bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of the Effectiveness of Jalaukavacharana (Leech therapy) and Shalmali Kantaka Lepa in a Mukhadushika (Acne Vulgaris): A Case Study
Authors: Bihari Krishana , Pandey Ajai Kumar , Meenu  , Nigam Tanmay , Singh Abhinav , Singh Praveen Kumar
Published: December 2023

ABSTRACT

Mukhadushika (acne vulgaris) has been described in the context of Kshudra roga in Ayurvedic classics. It occurs due to the vitiation of Vata and Kapha dosha and Rakta as important Dushyas. Acharya Sushruta has described Mukhadushika as a thorn-like eruption on the face. In the modern system, it can be called as acne vulgaris. It is a chronic inflammatory disease, characterized by papules, pustules, and often scarring, mainly on face, upper trunk, and back. Acne vulgaris is a nearly universal skin disorder affecting 79%–95% population of youths. In the current era, diet and lifestyle changes, stress, increasing pollution, and hormonal changes increases the problem of acne vulgaris. In the present case, the patient was treated with Shalmali Kantaka Lepa once in a day for 21 days and Jalaukavacharana (leech therapy) in four settings during 21 days with 7-day intervals. At the end of the therapy, patients had significant improvement in clinical features. From this case study, it can be concluded that seeks the attention of researchers to carry out the same therapeutic measures on lager sample sizes for fruitful clinical output.
Knowledge, attitude and practices about hypertension amongst adult residents in South-Eastern Nigeria
Authors: Awugosi Michael Chukwuebuka , Obi-Nwosu Amaka Lovelyn , Edeh Gabriel Chidera , Ekwebene Onyeka Chukwudalu , Abalihe Uchenna Onyedika , Anigwe Francis Chibuike , Chiekezie Chinonuju Franklin
Published: December 2023

Background:

Hypertension (HTN) is a global public health concern and has been identified as the leading risk factor for cardiovascular morbidity and mortality. The objective of this study is to assess the prevalence, knowledge, attitude and practices regarding HTN amongst adult residents in South-Eastern Nigeria.

Aims:

The objective of this study is to assess the prevalence, knowledge, attitude and practices regarding HTN amongst adult residents in South Eastern Nigeria.

Materials and Methods:

This cross-sectional survey was conducted amongst male and female adult residents of Anaocha local government area, Anambra State, South-Eastern Nigeria, 18 years and above. Data was collected using a pretested interviewer-administered questionnaire amongst 296 adults. Blood pressures and the body mass index of those found to be hypertensive were obtained. Results were analyzed using SPSS version 25.0.

Results:

The mean age was 41.7 years, with 55.1% being females and 44.9% males. The prevalence of HTN was 30%. Overall, 53.28% of the respondents had good knowledge of HTN, although knowledge of the risk factors was lower (43.41%), while 80.24% had good attitude and 62.16% had good practices regarding HTN. Gender showed a significant association with level of knowledge of HTN. Only tribe and occupation were associated with attitude of the respondents towards HTN. Practice regarding HTN showed no association with any of the socio-demographic factors.

Conclusion:

The study found an acceptable level of knowledge, attitude and practices regarding HTN amongst the respondents. The prevalence of HTN amongst the study group was high and more work needs to be done to improve awareness and reduce HTN risk factors amongst the people.
Something fishy: Raw fish bile-induced acute kidney injury
Authors: Choudhury Debarun , Tiwari Vaibhav , Chadha Shiv , Gupta Anurag , Bhargava Vinant , Gupta Pallav , Malik Manish , Gupta Ashwani , Bhalla Anil Kumar , Rana Devinder Singh
Published: December 2023

Acute kidney injury (AKI) can be caused by a number of etiologies. A rare but potentially life-threatening cause is the consumption of raw fish. This practice is rampant in certain parts of India as well as Asia due to the traditional belief that it can cure a number of chronic diseases such as bronchial asthma, arthritis and diabetes mellitus. A toxin present in fish gallbladder can cause multiorgan failure. Renal involvement is generally in the form of oliguric AKI and in majority of the cases requires renal replacement therapy. Early institution of supportive therapy is essential to prevent mortality. We report the case of a middle-aged diabetic female who consumed raw fish gallbladder in the hope of curing her diabetes and landed up with renal dysfunction requiring dialysis. Renal biopsy showed acute interstitial nephritis which was treated with steroids. She made a full recovery on follow-up.
Informed consent – Ethical doctrine and a legal mandate
Authors: Gera Anjali , Sood Jayashree
Published: December 2023

Informed consent is not only an ethical doctrine but also a legal mandate in medical practice and clinical research. The concept of consent has changed over the last few decades from doctor-focused to patient-focused. This provides adequate knowledge to the patient about disease and treatment options so that the patient and doctor can make shared decisions. Respecting the patient’s autonomy, disclosure of material risks and solicitation of the patient’s preferences are very important in the process of informed consent. The relationship between doctor and patient should be one of the trust and communication. An honest and ethically obtained consent can prevent litigations and medicolegal repercussions.
Comparing Pain Intensity of Two Instruments in Predicting the Outcomes of Patients Under Mechanical Ventilation Admitted to Intensive Care Units
Authors: Bahramnezhad Fatemeh , Salamat Elaheh , Sharifi Farshad , Hasanloie Mohammad Amin Valizade
Published: December 2023

Introduction and Purpose:

Pain assessment in the intensive care unit (ICU) is a main problem in mechanically ventilated patients (MVPs) as they are not able to self-report pain, hence exposing them to the risk of inadequate pain management that leads to unfavorable consequences. This research aimed to determine and compare pain intensity scores of two scales in predicting the hospitalization consequences of MVPs in ICUs.

Methods:

The analytical-longitudinal study was carried out in ICUs in 2020. Pain intensity was evaluated using observational pain scales in 60 patients who met inclusion criteria in three positions during suctioning once daily for 3 days.

Results:

There were significant inverse correlations between the Behavioral Pain Scale (BPS) and Critical Care Pain Observational Tool (CPOT) with the duration of hospitalization and mechanical ventilation. No significant relationships were observed between total mean scores obtained from the scales and the incidence of ventilator-associated pneumonia. There were no significant correlations between BPS and CPOT with frequencies and total dose of the prescribed opioid drug.

Conclusion:

The use of BPS and CPOT can be used for pain assessment and control in MVPs as a positive step towards improving their consequences.
Pulsed Radiofrequency Ablation of the Lumbar and Sacral Plexus for Intractable Pain in Pediatric Patients
Authors: Diwan Sandeep , Sahoo Rajendra , Madegowda Arkesh , Gaikwad Avinash , Dongre Himaunshu , Patwardhan Sandeep , Sancheti Parag
Published: December 2023

Severe and persistent pain of cancer and noncancer origin in pediatric patients can pose significant challenge to manage. The application of Radiofrequency ablation in Pediatric patients for pain management is not well reported in the literature. Here, we present pediatric cases where pulsed radiofrequency (PRF) treatment of the Lumbosacral plexus was done for pain relief.
A Scoping Review on Interventions for Chronic Pelvic Pain
Authors: Dey Samarjit , Arora Prateek , Chanu Sairem Mangolnganbi , Maurya Indubala , Gupta Sunit
Published: December 2023

Chronic pelvic pain (CPP) is a complex and debilitating condition affecting a significant portion of the global population, predominantly women. This review dwells on various interventions to alleviate the burden of CPP and improve patients’ quality of life. Traditional approaches have included patient education, pharmacotherapy, physical therapy, and cognitive behavioral therapy. However, the limited efficacy and potential side effects of long-term medications necessitate a multidisciplinary approach. The review lists a comprehensive tabulation of results from systematic reviews and meta-analyses on CPP interventions published in the past 5 years.
Prevalence of Multimorbidity and Associated Sociodemographic Factors among Elderly Population in a Rural Area in South Kerala
Authors: Pillai Rahul S. , Paul N Sherin Susan , Davis G. Deepak , Dev Sahya S.
Published: December 2023

Background:

Multimorbidity is defined as the coexistence of two or more chronic health conditions in the same individual. It is associated with an increased number of hospital visits, polypharmacy, adverse drug events, increased treatment costs, increased burden on the families, poor functional status, poor quality of life, and an increased risk of death.

Objective:

The objective of the study is to determine the prevalence of multimorbidity and associated sociodemographic factors among elderly population in a rural area in south Kerala.

Materials and Methods:

This cross-sectional study was conducted among elderly population residing in the field practice area of a rural health training center of a medical college in South Kerala for a duration of 3 months from October 2019 to December 2019. Data were collected by interview of the subjects by the investigator. Charlson comorbidity index was used to assess the morbidity status of the subjects.

Results:

The self-reported prevalence of multimorbidity among the study participants was 86.4% (95% confidence interval: 82.5–90.3). In this, 42.8% had mild, 22.4% had severe, and 21.4% had moderate multimorbidity. Hypertension was the most common (53.1%) morbidity among the participants, followed by rheumatic diseases (42.7%) and diabetes mellitus (41%). Multimorbidity among the study participants was found to be significantly associated with their age, occupation status, and smoking habit among them.

Conclusion:

Multimorbidity among elderly population deserves much more attention than it has at present, and hence, there is an urgent need to focus on it with emphasis on the need to strengthen the health-care facilities for them, with respect to early identification and holistic management of their morbidities under one roof.
Cervical Angina as a Neglected Symptom of Cervical Spine Pathologies: Retrospective Observational Study
Authors: Kurhade Varsha , Bawage Rupali Vaijnath , Bangar Kashinath A , Page Nivedita , Bangar Gayatri , Baheti Sandip
Published: December 2023

Objective:

The objective is to assess the incidence of cervical angina as presentation of cervical spine pathologies.

Materials and Methods:

Data were collected retrospectively from patients’ medical records from January 2018 to December 2022 who presented to our pain clinic with chest pain, neck pain, upper extremity pain and tingling numbness. A total of 168 patients with cervical spine pathologies were identified. Those having chest pains were analyzed subsequently treated with pharmacotherapy, intramuscular stimulation (IMS). Cervical epidural adhesiolysis was performed depending on spine pathology based on clinical picture, severity of symptoms and radiological findings.

Results:

Among 168 patients 25 had chest pain. Out of 25 patients, 18 (72%) had chest pain as presenting symptom and 7 (28%) patients had associated chest pain. All 25 patients had cervical radiculopathy with or without nerve compression. Nerve root involved were C4 in 4 patients, C5 in 16 patients, C6 in 22 patients, and C7 in 8 patients, commonly involved were C5 and C6 with C4-C5 and C5-C6 prolapsed intervertebral disc. Thirteen patients (52%) were treated with pharmacotherapy and physiotherapy; seven (28%) patients had 2–3 sessions of IMS with pharmacotherapy. Five patients (20%) had undergone cervical epidural adhesiolysis, where conservative management failed.

Conclusions:

Even though cervical angina is an underdiagnosed disease, pain physicians and spine surgeons should be familiar with it for diagnosis and treatment. Cervical angina is associated with broad range of cervical spinal pathologies; the most common is cervical disc herniation. It can be easily diagnosed with high level of suspicion and treated with pharmacotherapy, IMS, and cervical epidural adhesiolysis.
Chronic Pubalgia in a Young Adult Managed by Iliohypogastric and Ilioinguinal Nerve Blocks
Authors: Paul Shamik Kumar , Kumar J. John Magesh , Dua Amit , Paul Debashish
Published: December 2023

Chronic pubic pain is a commonly occurring problem in young males who are engaged in high-intensity physical activities such as sportsmen and army recruits among others. We would like to discuss a similar case of pubalgia which occurred in a 20-year-old male who is an avid athlete. The patient had reported multiple times to the hospital and was admitted and evaluated thoroughly. He was kept on nonsteroidal anti-inflammatory drugs and pregabalin for about a month. Despite this aggressive pain management, the patient continued to have continuous pain in his left groin. Due to his pain and inability to perform physically, the patient went into depression. After a thorough clinical evaluation, we offered the patient an ultrasound-guided iliohypogastric and ilioinguinal nerve block which resulted in the complete disappearance of his symptoms within a week, and he was able to return back to his regular training.
Acute on Chronic Presentation of Trigeminal Neuralgia
Authors: Phadke Medha , Kurhade Varsha , Bangar Kashinath , Page Nivedita
Published: December 2023

Trigeminal neuralgia (TN) is characterized by sudden, severe, brief, stabbing, usually unilateral, and recurrent pain within one or more branches of the trigeminal nerve. It is divided into three types: (1) primary or classical TN, which requires demonstration of morphologic changes in the trigeminal nerve root from vascular compression, (2) secondary to other identifiable neurologic causes such as multiple sclerosis and intracranial space-occupying lesion, and (3) idiopathic, in which the etiology is unknown. Treatment and prognosis depend on the type. We present this case of an elderly woman with an unusual presentation of TN in a previously diagnosed case. The episodes were increasing in severity and duration, not responding to medical management, allodynia and constant pain was present, and they were accompanied by uncontrolled hypertension. These features strongly suggested other likely causes such as intracranial space-occupying lesions, multiple sclerosis, and central pain. Expert consultations from physicians and neurologists were sought for control of hypertension and reaching a diagnosis. Magnetic resonance angiogram of the brain was done and a diagnosis of classical TN with persistent background facial pain was established. The treatment was successfully done by radiofrequency ablation of the Gasserian ganglion. The pain and blood pressure responded to the treatment.
Impact of Laptop Usage, Typing Skills, and Ergonomics on Musculoskeletal Pain among Medical Resident Doctors – An Observational Study
Authors: Goyal Sonal , Gupta Bhavna
Published: December 2023

Background:

In today’s era of digital learning, the utility of laptops has drastically been increased. Sustained postural strain resulting from poor ergonomics while using laptops may lead to musculoskeletal discomforts (MSD). This study aimed to determine touch-typing skills of medical students, quantitative assessment of their postural ergonomics, and implications of their efforts while typing on the prevalence of MSD.

Methods:

Sixty medical students were asked to take an online typing test (www.ratatype.com) and their typing speed in words per minute (WPM) and accuracy (%) were noted. The lateral pictures of the students were taken while performing the typing test and objective ergonomics analysis using craniovertebral angle (CVA) and rapid upper limb assessment (RULA) scoring system.

Results:

None of the students demonstrated touch typing proficiency. The average typing speed (WPM) and accuracy (%) were observed to be 27.893 and 94.768, respectively. The mean CVA was 33.17, much lower than the average norm. The mean final RULA score was 5.62, indicating a high degree of MSD risk. Moderate-to-severe laptop users (≥4 h/day) showed higher prevalence of MSDs (P < 0.05) as compared to normal-to-mild users. A significant negative correlation was found between CVA and RULA scores.

Conclusion:

The study concluded average typing speed and accuracy, poor ergonomics (low CVA), and moderate-to-high MSD risk (based on RULA score) were seen among students. A high MSD prevalence was reported in laptop usage of ≥ 4 h/day, which can be ascribed to postural strain from improper typing habits and poor ergonomics.
A new perspective on partial nail avulsion: Surgical pearl
Authors: Bhingradia Yogesh M , Shukla Ratnakar K
Published: December 2023

Ingrown nail or onychocryptosis is a common and prevalent condition associated with pain and discomfort resulting from recurrent inflammation. It is further categorized into 3 grades on the basis of severity as per classification by Heifetz and Mogensen, grade 1 can be easily managed with medical treatment; whereas grades 2 and 3 often requires surgical treatment; the most common surgical technique employed for ingrown nail is the simple nail avulsion by using a nail clipper. we have observed that due to the force of the nail clipper small amount of detachment in between nail plate and nail bed in addition to longer downtime post-procedure, so we proposed a new surgical modification of nail avulsion by using 11 no. surgical blade instead of nail clippers leading to very less trauma to nail bed and fine post-procedure outcomes.
Follicular unit extraction as a treatment modality for stable segmental inguinoscrotal vitiligo: A case report
Authors: Bhingradia Yogesh M , Maniya Surbhi G
Published: December 2023

Vitiligo is a common form of autoimmune, localized, or generalized cutaneous depigmentary disorder which has a detrimental effect on psychological and also psychosexual function of many individuals. It is an acquired condition resulting from the progressive loss of melanocytes. Here, we report a case of stable segmental vitiligo affecting inguinoscrotal region, which was successfully treated by follicular unit extraction (FUE).
Disposable barrel used for easy and fast toe space examination
Authors: Mukhtar Muhammed , Khan Bushra , Mukhtar Nadia
Published: December 2023

Chronic candidiasis with bacterial infection is common infection in the toe web which is is not inspected and treated well in early stage, and it is now the cause of cellulitis in the leg in a number of cases. To examine the narrow space of the toe web and to treat and to reduce the complication, we described the use a disposable syringe barrel.
Immunolocalization of epithelial cell adhesion molecule and matrix metalloproteinase-9 in oral epithelial dysplasia and oral squamous cell carcinoma
Authors: Maurya Shashi Bhal , Shetty Devi Charan , Rathore Ajit Singh , Juneja Saurabh , Jain Anshi , Banga Akanksha
Published: December 2023

Introduction:

Cancers are complex tissues composed of multiple distinct cell types that participate in heterotypic interactions with one another. Physiologically cell-to-cell contacts formed by dense populations of normal cells operate to suppress further cell proliferation.

Objectives:

The objective of the study is to evaluate and compare the immunoexpression of matrix metalloproteinase-9 (MMP-9) and epithelial cell adhesion molecule (EpCAM) in oral epithelial dysplasia (OED) and oral squamous cell carcinoma (OSCC) and to hypothesize their role in the progression in varying grades of these lesions.

Materials and Methods:

A total of 60 samples comprising of 30 cases each of OED and OSCC. Three micrometers thin sections were taken and subjected for hematoxylin and eosin stain and immunohistochemical procedure. The sections were incubated with monoclonal anti-EpCAM anti-MMP-9 antibody. The data were analyzed using SPSS software version 19.

Results:

The results of the study show EpCAM immunoexpression decreased in OSCC when compared to OED. MMP-9 immunoexpression increased in OSCC when compared to OED (statistically significant, P ≤ 0.05).

Conclusion:

Correlation between EpCAM and MMP-9 may help to unravel the signaling cascades involved in the carcinomatous changes, tumor cell invasion, and progression of OSCCs.
Metaplastic breast carcinoma with mesenchymal differentiation: A case series
Authors: Rani Ekta , Nibhoria Sarita , Shilpa
Published: December 2023

The metaplastic breast carcinoma is a rare malignancy with an incidence of 5% of all breast tumors. Metaplastic carcinoma of the breast with mesenchymal differentiation (MCMD), previously known as carcinosarcoma, is a very rare and aggressive tumor that has been recently classified as a subtype of metaplastic breast carcinoma. It accounts for 0.08%–0.2% of all breast cancers, with only a few cases reported in the literature. Metaplastic breast carcinoma most often affects women over 50 years of age, with an average age between 55 and 60 years. We report three cases of metaplastic breast carcinoma with mesenchymal differentiation presented at our hospital. Patients were in their 4th decade. All patients presented with a fast-growing large mass and were treated surgically (mastectomy), with the final histopathological diagnosis of MCMD.
The effectiveness of adjuvant treatment approaches for resectable esophageal cancer: A single-center experience
Authors: Algin Efnan , Esen Selin Akturk , Acikgoz Yusuf , Bal Oznur
Published: December 2023

Aims and Background:

In general, neoadjuvant treatment is the standard for clinical stage II/III esophageal cancer (EC), whereas the effect of adjuvant treatment on survival still remains controversial. The aim of this study was to investigate the efficacy of adjuvant treatment modalities on the survival of EC patients.

Patients and Methods:

A total of 63 patients with stage II–IVA EC who had undergone curative surgery between the years 2002 and 2020 were included in the study. Patients’ data were retrospectively collected from oncologic follow-up files. Various treatment regimens were administered during this period, including chemotherapy and chemoradiotherapy.

Results:

The median age was 56 years (24–73), and the number of males was slightly higher than females (male/female: 33/30). While 32 (51%) patients received postoperative adjuvant treatment, the remaining 31 (49%) patients underwent surgery alone. The median overall survival (OS) was 45.9 months (95% confidence interval [CI]: 25.1–66.8) in patients receiving adjuvant therapy and 37.6 months (95% CI: 20.9–54.4) in patients not receiving adjuvant therapy. The 8.3-month survival difference was statistically insignificant (P = 0.54). The 1-, 3-, and 5-year OS rates were 87.5% versus 77.4%, 58.4% versus 51.6%, and 40.8% versus 27.6% for patients with and without adjuvant therapy, respectively. Pathological stage (P = 0.028) and lymph node status (P = 0.044) were significant prognostic factors for survival.

Conclusions:

This study did not support the benefit of adjuvant treatment compared with surgery alone in completely resected EC patients. The reason for this result may be related to the small sample size and different treatment regimens due to the change in treatment options over time.
Dosimetric comparison of 3DCRT and IMRT in radical chemoradiotherapy of squamous cell carcinoma esophagus
Authors: Krishnapriya P , Sivanandan CD , Roshni S , Sarin B , Geethi MH , Jagathnath Krishna KM
Published: December 2023

Background:

Radical chemoradiation is the standard of treatment for locally advanced squamous cell carcinoma of esophagus and for patients with operable disease, but who are medically unfit or unwilling for surgery. As the esophagus is a central organ, the planning target volume (PTV) is central, lies close to the spinal cord and heart, and is surrounded by the lung, which is a radiosensitive organ. Irradiation of these critical structures is reduced by the use of three-dimensional conformal radiation therapy (3DCRT). Intensity-modulated radiation therapy (IMRT) has the potential to improve the uniformity of dose distribution to the tumor and reduce the dose received by surrounding normal tissues.

Aim and Objectives:

1. To compare the dose distribution, conformity, and homogeneity indices in radical radiotherapy of squamous cell carcinoma of esophagus using 3DCRT and IMRT techniques 2. To compare the doses received by critical structures such as heart, lung, spinal cord, and liver

Materials and Methods:

All cases of squamous cell carcinoma esophagus treated with radical chemoradiation to a dose of 50 Gy in 25 fractions using 3DCRT technique from January 2018 to July 2019 were included. IMRT plans were generated for these cases.

The parameters that represent dose distribution to the target volume and the dose received by the organs at risk were obtained from the dose–volume histogram. The difference in the mean values of the parameters between the two techniques was calculated. The statistical significance of the difference was determined using Student’s t-test and Wilcoxon signed-rank test.

Results:

The volume of PTV receiving 105% and 107% of prescribed dose was significantly lower with IMRT (3.540% and 0.008%, respectively) compared to 3DCRT (7.654% and 0.623%). The homogeneity index was better with IMRT (0.088 vs. 0.107) than 3DCRT. Conformity index was found to be better with IMRT (1.149 vs. 1.573). Mean heart dose (18.216 vs. 24.591 Gy) and the volume of heart receiving 30 Gy were reduced with IMRT. The volume of lung receiving 20 Gy and the volume receiving 5 Gy were not significantly different between 3DCRT and IMRT. Maximum dose to spinal cord was similar with 3DCRT and IMRT.

Conclusions:

IMRT avoids areas of excessive irradiation within the PTV. IMRT improves dose conformity to the target volume and homogeneity of dose distribution within the PTV. The cardiac dose is significantly reduced with IMRT. The mean lung dose remains similar to 3DCRT. There is no significant increase in the volume of lung receiving low-dose radiation with IMRT.
Usefulness of walkathon in improving knowledge on cancer: A cross-sectional study with the participants
Authors: Rao Suresh , Rao Pratima , Shetty Rajesh , Kulal Yathish , Gatty Nitish Chandra , Prabhu Nagraj , Suresh Sucharitha , D’souza Rhea Katherine , Baliga Manjeshwar Shrinath
Published: December 2023

Aim:

Globally, walkathon, a type of community event involving walking a determined distance to raise awareness and/or collect donations for a social cause is gaining a lot of public attention. This study was conducted to understand the usefulness of walkathon in creating cancer awareness among the participants.

Materials and Methods:

This was a pre- and post-test study and was carried out on World Cancer Day on February 4, 2019 in Mangalore, Karnataka, India. The study subjects were the walkathon participants willing to be volunteers for the study. Differences in the answers were calculated by ascertaining the difference between the pretest and posttest using McNemar, Chi-square, or Fisher’s exact test. A P < 0.05 was considered statistically significant.

Results:

Pretest scores indicated most volunteers were aware of the role of tobacco and alcohol in cancer, while most were unaware of the importance of fruits and consumption of vegetables and sedentary lifestyle in the development of cancer. Posttest showed a significant increase in knowledge gain (P = 0.003 to <0.001).

Conclusions:

For the first time, this study shows Walkathon to be helpful in improving cancer knowledge in the participants. Walkathon is an inexpensive and joyful way to educate people and warrants further study on a range of medical and social themes affecting society to establish its usefulness in public health education.
Mandibular metastasis of follicular thyroid carcinoma
Authors: Devi M. Gayathri , Regu P. , Bakyalakshmi K.
Published: December 2023

The orofacial region may be the first site for the dissemination of malignancies from the remote regions in the jawbones. The most common location of metastatic lesions in the jawbones is the mandible, with the molar region the most frequently involved site. Radiotherapy, chemotherapy, and surgical resection can be an approach in the treatment protocol depending upon patient age and growth of tumor mass. This case report presents a case of follicular variant thyroid carcinoma, infiltrative type, pT1bN0Mx with mandibular metastasis affecting both hard and soft tissue in a 55-year-old female.
Tumor budding in breast carcinoma: A systematic review and meta-analysis
Authors: Buch Archana , Khan Uzair , Rathod Hetal , Jain Khushi , Dwivedi Aryan , Rajesh Arasi
Published: December 2023

Tumor budding is gaining importance as a prognostic factor in various carcinomas due to its association with epithelial–mesenchymal transition (EMT) and hence clinical outcome. Reporting tumor budding in breast cancer lacks homogeneity. We aim to systematically review the existing literature and conduct a meta-analysis to assess the prognostic implication of tumor budding in breast carcinoma. A systematic search was performed to identify studies that compared different prognostic variables between high- and low-grade tumor budding. Quality assessment was performed using a modified Newcastle Ottawa Scale. Dichotomous variables were pooled using the odds ratio using the Der–Simonian–Laird method. Meta-analysis was conducted to study the association between low/high-grade tumor budding and tumor grade, lymph node metastasis, lymphovascular invasion, ER, PR, HER2neu, KI67, and the molecular subtype triple-negative breast carcinoma. Thirteen studies with a total of 1763 patients were included. A moderate risk of bias was noted. The median bias scoring was 7 (6–9). High-grade tumor budding was significantly associated with lymph node metastasis (OR: 2.25, 95% CI: 1.52–3.34, P < 0.01) and lymphovascular invasion (OR: 3.14, 95% CI: 2.10–4.71, P < 0.01), and low-grade budding was significantly associated with triple-negative breast carcinoma (OR: 0.61, 95% CI: 0.39–0.95, P = 0.03)

There was significant heterogeneity in the assessment and grading of tumor budding; thus, a checklist of items was identified that lacked standardization. Our meta-analysis concluded that tumor budding can act as an independent prognostic marker for breast cancer.
Dural and calvarial metastasis of thyroid follicular carcinoma mimicking Sindou type 6 parafalcine meningioma
Authors: Gokoglu Abdulkerim , Orunoglu Merdan , Eksi Murat Sakir , Arsa Vedat , Selcuklu Ahmet
Published: December 2023

Fifty-two years, NID type-2 diabetic female was admitted with progressive headache, enlarging, pulsatile midline mass, dizziness, and numbness of extremities. Physical examination revealed only hypoesthesia in the upper left extremity C7-dermatome. Preoperative computed tomography revealed eroded parafalcian dural mass and caused a round 7 cm calvarial defect over the superior sagittal sinus (SSS) and another left parietal 1.2 cm satellite mass. Magnetic resonance imaging revealed an extra-axial, diffuse heterogeneous gadolinium-enhanced, well-circumscribed lesion invading the SSS and Trolard veins (bilaterally). Supratotal resection 1 cm from the tumor borders was performed, histopathology suggested papillary thyroid carcinoma follicular variant. The euthyroid patient underwent total thyroidectomy, and final pathology revealed invasive TFC. 5-year follow-up was uneventful without recurrence or new metastasis. Parafalcian meningioma classification was reviewed for the best surgical approach. The definitive diagnosis of meningioma should be established with histopathological analysis. TFC should be included in the differential diagnosis in cases of extra-axial tumors.
Giant adrenal myelolipoma in a young male double heterozygous for HbS and beta-thalassemia trait, clinically simulating retroperitoneal sarcoma
Authors: Giri Ranjana , Sahu Saroj Ranjan , Parida Sabyasachi , Sahu Subrat Kumar
Published: December 2023

A 57-year-old male had abdominal pain and distension for 6–7 months with a palpable swelling in the right lumbar region. Contrast-enhanced computed tomography abdomen showed a large heterogeneous lesion with fat density measuring 22 cm ´ 16.5 cm in the right suprarenal region. Laparotomy was done which showed an encapsulated mass measuring 21 cm ´ 14 cm ´ 5 cm. Cut section revealed yellowish areas admixed with hemorrhage and large areas of necrosis. Microscopy revealed adrenal myelolipoma. The patient was found to have sickling positive. High-performance liquid chromatography showed double heterozygous for HbS and beta-thalassemia trait. The association of giant adrenal myelolipoma with double heterozygous for HbS and beta-thalassemia trait is rare, and as clinically it simulates retroperitoneal sarcoma, awareness of this rare entity is critical for its accurate diagnosis and proper management.
Role of curcumin on miR-26a and its effect on DNMT1, DNMT3b, and MEG3 expression in A549 lung cancer cell
Authors: Mahmoudi Zahra , Jahani Mojtaba , Nekouian Reza
Published: December 2023

Context:

Most of the patients diagnosed with non-small cell lung cancer (NSCLC) are in their advanced stages and as a result might not be cured in spite of the advances in aimed therapy. In the recent years, the role of noncoding RNAs (ncRNAs) has been expanded to cancer as potential targets for RNA-based epigenetic therapies. Curcumin, as an active ingredient, is associated with epigenetic alterations, and it might modulate the expression of tumor suppressor and oncogenic microRNAs.

Materials and Methods:

In this study, we investigated the RNA-based epigenetic effects of curcumin on NSCLC, and the effect of curcumin on A549 cell viability was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. The expression of miR-26a, MEG3, DNA methyltransferase 1 (DNMT1), and DNMT3 beta (DNMT3b) was assessed by quantitative polymerase chain reaction.

Statistical Analysis Used:

Data analysis was done using Prism®6 software (GraphPad Software, Inc., La Jolla, CA, USA), and statistical analysis was performed using t-test between control and vitality samples.

Results:

The results showed a significant increase (P < 0.05) of miR-26a expression which in turn was associated with a significant decrease (P < 0.05) in expression of DNMTs and subsequently a significant increase in MEG3 expression (P < 0.05) in A549 cell line after adding curcumin in the media.

Conclusion:

Considering all the data together, we could speculate the role of curcumin in ceasing the progression of cancer in its early stages and might be considered a potential drug for the treatment of NSCLC-derived lung cancer by establishing a meaningful relationship between epigenetic mechanisms and ncRNAs.
Outcomes of hypofractionation for early-stage glottic carcinoma
Authors: Uysal Bora , Gamsiz Hakan , Colak Onurhan , Beyzadeoglu Murat
Published: December 2023

Background:

Our goal is to evaluate hypofractionation in early-stage glottic carcinoma of a single center in line with randomized trials.

Materials and Methods:

Between June 2016 and January 2021, 33 early glottic carcinoma patients treated with IMRT (intensity-modulated radiotherapy) in the Radiation Oncology Department were analyzed. Descriptive statistics and survival analysis were applied. Survival analysis and curves were done via the Kaplan–Meier method. Survival curves were analyzed due to the T stage. Log-rank test was used for the analysis of T stage survival curves.

Results:

Twenty (60.1%) patients were T1 whereas six (18.2%) and seven (21.2%) were Tis. 56.25 Gy, 63 Gy, and 65.25 Gy were delivered to the patients with Tis, T1, and T2, respectively. All groups were treated with 2.25 Gy per fraction. T2 stage had lesser DFS (disease-free survival) compared to Tis and T1 stage and it was statistically significant (P = 0.035).

Conclusion:

Hypofractionation with 2.25 Gy per fraction may be standard for early glottic carcinoma with similar results compared to microsurgery and conventional fractionation radiotherapy.
Integrated bioinformatics approach to unwind key genes and pathways involved in colorectal cancer
Authors: Mobeen Syeda Anjum , Saxena Pallavi , Jain Arun Kumar , Deval Ravi , Riazunnisa Khateef , Pradhan Dibyabhaba
Published: December 2023

Background:

Colorectal cancer (CRC) is the fifth leading cause of death in India. Until now, the exact pathogenesis concerning CRC signaling pathways is largely unknown; however, the diseased condition is believed to deteriorate with lifestyle, aging, and inherited genetic disorders. Hence, the identification of hub genes and therapeutic targets is of great importance for disease monitoring.

Objective:

Identification of hub genes and targets for identification of candidate hub genes for CRC diagnosis and monitoring.

Materials and Methods:

The present study applied gene expression analysis by integrating two profile datasets (GSE20916 and GSE33113) from NCBI-GEO database to elucidate the potential key candidate genes and pathways in CRC. Differentially expressed genes (DEGs) between CRC (195 CRC tissues) and healthy control (46 normal mucosal tissue) were sorted using GEO2R tool. Further, Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway analysis were performed using Cluster Profiler in Rv. 3.6.1. Moreover, protein-protein interactions (PPI), module detection, and hub gene identification were accomplished and visualized through the Search Tool for the Retrieval of Interacting Genes, Molecular Complex Detection (MCODE) plug-in of Cytoscape v3.8.0. Further hub genes were imported into ToppGene webserver for pathway analysis and prognostic expression analysis was conducted using Gene Expression Profiling Interactive Analysis webserver.

Results:

A total of 2221 DEGs, including 1286 up-regulated and 935down-regulated genes mainly enriched in signaling pathways of NOD-like receptor, FoxO, AMPK signalling and leishmaniasis. Three key modules were detected from PPI network using MCODE. Besides, top 20 high prioritized hub genes were selected. Further, prognostic expression analysis revealed ten of the hub genes, namely IL1B, CD44, Glyceraldehyde-3-phosphate dehydrogenase (GAPDH, MMP9, CREB1, STAT1, vascular endothelial growth factor (VEGFA), CDC5 L, Ataxia-telangiectasia mutated (ATM + and CDH1 to be differently expressed in normal and cancer patients.

Conclusion:

The present study proposed five novel therapeutic targets, i.e., ATM, GAPDH, CREB1, VEGFA, and CDH1 genes that might provide new insights into molecular oncogenesis of CRC.
Salivary and serum levels of soluble E-cadherin in patients with gastrointestinal cancers: A comparative study
Authors: Aznab Mozaffar , Shahhosseini Rezvan , Safaei Mohsen , Mozaffari Hamid Reza
Published: December 2023

Aim:

According to the literature, high levels of salivary soluble E-cadherin may be lined to advanced stage and poor prognosis in cancers. This research aimed at comparing salivary and serum levels of soluble E-cadherin in cases with esophageal, gastric, and colorectal cancers.

Methods:

This case-control research was performed on 68 patients with gastrointestinal cancers and 57 healthy volunteers as a control group to measure salivary and serum levels of soluble E-cadherin using ELISA kits.

Results:

The results showed a statistically significant difference between salivary and serum levels of soluble E-cadherin in the case group, as opposed to the control group (P = 0.031). The salivary level of soluble E-cadherin in the control group was 2.138 ng/mL on average lower than that that in the case group. The median salivary level of soluble E-cadherin among cases with lymph node involvement was significantly higher compared with its median level in the control group (P = 0.049). Soluble E-cadherin salivary level and other variables, such as metastasis and cancer stage, were directly correlated, but it was not statistically significant.

Conclusion:

According to the findings, the salivary level of soluble E-cadherin among cases with gastric cancer could be considered as a prognostic marker, but the diagnostic value of saliva could not be judged in esophageal and colorectal cancers because of small sample size, and more investigations are required for a definite conclusion.
Assessment and clinicopathological correlation of p16 expression in cervical squamous cell carcinoma of Indian population: Diagnostic implications
Authors: Paul Arkadip , Dutta Priyanka , Basu Keya
Published: December 2023

Background:

Our aim was to assess the p16 expression in normal cervical epithelium and cervical lesions and how it correlated with HPV oncoprotein E7 and other etiological parameters of cervical cancer.

Methods:

For this purpose, we analyzed protein expression of p16 and E7 oncoprotein in total 20 normal cervical epithelium tissue (as control) and 62 cervical lesions. Next, the result was correlated with different clinico-pathological parameters.

Results:

Out of 62 cases of cervical lesions, we found around 75%–100% of the cervical lesion samples exhibited E7 nuclear protein expression, whereas around 33.33%–75% samples were p16 positive. On the other hand, p16 expression showed strong association with E7 oncoprotein and other clinico-pathological parameters (like high parity, early age of sextual debut) in the same set of samples of our study.

Conclusion:

We concluded that overexpression of p16 is very practical and can be readily implemented in most diagnostic pathology laboratories.
A comparative evaluation of effect of denture cleansers on color stability, surface roughness and hardness of polyamide denture base material
Authors: Punia Vikas , Khandelwal Meenakshi , Sharda Chirag , Porwal Anand , Sethia Abhijit
Published: December 2023

Context:

Different denture cleansers have an effect on color and different surface properties of polyamide denture base material. Thus, selecting a denture cleanser solution for polyamide denture base materials should be based on the properties of the denture cleanser itself. The present in vitro study is aimed to evaluate and compare the effect of different denture base cleansers on color, surface roughness and hardness of polyamide denture base material.

Methods and Material:

Thirty specimens of commercially available polyamide denture base material were fabricated and divided into three groups of 10 each. Specimens from each group were immersed in different denture cleansers (sodium perborate, thyme oil and ozonated water) for 10 mins per day for 180 days. Initial and final color, surface roughness and surface hardness of each specimen were measured and the difference was calculated. Data was tabulated and subjected to statistical analysis using One way ANOVA for pair wise comparison.

Results:

Polyamide denture base resin exhibited some degree of change in color, surface roughness, and surface hardness in all denture cleansers but was not statistically significant.

Conclusions:

The choice of denture cleanser for different denture base resins should be based on the chemistry of resin and the cleanser, denture cleanser concentration and duration of immersion.
Natural Cycle Frozen Embryo Transfer: Evaluating Optimal Protocols for Preparation and Timing
Authors: Holder Kai N. , Mormol Jessica S. , Bakkensen Jennifer B. , Pavone Mary Ellen , Goldman Kara N. , Yeh Chen , Muhammad Lutfiyya N. , Bernardi Lia A.
Published: December 2023

Background:

While natural cycle frozen embryo transfer (NC-FET) is becoming increasingly common, significant practice variation exists in the use of ovulation induction medications, administration of ovulation trigger, and timing of embryo transfer without consensus as to the optimal protocol.

Aims:

The objective of this study is to evaluate the association of key aspects of the NC-FET protocol with implantation, pregnancy and live birth.

Settings and Design:

This was a retrospective cohort study of blastocyst stage NC-FET cycles from October 2019 to July 2021 at a single academic fertility centre.

Materials and Methods:

Protocols varied between cycles across three key parameters which were evaluated as primary predictors of cycle outcomes: (1) use of letrozole for mild ovarian stimulation/ovulation induction, (2) administration of exogenous ovulation trigger versus spontaneous luteinising hormone surge and (3) transfer timing based on ovulation trigger versus sequential progesterone monitoring. Primary outcomes included implantation rate, clinical pregnancy and ongoing pregnancy.

Statistical Analysis Used:

Generalised estimating equations were fitted to obtain adjusted odds ratios or rate ratios as appropriate with 95% confidence intervals for each outcome across the three primary predictors.

Results:

A total of 183 cycles from 170 unique patients were eligible for inclusion. The average implantation rate was 0.58, resulting in an overall clinical pregnancy and ongoing pregnancy rate of 59.0% and 51.4%, respectively. After adjusting for age at embryo freeze and history of a failed embryo transfer, there were no significant associations between any predictor and implantation rate, clinical pregnancy, ongoing pregnancy, or live birth.

Conclusion:

In NC-FET, a variety of preparation and timing protocols may lead to comparable cycle outcomes, potentially allowing for flexibility on the basis of patient and physician preference. These findings warrant validation in a larger, randomised trial.
Combined Parental Thrombophilia Gene Mutation Defects in Couples with Repeated Pregnancy Loss
Authors: Kashifard Mehdi , Basirat Zahra , Ramezani Fatemeh , Ghofrani Faeze , Golsorkhtabaramiri Masoumeh
Published: December 2023

Background:

Several genetic mutations in female thrombotic defects have recently been shown to affect recurrent pregnancy loss (RPL); however, it is unclear which common parental mutations are involved in thrombosis-associated repeated pregnancy loss RPL.

Aims:

In this study, the prevalence of some combined parental thrombophilia gene mutation defects was studied in couples with RPL.

Settings and Design:

The observational study was done in babol infertility research center (Iran) in 2022.

Materials and Methods:

Sixty-two infertile women with a history of RPL and their male partners (124 individuals) participated in this study. The frequencies of common defects associated with methylenetetrahydrofolate reductase (MTHFR) C677T and A1298C, factor V Leiden, protein C, protein S and homocysteine were analysed in these couples.

Statistical analysis used:

The data were statistically analysed using the Mann–Whitney test.

Results:

Sixty-two couples (124 individuals) were analysed. 56.2% of couples with a history of RPL had MTHFR C677T and 23.1% had MTHFR A1298C. Forty percent of couples showed homocysteine deficiency and 12.5% protein C deficiency. Other genes tested were only observed in the mother or father but not both.

Conclusions:

Results obtained with RPL couples demonstrate the importance of further investigating combined parental thrombophilia gene mutation defects (not only maternal).