bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of tranexamic acid in reducing blood loss in vaginal delivery
Authors: Kaur Harsimran , Kaur Amrit Pal , Grover Suparna , Jyothi
Published: January 2025

Background: Postpartum hemorrhage (PPH) remains a significant reason for maternal death, especially in developing nations like India, where it accounts for 23% of maternal deaths. This prospective study aimed to assess the effectiveness of tranexamic acid (TXA) in reduction of blood loss during vaginal deliveries.
Methods: This study was conducted at Bebe Nanki mother and child care centre in Amritsar, Punjab. 200 pregnant women were randomly assigned to two groups: Group A received 1g TXA intravenously alongside 10 IU oxytocin intramuscularly, while group B received only oxytocin. The measurement of blood loss was done up to 2 hours post-delivery along with various vital and hemodynamic parameters.
Results: The results showed reduction in blood loss in group A in comparison to Group B which was significant, with mean blood loss of 106.25 mL in group A vs 222.45 mL in group B (p=0.001). Hb and PCV declines were also significantly lower in group A. Fewer patients in group A required additional uterotonics (4%) or blood transfusions (2%) versus group B (26% and 4%, respectively). No significant adverse effects, such as thromboembolic events, were observed in either group. Mild post-delivery nausea and vomiting was seen in both groups, with slightly higher incidence in group A.
Conclusions: TXA combined with oxytocin significantly reduces postpartum blood loss without major side effects, supporting its use as an adjunct therapy in PPH management. Further studies are recommended to validate these findings and promote wider adoption in clinical practice.
Unravelling the risk factors and treatment patterns of dyslipidemia in India (UNICORN study)
Authors: Mayabhate Mayur , Sharma Akhilesh
Published: January 2025

Background: The UNICORN study aims to determine the risk factors and patient demographics for dyslipidemia and assess the efficacy of the prevalent therapies in managing dyslipidemia.
Methods: The UNICORN study employed a retrospective cross-sectional design, analyzing data from 9,998 patient health records retrieved from tertiary care centers across India. Demographic variables, lipid profile parameters, risk factors (smoking status, alcohol consumption and dietary habits) and healthcare-related variables (treatment history of medication, lifestyle interventions and lipid profiles) were extracted from medical records. Descriptive statistics and hypothesis testing were used to assess lipid profiles, comorbidities and treatment impact. Odds ratios and paired t-tests evaluated morbidity risk and treatment efficacy.
Results: Statins were prescribed to 99.19% of the patients. 61.61% of the population did not follow any particular diet. Lipid parameters were better in obese and overweight patients, compared to normal and underweight patients (p<0.001). Patients with hypertension (239.5 vs 223.4 mg/dl), coronary artery disease (240.5 vs 231.4 mg/dl), stroke (230.3 vs 236.3 mg/dl) and peripheral arterial disease (238.1 vs 234.1 mg/dl) showed significantly higher total cholesterol levels. The odds ratio (OR) reported a higher likelihood of newly diagnosed patients developing hypertension (OR=1.76), coronary artery disease (OR=1.65), heart failure (OR=1.76), stroke (OR=1.82) and peripheral arterial disease (OR=1.71).
Conclusions: Statins were used by the majority of the patients and improved the serum lipid levels. However, the improved lipid measures were still indicative of dyslipidemia, with the absence of complete resolution of the condition. Hypertension, coronary artery disease, stroke and peripheral arterial disease are risk factors and frequently associated comorbidities with an unclear causal relationship.
A comparative study of mifepristone with dinoprostone for induction of labor in third trimester
Authors: Sivadas Akshaya , Grover Seema , Kaur Harpreet , Goyal Lajya Devi , Kaur Khushpreet
Published: January 2025

Background: Success of labor induction depends upon favourability of the cervix at the time of induction. Various methods have been tried for labor induction but the search for ideal induction agent continues. There is a paucity of literature regarding the safety and efficacy of Mifepristone as induction agent in live pregnancies. Our aim was to study the efficacy of tablet Mifepristone as a cervical ripening agent and to compare the feto-maternal outcome with Dinoprostone gel.
Methods: A total of 100 patients who required labor induction were enrolled and randomized to receive mifepristone and dinoprostone. 50 patients were given oral tablet Mifepristone 200mg and 50 patients were instilled with intracervical Dinoprostone 0.5mg gel. The outcome was assessed by improvement in bishop’s score, induction delivery interval, requirement of oxytocin, mode of delivery, and feto-maternal complications.
Results: The improvement in mean Bishop’s score after 24hours was more in Mifepristone group (2.78±1.28 to 7.22±2.02) than in Dinoprostone group (2.64±1.29 to 6.70±1.75) (p=0.173). The incidence of vaginal delivery and LSCS were 86% and 14% in Mifepristone group and 72% and 28% in Dinoprostone group, respectively (p=0.227). The requirement of mean dosage of oxytocin was lesser in Mifepristone group (2.26±0.71) as compared to Dinoprostone group (3.29±1.35) (p=0.001). NICU admission was required in 26% neonates in Dinoprostone group and 16% neonates in Mifepristone group (p=0.220).
Conclusions: Mifepristone is a safe and efficient cervical ripening agent with no significant adverse effects to both mother and fetus.
What strategies do cardiologists employ for heart failure management? Insights from Indian clinical practice
Authors: Khobragade Kunal , Kumar Neeraj
Published: January 2025

Background: Heart failure (HF) is a leading cause of morbidity and mortality in India, with ischemic heart disease (IHD) being a primary contributor, particularly in patients with reduced ejection fraction (HFrEF). Despite comprehensive guidelines, a gap exists between guideline-directed medical therapy (GDMT) and real-world practices.
Methods: A cross-sectional survey of 476 cardiologists across India was conducted from April to June 2023 to evaluate current therapeutic approaches for managing HFrEF. The study assessed alignment with established guidelines, including the American college of cardiology/American heart association (ACC/AHA) recommendations.
Results: HFrEF accounted for 40-60% of HF cases, typically diagnosed at advanced stages New York heart association (NYHA class III), with EF often reduced to 20-30%. While 94.5% of cardiologists supported NT-proBNP testing for HF management and 73.5% endorsed ARNi as first-line therapy, ARNi usage remained suboptimal at 20-60%. Most cardiologists (67%) preferred initiating quadruple therapy within 12-24 weeks of diagnosis, citing medication tolerance as a key barrier to achieving optimal treatment goals.
Conclusions: This study highlights substantial gaps in the adoption of guideline-recommended therapies for HFrEF in India. Improved strategies are needed to address barriers to GDMT implementation and ensure timely interventions to enhance patient outcomes.
Psychological determinants and its association with coronary artery disease: a prospective study
Authors: Abdagire Nitinkumar , Patil Sandeep , Dalal Dhaval , Singh Harminder , Ojha Soumya , Gawali Vijaykumar
Published: January 2025

Background: Psychological diseases like depression, anxiety and burnout are major public health problems of concern, as it is affecting both general as well as cardiac health. Therefore, present study aims to screen the patients for psychological determinants and its association with coronary artery disease.
Methods: The study is prospective, questionnaire based, observational study conducted on 166 patients having coronary artery disease based on conventional coronary angiography. Out of 166 participants, 132 were in conventional risk factors Group (comorbid condition group), and 34 in non-conventional risk factors group (without any comorbid condition group). Patients were screened for depression, anxiety and burn out using the patient health questionnaire (PHQ-9), generalised anxiety disorder (GAD-7), burnout self-test questionnaires respectively.
Results: The present study revealed majority of the participants had moderate anxiety, depression, and risk for burnout. Significant positive correlation was found between Syntax score and depression (P<0.05). No statistically significant difference was noted for anxiety, depression, and burnout score between comorbid group having conventional risk factors (patients having diabetes, hypertension and dyslipidaemia) and non-comorbid group with non-conventional risk factors (patients suffering from anxiety, depression and burnout without any comorbid conditions), suggesting major role of anxiety, depression, and burnout for the development of cardiovascular diseases.
Conclusions: Non-conventional risk factors add increased risk for the development of coronary artery disease; therefore, efforts should also be made to assess cardiac patients for psychological determinants and to improve patients psychological and social function.
A comparative study of catheter size effect after direct vision internal urethrotomy for small urethral strictures
Authors: Ajmera Rohit , Saini Piyush Kumar , Sharma Keshav , Pawar Rakesh Ramesh , Yadav Rohit
Published: January 2025

Background: Urethral stricture disease is the most common cause of obstructive voiding symptoms in younger males and has always been a challenge for urologists. Optical urethrotomy (OU) has been considered as the standard therapy for anterior urethral and short segments strictures.
Methods: In our study 164 consecutive treatment naive and recurrent urethral stricture patients who underwent direct vision internal urethrotomy (DVIU) were retrospectively analyzed. 22Fr urethral catheters were placed for longer durations and small calibre catheters (14 or 16Fr) were preferred for shorter dwell times after DVIU. Catheter dwell times were grouped as <7 and ≥7 days.
Results: A total of 164 patients with a mean age of 54.51±11.8 (range: 17 to 85) years were enrolled in the study during the follow-up, 24 (14.6%) patients experienced recurrences during 6 month follow up. The mean postoperative duration of catheterization was 8.47±2.03 and 6.49±1.14 days, in 6 patients with 14/16 Fr and 18 patients with 20 Fr catheter respectively have recurrence with p=0.00802.5 patients with less than 7 days and 19 patients with >7 days had recurrence with p=0.0019.
Conclusions: Urethral stricture disease is disease of high recurrence. Factors responsible for recurrence of disease after treatment like-etiology, length of stricture, duration /size of catheter, open or endoscopic procedure. putting a small diameter catheter and short duration of catheterization help in reducing recurrence.
Evaluation of ultrasound assisted peripheral nerve stimulator guided versus peripheral nerve stimulator guided lumbosacral plexus block for postoperative analgesia in patients undergoing lower limb surgery
Authors: Chatrath Veena , Attri Joginder P. , Bala Anju , Gupta Alisha , Gupta Malika
Published: January 2025

Background: The aim of the present study was to compare the efficacy of ultrasound (USG) assisted peripheral nerve stimulator (PNS) guided versus peripheral nerve stimulator (PNS) guided techniques of lumbosacral plexus block (LSPB) for postoperative analgesia.
Methods: This prospective, randomized, double-blind study was conducted on 60 ASA grade I-II patients of either sex, aged 20-60 years, undergoing unilateral lower limb surgery under spinal anaesthesia. On completion of surgery, group U (30 patients) received LSPB using USG assisted PNS guided technique and group P (30 patients) received LSPB using PNS guided technique, with 0.25% injection levobupivacaine (20 ml) + injection dexamethasone (4 mg) in lumbar plexus block and 0.25% injection levobupivacaine (20 ml) + injection dexamethasone (4 mg) in sacral plexus block.
Results: The mean procedure time of group U was significantly more (15.30±1.98 minutes) than that of group P (11.05±2.13 minutes) (p=0.001). The mean duration of postoperative analgesia was longer in group U (18.00±5.65 hours) as compared to group P (15.80±6.11 hours) (p>0.05). The mean number of doses of rescue analgesia with injection fentanyl in group U was 0.806±0.66 and in group P was 1.066±0.63 (p>0.05).
Conclusions: USG assisted PNS guided LSPB is a better choice as compared to PNS guided technique.
A study to assess the effectiveness of educational training for nurses regarding non-invasive positive pressure ventilation
Authors: Mehna Shanu , Gauba Anu , Chakrabarti Shibdas
Published: January 2025

Background: The use of non-invasive positive pressure ventilation (NIPPV) has significantly increased in the last three decades, becoming an essential, cost-effective tool for managing respiratory failure. The study aimed to evaluate the impact of an educational training program in improving nurses' knowledge and attitude towards non-invasive positive pressure ventilation (NIPPV) therapy.
Methods: A quasi-experimental study with single group pre and post intervention conducted from 01 May 2023 to 30 June 2023 with 42 nurses, working at respiratory unit selected through enumerative sampling technique. The educational program followed the recommendation proposed by NIPPV guidelines and included six hours of theoretical and hands on training sessions. Nurses’ knowledge and attitude were assessed using a questionnaire developed by the researcher. Administrative approval was obtained from the authority and informed consent taken from all the participants.
Results: Study findings reveals that there was substantial improvement in the pre and post training overall knowledge scores of nurses regarding different aspects of NIPPV therapy (15.31±3.28-26.93±1.69, with mean difference 11.62±3.56, 95% CI- 10.51-12.73, t- 21.15 p<0.001 respectively). In terms of attitude, the proportion of participants with positive attitudes increased from 0% pre-training to 100% (p<0.001) post-training.
Conclusions: The educational program has proven to be a valuable asset to the nursing team in the respiratory unit. It has enhanced evidence-based practices and the quality of care, resulting in improved effectiveness, timeliness, and safety. The study findings confirm that the program effectively enriches nurses' knowledge and attitudes.
The interplay between nicotine metabolites and reproductive hormones in women beedi rollers occupationally exposed to tobacco dust
Authors: Racharla Spandhana , Sultana Shehnaz , Reddy P. P.
Published: January 2025

Background: Although beedi-rolling is a convenient, home-based occupation for many women from lower socio-economic backgrounds, the strenuous and time-consuming process exposes beedi-rollers to tobacco dust for prolonged periods. This study aimed to investigate the effects of long-term exposure to tobacco dust on beedi-rollers and to examine the impact of nicotine metabolites on hormonal levels.
Methods: The study included 320 beedi-rollers (BR) and 280 control subjects (NBR). Signed consent forms were collected from all participants before conducting face-to-face interviews and blood collection. Serum was isolated from the blood samples to estimate reproductive hormones and nicotine metabolites using ELISA and LC-MS, respectively.
Results: Significant differences in hormone and nicotine metabolite levels were observed between the BR and NBR groups. The BR group was further divided into two subgroups based on years of service. Anabasine and 4- Methylnitrosamino-1-3- pyridyl-1 butanone (NNK), levels were significantly higher in beedi-rollers with more than 10 years of service. Increased anabasine and Cotinine levels were significantly correlated with reduced reproductive hormone levels.
Conclusions: Long-term exposure to tobacco dust leads to elevated nicotine metabolite levels, which may disrupt hormonal function and levels. Further research with a larger sample size is needed to better understand the impact of nicotine metabolites on the reproductive health of beedi-rollers.
Different machine learning language models for cardiovascular disease risk prediction: a systematic review
Authors: Lakhani Alisha , Chaudhary Abhishek , Khatri Aarti , Kantawala Rahul , Khan Usman , Gupta Srajan , Bhavsar Tirth , Vyas Ishita , Vejju Sarayu , Sivakumar Thiruvikram , Wodeyar Aishwarya , Aleemuddin Nuha , Rai Roshni , Rani Ivaturi Sai Deepthi Janaki , Kantawala Burhan
Published: January 2025

Cardiovascular diseases (CVDs) remain the leading cause of mortality worldwide, prompting the urgent need for accurate and efficient predictive tools. This systematic review evaluates the efficacy of various machine learning algorithms in predicting cardiovascular disease risk by analyzing multiple studies that employed diverse techniques, including support vector machines, decision trees, and neural networks. The results consistently demonstrate that machine learning algorithms outperform traditional risk assessment models in predicting critical outcomes such as myocardial infarction, heart failure, and stroke, with advanced methods like gradient boosting and deep learning models showing superior accuracy. The review highlights the potential of these technologies to enhance clinical decision-making and improve patient outcomes, while also recognizing challenges such as implementation barriers and the need for validation across broader populations. Furthermore, the review underscores the transformative potential of machine learning in cardiovascular risk assessment, emphasizing the necessity for continued validation and adaptation to diverse patient groups. These findings affirm the growing role of artificial intelligence in revolutionizing cardiovascular care through early diagnosis and precise risk stratification, while also addressing the strengths and limitations of AI-based tools.
Modified inverted-L glabellar flap for coverage of nasal dorsum defects: a case series
Authors: Orozco Grados Jose de Jesus , Quijano Hernandez Mario , Sanchez Llamas Luis Adolfo , Avila Lopez Sonia Yorlli , Macias Medina Daniel , Garcia Garcia Jose Antonio
Published: January 2025

Nasal reconstruction, particularly of the nasal dorsum, presents significant challenges due to the intricate aesthetic subunits and complex vascular supply. Traditional techniques often face limitations in terms of coverage and aesthetic outcomes. This study aims to enhance reconstructive outcomes by employing advanced flap designs, specifically the Inverted-L and modified frontonasal or glabellar flaps, to address these limitations. This study presents a single-surgeon retrospective case series involving sixteen patients diagnosed with isolated Basal Cell Carcinoma on the nasal dorsum. Between 2019 and 2021, patients underwent wide lesion resections with clear margins, followed by flap coverage using the Inverted-L or modified frontonasal flap. The flap design was planned to avoid the supratrochlear artery and ensure optimal vascular supply. Postoperative care included the use of medical-grade silicone sheets for scar management, and patients were monitored for two years for any recurrences or complications. The patient cohort included a diverse age range with no long-term flap compromise or dehiscence reported. The mean follow-up period was 24 months (range, 6 months to 3 years). Minor complications involved the removal of absorbable internal stitches in three cases due to granuloma and pustule formation. All patients achieved satisfactory aesthetic results with no tumor recurrence or significant adverse events. This case series demonstrates the efficacy of the Inverted-L flap in nasal dorsum reconstruction, offering significant improvements in both aesthetic and functional outcomes. The technique allows for versatile flap manipulation while maintaining robust vascular support, crucial for optimal healing and minimal scar visibility.
Clinical profile and outcome of viral encephalitis patients in a tertiary care hospital
Authors: A. Rajesh , N. N. Naseeb , John Robin K. , George David Jiju , Nizar Ruksana
Published: January 2025

Early detection and management of viral encephalitis patients presenting with various symptoms result in better outcomes. This study seeks to address gaps in timely diagnosis and management to reduce long-term neurological deficits. To study the clinical profile and outcomes of viral encephalitis patients admitted to a tertiary care hospital.
Retrospective, observational study of 30 patients admitted at Travancore Medical College Hospital from April 2023 to May 2024. Fever, altered sensorium, and seizures were the most common presentations. Recovery was slower among immunocompromised patients, particularly those with chronic kidney disease. Common etiologies included Dengue, Herpes Simplex Virus (HSV), and Varicella Zoster Virus (VZV). Viral encephalitis remains a significant neurological emergency. Early recognition and management improve outcomes and reduce morbidity.
Disseminated histoplasmosis in a patient with NADPH oxidase deficiency: a case report
Authors: Bhuiyan Mohd Mujtaba Akib , Rahaman Mohammad Ferdous Ur , Rahman Mahbubur , Islam M. Nazrul , Shefa Jannatara
Published: January 2025

Neutrophil nicotinamide adenine dinucleotide phosphate (NADPH) Oxidase plays a pivotal role in the production of reactive oxygen species and defect of its different subunit leads to the development of chronic granulomatous diseases. The defect of different sub-units of neutrophil NADPH oxidase affects different organs1.In endemic region, histoplasmosis is often seen in host with defective cell mediated immunity. Host with primary immunodeficiency with disseminated histoplasmosis is rare. Host with primary immunodeficiency due to Neutrophil NADPH Oxidase is even rarer2.One such presentation was seen in a 49 years old man who presented to us with recurrent attacks of histoplasmosis involving different organs which was treatment refractory. We report this case so that physicians can consider correlation between primary immunodeficiency and treatment refractory disseminated histoplasmosis in a seemingly immunocompetent patient.
Spinal cord infarction a rare complication of acute aortic intramural hematoma: a clinical case report and review of literature
Authors: A. Ahmed Munthir , A. Mejbel Hussein A. , A. Elsaadani Waleed , Khairallah Bahaaldeen I. , Ahmad Imran N.
Published: January 2025

Aortic intramural hematoma is a rare and very serious condition, it can rapidly progress and lead to severe complications if there is a delay in the diagnosis and starting appropriate management. In this case report we are presenting a male 67 years old presented to the emergency department complaining of sudden severe worsening of his lower back pain, associated with left lower limb weakness for which he is unable to walk. A case report of spinal cord infarction secondary to acute aortic intramural hematoma (IMH) type A Standford classification. It represents an unusual clinical presentation of acute aortic IMH. Surgical management done resulting in a successful outcome.
Elongated uvula: diagnosis and management of a rare condition: case report
Authors: N. Harshitha
Published: January 2025

Elongated uvula is a rare condition where the uvula extends into the oropharynx, causing discomfort such as throat irritation, choking during swallowing, and nocturnal dyspnea. This case study discusses a male patient in his 50s presenting with these symptoms, aiming to highlight the diagnostic process and treatment outcomes. The patient presented with throat irritation, choking sensation while swallowing, and nocturnal dyspnea. Clinical examination by a primary care physician revealed an elongated uvula, which was confirmed through CT imaging. Routine investigations, including CT-PNS scanning and polysomnography (PSG), were conducted. The patient underwent a uvulectomy under local anesthesia in an outpatient setting. Postoperative follow-up assessments were conducted to monitor symptom relief and any complications. CT imaging confirmed the diagnosis of an elongated uvula measuring 54 mm. PSG indicated fragmented sleep architecture. The uvulectomy procedure was performed successfully without complications. The patient reported significant relief from throat irritation and improved swallowing function postoperatively. Follow-up at 1 month showed sustained improvement in symptoms. This case highlights the importance of considering uvulectomy for patients with symptomatic elongated uvula. Accurate diagnosis is essential to differentiate it from other conditions like asthma. Uvulectomy is an effective treatment that can significantly improve symptoms and quality of life for appropriately selected patients. Proper patient selection and preoperative evaluation are crucial for achieving optimal outcomes.
Amyloidogenic occipital mass obscuring plasmacytoma: a rare presentation and review of literature
Authors: Verma Tripti , Srivastava Pallavi , Awasthi Namrata P. , Kaif Mohd. , Husain Nuzhat
Published: January 2025

Solitary plasmacytoma of bone are a spectrum of plasma cell disorder which are defined by presence of clonal plasma cell in the bone including skull. The occurrence of true plasmacytoma of skull with large amyloid deposits in young patient is a rare presentation. We present case of 25-year-old man with a 3-month history of a slowly growing mass in the occipital region associated with headache. Neurological examination was within normal limits. Magnetic resonance imaging revealed a large extra-axial mass, the inner table of the skull were partially destroyed by the tumour, but the dura was not involved. The tumour removed and the skull defect was reconstructed followed by radiotherapy. Histopathological examination confirmed plasmacytoma with amyloidosis, positive for amyloid P component on immunohistochemistry. Laboratory investigations revealed no systemic myelomatosis. After 2 years of close follow up patient had no signs of recurrence or progression to multiple myeloma. The different management stratagies for the two entities of plasma cell disorder spectrum i.e. solitary plasmacytoma of bone and multiple myeloma necessitates there differentiation by thorough clinical, radiological and hematological studies. Surgical treatment followed by radiotherapy is an effective treatment option.
Huge multinodular goiter with retrosternal extension, a challenge to both surgeon and anesthetist: a case report
Authors: Mohammad Benazeer H. , Manju  , Pusuluri Rahul , Pandey Srijan , Garg Ashish , Saini Rajat
Published: January 2025

Retrosternal goitre, defined as over 50% of the thyroid mass extending below the thoracic inlet, is a rare presentation of goitre. These cases are particularly observed among females in their 5th and 6th decades. Symptoms like breathlessness, facial flushing, and dysphagia, alongside complications like superior vena cava syndrome, increase morbidity. Surgery is the management of choice. While most cases are managed surgically via a cervical approach, some require thoracic intervention due to airway and neurovascular compression, including displacement of critical vessels like the subclavian and carotid arteries. We present a case of 63-year-old female with a huge euthyroid multinodular goiter with no pressure symptoms. Contrast enhanced computed tomography (CECT) neck was suggestive of bilateral enlargement of thyroid nodules, with left sided lobe also getting an additional supply from left brachiocephalic artery. Surgery of retrosternal goitre commonly involves a cervical approach, but thoracotomy maybe needed in cases of malignancy, redo thyroid surgery, or mediastinal goitres. Careful dissection to avoid damage to recurrent laryngeal nerve (RLN) and mediastinal structures is required, especially when nodules extend into the thorax. Tracheomalacia and vocal cord dysfunction, are rare but serious complications. Anesthesia challenges include difficult airway management due to tracheal deviation. Awake fibreoptic intubation is preferred, and patients may require intubation for 24 hours postoperatively due to anticipated airway edema. Large, long-standing retrosternal goitres require thorough preoperative surgical and anesthetic workup, often necessitating ear, nose and throat (ENT) and thoracic surgery backup, with CECT with angiograph aiding operative planning.
A case report on late onset linear discoid lupus erythematosus on the face mimicking linear morphoea
Authors: Piloly Ananthu B.
Published: January 2025

50-year-old female with no known comorbidities presented to the dermatology OPD with complaints of slowly progressive asymptomatic skin coloured linear atrophic plaque over left side of face since, 5 years. Cutaneous examination revealed well demarcated, linear atrophic plaque with hidebound skin over left side of face extending from scalp margin to tip of the nose, involving the lateral wall of nose along the lines of Blaschko. Dermoscopic examination showed structureless areas and loss of follicles as well as eccrine openings. Laboratory investigations including ANA-IFA were negative. A clinical diagnosis of linear morphoea (En- coup de sabre) was made. Further investigation with punch biopsy was performed from the lesion site which gave a histopathological diagnosis of Discoid Lupus Erythematosus and was confirmed with direct immunofluorescence study. Full physical examination, review of systems and laboratory workup showed no features to suggest systemic lupus. She was managed with hydroxychloroquine and sun protective measures. Linear discoid lupus erythematosus can clinically mimic linear morphoea, but histopathological examination provides distinctive features that aid in accurate diagnosis and differentiation between the two conditions. This case gave us valuable insight into keeping DLE as a differential for linear morphoea on the face.
Synchronous ovarian granulosa cell tumor and carcinoma endometrium due to excess estrogen secretion: a rare presentation
Authors: Asaithambi Shubha Supriya , Swamy Shruthi , V. Karpurmath Shashidhar , Nandennavar Manjunath , Angadi Veerendra
Published: January 2025

Granulosa cell tumor (GCT) is a low malignant potential ovarian tumor accounting for 70% of all sex cord stromal tumor. It is an estrogen secreting tumor, hence diagnosed in early stages, associated with 20-30% concomitant lesion in endometrium including 5% of invasive adenocarcinoma. Through this case report we present the synchronous occurrence of ovarian and endometrial malignancy of a 52-year-old female, P3L2A0 who presented with irregular menstrual bleeding since 2 months along with literature review. Imaging showed endometrial lesion with synchronous left ovarian lesion with a normal CA-125. Underwent total abdominal hysterectomy with bilateral salphingo-oophorectomy and post op histopathology showed FIGO stage IC GCT of left ovary and Endometrioid carcinoma of endometrium, grade1, FIGO stage IA, low risk with P-53 negative by IHC. In view of ovarian tumor FIGO stage IC GCT, she received adjuvant chemotherapy. Hence, presence of synchronous endometrial lesion with suspicious ovarian mass at presentation should suspect the diagnosis of estrogen secreting GCT with endometrial lesion.
Carcinoma ex pleomorphic adenoma of the parotid gland: a case with difficult diagnosis
Authors: Dandala Sridhar Reddy , Gonuru Vinod Kumar , Gandhi Vidhi
Published: January 2025

Carcinoma ex pleomorphic adenoma (CXPA) is carcinoma arising from a primary or recurrent benign pleomorphic adenoma. It might be non-invasive or invasive. It often poses a diagnostic challenge to clinicians and pathologists. Pathological assessment is the gold standard for diagnosis. Treatment for CXPA often involves an ablative surgical procedure, which may be followed by radiotherapy. We report to you a 63-year-old female who came to the ENT OPD with a complaint of swelling in the front of the right ear for 6 months and pain over swelling for 2 weeks. The patient was advised for USG-guided FNAC, which was suggestive of a benign cystic parotid lesion. The patient was planned for superficial parotidectomy and the tumor was surgically excised. The frozen section was suggestive of a benign salivary gland tumor and the histopathology report concluded of a non-invasive carcinoma ex pleomorphic adenoma. The patient was advised to undergo radiotherapy after the surgery. During the follow-up, the patient showed signs of Frey’s syndrome. Carcinoma ex pleomorphic adenoma is difficult to diagnose; clinicians and pathologists should work together to diagnose it and pathological assessment is the gold standard for the diagnosis.
Diagnosis and management of bone cysts
Authors: C. D. Deepak , Boregowdanapalya Anitha
Published: January 2025

Bone cysts are benign, fluid-filled lesions primarily occurring in the metaphyseal regions of tubular and flat bones, such as the humerus and femur. These lesions are commonly seen in children and adolescents during periods of rapid bone growth. While often asymptomatic, bone cysts are typically discovered incidentally or after a pathological fracture due to weakened bone structure. Radiographic imaging plays a pivotal role in diagnosis, revealing well-defined, lytic lesions with thin cortical margins. Management of bone cysts has evolved to emphasize minimally invasive techniques, including intralesional steroid or bone marrow injections, as well as curettage with bone grafting. These approaches aim to promote healing, prevent recurrence, and restore bone integrity. In some cases, internal fixation may be required for structural support. The prognosis is generally favourable, with high rates of healing and functional recovery, especially with timely intervention.
Expert opinion on challenges in the diagnosis and treatment of OCD in India
Authors: Porandla Kishan , Nagpal Rajesh , Garg Sanjay
Published: January 2025

Obsessive-compulsive disorder (OCD) is considered as a significant cause of disability worldwide, ranking among the top 10 causes. The diagnosis of OCD is often delayed due to the reluctance of patients to share their symptoms. OCD is also associated with the presence of other comorbid psychological conditions like anxiety, depression, and schizophrenia among others, which adds to the challenge of accurate diagnosis. Delayed diagnosis and the presence of comorbid conditions have a poor prognosis. Hence, an increased awareness about identifying symptoms of OCD among doctors and the general public is important. Even though clinical practice guidelines outline the management for OCD, challenges in appropriate management exist. This review elaborates the challenges associated with the diagnosis and management of OCD in India and presents insights from experts which can help doctors in early diagnosis and appropriate management of this debilitating condition.
Diverse ambulatory profiles in cerebral palsy: in-depth review
Authors: Sant Namrata , Singh Vinay Kumar , Fahim Tabish , Saharan Ajeet Kumar , Palaskar Pallavi
Published: January 2025

The estimation of ambulation prognosis in cerebral palsy children poses a challenge for parents, caregivers, neurologists, and pediatric rehabilitation specialists despite its status as the primary cause of chronic disability in this demographic. Currently, a scale is developed for predicting ambulation in these children, making it imperative to anticipate their ambulatory potential. Research indicates that a child's gross motor skill development, such as achieving neck control by nine months, independent sitting by two years, crawling, and meeting other developmental milestones by thirty months, in addition to factors like postural reactions, cognitive abilities, infantile reflexes, and auditory and visual functions, serve as predictive indicators of ambulation. Moreover, even favourable upper limb functions in cerebral palsy contribute to prognosis of ambulation. The primary cause of chronic disability in pediatric population is cerebral palsy, and it can be challenging for pediatric rehabilitation specialists, neurologists, and parents to predict a child's prognosis for walking. The ambulation chart is available, which is developed by researcher, A Thai, who provided guidance on this matter. It is yet unknown how valid and reliable this tool is to serve as a predictor of ambulation in patients with cerebral palsy. To develop a suitable method for predicting ambulation in cerebral palsy that takes into account all the variables except those listed above, more research in this area is required.
Real world use of T3 to alleviate symptoms of hypothyroidism during preparation of radioactive iodine ablation: experts viewpoint
Authors: Bhargav P. R. K. , Manthri Ranadheer
Published: January 2025

Thyroid carcinoma is a common endocrine malignancy with most of the cases being diagnosed as differentiated thyroid cancer. Thyroidectomy is the cornerstone of treatment for thyroid carcinoma. Adjuvant therapy with radioactive iodine after surgical resection of all known primary tumor tissue and metastatic foci is advocated. The preparation for radioactive iodine ablation requires elevation of thyroid stimulating hormone to 30 mIU/l for ensuring uptake of I-131 by thyroid follicular cells. In the Indian setting, there are specific challenges in preparation for radioactive iodine ablation including the high cost of recombinant TSH injection which may preclude its use in most patients. The practical approach adopted by Indian endocrinologists, endocrine surgeons and nuclear medicine physicians in the preparation of post-thyroidectomy thyroid cancer patients for radioactive iodine ablation in the real-world setting needs to elaborated and chronicled for providing guidance specific for the constraints encountered in the Indian scenario. Thyroid hormone withdrawal is affected by cessation of levothyroxine for 4 weeks prior to radioactive iodine ablation leading to profound hypothyroidism. This can be addressed by appropriate use of liothyronine (LT3) to substitute levothyroxine after its withdrawal. LT3 administration of 20 mcg twice or thrice a day (40 to 60 mcg/day in divided doses) is the best practice during THW. The duration of LT3 replacement following cessation of levothyroxine, is for 2-3 weeks and then 10-14 days off LT3. These practices are corroborated by evidence from literature and recommendations from guidelines elucidating the use of liothyronine during the period of thyroid hormone withdrawal.
Embracing the digital revolution: exploring the acceptance and potential of artificial intelligence in physiotherapy
Authors: K. B. Riyas Basheer , Bills Anusha
Published: January 2025

Recently, there has been significant discussion about artificial intelligence (AI) and Large Language Models (LLMs) as they relate to teaching and learning. To date, literature exists about the role of AI in Physical Therapy treatment, but not Physical Therapy education. This review will identify the benefits of adapting AI into Physical Therapy education to better prepare the healthcare providers of tomorrow. Survey research shows that AI can improve access to information, increase productivity, and reduce errors. However, most also feel ill-informed on the topic. A majority agreed that AI concepts should be included in Physical Therapy education. While valid concerns exist about AI sources giving false information, as well as the potential to use these services to plagiarize work, tools are already in existence to mitigate these issues. Potential benefits of AI in physical therapy education include the ability to produce examples, provide different explanations, and assist in assessing student learning while providing immediate feedback on performance. With the scope of AI rapidly expanding, we believe it is imperative for physical therapy educators to have access to current information about its potential benefits, uses, and limitations. While many professionals do not currently possess much knowledge on the topic, there is a growing consensus as to the role it will play in our profession in the future. While discussions of AI can raise more questions than answers, preparation now will reduce the need for urgent adaptations in the future.
Relações Socioespaciais e o Processo de Uso e Ocupação da Região Sul de Roraima- Brasil
Authors: Wickert Fabiola , Ribeiro Araújo Júnior Antônio Carlos
Published: January 2025

O presente trabalho apresenta a análise das relações socioespaciais no Município de Rorainópolis, associadas ao processo de uso e ocupação do solo, sob uma perspectiva geográfica, guiada pelos conceitos de espaço (produção e relações) e paisagem (gênese e transformação), cuja análise permite compreender as relações estabelecidas na localidade, a partir das políticas de colonização ocorridas em décadas anteriores (1970 e 1980) e da criação e gestão territorial na área de estudo, partindo de uma abordagem teórica, com revisão sistemática da literatura, objetivando o levantamento de informações prévias sobre o uso e ocupação do solo em Rorainópolis, com ênfase nos aspectos políticos, sociais, econômicos e ambientais, inerentes à transformação da paisagem e das relações socioespaciais, buscando entender os aspectos da ocupação da região sul do estado de Roraima, e analisar a relação escalar no concernente ao estabelecimento de suas relações sociais e espaciais e transformações da paisagem na porção meridional de Roraima.
Morfologia da Bacia Hidrográfica do Rio Cauamé, Roraima
Authors: Wankler Fábio Luiz , Dos Santos Nunes Ana Caroline , Lucas Vieira Carlos Eduardo
Published: January 2025

Contida no Sistema Hidrográfico do Alto Rio Branco, a Bacia Hidrográfica do Rio Cauamé (BHRC), faz parte dos municípios de Boa Vista e Alto Alegre, Estado de Roraima, Brasil. Sua geodiversidade a levou a ser o palco da expansão das atividades agropastoris, industriais e urbanas, tornando-a uma das regiões mais povoadas do estado de Roraima. O presente artigo visa caracterizar a morfologia desta região. A metodologia envolveu a coleta de dados primários e secundários, a partir de pesquisas bibliográficas, geoprocessamento de imagens remostas (Landsat 8 OLI e ALOS PALSAR), levantamento de campo e aplicação de ferramentas GIS para a análise de parâmetros morfométricos, o que possibilitou a classificação da área. Os resultados permitiram classificar três unidades geomorfológicas informais: A, B e C, sendo as duas primeiras subdivididas em A1 e A2 e B1 e B2, respectivamente. Observou-se que a gênese da paisagem da bacia está associada a um controle geotectônico que cria as grandes feições de relevo e estas, por sua vez, têm suas superfícies modeladas pelos fatores climáticos e geobiológicos, resultando nos compartimentos geomorfológicos e nas superfícies de aplainamento retratadas no presente estudo. A compreensão destes processos e das feições geomorfológicas derivadas é fundamental para uma melhor caracterização e mais acurado dimensionamento dos impactos ambientais resultantes das aceleradas transformações que esta paisagem vem sofrendo nos últimos anos.
Geomorphosite Hill of Horto (lookout type) and its geomorphological value (Geopark Araripe/CE)
Authors: Silva João Bandeira da , José Falcão Sobrinho  , Francisco Nataniel Batista de Albuquerque
Published: January 2025

Resumo
Os estudos geomorfológicos sobre a geodiversidade têm se mostrado uma importante base teórico-conceitual para a compreensão e conservação dos fatores abióticos da paisagem. Neste contexto, o presente trabalho tem como objetivo determinar o valor geomorfológico do geossítio Colina do Horto, no Geopark Araripe, Ceará, Brasil. Do ponto de vista metodológico, o geossítio foi classificado e valorizado como um geomorfossítio do tipo mirante com base em 11 parâmetros de valores científicos e estéticos. Como resultado, conclui-se que o Horto se configura como um ponto de vista de médio valor científico (10 pts.), estético (20 pts.) e, consequentemente, geomorfológico (30 pts.), permitindo uma visão geral do valor de a geodiversidade do geomorfossítio no contexto do Geopark Araripe.   
Palavras-chave: Geodiversidade. Geomorfodiversidade. Avaliação Quantitativa.
 
Abstract
Geomorphological studies on geodiversity have proven to be an important theoretical-conceptual basis for understanding and conserving abiotic factors in the landscape. In this context, the present work aims to determine the geomorphological value of the Colina do Horto geosite, in the Araripe Geopark, Ceará, Brazil. From a methodological point of view, the garden was classified and valued as a lookout-type geomorphosite based on 11 parameters of scientific and aesthetic values. As a result, it is concluded that the Horto is configured as a viewpoint of medium scientific (10 pts.), aesthetic (20 pts.) and, consequently, geomorphological (30 pts.) value, allowing a general overview of the value of the geodiversity of the geomorphosite in the context of Geopark Araripe.
Keywords: Geodiversity. Geomorphodiversity. Quantitative Valuation.
 
Resumen
Los estudios geomorfológicos sobre la geodiversidad han demostrado ser una base teórico-conceptual importante para comprender y conservar los factores abióticos del paisaje. En este contexto, el presente trabajo tiene como objetivo determinar el valor geomorfológico del geositio Colina do Horto, en el Geoparque Araripe, Ceará, Brasil. Desde el punto de vista metodológico el geositio fue clasificado y valorado como geomorfosito tipo mirador con base en 11 parámetros de valores científicos y estéticos. Como resultado, se concluye que el Horto se configura como un punto de vista de valor científico medio (10 pts.), estético (20 pts.) y, en consecuencia, geomorfológico (30 pts.), permitiendo una visión general del valor. de la geodiversidad del geomorfositio en el contexto del Geoparque Araripe.
Palabras clave: Geodiversidad. Geomorfodiversidad. Evaluación cuantitativa.
Transformações Intraurbanas em Cidades Médias da Amazônia
Authors: Nascimento Raimundo dos Santos , Rosa Filho Artur
Published: January 2025

O arranjo espacial e as transformações intraurbanas ocorrem por intermédio da atuação de vários agentes promotores do espaço. O objetivo geral deste estudo foi compreender as transformações intraurbanas no bairro Cidade Satélite em Boa Vista-RR, cidade média da Amazônia, a partir da implantação dos conjuntos habitacionais, valorização do espaço em decorrência da melhoria da infraestrutura, dinâmica comercial e mudanças no padrão construtivo. Em relação aos procedimentos metodológicos, realizou-se pesquisa bibliográfica abordando as cidades médias na Amazônia, o espaço urbano e os agentes produtores do espaço urbano, pesquisa documental e observação da área de estudo. Os resultados apontaram que as mudanças que ocorreram no bairro Cidade Satélite são produtos da ação tanto do Estado, quanto do setor imobiliário e dos moradores no processo de produção e reprodução do espaço urbano. Em função dos investimentos públicos e privados, o valor do metro quadrado no bairro se valorizou 494 por cento, entre os anos de 2009 e 2019. Nas principais vias de circulação do bairro Cidade Satélite, constatou-se as transformações no uso do solo, com a crescente implementação de novos estabelecimentos comerciais.
Sustentabilidade na geração de energia elétrica no estado de Roraima - Brasil
Authors: Wickert Fabíola de Souza , Araújo Júnior Antônio Carlos Ribeiro
Published: January 2025

A produção de energia elétrica é fator primordial para a fixação e reprodução da vida social. Todavia, em tempos de mudanças climáticas globais ocasionadas predominantemente de emissão de Gases de Efeito Estufa (GEE) produzidos a partir de sua queima, buscar alternativas sustentáveis torna-se uma necessidade. Para tanto, este trabalho tem como objetivo analisar em que medida a sustentabilidade da geração de energia elétrica ocorre no estado de Roraima, adotando como parâmetro de análise a instalação e operação do empreendimento operado com óleo de palma localizado no município de Rorainópolis, sul do estado de Roraima. Percebe-se que a geração de energia se vale de matéria orgânica e tem potencial de abastecimento razoável para o município de Rorainópolis, segundo mais populoso do estado de Roraima. Todavia, a real sustentabilidade da atividade de geração de energia elétrica a partir do óleo de palma deverá ser acompanhada pela sociedade civil e pelo poder público, com vistas a assegurar a perpetuação das comunidades e de suas atividades produtivas locais