bluuebunny/crossref_metadata_2025 huggingface dataset:
Some features of the diagnosis and clinical manifestations of pathological fractures of the spine in Bekhterev's disease (а clinical case)
Authors: Potapov Vitaly E. , Gorbunov Anatoly V. , Larionov Sergey N. , Zhivotenko Alexander P. , Sklyarenko Oxana V.
Published: January 2024

Background: A prolonged course of the autoimmune inflammatory process in Bekhterev's disease is accompanied by calcification of the vertebral column’s ligaments, damage to the costovertebral and true joints of the spine, and their ankylosis, that ultimately leads to a decrease in the support capacity of the spine, so that even a minor injury can lead to a fracture. Spinal fractures in ankylosing spondylitis often have an unstable character and a high risk of the spinal cord injury. The main methods for diagnosing the spinal instability in Bekhterev's disease are multispiral computed tomography and magnetic resonance imaging, since the informative significance of survey radiography is not high. An early surgical treatment is the method of choice for unstable fractures in ankylosing spondylitis, despite the comorbid pathology and age, which significantly burden the prognosis. Сlinical case description: Patient K., born in 1969, injured on October 07, 2021 as a result of falling on his back from a height of 2 meters. An MSCT study of the thoracolumbar spine revealed a fracture of the ThXII–LI vertebrae, rupture of the anterior longitudinal ligament, and instability of the ThXII–LI vertebral-motor segment. The following diagnosis was established: closed uncomplicated injury of the thoracolumbar spine; grade I unstable compression fracture of the ThXII, LI vertebrae with a damage to the posterior support complex against the background of ankylosing spondylitis; grade I kyphotic deformity of the thoracolumbar spine; bilateral vertebrogenic lumboishialgia syndrome; pronounced persistent pain and muscle-tonic syndromes. A surgical treatment was applied which included correction of the spinal deformity and stabilization of the thoracolumbar spine using a transpedicular fixation system. The pain vertebrogenic syndrome and clinical neurological disorders regressed. The MSCT control was carried out in 6 months with the detected completed fusion at the ThXII–LI level. Conclusion: A timely diagnosis using multispiral computed tomography and magnetic resonance imaging data allows us to assess the full picture of traumatic changes in the spinal column and choose the most effective type of surgical intervention, using, if necessary, stabilizing systems.
A rare form of the thyroid gland cancer against the background of autoimmune thyroiditis
Authors: Ryabchenko Evgeniy V.
Published: January 2024

Background: Sclerosing mucoepidermoid carcinoma of the thyroid gland was first reported in 1991. This type of a tumor may develop in connection with Hashimoto's thyroiditis. There are two variants of mucoepidermoid carcinoma of the thyroid gland: the normal and sclerosing types. Sclerosing mucoepidermoid carcinoma of the thyroid gland has recently been recognized by the World Health Organization as a separate disease. Сlinical case description: We present a clinical case of a 51-year-old woman who was observed for 2 years for autoimmune thyroiditis with nodulation. The patient had no symptoms or signs of compression. The level of thyroid–stimulating hormone was 15.8 (range 0.4–4.0), the level of antibodies to peroxidase was 150 IU/ml. Thyroid scintigraphy revealed a dominant cold node (1.5×2 cm) in the right lobe of the gland. During the control ultrasound examination of the neck, negative dynamics was observed, then a fine needle aspiration biopsy of the thyroid node was performed. A follicular tumor was found against the background of Hashimoto's thyroiditis, which was the reason for a timely treatment. In the described case, the patient underwent a total thyroidectomy without neck lymph node dissection, no postoperative radiotherapy or other auxiliary treatments were performed. A full-body scintigraphy showed no recurrence of the disease in 10 months after the initial treatment. Conclusion: Given the rarity of the disease and the impossibility to differentiate it from other thyroid tumor’s, a more thorough examination of the nearby lymphatic collectors is necessary to exclude metastatic lesions, and in the presence of altered lymph nodes, additional diagnosis by fine-needle aspiration biopsy with subsequent determination of the scope of surgical treatment and postoperative management of this category of patients is indicated.
The Legal Framework for Local Government Coordination in Romania
Authors: Murphy Anthony , Ghencea Flavia
Published: January 2024

This scientific paper aims to fill the gap in intergovernmental coordination in Romania by assessing the strengths and shortcomings of the corresponding legal framework. Methodologically, it employs the doctrinal legal research of institutions involved in the vertical and horizontal coordination of local government. In essence, local government coordination occurs both within and beyond a complex framework of institutional structures dedicated to cooperation. Local councils may engage in town twinning and join national or international local government associations, while county councils and prefects exist for the very purpose of local intergovernmental coordination: local councils are coordinated by county councils in the pursuit of county-level goals, whereas prefects head the deconcentrated public administration and may foster vertical coordination with the central government. However, coordination amongst local governments may also occur by setting up or joining intercommunity development associations or administrative consortia, especially if they are unable to secure EU funds on their own. The authors argue that the complex institutional framework of the Romanian legislation both fosters and hinders coordination.
The Right to Social Security in the Event of Incapacity to Work Due to Sickness in Light of Article 67 (1) of the Constitution of the Republic of Poland
Authors: Antonów Kamil
Published: January 2024

The topic of this study is to determine the substance of the right to social security in case of incapacity to work due to sickness in the light of Article 67 (1) of the Polish Constitution, and to establish the scope and form of social security on this account. The author presents and justifies the concept of social protection in the event of incapacity to work due to sickness based on the assumption that, although it is granted in connection with professional activity, it does not always have to be associated with loss of earnings. On the other hand, as for the scope of social security, it was assumed that it can cover (in the subjective aspect) not only persons subject to general social insurance and farmers’ social insurance, but also uniformed services as well as judges and prosecutors, while (in the objective aspect) also benefits from the employment (service) relationship, i.e. employee sick pay and emoluments (remuneration) for the time of incapacity to work due to sickness to which professional soldiers, police officers, judges or prosecutors are entitled. The latter is related to the formulation of the thesis that the exercise of the right to social security in case of incapacity to work due to sickness does not take place exclusively in the form of insurance disbursement, since – due to the open content of the norm included in Article 67 (1) of the Polish Constitution – it is also permissible to use other methods of legal protection, including the financing of benefits in this area from the own funds of the employing entities. The discussion is preceded by remarks on the concept of the right to social security, particularly with regard to the legal nature of Article 67 of the Polish Constitution and the essence of this right.
Change of Parties in the New Hungarian Civil Code from a Comparative Perspective
Authors: Gárdos Péter
Published: January 2024

The Hungarian Civil Code introduced changes regarding the change of parties. The paper argues that comparative law helped the Hungarian legislator to introduce new rules that address relevant market needs. The author shows how the clarification of the system of the transfer of receivables opened up new opportunities for the parties and how the treatment of non-assignment clauses changed in light of legislative changes in several European countries. It is argued that the new Hungarian Civil Code found the right balance between the interests of the debtor and the assignor. The second part of the article explains that the New Civil Code introduced a significant change through the rule on free transferability of rights. The third part presents how the New Civil Code introduced rules on the transfer of contracts, following the solutions of several European countries and international unification instruments, and explains the challenges posed by these rules.
Administrative Law Values – Attempts at Methodological Order
Authors: Kostecki Dawid
Published: January 2024

The appeals to values and the renaissance of axiological thought in the various legal dogmas naturally prompt a methodological order. The article is a voice in the debate on attempts to systematize values in administrative law. On the grounds of positive law, one usually reaches only to justify the thetic validity of norms. In administrative law, which concerns human beings, it is especially common to reach for the axiological basis of the validity of the law – hence the number of value classifications is considerable. The meanders of axiological reflection in administrative law are entering a higher level of complexity. The axiology of administrative law is very complex due to the great diversity of administrative law, and any typologies are contractual in nature. The doctrine is generating new catalogues of values. Each of them is threatened by a form of relativism. The author undertakes an analysis of the proposed classifications, pointing out the advantages and disadvantages of the various solutions. The purpose of the article is to present justifications for the separation and classification of values in administrative law and to confirm the relevance of axiological reflection within the framework of the legal dogma indicated. The main methods used in the text are formal-dogmatic and comparative.
The Idea of Civil Disobedience: A Few Words after the Judgment of the Voivodeship Administrative Court in Opole (II SA/Op 219/20) and the Judgment of the Supreme Administrative Court (II GSK 292/21)
Authors: Kulikowska-Kulesza Justyna
Published: January 2024

The global SARS-CoV-2 coronavirus pandemic carried a number of restrictions and prohibitions, the manifestation of which in Poland was, i.a., cyclical closing and opening of selected branches of the economy, which for the vast majority of entrepreneurs meant – at best – an uncertain future. The lack of clear and consistent actions when introducing restrictions and bans by the Polish Council of Ministers, as well as the failure to provide real financial aid, resulted in the growing opposition of many entrepreneurs, which in turn translated into breaking or circumventing the applicable regulations regarding restrictions and prohibitions in the field of economic freedom. Can such an action be considered a manifestation of civil disobedience? The author’s attempt to obtain an answer to this question is the result of the judgment of the Voivodeship Administrative Court in Opole of 27 October 2020 (II SA/Op 219/20), which for many Polish entrepreneurs was an excuse to express their civic objection and open a business against applicable restrictions and limitations, as well as the judgment of the Supreme Administrative Court of 28 August 2022 (II GSK 292/21).
Popular Sovereignty during the COVID-19 Pandemic: Lessons from the Visegrád Countries. National and Local Elections in the Shadow of the Coronavirus
Authors: Florczak-Wator Monika , Szentgáli-Tóth Boldizsár , Halász Iván
Published: January 2024

The coronavirus crisis led to severe restrictions of numerous fundamental rights almost globally, amongst which the right to vote was also concerned. Our research article aims to integrate the experience of the Visegrád region into the emerging strand of international legal scholarship from the long-term impact of the public health emergency on electoral frameworks. Based on a research collaboration funded by the International Visegrád Fund, the study presents the adaptative measures implemented by the four Visegrád countries to hold national or municipal elections in the shadow of the global pandemic, and contextualizes these interventions in the light of the global electoral tendencies. Finally, based on our research, the expected features of post-COVID electoral frameworks in the Visegrád region were also provided. Alternative electoral regimes are discussed for the promotion of flexibility and resilience, which are grounded on the combined elements of the traditional voting system, on additional public health requirements, and also on the extensive application of postal- and electronic voting.
Thermal Waste Conversion as Energy Source – the Polish Legal Context. Selected Issues
Authors: Modrzejewski Artur K.
Published: January 2024

The article presents Polish and related EU legal basis for thermal waste conversion (in particular municipal waste and waste of municipal origin) as an energy source. It was hypothesized that at the current stage of systemic development of municipal waste management in Polish legal conditions, thermal waste conversion is an extremely important element which not only allows for achieving quantifiable environmental benefits, but also constitutes a source of energy. However, waste incineration cannot be treated as a fundamental element of closed-loop waste management. Waste incineration plants are and should be treated as an element of complementing the waste system, taking into account energy recovery in the cogeneration system, but also the limitations arising from taxonomy. The unquestionable advantage of this type of installation is the possibility of producing thermal energy and a more beneficial impact on the environment than the combustion of fossil fuels.
Conceptualizing the Legal Capacity to Fundamental Rights
Authors: Gárdos-Orosz Fruzsina , Somody Bernadette
Published: January 2024

While the capacity to have rights has been a question since people started creating states and law, having the capacity to exercise fundamental rights is a contemporary legal issue. The article focuses on the legal capacity to fundamental rights and presents an innovative proposal for the legal doctrine related to the concept of the normative constitution of fundamental rights. The authors argue that protecting fundamental rights is incomplete if uncertainties exist regarding these rights’ subjects. Due to the complexity of the problem and the relevance of the “judge-made law”, the article offers a new methodological tool: instead of building a pre-set, abstractly defined comprehensive concept, concept mapping is advocated for conceptualizing the legal capacity to fundamental rights. The concept map is an organic and beneficial way to collect and structure the interrelated factors determining legal capacity. It can be a decision-support tool for judges in fundamental right-related cases to bring well-grounded decisions. As a starting point, the authors argue that an autonomous dogmatic category of legal capacity to fundamental rights is crucial for effectively protecting rights. To support this point, the complex theoretical background (the concept of person, personality, rights and fundamental rights) is reviewed. The authors point out that existing approaches do not give an unambiguous answer to what entity and how far can be the holder of what fundamental right. The article concludes with a methodological proposal of conceptualizing by mapping to maximize the effect of knowledge on factors that influence judicial decisions in this regard.
Comparative Law and Procedural Law in Poland in 1918–1933 with a Particular Emphasis on the Silesian Voivodeship
Authors: Stawarska-Rippel Anna
Published: January 2024

In 2023, 500 years have passed since the entry into force of the ordinary court procedure in Poland (formula processus iudiciarii, 1523), as well as 90 years since the unification of court procedures in Poland in general and 90 years since the entry into force of the first Polish Code of Civil Procedure (1933). Therefore, this is a special opportunity to refer, in this context, to the first transformation of procedural law in Poland in the 20th century, which took place after World War I, especially in the context of comparative procedural law issues. Applicability of foreign laws in the Polish territories after World War I: Russian, German, Austrian, and Hungarian (in a small area of Spisz and Orawa), as well as Polish-French legislation, gave rise to a complicated and territorial legal mosaic. The codification works undertaken at that time in Poland, unprecedented in Europe or even in the entire world, fell within a period of great development of comparative jurisprudence. They were profound comparative studies, which are proven by the published drafts, together with explanatory memorandums, offering an original synthesis of the legal thought. The considerations made in this article relate to procedural law, which was significantly diversified in the territory of Poland reborn in 1918, especially as regards the model of legal remedies, which gave rise to considerable difficulties in the practice of the system of justice prior to the unification of court procedures. Special attention was paid to the legal situation in the Silesian Voivodeship, being a peculiar microcosm of the legal situation in the entire country.
On the Perception of Law as a “Space of Opportunity” for Entrepreneurs
Authors: Kokocińska Katarzyna , Żywicka Agnieszka
Published: January 2024

The legal system provides both a framework for the development of economic activity, stating the principles according to which it is carried out, and a certain degree of protection for entrepreneurs. This article suggests an approach at normative regulations pertaining to entrepreneurship whereby they are perceived as a system composed of opportunities for entrepreneurs. The purpose of this study is to present the regulations of the Entrepreneur Law Act as a law comprising “opportunities” that stem from principles informed by a value system and the deriving, legally defined modes of action of the public authorities (economic administration) that shape relations with entrepreneurs. These principles and the resulting relations have been referred to the specific institution within the Entrepreneur Law Act, i.e. scrutiny of economic activity, which establishes legal scope (whose importance cannot be understated given the perspective of the protective function of public economic law) for not so much intervention as protection (respecting) of entrepreneurs’ rights. It was pointed out that measures aimed at protecting entrepreneurs constitute an important element of balancing the position of the inspecting and the inspected in the course of scrutiny, without compromising the efficacy of enforcing law by a public authority.
Cybersecurity and Protection of Critical Infrastructure
Authors: Czuryk Małgorzata
Published: January 2024

The functioning of critical infrastructure depends on information and communication technologies (ICT) systems that enable its equipment or facilities to operate smoothly. Threats to its functioning can present a major issue for the state and society, as it also spans strategic sectors which overlap with the essential services which remain within the purview of operators of essential services. Because of the relationship that links strategic systems within critical infrastructure and simultaneously supports its operation with essential services, ensuring cybersecurity will also affect the protection of this infrastructure. It should be emphasised that critical infrastructure may be adequately protected by ensuring the cyber resilience of the ICT systems it utilises and through cooperation between the public and the private sector.
Remuneration for the Provision of Legal Services: A Partially Critical Commentary on the Judgment of the Supreme Court of 3 June 2019 (I NSNc 7/19, OSN IKNiSP 2020, no. 3, item 19)
Authors: Bucoń Paweł
Published: January 2024

Under the ruling which is the subject of this commentary, the Supreme Court confirmed the possibility to calculate the rates of legal-service fees in the amount depending on the result of a given case (a success fee). The said ruling deserves attention as it has a substantial importance for legal practice and case law in analogous matters. On the one hand, it refers to the freedom in determining the amount of remuneration for a given service (including court representation), and on the other hand, it addresses the issue of protecting the client (who is often an aggrieved party affected by a prohibited act). Litigation proceedings themselves often concern compensation claims filed by an aggrieved party affected by a prohibited act. Although the Supreme Court did not refer to the issue of establishing the upper limits of remuneration for legal services in the statement of reasons to the judgment (especially in relation to the civil law concepts of exploitation – Article 388 of the Civil Code, as well as the rules of social conduct – Article 5 of the Civil Code), the decision, in its essential part, deserves approval.
The Justification of the Sectoral Model of Chambers of Commerce – Polish Perspective
Authors: Dąbrowski Karol , Dorożyński Tomasz , Marciniak Piotr
Published: January 2024

The authors of the conceptual article took up the topic of the sectoral model of chambers of commerce (of trade, of industry and commerce, etc.). This proposal complements the taxonomy of chambers present in the literature, based on three main models: continental, Anglo-Saxon and mixed. A comparative worldwide analysis of chambers of commerce indicates their significant diversity, but also the significant impact of historical and social conditions on their organization, position and effectiveness. Therefore, their system should be designed adequately to the needs of a given country, rather than directly transferring foreign or historical solutions into the domestic context. Present Polish chambers of commerce function as voluntary organizations associating entrepreneurs at various levels: sectoral, national, regional, local and bilateral (as Polish-foreign chambers). However, this solution does not provide effective communication between entrepreneurs and public authorities. Polish studies propose the creation of chambers of commerce in the continental model, which is based on the 19th-century regional structure. The authors argue that this concept is outdated in the era of global economic interconnections. The concentration of knowledge and competences needed today can be more effectively provided by the sectoral model. Sectoral chambers of commerce enable expert specialization appropriate to the needs of entrepreneurs and public authorities. They are also an effective platform for the decentralization of public administration. This model is an original concept of the authors in the discussion about possible evolution of chambers of commerce in the Polish context. Its implementation requires, i.a., proper definition of chambers’ tasks and the inclusion of entrepreneurs in the process of their creation. The discussion in the national press and industry magazines shows that these inquiries are valuable not only for science, but also for entrepreneurs and people responsible for the legislative process. Therefore, the aim of the conducted research was to justify the implementation of the sectoral model in the context of the current Polish practice and the increasing role of expert knowledge.
La teoría de la evolución en los juzgados
Authors: González Candelas Fernando
Published: January 2024

La teoría de la evolución y sus implicaciones en otros campos, concretamente en este artículo se incide en el aspecto judicial. Resulta que los mismos

postulados evolutivos que son discutidos y reprobados en algunos tribunales

son aceptados en otros como evidencias científicas en casos criminales. La

teoría evolutiva ha hecho una irrupción insospechada hace apenas unos años en

los tribunales de justicia
Written Subject Pronoun Expression among Spanish Heritage Language Learners
Authors: Fernández Flórez Carmen
Published: January 2024

Este artículo analiza la producción del pronombre sujeto en español desde una nueva perspectiva: el género escrito. A través del análisis de 90 ensayos escritos por estudiantes de español como lengua de herencia, el presente estudio ofrece avances en el entendimiento del comportamiento del pronombre sujeto en la escritura. Aunque el comportamiento del pronombre sujero varía en cuanto a su frecuencia de uso en las diferentes variedades de español, se han encontrado patrones similares que predicen el comportamiento de dichos pronombres (Carvalho et al., 2015). El presente estudio explora si estos patrones de comportamiento (explorados hasta ahora solo en el ámbito de la oralidad) se mantienen en la escritura de nuestros participantes: hablantes de herencia.
personal de los museos, su ordenación laboral y responsabilidad
Authors: Jaén González Raquel
Published: January 2024

En España a diferencia de lo que ocurre en otros países europeos conviven museos de diferentes tipologías lo que trae consigo grandes diferencias en las condiciones laborales de su personal. Además, no existe acuerdo sobre los procesos de selección para determinados puestos y se aprecia de forma general la falta de negociación colectiva en el sector.
Importación paralela de medicamentos genéricos reenvasados con la marca de los medicamentos de referencia (a propósito de la STJUE de 17 de noviembre de 2022, c-253/20 y c-254/20, asunto Impexeco)
Authors: Fernández Domínguez Juan José , Domínguez Fernández Guillermo
Published: January 2024

La estrategia emprendida por las multinacionales farmacéuticas consistente en crear filiales con la finalidad de competir con ventaja en el mercado de los medicamentos genéricos, ha tratado de ser contrarrestada por los importadores paralelos reenvasándolos en el Estado de exportación, pero poniendo las marcas con las que se comercializan los medicamentos de referencia en el Estado de importación (re-branding). A través de la exigencia de que ambos fármacos sean “idénticos en todos los aspectos”, y negando que haya cualquier otro interés digno de protección salvo el de aprovechar el renombre de la marca para obtener mayor rentabilidad, el Tribunal de Justicia de la Unión
Unstable intertrochanteric femoral fracture care in older population
Authors: Mohanty Rashmiranjan , Jena Arpita , Mohanty Ranjan Kumar
Published: January 2024

Background: The present study aimed to compare outcomes between geriatric patients treated with cementless bipolar hip arthroplasty (BHA) and proximal femoral nail (PFN) for intertrochanteric femur fractures, focusing on postoperative complications, reoperation rates, implant-related issues, and functional outcomes.
Methods: The present study took place at PRM medical college, Baripada for a period of 4 years and employed a prospective design with 76 individuals with femoral shaft fractures who underwent surgical treatment, wherein 40 were treated using cementless BHA and 36 with PFN. Evaluation included the HHS at the last follow-up, alongside recorded blood transfusion rates and surgery duration, statistically compared between the two groups.
Results: The study involved elderly patients with intertrochanteric femur fractures (average age: 82.9 years). BHA and PFN groups had differing average ages (81.4 and 83.9 years, respectively). Follow-up durations were 18.6 months overall, 23.8 months for BHA, and 13.1 months for PFN. PFN showed advantages in surgery duration and blood transfusion rates. Adverse effects in BHA included 4 epidermal infections, while PFN had 2 epidermal infections and 2 instances of implant malfunction, resulting in extraction. PFN demonstrated a 5.5% cut-out rate.
Conclusions: The study compares the outcomes of elderly patients with femoral shaft fractures treated with cementless BHA and PFN. The results indicate that PFN presents advantages over BHA in terms of shorter surgery duration and reduced blood transfusion rates. However, further research and extended review are warranted to draw definitive results about the superiority of either approach.
Spectrum of intestinal lesion: A clinicopathological study in a tertiary care centre
Authors: Usman Syeda Iqra , Khan Zoha , Khan Roobina , Afroz Nishat , Harris Syed Hasan
Published: January 2024

Intestine has wide spectrum of diseases comprising neoplastic and non-neoplastic lesions. Inflammatory bowel diseases are showing increasing trend and intestinal neoplasms are the most frequently observed and leading cause of death in India.

This study aims to find the occurrence of various intestinal lesions, classify them as neoplastic and non-neoplastic and to correlate the histopathological findings with clinical profile of patient in tertiary care hospital of north India.

1129 biopsies and resection specimens of intestinal lesions were examined over a period of two years. Sections were fixed, paraffin embedded and stained by H&E. Immunohistochemistry was applied wherever required.

Nearly two third patients were males in their second decade who presented with abdominal pain as the most common complaint and majority were diagnosed with non-neoplastic diseases. Among non-neoplastic lesions non-specific inflammation was predominant in small intestine (47.04% cases) and appendicitis (55.0%) in large intestine. Adenocarcinoma was predominant in both small and large intestine with 80.77% and79.45% of neoplastic cases respectively.

This work gives a panoramic view of different intestinal pathologies and emphasises on the need of planning accurate diagnostic and screening strategies along with effective treatment plans both for neoplastic as well as non-neoplastic diseases.
Invasive solid papillary breast carcinoma without neuroendocrine differentiation
Authors: Jayakumar Priya , Chauhan Devender Singh
Published: January 2024

Solid papillary carcinoma (SPC) is considered a rare malignant breast tumor. This tumour can be either in situ or invasive .Both usually show excellent prognosis. Solid papillary carcinoma often shows neuroendocrine differentiation.

74-year-old lady an ulcerative retroareolar mass in the right breast. CECT Thorax revealed a large lobulated fungating ulceroproliferative mass lesion in the right breast with pectoral muscle involvement.without neuroendocrine differentiation.

SPC with invasion is an uncommon variant of papillary carcinoma with frequent mucinous differentiation. Neuroendocrine differentiation although supports the diagnosis of solid papillary carcinoma may or may not be present.
Huge renal oncocytoma with solid and cystic areas - A case report and review of literature
Authors: Kalariya Jigna Jerambhai
Published: January 2024

This abstract presents a rare case of a huge renal oncocytoma, emphasizing its diagnostic challenges, clinical management, and unique characteristics. Oncocytomas are relatively uncommon benign neoplasms, typically found in various organs, including the kidneys, salivary glands, and thyroid. However, the occurrence of an exceptionally large renal oncocytoma poses distinct clinical considerations. We report the case of a patient who presented with a large palpable mass occupying almost whole abdomen with firm to hard in consistency. The diagnostic process involved an imaging studies, including computed tomography (CT) along with histopathological examination of specimen. The diagnostic challenges stemmed from the atypical size and radiological features. Surgical intervention was necessary due to the size of the renal oncocytoma. This case highlights the importance of considering renal oncocytomas in the differential diagnosis of large renal masses, even when their size exceeds typical dimensions. The management of huge oncocytomas involves a multidisciplinary approach, incorporating advanced imaging techniques, pathological assessment, and surgical expertise. Histology of renal oncocytoma in our case is also different as it is showing cystic areas. Immunohistochemistry confirmed the diagnosis of renal oncocytoma. Awareness of these rare cases is crucial for clinicians to guide appropriate diagnostic and therapeutic strategies, ensuring optimal patient outcomes.
Kikuchi fujimoto disease in a young male post-COVID -19 vaccination
Authors: Manjani Sekar , Bose Jackson , Srirangaramasamy Jamunarani , Karupasamy Khowsalya Subrajaa
Published: January 2024

Kikuchi disease (Kikuchi-Fujimoto disease) is one of the rarest forms of lymphadenopathy. It is also known as necrotizing lymphadenitis. The patients usually present with fever and lymphadenopathy. Here is a case of Kikuchi-Fujimoto disease presented with fever and cervical lymphadenopathy. Radiological imaging revealed matted lymph nodes. Fine needle aspiration of the lymph node revealed granulomatous inflammation. Acid Fast stain was negative and further investigations ruled out tuberculosis. A histopathological biopsy of the lymph node confirmed the diagnosis of Kikuchi-Fujimoto disease. The patient was treated with medications and the patient's condition improved in follow-up. Tuberculosis must be ruled out in such conditions as the symptoms and radiological and FNAC findings mimicking tuberculosis. The diagnosis of Kikuchi-Fujimoto disease is made by histopathology and confirmed by immunohistochemistry.
Collision tumour of thyroid – A case series
Authors: Pathak Tarali , Kakoti Lopa Mudra , Ahmed Shiraj , Sarma Anupam , Rhutso Yopovinu
Published: January 2024

A collision tumour is described as the coexistence of two adjacent but histologically distinct and morphologically independent malignant tumours in the same organ with no histological admixture. In this article we present 3 cases of simultaneous occurrence of two thyroid neoplasm in the same patient. A 49 year old lady with swelling in right lobe of thyroid, diagnosed as follicular neoplasm with hurthle cell morphology (Bethesda category IV) on Fine needle aspiration cytology (FNAC). Histopathological examination (HPE) showed Hurthle cell carcinoma, right lobe and 3 mm foci of NIFTP, left lobe. Another 45 year old lady with bilateral thyroid swelling diagnosed as hurthe cell neoplasm (Bethesda category IV), left lobe and suspicious of papillary thyroid carcinoma, right lobe on FNAC. HPE showed papillary thyroid carcinoma, classical variant in the right lobe with a focus of papillary carcinoma in the isthmus and hurthle cell adenoma in left thyroid. A 27 year old man with thyroid swelling revealed medullary carcinoma in FNAC. Final histopathological diagnosis was medullary carcinoma, right lobe of thyroid and isthmus, papillary carcinoma (micropapillary variant) in pyramidal lobe along with metastatic medullary carcinoma in right level II lymph nodes and metastatic medullary and papillary carcinoma in central compartment nodes. Collision tumors are a diagnostic as well as therapeutic challenge due to the dual pathology. Extensive sampling should be done as co-existence of different neoplasms can occur.
Sinonasal malignant melanoma- Diagnostically hidden Gem
Authors: Mangal Kalpana , Madhur Alankrita , Bansal Ishita
Published: January 2024

Malignant melanoma is a prevalent form of skin cancer, but its occurrence as a sinonasal tumour is exceptionally uncommon, constituting less than 1% of nasal and sinonasal malignancies. Typically diagnosed in individuals aged 50 to 60, these tumours often manifest with symptoms such as nasal obstruction and recurrent, painless epistaxis. Despite their location, malignant melanoma cases generally have a bleak prognosis. Diagnosis primarily relies on Immunohistochemistry and histopathology.
Assessment of critical impact of superbugs in human health: A known beyond
Authors: Karwa Pawan Nandkishor , Bhole Ritesh P , Gawade Mahesh
Published: January 2024

A superbug is described as a bacterium that has seen to develop resistance to traditional treatment of antibiotics. The World health organization has produced the first-ever fulfilled report on the AMR danger, which consists the information from 114 nations and ranks it amongst the one of the severe global health hazards of the 21 century. Every year, about 1 million people die due to the non-treatable drug-resistant diseases caused by these superbugs.

Bacterial resistance is on the rise, putting many of our current antibacterial treatments in danger. Discovery of brand-new antibiotics has lagged behind the growth of germs resistant to them. Numerous novel approaches to target different substances in bacterial cells have been developed and are being researched. The present review emphasizes on the various types of superbugs with its possible solution. Also, it illustrates that, we should not be startled by the fast emergence of resistant pathogens dubbed "superbugs" by the media but what has been astonishing is the rapidity with which these superbugs have evolved and spread resistance, frequently at little or no cost to their health. The article provides an overview of the most prevalent forms of superbugs and potential novel medicines that might be utilized in a clinical setting shortly to fight these superbugs.
A study on clinico- epidemiological profile & histopathological profile of cutaneous vasculitis
Authors: Yadav Ram Gyan , Rijal Arpana , Khadaka Dhan Keshar , Upadhayaya Paricha
Published: January 2024

: The study aimed to analyse the potential etiological factors, clinical presentation, past medical history & laboratory findings in patients with biopsy-proven cutaneous vasculitis to better understand the disease and identify the disease classifications. The objective of this study was to establish a database of the clinic-epidemiological profile and histopathological features of cutaneous vasculitis in a tertiary hospital in Eastern Nepal.

: A Descriptive cross-sectional study was planned to analyse and study the clinic-epidemiological profile and histopathological features of cutaneous vasculitis in Nepal. This study has reviewed the facts which were published earlier to determine the current scenario by vast study of statistics and derivation of facts. Proper examination of data was made to evaluate with final conclusion. The study included sample size of 30 consecutive patients with biopsy-proven cutaneous vasculitis attending the Dermatology outpatient department and admitted to the dermatology ward at B.P. Koirala Institute of Health Science, Dharan.

: The study population of 30 patients with biopsy-proven cutaneous vasculitis, with an average age of 32.96 years, and a female-to-male ratio of 1.3:1. The majority of patients (66.67%) had lesions lasting less than 6 weeks, and acute disease was observed in 86.66% of the cases. The most common symptoms were itching (73.66%) and arthralgia (66.67%). Palpable purpura was the predominant cutaneous manifestation (70%), mainly distributed on the legs and ankles (93.33%). Elevated ESR was the most common laboratory abnormality (73.33%). Histopathological examination revealed leukocytoclastic vasculitis in 97% of cases, with predominantly neutrophilic infiltrates. Henoch-Schoenlein purpura (HSP) was the most common classification (43.33%), followed by urticarial vasculitis (26.67%).

: This study provides valuable insights into the clinic-epidemiological profile and histopathological features of cutaneous vasculitis in the Nepalese population. It highlights the diverse clinical presentation and laboratory abnormalities associated with the condition, as well as potential etiological factors and disease classifications. The findings contribute to improved understanding, diagnosis, and management of cutaneous vasculitis. Further studies with larger cohorts are needed to validate and expand upon these findings.
Methotrexate toxicity encountered in dermatology department: A retrospective study at tertiary care center in western India
Authors: Modha Jay Dhirajlal , Bhabhor Bhavana Bharatbhai , Patel Bharati Kamlesh , Bhuptani Neela Vishanjibhai
Published: January 2024

Methotrexate (MTX) is considered a relatively safe drug when prescribed at dose ranging from 7.5mg-30mg per week. Severe acute toxicity is rare and present with mucositis, cutaneous ulceration and pancytopenia. Most cases occur as the result of inadvertent overdosing due to erroneously taking the drug daily.

A retrospective study of 10 cases of acute methotrexate toxicity in patients attending the dermatology OPD at P. D. U govt. medical College and hospital, Rajkot during a period of 1 year was done.

Out10 patients, 7 had both oral and cutaneous involvement, 4 had genital mucosal involvement while 2 cases had only oral ulcerations. Organ -specific toxicities includes pancytopenia in all cases, as well as hepatoxicity, renal toxicity, and GI toxicity in 3 patients. Additionally, cutaneous toxicity was observed in 6 cases. “Of the 10 patients, 2 recovered after stopping methotrexate with supportive care. The remaining 8 received injectable folinic acid, resulting in recovery for 6 patients, but 2 patients unfortunately died during treatment.

Although MTX appears to be a safe and effective medication when used at low-dose, acute MTX toxicity can be a life threating emergency when comorbidities are not addressed. Sensitization amongst doctors, general practitioners and resident doctors is of paramount importance to identify possible MTX toxicity in earlies phases and in a way ensure earliest management.
Acute generalized exanthematous pustulosis secondary to spider bites: Clinico-dermoscopic findings and review of literature
Authors: Rather Shagufta , Nazim Malik , Aslam Aqib
Published: January 2024

Acute generalized exanthematous pustulosis (AGEP) or toxic pustuloderma is a febrile adverse cutaneous reaction, characterized by small non-follicular sterile pustules. AGEP can occur in any age group and is found to be more common in women. A large proportion (>90%) of cases are triggered by medications, particularly macrolides and aminopenicillins. The occurrence of AGEP following spider bite has been rarely documented in the literature.We report two cases who presented to us with AGEP following spider bite along with dermoscopic findings and also present a brief review of literature on the same.
Oral tofacitinib in refractory chronic spontaneous urticaria
Authors: Godse Kiran , Shibu Elen Elu , Singh Gauri , Gautam Manjyot , Patil Sharmila
Published: January 2024

Chronic spontaneous urticaria (CSU) is a skin condition marked by the emergence of wheals on their own that persist for six weeks or more. CSU is quite common, affecting up to 1% of the population, and has a serious detrimental effect on a patient's health and quality of life. Antihistamines (AH) are currently the backbone of treatment for chronic urticaria (CU), however up to 40% of patients do not respond to even large (four-fold) daily dosages of AH. Tofacitinib is a small-molecule that inhibits intracellular signalling of several important cytokines involved in the inflammatory cascade and blocks JAK1/3. While there are reports of tofacitinib's positive effects in patients with mast cell activation disorder, there are none in those with urticaria.

The aim of our study is to assess the efficacy of oral tofacitinib in refractory chronic spontaneous urticaria. 5 cases of refractory CSU between the age group of 20 to 40 years were included in our study and they were followed up for 6 months. The patients were started on oral tofacitinib 5mg twice a day. On every weekly follow-up, we used clinical assessment, urticaria activity score and urticaria control test to evaluate the treatment response

The usage of oral tofacitinib significantly improves the clinical picture in refractory CSU. Although more research is required to determine Tofacitinib's effectiveness in CSU, our study raises the possibility that it could represent a novel therapeutic option for individuals with refractory CSU.
Difficult to treat superficial fungal infections: Which factors one should consider in clinical practice – An Indian perspective
Authors: Trailokya Abhijit Anil
Published: January 2024

Dermatophytosis is a superficial fungal infection caused by filamentous fungi- dermatophytes affecting the skin, hair and/or nails. They have also been termed tinea infections. Dermatophytes, the most common contributing agents, are pretending high importance in developing countries like India. Emerging Pathogen Causing Recalcitrant Dermatophytosis like Trichophyton indotineae, which is terbinafine resistant. Development of Anti-fungal resistance due to irrational usage of antifungals, steroid misuse, availability of topical creams with steroid combination on OTC, improper and inadequate treatment, lack of patient counselling and education are the most important factors which made dermatophyte difficult to treat. Proper diagnosis, correct selection of anti-fungal, with adequate duration of therapy, avoidance of steroid, patient education on lifestyle changes will be probable solutions in resolving current challenges.
Role of cetrorelix in the prevention and treatment of ovarian hyperstimulation syndrome: A prospective case control study
Authors: Inani Anita
Published: January 2024

Because of its terrible effects, ovarian hyperstimulation syndrome (OHSS) has long piqued the interest of medical professionals. Since the syndrome is an iatrogenic condition brought on by elective ovarian stimulation in the pursuit of pregnancy, its complete prevention is imperative. The gonadotropin releasing hormone (GnRH) antagonist Cetrorelix has been shown in some studies to be beneficial in the prevention of OHSS as well as an effective treatment for the condition. Therefore, we created a study at a hospital to find out how Cetrorelix works to prevent and treat OHSS in patients undergoing long and short protocols for those undergoing embryo transfer and in-vitro fertilization (IVF–ET) who are susceptible to the illness.

The study includes 102 patients undergoing COS for IVF in total. To stimulate each case, a long and a short protocol were employed. Depending on whether a GnRH antagonist was administered following ovum pick-up (OPU), the patients were split into two groups: the control group (n = 51) and the Cetrorelix (antagonist) group (n = 51). Beginning on the day of ovum pickup, the study group received five days' worth of Cetrorelix 0.25 mg.

: While the antagonist group had a significantly higher moderate OHSS incidence (p=0.01), the incidence between mild and severe OHSS was considerably reduced(p<0.05). Not a single patient experienced critical OHSS.

OHSS can be prevented and treated effectively by administering the GnRH antagonist Cetrorelix to patients undergoing either a long- or short-term protocol during the early luteal phase.