bluuebunny/crossref_metadata_2025 huggingface dataset:
ASSESSMENT OF THE PROGNOSTIC POTENTIAL OF EXPRESSION AND ABERRATIONS IN THE NUMBER OF DNA COPIES OF THE HOMOLOGICAL RECOMBINATION SYSTEM GENES IN PATIENTS WITH NON-SMALL CELL LUNG CANCER
Authors: Tsyganov M.M. , Rodionov E.O. , Ibragimova M.K. , Sorokovikova S.S. , Karchevskaya A.A.
Published: December 2023

Numerous studies have shown that the presence of homologous recombination deficiency (HRD) in breast tumors may be a good marker of the effectiveness of chemotherapy with DNA-damaging agents such as platinum-based and anthracycline-containing medication regimens. However, the formation of HRD due to disruptions in the BRCA1/2 genes is typical not only for breast cancer and ovarian cancer, but also for other cancer localizations, in particular for non-small cell lung cancer (NSCLC). Since the use of platinum-based drugs in patients with NSCLC is a standard treatment protocol, studying the expression profile of homologous recombination genes and the presence of chromosomal aberrations therein will allow us to fully study HRD in these patients and identify new prognostic markers.
SEARCH FOR NEW INHIBITORS OF PROTEIN KINASE SIGNALING PATHWAYS USING MOLECULAR DYNAMICS AND MOLECULAR DOCKING METHODS
Authors: Glushko A.A. , Kodonidi I.P. , Frantsiyants E.M. , Kaplieva I.V. , Chiryapkin A.S. , Sergienko E.V.
Published: December 2023

The development of new therapeutic strategies for the treatment of various diseases associated with impaired protein kinase activity is one of the most urgent tasks in modern medicine. The search for new protein kinase inhibitors is an effective approach in the struggle against cancer. However, the existing protein kinase inhibitors may have limitations in their effectiveness or may produce undesired side effects. Therefore, the development of new methods for searching for new inhibitors, which should be more effective and safe, is a topical issue. One of the promising areas is the use of molecular modeling to search for new protein kinase inhibitors.
SONODYNAMIC THERAPY (SDT) AND GENE THERAPY
Authors: Inui T.
Published: December 2023

One in Four Deaths in Japan Caused by Cancer. Cancer is the most common cause of death for Japanese people who are 40 and over, while suicide is the leading cause among young people.
European Research After the Archival Turn: A Response to Sonja de Leeuw’s Article ‘The Archive as Network’
Authors: Hoogland Grietje
Published: December 2023

In 2012, Professor Sonja de Leeuw discussed how the Archival Turn will allow four developments to happen, among which was the possibility for research to cross national borders, allowing more transnational and European research. Now, roughly 10 years after the article was published, is a good moment to see how far on this journey we currently are. This article maps out these four developments with emphasis on the ‘European-ness’ of current research, to show the remaining bottlenecks such as language barriers, and funding and accessibility issues. A discussion with members of FIAT/IFTA held in 2021 will show how collaborative research can be one way to improve conditions for transnational research.
Audio on Paper: The Merits and Pitfalls of the Dutch Digital Media Archive for Studying Transnational Entanglements during the Second World War
Authors: Brolsma Marjet , Kuitenbrouwer Vincent
Published: December 2023

This paper traces the transnational entanglements in the Dutch digital media archive, with a focus on the propaganda battle between pro-Nazi and pro-Allied Dutch media during the Second World War. Reflecting on newspaper and radio source materials in the CLARIAH Media Suite, it points out significant differences in the availability of these two source collections. It argues that these imbalances can be explained by the historical context in which these sources were created as well as by archival policies after 1945. The main problem lies in the digitized radio archive which contains only a relatively small amount of audio and leaves out the enormous amount of documents, such as transcripts and monitoring reports. With our article, we ask for more attention for this form of ‘audio on paper’, which has previously been overlooked by scholars and archivists. In the conclusion we argue for the digitization of these source materials and inclusion in the Media Suite as a first step towards redrawing the borders of media archives, enabling a new research agenda aimed at studying transnational entanglements in war time propaganda.
Unsettling Borders of Archives: Activating the Audiovisual Heritage of the Turkish Community in the Netherlands
Authors: Özgen Asli
Published: December 2023

This article explores issues with archival preservation and access in the case of the audiovisual heritage of migrant communities, which defies hegemonic categories of nation, race, ethnicity, language. As such, although these communities are somewhat present in archives, they are marginalised and remain absent, silent, and dormant. Through two case studies of audiovisual representations of Turkish migrants from Dutch public archives, the article tackles possible ways to unravel such hegemonic categories, thereby reflecting the multiplicities and instabilities of migrant archival objects. It explores the pivotal role of community engagement for more inclusive archival practices that undermine its constitutive limits –– to work with archives against the archives.
Management of sickle cell disease patients presenting to the emergency department with vaso-occlusive crisis: a retrospective study
Authors: Al Hussaini Zainab Abdullah , Al Kanhal Raghad , Al Ebrahaimi Futoon , Al Shalhoub Mohammed , Al Asmari Bader , Othman Fatmah
Published: December 2023

Background: Sickle cell anemia (SCA) is a hereditary disease of the hemoglobin, characterized by recurring vaso-occlusive crises (VOC) leading to severe pain. VOCs constitute the primary cause for emergency department (ED) visits among sicklers. Frequent VOC episodes are associated with greater mortality. This study aimed to evaluate pain treatment trends regarding admission, discharge, length of stay in the ED, and early ED revisits among SCA patients.
Methods: A cross-sectional study was conducted from January 2020 to January 2023 at the ED of King Abdulaziz medical city in Riyadh. SCA patients who presented with VOC episodes were included in this study. Demographic and clinical data of each patient were retrieved from the electronic medical file.
Results: Total of 144 patients were included in the analysis. Out of the total population, 34% were admitted to hospital. Compared to those patients who were not admitted, the number of VOC was more among patients who had been admitted. Around 34% had ED revisit within 30 days and those patients had higher frequency of VOC attacks compared to those who did not revisit the ED. Only 45% of the population received appropriate dosing, 30% received an insufficient dose, and 25% received over the appropriate dose. Receiving the correct dose of morphine reduced the likelihood of ED revisits within 30 days.
Conclusions: This study explores trends in VOC among sticklers, highlighting that adequate analgesia is associated with better outcomes. Addressing these variables may lead to improved care and better outcomes for SCA patients.
Chemical profiles and proximate analysis of n-hexane extract of Terminalia catappa kernel from Nigeria
Authors: Batubo Nimisoere P. , Ogbu Ojeka Sunday , Victor Dapper Datonye
Published: December 2023

Background: Terminalia catappa is a traditionally consumed edible plant used for various health conditions. This study aimed to characterise the phytochemical profile, nutritional composition, and acute oral toxicity of the n-hexane extract of Terminalia catappa nuts.
Methods: Gas chromatography-mass spectrometry (GC-MS) analysis was conducted to determine the phytochemical profile of the n-hexane extract of Terminalia catappa nuts. Proximate analysis was performed to evaluate the nutritional composition. Acute oral toxicity testing was carried out in Wistar rats as per OECD Guideline 425 to assess safety.
Results: The phytochemical analysis identified 19 bioactive compounds in the Terminalia catappa nut extract. The major components were cis-vaccenic acid (24.493%), propyleneglycol monoleate (23.783%), and mitotane (14.186%). Proximate analysis revealed the nuts to be rich sources of fat (56.71%) and protein (26.30%). The median lethal dose (LD50) of the n-hexane extract in rats was greater than 5000 mg/kg, indicating a high margin of safety.
Conclusions: This work provides valuable insights into the nutritional potential and safety profile of Terminalia catappa nuts. Phytochemical characterisation corroborates traditional uses, while the acute toxicity data establishes the relative safety of the n-hexane extract when consumed at high doses.
Expression of isocitrate dehydrogenase-1 in glioblastoma, Bangladesh perspective
Authors: Mir Ratim , Islam M. A. , Islam Nowfel , Islam M. Nasimul , Das Reba , Kabir Enamul
Published: December 2023

Background: Glioblastoma is the most frequent malignant brain tumor in adults. Various studies have identified IDH (isocitrate dehydrogenase) mutation as a hallmark genetic alteration in glial tumors. The World Health Organization (WHO) has classified glioblastoma based on IDH mutation status, including IDH-mutant glioblastoma, IDH-wildtype glioblastoma along with its variants and glioblastoma, NOS (not otherwise specified) (where IDH mutation status cannot be evaluated).
Methods: It was a cross-sectional observational study, conducted on 35 histologically diagnosed cases of glioblastoma, within the period of March, 2018 to December 2019.
Results: Among the 35 glioblastoma cases, 6 (17.14%) were found to be IDH-mutant (positive for IDH1 immunostain), while the remaining 29 cases were negative for IDH1 immunostain (therefore designated as IDH-wildtype glioblastoma). In the IDH-mutant group, 3 out of 6 patients were in the younger age group (≤40 years). On the other hand, IDH-wildtype glioblastoma was more common in elderly and most frequent was in the age group of 51-60 years (11 out of 29 cases).
Conclusions: In this study, IDH1 expression was observed in 17.14% of all glioblastoma cases (designated as IDH-mutant glioblastoma). Whereas, most (~82.86%) of the glioblastoma cases did not express IDH1 (designated as IDH-wildtype).
Clinical features and prognosis of COVID-19 in diabetic patients
Authors: Behera Ashok Kumar , Marndi Chhatray , Chhotaray Saubhagya , Beshra Sabitri , Patra Gopabandhu
Published: December 2023

Background: It is well-recognized that uncontrolled glycemia reflects the severity and mortality rates of respiratory virus epidemics. The aim of the study was to report the features and course of therapy of diabetic individuals admitted to a tertiary care facility with COVID-19 infection. Additionally, we tried to assess how hyperglycemia affected the clinical results.
Methods: This study used observational methods to conduct a retrospective chart review of 125 cases from October 2021 to March 2022 at a single center.
Results: Males made up 94.6% of the 125 examined cases. Within the age range of 21 to 78 years, the study group's average age was 49.6±10.4 years. Of the patients, 66.4% had prior knowledge of diabetes. When compared to pre-existing diabetes individuals with the newly diagnosed diabetes individuals, the latter had a higher death rate (p=0.03) and needed mechanical breathing (p=0.02).
Conclusions: Hyperglycemia that is uncontrolled harms COVID-19-infected patients. There is an increased risk of hyperglycemia problems that have been discovered or unknown.to screen for cases of undiscovered diabetes in hospital patients, which may be especially relevant during the COVID-19 pandemic, optimal glycemia optimization is essential.
Antitumor and cytotoxic potential of various extracts of Gloriosa superba L. Centaurea behen L., Elaeocarpus ganitrus Roxb and Ficus religiosa L. against human breast cancer (MDA-MB 231) cell lines
Authors: Singh Satnam , Saini Amandeep , Saini R. G.
Published: December 2023

Background: Medicinal plants are rich in a wide variety of secondary metabolites such as tannins, alkaloids, phenolic compounds, flavonoids etc.  which have the capability to inhibit many pathways that lead to cancer. The present study was conducted with the objectives to screen the extracts of dried roots Gloriosa superba L., dried roots of Centaurea behen L. dried fruits/beads of Elaeocarpus ganitrus Roxb., dried leaves of Ficus religiosa L. and investigate their antitumor activity on human breast cancer cell lines (MDA-MB 231).
Methods: Cytotoxic activity was evaluated against non-cancerous cell lines (MCF-10A). Hexane, chloroform, methanol and water were the solvents used for extraction of phytoconstituents by Soxhlet method. Anti-proliferative potential of the plant extracts was evaluated using MTT assay. The trypan blue dye exclusion test was used to determine the number of viable cells present in a cell suspension.
Results: On MDA MB-231 cell lines, 91.94% cell death was reported with G. superba aqueous extract followed by E. ganitrus methanol extract and F. religiosa hexane extract with 87.93% and 81.61% cell death respectively. Moreover, none of the extracts had shown cytotoxic effect while evaluated against normal non-cancerous cell lines (MCF- 10A).
Conclusions: It is inferred from the current findings that phytoconstituents present in the plant extracts have high anticancer potential. These phytoconstituents along with some new anticancer agents present in the plant extracts reflects the high cytotoxic potential against cancer cells.
Total leucocyte count and platelet indices: novel, early diagnostic markers of acute appendicitis
Authors: Ravikkumar Rithu , Vaidya Kuladeep , Sharma Aashish , Sukesh
Published: December 2023

Background: Among the plethora of causes for patients presenting with an acute abdomen, appendicitis is the most common conclusive diagnosis. Known being controversial for its etiology and pathogenesis, diagnosis of acute appendicitis has been challenging despite the development of various clinical and laboratory studies. Inflammatory markers of hematological origin-total leucocyte count (TLC), platelet indices viz. mean platelet count (MPV), plateletcrit (PCT), and platelet distribution width (PDW), have long been preferred as rudimentary diagnostic parameters for acute appendicitis despite being contentious.
Methods: An analytical and cross-sectional study among 100 individuals. Statistical evaluation of TLC, MPV, PCT and PDW of 21 appendicitis cases and 70 healthy individuals were complied.
Results: Compared to the control group, cases showed significantly higher values of TLC and MPV while the PCT and PDW were normally distributed and showed no significant statistics. The sensitivity of TLC and MPV was determined to be 95.2%, 71.4%, and specificity 100%, 73.8% respectively.
Conclusions: With equitable results, the routine and cost-effective TLC and MPV play a novel role in the early diagnosis of acute appendicitis.
Study of association of respiratory viruses in the etiology of acute lower respiratory tract infections in children and correlation with clinical and laboratory features: role of emerging new viruses
Authors: Pillai Swapna K. , Kailas Lalitha , M. Neziya
Published: December 2023

Background: Viruses are one of the major causes of childhood pneumonia with the respiratory syncytial virus getting great attention as an important organism for pneumonia.
Methods: This cross-sectional study was conducted in the Department of Paediatrics, Sree Gokulam Medical College and Research Foundation, Thiruvananthapuram, Kerala from May 2022 TO November 2022. 119 children admitted with lower respiratory tract infections were included in this study. Symptoms, signs, and investigation reports including PCR and clinical course in the hospital were recorded.
Results: 25% of children were in the age group less than 1 year, 52% were between 1-5 years and 23% were above 5 years. Viruses were isolated in 82 patients (68.9%). The main viruses were respiratory syncytial virus (23.5%), boca virus (16.14%), influenza A (7.5%), influenza B (4.2%), meta pneumonia virus (3.3%), and para influenza virus (2.5%). Patients with boca virus infections had a more severe clinical course.
Conclusions: Molecular testing with PCR along with clinical and lab parameters will help us to have more insights into the etiology and clinical presentation of respiratory infections in children and help us to do optimum management avoiding unnecessary antibiotic usage.
A prospective observational study on bolus administration of high-dose nitroglycerin in treating sympathetic collapsing acute pulmonary edoema
Authors: Marndi Chhatray , Behera Ashok Kumar , Patra Gopabandhu , Chhotaray Saubhagya
Published: December 2023

Background: Sympathetic crashing causes sudden cardiac failure in minutes or hours. Early diagnosis and treatment may avoid acute heart failure fatalities. Sympathetic crashing reduces afterload, shifting fluid into the pulmonary circulation and causing pulmonary edema. The usual strategy of progressively increasing vasodilator dosage has increased preload. Treating SCAPE with large doses of nitroglycerin and non-invasive breathing is helpful. High doses of nitroglycerin boost afterload and eliminate ICU admissions. In this study, a standard protocol for the treatment of patients with sympathetic crashing acute pulmonary edema is assessed for its effectiveness.
Methods: An observational study was conducted prospectively at Bhima Bhoi Medical College and Hospital in Balangir, Odisha, India over the course of a year. The patients presenting with SCAPE symptoms were treated according to standard protocol. The outcomes were subjected to statistical analysis to derive a correlation between treatment and response.
Results: The mean initial bolus given to all the patients was 836 µg. The total cumulative dose of nitroglycerin used in each patient was 36 mg. The symptoms of most of the patients resolved within the first 6 hours of treatment.
Conclusions: The standard protocol developed at the institute, which included a high dose of nitroglycerine along with non-invasive ventilation, was efficient in treating acute heart failure due to sympathetic crashing and acute pulmonary edema. Nitroglycerin, along with non-invasive ventilation, should be used in the management of sympathetic crashing pulmonary edema and acute heart failure.
Clinical profile of diabetic ketoacidosis in type 2 diabetes patients at a tertiary care centre
Authors: More Hardik , Patil Dilip , Singh Chahat
Published: December 2023

Background: The present study was undertaken to analyse the clinical profile of type 2 diabetes patients presenting with diabetic ketoacidosis at the time of presentation, owing to dearth of scientific enquiry into this research query.
Methods: The present study was an analytical, cross-sectional study conducted over the period of two years. All the type 2 diabetes patients with diabetic ketoacidosis admitted during the study period constituted the study population, after being subjected to prefixed selection criteria. Detailed clinical history was recorded and thorough physical examination was conducted of all the participants, along with basic relevant blood parameters.
Results: Out of the total 60 type 2 DM patients with DKA studied, 53.3% patients belonged to 51 to 60 years age group and 55% were males. All the patients had fruity breath odour at the presentation. Obesity was present in 48.3% and Kussmaul breathing observed in 90% of patients. Poor compliance to treatment (51.7%) was the biggest precipitating factor of DKA in type 2 DM patients. Around 2/3rd (68.3%) was on oral hypoglycemic agents (OHA), 10% were on OHA and insulin, while 21.7% were newly diagnosed at the time of presentation. Mean RBS in type 2 DM patients with DKA was 510.8±153.5 mg/dl and mean HbA1C was 9.15±0.78%.
Conclusions: Stricter compliance to the treatment will go a long way in avoiding occurrence of the dreaded complication in type 2 diabetes patients.
Prevalence, risk factors, causative organism and antibiotic susceptibility of catheter associated urinary tract infections
Authors: Venkataraman Rajesh , Manuel Gloriya Grifth , N. Jeevan Rai , R. S. Shahasanu , S. R. Akshay , Paul Eldho , Sanib Muhammed
Published: December 2023

Background: The most common nosocomial infection is catheter-associated urinary tract infection (CAUTI), with a 3-7% daily risk of developing CAUTI in acute care settings. This study's goal was to identify the prevalence, risk factors, causative organism of CAUTI and understanding the organism's current antimicrobial agent sensitivity profile.
Methods: Total 120 patients participated in a prospective and observational study conducted at Adichunchanagiri Hospital, Karnataka. Reviewing and evaluating patient case sheets, laboratory results, and treatment charts of participants who were hospital inpatients provided data needed for the study. Microsoft Excel was used to enter the data and version 28 of SPSS to analyze the data. Statistical significance was determined by using a P-value of less than 0.05.
Results: It was discovered that 12.5% of HAI cases were linked to catheter use. The most prevalent microbial agent in the current investigation was E. coli (41.7%). According to the current study, women are more likely than men to get UTIs. An underlying medical condition was found to have a strong correlation with UTIs in the current investigation. For CAUTI, drug resistance to cefotaxime and tigecycline was noted.
Conclusions: The study suggested that gender, age extremes, use of antibiotics, length of stay in intensive care unit, diabetes mellitus, immunosuppressive medication, and indwelling urinary devices are the major risk factors for CAUTI. E. coli was the most common microbiological agent in the current study. Therefore, to assist doctors in the treatment and management of CAUTIs, ongoing surveillance of antimicrobial resistance patterns is required.
Use of frontal flap for reconstruction of malar region following arteriovenous malformation resection: a case report
Authors: Olvera Yarza Francisco A. , Pallares Fernando Téllez , Lara Mejía Aldo , Yarza Miguel Jiménez , Guzmán Enrique E. Pérez
Published: December 2023

Arteriovenous malformations (AVMs) are rare congenital vascular anomalies characterized by abnormal artery-vein connections. These malformations often occur intracranially but can be found in extracranial regions, presenting unique clinical challenges. Diagnosis and staging, typically using the Schobinger clinical classification, are essential, and various imaging techniques aid in the process. Treatment of AVMs is a multidisciplinary effort, with minimally invasive endovascular procedures being preferred, and surgical resection considered for extensive cases. In this case report, a 52-year-old male with an AVM in the malar region underwent successful treatment. The procedure involved preoperative marking, anesthesia, flap division, AVM resection, and flap placement, followed by suturing and a second surgical stage. The successful utilization of a contralateral frontal flap for reconstruction following AVM resection is highlighted. This case underscores the importance of a multi-stage surgical approach and careful flap preservation in AVM treatment, emphasizing the skills of surgeons. Collaboration among various medical specialties is crucial for effectively managing AVMs, combining embolization, resection, and reconstruction for tailored treatment that improves both function and aesthetics.
Clinical insights into dermatofibrosarcoma protuberans
Authors: Arias Francisco J. C. , Campa Kassandra J. E. , Campa Alondra Y. E. , Estrada Jorge L. G. , Meza Guillermo C. G.
Published: December 2023

Dermatofibrosarcoma protuberans (DFSP) is a rare, locally aggressive cutaneous soft tissue sarcoma, it is the second most common skin sarcoma after Kaposi's sarcoma. The cause of DFSP remains unknown. The case of a 54-year-old female patient with a diagnosis of Dermatofibrosarcoma protuberans is presented, displaying a typical clinical presentation. It is characterized by an initial lesion in the form of a reddish spot on the anterior region of the chest, which showed slow growth until the development of a multinodular and irregular lesion with multiple recurrences. The lesion is resected, confined to the superficial layers of the skin, with 3 cm margins, confirming the histopathological diagnosis of dermatofibrosarcoma protuberans with clear margins. DFSP is an uncommon cutaneous sarcoma that is typically low- to intermediate-grade, and while it has a limited likelihood of metastasis, it exhibits a notable tendency for local recurrence. The risk of recurrence is closely linked to the extent of surgical resection.
Use of magnetic port finder for metallic foreign body extraction in hand
Authors: Guevara Valmaña Osvaldo I. , Triguieros-Guzman Sebastian , Fattel-Servin Omar S. , Prieto-Vargas Valentina , Balderas-Ruiz Katia , Apellaniz-campo Armando , Tellez-Placios Daniela
Published: December 2023

Foreign bodies are defined as any foreign object that enters the human body due to various circumstances. FBs are a common reason for emergency department visits. The hand's complex vascular and nervous structures make aggressive exploration dangerous. FBs can be composed of various materials, making their detection with a single imaging study difficult. We propose using a magnetic tissue expander locator for intraoperative FB localization, presenting the case of a 50-year-old female patient who, after falling from her height, presented with a foreign body in her right hand. Due to the complexity of locating the FB, we used the magnetic finder, successfully extracting it without damaging any underlying structures. Use of magnetic tissue expander locators are effective, practical, and safe alternative to help for locating magnetic foreign bodies.
Intestinal duplication cyst in the esophagogastric junction as a cause of gastroesophageal reflux disease: a case report
Authors: Mejía Aldo L. , Á. Sores Erik D. , G. Rojas Carlo A.
Published: December 2023

This report presents a rare case of a 42-year-old woman with refractory gastroesophageal reflux disease (GERD) attributable to a 5×4 cm enteric duplication cyst at the esophagogastric junction. Despite a year of proton pump inhibitor therapy, the patient experienced persistent symptoms, including nausea and nocturnal vomiting. Surgical intervention involved hiatal plasty, partial Dor fundoplication, and the unexpected discovery of the cystic tumor during the procedure. The cyst, firmly adhered and delimited, ruptured during dissection, leading to successful de-roofing, cauterization, and drainage. The patient's immediate postoperative course was satisfactory, demonstrating the effectiveness of this approach in managing an enteric duplication cyst. This case underscores the importance of considering congenital anomalies in the context of refractory GERD, with the enteric duplication cyst located at the esophagogastric junction representing a unique manifestation. The study contributes valuable insights into the atypical presentation, diagnostic challenges, and successful surgical management of such anomalies.
Indocyanine green guided laparoscopic management of Mirizzi syndrome
Authors: Rathod Amol , Thorat Santosh
Published: December 2023

Mirizzi syndrome is a rare condition caused by the obstruction of the common bile duct or common hepatic duct by external compression from multiple impacted gallstones or a single large impacted gallstone in the Hartman’s pouch. A 60-year-old female patient presented with complaints of abdominal pain with deranged liver functions. Mirizzi syndrome was diagnosed after radiological imaging and managed by laparoscopic cholecystectomy. Previously, Mirizzi syndrome was considered to be the absolute contra-indication for laparoscopic cholecystectomy. However, recent advances in radiology with the usage of indocyanine green and increased familiarity of the pathophysiology of the disease have successfully improved its laparoscopic management.
Extreme thrombocytosis in traumatic amputee and role of thromboembolism prophylaxis: a case report
Authors: Sharma Swati , Gunjiganvi Mallikarjun , Sharma Pulak , Bhalchandra Awale R.
Published: December 2023

Platelets are the smallest blood component produced in the bone marrow that plays a fundamental role in the blood clotting process. A normal platelet count applicable to all adults is 150 to 400×109/l. Thrombocytosis develops when the platelet count exceeds 450×109/l. Thrombocytosis is classified into primary thrombocytosis and secondary (or extreme) thrombocytosis. Primary thrombocytosis is a chronic myeloproliferative disorder in which sustained megakaryocyte proliferation leads to an increase in the number of circulating platelets. Extreme thrombocytosis or reactive thrombocytosis, is defined as abnormally high platelet count in the absence of chronic myeloproliferative disease, secondary to an underlying events, disease, or the use of certain medications. Causes of reactive thrombocytosis include acute blood loss, acute infection, amputation, iron deficiency, asplenia, cancer, chronic inflammatory or infectious diseases. Secondary thrombocytosis resolves when the underlying event is managed. Extreme thrombocytosis may result in thromboembolic episode such as mesenteric vein thrombosis, pulmonary embolism and acute myocardial infarction. In patients who survive after trauma the platelet count displays a bimodal response with an initial decrease below baseline values, followed by an increase above the normal range after 1 week. We report a similar experience of a trauma patient with reactive thrombocytosis and discussion on importance of thromboprophylaxis.
Immersive horizons: navigating ethical terrain and practical boundaries in the use of virtual reality for cancer symptom management – a comprehensive narrative review
Authors: Siddiqui Aisha R. , Kistipati Hari C. , Asghar Fatema A. , Bhimani Sameer , Habib Muhammad T. , Siddiqui Farina F. , Anwar Mariam , Gul Muhammad H. , Hassan Ali Hassan Ali , Khan Muhammad M. A.
Published: December 2023

Cancer is a significant healthcare problem. However, advancements in diagnostic procedures and therapeutic modalities have led to a decline in cancer mortality rates by 1% annually in most countries. Cancer patients often experience symptoms such as pain, cancer-related fatigue, anxiety, and lymphedema. To counter these side effects, there have been tremendous efforts. One such effort is the use of virtual reality (VR) technology, which is an interactive technology. VR has played a significant role in managing disorders such as phobias and anxiety disorders, and support for patients with cognitive and physical rehabilitation, acute and chronic pain management, and emotional support in different settings such as during hospitalizations. Our team conducted an extensive search for electronic literature on virtual reality in various databases, such as Medline, PubMed, Google Scholar, and Psych INFO, up to July 2023. We used keywords like "virtual reality," "cancer care," "depression," "cognition," "pain," "telemedicine," "rehabilitation care," "physical therapy," "radiotherapy," "telerehabilitation," "avatar," "video games," and "visual aid" as our search criteria. VR interventions for cancer patients include exposure therapy, psycho-education, and relaxation techniques, which have been shown to reduce symptoms significantly. VR distraction can also mitigate pain during medical procedures. Studies suggest that VR holds promise in rehabilitation and oncologic treatment, as it can improve function metrics, range of motion, and motivation for treatment. The review scrutinizes the use of digital information and virtual reality technology to alleviate cancer-related distress by providing remote care.
The pathophysiology and pathology of SARS-CoV-2 infection
Authors: Olaofe Olaejirinde O.
Published: December 2023

SARS-CoV-2 infection is a major pandemic that has involved all continents in the world. It has caused almost seven million deaths since its onset. SARS-CoV-2 commonly enters cells by binding to angiotensin-converting enzyme 2 (ACE2) molecules on the surface of cells in the human body. SARS-CoV-2 infection, although mild in many patients, has the potential to cause dysfunction of many organ systems in the body. The body response to the internalisation of the virus in the epithelial cells of the lungs can lead to alveolar epithelial inflammation, commonly referred to as the exudative phase of acute respiratory distress syndrome (ARDS). Cardiac symptoms shown by patients infected with SARS-CoV-2 include chest tightness/pain and palpitations. These features can be because of newly developed or worsening ischaemic heart disease and arrythmias, respectively. SARS-CoV-2 infection is known to cause a clinical condition known as COVID-19-associated nephropathy (COVAN), a disease quite similar to HIV-associated nephropathy (HIVAN). Like HIVAN, COVAN is relatively more common in people of African descent and is associated with the APOL1 variant gene. Researchers have not identified unique morphological changes that could be used to identify the infection in tissues. Hence, the use of RT-PCR for diagnosis is still very important.
Assessing protein‑energy wasting in chronic kidney disease
Authors: Verma Shailvi
Published: December 2023

Chronic kidney disease is often accompanied with a syndrome known as protein-energy wasting, which is defined by decreased protein consumption, protein loss due to metabolic disturbances, and physical consequences include sarcopenia and frailty. Due to population aging and advancements in the treatment of other chronic illnesses, this problem has drastically increased in recent years. The frequency of morbidity and death in chronic kidney disease patients may be greatly decreased with proper therapy of as protein-energy wasting. Therefore, it's crucial to prevent and manage as protein-energy wasting in chronic kidney disease patients by doing a thorough evaluation and offering each patient a customized, evidence-based treatment plan. Once protein-energy wasting is recognized, a nutritionist should be contacted to create a management strategy. A thorough diet specifically designed to fit the patient's requirements, any required nutritional supplements, and counselling about dietary changes, symptom management, and psychological support should all be part of this strategy. The risk of protein-energy wasting may be decreased with proper assessment and care. This includes changes to one's diet, resistance training or other forms of exercise, dialysis or organ transplantation when necessary, and drugs to treat any underlying disorders.
A review on caring of surgical wound after surgical procedure
Authors: Singh Mahendra , Kumar Dheeraj
Published: December 2023

Inadequate wound healing and scar formation continues to be major issues in day-to-day surgical practice. A wound infection (like pus formation, smelly discharge, and the incision line’s opening etc.) is one of them complications of surgical procedure. An infection may appear in surgical wound due to lack of care in post-operatively like dressing not being changed after regular interval, not following aseptic protocol during the dressing, and the dressing material not properly sterilized. Hence, the aim of proper care in post-operative practice was to reduce the risk of infection in surgical wound and promote healing. One of the most important aspects of post-operative wound care is prompt wound evaluation, appropriate hand washing, adhering to aseptic protocol when dressing, using sterile dressing material each time, and proper cleaning of the wound, as well as the prompt identification and management of wound complications.
Neutrophil lymphocyte ratio and platelet lymphocyte ratio as a marker for disease severity in children with COVID-19
Authors: Bari Attia , Fateen Tooba , Ch Aimen
Published: December 2023

Background: It had been observed that there is relationship of neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) with disease severity in children with COVID-19 and post-COVID, multisystem inflammatory disease in children (MIS-C).  Study conducted to determine NLR and PLR correlation with this disease severity.
Methods: Prospective descriptive analytical study conducted at the children’s hospital and university of child health sciences, Lahore. Consecutive confirmed cases of COVID-19 infection and post-COVID, MIS-C diagnosed on the basis of RT-PCR from nasopharyngeal swab and antibody test admitted from March 2020 to October 2021 were included through consecutive sampling. Complete blood (CBC) was done and NLR and PLR was determined
Results: Majority 198 (74.2%) of the 267 patients had a diagnosis of COVID-19 and 69 (25.8%) were post-COVID MIS-C. There was a male preponderance 177 (66.3%) and the mean age was 6.1±4.7 years (95% CI: 5.62-6.74). Majority children had mild disease 80 (30%), 34 (12.7%) were critical and there were 37 (13.8%) deaths. Underlying comorbidity was present in 55 (20.6%). As the severity of symptoms changed from asymptomatic to severe disease, there was a significant rise of mean NLR from 1.88±1.40 to 5.47±4.77 respectively (p<0.001). PLR however, failed to show any kind of association with severity of the symptoms (p=0.922).
Conclusions: NLR served as a marker of disease severity among pediatric patients suffering from COVID-19 and MIS-C. However, PLR failed to show any relation with disease severity.
Pattern of transcatheter interventional procedure have done in Cath lab and their immediate outcome: one year experience at Bangladesh Shishu hospital and institute
Authors: Munsi M. Abu Sayed , Akther Maher , Khan M. Khalid Ebna Shahid , Saha Chandan
Published: December 2023

Background: Congenital heart disease (CHD) is defined by structural and functional malformations of the heart. If CHD not managed through appropriate interventions, it affects quality of life of the individual and potential premature death. Objectives were assessing the frequency and pattern of interventional procedure done in Cath lab of paediatric cardiology department, Bangladesh Shishu Hospital and Institute and their immediate outcome.
Methods: It was a cross sectional retrospective study. Total 56 patients of ventricular septal defect (VSD), atrial septal defect (ASD), patent ductus arteriosus (PDA), pulmonary stenosis (PS), aortic stenosis (AS), coarctation of aorta, pulmonary atresia, TGA from January 2019 to December 2019 who underwent trans-catheter interventional procedure by author at Cath lab of paediatric cardiology department, Bangladesh Shishu Hospital and Institute were enrolled in this study.
Results: Among 56 patients, PDA device closure done in 19, balloon pulmonary valvuloplasty (BPV) in 13 patients, device closure of ASD in 3 patients, device closure of VSD in 2 patients and balloon aortic valvuloplasty (BAV) in 1 patient. Two patients died; one is pulmonary atresia with PDA dependent pulmonary circulation following ductal stenting another is d-TGA intact IVS with PFO following BAS. One PDA device embolized and retrieved surgically from main and right pulmonary artery. Mean fluoroscopy time=17.29 and mean total procedure time=38.52 min.
Conclusions: Trans-catheter interventional procedure for PS, coarctation of aorta, PDA, ASD, VSD, AS, d-TGA, Pulmonary atresia is a safe and some procedure such as BAS for d- TGA, BPV for critical PS, Ductal stenting for pulmonary atresia, Balloon angioplasty for severe coarctation of aorta with LV dysfunction is lifesaving with a low adverse event rate.
Association of iron deficiency anemia with acute bronchiolitis in children below 2 years of age
Authors: Kumer Prodip , Rouf M. Abdur , Bhuiyan Mohammad Moniruzzaman , Taleb M. Abu , Nesa Vikarun
Published: December 2023

Background: Bronchiolitis is the leading cause of respiratory distress in small children and one of the main causes of hospitalization in children <2 years of age. Anemia is also identified as a risk factor for lower respiratory tract infection. Iron deficiency is considered the most common cause of anemia in developing countries. As anemia is highly prevalent in children of our country, this study was undertaken to evaluate whether iron deficiency anemia is associated with acute bronchiolitis.
Method: This Cross-Sectional Analytical study was carried out in the Department of Paediatrics, Sir Salimullah Medical College Mitford Hospital (SSMCMH), Dhaka, during the period of December 2021 to November 2022 after obtaining ethical approval to explore the association between iron deficiency anemia and bronchiolitis. Hemoglobin level, RBC indices, TWBC count, serum iron, TIBC level, Transferrin saturation, and PBF were investigated and compared in all children with bronchiolitis and control. For this purpose, a total number of 71 patients were enrolled in the study and among them, 35 children with bronchiolitis were considered as cases, and 36 healthy children without bronchiolitis were considered as control, who were matched with age. After taking written informed consent from parents/legal guardians, a detailed history and thorough clinical examination and laboratory investigations were carried out on each child. Data were recorded in separate case record form and analyzed by SPSS version 23.0.
Results: The mean age was found 12.1±6.7 months in cases and 14.1±6.9 months in controls. Male participants (47, 66.2%) were the predominant group in the study and female participants were (24, 33.8%). Exclusive breastfeeding was found in 10 (28.6%) cases and 25 (71.4%) controls. There was a statistically significant difference in Hb (gm/dl), MCV (fl), S.Iron (µg/dl), Transferrin Saturation (%) and RDW-CV (%) between cases and controls (p<0.05). Among 35 cases, 25 (67.6%) had Iron Deficiency Anemia and statistical difference between the case and control was significant (p=0.001) with an odds ratio of 5.0.
Conclusion: Iron deficiency anemia has a significant association with bronchiolitis. A larger and more extensive study was recommended.
Clinical profile and laboratory parameters of confirmed pediatric scrub typhus cases in a tertiary health care institute
Authors: Chadha Nidhi , Aulakh Roosy
Published: December 2023

Background: Scrub typhus is one of the vector borne tropical infectious disease, caused by O. Tsutsugamushi. Because of nonspecific signs and symptoms and variable prevalence of pathognomic sign (eschar), diagnosis is very difficult in early stage. The purpose of present research was to differentiate that whether case presenting at our institution are different from previously conducted research in various regions.
Methods: Hospital record of all reported cases of scrub typhus admitted to department of pediatrics at tertiary health care institute in North India over last two years (2018-2019) was retrieved and reviewed.
Results: More cases were reported in male. Maximum number of cases were in 5-10 years i.e. 32 (50.0%) and only one case in less than 12 months. Maximum number cases were reported in August to October 53 (82.8%) as shown. Most common presenting complaint was fever. Most of cases reported with fever of duration of 7-14 days in (51.6%). Rash was present in 7 (10.5%) and eschar in 1 (1.5%). In lab parameters reported abnormalities severe hypoalbuminemia, hyperbilirubinemia, elevated transaminases, anemia, thrombocytopenia leucopenia and leucocytosis. Hepatitis in 48 (75%) was most common complication followed by pneumonia. Other reported complications were myocarditis, acute kidney injury, pneumonia, bleeding, meningitis, enchepalopathy , papilledema, ARDS and hemophagocytosis.
Conclusions: Pediatrician should keep high index of suspicion for suspect scrub typhus in a child presents with febrile illness and early treat should be started. Hepatitis is most common complication. As Scrub typhus is associated with multisystem involvement, thorough assessment of patient should be done to look for these complications and appropriate management of complications should be provided to prevent mortality.
Prevalence and risk factors of hearing loss in high-risk neonates at a tertiary care hospital in Mumbai
Authors: Pradhan Monalisa , Bhaisara Baraturam , Shinde Srinivas Rao G.
Published: December 2023

Background: The present study was conducted to assess the prevalence of hearing loss using measurements of otoacoustic emission (OAE) in newborns admitted to NICU and to determine the risk factors predictive of hearing impairment in these newborns.
Methods: This was a Prospective observational study conducted among 220 newborns admitted to the NICU over 18 months. Ethical clearance was obtained from the IEC. The sample size was obtained by the universal sampling technique. All candidates underwent hearing assessment in a sound-treated room in the department using a distortion product OAEs (DPOAE) test at the time of discharge.  Babies who did not pass the initial screening underwent another OAE test within one month after being discharged. If they failed the test again, they were referred to an otologist for BERA.
Results: Of the 226 neonates included in the study, 40 cases (17.7%) failed the initial screening. 29 cases (12.8%) failed the second OAE screening and were subjected to BERA. Risk factors included asphyxia (p≤0.001), mechanical ventilation (p<0.0004), history of ototoxic medication (p=0.004), neonates with hyperbilirubinemia requiring exchange transfusion (p=0.005), low Apgar scores (p≤0.001).
Conclusions: A two-stage OAE hearing screening can be a suitable method for early detection of hearing impairment in newborns. This method has shown high prevalence of hearing loss among high-risk neonates but needs to be confirmed with diagnostic BERA. It is crucial to have universal hearing screening to detect the large number of hearing-impaired neonates in the newborn population of our country, including those who are not considered at risk.
Biotinidase deficiency: a novel phenotype from a tertiary care centre
Authors: Paul Ebin Roshan , Manuel Davis , Shajahan R. A. , U. Jayalekshmi , Chacko Anjali Ann
Published: December 2023

Biotinidase deficiency (BD) (OMIM 609019) autosomal recessive inherited metabolic disorder where enzyme biotinidase, is defective and biotin is not recycled in body. One novel phenotype reported from our tertiary care centre, 3-month-old baby presented with bilateral corneal haziness, development delay and seizures. Evaluation showed metabolic acidosis, persistent lactate elevation and MRI showed acute infract. Metabolic evaluation showed profound BD, confirmed by molecular testing. Treatment and follow up with biotin showed clearing of corneal opacity, resolution of bleed and improvement in development and seizures. BD has got wide range of clinical manifestations- neurologic, dermatologic, ophthalmologic and immunological features. Acute infract and corneal opacity are not yet reported in OMIM literature and BD not considered in differential diagnosis of stroke in metabolic disorders. Being clinicians, it is our responsibility to add novel associations and clinical findings and thus broaden the phenotype.
A case of persistent left superior vena cava: an anatomical rarity with clinical implications
Authors: Saraswat Pawan , Prasad Rajniti , Singh Ankur , Baranwal Sandeep Kumar , Kumar Nitish , Abhinay Abhishek
Published: December 2023

Persistent left superior vena cava (PLSVC) is a rare congenital anomaly characterised by the presence of a persistent left-sided SVC in addition to the normal right-sided SVC. This case report presents a unique instance of PLSVC in a 13-year-old male patient who was incidentally diagnosed during routine cardiac imaging for an unrelated condition. The diagnostic journey, including imaging modalities such as echocardiography and computed tomography, revealed the presence of this anatomical variation. Despite being asymptomatic, the case highlights the importance of recognising PLSVC, as it can have clinical implications in various medical and surgical scenarios, particularly in cardiac catheterization, pacemaker implantation, and central venous access procedures. This report discusses the clinical significance, diagnostic challenges, and management considerations associated with PLSVC, emphasising the need for increased awareness among healthcare professionals to ensure safe and effective patient care.