bluuebunny/crossref_metadata_2025 huggingface dataset:
Sarcopenia as a prognostic factor in patients with hepatocellular carcinoma treated with transcatheter arterial chemoembolization plus sorafenib
Authors: Wang Rujian , Wang Ligang , Jiang Yutian , Dong Mei , Li Mei , Sun Ping
Published: August 2024

Introduction:

Loss of skeletal muscle volume is an important aspect of sarcopenia in hepatocellular carcinoma (HCC) patients treated by surgical resection, transcatheter arterial chemoembolization (TACE), or sorafenib.

Purpose:

This study determined the influence of sarcopenia and other laboratory results on survival in patients with HCC treated with TACE plus sorafenib.

Methods:

The patients were divided into two groups based on the presence of sarcopenia. The skeletal muscle index was calculated by normalizing the cross-sectional muscle area at the L3 level on an abdominal computed tomography scan before embolization according to the patient’s height. The clinical characteristics of the two groups were then compared. The progression-free survival (PFS) and overall survival (OS) rates after treatment were determined.

Results:

Sarcopenia was present in 75 of the 102 (74%) patients with HCC included in this study. The albumin, prealbumin, and cholinesterase levels were lower in those with sarcopenia. The OS (P = 0.001) and PFS (P = 0.008) were significantly prolonged in the nonsarcopenia group compared to the sarcopenia group. Sarcopenia, ECOG (≥2), and prealbumin (<180 mg/L) were significantly associated with PFS. Sarcopenia, ECOG (≥2), Child–Pugh B, BCLC stage C, prealbumin (<180 mg/L), and cholinesterase (<5,320 U/L) were significantly associated with OS. The prognostic factors for OS included sarcopenia, ECOG (≥2), and cholinesterase (<5,320 U/L), whereas only ECOG (≥2) was identified as a prognostic factor for PFS.

Conclusion:

Sarcopenia may be an indicator of poor clinical outcome in patients with HCC receiving TACE plus sorafenib.
An aggressive Cushing’s syndrome originating from a rare thymic neuroendocrine tumor, controlled successfully with fluconazole and octreotide therapy before surgery
Authors: Kargun Sinem , Aydemir Mustafa , Yilmaz Nusret , Gürer İnanc Elif , Sari Ramazan , Altunbas Hasan
Published: August 2024

Cushing’s syndromes (CSs) due to the thymic neuroendocrine tumors are rarely seen. Here, a case of ectopic CS originating from an atypical neuroendocrine tumor has been presented. A 49-year-old woman was hospitalized with symptoms of fatigue, chest pressure, dyspnea, muscle weakness, and resistant hypertension. There was marked hyperpigmentation in the whole-body surface suggestive of adrenocorticotropic hormone (ACTH) excess and there were physical features of CS. There was deep hypokalemia. Basal hormone profile, dexamethasone suppression tests, midnight cortisol, and 24-hour urine cortisol levels were suggestive of ectopic CS. The pituitary magnetic resonance imaging revealed a 5 mm cystic lesion and the patient refused inferior petrosal sinus sampling. Thorax computerized tomography showed an anterior mediastinal mass. A fluorodeoxyglucose-positron emission tomography showed the same mediastinal lesion (suvmax: 11.4), and no other tumor focus was detected. There was an aggressive cortisol excess causing acute respiratory distress syndrome, making it difficult to perform the surgery. We immediately started fluconazole and octreotide therapy and were successful in lowering the cortisol level. Then a complete resection of the tumor had been able to be surgically performed and tumor cells showed strong cytoplasmic immunopositivity with ACTH. A definitive diagnosis of “ACTH secreting atypical thymic carcinoid tumor” was rendered based on the histopathological and immunohistochemical features. There was only surrounding vessel invasion, and no lymphoid or other organ metastases were detected. As there were surrounding vessel invasions, a two-cycle regimen cisplatin-etoposide chemotherapy and radiotherapy were employed. After surgical and medical therapy, the cortisol and ACTH levels turned to normal. The patient is in biochemical and clinical remission and has no tumor recurrence yet. Ectopic ACTH-producing thymic carcinoids are rare but life-threatening tumors because of the underlying malignancy and severe hypercortisolemia. It is important to consider this disease and perform appropriate treatment at the right time. Today, surgery is the standard therapeutic modality if it is possible to perform, but there is not a clear and constant recommendation for nonsurgical therapeutic modalities. Further studies are needed for the optimal treatment strategies.
Clinical efficacy and safety of irreversible electroporation combined with chemotherapy in stage IV pancreatic cancer treatment
Authors: Zeng Jia , Liu Boyu , Lang Xu , Wang Zhe , Fan Yong , Gao Chuntao , Fu Dianxun
Published: August 2024

Purpose:

This study evaluates the clinical efficacy and safety of irreversible electroporation (IRE) therapy combined with chemotherapy in patients with stage IV pancreatic cancer.

Methods:

Between September 2021 and November 2023, we enrolled 38 patients with stage IV pancreatic cancer, with 20 receiving IRE plus chemotherapy and 18 receiving only chemotherapy. We recorded the general information of the patients and regularly followed up postoperative IRE-related adverse reactions. Progression-free survival (PFS) and overall survival (OS) were evaluated during follow-up.

Results:

Median OS was longer in the IRE group than in the chemotherapy group. Median PFS was slightly extended with IRE compared to chemotherapy alone. The mean hospital stay for the IRE group was 5.90 ± 0.75 days. Four serious adverse events occurred after IRE. Postoperative pain scores were significantly lower than preoperative scores.

Conclusion:

IRE combined with chemotherapy showed clinical effectiveness in stage IV pancreatic cancer treatment, offering potential pain reduction benefits with fewer adverse effects and shorter hospital stays.
Exosomes derived from gastric cancer cells promote phenotypic transformation of hepatic stellate cells and affect the malignant behavior of gastric cancer cells
Authors: Zhang Donghuan , Luo Qiong , Xiao Lirong , Chen Xiangqi , Yang Sheng , Zhang Suyun
Published: August 2024

Objective:

This study aimed to evaluate the effect of exosomes derived from gastric cancer cells on the phenotypic transformation of hepatic stellate cells (HSCs) and the effect of HSC activation on the malignant behavior of gastric cancer cells, including its molecular mechanism.

Methods:

Exosomes derived from the human gastric adenocarcinoma cell line AGS were extracted and purified by polymer precipitation and ultrafiltration, respectively. The exosomes’ morphologic characteristics were observed using transmission electron microscopy, particle size was determined through nanoparticle-tracking analysis, and marker proteins were detected using western blotting. Exosome uptake by LX-2 HSCs was observed through fluorescence-based tracing. Reverse transcription quantitative PCR (RT-qPCR) was used to detect the messenger RNA (mRNA) expression of alpha-smooth muscle actin (α-SMA) and fibroblast activation protein (FAP). Using functional assays, the effects of LX-2 HSC activation on the biological behavior of malignant gastric cancer cells were evaluated. The effects of LX-2 HSC activation on the protein expression of epithelial–mesenchymal transition (EMT)-related genes and β-catenin were evaluated via western blotting.

Results:

The extracted particles conformed to the definitions of exosomes and were thus considered gastric cancer cell-derived exosomes. Fluorescence-based tracing successfully demonstrated that exosomes were enriched in LX-2 HSCs. RT-qPCR revealed that the mRNA expression of the cancer-associated fibroblast markers α-SMA and FAP was significantly increased. LX-2 HSC activation considerably enhanced gastric cancer cell proliferation, invasion, and migration. Western blotting showed that the expression of the EMT-related epithelial marker E-cadherin was significantly downregulated, whereas the expression of interstitial markers (N-cadherin and vimentin) and β-catenin was remarkably upregulated in gastric cancer cells.

Conclusion:

Exosomes derived from gastric cancer cells promoted phenotypic transformation of HSCs and activated HSCs to become tumor-associated fibroblasts. Gastric cancer cell-derived cells significantly enhanced gastric cancer cell proliferation, invasion, and migration after HSC activation, which may promote EMT of gastric cancer cells through the Wnt/β-catenin pathway.
Human Leukocyte Antigen and Periodontal Diseases
Authors: Durge Khushboo , Baliga Vidya , Dhadse Prasad , Agrawal Diksha , Sethiya Kiran , Nibudey Akanksha
Published: August 2024

It is well recognized that plaque microbiota alone cannot account for periodontal tissue destruction, as some individuals are relatively at a higher risk for tissue destruction than others. Probably, some host factors have a role to play in this field. It is well documented that the human leukocyte antigens (HLA) system is a complex genetic polymorphic system in man. HLA have been considered a candidate of genetic risk markers for aggressive periodontitis (AP). The HLA play an important role in immune responsiveness and may be involved in antigen recognition of periodontal pathogens. These cell surface molecules have a key role in antigen presentation and activation of T-cells. The polymorphisms of HLA can directly affect the binding capability of antigen peptides and thus affect the antigen-specific T-cell response. Hence, these polymorphisms could represent an important susceptibility or resistance factor to periodontitis.
To Study a Specific Radiological Pattern of “Diabetic Tuberculosis” (as Described by Sosman and Steidl in 1923) Observed in Patients with Diabetes Mellitus Associated with Pulmonary Tuberculosis
Authors: Jadhav Ulhas S.
Published: August 2024

Background:

Sosman and Steidl (1923) had described “diabetic tuberculosis” a specific radiological pattern in patients with diabetes mellitus associated with pulmonary tuberculosis. These lesions usually consist of wedge-shaped area of density in which there is often cavitation in the neighborhood of hilum and spreading toward periphery including the bases occurring in diabetics over the age of 40 years. The present study was undertaken to study and highlight this specific radiological pattern of “diabetic tuberculosis” along with the clinical profile of this association.

Materials and Methods:

The present study was carried out in patients with pulmonary tuberculosis admitted to Poona Chest Hospital Aundh Pune, between July 1, 1991, and June 30, 1992. The patients diagnosed as pulmonary tuberculosis were subjected for diabetic status by detailed history, clinical examination, and investigations.

Results:

Among 440 cases of pulmonary tuberculosis prevalence rate of diabetes mellitus was 9.55% (42/440) and a specific radiological pattern “diabetic tuberculosis” was observed in 16.66% (7/42) in diabetics associated with tuberculosis.

Conclusion:

All patients with pulmonary tuberculosis above the age of 40 years should be screened for diabetes and all patients with diabetes should be screened to rule out pulmonary tuberculosis every year. A specific radiological pattern of “diabetic tuberculosis” and lower zone lesions on X-ray observed during clinical examination should be screened to rule out pulmonary tuberculosis as well as diabetes.
Missed Care and Nurses' Job Satisfaction
Authors: Mandal Lata , Seethalakshmi Avudaiappan
Published: August 2024

Background:

Job satisfaction among nurses is a global concern for its crucial impact on nursing shortage and quality of care. Missed nursing care defined as nurses' decision to omit or delay aspects of patient care activities is hypothesized to influence nurses' job satisfaction.

Aim:

The aim of this study was to explore the relationship between missed nursing care and nurses' job satisfaction.

Materials and Methods:

The study used a cross-sectional design, and data were collected using the MISSCARE survey and Nurses' Work Satisfaction Scale from 205 randomly selected nurses working in the medical–surgical units of four tertiary care hospitals in India. Data were analyzed using IBM SPSS version 23.

Results:

Nurses' job satisfaction was significantly related to missed nursing care, hospital types, and education which together explained 27% of the variance in nurses' job satisfaction.

Conclusion:

Focused strategies to decrease missed nursing care can improve job satisfaction among nurses. Nurse leaders can use missed nursing care as a process indicator to assess and predict nurses' job satisfaction.
Clinicopathological Features of Extranasal Rhinosporidiosis
Authors: Singh Varun Kumar , Bhattacharya Riti , Jaiprakash Padmapriya , Shivamurthy Archana
Published: August 2024

Aim:

The present series aims to highlight the sites, clinical presentation, histopathological features, anddiagnostic dilemmas of extra-nasal rhinosporidiosis.

Materials and methods:

A review of pertinent demographic and laboratory data for patients diagnosed with extra-nasal rhinosporidiosis, over a period of 7 years (2012- 2019) was done.

Results:

Amongst the 8 cases of extra-nasal rhinosporidiosis, the sites of involvement were medialcanthus (2/8), trachea (2/8), skin and bone (1/8), hard palate (1/8), and concurrent multiple sites (2/8). Clinical differential diagnoses included fungal osteomyelitis, laryngeal papilloma, conjunctival tumor, disseminated rhinosporidiosis, and carcinoma palate. The presence of sporangia, endospores, chronic inflammation, histiocytes was the most consistent histopathological features. Sevencases were managed with a laser-guided excision, and one underwent wide local excision with cauterization. Recurrence was seen in 5/8 cases (62.5%).

Conclusion:

The diagnosis of extra-nasal rhinosporidiosisis often missed due to an unusual site of presentation, or mistaken for a tumor. A proper history and histopathological examination must be carried out in patients with bleeding polyps, especially in an endemic region. The rate of local recurrence is high, which may be reduced by the use of lasers during surgery.
Periosteal Osteosarcoma of the Mandible
Authors: Deshpande Suvarna , Dhande Rajasbala , Vaidya Shirish , Madurwar Kaustubh
Published: August 2024

This is a case report of a rare malignant mesenchymal tumor, juxtacortical (periosteal) osteosarcoma arising from the mandible in a 17 year old boy. About 4%-6% of osteosarcomas occur in the maxillofacial region, while incidence of osteosarcoma occurring in jaw is 0.7 per million population. Due to its unique feature, they are high number of chances of misdiagnosing the tumor with other peripheral fibro-osseous lesions. The prognosis of the tumor is good if detected early and a wide margin resection is performed to make the recurrence obsolete.
Role of Physiotherapeutic Interventions in Dagdha (Burn) Injuries
Authors: Bele Ashish , Irshad M. Qureshi , Singh Nivedita Chandrapal , Jethwani Divya , Shalaka Dhankar , Madhuri Wane
Published: August 2024

Background:

In developing countries with low income, one of the most common causes of hospitalization is Dagdha (burn) and it also contributes to secondary problems, such as disfigurement, contractures, and scar tissue development. On the basis of degree/depth of tissues involved the burn may be classified as superficial, superficial partial, and deep partial, deep. Physiotherapists and occupational therapists, as part of the specialist burn multidisciplinary team, have many overlapping expertise and positions in the treatment of burn injury victims by delivering drills and splintering.

Methodology:

The data were collected from the electronic databases, including PubMed, Web of Science, Cochrane Library, EMBASE, Google Scholar, ResearchGate, Springer publications, Statewide Burn Injury Service, McGraw-Hill publications, etc., This review included burn patients of all age groups and both genders.

Results:

This systematic review indicated that physiotherapeutic intervention played a vital role in the management of Dagdha (burn) injury not only to reduce pain and scar but restoring the musculoskeletal and cardiopulmonary functions and making patient functionally independent so that they can enjoy their rest of life independently.

Conclusion:

This systematic review study concluded that physiotherapy played an important role in the management of all types of Dagdha (Burn) injuries of all age groups.
A Novel Code for Coding of Ceramic Prosthesis
Authors: Sathe Seema , Godbole Surekha , Shrivastav1 Sunita , Rajanikanth K. , Bhoyar Anjali , Dhamande Mithilesh
Published: August 2024

Background:

Forensic dentistry provides identification for the victim in many different scenarios. Data other than the description of the dental condition can be utilized in forensic dentistry like in case of marked dental prosthesis, it can provide important information in cases of major mass disasters where identification of the person becomes a tedious process. The coding system in prosthetic dentistry is available for removable dentures either partial or complete and also for metal crowns. As more people are opting for fixed prosthesis that too for ceramics, the need for having a coding system for ceramic restorations has gained paramount importance. In the current scenario the significance of dental marking or coding system is of vital significance. Removable prosthesis may get dislodged but this is not the case with the fixed prosthesis. Therefore it can play a vital role for identification of the individual either living or dead.

Aim:

To develop and evaluate the efficacy of coding system for ceramic restorations for retrieving the identity of individual in forensic dentistry.

Technique:

IPS E-max Press ingots, Glaze & Stain Liquid for E-max, Thermal transfer ink ribbon-YS-350T, Heat resistant QR code strips-HP-CBR X1617. This study focused on developing of the code to be used for ceramic restoration. A QR code (data matrix) was developed to be incorporated in the all ceramic restorations. A total of fifty samples were used to incorporate the code which were then subjected to readability by the scanner/ android mobile phone.

Conclusion:

AQR (data matrix) was developed of size 3.75 mm which was readable after incorporation in the all ceramic restoration.
Upheaval of Nanoscience in Periodontics
Authors: Gowri S. Pendyala , Saurabh R. Joshi , Preeti P. Kale , Shruti S. Deshmukh
Published: August 2024

Periodontitis is one of the most common diseases involving tooth and its supporting structures. Management of periodontitis is important for improvement of quality of life of the patient that ultimately has its impact on the overall health of an individual. Nanotechnology has evolved as a promising mode of treatment with upsurge of various treatment methodologies for the treatment of periodontitis. Nanotechnology has proven to be a reliable technology in dentistry as it provides different types of innovative nanomaterials which can be used in a variety of dental treatment options. A systematic search was conducted using Medline, PubMed, Scopus, and Google Scholar up to and including the year 2014, to identify relevant studies. All cross-reference lists of the selected studies were also screened. The inclusion criteria were articles in English or those having a detailed summary in English, published between 2000 and 2014. Review, case reports, abstracts, letters to editors, and editorials were excluded. In vivo studies were excluded from this systematic review. This paper will help the reader to understand nanoscience and the benefits and limitations of nanotechnology in periodontics by addressing its ethical, social, and health implications.
Accessory Mammary Gland Mimicking Sessile Lipoma
Authors: Chandak Suresh , Ponugoti Ravi , Chandak Meenakshi
Published: August 2024

Accessory mammary gland is an uncommon lesion, which occurs in 0.4%–6% of women. It is mostly located in the axilla of both sides, but when it presents unilateral large in size and sessile, it can cause difficulty in clinical diagnosis, which mimics lipoma or adipose tissue lesion, usually, it is bilateral and presents asymptomatic lump in the axilla during pregnancy and lactational period. Anxiety is the major cause of concern, as the general population are not aware of accessory breast. Histopathological diagnosis is very important as axillary mass or breast tissue may undergo changes like mastitis, fibrocystic disease, and rarely carcinoma. We present an axillary mass on the left side in 24-year-old female, which has been diagnosed with accessory mammary gland on fine-needle aspiration cytology study, which was mimicking sessile lipoma as a rare clinical presentation.
Effect of Concentrated Acids on Teeth
Authors: Kadashett Vidya , Shivakumar K. M. , Baad Rajendra , Vibhute Nupura , Belgaumi Uzma , Bommanavar Sushma , Kamate Wasim
Published: August 2024

Background:

The proceedings of destroying the body of human by putting in acid or some other injurious materials in order to prevent any individual identification is drawing a great deal of importance in forensic field. The idea of such crime is to destroy any physical evidence of cause of death, time interval of death to body identification, and victim identification. Teeth are also good reservoirs for the identification of individuals by morphological as well as identification by mitochondrial DNA extraction.

Aims and Objectives:

To assess the morphological changes and duration of dissolution of teeth from different acids.

Materials and Methods:

Concentrated hydrochloric acid (HCl), nitric acid (HNO3), and sulfuric acid were employed for tooth.

Results:

Results showed that compared to sulfuric acid, HCl and HNO3 have more destructive capacity.

Conclusion:

Sulfuric acid, HNO3, and HCl criminals may be used to destroy the person identification; still, the individuals can be identified using teeth because it is the strongest structure of the human body and can preserve some structures even after exposure to the concentrated acids.
International Academy of Cytology Guidelines Based Categorization of Breast Fine-Needle Aspiration Cytology Lesions and their Histopathological Correlation
Authors: Deshpande Shruti Amit , Rao Kandibanda Sai Sri Ram , Sushma Yalavarthi , Saikumar Gopalam Vashita
Published: August 2024

Context:

International academy of cytology (IAC) has established a standardized reporting system for fine-needle aspiration (FNA) cytology of breast lesions. They have introduced five categories (Code C1 to Code C5) for reporting breast cytology, each with clear descriptive term for the category, risk of malignancy (ROM) and a suggested management algorithm.

Aim:

Aims of the present study were to reclassify and correlate the breast FNA (IAC guidelines) with histopathological findings and to calculate the ROM for each category with special emphasis on assessing the diagnostic efficacy of cytological evaluation of code 3 and code 4.

Materials and Methods:

A 3 years' retrospective cross sectional study included 448 breast FNA samples that were reassessed and reclassified according to the IAC reporting system. The ROM for each category was analyzed.

Results:

The breast FNA samples were distributed in following categories as: C1 (insufficient material)− 1.78% (n = 8), C2 (benign) – 71.66% (n = 321), C3 (Atypical but benign) −10.81% (n = 45), C4 (Suspicious for malignancy) – 4.91% (n = 22), and C5 (Malignant)– 11.60% (n = 52). Out of the 448 cases, histopathological correlation was available for 205 cases. The ROM for each category was calculated as: 0% for C1, 2.04% for C2, 10.8% for C3, 85.71% for C4, and 100% for C5. The ability of C3 and C4 lesions to diagnose breast malignancy was statistically significant, P value 0.042 (P < 0.05).

Conclusion:

The IAC system for reporting of breast cytology effectively helps in accurate diagnosis and assessment of ROM for each category which helps in better patient management and further research.
Horseshoe Kidney with Multiple Bilateral Renal Calculi – Ultrasonography and Intravenous Urography Evaluation
Authors: Pavanan Asish , Phatak Suresh , Unadkat Bhavik , Patwa Prerna
Published: August 2024

Horseshoe kidney is a congenital fusion anomaly of kidneys associated with many complications. A 57-year-old male presented with abdominal pain, hematuria, and burning micturition which on ultrasound examination was diagnosed to be a case of horseshoe kidney with multiple bilateral renal calculi. High-resolution sonography, radiography, and intravenous urography findings are discussed.
Endoscopic Profile of Acute Upper Gastrointestinal Bleed in Adults
Authors: Dhande Sachin K. , Pichaimuthu Anbalagan
Published: August 2024

Background:

Acute upper gastrointestinal bleeding (UGIB) is one of the most common causes of medical emergencies and associated with high morbidity and mortality in adults. Although there is decline in peptic ulcer bleed as an etiology of acute UGI bleed due to discovery of proton pump inhibitors, the Emergency Room (ER) visits for UGI bleed are increasing due to other etiologies including variceal bleed and drug-induced gastrointestinal (GI) bleed. This study was designed with the aim to assess the endoscopic profile of UGIB presenting to our tertiary care center in south India.

Materials and Methods:

This was a prospective analytical study. It was done over a period of 6 months from January 2020 to June 2020. All adult patients presenting with acute hematemesis and/or melena were included in the study. All included patients underwent detailed history, clinical examination, blood tests, and upper GI endoscopy.

Results:

One hundred and eighty-two patients were included in the study. Out of 182 patients, 76% were males. The most common age group was 51–60 years contributing to 34%. The commonest presentation was hematemesis than that of melena. Out of all patients, 69% of patients were hemodynamically stable and 31% patients were unstable at the time of admission. The causes of bleed included esophageal varices, gastric varix, peptic ulcer, portal hypertensive gastropathy (PHG), Mallory-Weiss tear, gastric cancer, drug-induced gastritis, and esophageal tear. Variceal bleed was the most common cause of UGI bleed comprising 34.16% of cases.

Conclusions:

From our study, we conclude that the most common cause of upper GI bleed in our part of India is portal hypertension related bleeding which included esophageal varices, gastric varices, and severe PHG. This was in contrary to most of the studies from other part of the country as peptic ulcer is far more common than variceal bleed in other studies.
The Effect of Locally Infiltrated Platelet-Rich Plasma on Survival of Skin Flaps in Degloving Injuries
Authors: Pundkar Aditya , Shrivastav Sandeep , Date Swapnil
Published: August 2024

Background:

Partial- or full-thickness necrosis is normally encountered complication postoperatively in skin flap patients. The chief causes of necrosis are reduced arterial flow, venous insufficiency, or both. Particularly, necrosis of the skin flap occurs in the more distal portion of the flap, if arterial or venous flux insufficient. The other factors owing to the necrosis of skin flap are qualitative and quantitative deficiency of local growth factors (GFs) and lack of regulation of various GFs. Platelet-rich plasma (PRP) is the concentrate of plasma prepared by serial centrifugation and contains high concentrates of platelets. It is rich in various GFs which are essential for wound healing.

Materials and Methods:

Six patients were included in the study. All the patients had traumatic degloving injuries of lower limbs. After primary cleaning and closure of the flaps, from postoperative day 1, all the flaps were infiltrated with autologous PRP infiltration according to STARS therapy till the wounds healed.

Results and Observations:

All the wounds healed completely with PRP. PRP sessions required ranged from 4 to 7 with an average of 5.4. There was no need of any additional procedure for wound healing such as serial debridements and skin grafting in any of the patients. Two patients required additional procedures for associated fractures which involved K-wire removal and amputation of the fifth toe. Complications such as infection, abscess, or sinus formation were not seen in any of the patients. After suture removal, the mean ± 2 standard deviation total wound area was 31.5 ± 17.6 cm2, mean necrotic area was 7.75 ± 5 cm2, and mean surviving area was 23.75 ± 13.8 cm2. The mean percentage survival of the flaps was 75.119%. This value is comparable with other studies.

Conclusion:

In our study, it was found that local autologous PRP infiltration in the skin flap of degloving wounds according to the STARS therapy increases the chances of survival of flap.
Informative Draft on COVID-19
Authors: Gupta Aishwarya , Bhola Nitin , Kambala Rajanikant
Published: August 2024

In 2019, number of cases diagnosed with coronavirus pneumonia aroused in China. Number of studies were done that showed clinical characteristics of this disease. The aim of this brief informative draft is to summarize the clinical features, virulence, transmission, and various treatment modalities for the treatment of the disease. Also the various protective measures for the general population and health care professionals to prevent the growing pandemicity and control the outbreak of the condition.
Usefulness of Routine Preoperative Investigations in Patients Undergoing Uncomplicated Elective General Surgical Procedures
Authors: Danvath Kishan , Matta Sridhar
Published: August 2024

Background:

Investigations are classified as routine and specific. Specific investigations are done to confirm or exclude a strongly suspected diagnosis, and routine investigations are done to find occult disease not detected during clinical evaluation. Mostly, these are done as an institutional policy or custom and for medicolegal reasons in the event of any complications. The value of these routine investigations in all patients is controversial. Data suggest that these have little influence on patient management and perioperative complications.

Aims and Objectives:

The objective of this study was to evaluate the usefulness of routine preoperative investigations in patients undergoing elective surgical procedures and their influence on perioperative management.

Materials and Methods:

We included various laboratory, radiological, and hematological investigations which were performed routinely in all patients irrespective of diagnosis.

Results:

A total of 1671 investigations were performed in 170 patients. Only 153 (9.2%) investigations were found to be abnormal. Complete blood picture was performed in 168 (98.2%) patients; random blood sugar estimation was done in 147 (86.4%) patients. Chest X-rays were performed in 166 (97.6%) patients. Electrocardiography was performed in 160 (94.2%) patients. The percentage of overall abnormal results was very low. None of these abnormal investigations influenced surgical management and had adverse perioperative complications.

Conclusion:

Preoperative investigations should be done based on clinical examination and comorbid conditions. Routine preoperative investigations do not influence patient management and predict complications and should not be done in all patients.
Quality and Effectiveness of Online Medical Education During COVID-19 Outbreak
Authors: Potdar Pratishtha , Sharma Jyotsna , Gupta Uday Kumar , Aggarwal Deepika , Yadav Yogesh
Published: August 2024

Introduction:

Necessity is the mother of invention, is not only an English language proverb but it has been proved several times in several ways, and recently it has been proved during this COVID-19 outbreak that online medical education has erupted as one of the inventions during these stressful situations as a necessity. In these difficult situations, universities seek to deliver medical education through various new methods or modalities, to ensure the continuous learning of medical students. Novel ways of online teaching should be considered in new medical curriculum development, as well as methods of delivering lectures and practical skills for medical students. In this pandemic situations, medical faculty administrators also had to improvise to make an adjustment, from the formerly class-based lecture to online lecture. This study aimed to measure the perception of medical students regarding the quality and effectiveness of online medical education during COVID-19 Pandemic.

Materials and Methods:

This study was held in Santosh Medical College, Ghaziabad, from April 2020 to August 2020. This is a cross-sectional survey done by using an electronic questionnaire which was based on the result of previously conducted lectures, practical, and small group discussions. It is carefully checked for validation and reliability before considering it for a study. Questionnaires were made on Google Forms and then this e-questionnaire was sent via WhatsApp to all of students. All the data were collected, tabulated, and analyzed.

Results:

Three hundred and ninety-nine number of students responded to the electronic survey conducted via WhatsApp. Students' perception about the effectiveness and quality of medical online education revealed few supportive and few inhibitory factors.

Conclusions:

Data obtained in this study can be used as a valuable input to judge the effectiveness and utility of the online methodology in the future.
A Comparative Study of Cord Blood Bilirubin and Albumin as a Predictor for Neonatal Jaundice in Term Newborns
Authors: Huda Walia Murshida , Sharma Preeti , Aggarwa Juhi , Agrawal Alka
Published: August 2024

Background:

Neonatal hyperbilirubinemia (NH) is the commonest abnormal physiological finding during the 1st week of life. More than two-third of newborn babies develop clinical jaundice. The clinical finding such as yellowish discoloration of the skin and sclera in newborns is because of accumulation of unconjugated bilirubin. In most infants, however, unconjugated hyperbilirubinemia is a normal physiological phenomenon.

Aim of the Study:

The aim of the study was to predict the development of NH at birth in term newborns using cord blood bilirubin and albumin as a risk predictor.

Materials and Methods:

The present cross-sectional study was performed on 150 healthy term newborns, i.e., both males (n = 84) and females (n = 66) with gestational age >38 weeks delivered by caesarian section from the Department of Obstetrics and Gynaecology and Department of Pediatrics and Department of Biochemistry, Santosh Medical College, Ghaziabad.

Results:

Cord serum albumin (CSA) level of ≤2.8 g/dl cutoff value is chosen based on the receiver operating characteristics (ROC) analysis. Shows the neonates who developed NH, 95.2% of these cases had CSA level ≤2.8 g/dl (20/21). If CSA level ≤2.8 g/dl, 28.9% probability of developing NH, and if CSA >2.9 g/dl, then 97.7% chance of not developing NH. Similarly, if CSA level ≥3.4 g/dl, nil or 0% chance of developing NH. Hence, CSA level ≤2.8 g/dl can be considered as critical value or risk factor for the development of NH, whereas newborn with CSA level ≥3.4 g/dl is safe for early discharge.

Conclusion:

Increasing incidence of kernicterus in healthy term neonates as Kernicteus is the chronic sequelae of acute bilirubin encephalopathy. Hyperbilirubinemia is one of the most common causes for readmission of the newborns. Incidence of kernicterus is unknown. Hence, defining a certain bilirubin level as physiological can be misleading and potentially dangerous. NH is a potentially correctable and kernicterus is preventable.
A Cytohistologic Correlation Study of Breast Carcinoma with Reference to Robinson's Cytologic Grading System
Authors: Nanda Rojalin , Sahu Alaka , Mohapatra Kaustav
Published: August 2024

Aim:

The present study has been conducted on cases of infiltrating ductal carcinoma of the breast to correlate cytological Robinson's grading system with histological Nottingham modified Bloom–Richardson grading system.

Settings and Design:

This is a retrospective study conducted on fifty cytologically diagnosed breast carcinoma cases in the Department of Pathology, VIMSAR, Burla, Odisha.

Materials and Methods:

Fifty cases of cytologically diagnosed breast carcinoma were graded according to Robinson's system, and the respective histopathology slides were graded according to Nottingham modified Bloom–Richardson scoring system. The axillary lymph node (if any) status was also checked for any metastases. The sensitivity, specificity, positive predictive value, and negative predictive value of Robinson's cytological grading system were calculated.

Results:

The absolute concordance rate between cytological and histological grades was 78% which indicates a strong correlation and significant association. Sensitivity was maximum for Grade II tumors (88.00%) while specificity was maximum for Grade III tumors (97.50%). The positive predictive value was maximum for Grade III tumors (85.71%) while the negative predictive value was maximum for Grade I tumors (94.11%). Lymph node metastases were found in 42% (21 cases) of all the tumors; maximum was (100%) in Grade III tumors.

Conclusion:

Cytological grade strongly correlates with histological grade and is helpful in selecting the treatment regimen.
The effect of a caring program based on the Pender’s health promotion model on caregiver burden in family caregivers of patients with chronic heart failure: A quasi-experimental study
Authors: Khaninezhad Loghman , Valiee Sina , Moradi Yousef , Mahmoudi Mokhtar
Published: August 2024

BACKGROUND:

The Pender’s Health Promotion Model is a comprehensive solution to improve health and reduce the risk of chronic conditions. This study aimed to determine the effect of a care program based on the Pender’s Health Promotion Model on the caregiving burden of family caregivers of patients with chronic heart failure.

METHODS:

This semi-experimental study with a control group was conducted at the Imam Khomeini Heart Clinic in Saqqez in 2022-2023. In this study, 90 family caregivers from patients with chronic heart failure were randomized to intervention and control groups. Data were collected through a demographic information questionnaire and the Caregiver Burden Inventory (CBI) prior to and 50 days after the intervention. Data were analyzed using independent t-test, Chi-square, and paired t-test in SPSS V 25. A significance level of 5% was considered.

RESULTS:

The results of this study indicated that the control and intervention groups were homogeneous in terms of demographic characteristics (P = 0.643). The findings also showed a statistically significant difference in the mean scores of all dimensions of caregiving burden between the two groups after the intervention, such that the overall mean score of caregiving burden in the intervention group had a significant reduction (P < 0.0001).

CONCLUSION:

The present study demonstrated that a care program based on the Pender’s Health Promotion Model can reduce the caregiving burden of family caregivers of patients suffering from chronic heart failure. Additionally based on health policies, this program can play an effective role in improving the quality of life of families with chronic heart failure patients and reducing their medical costs as a comprehensive solution for improving health and reducing the risk of chronic diseases.
Impact of Youth Health Ambassador Programme on health awareness in youths in Singapore
Authors: Lim Shermane Y. W. , Loh Ryan J. , Teo Yao Hao , Chong Elliot Y. , Tan Zhong Chen , Du Sherry D. X. , Lee Abigail K. , Ren Yi Ping , Chia Joshua , Teo Desmond B. , Lim Fong Seng
Published: August 2024

BACKGROUND:

The Youth Health Ambassador Programme (YHAP) is a health educational program aimed at empowering youths to become health ambassadors in the community through raising their health awareness and training them in primary health prevention. This study evaluates the effectiveness of YHAP in improving the knowledge, attitudes, and practices (KAP) of participants in physical and mental health.

MATERIALS AND METHODS:

This study followed a single-group quasi-experimental design, with a pre- and postworkshop KAP survey. Participants were junior college (JC) and polytechnic students in Singapore enrolled in YHAP. In total, 131 responses were analyzed for changes in KAP for physical and mental health before and after the program. This article also studied the participants’ barriers to educating others, including environment factors, intrinsic factors, and receptiveness of the target audience.

RESULTS:

Mean scores of all six KAP domains increased from the preworkshop survey to the postworkshop survey, with significant improvements (P < 0.05) in all domains except mental health knowledge. Individually, 16 out of 29 questions in the KAP sections had a significant increment in mean score after the program (P < 0.05). Mean scores for intrinsic barriers also decreased significantly (P < 0.001) postintervention, indicating that participants were less likely to agree that intrinsic factors were a barrier to educating people around them about health postintervention.

CONCLUSION:

YHAP is effective in improving the KAP of physical health and the attitudes and practices of mental health JC and polytechnic students and may reduce the effect of intrinsic barriers that participants face when teaching others.
Navigating the death attitudes and anxiety during COVID-19: Role of dispositional mindfulness and tranquil ego
Authors: Mandal Satchit Prasun , Pandey Vijyendra , Bonal Raghavendra B. , Sharma Abhishek , Astha Arora , Rajesh Viju , Saha Proshanto Kr
Published: August 2024

BACKGROUND:

Anecdotally, the concept of death consistently evokes profound unease. This study explores the intricate relationship between individuals’ attitudes toward death and the associated anxiety, introducing a two-step model that posits dispositional mindfulness and tranquil ego as mediators.

MATERIALS AND METHODS:

We used a correlational design in this study and assessed 209 Indian adults (111 males and 98 females) who recovered from corona symptoms on self-report measures of attitudes toward death, death anxiety, dispositional mindfulness, and tranquil ego. Bivariate correlational analyses and path analysis were used to analyze the data.

RESULTS:

Findings revealed that attitudes toward death involving fear, avoidance, approach, and escape acceptance of death correlated positively with death anxiety. Dispositional mindfulness and tranquil ego correlated negatively with death anxiety. Path analyses with percentile bootstrapping supported our hypothesis and showed that dispositional mindfulness and tranquil ego sequentially mediated the relationship.

CONCLUSION:

These findings indicate that various aspects of attitudes toward death differentially predict death anxiety. Moreover, the relationship between death attitudes and death anxiety is potentially mediated by dispositional mindfulness and a tranquil ego. The findings were discussed in light of existing literature.
Assessment of self-satisfaction, happiness, and quality of life (QoL) among adults: An online survey
Authors: Dehury Ranjit Kumar , Gadiraju Padmaja , Singh Punam , Vanlalhruaii C. , Dehury Parthsarathi , Devaraju Kadari , Behera Sangita
Published: August 2024

BACKGROUND:

Health and QoL are essential for every individual. Regardless of their psychological status, every individual needs an optimum level of Self-satisfaction, Happiness, and QoL. The paper aimed to explore the QoL of the Indian population concerning their day-to-day needs.

MATERIAL AND METHODS:

The study used an online survey method to assess the QoL of Indian adults. The Questionnaires have been sent to more than 3000 participants through social media like Emails, Facebook, Instagram, Telegram, and WhatsApp. A total of 200 participants filled out the Google form completely. The data was collected from March 2022 to June 2022. The collected data was analyzed by using SPSS (version 24).

RESULTS:

The Overall mean was found to be 3.25 [N = 200, Range 18-36 above, Mean = 3.25 and SD = 1.04]. A few important dimensions are mentioned, such as QoL (50% people with mean = 4.00), Self-satisfaction (38% people with mean = 4.00), enjoyment in life (45% people with mean = 4.00), sleep (42% people with mean = 4.00), sex life (36.5% people with mean = 3.00), constant strain (33.5% people with mean = 3.00), loss of self-confidence (26% people with mean = 3.00).

CONCLUSION:

The study indicates low scores on self-satisfaction, QoL, and above-average scores for happiness. There must be interventions to improve the levels of psychological functioning among adults concerning these variables, which would, in turn, help improve the overall adults’ functioning. The relevant interventions need to be planned to improve self-satisfaction, happiness, and QoL by improving daily activities.
“The feedback dilemma”—provider and learner perspectives regarding the barriers and facilitators for giving and receiving feedback in medical education: A parallel mixed methods approach
Authors: Pusdekar Yamini , Pusdekar Vinod , Dani Akanksha , Saoji Ajeet , Gupta Madhur
Published: August 2024

BACKGROUND:

Learning in medical education involves a multitude of practical tasks and skills that are amenable to feedback provision. Though passive feedback is given, there is a consistent gap in feedback provision and its receipt. This study aims to assess provider perspectives on feedback and learner attributes influencing the receipt of feedback in medical educational settings.

MATERIALS AND METHODS:

A parallel mixed methods study was conducted in September 2023 at a tertiary care teaching institute. A convenience sample of 40 medical teachers comprising two faculties per department and 30 students were included. Focus group discussions (FGDs) were conducted with students from each academic year for assessing the student-level factors (facilitators and barriers) in the receipt of feedback.

RESULTS:

Among the 40 medical teachers who were interviewed, the majority of 23 (57.5%) were assistant professors and nearly half of them (18; 45.0%) were below the age of 30 years. The majority of the respondents (28; 70.0%) were females, and 34 (85.0%) of them were postgraduates. Most of them (24; 60.0%) had worked for more than 10 years at the institute. It was observed that 80.0% of the respondents had given feedback to their students at some point in their careers. The major barriers for providing feedback were lack of curricular guidelines, fear of affective responses from students, burden of clinical, administrative work, and lack of perceived need by both students and teachers. DESTEP analysis of the student-level factors governing the receipt of feedback shows the effects of institutional ethics and culture, feedback model utilized, and the influence of learner behaviors, motivations, and teacher attributes.

CONCLUSION:

The study elucidates mentor- and mentee-level influencers for providing and receiving feedback. Effective teacher-student partnerships along with an optimal skill set are required to recognize the need, opportunities, and processes to provide and seek feedback. Shifting the focus from feedback giving to active feedback seeking would be a step toward creating effective and pragmatic feedback systems.