may clinically mimic more serious pathology. Histopathological confirmation is essential for definitive diagnosis. Careful surgical planning, including general anaesthesia selection, ensures favourable functional outcomes and low recurrence risk. Awareness of atypical presentations, accurate diagnosis and appropriate clinical management lead to excellent prognosis.

Keywords: Squamous cell papilloma; lateral tongue; oral surgery; case report

The Surgical Management of Large Denture-Induced Fibrous Hyperplasia of The Upper Labial Mucose: A Case Report

Sonya Astri — 2026-03-29

Background: Denture-induced fibrous hyperplasia often occurs because of mechanical irritation from ill-fitting denture on the oral mucosa. Although it is asymptomatic, it may affect the mastication and aesthetic of the patient negatively due to discomfort. Chronic trauma by the borders of ill-fitting dentures has the potential to cause oral carcinoma. Hence, denture-induced fibrous hyperplasia should not be overlooked. The treatment of this oral lesion can be surgical removal with scalpels.

Case Report: A 62-year-old woman presented with a painless mass on the upper labial mucosa. The patient reported that the lesion had gradually enlarged over time. The patient had no history of systemic disease. Clinical examination revealed a well-defined nodular mass measuring approximately 3.5 × 2 × 1.5 cm located on the upper lip mucosa. The lesion appeared pinkish in color with a smooth surface and firm consistency on palpation. The patient reported prolonged use of a removable denture that had become unstable, which frequently caused irritation to the right maxillary lip mucosa. Based on the clinical findings, a provisional diagnosis of fibromatous epulis (inflammatory fibrous hyperplasia) was considered.

Management and Outcome: Complete surgical excision was performed under general anaesthesia, considering the large size of the lesion, the need for optimal surgical access, and perioperative considerations in a geriatric patient. The lesion was removed using an elliptical incision followed by careful dissection and wound closure with a combination of interrupted and continuous sutures. Histopathological examination confirmed the diagnosis of denture-induced fibrous hyperplasia. Postoperative healing was uneventful, and the patient reported significant improvement in comfort and lip contour.

Conclusion: Surgical excision is an effective treatment for large denture-induced fibrous hyperplasia. Careful surgical planning and appropriate perioperative management in geriatric patients are essential to achieve favorable clinical outcomes and prevent recurrence.

Keywords: Denture-induced fibrous hyperplasia, Epulis fissuratum, Oral surgery, Geriatric patient

Pectoralis Major Myocutaneus Flap Failure in Cheek Reconstruction: A Case Report with Review of Controversial Considerations

Afif R. Thabrani — 2026-04-16

Background: Pectoralis Major Myocutaneous Flap (PMMCF) is a commonly used approach in reconstructive surgery for defects in the head and neck region, especially for closing cheek defects. Although flap failure is uncommon, it significantly impacts patient morbidity and diminishes quality of life, making investigation into its causes important.

Methods: A case of pectoralis major myocutaneous flap failure following cheek reconstruction is presented. A focused literature review was conducted through PubMed, Scopus, and ScienceDirect to identify studies reporting PMMCF complications, proposed etiologic mechanisms, and management considerations in head and neck reconstruction.

Results: The literature review identified multiple studies reporting pectoralis major myocutaneous flap complications in head and neck reconstruction, most commonly venous congestion and partial flap necrosis. Reported failure mechanisms were heterogeneous, with pedicle compression, tunneling-related tension, infection, and patient-related factors emerging as recurrent themes.

Conclusion: PMMCF has a multifactorial etiology. Close postoperative monitoring is essential to detect early complications and optimize outcomes. PMMCF is insufficient for stage 3 defects, worsened by poor vascularization and oxygenation.

Keywords: Pectoralis Major Myocutaneous Flap failure; Oral cancer reconstruction; Squamous cell carcinoma, Adjuvant therapy

Wound Care Therapy on Raw Surface after V-Y Advancement Flap: A Case Report

Yudi Setiawan — 2026-04-16

Abstract

Introduction: The V-Y advancement flap (VYAF) can be used for trauma case of the head and neck and it is commonly used for reconstruction on the cheek or upper lip. This technique uses adjacent from the defect skin that matches in color and texture. Various wound care therapy is used to accelerate the healing process. This study aimed to demonstrate our experience of VYAF procedure for maxillofacial trauma case and combined with wound therapy at home can lead to favorable outcomes.

Case Report: A 41-year-old male patient presented with facial injuries after a motorcycle vehicle accident. Physical examination revealed skin loss, nasolabial penetrating wound, abrasive wounds on the facial area and facial asymmetry. From skull AP-Lateral X-ray revealed there is no signs of skull fracture. The patient underwent wound debridement, and VYAF procedure under local anesthetic. Wound care therapy at home included routine irrigation with antibacterial agent wound irrigation and NaCl solution, and applied wound gel. Clinical outcomes showed gradual improvement with reduced swelling, granulation tissue formation, and excellent wound healing over 15 days.

Discussion: The VYAF procedure with the Langer’s line reference direction can minimize tension and maximize aesthetic outcomes. The application of wound care therapy, including routine irrigation solutions and gel to prevent biofilm, can be a favorable combination after surgical treatment. The limitation of this study is the lack of a comparison group using other types of wound care.

Conclusion: The VYAF procedure and wound care therapy for maxillofacial trauma can lead to excellent outcomes.

Proportion and Demographic Profile of Metabolic Syndrome Among Young Adults (<40 years)

Chandrakala . — 2026-04-01

Background: Metabolic Syndrome is diagnosed in an individual when there is a clustering of risk factors such as central obesity, impaired fasting glucose, elevated blood pressure, increased triglyceride level, and low levels of highdensity lipoprotein-cholesterol. These factors trigger insulin resistance and thus results in hyperinsulinemia. Understanding the demographic profile and risk factors among the young population is the need for hour to assist in planning appropriative preventive strategies.

Objective: To determine the prevalence of metabolic syndrome among the young adults visiting a tertiary care centre and to describe their demographic profile.

Methods: A cross-section study was done among 327 patients visiting the Out-Patients or admitted in the wards of General Medicine department. Semi-structured questionnaire was used to collected patients’ information and personal habits. Clinical assessment included blood pressure and anthropometric measurements. Biochemical measurement of fasting blood sugar, post prandial blood sugar and lipid profile (triglycerides and high-density lipoprotein) was done. National Cholesterol Education Program - Adult Treatment Panel III guidelines was used to identify those with metabolic syndrome.

Results: The mean age of study participants was 35.4 ± 5.4 years and 56% were male. Out of 327 patients screened 143 (43.7%, 95%CI: 38.2-49.3%) were diagnosed to have metabolic syndrome. Age between 30 to 40 years, residence of urban area, frequent intake of fast food, alcohol consumption and smoking were found to significantly associated with the occurrence of metabolic syndrome, while sex, socioeconomic status and sleep was not.

Conclusion: There is a high burden of metabolic syndrome among the young adults. Several modifiable risk factors such as consumption of fast food, alcohol and smoking were found to be significantly associated. There is need to create awareness on the impact of health by metabolic syndrome and provide health education on its control.

Keywords: Metabolic syndrome, Central obesity, Risk factors, NCEP ATPIII

Radiological Imaging in the Early Diagnosis of Pediatric Epilepsy and Brain Lesions

Monika Seth — 2026-04-12

Background: Early identification of structural and functional abnormalities in pediatric epilepsy is critical for timely intervention and improved neurological outcomes. Radiological imaging, particularly MRI and CT, plays a pivotal role in detecting underlying brain lesions.

Objectives: To evaluate the role of radiological imaging in early diagnosis of pediatric epilepsy and associated brain lesions.

Methods: A prospective observational study was conducted on 110 pediatric patients over 11 months at Shyamlal Chandrashekhar Medical College and Hospital, Khagaria, Bihar. Clinical data and radiological findings were analyzed.

Results: MRI detected abnormalities in 68.2% of cases, significantly higher than CT (41.8%). Common findings included cortical dysplasia, neurocysticercosis, and hypoxic-ischemic injury. Statistical analysis revealed strong correlation between abnormal imaging and seizure type (p<0.05).

Conclusion: MRI is superior to CT in early detection of epileptogenic lesions. Early imaging significantly enhances diagnostic accuracy and management planning.

Keywords: Pediatric epilepsy, MRI, CT scan, brain lesions, neuroimaging

Imaging Spectrum of Pancreatic Neoplasms on Multiphase CT and MRI

Sonu Kumar — 2026-04-12

Background: Pancreatic neoplasms encompass a diverse group of lesions with varying biological behaviour and imaging characteristics. Accurate characterization using multiphase CT and MRI is essential for diagnosis, staging, and management.

Objective: To evaluate the imaging spectrum of pancreatic neoplasms using multiphase CT and MRI and to correlate imaging features with histopathological findings.

Methods: This prospective observational study included 95 patients with suspected pancreatic neoplasms. All patients underwent multiphase contrast-enhanced CT and MRI. Imaging features such as lesion morphology, enhancement pattern, ductal involvement, and vascular invasion were analysed and correlated with histopathology.

Results: The most common neoplasm was pancreatic ductal adenocarcinoma (PDAC) (52.6%), followed by neuroendocrine tumors (18.9%), cystic neoplasms (17.9%), and solid pseudopapillary neoplasms (10.5%). Hypoenhancement on arterial phase CT was characteristic of PDAC (92%). MRI demonstrated superior characterization of cystic lesions and ductal communication. Vascular invasion was observed in 48% of malignant lesions.

Conclusion: Multiphase CT and MRI play complementary roles in evaluating pancreatic neoplasms. CT is superior for staging and vascular assessment, whereas MRI provides better tissue characterization, particularly for cystic lesions.

Keywords: Pancreatic neoplasms, diagnosis, staging, management, lesion morphology

Maternal anaemia in pregnancy and its association with low birth weight and developmental delay in infants

Monika Seth — 2026-04-12

Background: Maternal anaemia is a prevalent condition in pregnancy, particularly in developing countries, and is associated with significant adverse neonatal outcomes. It leads to reduced oxygen-carrying capacity of blood, resulting in impaired fetal growth, low birth weight, preterm birth, and an increased risk of developmental delays in infants.

Objective: To evaluate the association between maternal anaemia, low birth weight, and developmental delay in infants.

Methods: A prospective observational study was conducted over 11 months among 100 pregnant women. Maternal haemoglobin levels were categorized into severe, moderate, mild anaemia, and normal. Birth weight was recorded at delivery, and infants were assessed for developmental delay using standard screening tools. Statistical analysis was performed using the chi-square test, with p < 0.05 considered significant.

Results: The prevalence of low birth weight was higher among mothers with severe and moderate anaemia. Developmental delay was also more frequent in infants born to anaemic mothers. A statistically significant association was observed between maternal anaemia and low birth weight (p < 0.01), as well as developmental delay (p < 0.01). Additionally, low birth weight infants showed a higher incidence of developmental delay (p < 0.05).

Conclusion: Maternal anaemia is significantly associated with low birth weight and developmental delay in infants. Early screening and management of anaemia during pregnancy are essential to improve neonatal and developmental outcomes.

Keywords: Maternal anaemia, low birth weight, developmental delay, infants, neonatal

Aeromonas hydrophila Osteomyelitis of the Femur in a 14-Year-Old Girl on Antituber-cular Therapy: A Rare Presentation

Mohit Gandhi — 2026-04-17

Introduction: Aeromonas hydrophila is an uncommon cause of musculoskeletal infections, particularly in immunocompetent pediatric patients [1]

Case Presentation: We report a 14-year-old girl on antitubercular therapy (ATT) who developed chronic non-healing medial thigh wound and femoral osteomyelitis following an aspiration procedure. MRI showed intramedullary osteomyelitis with multiloculated intramuscular collections. Surgical incision and drainage with cortical windowing was performed. Culture revealed Aeromonas hydrophila, sensitive to trimethoprim- sulphamethoxazole, levofloxacin, and gentamicin. She improved well with targeted therapy and continued ATT.

Conclusion: Atypical pathogens should be considered in osteomyelitis cases with prior invasive procedures or chronic systemic illness. Early surgical intervention and organism-specific antibiotics lead to good outcomes.