bluuebunny/crossref_metadata_2025 huggingface dataset:
The Significance of Rapid Eye Movement Sleep Behavior Disorder in Neurodegenerative Diseases
Authors: Bhatti Karandeep S , Kaleru Thanmai , Vankeshwaram Varun , Maheshwary Ankush , Khan Safeera
Published: February 2024

Background:

Rapid eye movement (REM) sleep behavior disorder (RBD), a parasomnia, after being diagnosed, can predict the emergence of an alpha-synuclein-associated neurodegenerative disease (NDD) in 20-45% and 92% of patients within 5 and 14 years, respectively. RBD is less common in tauopathies, and the studies to evaluate its association with polyglutamine diseases have been very few.

Objective:

To revisit our knowledge on the significance of RBD in the emergence of NDDs and to review the recent updates in the potential biomarkers, which can help predict the risk of phenconversion into NDDs in idiopathic RBD (iRBD) patients. We also aimed to look at the potential neuroprotective therapies that can potentially be used earlier in iRBD patients.

Methods:

We conducted a review of the papers, after selecting them from the PubMed database. After a thorough screening, 51 articles were chosen to be included in this review.

Results and Conclusion:

The prospective studies showed that the risk of phenoconversion of iRBD into overt NDDs increased over the longer duration of follow up. Magnetic resonance imaging (MRI) findings, Electroencephalographic findings along with subtle motor signs, autonomic dysfunction, impaired olfaction, and color vision, among others, can be used to predict the onset of an NDD in iRBD. Phytocannabinoids showed a possible neuroprotective effect in animal studies. Considering how RBD is the antecedent of NDDs, there is a need for additional studies to better understand the utility of the aforementioned biomarkers and institute potential neuroprotective therapies early in the process.
Infectious Spondylodiscitis of the Lumbar Spine
Authors: Hohenberger Christoph , Schmidt Nils-Ole , Doenitz Christian , Ullrich Odo Winfried , Schebesch Karl-Michael
Published: February 2024

Background:

Infectious spondylodiscitis of the lumbar spine is a common serious disease for which evidence-based therapeutic concepts are still lacking.

Objective:

This retrospective study compared the impact of the health status of patients on the length of hospital stay with regard to the treatment concept, i.e., antibiotic therapy or antibiotic therapy in combination with fixation surgery.

Patients and Methods:

The study included 54 consecutive patients with infectious spondylodiscitis of the lumbar spine who had been treated at our clinic between 2004 and 2013. Records included patient demographics, concomitant diseases, the neurological status and treatment modality, and the length of hospital stay.

Results:

40 men and 14 women with a mean age of 64.2 (30-89) years were included. 13 patients were only treated with antibiotics (group A), 7 patients with abscess decompression (group B), 18 patients with early dorsal fusion (<10 days after admission) (group C), and 16 patients with late dorsal fusion (≥10 days after admission; group D). Patients undergoing early dorsal fusion had a significantly shorter hospital stay (33.2 days) than patients undergoing late dorsal fusion (57.0 days), P = 0.016. Mean hospital stay of patients treated with antibiotics was 30.3 days, that of patients receiving abscess decompression 57.8 days. Patients receiving only antibiotics had a significantly lower CRP level at admission than patients undergoing early fusion, P < 0.05.

Conclusion:

Patients with one or more relevant chronic concomitant diseases showed faster recovery, shorter hospital stays, and earlier return to daily routine after early dorsal fusion than after late dorsal fusion or abscess evacuation alone.
Exosomal PTEN as a Predictive Marker of Aggressive Gliomas
Authors: Patnam Sreekanth , Samal Rasmita , Koyyada Rajeswari , Joshi Partha , Singh Anula D , Nagalla Balakrishna , Soma Madan R , Sannareddy Rajesh R , Ippili Kaushal , Raju Subodh , Boola Ratnam G , Lath Rahul , Ranjan Alok , Ghosh Siddharth , Balamurugan M , Ray Amitava , Manda Sasidhar V
Published: February 2024

Background:

Liquid biopsies have emerged as convenient alternative diagnostic methods to invasive biopsies, by evaluating disease-specific biomarkers and monitoring the disease risk noninvasively. Phosphatase and tensin homolog deleted in chromosome 10 (PTEN) is a potent tumor suppressor, and its deletion/mutations are common in gliomas.

Objective:

Evaluate the feasibility of non-invasive detection of PTEN and its downstream genes in serum exosomes of glioma patients.

Materials and methods:

PTEN, Yes-associated-protein 1 (YAP1), and lysyl oxidase (LOX) transcript expression were monitored through polymerase chain reaction (PCR) in serum exosomes and their paired tumor tissues. The impact of PTEN and its axis genes expression on the overall survival (OS) was monitored.

Results:

Out of the 106 glioma serum samples evaluated, PTEN was retained/lost in 65.4%/34.6% of the tumor samples while it was retained/lost in 67.1%/32.9% of their paired exosomal fractions. PTEN expression in both tissue and paired exosomal fractions was observed in 48.11% of the samples. Sanger sequencing detected three mutations (Chr10: 89720791(A>G), Chr10:89720749(C>T), and Chr10:89720850(A>G). Both PTEN-responsive downstream genes (YAP1) and LOX axis were upregulated in the PTEN-deficient samples. PTEN loss was associated with poor survival in the glioma patients (hazard ratio (HR) 0.68, confidence interval (CI): 0.35–1.31, P = 0.28). The OS of the exosomal PTEN cohort coincided with the tumor-tissue PTEN devoid group (HR 1.08, CI: 0.49–2.36, P = 0.85). While, old age yielded the worst prognosis; gender, location, and grade were not prognostic of OS in the multivariate analysis.

Conclusions:

PTEN and its responsive genes YAP1 and LOX can be detected in serum exosomes and can serve as essential tools for the non-invasive evaluation/identification of aggressive gliomas.
Impact of Stellate Ganglion Block in the Management of Cerebral Vasospasm
Authors: Samagh Navneh , Panda Nidhi B. , Gupta Vivek , Bharti Neerja , Tripathi Manjul , Bhagat Hemant , Chhabra Rajesh K. , Jangra Kiran , Luthra Ankur
Published: February 2024

Background:

Stellate ganglion block (SGB) causes blockage of sympathetic nerve activity, which may lead to intracerebral vessel dilatation and relieve cerebral vasospasm in patients of aneurysmal subarachnoid hemorrhage (aSAH).

Objective:

The aim of this study was to evaluate the efficacy and safety of SGB to relieve cerebral vasospasm on clinicoradiological parameters.

Materials and Methods:

We prospectively included 20 patients with clinical and angiographic evidence of vasospasm post aneurysmal clipping. Cerebral blood flow velocity and Lindegaard ratio were assessed using transcranial Doppler (TCD). Location of vasospasm, vessel diameter, vasospasm severity, parenchymal filling time, and venous sinus filling time were assessed on digital subtraction angiography (DSA). Patients received ultrasound-guided SGB with 10 mL of 0.5% bupivacaine on the ipsilateral side of the vasospasm. After 30 minutes, the neurological status, TCD, and DSA parameters were reevaluated.

Results:

After SGB, there was statistically significant reduction in the middle cerebral artery (MCA) peak systolic velocity (P= 0.005), mean flow velocity (P= 0.025), and Lindegaard ratio (P= 0.022) on TCD. We observed significant dilatation in the mean vessel diameter measured at the mid-M1 segment of MCA (P= 0.003) and mid-A1 segment of ACA (P= 0.002) on DSA. The mean parenchymal filling time and mean venous sinus filling time decreased nonsignificantly after SGB (P= 0.163/0.104). Neurological improvement was observed in five (25%) patients.

Conclusion:

SGB has positive clinicoradiological influence in the management of cerebral vasospasm of large vessels. However, its effect on cerebral microvasculature is limited and needs a larger database for further analysis.
Strategies for humanizing technology in health profession education
Authors: Yusoff Muhamad Saiful Bahri
Published: February 2024

Technology is rapidly advancing and becoming increasingly critical in the health profession education. Therefore, it is crucial to prioritize the humanization of its implementation to provide students with a personalized, meaningful, and supportive learning experience. Various strategies can be employed to achieve this goal, including humanizing learning institutions, leveraging the urbanization of higher education, revitalizing educational ecosystems, and preparing health-care learners for a changing world. In addition, it is essential to understand the needs of students, use technology as a complementary tool, foster a sense of community, provide training and support, and consider accessibility to ensure the equitable and effective implementation of these strategies. By collaboratively working to humanize technology in health profession education, we can provide students with the education they deserve to excel in their careers.
Polytetrafluoroethylene Infection-related Sepsis in Liver Transplant Recipients
Authors: Jothimani Dinesh , Devarajan Vidya , Kumar Sweatha , Sampath Santhosh , Rela Mohamed
Published: February 2024

Synthetic vascular grafts are commonly used in liver transplantation. Polytetrafluoroethylene (PTFE) grafts should be monitored for infectious complications that require percutaneous drainage or graft removal. Herein, we report three cases of PTFE graft infection in living-donor liver transplant recipients. Two of the three patients presented with bacteremia and one of the patients had culture-negative sepsis, and fluorodeoxyglucose-positron emission tomography/computed tomography in all three cases suggested synthetic vascular graft infection with thrombosis. Two of the three patients developed PTFE graft infection with thrombosis within 1–4 months of transplantation, and the third patient developed it 9 months posttransplantation. Timely detection of infection and appropriate antibiotic therapy preserved the graft function. When unexplained bacteremia or persistent fever occurs in patients with liver transplants, prosthetic material should be considered as a focus, and appropriate imaging, culture, and antibiotic therapy will help in preserving graft function. Although the gold standard treatment is the removal of infected tissue, our patients did remarkably well with conservative management.
Clinical Problem Solving: A Case of Complicated Staphylococcal Infection
Authors: Bende Tejas , Rao Vineet , Deore Tushar , Bhalerao Suryabhan , Joe Geethu , Shaha Kunal , Soman Rajeev
Published: February 2024

A 61-year-old male with diabetes mellitus and cervical spondylosis presented with severe neck pain and fever. Magnetic resonance imaging spine showed prevertebral abscess and spondylodiscitis. Blood culture done elsewhere grew Staphylococcus aureus. On further evaluation, Positron emission tomography-computed tomography showed prevertebral collection with air foci within. Differential diagnosis based on possible clinical scenarios is discussed in the case. This case report highlights the importance of accurate identification of susceptibility of Staphylococcal aureus, off label use of joint infection multiplex polymerase chain reaction, targeted antibiotic therapy, timely surgical intervention, and de-escalation to oral therapy.
Comparative evaluation of antimicrobial efficacy of triple antibiotic paste and amoxicillin clavulanate paste as an intracanal medicament against Enterococcus faecalis: An in vitro study
Authors: Sasikala Dhandayuthapani , Baghkomeh Parisa Norouzi , Farzan Jamaluddin Mohammed
Published: February 2024

Background:

Triple antibiotic paste (TAP) is the commonly used intracanal medicament against Enterococcus
faecalis. Amoxicillin clavulanate paste (ACP) is recommended as a “fall-back” antibiotic when traditional dental antibiotics fail. Literature comparing the antimicrobial efficacy of TAP and ACP in eradicating E.
faecalis from the root canal system is sparse; hence, this in vitro study was conducted to evaluate and compare the antimicrobial efficacy of TAP and ACP as an intracanal medicament for endodontic treatment of single-rooted permanent teeth against E.
faecalis.

Materials and Methods:

This in
vitro, experimental study evaluated 60 root samples obtained from extracted single-rooted human permanent teeth. The canal diameter was enlarged and subsequently infected with E.
faecalis for 21 days. Four groups of the contaminated samples were treated with TAP, ACP, calcium hydroxide (positive control), and saline (negative control), respectively. Dentinal shavings were collected at the end of the 1st, 7th, and 10th day and inoculated in agar plates. The number of colony-forming units was determined, and the data were statistically analyzed using the Kolmogorov–Smirnov and Shapiro–Wilks test. P <0.05 was considered statistically significant.

Results:

The mean number of E.
faecalis colony counts across all 3 test days demonstrated that TAP exhibited the highest inhibition of bacterial growth, followed by ACP which is not statistically significant (P = 1.00).

Conclusion:

Considering the limitations of this in vitro study, the findings suggest that ACP could be an effective alternative intracanal medicament to TAP for endodontic therapy.
Evaluation of apical transportation and centering ability of three single-file systems in severely curved canals using micro-computed tomography
Authors: Hasheminia Seyed Mohsen , Soltani Samaneh , Mohamadian Fateme , Saatchi Masoud , Sadeghi Seyed Mohsen
Published: February 2024

Background:

This study aimed to compare the apical transportation and centering ability of One Curve, HyFlex EDM, and EdgeFile X1 in curved mesiobuccal and mesiolingual canals of mandibular first molars.

Materials and Methods:

In this in vitro experimental study, 60 mesiobuccal and mesiolingual canals of the mandibular first molars with a minimum length of 19 mm and 25°–40° curvature were randomly divided into three groups (n = 20) for root canal preparation with One Curve, HyFlex EDM, and EdgeFile X1. After access cavity preparation and confirming the glide path, the baseline micro-computed tomography (micro-CT) scans were obtained, and the root canals were instrumented with the respective systems according to the manufacturers’ instructions. Apical transportation and centering ability were assessed at 1, 3, 5, and 7 mm from the apex by comparing pre- and postinstrumentation micro-CT scans. One-way ANOVA, independent t-test, and Duncan's post hoc test were used to statistically compare the groups, and data were analyzed by SPSS version 24 (alpha = 0.05).

Results:

The three groups were not significantly different regarding apical transportation at 5 and 7 mm from the apex (P > 0.05). At 1 mm level, One Curve caused significantly lower apical transportation; while, at 3 mm level, HyFlex EDM resulted in significantly higher apical transportation (P < 0.05). No significant difference was noted in the centering ability of the three groups at 1, 3, and 5 mm from the apex (P > 0.05). At 7 mm level, EdgeFile X1 showed significantly lower centering ability (P < 0.05).

Conclusion:

One Curve caused lower canal transportation in the apical third compared with EdgeFile and HyFlex EDM, but no significant difference was noted among the three in the coronal third of the roots.
Comparison of coronal sealing of flowable composite, resin-modified glass ionomer, and mineral trioxide aggregate in endodontically treated teeth: An in-vitro study
Authors: Tavakoli Mahla , Araghi Solmaz , Fathi Amirhossein , Jalalian Shahriar
Published: February 2024

Background:

Coronal seal is one of the essential factors that affects the success of endodontic treatment and reinforces the apical seal. The intra-orifice barrier is an efficient alternative approach to decrease coronal leakage in endodontically treated teeth and various materials have been used for this purpose. This study aimed to compare the coronal sealing of flowable composite, resin-modified glass ionomer (RMGI), and mineral trioxide aggregate (MTA) in endodontically treated teeth.

Materials and Methods:

In this in vitro study, 35 single-canal canine teeth were divided into five groups, including flowable composite, RMGI, MTA, positive control, and negative control groups. The teeth were filled with restorative materials according to the factory's instructions. Afterward, the samples were immersed in 2% methylene blue dye solution for 1 week at 37°C and 100% humidity condition. Finally, the teeth were sectioned longitudinally and dye penetration was measured using a stereomicroscope with ×10. Data were analyzed with Kolmogorov–Smirnov and Kruskal–Wallis tests (α = 0.05).

Results:

The positive control group showed the highest amount of dye penetration compared to other groups (12.34 ± 0.46). Dye penetration in the MTA group was significantly lower (4.25 ± 0.31) compared to the RMGI group (5.94 ± 0.24) (P = 0.02). Moreover, while the dye penetration in the MTA group was lower than in the flowable composite group (5.65 ± 0.26), the difference was not statistically significant (P = 0.12).

Conclusion:

MTA reduces the coronal leakage and provides an acceptable coronal seal in endodontically treated teeth, especially compared to RMGI, and therefore, using MTA as an intra-orifice barrier increases the endodontic treatment success rate.
Comparison of intelligent development (IQ & EQ) of children with cleft lip and palate
Authors: Maryan Rasool Esmaeili , Feizbakhsh Masood , Esmaeilian Zohreh , Sedaghati Golnoosh
Published: February 2024

Background:

Attention to the issue of intelligence and its promotion in children with cleft lip and cleft palate (CL and CP) is necessary to reduce their injuries in life. This study aimed to determine the intelligence quotient (IQ) and emotional intelligence (EQ) in children with CL and CP in comparison to healthy children.

Materials and Methods:

In this descriptive study, 140 children, including 70 children with CL and CP, were selected from the Children treated in Craniofacial and Cleft Research Center, Spearman correlation, ANOVA and 70 healthy children were selected from the Pediatric Dentistry Department of Isfahan University, in the age range of 5–9 years. After obtaining the consent of the children's parents, the Raven IQ questionnaire and the Mayer and Salovey EQ questionnaire were given to the children. Data were analyzed by the Pearson correlation coefficient tests (α =0.05).

Results:

EQ score in healthy children was significantly higher than in children with CL and CP (P < 0.001). The percentage of IQ cognitive intelligence in healthy children and children with CL and CP was not significantly different (P = 0.641). In healthy children, no significant relationship was observed between cognitive intelligence IQ and EQ (r = 0.018, P = 0.882). However, among children with CL and CP, there was a significant inverse relationship between cognitive intelligence IQ and EQ (P < 0.001, r = −0.526).

Conclusion:

CL and CP have no effect on IQ in children, but it does affect EQ.
Direct immunofluorescence (DIF) versus immunohistochemical (IHC) staining of complements and immunoglobulins (Ig) in pemphigus group
Authors: Rana Deepika , Khurana Nita , Mandal Shramana , Sahoo Bijay Laxmi
Published: February 2024

Introduction:

Pemphigus is a group of bullous disorders of the skin characterized by the formation of autoantibodies present in the intercellular junction of the epidermis. Diagnosis is made by clinical, histopathological examination, and DIF. As DIF needs frozen sections, fluorescent tagged antibodies, UV light microscope for examination, and trained personnel, its non-availability makes a definitive diagnosis challenging.

Aims and Objectives:

To evaluate the utility of IHC staining of complements and Ig in cases of Pemphigus.

Materials and Methods:

Twenty-six diagnosed cases of Pemphigus were stained by Peroxidase immunohistochemical method using monoclonal antibody to IgG, IgA, IgM, IgG4, C3, C4 d with DAB as chromogen. Pemphigus cases include twenty of pemphigus vulgaris (PV), four cases of pemphigus foliaceous (PF), and two of pemphigus vegetans (Pveg). Positivity was defined as the deposition of Ig and complements as distinct, continuous brown staining of keratinocytes at intercellular junctions.

Result:

On IHC total of 20 PV 17 showed positivity (85%) for IgG, 11 (55%) C4d, 19 (95%) C3d, and 16 (80%) IgG4 deposits at the intercellular junction of the epidermis. All cases of PF showed a deposit of IgG, with three (75%) cases for IgG4, C3d, and C4d. Both cases of Pveg showed positivity for IgG and C4d while one case was negative for IgG4 and C3d. The overall IgG, C3, IgG4, and C4d expression for pemphigus was seen in 88%, 88%, 76.9%, and 61.5% of cases. The relation between these markers, combination of IgG and C3, was best related to each other (P value = 0.80). The sensitivities for IgG, IgG4, and C3 were 77.8%%, 73%, and 73% resp.

Conclusion:

We conclude that IHC is a useful tool in the diagnosis of PV with the highest sensitivity of IgG and C3d. The combination of IgG and C3d could replace the DIF in almost all of our cases, so IHC on FFPE sections be used as an alternative method to DIF.
Preoperative evaluation of red blood cell distribution width as a promising biomarker for discriminating between benign and malignant breast tumors and assessing breast cancer activity
Authors: Thakur Ajay Singh , Indoria Chandrashekhar , Sahu Ruby , Kujur Pratima , Gahine Renuka
Published: February 2024

Background:

The red cell distribution width (RDW) has been recognized as a new prognostic factor in various pathophysiological states including breast cancers. The aim of this study was to compare the RDW values between patients diagnosed with benign and malignant breast tumors and to evaluate the potential of elevated RDW as a biomarker for breast cancer activity.

Materials and Methods:

A cross-sectional study compared RDW values in age-matched cohorts diagnosed with benign and malignant breast lesions and correlated them with prognostic factors for malignant breast tumors. The study excluded individuals with inflammatory disorders, pre-neoplastic disease, hematological disorders, or those taking immunosuppressive or anti-inflammatory medications. The RDW values were measured using an automated hematology analyzer. The study’s statistical analysis was conducted using SPSS software at a significance level of 0.05.

Results:

RDW demonstrated a statistically significant elevation in the cohort of patients with malignant breast tumors, those with metastatic breast tumors, a greater number of infiltrated axillary lymph nodes, larger tumor diameter, and a higher grade of the primary tumor mass.

Conclusions:

The findings of this study suggest that RDW has the potential to serve as a biomarker for assessing breast cancer activity and could offer substantial advantages in clinical contexts. The present study is not without limitations, and the authors suggest that a larger multicenter prospective study be conducted to further validate it’s efficacy over an extended duration.
A rare case of neglected parasitic zoonosis
Authors: Noufal Amal , Mukundan Aiswarya , John Reena
Published: February 2024

Infections caused due to zoonotic hookworms are rare and are often under reported. Here we report a case of diarrheal disease caused by Ancylostoma ceylanicum, an important emerging zoonotic hookworm. There is limited knowledge about the epidemiology and disease burden of A. ceylanicum infections in Kerala. A 50-year-old male patient presented with complaints of loose stools for past five weeks. The laboratory investigations revealed a high total WBC count and eosinophil count. Diagnostic colonoscopy showed numerous worms which were identified as A. ceylanicum. Timely diagnosis aided in successful treatment of the patient. Improvement in diagnostic tools and awareness enable accurate and early detection of this neglected but emerging pathogen.
Evaluation of immunohistochemical expression of novel neuroendocrine marker INSM1 and histological tumor growth pattern in well-differentiated neuroendocrine tumors of the appendix: 15-year single tertiary center experience
Authors: Koyuncuer Ali , Canbak Tolga , Acar Aylin , Şahin Onur
Published: February 2024

Introduction:

Well-differentiated neuroendocrine tumors of the appendix (A-WDNET) are the most common neoplasms of the appendix but are rare and incidental. INSM1 is a novel transcription factor marker with high sensitivity and specificity for neuroendocrine differentiation. It may display architecturally diverse tumor growth patterns including solid, nest, insular trabecular, and acinar.

Aims:

The aim of this study was to determine the staining expression of INSM1 in A-WDNETs and detail the morphological tumor growth patterns.

Materials and Methods:

INSM1 immunohistochemistry was performed on 35 A-WDNET patients. Tumors were histologically classified according to their growth patterns.

Results:

Thirty-five patients, 60% of whom were male, had a mean age of 30 years at diagnosis and a mean tumor size of 0.9 cm. Eight percent of the tumors invaded the mucosa/submucosa, 34.3% showed invasion into the muscularis propria, 57.1% showed invasion into the subserosa or mesoappendix, LN metastasis was observed in two patients, lymph-vascular invasion in two patients, and perineural invasion in five patients. Ninety-four percent of the tumors were grade 1, the mitotic rate was >2% in two cases, and Ki-67 PI was >3% in two cases. INSM1 was positive in all cases (100%), 1+ 8.6%, 2+ 5.7%, 3+ 17.1%, 4+ 68.6%, weak staining in 11.4%, moderate staining in 22.9%, and strong staining in 67.7%. Type A histological growth pattern was observed in 54.3%, type B in 31.4%, and type C in 14.3% architecturally.

Conclusions:

INSM1 was positive in all A-WDNET morphological patterns and was 100% sensitive. INSM1 IHC can be used as an alternative to traditional neuroendocrine markers or in combination with the diagnosis of neuroendocrine tumors.
A Comparative Study of Postoperative Analgesic Efficacy of Suprainguinal versus Infrainguinal Approach of Ultrasound-guided Fascia Iliaca Compartment Block using 0.2% Ropivacaine in Patients Undergoing Surgery for Hip Fracture under Spinal Anesthesia
Authors: Mathur Pooja Rawat , Banerjee Ananda Prakash , Yadav Ratan Lal
Published: February 2024

Context:

Fascia iliaca compartment block (FICB) is a useful modality to provide postoperative analgesia in patients with hip fracture undergoing surgery.

Aims:

The aims of this study were to compare the analgesic efficacy of suprainguinal versus infrainguinal approach of ultrasound-guided FICB using 0.2% ropivacaine in patients undergoing surgery for hip fracture under spinal anesthesia.

Settings and Design:

It was a prospective, randomized, controlled study.

Subject and Methods:

Group A (n = 25) received ultrasound-guided FICB by suprainguinal approach and Group B (n = 25) received ultrasound-guided FICB by infrainguinal approach. The primary objective was to compare 24-h postoperative analgesic efficacy using Numeric Rating Scale (NRS) score.

Statistical Analysis:

For data analysis, t-test, Mann–Whitney test, and Chi-square test were applied.

Results:

NRS score after 30 min of FICB in Group A was 2.36 ± 1.11 which was lower in comparison to 3.28 ± 0.94 in Group B (P = 0.002). NRS score during positioning in Group A was 2.16 ± 0.90, which was lower than Group B 3.08 ± 0.81 (P = 0. 0004). Greater block coverage was achieved in obturator nerve distribution in Group A 0.76 ± 0.52 compared to 0.16 ± 0.37 in Group B (P < 0.001). The total duration of analgesia was 493.40 ± 214.83 min, which was more in Group A than in Group B 367.48 ± 63.92 min (P = 0.007). Quality of recovery (QoR) score out of 150 in Group A was 120.60 ± 8.91 compared to 110.40 ± 7.59 in Group B (P < 0.001).

Conclusion:

FICB by suprainguinal approach provides better analgesia, sensory block coverage, and conditions for positioning for spinal anesthesia and also has a higher time to first rescue analgesic requirement with better QoR compared to infrainguinal approach.
Therapeutic pearl: A simple cost-effective treatment for chronic digital intertrigo of toes
Authors: Mukhtar Muhammed , Mukhtar Nadia
Published: February 2024

Chronic intertrigo of toe-web space is a recalcitrant problem which is often associated with multi-organism infections. For this, a number of topical therapy with preventative measure are used, but many of them are cumbersome and not very effective. Cryotherapy is a good option for treating the toe intertrigo, but its availability is major concern. Here as an alternative to cryotherapy, TCA cautery and NaOCl (a broad spectrum anti-infective agent) solution is advocated as a simple, feasible, and cost-effective treatment of chronic inter-digital intertrigo.
A customized syringe for separating ingrown toe nail from the gutter
Authors: Mukhtar Muhammed , Mukhtar Nadia
Published: February 2024

Ingrown toenails is a painful foot problems seen in primary care among young men. To provide immediate pain relief, some types of splints are placed in the gutter to separate it from the ingrown lateral nail. There are time-consuming and effort-intensive procedures that use available nail separators and elevators to separate the nail plate. Here, the hub of the syringe is cut obliquely to create a bevelled or slant edge to create a custom nail separator which is a useful device for the easy and less painful separation of the ingrown nail plate from its gutter, which is an important stage of nail splinting.
Ovarian cancer with osteoblastic bone metastasis – A rare case report
Authors: Singhal Saloni , Sharma Ruchi , Sharma Somya , Lodi Ashar I. , Bhandari Virendra
Published: February 2024

Ovarian cancer with bone involvement occurs rarely with an incidence of 0.1–0.12%. The common sites of bone metastasis are vertebrae, pelvic bones, and the skull. Patients present with severe localized bone pain, swelling, and difficulty in walking. We report a rare case of a 53-year-old female with metastatic epithelial serous adenocarcinoma of the ovary presented with multiple bony lesions in pelvic bones involving the sacrum, bilateral ilium, ischium and pubic bones and the right femur in the region of greater trochanter, smaller lesions in the left femur, and dorso lumbar vertebral metastasis while undergoing treatment as a part of distant spread. Radiologically, the osteolytic lesions are the most common, but in our case, the lesions are osteoblastic, which is rare.
Investigating the resistance mechanism of 5-fluorouracil in colorectal cancer based on surface markers of cancer stemness and cytokine level: A pre-clinical study
Authors: Patel Samir G. , Patel Alkeshkumar , Patel Nupur , Raiya Birva , Vora Hemangini , Jain Neeraj
Published: February 2024

ABSTRACTS

Background:

Colorectal cancer (CRC) is the deadliest malignancy in the world. The first-line chemotherapy used for CRC is 5-fluorouracil (5-FU). 5-FU completely eradicates rapidly proliferating and terminally differentiated tumor cells but fails to target cancer stem cells (CSCs). As a result, the tumor may shrink temporarily, but remnant CSC multiplies and forms a tumor again more aggressively. The recurrence and resistance lead to metastasis.

Methodology:

CRC was induced in 12 Sprague–Dawley (RPCP/IAEC/2019-20/R2) rats by 1,2 dimethyl hydrazine. Later, animals were treated with 5-FU for 7 weeks at a 10 mg/kg dose by the subcutaneous route. At the end of treatment, half population was sacrificed (6), whereas the remaining half (6) was left without treatment of 5-FU for 5 weeks and then sacrificed. Parameters such as body weight, complete blood count (CBC), immune cell subset (CD4, CD8, and NK cells), colon length to weight index, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) level, occult blood in stool, tumor multiplicity, and liver metastasis were estimated. In addition, the dissected colon was fixed in formalin and sent to the histology lab for hematoxylin-eosin staining and immunohistochemistry at both intervals.

Results:

All blood and tissue-based markers have shown significant differences (p < 0.05) between the animals sacrificed at the end of the 27th week and the end of the 32nd week for 5-FU treatment.

Conclusion:

It can be concluded that 5-FU up-regulates inflammatory cytokines and cell surface markers of CSC that promote CRC stemness via the Wnt/β-catenin pathway. Also, involvement of Nf-κB, fibronectin, MMP-9, and RANKL leads to tumorigenesis, disease aggressiveness, metastasis, and resistance.
Evaluation of EGFR in prognostic characterization in histopathological variants of oral squamous cell carcinoma
Authors: Tyagi Deepanshu , Singhal Meenakshi , Gulati Nikita , Jain Anshi , Shetty Devi Charan
Published: February 2024

Aim of the Study:

Epidermal growth factor receptor (EGFR) is a tyrosine kinase receptor of the Erb B family contributing to proliferation, invasion, and metastasis. EGFR overexpression is frequently associated with poor clinical outcome in malignant neoplasms.

• To evaluate and compare immunoexpression of EGFR in histopathological variants of oral squamous cell carcinoma (OSCC).

• To hypothesize the role of EGFR in determining biological behavior and prognostic course of histopathological variants of OSCC

Materials and Methods:

The study comprised a total of 40 cases including 10 cases each of Squamous cell carcinoma, Verrucous carcinoma, Adenosquamous cell carcinoma, and Adenoid squamous cell carcinoma. EGFR immunoexpression was observed qualitatively as low (1), moderate (2) and strong (3) and quantitatively as score 1 for <10%, 2 for 10%-50%, and 3 for >50% positive cells. The resulting data were analyzed using SPSS software version 19. Data have been expressed as mean and standard deviation. Differences between the different variables were analyzed using ANOVA, and Pearson’s Chi-square. (p ≤ 0.05)

Result:

The study results revealed that the EFGR immunoexpression was highest in adenosquamous cell carcinoma followed by adenoid squamous cell carcinoma then conventional squamous cell carcinoma followed by lowest immunoexpression in verrucous carcinoma. The results were statistically significant. (p ≤ 0.05)

Conclusion:

Expression of EGFR could be established as a valuable biomarker with significant association in predicting aggressive potential and treatment response in various histopathological variants of OSCC. Further studies where EGFR could be linked to predictive indicators and tumor prognosis could be undertaken.
Prognostic implications of malignancy grading of invasive fronts of oral squamous cell carcinoma
Authors: Sharma Preeti , Wadhwan Vijay
Published: February 2024

Objective:

Invasive front malignancy grading system in oral squamous cell carcinoma (OSCC) introduced by Bryne et al. is reported to be of prognostic significance in a number of studies conducted in Western countries. The aim of this study was to evaluate the prognostic significance of the modified Bryne’s malignancy grading system and to compare it with the World Health Organization (WHO) grading system in the Indian population.

Methods:

The records of 50 patients diagnosed with primary OSCC were evaluated. Only large surgically resected specimens that had deep invasive fronts in the cut sections were selected. All hematoxylin and eosin-stained slides were analyzed by two grading systems: the WHO grading system and the Bryne’s malignancy grading of the deep invasive fronts of OSCCs.

Results:

Histopathologic grading in the invasive sites had highly significant prognostic value and had significant correlation with overall survival rate. The Kaplan-Meier survival curves showed that five years following therapy, the proportion of cases surviving with Bryne’s scores lower or equal to 12 was 60.6% compared to only 17.6% for those with scores greater than 12. The drop in the survival curve of the patients with Bryne’s scores greater than 12 was much steeper toward the end of the two years (nearly 16 months). In WHO Grades I and II, the survival rate was 48.9% and in Grade III, it was Nil.

Conclusion:

The histologically invasive areas may be the only prognostic indicator for the clinical behavior of OSCC and can be used to predict overall survival in patients.
Efficacy of Nanoparticles in dose enhancement with high dose rate of Iridium-192 and Cobalt-60 radionuclide sources in the Treatment of Cancer: A systematic review
Authors: Gebremariam Tsige Y. , Geraily Ghazale , Arero Amanuel G. , Gholami Somayeh
Published: February 2024

ABSTRACTS

A key challenge in radiation therapy is to maximize the radiation dose to cancer cells while minimizing damage to healthy tissues. In recent years, the introduction of remote after-loading technology such as high-dose-rate (HDR) brachytherapy becomes the safest and more precise way of radiation delivery compared to classical low-dose-rate (LDR) brachytherapy. However, the axially symmetric dose distribution of HDR with single channel cylindrical applicator, the physical “dead-space” with multichannel applicators, and shielding material heterogeneities are the main challenges of HDR brachytherapy. Thus, this review aimed to quantitatively evaluate the dose enhancement factor (DEF) produced by high atomic number nanoparticles (NPs) which increases the interaction probability of photons mainly through the photoelectric effect induced in the great number of atoms contained in each nanoparticle. The NPs loaded to the target volume create a local intensification effect on the target tissue that allows imparting the prescribed therapeutic dose using lower fluxes of irradiation and spare the surrounding healthy tissues. An electronic database such as PubMed/Medline, Embase, Scopus, and Google Scholar was searched to retrieve the required articles. Unpublished articles were also reached by hand from available sources. The dose is increased using the high atomic number of nanoparticle elements under the high dose iridium radionuclide whereas the cobalt-60 radionuclide source did not. However, much work is required to determine the dose distribution outside the target organ or tumor to spare the surrounding healthy tissues for the iridium source and make compressive work to have more data for the cobalt source.
Sacrococcygeal mass in a 3-year-old unfolding as Dabska tumor—A very rare entity
Authors: Rajendran Ulagarasi , Arumugam Vasugi , Sundaram Sandhya , Ramasundaram Madhu
Published: February 2024

Papillary intralymphatic angioendothelioma, previously known as Dabska’s tumor, is a very rare entity in children involving the skin and soft tissue. It is a low grade tumor characterized by papillary endovascular proliferations of atypical endothelial cells and anastomosing vascular channels in the dermis. We present a 3-year-old male child, with a history of swelling and mild pain in the right upper gluteal region, progressive in nature for 1 month duration. On examination, the swelling was soft to firm and mildly tender. Radiology was suggestive of Sacro-coccygeal teratoma. Grossly, it was an ill-defined grey brown lesion measuring 3.5 × 3 × 2 cm. Microscopy showed lesion arranged in papillary pattern with slit like vascular channels and intra luminal proliferations of hobnail like endothelial cells. Morphology and immunohistochemical studies revealed a diagnosis of Papillary intralymphatic angioendothelioma.
Ovarian cancer: A report from population-based cancer registry at central rural India
Authors: Gangane Nitin M. , Patil Bharat U. , Ghongade Pravinkumar V.
Published: February 2024

Introduction:

Ovarian neoplasms affect a huge part of the female population and, simultaneously, have the worst prognosis among all gynecological malignancies. In most of the population-based cancer registries (PBCR) in India, ovarian cancer is the third leading site of cancer among women, trailing behind cervix and breast cancer.

Materials and Methods:

In the present study, we have summarized the number of new cases of ovarian malignancy and its profile observed in the PBCR in central India during 7 years.

Reports:

During a 7-year duration (2010–2016), 6,515 cancer patients were recorded at PBCR, and 228 cases were of ovarian malignancy. It was observed that most of the cases in this study were in 41–50 years of life. The age-standardized incidence rate of ovarian cancers in the present study was 4.61 per 100,000, and the crude incidence rate was 5.08 per 100,000. The crude mortality rate and age-standardized mortality rate of ovarian cancer were 2.3 and 2.02 per 100,000, respectively. Serous carcinoma was our study’s most common histological subtype (43.75%), followed by mucinous carcinoma.

Conclusion:

A steady increase has been observed in the incidence of ovarian cancer in several registries. A significant goal in managing ovarian cancer is to develop an effective test to detect the disease at its earlier stages, resulting in reduced mortality.
Micrometastasis detection using modified papanicolaou stain in nodal tissues of oral squamous cell carcinoma – A histological study
Authors: Fernandes Anisha , Jayanth Diya , Sowmya S.V , Augustine Dominic , Haragannavar Vanishri C. , Prasad Kavitha , Hegde Usha , Sreeshyla H. S
Published: February 2024

Context:

Cervical lymph node metastasis is the most important prognostic factor in Squamous Cell Carcinoma of Head and Neck (SCCHN). Detection and evaluation of micro-metastasis forms the basis for diagnosis, staging, treatment options and prognosis. Lymph node prognostic factors are extremely important for the survival and recurrence in the patient. Assessing lymph node metastasis in the absence of clinical enlargement is challenging.

Aim:

To evaluate micrometastasis and individual tumor cells (ITC) in regional lymph nodes of oral squamous cell carcinoma (OSCC) by modified papanicolaou (PAP) stain and re-evaluate the tumor staging.

Settings and Design:

The retrospective study was executed at MS Ramaiah University of Applied Sciences.

Methods and Materials:

The current study constituted a total of 40 lymph nodes from OSCC patients, metastatic (n=20) and non-metastatic lymph nodes (n=20). All sections were stained with H & E followed by modified PAP stain. Modified PAP was used for identification of micrometastasis deposits.

Statistical Analysis Used:

The Chi square test was employed to analyze significance.

Results:

Modified PAP stain proved to be more accurate (p = 0.006) than H and E stain in detecting micrometastasis which accounted for 15% of non-metastatic lymph node sections used in our study.

Conclusion:

Special stain like modified PAP stain is valuable and sensitive in detecting micro-metastasis over H and E stain. Detection of micrometastasis in OSCC patients is advantageous for the patient as it influences staging, it modifies the treatment plan in terms of both radiotherapy and chemotherapy.
Melanoma publications do not increase as much as the incidence of melanoma in the last two decades
Authors: Tas Faruk , Erturk Kayhan
Published: February 2024

In recent years, the incidence of melanoma has increased more dramatically than any other malignancy. We compared the number of publications between melanoma and other cancers in the last two decades. We performed a systematic search on PubMed using the search terms “melanoma” and “cancer” to determine the number of publications on melanoma and other cancers. The numbers and lifetime risk ratios of both melanoma and other cancer patients by year were obtained from the “Cancer Statistics” articles published annually by the American Cancer Society. The number of both melanoma and cancer publications increased at the same rate (3.01-fold), and the ratio of melanoma publications to all cancer publications did not change over the years: nearly, 3.4% on average. Melanoma rates increased faster than other cancers; 2.02 and 1.44 times, respectively. Similarly, the incidence of melanoma increased from 3.91% to 5.47%. In conclusion, the increase in the number of publications related to melanoma could not meet the dramatic increase in the number of melanoma patients.
Temozolomide-induced vitiligo-like reaction: An extremely rare phenomenon
Authors: Madan Renu , Raja M Karthik , Mahajan Rahul , Goyal Shikha
Published: February 2024

Temozolomide (TMZ) is an alkylating chemotherapeutic drug, often used in high-grade glioma and metastatic melanoma. Common side effects of this include myelosuppression and gastrointestinal side effects. Vitiligo-like reaction is extremely rare after TMZ. Here, we report a case of a 55-year-old patient of glioblastoma who developed vitiligo-like reaction after starting adjuvant TMZ.
Lung cancer metastasizing to salivary glands: Systematic review
Authors: Gupta Sonia , Brar Sukhmeet Kaur , Shubha Kiran , Kaur Arshdeep , Basavaraju Suman , Kedia Neal Bharat , Garewal Navdeep Kaur , Kaur Manjinder , Singh Rajvir
Published: February 2024

ABSTRACTS

Metastasis to salivary glands from the secondary source outside the head and neck region is extremely rare and Carcinoma Lung is one of the rarest sources of distant spread to salivary glands. Owing to missed diagnosis and misdiagnosis, accurate identification of clinical and pathological aspects of these metastatic lesions remains a challenging task. Many studies regarding metastasis to the oral cavity have been already documented in the literature, but very little research work has been done to analyse the cases of lung cancer metastasis as the sole primary source, particularly to salivary glands. Thus this review was conducted to analyse the published cases of lung cancer metastasizing to salivary glands as the only primary source till date. An electronic search of the published literature was performed without publication year limitation in PubMed/ Medline, Scopus, Google Scholar, Web of Science, Science direct, Embase, and Research gate databases, using Mesh keywords like (Lung cancer’, OR ‘Lung carcinoma), AND (Metastasis OR Metastases), And (Salivary glands OR Parotid gland OR Submandibular gland OR Sublingual gland). We also searched all related journals manually. The reference list of all articles was also checked. Our research revealed 34 relevant papers between 1965-2022 with a total of 44 patients. The most prevalent diagnosed metastatic Lung cancer was Small cell lung cancer. Parotid was the most common gland involved in metastasis. 48% of patients died of metastasis with a mean survival time of 2.2 years. Salivary gland metastasis from Lung cancer is very rare and has a poor prognosis. More cases need to be published in order to raise awareness of these lesions and gain a better understanding of their characteristics.
Tagging the pre-metastatic node in oral cancer: A cross-sectional study
Authors: Priya Bhanu , Spadigam Anita , Dhupar Anita , Syed Shaheen
Published: February 2024

ABSTRACTS

Introduction:

Lymph node involvement is the first indication of spread of oral squamous cell carcinoma (OSCC) and it is also a most significant prognostic factor. Lymph nodes show various tumor-induced histological changes preceding actual metastasis, viz. increased vascularity, follicular hyperplasia and desmoplasia which leads to pre-metastatic niche formation. This pre-metastatic niche primarily provides a favorable microenvironment to for the survival and subsequent growth of cancer cells within the lymph node.

Aim:

A retrospective study to evaluate carcinoma-induced changes in lymph nodes harvested from radical neck dissection in OSCC patients.

Objectives:

1) To evaluate cancer-induced histological changes in positive and negative lymph nodes in OSCC patients. 2) To look for common histopathological changes in both pre-metastatic and metastatic lymph nodes.

Materials and Methods:

Forty lymph nodes harvested from seven OSCC patients were sectioned and stained (Hematoxylin-Eosin) for documentation of histologically evident morphological and functional alterations. The Chi-square test was applied between the non-metastatic and metastatic lymph nodes findings and a statistically significant difference was seen.

Results:

Sections from 28 negative nodes showed changes associated with pre-metastatic niche conditioning whereas, 12 sections exhibit frank metastases.

Conclusion:

The modified immunological responses and remodeling of the vasculature are the most common histologic tumor-induced pre-metastatic changes. This study reviewed and categorized these histological changes that point to pre-metastatic niche conditioning of lymph nodes.