bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical and visual outcomes of flap repositioning for various flap-related pathologies post laser in-situ keratomileusis (LASIK)
Authors: Dvivedi Arundhati , Murthy Somasheila I , Akkulugari Vidhyadhar , Ali Hasnat
Published: December 2023

To evaluate the surgical and visual outcomes of flap repositioning for various post-laser-assisted in-situ keratomileusis (LASIK) flap pathologies. Retrospective review of consecutive cases between April 1, 2017 and February 28, 2022, where surgical flap repositioning was performed following LASIK for various flap-related complications. Of the 6018 eyes, 31 needed flap repositioning (0.51%). Indications were flap displacement and folds in 20 eyes (64%), flap subluxation in five eyes (16%), epithelial ingrowth and interface debris in two each, and one eye each of diffuse lamellar keratitis and incomplete flap. Final best spectacle-corrected visual acuity of ≥ 20/25 was obtained in 25/31 (80%) eyes. The efficacy index pre to post repositioning showed significant improvement (0.86 ± 0.39 vs. 0.63 ± 0.29 preop, P = 0.011). Flap repositioning incidence was significantly higher (7/602 (1.16%)) during the COVID lockdown phases compared to the non-COVID lockdown phase (24/5416 (0.44%, P = 0.019)). The COVID group had lower efficacy (0.72 ± 0.36 vs. 0.90 ± 0.39, P = 0.300) and safety indices (0.85 ± 0.24 vs. 1.06 ± 0.35, P = 0.144) compared to the non-COVID group; however, the results were not statistically significant. The flap displacement rate was statistically higher in nasal hinged (microkeratome) flaps (18/2013, 0.89%) compared to superior hinged (Femto) flaps (13/4005, 0.32%) (0.32%, P = 0.003). Our study shows that flap repositioning has a low incidence in LASIK, with the most common indication being flap displacement/folds. The outcome post flap repositioning was poorer during the lockdown period, perhaps due to the inability to follow up early. Early identification and surgical repositioning are successful in both anatomical and visual restoration.
A Comparative Clinical Study to Evaluate the Antinociceptive Efficacy of Intravenous versus Intraperitoneal Dexmedetomidine with Ropivacaine in Patients Undergoing Laparoscopic Cholecystectomy
Authors: Khare Arvind , Thada Beena , Meena Jyoti , Jonwal Kuldeep , Mathur Veena
Published: December 2023

Background and Aims:

Intraperitoneal (IP) local anesthetic administration has become a routine in laparoscopic surgeries. An additive to local anesthetic like alpha-2 agonist such as dexmedetomidine may enhance the efficacy of local anesthetic. Our primary objective was to compare the duration of analgesia and our secondary objectives were to compare the total amount of rescue analgesics in 24 h, hemodynamic changes, and adverse effects after the use of dexmedetomidine intraperitoneally versus intravenously in addition to 0.25% ropivacaine instillation intraperitoneally.

Materials and Methods:

Eighty patients aged 18–60 years of American Society of Anesthesiologists physical status I and II, undergoing laparoscopic cholecystectomy, were randomly allocated into two groups – Group V (n = 40) received 100 ml normal saline (NS) with 0.7 µg/kg dexmedetomidine over 15 min followed by 30 ml 0.25% ropivacaine intraperitoneally and Group P (n = 40) received 100 ml NS over 15 min followed by 30 ml 0.25% ropivacaine with 0.7 µg/kg dexmedetomidine intraperitoneally soon after removal of gallbladder at the end of surgery.

Results:

The duration of analgesia was significantly longer in Group V (246.45 ± 27.00 min) as compared to Group P (112.83 ± 11.61 min) (P < 0.0001). The total amount of rescue analgesic consumption in 24 h was significantly reduced in Group V (185.00 ± 73.55 mg) as compared to Group P (225.00 ± 77.63 mg) (P < 0.05). As compared to Group P, patients in Group V had a statistically significant Ramsay Sedation Score. The hemodynamic parameters and side effect profile were comparable in both the groups.

Conclusion:

IV dexmedetomidine 0.7μg/kg is more efficacious as compared to IP dexmedetomidine along with IP ropivacaine 0.25% in laparoscopic cholecystectomy in terms of prolonged duration of analgesia and decreased requirement of rescue analgesia in 24 h.
Midpoint Transverse Process to Pleura Block for Analgesia in Breast Surgeries: A Case Series
Authors: Chaudhary Kriti , Sharma Ravi Shankar , Sharma Suyashi
Published: December 2023

Among the various techniques described for analgesia in breast surgeries, thoracic epidural and thoracic paravertebral block is the gold standard but have potential complications of hypotension and pneumothorax. Midpoint transverse process to pleura (MTP) block is one of the newest techniques developed to reduce these complications by injection of local anesthetic between the midpoint of the posterior transverse process and pleura. Originally performed at multiple levels, the literature is scant regarding the placement of a catheter. We report MTP block with catheter placement providing continuous infusion in five patients posted for modified radical mastectomy and found it a safe and effective alternative.
Evaluation of Patient’s Pain Assessment Format for Postoperative Pain in Patients Undergoing Abdominal Surgery: A Prospective Observational Study
Authors: Gaurav Nishant , Gautam Sujeet , Agarwal Anil , Dhiraaj Sanjay
Published: December 2023

Introduction:

The efficiency of pain management depends on appropriate pain assessment. Postoperative pain assessment is done by acute pain service (APS) team; patients may also assess their pain scores with the help of a patient’s pain assessment format. The present study has evaluated the efficacy of patient’s pain assessment format by comparing it with pain assessment done by the APS team.

Materials and Methods:

Thirty-five patients undergoing abdominal surgery were enrolled in this study; postoperative pain assessment was done by patient’s pain assessment format and APS team for a period of 3 days after surgery. The primary outcome measure was postoperative pain score and the secondary outcome measures were postoperative nausea and vomiting, abdominal distension, pruritus, numbness, paresthesia, or weakness in the legs. Results were analyzed by the Mann–Whitney U-test and Fisher’s exact test. P <0.05 was considered as statistically significant.

Results:

Pain scores and incidence of side effects assessed by the patient’s pain assessment format were comparable to those assessed by the APS team; however, the first reading of pain scores after surgery assessed by the patient’s pain assessment format was significantly higher than that assessed by the APS team (P < 0.05).

Conclusion:

Pain scores assessed by the patient’s pain assessment format were comparable to the pain scores assessed by the APS team. Hence, we recommend the use of patient’s pain assessment format as a valid tool for the assessment of postoperative pain by the APS team.
A comparative study between autologous noncultured trypsinized melanocytes–keratinocytes cell suspension and autologous noncultured nontrypsinized epidermal cells grafting (Jodhpur technique) in stable vitiligo
Authors: Saini Shivani , Sharma Deepak , Yadav Chinmai , Singrodia Rahul , Chouhan Chandraprakash , Kachhawa Dilip
Published: December 2023

Background:

Noncultured epidermal cell suspension (NCES) and Jodhpur technique (JT) are two treatment options in vitiligo, in which the basic principle is the transfer of melanocytes from uninvolved skin to stable vitiligo patch in the form of either tissue graft or cellular graft.

Objectives:

The aim of this study was to evaluate effectiveness of two different treatment methods (NCES and JT) in stable vitiligo.

Materials and Methods:

This was a randomized comparative study, which included 45 patients with 153 stable vitiligo patches. Cases were randomly divided into two groups. Appropriate statistical analysis was done. A value of P < 0.05 was considered statistically significant.

Results:

Of 45 cases, female-to-male ratio was 1.36:1. Mean duration of disease and stability were found to be 10.44 ± 5.24 and 3.83 ± 2.31 years, respectively. Mean size of treated area for NCES and JT was 10.11 ± 10.31 and 10.13 ± 10.29 cm2, respectively. Earliest repigmentation was found at 3 weeks in NCES and 6 weeks in JT. At 6 weeks, repigmentation was better in NCES, whereas later JT showed better pigmentation. Follow-up was done at 8 days and 6, 10, 14, and 24 weeks. With respect to color match at 6 weeks, JT was found superior; however, at 24 weeks both showed similar efficacy. Mean reduction in daily life quality index was significantly decreased post-surgery.

Limitations:

This was a single-center, small sample size study.

Conclusion:

Melanocyte plus keratinocyte cell transfer is very effective in the treatment of stable vitiligo. On the basis of the results, JT may show significant contribution in vitiligo.
Carboxylesterase-overexpressing hTERT-immortalized human adipose stem cells in prostate tumor growth inhibition by irinotecan
Authors: Kim Jae Heon , Oh Eunjeong , Song Eun Seop , Yun Chul Won , Lee Sang Hun , Song Yun Seob
Published: December 2023

Introduction:

Effective chemotherapy has not yet to be developed for castration-resistant prostate cancer (CRPC). Cell-mediated enzyme prodrug therapy (EPT), including a combination of carboxylesterase (CE) and irinotecan (CPT-11), could be a possible treatment option. This study explored a cell-mediated EPT, including a combination of CE and irinotecan (CPT-11), to inhibit CRPC tumor growth using rabbit CE-overexpressing human TERT-immortalized adipose-derived stem cells (hTERT-ADSC.CE).

Materials and Methods:

An hTERT ADSC.CE cell line was established by transfection with a lentiviral vector (CLV-Ubic) encoding the rabbit CE gene. To determine the in vitro suicide effects of hTERT-ADSC.CE, cell cultures were performed using various concentrations of CPT-11 (0.01–5 μM), and to determine the in vitro cytotoxic effects of hTERT-ADSC.CE cells, PC3 and hTERT-ADSC.CE cells were co-cultured. For the in vivo model, PC3 cells (1 × 106 cells) were injected subcutaneously into the flanks of nude mice and hTERT-ADSC.CE cells were injected via an intracardiac route, followed by the continuous treatment using CPT-11 for 2 weeks. The final change in tumor volume was measured and immunohistochemical analysis was performed.

Results:

The directional and selective migration of hTERT-ADSC.CE cells toward PC3 cells was significantly stimulated by PC3 cells in vitro. The number of apoptotic PC3 cells significantly increased in the presence of hTERT-ADSC.CE and CPT-11 compared to CPT-11 alone. In the in vivo study, the inhibitory effects of hTERT-ADSC.CE combined with CPT-11 were higher than those of CPT-11 monotherapy. After treatment with CPT-11 alone or ADSC.CE in combination with CPT-11, the removed tumor tissues showed hyperchromatic nuclei and apoptotic bodies. CE-overexpressing ADSCs potentiated the inhibition of tumor growth in CRPC-bearing mice in the presence of CPT-11 prodrugs.

Conclusions:

This report suggests that cell-mediated EPT including CE and CPT-11 may be efficacious in treating CRPC
Leucine-rich repeats and immunoglobulin-like domains protein 1 (LRIG1) is downregulated in Invasive ductal carcinoma and potential prognostic marker of breast cancer
Authors: Piracha Zahra Zahid , Saeed Umar
Published: December 2023

Background:

LRIG1 belongs to the family of transmembrane proteins containing leucine-rich repeats. LRIGs are considered as tumor suppressors as they negatively regulate receptor tyrosine kinases. The role of LRIG1 as an EGFR regulator makes it an important marker to be studied in various epithelial-derived cancers.

Methods:

LRIG1 expression was determined in Erbb2 + cell lines by western blotting, and cell motility was examined by cell migration assay. The AKT/GSK3-β/β-catenin pathway was determined in the presence of LRIG1 and Erbb2 by using western blotting.

Results:

So far, no study has reported the expression of LRIG1 in benign forms of tumor such as fibroadenoma. The current study aims to analyze LRIG1 expression in fibroadenoma and invasive ductal carcinoma (IDC) tissues. In this study, we compared the LRIG1 expression with different clinicopathological parameters of patients having IDC or fibroadenoma. LRIG1 expression was low in Erbb2+ cell lines, and more cell motility was observed. The AKT/GSK3-β/β-catenin pathway was activated when LRIG1 was downregulated; consequently, Erbb2 was upregulated. Our results indicated that LRIG1 expression can be significantly correlated with age, Nottingham index, and Her2/neu status of cancer. The expression of LRIG1 in IDC and fibroadenoma were found to be significantly different.

Conclusion:

The fibroadenoma tissue sections were found to express LRIG1 more intensely as compared to the IDC sections, which are in line with the studies reporting reduced copy number of the gene either due to gene deletion or transcriptional inhibition. This further supports that the downregulation of LRIG1 may lead to malignant tumor acting as a tumor suppressor.
Identification of key gene signatures and their characterization by expression correlation with drug sensitivity in smoking-associated oral squamous cell carcinoma
Authors: Gollapalli Pavan , Alagundagi Dhananjay , Ghate Sudeep D. , Shetty Vijith V. , Shetty Praveenkumar , Patil Prakash
Published: December 2023

Aims:

Oral squamous cell carcinoma (OSCC), a most frequent type of head-and-neck cancer, is becoming more common and posing a substantial health risk. Using a network biology strategy, this study intended to find and investigate critical genes associated with OSCC.

Materials and Methods:

The extended protein–protein interaction networks for differentially expressed genes related to smoking and nonsmoking conditions of OSCC were constructed and visualized using Cytoscape software. The hub genes/proteins were determined based on degree and betweenness centrality measures and then evaluated and validated for expression using the Gene Expression Profiling Interactive Analysis 2 (GEPIA2), and their relationship to the sensitivity of small molecules was discovered utilizing the Gene Set Cancer Analysis (GSCA) web server.

Results:

A total of 596 differentially expressed genes were screened, and four genes, interleukin (IL)-6, JUN, tumor necrosis factor (TNF), and vascular endothelial growth factor A (VEGFA), were identified as hub proteins, and their expression and overall survival in head-and-neck cancers were further investigated using GEPIA2. TNF and VEGFA gene expressions were considerably greater in cancers when compared to normal samples, while JUN and IL-6 gene expressions were not statistically significant. Further, these hub proteins are found to have a substantial favorable correlation with overall survival of head-and-neck cancer patients. Finally, GSCA was used to predict gene-specific potential drugs that act on these molecules by combining mRNA expression and drug sensitivity data from the Genomics of Drug Sensitivity in Cancer and the Cancer Therapeutics Response Portal.

Conclusions:

The hub genes/proteins identified in this study could help researchers better understand the molecular processes involved in the progression and metastasis of oral cancer in smokers.
Sexual function status after adjuvant radiation including vaginal cuff brachytherapy in survivors of cancer cervix
Authors: Puri Isha , Sharma Rahul , Dewan Deepika , Angurana Shabab , Abrol Deepak , Kumar Dinesh
Published: December 2023

Context:

Adjuvant radiation therapy plays an important role in the management of high-risk cervical cancer after radical hysterectomy or inadvertent hysterectomy. The prime concern with the use of dual modality is steep decline in sexual well-being in cervical cancer survivors. Intravaginal brachytherapy (IVBT) delivered by vaginal cylinder or ovoids is essential for local control but at the cost of impairment of sexual function.

Aim:

The purpose of this study was to assess the sexual well-being of cervical cancer survivors, who underwent surgery followed by adjuvant radiation and compare the subgroups of ovoids with sorbo brachytherapy.

Settings and Design:

This was an observational, cross-sectional, and analytical study, whereby we evaluated sexual function of cervical cancer survivors by the Female Sexual Function Index (FSFI) instrument.

Subjects and Methods:

Seventy-five women, identified as cervical cancer survivors who had received adjuvant radiation and IVBT, were administered FSFI questionnaire in face-to-face interviews.

Results:

The mean age of 75 interviewed women was 48.64 years. Fifty survivors had received IVBT with a sorbo applicator and twenty-five with ovoids. FSFI full score ranged from 4.4 to 32.40. The mean full score for the whole group was 11.3. The mean FSFI full score was 24.91 (± standard deviation [SD] 5.71) in the ovoid group versus 4.49 (± SD 0.35) in the sorbo group. On Pearson’s correlation analysis, age and type of brachytherapy were significantly correlated with FSFI full score (P = 0.006) with correlation coefficient of − 0.312 and − 0.948, respectively.

Conclusions:

Sexual dysfunction was found prevalent in 83% of cervical cancer survivors. The patients treated with IVBT with sorbo had worse sexual functioning than those treated with ovoids.
Comparison and estimation of photoneutron dose produce between 10 MV flattened and unflattened beam in Elekta Versa HD™ medical linac
Authors: Khilafath Hajee Reyaz Ali Sahib , Ganesan Bharanidharan , Sekar Nandakumar , Mohapatra Dinakrushna , Vellingiri Jayaprakash , Prakasarao Aruna , Mahadevan Pramod , Singaravelu Ganesan
Published: December 2023

Background:

In a high-energy medical linear accelerator (linac), if the interaction of photon energy is higher than the neutron binding energy of high atomic material, it emits a neutron field through photonuclear (γ, n) reaction.

Aim:

The current study, evaluates the photoneutron dose equivalent (PNDE) produced between the 10 MV flattened and unflattened beams as a function of field sizes in the Elekta Versa HD™ linac.

Materials and Methods:

The PNDE produced from Versa linac was recorded along the patient plane using the bubble detector personal neutron dosimeter and from the measured PNDE values, the theoretical PNDE values were simulated for various field sizes using nonlinear least-squares curve-fitting as a function of a polynomial. The percentage of deviation (PoD) and Chi-square (χ2) tests were performed between the measured and simulated PNDE values to study the reliability and validity.

Results:

The results show that the mean PoD between the measured and simulated PNDE values for respective positions of a field size of FF beam was found to be -1.99% for 0.3×0.3, -4.39% for 5×5, -3.868% for 10×10, 0.590% for 15×15, 9.18% for 20×20, -4.133% for 25×25, and 0.467% for 30×30 cm2. Similarly, the mean PoD between the measured and simulated PNDE values for flattening filter-free (FFF) beam was found to be 1.36% for 0.3×0.3, -1.39% for 5×5, -5.38% for 10×10, 4.41% for 15×15, 3.84% for 20×20, 5.69% for 25×25, and -1.75% for 30×30 cm2. The maximum deviation between the measured and simulated PNDE values lies within the range ± 5%.

Conclusions:

From the study, it is observed that the FFF beam produces lesser neutron contamination than the FF beam.
Decoding the significant diagnostic and prognostic importance of maternal embryonic leucine zipper kinase in human cancers through deep integrative analyses
Authors: Hameed Yasir
Published: December 2023

Background:

Cancer is a multifactorial disease and the second leading cause of human deaths worldwide. So far, the underlying mechanisms of cancer have not been yet fully elucidated.

Methods:

By using TCGA expression data, we determine the pathogenic roles of the maternal embryonic leucine zipper kinase (MELK) gene in various human cancers in this study. For this purpose, different online databases and tools (UALCAN, Kaplan–Meier (KM) plotter, TNMplot, GENT2, GEPIA, HPA, cBioPortal, STRING, Enrichr, TIMER, Cytoscape, DAVID, MuTarget, and CTD) were used.

Results:

MELK gene expression was analyzed in a total of 24 human cancers and was found notably up-regulated in all the 24 analyzed tumor tissues relative to controls. Moreover, across a few specific cancers, including kidney renal clear cell carcinoma (KIRC), stomach adenocarcinoma (STAD), lung adenocarcinoma (LUAD), and liver hepatocellular carcinoma (LIHC) patients, MELK up-regulation was observed to be correlated with the shorter survival duration and metastasis. This valuable information highlighted that MELK plays a significant role in the development and progression of these four cancers. Based on clinical variables, MELK higher expression was also found in KIRC, STAD, LUAD, and LIHC patients with different clinical variables. Gene ontology and pathway analysis outcomes showed that MELK-associated genes notably co-expressed with MELK and belongs to a variety of diverse biological processes, molecular functions, and pathways. MELK expression was also correlated with promoter methylation levels, genetic alterations, other mutant genes, tumor purity, CD8+ T, and CD+4 T immune cells infiltrations in KIRC, STAD, LUAD, and LIHC.

Conclusion:

This pan-cancer study revealed the diagnostic and prognostic roles of MELK across four different cancers.
Spindle cell carcinoma of male breast: Report of a rare case
Authors: Palo Seetu , Jaiswal Sushila
Published: December 2023

We report a rare case of spindle cell carcinoma, a histological subtype of metaplastic breast carcinoma, in a 40-year-old male who presented with an ulcero-proliferative lump in the right breast. Fine-needle aspiration cytology of the lesion showed poorly cohesive clusters of pleomorphic spindle-shaped cells, suggestive of malignant spindle cell tumor. Right mastectomy along with ipsilateral lymph node dissection was performed. Microscopic evaluation revealed a neoplasm comprising interlacing fascicles of oval to spindled pleomorphic cells with brisk mitosis and areas of necrosis. There was no nodal metastasis. Immunohistochemistry revealed a triple-negative phenotype along with diffuse positivity for CK5/6, vimentin, and smooth muscle actin. p63, beta-catenin, and CD34 were negative. The patient subsequently received adjuvant chemotherapy with 5-fluorouracil, adriamycin, and cyclophosphamide regimen and was disease-free at 1-year follow-up.
Localized aggressive angiomyxoma of axilla: A rare case report
Authors: Sidhu Manjinder Singh , Jain Kunal , Sood Sandhya , Kaur Harpreet
Published: December 2023

Aggressive angiomyxoma (AAM) is a rare mesenchymal locally aggressive tumor arising in the pelvis and perineal region in females. On the other hand, extragenital AAMs are extremely rare, specifically in males. We are reporting male AAM which involves only axillary region along with its pathological features. To confirm it, immunohistochemistry (IHC) was done. In sum, pathological examination and IHC aid in distinguishing this lesion and help in differentiating it from other tumors of similar histology. Furthermore, it also aids in planning treatment.
A novel EML4–NTRK3 fusion in lung adenocarcinoma with dramatic response to entrectinib
Authors: Batra Ullas , Nathany Shrinidhi , Sharma Mansi , Jain Parveen , Mehta Anurag , Bansal Abhishek
Published: December 2023

In-frame fusions in NTRK genes, with intact kinase domain, have been reported to occur at higher frequencies in rare tumors like infantile fibrosarcoma, congenital mesoblastic nephroma, and secretory carcinoma, whereas they occur at very low frequencies in common malignancies like NSCLC and colon cancers (0.1%–1%). Despite the rare occurrence, these alterations have gained importance owing to approval of drugs like entrectinib and larotrectinib targeting the kinase domain of the gene. More than 50 fusion partners have been described, and only in-frame fusions result in constitutive ligand-independent kinase activity leading to oncogenesis. The commonly reported NTRK fusions in the lung include SQSTM1–NTRK1, ETV6–NTRK3, and SQSTM1–NTRK3. Detection of these rests on the use of conventional modalities like Immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH); however, accurate characterization requires direct sequencing methods. We report an interesting case of an NTRK fusion-positive NSCLC, exhibiting good response to entrectinib.
Clinicopathologic characteristics and prognostic factors in patients with male breast cancer: A single tertiary center experience
Authors: Dogan Izzet , Aydin Esra , Ak Naziye , Ozkurt Selnur , Ibıs Kamuran , Sükrüoglu Ozge , Erciyas Seda Kılıc , Küçücük Seden , Yazici Hulya , Aydiner Adnan , Saip Pinar
Published: December 2023

Background:

The goal of this study was to assess the clinicopathologic characteristics and prognostic variables in men with breast cancer (BC).

Methods:

Clinical features, pathological characteristics, stage at diagnosis, and therapy data were noted. Survival analysis was performed using the log-rank technique and Cox regression model.

Results:

Eighty patients were included in the study. In 31% of the individuals, BRCA (BReast CAncer genes 1 and 2) mutations were identified. The estrogen receptor (ER) positivity ratio was 93.6%, whereas the progesterone receptor (PR) positivity ratio was 74.4%. In 16.9% of the cases, HER2 overexpression was found. The median survival time was 120.9 months (70.3–171.5), and the five-year overall survival (OS) ratio was 74.9%. In univariate analysis, BRCA mutation status had no effect on OS (P = 0.50). CA15-3 levels (P = 0.03) at diagnosis and history of smoking (P = 0.03) were significantly linked with OS. However, the multivariate analysis could not confirm these results.

Conclusions:

We found that BRCA mutation, body mass index, a history of smoking, and alcohol consumption did not affect the OS in this research.
Capecitabine is effective as palliative chemotherapy in a patient with androgen receptor and HER2 positive metastatic salivary duct carcinoma. A case report
Authors: Čavka Luka , Zakotnik Branko
Published: December 2023

Metastatic salivary duct carcinomas (SDC) are rare tumors and evidence-based guidelines for their treatment have not yet been established. Reports of such cases like ours could be beneficial in the decision-making in the similar clinical circumstances. Here we present the 64-year-old Caucasian man with bone pain and pancytopenia two years after local treatment of SDC, in whom a bone marrow biopsy revealed poorly differentiated carcinoma of salivary origin with nuclear androgen receptor (AR) and human epidermal growth factor receptor 2 (HER2/neu) positivity. Clinical response was achieved with cis-platin based cytotoxic therapy and maintenance hormonal treatment. At progression after 12 months, he was treated with anti-HER2 therapy combined with taxanes. The response lasted for 14 months. Then palliative therapy with capecitabine was introduced. With a relatively sustained quality of life, the response lasted for 15 months.
Expression of heat shock protein 70 in oral epithelial dysplasia and squamous cell carcinoma
Authors: Karri Roja Lakshmi , Subramanyam RV , Venigella Aparna , Babburi Suresh , Pinisetti Soujanya , Amrutha Rudraraju , Nelakurthi Hasini
Published: December 2023

Background:

Heat shock proteins (HSPs) are overexpressed in a variety of human malignancies. They are involved in tumor cell proliferation, differentiation, invasion, metastasis, death, and immune system detection. HSP 70 has been shown to resist cytotoxicity in cancer cells and even enhance tumor development through an immune escape mechanism, suggesting that HSP70 may play a role in carcinogenesis. The aim of our study was to evaluate the role of HSP70 as a predictive marker for malignant transformation in oral epithelial dysplasia.

Materials and Methods:

Thirty samples of epithelial dysplasia (10 mild dysplasia, 10 moderate dysplasia, and 10 severe dysplasia/carcinoma-in-situ cases), 10 samples of well-differentiated oral squamous cell carcinoma (OSCC), and 10 samples of normal oral mucosa were routinely processed, formalin-fixed, paraffin-embedded, and immunohistochemically examined for HSP70 expressions. To determine the statistical difference between two groups, a one-way analysis of variance (ANOVA) and the Mann–Whitney test were used.

Results:

HSP70 expression was high but not homogenous in normal mucosa. Dysplasia showed an initial drop, and the expression increased with increasing degrees of dysplasia. There was no statistically significant difference across various types of epithelial dysplasia. From dysplasias to well-differentiated carcinoma, HSP70 exhibited a considerable rise.

Conclusion:

Overexpression of HSP70 in clinically suspicious and histologically established epithelial dysplasia may suggest a likelihood of transformation to well-differentiated OSCC and may have a prognostic value. However, more studies with a bigger sample size are needed to prove HSP70’s role as a predictor.
Potential implications of mobile applications in oral cancer
Authors: Sharma Deepti , Gupta Shruti , Koshy George , Sharma Vishal Kumar , Hooda Anita
Published: December 2023

The modern era has observed vast technological advancements with a definite impact on the health sector. There has been an upsurge in mobile applications (mApps) used for varied purposes. Many mApps are available that target different arenas in dentistry including a range of oral health issues, the most important being oral cancer. These mApps with specific algorithms have been used for risk assessment, screening and diagnosis of oral potentially malignant and malignant disorders. Other benefits include remote consultation, timely referral, treatment of the disease, self monitoring and adherence to medications. Therefore, this review is designed to appraise the utility of mobile apps in oral cancer. The systematic research of the literature was done to find relevant articles regarding the development and applications of mApps in oral cancer by using specific research engines. PubMed, Cochrane and Clinical Key databases were searched electronically, irrespective of date of publication, with an assortment of several independent terms. A total of 423 articles were accessed, and screened. After applying the definite inclusion and exclusion criteria, 9 articles were finally selected which highlighted the impact of mApps in oral cancer. It was concluded that the potential of mobile applications could be harnessed judiciously to improve the screening, diagnosis and treatment of oral cancer.
Intestinal Fatty Acid-binding Protein in Patients with Psoriasis: A Marker of Impaired Intestinal Permeability Barrier and its Relation to Demographic Data and Clinical Characteristics
Authors: Mahran Ayman , Hosni Amal , Mageed Ahmed A. A.
Published: December 2023

Background:

Alterations of intestinal microbiota may play a role in the pathogenesis of psoriasis. Dysbiosis may cause disruption of the intestinal barrier, which contributes to immune activation by translocation of microbial antigens and metabolites. Intestinal fatty acid-binding protein (I-FABP) serves as a biomarker of enterocyte damage.

Purpose:

The aim of this study was to investigate serum concentration of I-FABP in patients with psoriasis.

Methods:

A cross-sectional hospital-based study on fifty psoriatic patients and thirty-five age and sex-matched healthy volunteers as a control group were enrolled in the study, serum I-FABP concentration was measured using an enzyme-linked immunosorbent assay.

Results:

Concentration of serum I-FABP was higher in patients compared to controls (P = 0.04). The serum level of I-FABP was higher in patients with skin phototype IV than in those with skin phototype III (P = 0.040). There were significant positive statistical correlations between I-FABP with age and disease duration.

Conclusion:

I-FABP, a biomarker for gut permeability, is increased in psoriasis and correlates with disease duration and age. Further investigations are needed to determine whether reinforcing intestinal barrier may be a new therapeutic target in psoriasis.
Successful Management of Cervical Ectopic Pregnancy: A Multidisciplinary Approach Utilising Uterine Artery Embolisation and Hysteroscopic Resection
Authors: Jha Sangam , Jafeesha B
Published: December 2023

Cervical ectopic pregnancy (CEP) is a rare and challenging condition that requires prompt management to prevent complications. We present a case of a 27-year-old woman with a history of prior uterine surgeries who presented with vaginal spotting. Ultrasonography revealed an empty uterine cavity and a growing gestational sac with a viable foetus in the cervical canal. Despite methotrexate therapy, her beta-human chorionic gonadotropin hCG levels continued to rise, necessitating an alternative treatment approach. Bilateral uterine artery embolisation (UAE) was performed to reduce the risk of haemorrhage before hysteroscopic resection of the pregnancy. The combined approach of UAE and hysteroscopic resection successfully managed the CEP, leading to a favourable outcome. This case highlights the importance of early detection, tailored interventions and multidisciplinary collaboration in the management of CEP. UAE, in conjunction with hysteroscopic resection, offers a promising treatment option for CEP, minimising complications and preserving reproductive health.
Psychometric Measurement of Fertility-related Quality of Life across Gender in Primary Infertile Couples
Authors: Kumari Amita , Itagi Afreen Begum H. , Kanchi V. Bhargava Reddy , Sharmila Vijayan , Dipankar Satish Pundlik
Published: December 2023

Background:

Infertility is a crucial global public health issue that affects millions of people of reproductive age. Fertility-related stress can negatively impact infertile couples’ quality of life (QoL).

Aims:

This study aimed to assess and compare the psychometric properties of fertility QoL between primary infertile couples’ male and female partners.

Settings and Design:

This cross-sectional study included 114 primary infertile couples visiting the Andrology Laboratory referred from the Gynaecology and Obstetrics Department, AIIMS, Patna.

Materials and Methods:

Data were collected using the Fertility QoL (FertiQoL) tool, an internationally validated questionnaire to measure the reproductive QoL, demographic information and medical history. The FertiQoL questionnaire responses were recorded and analysed.

Statistical Analyses Used:

Statistical analyses used were performed using the SPSS 20.0 version. Descriptive statistics, Kolmogorov–Smirnov test, Cronbach’s alpha and Student’s independent t-tests were used. Statistical significance was set at P < 0.05.

Results:

In our study, the overall estimated Cronbach’s α was 0.83, and males had a significantly better fertility-related QoL in all domains of the FertiQoL, such as emotional (P < 0.000), mind–body (P < 0.000), social (P < 0.004) and tolerability (P < 0.000), except relational and environmental domains, which were lower in them. However, between the groups, the relational domain was significant (0.000) and the environmental domain was non-significant (0.592). Overall, males had a significantly better total core score, total treatment score and overall total FertiQoL score, while females had lower scores.

Conclusion:

Amongst infertile couples, the reproductive QoL was poorer in females than in males. Our study suggests psychological counselling and mental support for females during infertility management.
Effect of Chitosan on the Mechanical Properties and Color Stability of Two Commercially Available Heat Cure Denture Base Resins: An In vitro Study
Authors: Verma Nivea , Lahori Manesh
Published: December 2023

ABSTRACT

Background:

Chitosan is one of the new and promising biomaterials being used in dentistry. However, there are fewer studies available in the literature to estimate the mechanical properties of chitosan with heat polymerized denture base resin (DBR). This study aimed to evaluate the effect of incorporation of chitosan nanoparticles on flexural strength, fracture toughness, and color stability of two different types of heat cure DBR.

Aim:

The aim of the study is to evaluate the mechanical properties and color stability of two DBRs reinforced with different concentrations of chitosan.

Materials and Methods:

A total of 240 samples were made of DPI (n = 120) and Trevalon (n = 120) DBR. The samples of each type were divided into four groups depending on the concentration of chitosan-C 0, C 5, C 12.5, and C 20. Flexural strength and fracture toughness were estimated with a universal testing machine. Spectrophotometer was used to evaluate the color stability.

Statistical Analysis:

Results were compared with one-way analysis of variance, post
hoc Tukey honest significant difference test, and Student’s t-test.

Results:

The results of the study showed that chitosan-reinforced DBR displayed enhanced mechanical properties. The test group with 5% chitosan nanoparticles had optimum mechanical properties among different test groups for both the DBR. The values for flexural strength and fracture toughness decreased with an increase in the percentage of chitosan. The addition of chitosan to DPI and Trevalon DBRs showed visible color change.

Conclusion:

The study concluded the Trevalon DBR with 5% chitosan showed the highest flexural strength and fracture toughness values. The addition of chitosan nanoparticles had no significant negative effects on heat-cure acrylic resin’s color change property.

CLINICAL RELEVANCE TO INTERDISCIPLINARY DENTISTRY

Gives knowledge about the mechanical properties as well as the physical properties of denture base resin which is beneficial for the dentists.
Patient Satisfaction in Relation to Esthetic Outcome of Dental Treatment: A Systematic Review and Pooled Analysis
Authors: Agarwal Bhaskar , Srivastava Shitij , Shekhar Abhinav , Arora Kshitij
Published: December 2023

ABSTRACT

Introduction:

Esthetics is often an essential yet ignored aspect of dental treatment. In the present study, an attempt was made to evaluate patient satisfaction in terms of esthetic outcome of dental treatment.

MaterialS and Methods:

For this purpose, a systematic review was carried out by searching, MEDLINE, PubMed, and Scopus databases using the keywords “esthetics,” “orthodontic treatment need,” “dental treatment need,” “satisfaction,” and “determinants.” A total of 1075 studies were shortlisted, out of which a total of 927 were excluded in the preliminary assessment itself. A further 779 were excluded during the process of identification of themes and concepts and another 73 were out of sampling frame/inappropriate methodology. Of the remaining 75, a total of 44 studies were related with expectation and perceptions and thus only 31 (2.9%) studies were left that had evaluated esthetics as the treatment outcome. Among these, 9 studies each were related with orthodontic and prosthodontic/implantology treatment, respectively, while 6 studies were related with general dental treatment, and the remaining 7 were related with specialized/esthetic procedures.

Results:

The overall patient satisfaction rate was 67.3%. It was highest in the prosthodontics and dental implantology group (75.1%) and lowest in patients availing of generalized dental (32.4%).

Conclusion:

Patient satisfaction was affected by gender, pretreatment appearance, patient personality characteristics, type of disorder, patient education, previous bad experience, treatment time, cost of treatment, use of appliance/treatment modality/material, practice location and environment, dentist personality, quality of treatment, patient’s esthetic perception, negligence/regularity, smoking, and oral health factors.

CLINICAL RELEVANCE TO INTERDISCIPLINARY DENTISTRY

The article targets to describe the patient expectations with respect to esthetic dental treatment and how patient’s satisfaction is affected by different esthetic dental treatments availed by them for various purposes. The article also highlights the various dental treatment options availed by the patients and their esthetic outcome.
The Paraneural Sciatic Sheaths in Longitudinal Axis at the Level of Greater Trochanter: An Ultrasound Cadaveric and Clinical Correlation Study
Authors: Diwan Sandeep , Feigl Georg , Nair Abhijit , Sancheti Parag
Published: December 2023

Background:

Paraneural sheath engulfing the sciatic nerve (SN) between the ischial tuberosity and the greater trochanter is well known.

Methods:

In order to explore the anatomical planes separating the paraneurium from the epineurium in SN, we conducted a cadaveric study (two patients and four specimens), followed by a clinical study in 10 patients.

Results:

We demonstrated an elevation of 5–7 layers of paraneural tissues after an in-plane injection in the longitudinal axis of the proximal SN, which was possibly the last of the paraneural sheath. In the clinical study, the block provided low pain scores with no rescue analgesia postoperatively and no neurological deficit at the time of discharge.

Conclusion:

This is probably the first series which has described the elevation of several layers of paraneural tissues after an in-plane injection in the longitudinal axis of the proximal SN.
Nora Lesion (Bizarre Parosteal Osteochondromatous Proliferation): An Ultrasound Diagnosis with Magnetic Resonance Imaging Correlation
Authors: Theodorou Daphne J. , Theodorou Stavroula J. , Kakitsubata Yousuke
Published: December 2023

Advanced cross-sectional imaging techniques are firmly established as a means of evaluating musculoskeletal disease, and ultrasound (US) is increasingly being used for the assessment of a diversity of tendon, joint, and soft-tissue abnormalities. A benign condition – bizarre parosteal osteochondromatous proliferation (BPOP) – arises from the periosteum, typically in the small bones of the hands and feet, and grows as a surface bone lesion in the surrounding soft tissue. Proliferations can become symptomatic, exercising mass effect on adjacent structures that may require operative management. As a bone-forming process, BPOP may occasionally assume worrisome histologic features that mimic sarcoma, and a pronounced tendency to recur after primary excision. A solitary mass was growing in the middle finger of a young woman that curtailed proper hand function. With US, a partially ossified formation was revealed in the proximal phalanx situated on the outer surface of the bone. There was faint acoustic shadowing distal to the lesion, and a hypoechoic halo was seen covering part of the abnormal tissue growth. Importantly, the lesion caused significant limitation of motion of the finger, on the dynamic flexion US images with the displacement of the flexor tendon and compression of a digital nerve. To restore the range of motion in the finger, surgical excision of the juxtacortical mass was performed and histology yielded a diagnosis of BPOP. We describe the US features of digital BPOP, which were found to correspond closely to those of computed tomography and magnetic resonance imaging.
Lateral Teardrop Sign: A New Distinguishing Feature of Anteroposterior Projection of Chest Radiograph
Authors: Fatade Oluwatosin Ebunoluwa , Akinmoladun Janet Adetinuke
Published: December 2023

Introduction:

The posteroanterior (PA) projection is the standard view for chest radiographs with the alternative of anteroposterior (AP) chest view. Proper identification of the projection of any chest radiograph is critical to the interpretation and eventual inferences made. The teardrop sign in radiology is a well-known feature that is observed wherever two or more bones are projected over one another. This article aims to introduce a lateral teardrop sign seen on AP projections of the chest and to assess its prevalence and predictive value as a distinguishing parameter between AP and PA views of the chest radiograph.

Methodology:

This retrospective observational study was conducted at the outpatient X-ray unit of the Department of Radiology, University College Hospital, Ibadan. Chest radiographs with AP and PA projections acquired between August 25, 2021, and July 15, 2022, were retrieved from the Picture Archival Communication System and assessed for the presence of lateral teardrop sign. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 25.

Results:

Two hundred and seven radiographs were retrieved and analyzed. These included radiographs of 106 (51.2%) males and 101 (48.8%) females. Eighty-eight (42.5%) were taken in the AP projection while 119 (57.5%) were PA. Only 46 (22.2%) of these radiographs showed the lateral teardrop sign. Of the 46 radiographs showing the sign, 45 (97.8%) were AP constituting 51.1% of all AP radiographs. One hundred and eighteen (73.3%) of radiographs without the sign were PA. A negative and positive predictive value of 73.5% and 98.9% were calculated, respectively, for the lateral teardrop sign, with a sensitivity of 67.2% and specificity of 99.2%.

Conclusion:

Even though there are already existing parameters used to differentiate between AP and PA views, the presence of lateral teardrop sign can be a useful addition in the identification and distinguishing of AP radiographs.
A study of white blood cell counts as a prognostic marker among patients sustaining organophosphate poisoning presenting to the Emergency Department of a Tertiary Care Hospital
Authors: Mathour Abdussamad , Marappan Senthil , Pooja Rani Thiyagarajan , Haneendhar Raju , Senthilkumar Manickam , Dominic Melvin
Published: December 2023

Background:

Organophosphate (OP) pesticide poisoning is a primary concern in rural regions of developing nations, posing a significant clinical challenge. The mortality rate from acute OP compound poisoning surpasses any other harmful substance. In the case of stressful events like injuries and poisoning, the observed leucocytosis and neutrophilia can be attributed to neutrophil margination rather than an increase in bone marrow production.

Materials and Methods:

Between June 2020 and September 2021, a prospective observational study was conducted at a tertiary care institute in Tamil Nadu. The study included 50 patients admitted to the Institute’s Medical Emergency Ward with suspected Organophosphorus poisoning. These patients were categorized into three grades, mild, moderate, and severe, using Dresbach’s classification based on the severity of their manifestations.

Results:

Among the 50 cases studied, 29 were females, and 21 were males. The predominant agent is responsible for organophosphate (OP) poisoning was chlorpyrifos, affecting 37 patients. Most cases (78%) presented with mild manifestations, 12% presented with moderate presentations, and 10% had severe manifestations. Most (72%) of patients sought medical attention within 4 h of consumption (n = 36).

Conclusion:

While insufficient to confirm or rule out severe poisoning, leukocyte counts hold some moderate capacity to differentiate between patients with and without significant poisoning. As a result, these counts could have a meaningful impact on decisions regarding patient disposition.