bluuebunny/crossref_metadata_2025 huggingface dataset:
Interspecific Facilitation of Nutrient Uptake and Productivity Performance of Finger Millet-Green Gram Intercropping System under Varying Moisture Availability
Authors: Senevirathne A. G. U. N. , Dissanayaka D. M. S. B. , De Silva S. H. N. P.
Published: January 2025

Finger mi llet (FM/ Eleusine coracana L. Gaertn.) and green gram (GG/ Vigna radiata L. Wilczek) are suitable crops to be cultivated  under moisture-limited conditions. This experiment investigated the interspecific facilitation of nitrogen  (N) and phosphorus (P) uptake and productivity performance of FM-GG intercropping system under moisture-s tressed conditions. In a pot experiment, two crop species were cultivated as mono-cropping and intercropping under two moisture levels (well-watered and moisture-stressed).  Soil moisture in well-watered condition was maintained at 80% of field capacity, whereas moisture-stress was  imposed with 40%. Plant dry weight, panicle/ grain yield, uptake of N and P, and use efficiency of those nutrients i n biomass production were measured. Moisture-stress significantly (P<0.05) decreased the panicle/grain dry weight of  FM and GG. Though intercropping had no yield advantage for FM or GG either in well-watered or moisture-stressed c onditions, intercropped FM under drought stress and well-watered conditions had respectively 42% and 53% greater grai n N accumulation than those of its monocultures. FM grown  with GG acquired more (P<0.05) N than those cultivated in mono-cropping system indicating the interspecif ic facilitation of N uptake by FM in intercropping. Grain N accumulation of FM was also enhanced in intercroppin g system. There were no P benefits from the intercropping. The study indicates that interspecific facilitation  of nutrient uptake in FM-GG intercropping happens only for N, resulting in grain N fortification of FM. Incorporati on of legumes, particularly green gram, into FM cultivation in drought-prone areas could be a potential strategy for g rain N enrichment of FM.
An Approach for Common Web GIS Platform for Agriculture Sector Modernization in Sri Lanka
Authors: De Silva S. T. S. , De Silva R. P. , Dayawansa N. D. K.
Published: January 2025

The status of innovative technology adoption in the Sri Lankan agriculture sector is significantly low. A detailed study conducted by the Department of Agriculture, Sri Lanka and TRCSL, with the assistance of FAO – UN, clearly identified the need for a common platform to manage all stakeholders in an integrated single platform. There have been some attempts by the private and government sectors to overcome the identified gap, but these have yet to produce results. Th is research identified the technology and services gaps and introduced a Cloud-based Microservice Architecture-based Geographical Information Management Platform, "AgriMIS", to manage the country's entire agricultural sector in a single platform. The AgriMIS platform was develope d so that preloaded spatial layers such as administration boundaries, census data, land use data, disaster data, and many more are preloaded and available to the public. Privately owned data such as farmer, farm, land use, fertilizer usage, crops and other relevant details are hosted privately on the same cloud with multitenant access where only that particular data owner can access the data, and this allows the users to access public data hosted on the cloud and conduct a significant number of spatial and nonspatial analyses with the given user interfaces. Also, the platform allows users to connect their existing decision support systems through APIs to the AgriMIS platform. The platform has been assessed and proved to be successful.
Wind Tunnel Testing and Aeromechanics Predictions on Slowed Mach-Scaled Thrust Compounding Rotorcraft with a Trailing Propeller
Authors: Kaplan Noam , Patil Mrinalgouda , Chopra Inderjit , Datta Anubhav
Published: January 2025

A thrust compounded helicopter—a main rotor with a trailing propeller was tested in the Glenn L. Martin Wind Tunnel to evaluate its performance under different ight conditions. The main rotor rig consists of a hingeless hub with four fully instrumented NACA 0012 blades and a modified
Robin fuselage. The propeller rig consists of a rigid Sensenich L26H propeller with four blades. Tunnel tests were carried out for the isolated propeller and thrust compounded rotor con gurations. The isolated propeller tests were conducted with and without the fuselage installed ahead of
it to understand the effects of the fuselage on propeller performance. The thrust compound con guration was tested at three different main rotor shaft tilt angles (α s):– 4°, 0°, and 4° (fwd tilt, vertical, rearward tilt), advance ratios (μ) from 0.3
to 0.6, and multiple lift (C L/σ) and propulsive (C X/σ) trim targets. Main rotor hub loads, oscillatory blade structural loads, and propeller hub loads were measured for all the tests. The test data were verified with a full vehicle aeromechanical analysis using
the University of Maryland Advanced Rotorcraft Code. The thrust compound configuration with the main rotor shaft tilt of 4 ° (rearward tilt) provided the best performance. Thrust compounding with rearward shaft tilt (4 °) resulted in a 50% increase in the maximum aircraft lift-to-drag
ratio compared to a single-rotor helicopter. Half peak-to-peak hub vibratory loads and blade bending loads decreased with thrust compounding. It was observed that for the same lift target (C L/σ), thrust compounding achieved 20% higher ight speeds than a single rotor.
REFINING HIGH-RISK MULTIPLE MYELOMA: ADVANCEMENTS IN GENOMIC, CLINICAL, AND PROGNOSTIC CRITERIA
Authors: Martino Enrica Antonia , Mele Giuseppe , Morabito Fortunato , Gentile Massimo
Published: January 2025

Multiple myeloma (MM) is a heterogeneous disease with MM patients experiencing different clinical outcomes depending on the disease’s biological features. Novel insights into the molecular mechanisms of MM have led to the introduction of sophisticated drugs, which dramatically improved patient treatment and survival. To date, young patients with newly diagnosed MM could experience a median overall survival (OS) of 10 years. Nevertheless, a small proportion of patients still undergoes early disease progression and death. Indeed, cases defined as ultra-high-risk MM (uHRMM) and high-risk MM (HRMM) are destined for a worse outcome, with an OS of 2-3 and 3-5 years, respectively. In this regard, current risk stratification systems failed to identify this subset of patients better. The application of existing risk models has led to the identification of extremely heterogeneous categories of patients, and they have not taken into account biological and clinical differences.  The concept of HRMM was initially formalized in 2015. Since then, a great effort has been made to identify those parameters whose presence pone MM patients at higher risk of developing an early relapse. The simultaneous presence of 2 or more unfavorable cytogenetic abnormalities, the identification of an extramedullary disease or the detection of circulating plasma cells, as well as high-risk gene expression profiling (GEP) signature, have shown to be well related to a worse outcome and are going to be incorporated into new prognostic systems. The introduction of the Individualized Risk Model for Multiple Myeloma (IRMMa) marks a significant advancement in the management of HRMM by integrating genomic and clinical data to tailor treatment strategies. This model demonstrates improved prognostic accuracy compared to traditional staging systems and emphasizes the importance of personalized treatment approaches. The implementation of these advanced tools is essential for enhancing precision medicine in MM and improving outcomes for patients in high-risk categories.
The diagnostic sensitivity of beta-D-glucan assay in patients with chronic disseminated candidiasis
Authors: Son Hyo Ju , Jung Kyung Hwa
Published: January 2025

Objectives: Chronic disseminated candidiasis (CDC) is a specific syndrome in patients with hematologic malignancies which usually occurs after the recovery of neutrophils due to previous chemotherapy. The beta-D-glucan (BDG) assay has been proposed as an adjunct test for diagnosing invasive fungal infection. However, data on BDG assay in patients with CDC are scarce. We aimed to investigate the diagnostic sensitivity of BDG assay in patients with CDC.
Methods: All adult patients who were diagnosed as CDC in a tertiary hospital in Seoul, South Korea, from January 2017 to December 2019 and underwent BDG assay (Gold Mountain River Tech Development, Beijing, China) were retrospectively reviewed. CDC was defined by the demonstration of small, target-like abscesses in the liver or spleen (bull’s-eye lesions) or in the brain at the time of neutrophil recovery after a prolonged phase of neutropenia. The values for BDG over 80 pg/mL were classified as positive.
Results: A total of 20 patients were enrolled. The median age was 51 years (IQR 39 – 64). Of these, 13 patients had AML, 3 ALL, 2 MDS, and 1 aplastic anemia. Candida spp. were isolated in 6 patients; 3 were C. tropicalis, 2 C. glabrata, and 1 C. krusei. Of the 20 patients, 10 (50%) revealed positive BDG results. The median BDG value was 174 pg/dL (IQR 137–402). More CDC patients with previous candidemia had positive BDG assay than those without candidemia, but with no statistical significance (4/5 (80%) vs. 6/15 (40%), P = 0.30). In the 7 patients with BDG assay-positive CDC, for whom follow-up BDG results were available, the BDG remained high in 6 patients (86%) for more than 4 weeks after adequate antifungal therapy. All 4 patients who died had a positive BDG assay, and 3 of them showed an increasing trend of BDG values during treatment.
Conclusions: Negative BDG assay appears to be not useful to rule out CDC. BDG assay decreased slowly during the adequate treatment of CDC.
Cancer through the ayurvedic lens: An agadatantra path to healing
Authors: Sundaramourthy Divyashri , Venkateshperumal S. K. , Mishra Balram , Muzzammel Mohamed
Published: January 2025

Cancer is a complicated illness, and its therapies, such as chemotherapy and radiotherapy, frequently lead to harmful side effects. Ayurveda perceives cancer through concepts such as Viruddhahara and Visha, offering a framework to evaluate disease development and inform treatment by restoring balance in Doshas (biological energies) and revitalizing Dhatus (tissues). Aacharya’s age-old idea of Visha describes the phases of illness, highlighting the role of Doshic imbalances and diminished Dhatus in cancer development. Vishachikitsa (study of ayurvedic management of poison), part of Ayurveda, explores the impact of toxins on the progression of diseases, such as cancer. Nongenetic factors such as diet, lifestyle, environmental pollutants, and inadequate hygiene significantly contribute to cancer, accumulating as toxins known as Garavisha and Dooshivisha in Ayurveda. These hidden toxins disturb the body’s equilibrium and encourage illness over time. Ayurvedic detox techniques (Shodhana) and anti-toxic medicinal preparations (Agada Kalpas) aim to remove these toxins and promote health restoration. By combining Ayurvedic concepts with contemporary diagnostic technologies, there is an opportunity to improve cancer prevention, early identification, and treatment. This comprehensive strategy may lower the occurrence of cancer and ease the financial strain it places on both individuals and the community. This article explores the Ayurvedic method for handling cancer and the side effects of treatment, emphasizing potential causes and solutions.
Cancer care beyond the conventional: Challenges of integrative oncology in India
Authors: Venate Parvathy , Huddar Vitthal G.
Published: January 2025

The growing burden of cancer in India has led to increased reliance on traditional medicine systems like AYUSH (Ayurveda, Yoga, Unani, Siddha, and Homeopathy) alongside conventional cancer treatments. Integrative oncology (IO) has emerged as an evidence-based, patient-centred approach that combines conventional treatments with complementary therapies to improve health outcomes. This article explores the challenges and opportunities in integrating AYUSH with conventional oncology through a review of physician perspectives, patient experiences, research gaps, and policy frameworks. Despite the potential benefits, IO faces barriers, including lack of awareness, mistrust between disciplines, inadequate regulation of AYUSH products, and insufficient research. The absence of structured integration in clinical practice limits its widespread adoption. To promote IO in India, a unified approach is needed, including integrating AYUSH in medical curricula, fostering research, and creating supportive policies that ensure safe, effective, and patient-centered care.
Interleukin 38 as a bio marker for metabolic syndrome in psoriatic patients
Authors: Mohamed Rasha I. , Abd-elmagid Wafaa M. , Mohammed Abdellatif Yomna A. , Abo elmagd Marwa A.
Published: January 2025

Background

Metabolic syndrome (MetS) is more common comorbidity in psoriasis and a risk factor for cardiovascular disease. Interleukin 38 (IL-38) is an anti-inflammatory cytokine that has a vital role in MetS.

Aim

This research aimed to identify the possible relationship between plasma IL-38 levels in psoriatic cases and MetS development.

Methods

This case-control study included 88 adults aged greater than 18 years, divided into four groups of 22: group (1) cases with psoriasis vulgaris only, group (2) cases with psoriasis vulgaris and MetS, group (3) cases with MetS only, and group (4) healthy control subjects. All participants were subjected to full history taking, clinical assessment, laboratory investigation (fasting blood sugar, fasting triglyceride level, high-density lipoprotein), and plasma levels of IL-38 using ELISA kits.

Results

IL-38 levels were significantly decreased in each of the diseased patients (psoriasis, MetS, or both) than in controls. patients with psoriasis and MetS had the lowest level of IL-38 than those with psoriasis only or MetS only. There was a highly significant difference in the IL-38 levels among the groups (P<0.0001). In patients with psoriasis there was a significantly negative correlation between the PASI score and IL-38 levels.

Conclusion

The decreased serum level of IL-38 among psoriatic patients with MetS is more than patients with either disease alone due to its role in the pathogenesis of both conditions. Much decrease in its level in psoriatic patients can be an indicator of development of metabolic abnormalities. This opens a new scope in the treatment of both conditions using IL-38.
Comparison of using dermapen device assisted delivery of Botulinum Toxin a versus its intradermal injection in the treatment of palmar hyperhidrosis
Authors: El-Gayar Maha A. , Alashry Shereen E. , Eldahshan Reem I.M.
Published: January 2025

Background

Hyperhidrosis (HH) is a condition characterized by excessive sweating caused by overstimulation of cholinergic receptors on eccrine glands. Primary hyperhidrosis (PH) is idiopathic, bilaterally symmetric, and affects various parts of the body. Botulinum neurotoxin-A (BTX-A) has a role in the nonsurgical management of HH. Dermapen was introduced for transdermal drug delivery.

Objective

To evaluate the clinical efficacy of Dermapen assisted delivery of BTX-A versus its intradermal injection in the treatment of primary palmar HH.

Patients and methods

A prospective intrapatient comparative study, conducted on 20 patients with bilateral palmar HH categorized into two groups, group A: left palm was treated by intradermal injection of BTX-A, group B: right palm was treated by Dermapen combined with topically applied BTX-A.

Results

Both groups had significant improvement after treatment. However, group A showed significantly better grades regarding hyperhidrosis disease severity scale, dermatology life quality index, and patient satisfaction.

Conclusion

Both methods were effective and tolerable. Intradermal injection intervention was better regarding hyperhidrosis disease severity scale, dermatology life quality index, patients satisfaction, and long-term follow-up.
Toll-like receptor 4 +896 A>G and CD14–159 C>T polymorphism in Egyptian patients with atopic dermatitis
Authors: Hasan Ahmad S. , Ragab Aml F. , Salem Hanan A. , Metwally Shereen S. , Fathy Amr M.
Published: January 2025

Aim

To investigate the possible association of Toll-like receptor (TLR4) +896 A/G and CD14 −159C/T single nucleotide polymorphisms (SNPs) with the development of atopic dermatitis (AD) in a sample of Egyptian AD cases and to evaluate their correlation with total serum immunoglobulin E (IgE) level and disease severity.

Patients and methods

This work comprises 100 AD cases in addition to 100 patients similar in age and sex as controls. TLR4 +896 A>G rs 4986790 and CD14–159 C>T rs 2569190 polymorphisms were determined using polymerase chain reaction-restriction fragment length polymorphism.

Results

TLR4 +896 A/G genotyping, showed a statistically significant higher frequency of AG genotype (30%), AG+GG genotype (33%), and G allele (36%) in AD patients versus controls (2%) (P<0.001), with high risk to develop AD (OR =21.9, 24.1, and 21.7), respectively. CD14–159 C>T rs 2569190 genotyping, showed a higher frequency of CT, TT, and combined CT+TT genotypes in the control group (57%, 27%, 84%), versus AD patients (39%, 20%, 59%), respectively. Also, the T allele showed a statistically significant higher frequency in controls (55.5%) compared with AD patients (39.5%), (P<0.001, 0.002, <0.001, and 0.001), respectively. Still, they are not associated with the clinical features, serum IgE level, and SCORAD in all studied AD patients.

Conclusion

TLR4 (+896 A>G) rs 4986790 AG, combined AG+GG genotype, in addition to G allelomorph may be considered risky, while CD14 −159 C>T rs 2569190 (CT), (CT+TT) genotype and T allelomorph may be considered safeguarding elements against development of AD in Egyptian cases. Still, neither is associated with the clinical features, serum IgE level, or disease severity.
Prolargin serum and tissue expression levels in hypertrophic scars and keloids
Authors: Sorour Neveen E. , Abdeltwab Asmaa O. , Azab Naglaa I. , El Habak Doaa M.
Published: January 2025

Background

Uncertainty surrounds the exact etiology of hypertrophic scars and keloids. It is generally accepted, nevertheless, that they are caused by reticular dermal chronic inflammation, which typically begins shortly after wounding. Prolonged inflammation increases myofibroblast differentiation and fibroblast proliferation.

Objective

To measure prolargin’s tissue expression and serum level in individuals with keloids and hypertrophic scars to determine how these factors are related to the disease.

Patients and methods

This was a case–control study on 90 patients who were classified into three equal groups. Group I: patients with hypertrophic scars. Group II: patients with keloids. Group III: healthy individuals, age-matched and sex-matched, as controls. Blood samples and tissue biopsies were taken to assess serum and tissue levels of prolargin using the enzyme-linked immunosorbent assay technique.

Results

Serum and tissue prolargin were significantly lower in groups I and II than in group III (P<0.001). Multinomial logistic regression was done for serum prolargin to predict hypertrophic scars and keloids. Group III was used as a reference category. Serum prolargin was a significant predictor for hypertrophic scars (odds ratio=0.933, 95% confidence interval= 0.902–0.965, P<0.001) and keloids (odds ratio=0.946, 95% confidence interval=0.919–0.974, P<0.001).

Conclusion

The current study sheds light on prolargin’s possible role in hypertrophic scars and keloid pathogenesis. The results open up the possibility of investigating prolargin’s intricate pathologic role and its potential as a marker for diagnosis and prognosis for these difficult fibroproliferative skin disorders.
Can lesion volume and prostate-specific antigen density play a role in detecting clinically significant prostate cancer in Prostate Imaging Reporting and Data System-3 lesions on multiparametric magnetic resonance imaging?
Authors: Agrawal Shashank , Prasad Vishnu , Menon Arun Ramadas , Pooleri Ginil Kumar
Published: January 2025

Introduction:

Recently, the Prostate Imaging Reporting and Data System – 3 lesions (PI-RADS 3) have been sub classified into “3a” - lesions with a volume of <0.5 mL and “3b” - lesions exceeding 0.5 mL, whereas the prostate-specific antigen density (PSAD) is an established adjunct tool for predicting clinically significant prostate cancer (csPCa). The objective of this study was to evaluate the association between the volume of PI-RADS 3 lesions and PSAD in diagnosing csPCa and to assess the sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) when PSAD is combined with the lesion volume.

Methods:

This retrospective single-center study reviewed the data of transperineal prostate biopsies performed under transrectal ultrasound guidance from January 2018 to December 2023. csPCa was defined as a Gleason score ≥3 + 4. Patients were divided into two groups based on the PIRADS-3 subclassification and PSAD.

Results:

Out of the 108 PIRADS-3 lesions, 17 patients had csPCa. All the patients with PIRADS-3a (n = 37) had clinically insignificant tumors or benign conditions. Receiver operating characteristic curve analysis for predicting csPCa showed that the (Area under the curve) AUC values of PSAD, prostate volume, and prostate-specific antigen were 0.899, 0.746, and 0.381, respectively. 16 csPCa patients in PIRADS-3b category had PSAD ≥0.29 ng/ml2, whereas 1 patient had PSAD <0.29 ng/ml2. Sensitivity, specificity, PPV, and NPV of PIRADS-3b lesions were 100%, 40.66%, 23.94%, and 100%, respectively, and it became 94.12%, 74.07%, 53.33%, and 97.56%, respectively, when PSAD was added to PIRADS-3b lesions.

Conclusion:

The combination of lesion volume of the PI-RADS 3 lesion and PSAD improved the PPV and specificity of detecting csPCa.
Assessing neoadjuvant chemotherapy’s impact on complications following radical cystectomy
Authors: Nuthalapati Mounish , Menon Arun Ramdas , Patil Vivek Dadasaheb , Sukumaran Sheejamol Velickakathu , Yensani Prashanth Reddy , Agrawal Shashank , Haridas Nikhil Krishna , Nair Haridas , Ganesuni Sohini Chandra , Suresh Nivedita , Rajamma Bindu Mangalath , Pooleri Ginil Kumar
Published: January 2025

Introduction:

Despite level 1 evidence supporting neoadjuvant chemotherapy (NACT) followed by radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC), its adoption is hindered by concerns about toxicity and detrimental impact on post-RC complications. We retrospectively reviewed post-RC complications at a tertiary care hospital, particularly assessing impact of NACT.

Methods:

Data from the institutional bladder cancer database were retrieved for patients aged ≥18 with MIBC (≥American Joint Committee on Cancer Clinical Stage T2), treated with RC between May 2013 and July 2023. Exclusions were nonurothelial histology, salvage cystectomy, and palliative intent. Data abstracted included patient characteristics, NACT administration, surgery, and outcomes. Patients were divided into two groups based on NACT and compared. Complications were categorized as early (≤30 days) or late (31–90 days) and graded. Statistical analysis set significance at P < 0.05.

Results:

Of 154 patients who underwent RC, 33 were excluded due to non-MIBC, nonurothelial histology, or salvage cystectomy. The 121 patients analyzed had a mean age of 64 years and a Charlson Comorbidity Index (CCI) of 4.9. Among them, 61 received NACT and 60 did not. There was no significant difference between the NACT+RC and RC-only groups in overall complication rates (85.3% vs. 75.0%, P = 0.16) or in major complications (50.8% vs. 58.3%, P = 0.41). CCI >5 predicted major complications, while NACT did not.

Conclusion:

In our study of MIBC patients managed at a tertiary care institute in India, NACT administration did not increase postoperative complications.
Shifting tides: A survey analysis of urologists’ evolving attitudes toward focal therapy for prostate cancer
Authors: Koehler Jason , Lazarovich Alon , Tayebi Shima , Viswanath Vijay , George Arvin , Hsu Wei-Wen , Sidana Abhinav
Published: January 2025

Introduction:

Focal therapy (FT) is emerging as an alternative to radical treatment for prostate cancer (CaP). The purpose of this study is to assess the current perceptions of FT amongst urologists.

Methods:

A 22-item questionnaire was e-mailed to members of the American Urological Association. Multivariate logistic regression analysis was used to identify predictors of FT utilization. Results were compared to a previous survey from 2019.

Results:

Two hundred and sixty-four responses were recorded. Less than half (115/264, 43.6%) of respondents utilize FT; among them, 42% perform FT on more than 10 patients/year. Reasons for avoiding FT included: lack of experience (51.8%), belief that CaP is multifocal (46.0%), and lack of infrastructure (43.1%). The most common modalities for FT were high-intensity focused ultrasound (63.4%) and cryoablation (47.3%). Preferred patients for FT were primarily unilateral/anterior only Gleason Grade Group 2 (95/110, 86.4%). A fellowship training in urologic oncology (odds ratio [OR] = 2.86, P = 0.008) and seeing more than 10 CaP patients per month (OR = 2.46, P = 0.002) were associated with greater utilization of FT. Most respondents (85.4%) cited better imaging methods as a factor that has increased FT utilization. Compared to a previous survey, a higher number of respondents (43% vs. 24%) utilize FT and more respondents believe in the “index lesion theory.”

Conclusions:

Less than half of the respondents utilize FT in their practice. Fellowship training in urologic oncology and a higher volume of CaP patients were correlated with FT utilization. As urologists gain more experience, the trend of further utilization of FT for CaP may continue.
Urethral duplication with five openings in anal canal: A novel case report
Authors: Pirzada Faisal Masood , Nayyar Rishi , Yadav Devendra Kumar
Published: January 2025

Urethral duplication is a rare congenital anomaly characterized by more than one urethral channel, with varied course, location of the external opening, and presentation. Presentations can be varied, depending upon individual anatomical dispensation but mostly present as obstruction, recurrent urinary infection, or double urinary stream. Treatment depends on the type of duplication and associated anomalies. Here, we report a case of urethral duplication which did not fit into any known reported type of urethral duplication forms and had five openings at the anal verge.
A retrospective analysis of patients undergoing keratoplasty in a tertiary care center
Authors: Tamboli Nikhat Iqbal , Joshi Rajesh S , Hussain Murtaza , Shilpa  , Husain Bilal , Darade Nikhil Nivritti
Published: January 2025

Purpose:

The purpose of the study was to study keratoplasty indications and outcomes at a tertiary care center in Western Vidarbha.

Subjects and Methods:

It is a retrospective cross-sectional study in which medical records of all patients undergoing keratoplasty at tertiary care in Western Vidarbha, Maharashtra, India, between October 2021 and October 2023, with a minimum follow-up period of 6 months were reviewed. Data were represented as numbers, percentages, and means.

Study Parameters:

Indications, surgical procedures, and outcomes of all surgeries collected and studied.

Main Outcomes:

Graft survival and visual acuity.

Results:

One hundred cases of keratoplasty were recorded during the study period. Total (33) optical keratoplasties, (41) therapeutic/tectonic keratoplasties, (11) descemet stripping endothelial keratoplasty (DSEK), and (15) deep anterior lamellar keratoplasty (DALK) were included. Out of those, 15 grafts survived and 79 grafts failed. Regrafting was done in six cases.

Conclusion:

Fifteen percent graft survival, visual acuity improved in 30% of patients of optical KP, 28% of patients of DSEK, and 13% of patients of DALK. The most common indication for keratoplasty was a perforated corneal ulcer. Graft failures are seen in infected and rheumatoid arthritis cases commonly. Postoperative complications occurred in 73% of cases. The outcome was better in optical keratoplasty patients than in therapeutic.
Nummular retinal pigment epithelium loss in bilateral diffuse uveal melanocytic proliferation
Authors: Goel Neha
Published: January 2025

A rare case of cancer-associated nummular loss of retinal pigment epithelium (RPE) is presented. This subtype of the more commonly reported bilateral diffuse uveal melanocytic proliferation is notable for absence of typical uveal melanocytic proliferation. A 71-year-old male with pancreatic cancer exhibited multiple hypopigmented patches on fundus examination, with corresponding transmission defects on fluorescein angiography and outer retinal and RPE loss on optical coherence tomography, confirming RPE loss as the predominant feature. This was interspersed with zones of preserved RPE which were most prominent on near-infrared reflectance imaging. Recognition of this unusual variant is important to establish an early diagnosis.
Drive slow, craters everywhere: A rare presentation of double macular coloboma with contralateral optic disc coloboma
Authors: Sarkar Avik Dey , Vallinayagam Muthukrishnan , Kannan Naresh Babu , Balakrishnan Tanya
Published: January 2025

Ocular coloboma can involve various structures, e.g., iris, lens, eyelid, zonules, retina-choroid, and optic disc. Here, we have discussed a rare co-occurrence of macular coloboma and optic disc coloboma (ODC) in the same patient. A 15-year-old boy presented with diminished best-corrected visual acuity measured in the right eye (OD) was 20/20 N6 and 20/60 N10 in the left eye (OS). On dilated fundoscopy, in OD, a large, deep hole with sharp borders on the temporal edge of the optic disc without any retinal tissue herniation was noted, while in OS, two large sharply demarcated excavations near the inferior arcade were evident. The larger one was measuring 5350 µm × 3928 µm. Detailed optical coherence tomography and fundus autofluorescence-based documentation were completed. This co-occurrence of double macular coloboma with contralateral ODC, in the history of ophthalmic literature, is considered extremely rare and has never been reported before to the best of our knowledge.
Conjunctival Lymphangiectasia: “String of pearls” appearance
Authors: Kaur Rajwinder , Rai Supreet , Kaur Harleen , Kaur Navdeep
Published: January 2025

Conjunctival lymphangiectasia is a rare ocular condition marked by abnormal lymphatic duct enlargement, leading to the collection of lymph in interconnecting channels in the conjunctiva. It can be primary (from congenital issues) or secondary (due to lymphatic vessel blockage from factors like radiation or surgery). In our case, a 64-year-old man had a history of persistent eye discomfort and persistent foreign-body sensation, which was his main cause of concern. On examination, he had evidence of cystic channels with clear fluid (lymph) in both eyes. Anterior segment optical coherence tomography confirmed interconnecting fluid-filled cysts in both eyes.
Effect of prednisolone acetate eye drops on blood glucose profile in Indian population
Authors: Bhat Archana , Paritekar Prajakta , Umesh Y.
Published: January 2025

Background:

One of the common indications of topical steroids is to control postoperative inflammation. This study aims to evaluate changes in blood glucose concentrations in diabetic and nondiabetic patients treated with a postoperative regimen of 1% topical prednisolone acetate after cataract surgery.

Materials and Methods:

Prospective, observational cohort study conducted in a tertiary eye care hospital in South India from August 2022 to May 2023. Nondiabetics (Group A) and diabetics with good glycemic control, i.e., glycated hemoglobin (HbA1c) <7% (Group B) undergoing routine uneventful cataract surgery by a single surgeon were included in the study. All patients were prescribed the same regimen of topical corticosteroids after cataract surgery for 2 weeks, i.e., topical prednisolone acetate 1%, 1 drop six times a day for 1 week followed by three times a day for 1 week. All patients underwent capillary fasting blood sugar (FBS) test at the following time points: before the start of surgery, 1-week postoperative, 1-month postoperative, and HbA1c at 3 months postoperative.

Results:

Forty nondiabetic patients (Group A) and 40 well-controlled diabetic patients (Group B) were included in the study. Group A showed a statistically significant increase when 1-week preoperative FBS level (105.9 ± 13.3) was compared with 1-week postoperative (114.42 ± 15.6) which returned to the pretreatment level (102.92 ± 8.9) on 1-month follow-up. In Group B, 1-week preoperative (126.05 ± 31.2) and 1-week postoperative FBS levels (126.37 ± 19.5) were comparable.

Conclusion:

Topical prednisolone acetate can be safely used as a short-term routine postcataract surgery regimen in nondiabetics and diabetics with good glycemic control, without a significant increase in blood sugar levels.
Robotic Repair of a Rare Morgagni Hernia in an Infant
Authors: Gupta Apurva , Sinha Arvind , Rathod Kirtikumar J. , Saxena Rahul , Pathak Manish
Published: January 2025

ABSTRACT

This case report describes the successful robotic-assisted repair of a large Morgagni hernia in an 8-month-old infant. Using the da Vinci Xi system, the hernial sac was excised, and the patient recovered without complications. It highlights the advantages of robotic surgery, including enhanced optics and precision, for complex hernia repairs in infants.
Treatment of Femoral Neck Fractures with Intramedullary Fixation with Integrated Interlocking Lag and Compression Screws
Authors: Lezak Bradley , Hernandez-Irizarry Roberto , Quinnan Stephen
Published: January 2025

Objectives:

(1) To describe our operative technique for femoral neck fractures using an intramedullary device with integrated compression screws. (2) Retrospective analysis of patients treated with intramedullary fixation with interlocking lag and compression screws for femoral neck fracture (3). To compare our results to published literature on more classic fixation techniques.

Design:

Single-center retrospective cohort.

Setting:

Level 1 trauma center.

Patients/Participants:

Thirty-eight patients with 39 femoral neck fractures were treated with internal fixation. Only patients treated with intramedullary fixation with integrated interlocking lag and compression screws were included; patients treated for femoral neck fractures with a sliding hip screw, screw fixation alone, or intramedullary devices without integrated interlocking screws were excluded. Our final cohort consisted of 19 patients (47% female) with an average age of 50 (27–82) who had 15 (79%) isolated femoral neck fractures and 4 (21%) femoral neck-shaft combined fractures.

Intervention:

Internal fixation with intramedullary fixation using interlocking lag and compression screws for femoral neck fracture.

Outcome Measurements:

Quality of reduction, radiographic healing, and radiographic assessment of nonunion/avascular necrosis (AVN).

Results:

Follow-up time was on average 50 months (range: 34–84), with a median of 50 months (interquartile range: 42–56). Nineteen patients (100%) had successful healing without further intervention. There were no nonunions, and 2 (10%) patients developed AVN leading to conversion to total hip arthroplasty.

Conclusion:

Femoral neck fractures are challenging to manage due to their intracapsular location and the tenuous blood supply to the femoral head. The use of intramedullary devices with integrated lag and compression screws is an effective method for the operative fixation of femoral neck fractures. Level of evidence: Level IV therapeutic.
Anterior Opening Wedge High Tibial Osteotomy for Recurvatum Deformity of the Proximal Tibia Secondary to Physeal Arrest: A Dual Site Study
Authors: Bartoletta John J. , Schmale Gregory A. , Mattioli-Lewis Tressa M. , Bouchard Maryse
Published: January 2025

Context:

Injury to the anterior proximal tibial physis or tibial tubercle can result in recurvatum deformity of the tibia. Anterior opening wedge high tibial osteotomy (AHTO) with and without tibial tubercle osteotomy (TTO) can restore posterior tibial slope, improving patient symptoms and function.

Aims:

Review radiographic and surgical outcomes of patients that undergo AHTO for recurvatum deformity of the proximal tibia.

Settings and Design:

Patients from two tertiary pediatric institutions with proximal tibial recurvatum treated with an AHTO between 2002 and 2017 were retrospectively reviewed.

Materials and Methods:

Deformity was assessed radiographically using the posterior proximal tibial angle (PPTA), medial proximal tibial angle, and Caton–Deschamps index (CDI). Surgical techniques and complications were recorded.

Statistical Analysis Used:

Descriptive statistics were expressed as means and standard deviations.

Results:

Twelve patients with a mean age of 13.1 years (10–15 years) were included in this study. Acute AHTO proximal to the tibial tubercle was performed in nine cases. Two patients had concurrent TTO. Three patients underwent AHTO with gradual correction with a Circular external fixator with the corticotomy distal to the tibial tubercle. Mean postsurgical follow-up was 6.1 months (1.3–15.6 months). Mean preoperative PPTA improved to within normal for all surgical techniques (AHTO 98.7° to 82.6°, AHTO + TTO 102° to 80.9°, and gradual AHTO 104° to 76.9°). Three patients had residual radiographic hyperextension deformity at last follow-up (PPTA: 85.0°, 87.9°, 94.0°). No clinically significant secondary coronal plane deformities occurred. One patient who underwent acute AHTO had postoperative radiographic patella baja (CDI 0.51). Ten complications (7 Grade I and 3 Grade II) occurred in seven cases.

Conclusions:

Opening wedge AHTO with acute and gradual techniques corrects the sagittal plane deformity of recurvatum without inducing clinically significant coronal plane deformities, but minor complications are frequent.
Detection of Infection Following an Open Tibial Fracture via Synovial Alpha-defensins
Authors: Donnelly Katelynn M. , Rivera Jessica C.
Published: January 2025

Fracture-related infections are challenging complications following the fixation of open fractures. Because of commonly used surgical approaches used for intramedullary nailing, the knee joint is also susceptible to infection following fixation, either as a complication of the surgical approach itself or due to the communication of the joint space with intramedullary implants placed through the joint. This is a case report of an early postoperative knee joint sepsis following suprapatellar nailing of an open tibia fracture where the joint infection was differentiated from postoperative effusion by the use of alpha-defensin testing. The follow-on treatment addressed the infection identified in the joint as well as exchanged nailing with an antibiotic-coated nail to protect the fracture.
Factors Thought to Cause and Aggravate Acne Vulgaris as Perceived by Adolescent High School Students in an Urban City and the Effect of Acne on their Quality of Life
Authors: Villanueva Marie Antoinette O. , Carpio Carolina A. , Coo Elisa Rae L.
Published: January 2025

Background:

Acne vulgaris is a common disorder of the pilosebaceous unit seen primarily in adolescents. There is still a paucity on understanding about acne. Although nonlife-threatening, acne has a significant impact on social, psychological, and emotional well-being.

Materials and Methods:

Ananalytical cross-sectional study was conducted among high school students using constructed, self-administered questionnaires adapted from previous studies.

Results:

Among 416 respondents, 340 (81.73%) have acne. Acne is not considered contagious which was believed by 154 (45.26%) students with acne and 28/76 (36.84%) of those without. Despite controversial findings, diet, hormones, genetics, emotional stress, lifestyle, menstruation, and cosmetics are thought to play roles in acne. Students believed lack of sleep, hormones, stress, oily/fatty foods, menstruation, cosmetics, sunlight, and poor hygiene aggravate acne. There were significant differences in responses of those with and without acne to food/diet and hormones (P 0.000 and 0.006, respectively). There were also significant differences in the distribution of answers between those with and without acne on sweets (P 0.002) and heat/sun exposure (P 0.004). The students’ quality of life (QOL) assessed using teenagers’ QOL and Cardiff Acne Disability Index showed weak positive and statistically significant correlation between scores and acne severity indicating that as the severity of acne increases, the greater the impairment in their QOL.

Conclusion:

Beliefs and perceptions about acne play an important part in management and compliance. The results generally equate from evidence-based data. Few misconceptions may be brought by misleading information and different opinions. The physical, social, and psychological morbidity associated with acne can be profound and the QOL can be impaired.
Oral and Topical Retinoid Therapy for the Treatment of Lichen Planus Pigmentosus in a 21-year-old Filipino
Authors: Paredes Ma Bernadette Beatrize L. , Tapales Martha Joy Bruan
Published: January 2025

Lichen planus pigmentosus (LPP) is a rare condition causing dark brown to gray patches, usually appearing on sun-exposed areas such as the face and neck. Various treatment modalities have been reported to be beneficial in stabilizing the disease and improving pigmentation; however, an optimal treatment method is yet to be established. We report a case of a 21-year-old healthy Filipino female, who presented with a 1-year history of multiple grayish-brown macules and patches that were visible on the face, neck, trunk, limbs, and flexures. The patient was started on oral isotretinoin (20 mg/day) and daily application of topical tretinoin 0.05% cream. After 4 months, her condition stabilized with no new lesions, and by the 7th month, hyperpigmentation reduced significantly. The recalcitrant nature of LPP makes therapy challenging, and there is still no definitive treatment for this condition. In this case, combining oral and topical retinoids worked well for stabilization and pigmentation reduction. However, additional treatments might be needed for more significant skin lightening since retinoids alone may not fully reduce the hyperpigmentation.
Adjunct Treatment with Platelet-rich Plasma for the Treatment of Inflammatory Alopecia in an Adult Filipino Female with Systemic Lupus Erythematosus
Authors: Imam Precious Usman , Bautista Jema Fe Fajardo , Villanueva Veronica Therese Larrazabal , Monsanto Kenzle Denise Gonzales , Zalsos Lady Hero Dale Jainga
Published: January 2025

Systemic lupus erythematosus (SLE) is an autoimmune disease manifesting a wide range of symptoms from mucocutaneous to widespread involvement of multiple organs. A total of 60% of SLE patients suffer from scarring alopecia, affecting their quality of life. Herein is a case of a female adult with SLE and severe alopecia. While the patient received several systemic treatments, her alopecia was treated with intralesional triamcinolone and adjunct platelet-rich plasma (PRP) injections for 4 months, and tacrolimus 0.1% ointment applied twice a day for 6 weeks. Four months into treatment, there was a note of increase in terminal and vellus hair, decreasing the affected body surface area from 2.5% to 1%. This case highlights that PRP is a viable option as an adjunct therapy for inflammatory alopecia and that collaboration among different specialties in the management of lupus and exploring novel treatment options for alopecia are important.
Management of Nail Disease by Philippine Dermatologists: A Cross-sectional Study
Authors: Erfe Ma. Georgina Victoria De Guzman , Pineda Raphaela Martina Canga , Dim-Jamora Krisinda Clare Cuyong
Published: January 2025

Background:

Nail disorders, comprising around 10% of dermatological cases, can arise at any age. There is no current data on the management patterns of Filipino dermatologists regarding nail diseases in the Philippines.

Aims:

This study aims to identify the management patterns of board-certified Filipino dermatologists categorized as private practice dermatologist, public government dermatologist, and combined practice dermatologist for common nail diseases and assess whether their approaches align with current clinical guidelines.

Settings and Design:

A cross-sectional analytic design was employed, with data collected through a validated online questionnaire distributed to Philippine Dermatological Society board-certified dermatologists.

Materials and Methods:

A structured questionnaire was electronically distributed to Filipino dermatologists, gathering data on the types of nail conditions encountered and the treatment modalities employed, from July to October 2022.

Statistical Analysis Used:

Sample size was calculated with a 95% confidence level and an 8% margin of error, yielding 159 participants. Descriptive statistics using frequency and percentage were used to summarize the data. STATA 15.0 was utilized for analysis.

Results:

There were 221 dermatologists who participated; 65.2% are in private practice, 5.4% work exclusively for the government, and 29.4% are in both private and public practice. The most common nail disorders managed were onychomycosis, periungual warts, and nail psoriasis. Management approaches varied by practice setting. Discrepancies between practice habits and guidelines, particularly in treating conditions such as paronychia and antifungal use, highlight the need for updated information and access to advanced treatments, especially in resource-limited settings.

Conclusions:

Filipino dermatologists generally follow global guidelines for managing nail diseases, but treatment choices are influenced by factors such as clinical presentation and resource availability, which differ between private, government, and combined practices. While private practitioners often refer to surgical cases such as onychocryptosis, government dermatologists tend to handle them themselves. Despite these challenges, dermatologists adapt pragmatically to provide effective care.
Starting and Maintaining Patients on Biologics and Janus Kinase Inhibitors for Various Immune-mediated Inflammatory Dermatologic Conditions
Authors: Mendoza Clarisse G. , Jesus Corrine Sison-De , Iniego-Rodas Ma. Corazon
Published: January 2025

Targeted therapies, including biologics and small molecules like Janus kinase inhibitors, have revolutionized the treatment of challenging immune-mediated inflammatory skin conditions. However, their use in the Philippines remains limited, primarily due to economic barriers. In this article, we address the key challenges faced in initiating and sustaining patients on these therapies.