bluuebunny/crossref_metadata_2025 huggingface dataset:
Global dynamics to a quasilinear chemotaxis system under some critical parameter conditions
Authors: Wang Changjian , Zhu Jiayue
Published: March 2024

In this manuscript, the following chemotaxis system has been considered:

   \begin{document}$ \begin{equation*} \left\{ \begin{array}{ll} v_{t} = \nabla\cdot(\phi(v)\nabla v-\varphi(v)\nabla w_{1}+\psi(v)\nabla w_{2})+av-bv^{\kappa},\ &\ \ x\in \Omega, \ t>0,\\[2.5mm] 0 = \Delta w_{1}+\alpha v^{\gamma_{1}}-\beta w_{1}, \ &\ \ x\in \Omega, \ t>0,\\[2.5mm] 0 = \Delta w_{2}+\gamma v^{\gamma_{2}}-\delta w_{2}, \ &\ \ x\in \Omega, \ t>0 , \end{array} \right. \end{equation*} $\end{document}

where $ \Omega $ is a bounded smooth domain of $ \mathbb{R}^{n}(n\geq 1), $ the parameters $ a, b, \alpha, \beta, \gamma, \delta, \gamma_{1}, \gamma_{2} > 0, \kappa > 1, $ and nonnegative functions $ \phi(\varrho) = (\varrho+1)^{m}, $ $ \varphi(\varrho) = \chi \varrho(\varrho+1)^{\theta-1} $ and $ \psi(\varrho) = \xi \varrho(\varrho+1)^{l-1} $ for $ \varrho\geq 0 $ with $ m, \theta, l \in \mathbb{R} $ and $ \chi, \xi > 0. $ In the present work, we improve the boundedness criteria established in previous work and further show that under the corresponding critical cases, namely, assume that $ \theta+\gamma_{1} = \max\{l+\gamma_{2}, \kappa\}\geq m+\frac{2}{n}+1 $ with $ m > -\frac{2}{n}, n\geq 3, $ if one of the following conditions holds:

(a) when $ \theta+\gamma_{1} = l+\gamma_{2} = \kappa, $ if $ \theta\geq l\geq 1 $ and $ \frac{[(\kappa-1-m)n-2](2\alpha \chi-\gamma\xi)}{2(l-1)+(\kappa-1-m)n} = b, $ or $ l\geq \theta\geq 1 $ and $ \frac{2\alpha\chi[(\kappa-1-m)n-2]} {2(\theta-1)+(\kappa-1-m)n} = b; $

(b) when $ \theta+\gamma_{1} = \kappa > l+\gamma_{2}, $ if $ \theta\geq 1 $ and $ \frac{2\alpha \chi[(\kappa-1-m)n-2]}{2(\theta-1)+(\kappa-1-m)n} = b, $

then the system still possesses at least a global classical solution, which is bounded in $ \Omega \times (0, \infty) $. Additionally, we have also explored the long time behavior of the classical solution mentioned above.
Estimation methods based on ranked set sampling for the arctan uniform distribution with application
Authors: Alyami Salem A. , Hassan Amal S. , Elbatal Ibrahim , Alotaibi Naif , Gemeay Ahmed M. , Elgarhy Mohammed
Published: March 2024

The arctan uniform distribution (AUD) is a brand-new bounded distribution that may be used for modeling a variety of existing bounded real-world datasets. Ranked set sampling (RSS) is a useful technique for parameter estimation when accurate measurement of the observation is challenging and/or expensive. In the current study, the parameter estimator of the AUD is addressed based on RSS and simple random sampling (SRS) techniques. Some of the popular conventional estimating techniques are considered. The efficiency of the produced estimates is compared using a Monte Carlo simulation. It appears that the maximum product spacing method has an advantage in assessing the quality of proposed estimates based on the outcomes of our simulations for both the SRS and RSS datasets. In comparison to estimates produced from the SRS datasets, it can be seen that those from the RSS datasets are more reliable. This implies that RSS is a more effective sampling technique in terms of generating estimates with a smaller mean squared error. The benefit of the RSS design over the SRS design is further supported by real data results.
Randomization Tests for Peer Effects in Group Formation Experiments
Authors: Basse Guillaume , Ding Peng , Feller Avi , Toulis Panos
Published: March 2024

Measuring the effect of peers on individuals' outcomes is a challenging problem, in part because individuals often select peers who are similar in both observable and unobservable ways. Group formation experiments avoid this problem by randomly assigning individuals to groups and observing their responses; for example, do first‐year students have better grades when they are randomly assigned roommates who have stronger academic backgrounds? In this paper, we propose randomization‐based permutation tests for group formation experiments, extending classical Fisher Randomization Tests to this setting. The proposed tests are justified by the randomization itself, require relatively few assumptions, and are exact in finite samples. This approach can also complement existing strategies, such as linear‐in‐means models, by using a regression coefficient as the test statistic. We apply the proposed tests to two recent group formation experiments.
Flexible Moral Hazard Problems
Authors: Georgiadis George , Ravid Doron , Szentes Balázs
Published: March 2024

This paper considers a moral hazard problem where the agent can choose any output distribution with a support in a given compact set. The agent's effort‐cost is
smooth and increasing in first‐order stochastic dominance. To analyze this model, we develop a generalized notion of the first‐order approach applicable to optimization problems over measures. We demonstrate each output distribution can be implemented and identify those contracts that implement that distribution. These contracts are characterized by a simple first‐order condition for each output that equates the agent's marginal cost of changing the implemented distribution around that output with its marginal benefit. Furthermore, the agent's wage is shown to be increasing in output. Finally, we consider the problem of a profit‐maximizing principal and provide a first‐order characterization of principal‐optimal distributions.
Flexible Ureteroscopy Lithotripsy Operative Time Prediction Model for the Treatment of Kidney Stones
Authors: Baidada Chafik , Aatila Mustapha , Lachgar Mohamed , Hrimech Hamid , Ommane Younes , Abderrahim Houlali
Published: March 2024

Effective time and resource management is crucial not only in the operating room but also in healthcare supply chains. Healthcare supply chains involve the movement of medical supplies, equipment, and medications from manufacturers to healthcare providers. Effective management is crucial to ensuring that patients receive the care they need promptly. In the operating room, it is essential to have an information process in place to effectively manage time and resources during the current surgical procedure. This paper focuses on developing a predictive model for the operating time of flexible ureteroscopy for kidney stones. The model can forecast surgical and preoperative time based on patient characteristics and surgeon experience. The model can assist in planning ureteroscopy procedures and preventing surgical complications, which is crucial not only for the operating room but also for healthcare supply chains. The paper presents a study that compares different feature selection methods and regression techniques. The study found that sequential backward selection combined with the extra tree regressor was the most effective approach.
Electricity Pricing, Electricity Access and Household Welfare in Lagos State, Nigeria: A Household Survey
Authors: Adaramola Abigail Bolade , Oderinde L. Oladele , Nweke-Eze Chigozie
Published: March 2024

This research work investigated Electricity Pricing in Relation to Households in Lagos State, Nigeria. The population covered household in three specific locations which include Ayobo, Iyana-Ipaja and Ikeja in Lagos State of Nigeria. A sample size of 383 was determined using Cochran Formula. Statistical methods used were percentage and frequency tables for the study. The results of the analysis revealed that majority of the respondents are less familiar with cost/pricing method of electricity in Nigeria. The study also revealed that there is negative welfare effect of the recent pricing adjustment on households in the selected study areas. The study recommended that awareness campaign should be organized by the Electricity distribution companies and other stakeholders with the use of jingles, radio presentation or text messages to all household in their areas of operation to educate them on the pricing methods of electricity.
Bilateral Thalamic Astrocytoma Presenting as Depression and Cognitive Impairment
Authors: Annigeri Bindu , Priyankha K , Raman Rajesh
Published: March 2024

The thalamus is the relay site for most afferent pathways. Thalamic lesions cause mental symptoms such as depressive symptoms, anxiety, poor attention and concentration, and memory disturbances. This case report describes a 35-year-old female patient who presented with sadness, disinterest in daily activities, anxiety, crying spells, and other mental symptoms. On detailed inquiry, she was also found to have reduced attention, concentration, and short-term memory disturbances, with no focal neurological deficit on examination. Imaging with magnetic resonance imaging brain revealed a bilateral thalamic low-grade astrocytoma. This case demonstrates that a careful understanding of the apathy and cognitive dysfunction in the presence of depression/anxiety is consequential. In this case, there is more to the clinical presentation of the symptoms of depression and anxiety than meets the eye. The expressionless face, apathy, and a certain degree of unawareness mark out the familiar depressive and anxiety symptoms from cognitive decline seen in thalamic lesions.
Venetoclax: A narrative drug review
Authors: Rajendra Akhil , Sengar Manju
Published: March 2024

B cell lymphoma 2 (BCL2) is frequently overexpressed in lymphoid and myeloid malignancies. Targeting BCL2 using venetoclax has significantly improved outcomes in patients with chronic lymphocytic leukemia (CLL) and acute myeloid leukemia (AML), resulting in its approval in the first line in both these diseases. Its role in the management of mantle cell lymphoma, multiple myeloma, and diffuse large B cell lymphoma (DLBCL) is also being explored. This review of venetoclax details the pharmacodynamics, pharmacokinetics, clinical indications, dosing strategies, methods to prevent tumor lysis syndrome, and dose modifications. To prepare this review, we comprehensively searched various websites, including that of the United States Food and Drug Administration (US FDA), European Medicines Agency (EMA) drug manual, PubMed, and UpToDate using the search terms, “Venetoclax,” “AML,” “CLL,” “Pharmacology,” and “hematolymphoid malignancy.” We shortlisted all the full-text articles published in the preceding 10 years. Out of a total of 397 manuscripts identified, we included 57. We also incorporated information from the abstracts and various conference proceedings.
Clinical and demographic profile of lower gastrointestinal malignancies: A retrospective observational study from Eastern India
Authors: Raj Shraddha , Singh Rajesh K. , Kumar Shishir , Devi Seema , Kishor Kunal , Sinha Dinesh K. , Madhawi Richa , Kumar Prince , Choubey Subhadra , Prakash Aman
Published: March 2024

Background:

Lower gastrointestinal (GI) cancers including colorectal and anal cancers are less common in India than in the rest of the world. Literature regarding these malignancies from Eastern India is scarce.

Objectives:

Our primary objective was to determine the clinical and demographic profile of patients with lower GI malignancies reporting to our center.

Materials and Methods:

This observational study was conducted in the Department of Radiation Oncology at State Cancer Institute, Indira Gandhi Institute of Medical Sciences in Patna (Bihar), a tertiary care center in Eastern India. The details of 1191 patients with lower GI cancers were extracted retrospectively from the Hospital-Based Cancer Registry from 2014 to 2021 and analyzed for basic clinical and demographic parameters. The total number of lower GI cancer cases over these consecutive calendar years was calculated. Calculation of annual percentage change (APC) and analysis of the time trend was done using Joinpoint regression software (4.0.1).

Results:

There were 1028 patients with colorectal cancer and 163 patients with anal cancer. The median ages at presentation were 49.5 (range, 12–92) years for colorectal cancer, and 48 (range, 12–85) years for anal cancer, with a male predominance (M:F ratio 1.7 [or 1.7:1 for colorectal cancer] and 2.7 [or 2.7:1 for anal cancer]) patients with colorectal cancer who were younger than 39 years (young colorectal cancer). The rectum (n = 594, 50%) was the commonest site involved. Nearly three-quarter patients (562 with colorectal cancer [74.7%] and 84 with anal cancer [73%]) presented with advanced disease (Stages III and IV). Chemotherapy was the most commonly administered treatment modality (colorectal cancer [n = 383, 37.1%] and anal cancer [n = 70, 43.1%]). There was a rising trend observed in the number of lower GI cancer cases with a significant APC (P < 0.01).

Conclusion:

The number of lower GI cancers is increasing as per the data from our hospital-based cancer registry in Eastern India. Greater frequency of advanced disease coupled with early age at presentation are causes concern. Measures to increase awareness and facilitate early diagnosis are urgently required. Population-based studies are required to validate these findings.
A narrative review of survival analysis in oncology using R
Authors: Pawar Akash , Chowdhury Oindrila R. , Salvi Omkar
Published: March 2024

Clinical trials in oncology largely include survival analysis, that is, the time to the occurrence of an event of interest as the primary outcome of the study. Survival analysis can be performed using non-parametric methods. In this review, we have provided the details of the statistical model for the probability of an individual surviving until time t. We have also discussed the use of the Cox proportional model to obtain the hazard or risk of occurrence of an event at a certain time while enrolled in the study. Hazard ratios and their confidence intervals are discussed and interpreted. We have also discussed the reporting of various survival endpoints, including the median recurrence-free and overall survival (in days and months), and the five-year recurrence-free and overall survival probability with 95% confidence intervals (CIs). We have discussed the P values obtained through the comparison of the survivals between various groups of patients and the methods of graphically representing the survival curves. To prepare this review, we searched the internet using Google for packages available for survival analysis on the Comprehensive R Archive Network (CRAN). We selected the Survival package and used the latest version 3.4-0. As an example, to demonstrate the methodology and applications, we used the rotterdam data set on primary breast cancer patients available in the Survival package, and the survminer package version 0.4.9 to visualize the survival curves. We have thus attempted to provide an easily understandable process for analyzing survival data using RStudio in the oncology setup. The results obtained by the listed procedure are accurate and highly dependable.
Randomized study assessing the cardiopulmonary toxicities from postoperative conventional versus hypofractionated radiotherapy in locally advanced left breast carcinoma
Authors: Saha Subhayan , Chatterjee Koushik , Mukherjee Pratyusha , Mondal Santu , Pal Santanu , Mitra Debabrata
Published: March 2024

Background:

Radiotherapy plays an important role in decreasing the risk of locoregional recurrence in patients with locally advanced breast carcinoma. However, radiotherapy can lead to late side-effects in the normal tissues.

Objectives:

We aimed to assess and compare the late toxicities in the heart and lungs in patients with left breast carcinoma who were treated with adjuvant conventional versus hypofractionated radiotherapy.

Materials and Methods:

This was a randomized study conducted between February 2019 and August 2021 in the Department of Radiotherapy at the Institute of Postgraduate Medical Education and Research and SSKM Hospital, Kolkata. Patients with histopathologically proven locally advanced left breast carcinoma who had undergone surgical resection were randomized to receive either hypofractionated radiation (39 Gy in 13 fractions) or conventional radiation (50 Gy in 25 fractions). Pulmonary toxicities were assessed through pulmonary function tests performed at baseline and every 6 mo, with measurement of the forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and the diffusion capacity of the lung for carbon monoxide (DLCO). Cardiac toxicity was assessed by measuring the left ventricular ejection fraction (LVEF) on echocardiography at baseline and every 6 mo after the completion of radiotherapy.

Results:

We analyzed the data of 51 patients, 27 on the hypofractionated arm and 24 on the conventional radiation arm. At 6 mo of follow-up, there were no statistically significant differences in the cardiopulmonary toxicities between the patients treated with either conventional or hypofractionated radiation. The mean reductions in the LVEF [1.48% (95% CI, 0.7–2.26) vs. 1.13% (95% CI, 0.49–1.77), P = 0.49], FVC [2.19% (95% CI, 1.21– 3.17) vs. 1.92% (95% CI, 1.18–2.66), P = 0.67], FEV1 [1.36% (95% CI, 0.44–2.28) vs. 0.96% (95% CI, 0.34 –1.58), P = 0.49], DLCO [2.96% (95% CI, 1.38–4.54) vs. 2% (95% CI, 0.92–3.08), P = 0.33] were similar between the hypofractionated and conventional radiation arms, respectively. Similarly, at 12 and 18 mo of follow-up, there were no statistically significant differences between the mean reductions in all the four parameters, and no differences in the 2-year survivals of the patients treated with the two radiation techniques.

Conclusion:

Hypofractionated radiation post-mastectomy does not lead to an increase in the late cardiopulmonary toxicities and may be considered a reasonable alternative to conventional fractionation in breast carcinoma.
A narrative review of the role of cross-sectional imaging in the management of thyroid carcinoma: Imaging guidelines and T-CIRADS
Authors: Mahajan Abhishek , Agarwal Ujjwal , Padashetty Shubham , Shukla Shreya , Smriti Vasundhara , Rastogi Shivam , Vaish Richa , Kumar Suman , D’Cruz Anil
Published: March 2024

Thyroid cancer is the most common endocrine malignancy and cross-sectional imaging plays an increasing role in management, especially for pre-surgical staging. It is important for the radiologist to know about the invasive nature of thyroid carcinoma and to highlight key imaging findings in the report thus permitting better surgical planning and improving surgical outcomes. For this review, we performed a comprehensive search of abstracts regarding the pre-operative markers in thyroid carcinoma and their key implications. We searched in PubMed, Cochrane CENTRAL, MEDLINE, Embase, and Google Scholar. This review article focuses on the major changes and key pre-surgical cross-sectional imaging findings mentioned in the 8th edition of the American Joint Committee on Cancer staging and the manner in which these changes should be incorporated in radiology reports. We conclude that the behavior and appearance of locally invasive thyroid cancer on computed tomography are crucial for the pre-operative evaluation of thyroid carcinoma. We also discuss synoptic reporting for thyroid malignancies, that is, T-CIRADS. Total thyroidectomy with possible removal of adjacent infiltrated critical structures along with neck dissection and post-operative risk stratification according to the American Thyroid Association is essential for an optimal curative result and survival.
Esophageal cancer imaging - reporting and data system (ECI-RADS) and post-therapy ECI-RADS (pECI-RADS): Comprehensive synoptic reporting formats for esophageal cancer imaging: A narrative review
Authors: Chakrabarty Nivedita , Mahajan Abhishek
Published: March 2024

Using a comprehensive synoptic reporting format effectively conveys the imaging findings from the radiologist to the treating physician/surgeon, relaying maximum relevant information in a standardized manner without missing any pertinent findings. We believe that two separate reporting templates are required for cancer image reporting: one for conveying baseline imaging findings on initial staging and the other for recording post-treatment findings. As no such reporting format is available for esophageal cancer on the American College of Radiology website, we have prepared two structured reporting templates: Pretreatment Esophageal Cancer Imaging–Reporting and Data System and Post-therapy Esophageal Cancer Imaging–Reporting and Data System to enable the radiologist to convey important findings pertaining to staging and post-therapy assessment of esophageal cancer. For this, we searched the internet using Google and referred to all the relevant articles and their references published in the preceding 25 years; we also included an article from 1984 because of relevance. In addition, we referred to the management guidelines of the National Comprehensive Cancer Network version 2.2022 for formulating the synoptic reporting formats.
Programmed death ligand (PD-L1) expression in invasive squamous cell carcinoma of the uterine cervix: A cross-sectional observational study
Authors: Chaudhary Nikhil , Raju Kalyani , Sheela SR , Sakalecha Anil Kumar , Manjunath G N
Published: March 2024

Background:

Normal cervical epithelium does not express programmed death ligand-1 (PD-L1) protein. Expression of PD-L1 has been reported in 50% cells of cervical carcinoma. Approximately 17% of adenocarcinomas and 35% of squamous cell carcinomas (SCC) of the cervix express PD-L1.

Objectives:

To determine the expression of PD-L1 in invasive SCC of the cervix and to correlate the expression with various clinicopathological parameters.

Materials and Methods:

This was a cross-sectional study conducted between July 2016 and June 2021 in the Department of Pathology, in collaboration with the Department of Obstetrics and Gynecology at the R. L. Jalappa Hospital and Research Center, Kolar, in South India. proportion of PD-L1 expression was evaluated on the biopsy specimens by immunohistochemistry (PD-L1 Antibody Biogenex AN921-M) and based on the PD-L1 positive cells, was scored as 0 (<5%), 1 (5–29%), 2 (30–59%), and 3 (>60%). We evaluated the association of PD-L1 expression with the clinicopathological parameters.

Results:

We included 90 cases of SCC of the cervix. The median age was 52.5 years (range, 30–74), with the majority of patients between the ages of 40–49 years. Overall, PD-L1 expression was noted in 66.7% cases of SCC of the cervix. PD-L1 marker expression increased with age, from 40–49 years (n = 14/28, 50%) to 70–79 years (n = 10/12, 83.3%); P = 0.037. PD-L1 expression was maximum (n = 40/47, 85.1%) in moderately differentiated SCC; there was a significant correlation between histological grade and PD-L1 expression; P < 0.001. There were no significant correlations between the PD-L1 expression and other clinicopathological parameters such as parity, clinical findings, disease stage, size of lesion, lymph node status, and overall survival.

Conclusion:

Two-thirds of cervical SCC cases express PD-L1. The PD-L1 expression is significantly associated with the patient’s age and the grade of the disease. Evaluation of PD-L1 expression in SCC of the cervix is important as anti-PD-L1/PD-1 immunotherapies can be used in PD-L1 positive cervical cancer.
Clinical Presentations of Melioidosis and Antibiogram of Burkholderia pseudomallei: An 8-year Study in a Tertiary Care Center, South India
Authors: Suseela Kundoly Velayudhan , Alex Aiswariya , Das Subi
Published: March 2024

Background:

Melioidosis, an infectious disease caused by Burkholderia pseudomallei, is endemic in tropical countries. In nonendemic areas, the disease is rarely suspected because of varying clinical presentations and only a few attempts are made to isolate the pathogen. Many cases are left underdiagnosed or underreported in geographical areas where the disease is not endemic. This study aimed to analyze the clinical presentations, comorbidities, and antibiotic susceptibility patterns in patients with melioidosis in a tertiary care center.

Materials and Methods:

A retrospective study was done on culture-confirmed melioidosis patients admitted to a tertiary care center, from January 2015 to December 2022. Relevant information on clinical presentations, mortality rate, comorbidities, and antibiogram was collected from hospital medical records.

Results:

A total of 73 culture-confirmed cases of melioidosis were included in the study. Common clinical presentations were pneumonia (n = 35, 47.9%), septicemia (n = 13, 17.8%), and deep abscesses (n = 9, 12.3%). The mortality rate from melioidosis was 15.1% (n = 11). No significant difference was found in the mortality rate between pneumonia and septicemia groups (P = 0.716). Diabetes mellitus (DM) was the major comorbidity detected (n = 56, 76.7%). Isolates were susceptible to ceftazidime (n = 71, 97.3%), meropenem (n = 71, 97.3%), and co-trimoxazole (n = 60, 82.2%).

Conclusions:

Common clinical presentations of melioidosis in our setting were pneumonia and septicemia. DM was the major comorbidity. Nearly one in six patients died. Ceftazidime and meropenem were the effective antibiotics. These findings may help physicians to make an early microbiological diagnosis which is essential to reduce mortality.
A Cross-sectional Study of Cutaneous Manifestations in Overweight and Obese Children
Authors: Thomas Ann Willie , Bhatia Anuradha , Sharma Monika
Published: March 2024

Background:

Overweight and obesity are a major public health problem and are now considered to be a global epidemic. The skin is one of the main organs to be affected due to metabolic abnormalities in obesity. The various cutaneous manifestations of obesity are directly related to the age of onset, duration, and severity of the underlying disease.

Aims:

The aim of this study is to determine the frequency and pattern of cutaneous manifestations in overweight and obese children.

Materials and Methods:

The present study was a cross-sectional study conducted among 150 overweight and obese children (according to the World Health Organization definition), of age group 5–19 years (school-going children) attending the dermatology and pediatrics outpatient department. The study utilized a prestructured pro forma to record demographic profile, weight, height, and body mass index; the different cutaneous manifestations were noted in overweight and obese children. Relevant investigations such as pus culture, potassium hydroxide (KOH) preparation, and skin biopsy were done wherever indicated.

Results:

Most of the patients were overweight (82%). Males (61.33%) outnumbered females (38.67%) in our study. Majority of the patients had acanthosis nigricans (74.67%), followed by striae distensae (32.67%), acne vulgaris (20%), and dermatophytosis (17.33%). Hidradenitis suppurativa was found in two children, and cellulite in one child.

Conclusion:

As obesity and its effects on the skin in school-going children are understudied by dermatologists and pediatricians, a proper examination and diagnosis of different cutaneous manifestations of obesity in children will further help in preventing multiple comorbidities in future.
A Case Report of Giant Tuberous Xanthoma with Type IIa Familial Hypercholesterolemia
Authors: Sharanya Bommakanti Sai , Logeshwari J. , Pinjala Padmaja , Thakur Rajeev Singh
Published: March 2024

Tuberous xanthomas are nontender, yellow to red papules to nodules that occur on the extensor surface, and trauma-prone areas such as the elbows, knees, Achilles tendon, and buttocks. A 10-year-old female child born out of second-degree consanguineous marriage presented with multiple skin-colored nodular lesions on axillary folds, both elbows, cubital fossa, medial side of the wrist, interphalangeal joints, buttocks, knees, popliteal fossa, and Achilles tendons. After complete evaluation, diagnosis of familial hypercholesterolemia type IIa with tuberous xanthoma was made. Tuberous xanthoma usually presents in combined type III dyslipidemias, but in our case, it is presented in type IIa familial hypercholesterolemia. Early diagnosis and treatment of familial hypercholesterolemia are important for preventing complications.
Eruptive Syringoma in a Case of Mucopolysaccharidosis Type IIIB-Sanfilippo B
Authors: Rajendran Arthi , Raviprakash Divya , Priyadarshini Anuradha , Adikrishnan S.
Published: March 2024

Eruptive syringoma is a rare clinical variant of syringomas and is commonly described in the setting of Down’s syndrome. Hereby, we report the case of a 22-year-old female presenting with multiple, small, skin-yellow-hyperpigmented, round-ovoid papules over the face, forearms, hands, lower abdomen, and thighs associated with facial dysmorphism, hepatomegaly, macular dystrophy, and behavioral disturbances. Histopathology of the cutaneous lesion revealed ductal epithelial cells forming tadpole structures suggestive of syringomas and whole exome sequencing confirmed the underlying genetic defect: mucopolysaccharidosis Type IIIB-Sanfillipo B syndrome. Hence, we present this rare case of eruptive syringomas associated with mucopolysaccharidosis.
Carbon Baby Syndrome: A Case Report with Review of Literature
Authors: Kumari Sandhya , Verma G. K. , Gulati Anchana , Negi Ajeet
Published: March 2024

Carbon baby syndrome also known as universal acquired melanosis is one of the rare causes of diffuse and progressive hyperpigmentation of the skin. A case of a 9-year-old Nepali child was reported in whom darkening of the skin began at the age of 5 months. At presentation, generalized hyperpigmentation was observed with characteristic sparing of pressure areas over the palms and soles. The diagnosis was established by histopathological evidence of epidermal and dermal melanization after the exclusion of all cutaneous and systemic causes for such hyperpigmentation. This case is reported for its rarity and unusual clinicohistopathological features.
Insulin-induced Panniculitis in a Child: A Rare Entity
Authors: Mendiratta Vibhu , Meena Amit Kumar , Verma Bharati , Bhattacharya Jenna
Published: March 2024

Insulin-induced panniculitis is a rare entity. It represents the early stage of development of lipoatrophy. The complex of insulin and insulin antibodies leads to the activation of macrophages, which is responsible for the initiation of autoimmune process and leading to panniculitis followed by subsequent development of lipoatrophy. Here, we report the case of insulin-induced panniculitis with lipoatrophy associated with Type 1 diabetes mellitus in an 11-year-old female child.
Cerebriform Intradermal Nevus Presenting as Cutis Verticis Gyrata: A Rare Presentation
Authors: Jaiswal Prashansa , Shukla Akhilesh , Rana Shiwangi , Shloka Shilpi
Published: March 2024

Cerebriform intradermal nevus (CIN) is one of the causes for secondary cutis verticis gyrata (CVG). Here, we report a 9-year-old boy with well-demarcated swelling over the left temporal area of his scalp since birth. The swelling was about 15 cm × 10 cm in size with cerebriform folds. It was soft in consistency and loss of hair was present. Histopathology confirmed CIN. This report serves as an example of a rare case of secondary CVG due to a CIN.
Comparison of efficacy and safety of three different concentrations of ropivacaine for labor pain management using patient-controlled epidural analgesia (PCEA): A double-blind, randomized controlled trial
Authors: Bihani Pooja , Vyas Medha , Soni Shikha , Jaju Rishabh , Janweja Sarita , Choudhary Usha
Published: March 2024

Background and Aims:

Labor pain is consistently ranked high on the various pain rating scales, when compared to other painful life experiences, and the experience of labor during the process of childbirth is both complex and subjective. Though patient-controlled epidural analgesia (PCEA) using dilute concentrations of local anesthetics (LAs) has been a popular method to control labor pain, yet the optimal dose and regimen for PCEA remain ambiguous. So, the present study was undertaken to evaluate the safety and efficacy of three different concentrations of ropivacaine for labor analgesia using PCEA.

Materials and Methods:

Seventy-five healthy nulliparous women who gave voluntary consent for labor analgesia using PCEA were randomly assigned to three groups to receive three different ropivacaine concentrations (0.0625%, 0.1%, and 0.125%) with adjuvant fentanyl 2 μg/ml, after double-blinding. Analgesic efficacy, neuraxial blockade, vital parameters, neonatal outcomes, maternal satisfaction, and side effects were assessed. Primary outcome was total dose of ropivacaine consumed in milligrams.

Results:

Number of pain breakthroughs (Visual Analog Score >4) and PCEA demand and rescue boluses were found to be statistically more in group 0.0625% (P < 0.01), followed by group 0.1% and were the least in 0.125%. Still, total drug consumed in milligrams was significantly less in 0.0625% group. Maternal satisfaction was comparable among the three groups (P = 0.33). There was no significant difference in maternal side effects and neonatal APGAR scores among the three groups.

Conclusion:

When three different concentrations of ropivacaine, that is, 0.0625%, 0.1%, and 0.125%, are used for labor analgesia, the use of 0.125% ropivacaine leads to higher total amount of ropivacaine consumed. Despite the lower efficacy in terms of breakthrough pain episodes observed with a 0.0625% ropivacaine concentration for labor analgesia, maternal satisfaction remained consistent across all three doses of ropivacaine. PCEA demand and rescue boluses for the lowest concentration, that is, 0.0625%; and did not affect maternal satisfaction with the management of labor pain.
Comparison of bolus dose administration of propofol and dexmedetomidine for incidence of emergence delirium in pediatric patients undergoing surgery with general anesthesia: A randomized, double-blind trial
Authors: Tharu Vidya , Paliwal Naveen , Bihani Pooja , Janweja Sarita , Jaju Rishabh , Kothari Sunil
Published: March 2024

Background and Aims:

Emergence delirium (ED) during the postanesthesia recovery phase presents significant challenges, especially among pediatric patients, with incidence rates spanning from 2% to 80%. This study sought to assess and compare the effectiveness of propofol and dexmedetomidine in addressing ED in pediatric patients undergoing sevoflurane anesthesia. The primary aim was to ascertain the prevalence of ED in both treatment cohorts, while secondary outcomes encompassed postoperative pain, hemodynamic responses, and the occurrence of complications.

Material and Methods:

Eighty children aged 2–6 years scheduled for short infraumbilical surgeries under general anesthesia were recruited in this trial. Propofol (1 mg/kg) or dexmedetomidine (0.3 μg/kg) was administered 10 min before completion of surgery. The Paediatric Anaesthesia Emergence Delirium scale was employed to evaluate ED every 5 min following extubation, wherein a score exceeding 12 was indicative of ED. Postoperative sedation was assessed using the Ramsay Sedation Scale, while pain levels were determined through the Face, Legs, Activity, Cry, and Consolability (FLACC) score. Any potential complications were closely monitored.

Results:

The incidence of ED at extubation was 2.50% and 70% in group D and P, respectively, and the trend of lower ED incidence was consistently observed at 5, 10, 15, and 30 min postextubation. The relative risk ratio at extubation was 4.103 (95% confidence interval: 2.49–6.76), highlighting a significant reduction of 4.1 times in the risk of ED when dexmedetomidine was administered. The dexmedetomidine group exhibited a lower incidence of postoperative pain.

Conclusion:

In comparison to propofol, dexmedetomidine demonstrated superior efficacy in reducing ED and postoperative pain in pediatric patients during general anesthesia, when administered before completion of surgery.
A concise review of the effect of efflux pump on biofilm intensity in bacteria with a special view to Mycobacterium
Authors: Fouladi Marjan Darbani , Besharati Saeid , Farnia Parissa , Khosravi Adnan
Published: March 2024

Excessive, arbitrary, self-medication, and misuse of antibiotics have caused widespread antibiotic resistance, but with the emergence of multiple antibiotic resistances, these concerns have increased. Efflux pumps are an important pathway involved in antibiotic resistance and can send the drug used in clinical cases out of the bacterial cell. Many studies show the role of these pumps in biofilm formation as well as increasing biofilm formation. Considering the effective relationship between antibiotic resistance from the efflux pump pathway and biofilm increase in bacteria, the purpose of this study was to investigate various aspects of the efflux pump pathway in biofilm exacerbation, especially in Mycobacterium. For this purpose, we studied more than 60 articles with keywords efflux pump, antibiotic resistance, biofilm formation, and Mycobacterium tuberculosis from valuable data sources such as PubMed, Scopus, Google Scholar, and Web of Science. Through the investigation, we came to the conclusion that the efflux pump is one of the main pathways of antibiotic resistance in bacteria, especially M. tuberculosis, which can increase the formation of biofilm in them, and as a result of this cooperation, the treatment process can become much more difficult. We suggest that all drug resistance pathways and their genes are investigated in the occurrence of other diseases, not only tuberculosis, in different geographical areas.
Tuberculosis Prevention, Diagnosis, and Treatment Financial Profile during 2006–2021: Part B
Authors: Madadi-Goli Nahid , Ahmadi Kamal , Meskini Maryam , Vaziri Farzam , Fateh Abolfazl , Siadat Seyed Davar
Published: March 2024

BACKGROUND:

Tuberculosis (TB) is a highly contagious infectious disease that is still considered one of the main causes of mortality associated with infectious diseases. To effectively prevent, treat, and diagnose TB, it is essential to analyze and interpret the funds allocated by health agencies and countries to treat, prevent, and diagnose TB.

METHODS:

In this study, the World Health Organization and research databases were used to analyze the financial status of TB prevention, diagnosis, and treatment over the past 20 years.

RESULTS:

Based on the results of this study between 2006 and 2021, Europe (22,469.488), Asia (18,708.125), and Africa (14,373.899) received the most funding (US $ million). Oceania (202.655) and America (3117.571) were allocated the lowest budgets (US $ million). The highest and lowest TB eradication budgets were in Asia and Oceania, respectively. As far as funding for drug-resistant TB is concerned, Europe and Oceania had the highest and lowest levels of funding between 2006 and 2021.

CONCLUSIONS:

Funding allocations for TB programs have generally been found to be the highest, potentially reducing the number of treatment-resistant TB cases and the devastating costs associated with this disease.
Guttate hypopigmentation in Darier disease: A rare presentation
Authors: Rout Aradhana , Pandey Ashish Kumar , Kishore Karthi
Published: March 2024

Darier disease (DD) is an autosomal dominant genodermatosis attributed to ATP2A2 gene mutation which encodes the sarco/endoplasmic reticulum Ca2+ATPase isoform 2. Due to variable gene expressivity, the clinical manifestations are often atypical and of varied severity. The classical feature of DD is the presence of firm yellowish brown flat to hyperkeratotic papules in a seborrheic distribution. Cobblestoning of oral mucosa and V shaped nicking of nails are also important associated findings of DD. Herein, we report a 35-year-old male patient with guttate leukoderma as a presenting feature of Darier disease with its clinical, histopathological, and dermoscopic findings.
Vitiligo-like lesions following imatinib mesylate therapy: a case series and review of literature
Authors: Saraswat Neerja , Neema Shekhar , Kumar Sushil
Published: March 2024

Imatinib mesylate (IM), a tyrosine kinase inhibitor, has become a standard of care for the management of chronic myeloid leukemia. The safety profile of IM is favorable; however, few adverse effects such as gastrointestinal disturbances, fluid retention, skin rashes, and myelosuppression have been reported. Hypopigmentation of the skin is a rare adverse effect of IM. In this report, we describe two cases of chronic myeloid leukemia who developed skin hypopigmentation while on IM.
Pigmented purpuric dermatoses: A review
Authors: Shekhar Neema , Eeshaan Ranjan , Tripathy Durga Madhab , Siddharth Mani , Bhavni Oberoi
Published: March 2024

Pigmented purpuric dermatosis (PPD) comprises a group of skin conditions characterized by flat, nonpalpable petechiae and purpura as a result of capillaritis. Although the precise cause of PPD is as yet unknown, increased vascular permeability and capillary fragility are key factors in its pathophysiology. PPD has diverse clinical presentations, but the histopathology of all these variants essentially remains the same. The initial purpuric lesions develop a golden-brown hue owing to hemosiderin absorption and eventually progress to chronic pigmentary changes. These lesions, which often affect the lower limbs, are either asymptomatic or accompanied by moderate pruritus, and can be difficult to diagnose and treat. There are several subtypes of clinical presentations that have been documented over the years. In order to accurately diagnose PPD, a thorough clinical evaluation and, occasionally, a biopsy may be required. It is essential to identify the condition and reassure patients of its benign nature. Treatment is usually necessary due to the chronic nature of the condition, its consequences on physical and mental well-being, and the presence of significant lesions or itching. In this review, we outline the various prevalent PPDs and discuss their etiopathogenesis, clinical features, and diagnostic and treatment modalities.
Linear atrophoderma of Moulin: case report of a rare disease
Authors: Sinha Preema , Ayub Afreen , Madakshira Manoj Gopal , Sharma Juhi
Published: March 2024

Linear atrophoderma of Moulin is a rare, acquired, mostly unilateral entity often presenting with hyperpigmented and atrophic band-like skin lesions that follow the lines of Blaschko. There is a considerable amount of overlap among disorders presenting along the lines of Blaschko. In this report, we discuss one such rare case along with its differential diagnosis.
A Deep Learning Approach for Ship Detection Using Satellite Imagery
Authors: Niranjan Alakh , Patial Sparsh , Aryan Aditya , Mittal Akshat , Choudhury Tanupriya , Rabiei-Dastjerdi Hamidreza , Kumar Praveen
Published: March 2024

INTRODUCTION: This paper addresses ship detection in satellite imagery through a deep learning approach, vital for maritime applications. Traditional methods face challenges with large datasets, motivating the adoption of deep learning techniques.
OBJECTIVES: The primary objective is to present an algorithmic methodology for U-Net model training, focusing on achieving accuracy, efficiency, and robust ship detection. Overcoming manual limitations and enhancing real-time monitoring capabilities are key objectives.
METHOD: The methodology involves dataset collection from Copernicus Open Hub, employing run-length encoding for efficient preprocessing, and utilizing a U-Net model trained on Sentinel-2 images. Data manipulation includes run-length encoding, masking, and balanced dataset preprocessing.
RESULT: Results demonstrate the proposed deep learning model's effectiveness in handling diverse datasets, ensuring accuracy through U-Net architecture, and addressing imbalances. The algorithmic process showcases proficiency in ship detection.
CONCLUSION: In conclusion, this paper contributes a comprehensive methodology for ship detection, significantly advancing accuracy, efficiency, and robustness in maritime applications. The U-Net-based model successfully automates ship detection, promising real-time monitoring enhancements and improved maritime security.
Basketball Anterior and Posterior Portal Veins Doppler Imaging of Sports Medicine Technique Exploration
Authors: Zhu Wei
Published: March 2024

INTRODUCTION: Basketball, as a high-intensity sport, has attracted much attention for its effects on the cardiovascular system of athletes. The anterior and posterior portal veins are some of the vital blood vessels in the human circulatory system, and their blood flow is closely related to the athletes' physical status. Doppler ultrasound technology is widely used in sports medicine and provides a powerful tool for an in-depth understanding of the effects of basketball on portal vein blood flow. This study aimed to explore the potential of sports medicine technology in assessing cardiovascular adaptations in athletes through portal Doppler imaging before and after basketball exercise.OBJECTIVES: The primary objective of this study was to analyze the effects of basketball exercise on portal vein blood flow in athletes before and after basketball exercise through the use of Doppler ultrasound technology. Specifically, this study aimed to explore the dynamics of pre- and post-exercise Doppler imaging of the posterior and posterior veins in order to assess the cardiovascular adaptations of athletes during exercise more comprehensively and objectively.METHODS: A group of healthy professional basketball players were selected as the study subjects, and Doppler ultrasound instruments were utilized to obtain portal Doppler images before, during, and after exercise. The functional status of the vasculature was assessed by analyzing parameters such as portal blood flow velocity and resistance index. At the same time, the physiological parameters of the athletes, such as heart rate and blood pressure, were combined to gain a comprehensive understanding of the effects of basketball on portal blood flow.RESULTS: The results of the study showed that the anterior and posterior portal blood flow velocities of the athletes changed significantly during basketball exercise. Before the exercise, the blood flow velocity was relatively low, while it rapidly increased and reached the peak state during the exercise. After exercise, blood flow velocity gradually dropped back to the baseline level. In addition, the change in resistance index also indicated that portal blood vessels experienced a particular stress and adaptation process during exercise.CONCLUSION: This study revealed the effects of exercise on the cardiovascular system of athletes by analyzing the Doppler images of the portal vein before and after basketball exercise. Basketball exercise leads to significant changes in portal hemodynamics, which provides a new perspective for sports medicine. These findings are of guiding significance for the development of training programs for athletes and the prevention of exercise-related cardiovascular problems and provide a valuable reference for further research in the field of sports medicine.