bluuebunny/crossref_metadata_2025 huggingface dataset:
Transfer Learning with Pretrained Convolutional Neural Network for Automated Gleason Grading of Prostate Cancer Tissue Microarrays
Authors: Gifani Parisa , Shalbaf Ahmad
Published: February 2024

Background:

The Gleason grading system has been the most effective prediction for prostate cancer patients. This grading system provides this possibility to assess prostate cancer’s aggressiveness and then constitutes an important factor for stratification and therapeutic decisions. However, determining Gleason grade requires highly-trained pathologists and is time-consuming and tedious, and suffers from inter-pathologist variability. To remedy these limitations, this paper introduces an automatic methodology based on transfer learning with pretrained convolutional neural networks (CNNs) for automatic Gleason grading of prostate cancer tissue microarray (TMA).

Methods:

Fifteen pretrained (CNNs): Efficient Nets (B0-B5), NasNetLarge, NasNetMobile, InceptionV3, ResNet-50, SeResnet 50, Xception, DenseNet121, ResNext50, and inception_resnet_v2 were fine-tuned on a dataset of prostate carcinoma TMA images. Six pathologists separately identified benign and cancerous areas for each prostate TMA image by allocating benign, 3, 4, or 5 Gleason grade for 244 patients. The dataset was labeled by these pathologists and majority vote was applied on pixel-wise annotations to obtain a unified label.

Results:

Results showed the NasnetLarge architecture is the best model among them in the classification of prostate TMA images of 244 patients with accuracy of 0.93 and area under the curve of 0.98.

Conclusion:

Our study can act as a highly trained pathologist to categorize the prostate cancer stages with more objective and reproducible results.
Factors precipitating breakthrough seizures in childhood epilepsy
Authors: Thandapani Kanimozhi , Revathi K , Bharath Kumar T
Published: February 2024

Abstract

Background:

Breakthrough seizures occur in 37% of epilepsy patients even though remission has been attained. Counseling on precipitating factors form an integral part of treatment along with anti-epileptic drugs (AEDs). Identification of precipitating factors may help in reducing unnecessary hospitalization and complications of breakthrough seizures.

Materials and Methods:

This retrospective study was conducted in a tertiary healthcare center in Puducherry. All children with epilepsy admitted with breakthrough seizures from January 2017 to December 2019 were included in the study. Those with neonatal seizures, diagnosis of either Neurocysticercosis or tuberculoma, cases without seizure free period of 6 months and case records without adequate details were excluded. Data regarding precipitating factors were collected from case records and analyzed using SPSS version 24.0 software.

Results:

Of the 80 children included in the study, mean age was 4.98 (±3.52) years and 56.3% were less than 5 years of age. In total, 90% (n = 72) of the participants had generalized epilepsy, of which 67 had generalized seizures, four had absence seizures and one had atonic seizures. Majority (85%) reported at least one possible precipitating factor for breakthrough seizures and common ones were fever (27.5%) and non-compliance to medication (26.25%). Most common reason for non-compliance was forgetting to take medication (38%). Also illiterate mothers and multiple AEDs had a significant association with non-compliance (P < 0.05).

Conclusion:

The results of our study stress the need on adequate counseling about possible precipitants and prescription on minimum AEDs whenever possible. Parents need to ensure strict adherence to AEDs and avoidance of trigger factors.
Complete intraventricular migration of ventriculoperitoneal shunt: A case report and review of literature
Authors: Rathore Lavlesh , Sahana Debabrata , Kumar Sanjeev , Borde Pravin R , Jain Amit K , Sahu Rajiv K
Published: February 2024

Abstract

Ventriculoperitoneal shunt (VP shunt) is a commonly performed surgery for hydrocephalus, and like for any other surgery, complications are an inseparable part of this surgery as well. Here, we present a rare complication of VP shunt in a six-month-old child where complete shunt assembly had migrated into the lateral ventricle. Endoscopic retrieval of the migrated shunt with simultaneously endoscopic third ventriculostomy was performed. Operative steps for the procedure have been described. A detailed literature review of the migrated intraventricular shunt and its possible pathogenesis has been discussed.
Acute necrotizing pancreatitis in a child with recurrent craniopharyngioma after transnasal transsphenoidal surgery
Authors: Pathak Sharmishtha , Gupta Priyanka , Ramakumar Nirupa , Rekapalli Rajasekhar , Gupta Gaurav
Published: February 2024

Abstract

Hyperlipemia, steroids, and many drugs have been associated as both a precipitant and a causative factor for acute pancreatitis (AP), among others. However, acute necrotizing pancreatitis is uncommon in children. We present a known case of an 11-year-old girl with craniopharyngioma associated with panhypopituitarism, central diabetes insipidus, and aggressive behavior on multiple drugs. She developed acute necrotizing pancreatitis after trans nasal trans sphenoidal (TNTS) decompression of craniopharyngioma.
The Study of the Correlation between the Surgeon and the Patient Perspective in the Outcome Analysis of Patients Undergoing Liposuction and Excision for Gynaecomastia
Authors: Sreelesh L. S. , Ajayakumar K. , Anu A. K.
Published: February 2024

Background:

Most patients with gynaecomastia seek surgical treatment because it causes embarrassment as well as anxiety for them. Hence, apart from cosmesis, mental satisfaction also plays an important role in the surgical treatment of gynaecomastia. This study was aimed at evaluating the outcome of gynaecomastia treated by liposuction and excision.

Materials Methods:

A retrospective analysis of patients who underwent liposuction and excision for gynaecomastia was done. Cosmetic results were assessed at least 6 months after the surgery and included factors like breast size, breast symmetry, the shape of the Nipple areolar Complex (NAC), symmetry of NAC and quality and visibility of scars. For each of these factors, a score from 1 to 10 was given by the patient as well as the surgeon.

Results:

Out of 58 patients included in this study, the overall mean patient score and surgeon score were 42.53 and 42.74, respectively. Grade I patients were having the best final aesthetic result (score = 44.28) and Grade III patients were having the least score (37.66) There was a good correlation between patients’ scores and surgeons’ scores on the symmetry of breasts, size of the breast and shape of the nipple-areolar complex. The mean value for overall satisfaction was 9.15. The overall complication rate was 17.2%.

Conclusions:

Gynaecomastia patients treated with liposuction and excision were having very good results in terms of aesthetic outcomes. There was a good correlation between patients’ perspectives and surgeons’ perspectives on the symmetry of breasts, size of breasts and shape of the nipple-areolar complexes. They also had good overall satisfaction and confidence levels.
Internal Hernia with Volvulus – A Rare Cause of Recurrent Abdominal Pain after Frey’s Procedure
Authors: Sreesanth Kelu Sreedharan , Kambrath Prathapan Valiya
Published: February 2024

Acquired internal hernia can be a rare cause of abdominal pain after Frey’s procedure for chronic pancreatitis. The presentation and imaging findings can be non-specific and there should be a high index of suspicion in dealing with these patients. The delay in diagnosis can be catastrophic in some cases, as the bowel can undergo volvulus and gangrene. Prompt surgical treatment is the key to avoid major morbidity and mortality.
Atypical Clinical Presentation and Late Diagnosis: A Retrospective Study of Uncomplicated and Complicated Appendicitis in Paediatric Age Groups
Authors: Seviar Prince , Joseph John , Kurian Nisha , John Atul , Kuriakose Albin
Published: February 2024

Introduction:

Children tend to have a higher rate of appendicular perforation compared to adults. In small children and the elderly, the diagnostic accuracy is low, and the perforation rate is high. Children with appendicitis are brought late to the hospital compared to adults, leading to delays in the diagnosis and treatment, thereby increasing the risk of complicated appendicitis.

Objective:

The objective of this study was to delineate the atypical presentations of appendicitis across the different paediatric age groups treated in a tertiary care center and to compare the disease course and outcomes of complicated appendicitis in atypical and typical presentations.

Study Design:

This was a retrospective study of 273 children who developed appendicitis and underwent treatment for the same in a tertiary hospital between June 2011 and May 2019.

Results:

Children who presented with loose stools and dysuria in addition to abdominal pain, fever and vomiting were grouped under the atypical category. The appendix was perforated more in the atypical group (67.6%) compared to the typical group (29.2%) found during surgery (P < 0.001). Similarly, the atypical group had a higher number of mass (37.8%) (P < 0.001) and abscess formation (40.5%) (P = 0.004) compared to the typical group. Children with atypical presentation in the age group of <6 years (87.5% as against 39.3%; P = 0.041) and 6–11 years (68.2% as against 31.6%, P = 0.002) when compared to older paediatric age group had significantly more complications.

Conclusion:

Diagnosis of appendicitis in preschoolers and young children is a difficult task due to uncommon or atypical presentations. Misdiagnosis or delay in diagnosis and treatment in atypical cases of appendicitis in children have an increased risk of presenting with complications.
Classical Heidelberg Pancreaticojejunostomy in Bifid Pancreatic Duct after Pancreatoduodenectomy
Authors: Sreesanth Kelu Sreedharan , Kambrath Prathapan Valiya
Published: February 2024

Bifid pancreatic duct (BPD) is a rare embryological abnormality of the pancreatic ductal system, in which there is duplication of the main pancreatic duct. During pancreatoduodenectomy (PD), these ductal variations can make pancreaticojejunostomy difficult and are associated with an increased risk of postoperative pancreatic fistula. Here, we present a case of BPD identified during PD, which was managed by classical Heidelberg pancreaticojejunostomy without any complications.
Efficacy of Topical Oxygen Therapy as an Adjuvant to Conventional Dressing in Wound Healing – A Randomised Controlled Study
Authors: Jarande Omkar , Dumbre Ramesh , Fernandes Arun , Phalgune Deepak Sadashiv
Published: February 2024

Background:

The prevalence of lower limb ulcers is common in India and there is a dearth of research work regarding the use of topical oxygen therapy (TOT) in wound healing. The present research aimed to compare the efficacy of wound healing in lower limb ulcers with and without TOT as an adjuvant to conventional dressing.

Materials and Methods:

This randomised controlled study was conducted in patients aged between 18 and 65 years with diabetic foot ulcers, ulcers secondary to peripheral arterial disease, ulcers due to chronic venous insufficiency, pressure sores and traumatic ulcers. Post-debridement patients were randomised into two groups of 35 patients each. Group A and Group B patients received TOT along with normal saline dressing and only normal saline dressings, respectively.

Results:

The median surface area of the wound on post-debridement day, day 3, day 7, 1 week after discharge and 1-month post-operatively was significantly lower in Group A as compared to Group B. The percentage reduction in surface area of the wound at 1-month post-operative follow-up was significantly higher in Group A as compared to Group B. Significantly higher proportion of cases in Group A had relatively better ulcer bed score (scores 0 or 1) at day 7 and 1-month post-operative follow-up as compared to Group B. The median amount of exudate on post-debridement day, day 3, day 7 and 1 week after discharge was significantly lower in Group A as compared to Group B.

Conclusions:

TOT can be used to improve wound healing in lower limb ulcers.
Assessment of Felt Needs Regarding Reproductive Health among Adolescent Girls in Schools Located in Urban Area
Authors: Baviskar Rupali Narendra , Abhivant Niteen Naganath , Parande Malangori Abdulgani , Tambe Muralidhar Parshuram , Mule Namrata Dinkar , Hatanpure Minal Bhimrao , Salunke Priyanka Hemant , Jagadale Ganesh Rajndra , Chavhan Pawan Namdeorao
Published: February 2024

ABSTRACT

Introduction:

Among adolescents, girls are more vulnerable than boys1. To promote these girls and for progress on all grounds, it has become very important to find out their problems and their felt needs.

Aim:

To assess the felt needs of adolescent girls of secondary schools in urban areas regarding reproductive health.

Objectives:

1) To assess the felt needs of adolescent girls regarding reproductive health.

Materials and Methods:

This is a cross-sectional study conducted over 6 months of period among 9th-class girls of 2 municipal secondary schools located in urban area. The sample size was calculated to be 139.

Result:

Felt need of a maximum (82%) of participants was that education about reproductive health should be provided to adolescent girls by a female doctor in school followed by (41%) confidential health check-up of girls regarding reproductive health issues.

Conclusion:

Present study reveals that the Primary felt needs of 9th-class girls in municipal schools of urban area is reproductive health education by a female doctor in school followed by confidential health check-ups for reproductive health issues.
Concomitant Carbapenem and Colistin Resistance among Escherichia coli and Klebsiella pneumoniae Isolates from Patients Visiting a Hospital in Haryana, India
Authors: Devi Leimapokpam Sumitra , Sardar Moumita , Sharma Mukesh
Published: February 2024

ABSTRACT

Background:

Increasing prevalence of carbapenem resistance among Enterobacterales, particularly Escherichia coli and Klebsiella pneumoniae, poses a serious public health threat globally. Furthermore, these bacteria exhibit multidrug resistance, making treatment of infections caused by them challenging. Colistin is one of the antibiotics used in the treatment of infections caused by carbapenem resistant Enterobacterales; however, its unrestricted usage has resulted in the emergence of colistin resistant strains. The present study was conducted to determine the prevalence of carbapenem resistance and co-resistance to carbapenem and colistin resistance among E. coli and K. pneumoniae isolated from various clinical specimens from patients attending various departments of a multispecialty teaching hospital in Haryana, India.

Methods:

A total of 597 isolates comprising 425 E. coli and 172 K. pneumoniae isolated between March 2019 to November 2021 were included in the study. The isolates were subjected to screening for the detection of carbapenemase production using carbapenem discs and a phenotypic test, that is, the CarbaNP test. Antibiogram of the carbapenem-resistant isolates was further analyzed by the Kirby–Bauer disc diffusion method and to evaluate colistin resistance, isolates were subjected to colistin broth disc elution test.

Results:

The prevalence of carbapenemase production among the E. coli and K. pneumoniae isolates by the screening test were detected to be 98/425 (23.1%) for E. coli and 90/172 (52.3%) for K. pneumoniae, whereas the CarbaNP test confirmed 93/425 (21.9%) and 84/172 (48.8%) of the two categories of bacterial isolates, thus showing a false positivity rate of 2.6% (n = 11) by screening test for the detection of carbapenemase production. Among the bacterial isolates, 3 (1.7%) comprising 1 (1.1%) E. coli and 2 (2.6%) K. pneumoniae were found to be dual carbapenem- and colistin-resistant strains. K. pneumoniae isolates showed higher resistance rates to non-carbapenem antibiotics compared to E. coli isolates.

Conclusions:

The emergence of bacteria with concurrent resistance to carbapenems and colistin is a serious concern as they are the last-resort drugs against multidrug-resistant and extensively drug-resistant bacteria.
Evaluation of Static and Dynamic Plantar Pressure Distribution along with Other Musculoskeletal Parameters in Athletes with and without Medial Tibial Stress Syndrome
Authors: Chaudhary Sarika , Chauhan Bhanukiran R.
Published: February 2024

ABSTRACT

Background:

Medial tibial stress syndrome is one of the most common overuse injuries in all running-related activities. Despite the high prevalence, various controversy exist in the literature regarding the risk factors for MTSS.

Purpose:

The main purpose of the present study was to evaluate and compare the risk factors for MTSS such as passive ankle range of motion, static and dynamic plantar pressure distribution, navicular drop, hip flexors, and hamstring flexibility as well as the foot posture between the athletes with MTSS and normal athletes.

Materials and Methods:

Fourty-eight participants after detailed assessment were recruited in the present study and were divided into two groups, Group A (subjects with MTSS) and Group B (subjects without MTSS). They all went through a musculoskeletal examination for quantifying the navicular drop, foot posture, hamstring and hip flexor’s flexibility, ankle plantarflexion and dorsiflexion range of motion. Plantar pressure analysis was used to quantify plantar pressure while standing and running.

Results:

Independent t-test was used. Subjects with MTSS demonstrated deficit in hamstring flexibility (P = 0.0006), dorsiflexion range of motion (P = 0.0039), a greater navicular drop (P < 0.0001), and a more pronated foot posture (P = 0.0245) when compared with the normal athletes. MTSS subjects also showed more total force and pressure under the forefoot region in both static and dynamic measurement of plantar pressure.

Conclusion:

The findings demonstrated that MTSS is multifactorial syndrome with passive ankle range of motion, foot posture and navicular drop, plantar pressure distributions, as well as flexibility playing a major role.
Sebaceous Gland Carcinoma of the Eyelid Presenting as Metastasis to the Parotid Gland: A Rare Occurrence
Authors: Gupte Prajakta , Khatib Yasmeen , Shah Nikita , Khare Manisha S.
Published: February 2024

ABSTRACT

Sebaceous carcinoma of the eyelid frequently presents with metastatic disease involving regional lymph nodes. However, metastasis to parotid gland is very rare and can be mistaken for a primary parotid gland tumor. We present a case of a 53-year-old female who presented with right parotid swelling. MRI of the head and neck with contrast was suggestive of a pleomorphic adenoma. She was operated on for sebaceous carcinoma of the eyelid four years back. Characteristic cytological findings of a mixture of high-grade malignant cells with vacuolated cells along with clinical correlation were helpful in the diagnosis of this tumor following which the patient underwent parotidectomy.
Fast Pace Sun Salutations (FPSS) Yoga Postures Influence Brain waves Activity in Addition to Heart Rate Variability Pattern: A Pilot Study
Authors: Malhotra Varun , Javed Danish , Bharshankar Rajay , Porter Patrick K.
Published: February 2024

ABSTRACT

Background:

Sun salutation (Surya namaskar) is an ancient yogic exercise, which is a combination of 12 different postures rhythmically. Yoga practitioners perform this procedure in a slow as well as fast pace manner.

Aim:

We undertook this study to find out the immediate changes in heart rate variability (HRV) and brain waves spectrum after the practice of fast pace sun salutation (FPSS).

Settings and Design:

This prospective interventional observational study was conducted on 30 male healthy subjects in the 30–45 years age group from September 2021 to December 2021 after approval from the Institutional Ethics Committee. Participants gave their written consent in the prescribed format.

Materials and Methods:

Fourteen rounds of FPSS were performed in approximately 10 min under the guidance of a yoga expert. Brain Tap Dinamika Machine (Advanced HRV Test System, Moscow, Russia) was used to assess different HRV and brain waves parameters before and after FPSS.

Statistical Analysis Used:

Statistical analysis was done by Student’s paired t-test using GraphPad online software.

Results:

All independent variables of time and frequency domain analysis of HRV were found to be increased after the intervention. A significant upsurge in low frequency (LF)% as compared to high frequency (HF)% and very low frequency (VLF)% showed a relative increase in sympathetic activity. In brain waves, delta, theta, and alpha were decreased, whereas activities of beta and gamma waves were found to be increased.

Conclusions:

Increase in both LF and HF components showed that both sympathetic and parasympathetic components have increased. Brain wave analysis suggested increased mental alertness after FPSS.
Leiomyoma with Isolated Foam Cell Vasculopathy: A Case Report
Authors: Singh Brij M. K. , Singh Varun K. , Guruvare Shyamala
Published: February 2024

ABSTRACT

Foam cell vasculopathy is an obliterating type of vasculitis characterized by fibrinoid necrosis, sub-intimal foam cell deposition, vessel wall hyalinosis, and lymphocytic infiltrate. Isolated intra-tumoral foam cell vasculitis is rare and similar changes have been reported in a leiomyoma attributed to treatment with tranexamic acid and gonadotropin-releasing hormone (GnRH) analogs. A 68-year-old hypertensive and diabetic female (P2L2) presented with vaginal spotting and vague abdominal pain. An ultrasound abdomen showed an anterior wall fibroid measuring 5 × 4 cm. She underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. Microscopic sections from the leiomyoma showed multiple foci of obliterating vasculitis, along with fibrinoid necrosis, sub-intimal foam cell deposition, and hyalinosis. There was no involvement of the endometrium, cervix, or ovaries. There were no pulmonary, skin, or renal lesions, or history of systemic vasculitis, and treatment by tranexamic acid or GnRH analogs. This prompted a diagnosis of idiopathic intra-tumoral foam cell vasculitis. This finding has been documented previously in three instances, namely, within a renal angiomyolipoma, cerebral Hodgkin’s lymphoma, and a gastrointestinal stromal tumor; the present case provides the first-ever documentation of isolated intra-tumoral acute atherosis-like/foam cell vasculopathy in leiomyoma.
A Study of Psychiatric Co-morbidities, Anxiety, Depression and Quality of Life in Patients of Chronic Obstructive Pulmonary Disease
Authors: Singh Pawel , Chaudhari Bhushan , Chaudhury Suprakash , Saldanha Daniel , Prakash Jyoti , Verma Pankaj K.
Published: February 2024

ABSTRACT

Aim:

To study psychiatric co-morbidities, anxiety, depression, and quality of life in patients of chronic obstructive pulmonary disease (COPD).

Materials and Methods:

A cross-sectional, case-control study was conducted on 122 cases of COPD and equal number of age- and sex-matched controls in a tertiary care hospital. They were assessed with the Mini-International Neuropsychiatric Interview (MINI), depression, anxiety stress scale-42 (DASS-42), St. George Respiratory Questionnaire (SGRQ), and COPD Assessment Test (CAT).

Results:

COPD patients and control subjects were matched with respect to age, sex, education, employment, domicile, and socioeconomic status. Psychiatric disorders were diagnosed in 56% of cases and 14% of controls. Major depressive disorder, alcohol dependence, and anxiety disorders were the most common psychiatric diagnoses. There was significantly higher prevalence of smoking in cases with COPD compared to control subjects suicidality was present in two patients. The mean scores on depression, anxiety, and stress on DASS-42 of COPD patients were significantly higher than normal controls. On the CAT majority of the COPD patients belonged to the high-impact group followed by the very high-impact group. Mean scores on the SGRQ were in the range expected in COPD patients. A multiple regression analysis revealed that significant predictors of SGRQ scores were age, gender, economic status, domicile, alcohol habits, depression, anxiety, and stress.

Conclusion:

COPD patients have a significantly higher prevalence of psychiatric co-morbidities compared to healthy controls. Common psychiatric disorders were major depression, alcohol dependence, and anxiety disorders along with smoking.
Interleukin-35 as a New Biomarker for SARS-CoV-2 in Iraqi Patients
Authors: AL-Khikani Falah Hasan Obayes , Alkhafaji Zaytoon Abdulridha
Published: February 2024

ABSTRACT

Background:

Interleukin-35 (IL-35) is a newly discovered heterodimeric cytokine that belongs to the IL-12 family. It works as an inhibitory cytokine in the immune system, modulating malfunctioning T cells and regulating various immune-related inflammatory factors. As a result, the control of IL-35 may be critical to manage a cytokine storm that occurs in COVID-19 patients.

Materials and Methods:

A total of 125 severe COVID-19 patients, including 56 (44.8%) males and 69 (55.2%) females, were enrolled in this study as well as 60 persons involved as a control group. Between February 2022 and July 2022, these patients were admitted to Marjan medical city and Al-Sadeq hospital. Patients were classified as severe cases according to the guidelines released by National Health World depending on SpO2 percentage. The inflammatory cytokine (IL-35) was measured using the ELISA technique.

Results:

IL-35 showed statically significant differences between patients 6.86 ± 2.31 (pg/ml) and control group 3.86 ± 2.07 (pg/ml) (p < 0.0001). IL-35 revealed a significant positive strong correlation with glucose level in patients with COVID-19 (r = 0.0241; P = 0.007). as Also, a positive significant correlation observed between IL-35 and creatinine (r = 0.182; P = 0.043). Correlations between IL-35 and each gender, age, death status, SpO2, and computed tomography (CT) scan were nonsignificant (p > 0.05). Age group 62–74 years showed more IL-35 titer (8.40 pg/ml) than other groups followed by the age group 16–61 years (6.78 pg/ml) with significant differences (p = 0.004).

Conclusion:

This study further confirms the growing evidence on the direct role of regulatory or anti-inflammatory cytokines in the development and controlling COVID-19. IL-35 revealed a positive significant correlation with creatinine (r = 0.182; P = 0.043) that may reflect the impact of IL-35 level on the kidney function test distributions such as acute kidney injury.
An Unusual Dual Coinfection of Dengue Fever and COVID-19 in India
Authors: Chaturvedi Ayesha , Meshram Shailesh B. , Ashwin Ramesh CB
Published: February 2024

ABSTRACT

Rationale—Our article reaffirms challenges associated with diagnosing COVID-19 in areas hyperendemic for tropical infections with overlapping presentations such as dengue. Patient Concerns—A 47-year-old male healthcare provider, previously diagnosed with COVID-19 infection five months prior, presented with fever, dry cough, and generalized weakness for three days. He had completed vaccination for COVID-19 two weeks prior to his illness and was on medications for diabetes and hypertension. Additionally, he had a history of COVID infection which followed a mild course five months prior to the current symptoms. Diagnosis—Investigations revealed a positive test on COVID-19 real-time polymerase chain reaction (RTPCR) as well as for dengue NS1 antigen, while his anti–severe acute respiratory syndrome (SARS) IgG antibodies were measured at 38 × 103 AU/ml (Normal—<12.0). Outcome—The patient was treated with supportive therapy and monitored with daily platelet counts which normalized on the fifth day of treatment. Thus, the known potential for repeat dengue infections and the possibility for repeat SARS-CoV-2 infections add further complications and must be incorporated into triage and hospital protocols.
Nutritional Status of HIV-Positive Children (2–15-Year Age Group) in Western Maharashtra, India – A Cross-Sectional Study
Authors: Pushkar Kumar , Hiremath Ravishekar N. , Gupta Rajul K.
Published: February 2024

ABSTRACT

Background:

Children with HIV disease require frequent growth monitoring. It also acts as proxy indicator to assess the HIV disease progression and antiretroviral therapy efficacy in children.

Objective:

We conducted this study to assess the Nutritional status of HIV positive children and have a valuable baseline data of HIV-positive children living in western Maharashtra.

Methodology:

A cross-sectional epidemiological study was carried out in Western Maharashtra, India on HIV-positive children attending the Pediatric HIV OPD of multispecialty hospital in an urban setting in a specified time period. Data was collected from 106 children by means of pretested questionnaire’s along with clinical examination and anthropometric measurements. Institutional Ethical clearance was taken, and data was collected after taking informed consent of the parent/guardian accompanying the child.

Results:

48 (45.3%) were females and 58 (54.7%) were males. The mean height in all age groups is lower than their respective WHO standards except in age group 3–5 years. 64.2% showed various degree of stunting, more than a third (37.7%) being severely stunted. The prevalence of underweight among boys (84.5%) was more compared with girls (54.2%). This relation was statistically significant (P < 0.05). The prevalence of wasting among boys (60.3%) was apparently more compared with girls (47.9%) and this relation was not statistically significant (P > 0.05). Mid upper arm circumference of subjects in all age groups was lower than respective WHO standard. The prevalence of malnourishment was increasing as age of subjects was increasing across all age groups and this trend was statistically significant (P < 0.05).

Conclusion:

Overall prevalence of underweight was high. As age was increasing, underweight percentage was also increasing which proves that HIV/AIDS and opportunistic infection is taking it toll on growth of the children. Overall prevalence of wasting (acute malnutrition) was 54.7% and prevalence of overall stunting was 64.2%. Since the causes of malnutrition are complex and multiple, this study could highlight some of these factors. It has proved to be a valuable baseline data of the current nutritional status of HIV-positive children, and thus, dietary supplementation and nutritional education are need of the hour at all levels.
An Unusual Presentation of Paranasal Sinus Mucormycosis
Authors: Bhat Vadisha S. , Sinha Devika , Kamath P Shrinath D. , Bhat Shubha P. , Saldanha Marina , Ravikumar Aishwarya
Published: February 2024

ABSTRACT

Mucormycosis is an opportunistic infection caused by saprophytic fungi of the order Mucorales. This infection is seen mainly in immunocompromised people with diabetes but can be seen rarely in immunocompetent hosts. Recently, this disease is frequently seen in many patients who had suffered from COVID-19. Among the different sites of mucormycosis, rhinocerebral mucormycosis is the most prevalent form, followed by cutaneous. Surgical debridement followed by antifungal therapy with amphotericin B and the control of the immunocompromised state is the recommended treatment. This case is an unusual presentation of mucormycosis involving the maxillary sinus and the cheek, presented without any nasal symptoms.
An Unusual Presentation of Anti Pm/Scl Antibody-positive Idiopathic Inflammatory Myositis
Authors: Mamidi Sreenivasu , Soni Rahul , Ponnada Chandra Sekhar
Published: February 2024

ABSTRACT

Idiopathic inflammatory myopathies are the heterogeneous group of diseases that affect multiple systems apart from the skeletal muscles, preferentially affecting the proximal skeletal muscle. We present a rare case with quadriparesis, purely involvement of proximal muscles without any extra muscular symptoms with positive Anti Pm/Scl antibodies. Our patients was 52 year old male who presented to be symptomatic with generalized swelling all over the body followed by progressive pure proximal group of muscles motor weakness of all four limbs without sensory involvement. He also developed oropharyngeal weakness, in the form of nasal regurgitation of food and significant weight loss. C reactive protein was 22 mg/L, erthryocyte sedimentation rate was 30 mm after 1 h, and liver enzymes were also increased (aminotransferase was 236 U/L and alanine aminotransferase was 145 U/L). His lactate dehydrogenase was 1175 U/L whereas creatinine kinase was 3290 U/L. His ANA profile was positive for Anti Pm/ Scl antibodies. MRI of both thighs was suggestive of diffuse inflammatory changes in both lower limbs and pelvic girdle and PET CT was suggestive of increased uptake in proximal limb muscles. He was managed with pulse Inj Methylprednisolone and intravenous Immunoglobulin. This followed by oral prednisolone for a few months than slow tapering. In Conclusion that Anti Pm/Scl antibody positive idiopathic inflammatory myositis can also present atypically without any other systemic manifestation and weakness in lower limb more than upper limbs. Idiopathic inflammatory myopathies disease is one of the treatable diseases that repones to immunomodulation therapy.
A Case of Toxic Optic Neuropathy
Authors: Sharma Aakriti , Raghunath Apeksha , Apte Parag
Published: February 2024

ABSTRACT

A 28-year-old male arrived in our Ophthalmology Out patient department (OPD) with a chief complaint of bilateral sudden loss of vision in both his eyes of three days’ duration and a history of consumption of 90 mL of alcohol five days prior to the onset of symptoms. An ophthalmic examination revealed no perception of light in both eyes. Both pupils were dilated and sluggishly reacting to light. His fundus examination showed bilateral, hyperemic, and edematous discs. The veins around the disc were mildly dilated and tortuous. Magnetic resonance imaging (MRI) brain showed symmetrical hyperintensities and hemorrhages in bilateral gangliocapsular regions and signal abnormalities areas in bilateral cerebellar hemispheres, posterior part of cerebellar vermis, bilateral cingulate gyrus showing diffusion restriction which was suggestive of toxic encephalopathy and toxic neuropathy. Fundus fluorescein angiography was also done for the patient, which showed optic disc staining in the late phase suggestive of optic neuropathy. His vision improved to 20/200 in both eyes with treatment after two months.
Surgical Management and Functional Outcome of Acetabular Fractures – A Prospective Study
Authors: Sahu Santosh K. , Reddy Srujan , Nayak Satya Prasanna , Kar Dattatreya
Published: February 2024

Context:

Acetabulum fractures are commonly a result of high-velocity road traffic accidents and falls from height. These fractures were previously treated nonoperatively which had led to high morbidity causing secondary osteoarthritis, limping, instability, and chronic pain.

Aims:

To surgically manage the functional outcome of acetabular fractures.

Settings and Design:

The prospective study involves 28 patients of a tertiary care hospital at Bhubaneswar, for analysis of functional and radiological outcomes of surgical management of acetabular fractures.

Subjects and Methods:

Patients are chosen from emergency and outpatient on the criteria of age group 18–65 years, pelvi-acetabular fractures of 2-mm displacement, more than 3-week-old fracture, with or without hip dislocation. Inflammatory arthritis and pathological fractures patients were excluded. Surgery time was 173 min with a minimum of 110 min and a maximum of 240 min.

Statistical Analysis Used:

All the data were analyzed using SPSS 20 software.

Results:

Twelve patients had excellent (42%), seven patients had well (25%), seven patients had fair (25%), and two patients had poor (8%) functional outcomes. Two patients had restricted range of movement and pain on walking and had undergone total hip replacement after 1 year. The mean score in the anatomically reduced fracture is 16.4, imperfectly reduced is 14.4, and poorly reduced is 8. The average functional outcome score was 14.2 (range – 5–18).

Conclusions:

As the articular surface requires smooth congruity, anatomical fixation of fracture fragments is essential for early mobilization and better functional outcomes. Proper preoperative planning, anatomical reduction, adequate fixation, and early mobilization are required to achieve good functional outcomes in acetabular fractures.
A Huge Maxillary Sinus Antrolith Causing Persistent Nasal Obstruction: A Rare Presentation
Authors: Shu’aibu Lawal , Usman Asma’u , Abdullahi Naimatu A. T.
Published: February 2024

Maxillary antrolith is a rare condition often seen in the maxillary sinus, with its presentation and treatment depending on its size. It is often an incidental, uncommon, and asymptomatic finding seen on radiographs. Thus, we present a rare case of huge maxillary antrolith presenting with persistent nasal obstruction and an infra-orbital fistula.
Molecular diagnosis of echinococcosis in patients based on frozen paraffin tissue samples and fixed formalin and hydatid cysts isolated from livestock in a slaughterhouse
Authors: Rahpima Behjat , Dabirzadeh Mansour
Published: February 2024

Background:

Various genotypes of Echinococcus granulosus have been studied in high-disease-risk areas and identified as causative agents of cystic echinococcosis (CE). This study was performed to examine and identify the molecular hydatid cyst in the dissected human specimens in paraffin tissue, and the dissected animal cyst was characterized using the DNA polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP) of internal transcribed spacer 1 (ITS1).

Materials and Methods:

To determine the molecular properties of E. granulosus, 20 hydatid cyst samples (including 6 sheep samples, 9 camel samples, and 10 human paraffin samples) were collected from Zahedan and Zabol cities. After DNA extraction, molecular PCR was performed, and RFLP was evaluated. In this study, the Taq1 endonuclease cleavage enzyme was used.

Results:

The patterns of DNA bands found in the isolates from human CE and animal bladder cysts were the same, as indicated by the results of ribosomal DNA-ITS1 amplification from E. granulosus. Two nested primer pairs were used. The rough size of the enhanced ITS1 piece was 444 and 391 base pairs (bp), individually. After cutting the PCR product with the Taq1 enzyme, the patterns of the fragments revealed that the samples had two identical RFLP patterns. The aftereffects of this study showed that the parasite genotypes confined to sheep, camels, and people had hereditary changes.

Conclusion:

The transcendent type of E. granulosus sensu lato in the area is E. granulosus sensu stricto, which featured the meaning of the sheep/canine cycle in human transmission. Albeit the band profile in the camel is now and again like the sheep strain, RLFP can be recognized utilizing the PCR strategy, and two differentiating band profiles using the chemical were found in this review.
Prevalence of polymorphisms in marker genes associated with antimalarial drug resistance in Plasmodium falciparum following 10 years of artemisinin-based combination therapy implementation in urban Kolkata
Authors: Acharya Alisha , Naskar Arindam , Chaudhury Abhijit , Sardar Ashif Ali , Samanta Anwesha , Guha Subhasish Kamal , Maji Ardhendu Kumar , Bera Dilip Kumar , Saha Pabitra
Published: February 2024

Context:

Resistance to antimalarial drugs is one of the major challenges for malaria elimination. In India, artemisinin combination therapy (artesunate-sulfadoxin pyrimethamine) was introduced in place of chloroquine (CQ) for the treatment of uncomplicated falciparum malaria in 2010. Periodical monitoring of polymorphisms in antimalarial drug resistance marker genes will be useful for assessing drug pressure, mapping and monitoring of drug resistance status; and will be helpful for searching alternative treatments.

Objectives:

This study was conducted to study the polymorphisms in antimalarial drug resistance marker genes among clinicalPlasmodium falciparumisolates collected from Kolkata after 10 years of artemisinin-based combination therapie (ACT) implementation.

Materials and Methods:

Blood samples were collected fromP. falciparummono-infected patients and polymorphisms inP. falciparumCQ resistance transporter(pfcrt),P. falciparummultidrug resistance(pfmdr-1),P. falciparumdihydrofolate reductase(pfdhfr),P. falciparumdihydropteroate synthetase(pfdhps),pfATPase6andpfK-13propeller genes were analysed by polymerase chain reaction and DNA sequencing.

Results:

Inpfcrtgene, C72S, and K76T mutation was recorded in 100% isolates and no mutations was detected in any of the targeted codons ofpfmdr-1gene. A double mutantpfcrthaplotype SVMNT and wildtype haplotype NYD inpfmdr-1were prevalent in 100% of study isolates. Triple mutantpfdhfr-pfdhpshaplotype ANRNI-SGKAA was recorded. No polymorphism inpfK13gene was documented in any of the isolates.

Conclusions:

Observed wild codon N86 along with Y184 and D1246 ofpfmdr-1gene might be an indication of the reappearance of CQ sensitivity. The absence of quadruple and quintuple haplotypes inpfdhfr-pfdhpsgene along with the wild haplotype of pfK13 is evidence of ACT effectivity. Hence, similar studies with large sample size are highly suggested for monitoring the drug resistance status ofP. falciparum.
An uncommon case of a fleeting rash from Western Rajasthan
Authors: Jalootharia Garima , Sivakumar Haripriya , Soni Bhavesh , Tak Vibhor , Agrawal Himanshu , Gonnade Nitesh Manohar , Gaur Ravi , Kumar Deepak
Published: February 2024

A 35 year old farmer presented with an erythematous serpiginous rash on dorsal aspect of left foot with intense pruritus and a feeling of something moving slowly in the rash. The photo of the rash is presented below and the case is discussed further.
Artificial intelligence in parasitic disease control: A paradigm shift in health care
Authors: Parija Subhash Chandra , Poddar Abhijit
Published: February 2024

Parasitic diseases, including malaria, leishmaniasis, and trypanosomiasis, continue to plague populations worldwide, particularly in resource-limited settings and disproportionately affecting vulnerable populations. It has limited the use of conventional health-care delivery and disease control approaches and necessitated exploring innovative strategies. In this direction, artificial intelligence (AI) has emerged as a transformative tool with immense promise in parasitic disease control, offering the potential for enhanced diagnostics, precision drug discovery, predictive modeling, and personalized treatment. Predictive AI algorithms have assisted in understanding parasite transmission patterns and outbreaks by analyzing vast amounts of epidemiological data, environmental factors, and population demographics. This has strengthened public health interventions, resource allocation, and outbreak preparedness strategies, enabling proactive measures to mitigate disease spread. In diagnostics, AI-enabled accurate and rapid identification of parasites by analyzing microscopic images. This capability is particularly valuable in remote regions with limited access to diagnostic facilities. AI-driven computational methods have also assisted in drug discovery for parasitic diseases by identifying novel drug targets and predicting the efficacy and safety of potential drug candidates. This approach has streamlined drug development, leading to more effective and targeted therapies. This article reviews these current developments and their transformative impacts on the health-care sector. It also assessed the hurdles that require attention before these transformations can be realized in real-life scenarios.
Quantum integrable systems and concentration of plasmon resonance
Authors: Ammari Habib , Chow Yat Tin , Liu Hongyu , Sunkula Mahesh
Published: February 2024

We are concerned with the quantitative mathematical understanding of surface plasmon resonance (SPR) when

d \geq 3

. SPR is the resonant oscillation of conducting electrons at the interface between negative and positive permittivity materials and forms the basis of many cutting-edge applications of metamaterials. It has recently been found that the SPR concentrates due to a curvature effect. In this paper, we derive sharper and more explicit characterizations of the SPR concentration at high-curvature places in both static and quasi-static regimes. The study boils down to analyzing the geometry of the so-called Neumann–Poincaré (NP) operators, which are certain pseudodifferential operators acting on the interfacial boundary. We propose to study the joint Hamiltonian flow of an integrable system given by the moment map defined by the NP operator. Via considering the Heisenberg picture and lifting the joint flow to a joint wave propagator, we establish a more general version of quantum ergodicity on each leaf of the foliation of this integrable system, which can then be used to establish the desired SPR concentration results. The mathematical framework developed in this paper leverages the Heisenberg picture of quantization and extends some results on quantum integrable systems via generalizing the concept of quantum ergodicity, which can be of independent interest in spectral theory and potential theory.
Isolation of Endophytic Fungi from Rui (Harrisonia perforata (Blanco) Merr.) and Determining Their Antibacterial, Antioxidant, and Cytotoxic Activity
Authors: Anam Syariful , Syamsidi Armini , Tunreng Muh. Fadil Usman , Djaleha Helena Fransisca , Arisca Windhy Nur , Syaputra Gunawan , Iklima  , Indriani Meri Feki , Widodo Agustinus , Pratiwi Ritha , Yuliet  , Razak Abd. Rahman
Published: February 2024

Endophytic fungi produce bioactive metabolites that exhibit antibacterial, antioxidant, and anti-cancer activity. Rui (Harrisonia perforata (Blanco) Merr.) is a traditional medicinal plant proven to be an antibacterial and anticancer. Endophytic fungi live in plant tissues without damaging or producing chemicals that infect the host cell. Endophytes produce the same and similar compound as an original plant. This study aimed to isolate the endophytic fungi from Rui and determine their antibacterial, antioxidant, and cytotoxic activity. 13 fungal isolates were successfully isolated using PDA for seven days at 30°C. Molecular identification using the ITS1 and ITS4 DNA sequences only revealed six species: Diaporthe sp., Phomopsis sp., Aspergillus tubingensis, Aspergillus viridinutans, Pseudofusicoccum sp., and Daldinia eschscholtz. Seven isolates showed antibacterial activity based on plate assay. Aspergillus tubingensis and RA-1 exhibited antibacterial activity against Staphylococcus aureus and Salmonella typhi, with the MIC and MBC starting from 24 to 32 mg/ml. The DPPH assay showed the most increased antioxidant activity in Daldinia eschscholtzii with an IC50 of 98.14±2.39 µg/ml. The Brine Shrimp Lethality Test (BSLT) showed the highest potential cytotoxic activity, as shown by Aspergillus tubingensis and Phomopsis sp. with LC50 of  7.78±7.48 and 30.83±0.39 µg/ml. In conclusion, our study demonstrates that the fungal extract from Rui could be a source of antibacterial, antioxidant, and cytotoxic agents.