bluuebunny/crossref_metadata_2025 huggingface dataset:
Subacute sclerosing panencephalitis with a fulminant course: Case series
Authors: Bhandari Ankkita Sharma , Khanna Laxmi , Kumar Praveen , Gourie-Devi Mandaville
Published: August 2024

Subacute sclerosing panencephalitis (SSPE) is a life-threatening and delayed complication of measles. It may rarely follow a fulminant course, with rapid progression to a vegetative state. There have been case reports of this challenging and aggressive form of SSPE in previously immunised children. The cause of the rapid progression in many patients is unknown. However, it is postulated that genetically determined immune dysfunction can prevent cell-mediated immune clearance of the measles virus. This was a retrospective study of five patients who presented with clinical features and laboratory investigations suggestive of fulminant SSPE over the previous year. The diagnosis of SSPE was established using Radermecker’s complexes in electroencephalogram, encephalitis on brain magnetic resonance imaging and elevated titres of immunoglobulin (Ig) M and IgG measles antibodies in the serum and cerebrospinal fluid. Treatment included isoprinosine, intravenous Igs, sodium valproate, levetiracetam and clobazam. The outcome was dismal in all patients, with progression to a bedridden state despite timely intervention. In our series of five cases, the diagnosis of SSPE was often missed because the children were immunised and healthy before the onset of symptoms. However, after excluding other central nervous system viral infections, the clinical presentation and laboratory findings corroborated the fulminant course of SSPE. This article captures the presentation and outcomes of five patients and emphasises the importance of clinicians’ awareness of this condition.
Comparison of oral indices in patients with Down syndrome and healthy individuals: A meta-analysis study
Authors: Nilchian Firouzeh , Mosayebi Neda , Tarrahi Mohammad Javad , Pasyar Hamidreza
Published: August 2024

Background:

The aim of the present study was to compare dental indexes of pediatric Down syndrome (DS) patients to those who are healthy.

Materials and Methods:

This study was carried out based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement guidelines. The researchers searched title and abstract of major databases, including ProQuest (ProQuest Dissertations and Theses Full Text: Health and Medicine, ProQuest Nursing and Allie Health Source), PubMed, Google Scholar, clinical key, up to date, springer, Cochrane, Scopus, Embase, and Web of Science (ISI), up to September 2020 with restriction to English and Persian language This meta-analysis study had three outcomes: decay/miss/filled index, plaque index, and gingival index. Effect size, including mean difference and its 95% of confidence interval, was calculated. The Newcastle–Ottawa Scale measured the quality of the selected studies. Heterogeneity was performed using the Q test and I
2 index, and reporting bias was assessed using a funnel plot and Egger and Begg’s tests.

Results:

Fifteen studies conducted were included in the meta-analysis process.

Conclusion:

It showed that DS patients had a higher plaque index and gingival index than healthy individuals, which means that the oral health status of these patients is worse and needs more attention.
Cyclin D1 and Ki-67 expression and its correlation with histopathological parameters and cervical lymph node metastasis in oral squamous cell carcinoma
Authors: Khalesi Saeedeh , Maleki Laleh , Eskandari Shahnaz , Dehabadi Foad Zare , Kohpaee Amirhossein Yousefi
Published: August 2024

Background:

Oral squamous cell carcinoma (OSCC) is the most common malignant tumor among oral cancers. Cyclin D1 and Ki-67 have associated with cell division. The aim of this study was to compare the expression of these markers in OSCC with and without cervical lymph node (LN) metastasis.

Materials and Methods:

This cross-sectional study was performed on 40 OSCCs with and without cervical LN metastasis (20 in each group) that was recorded in the pathology archive of Ayatollah Kashani Hospital in Isfahan. Clinical information including age, gender, and location was collected. Some histopathological parameters including depth of invasion, lymphovascular invasion (LVI), perineural invasion (PNI), number of LN metastases, histopathological grade, and stage of disease were evaluated. Immunohistochemical staining was performed for cyclin D1 and Ki-67. All data were entered into SPSS24 software and were analyzed by Mann–Whitney, Kruskal–Wallis, Chi-square, Fisher’s exact, and t-tests. P < 0.05 was considered statistically significant.

Results:

Based on LVI and stage of disease, a significant correlation was found between the two groups (P < 0.001). There was a significant difference between the two groups based on cyclin D1 expression (P = 0.05). The expression of the Ki-67 showed a significant difference based on tumor location (P = 0.026) and PNI (P = 0.033).

Conclusion:

The use of markers should be considered in determining the prognosis of OSCC, and the cyclin D1 marker is one of the useful markers for predictors of cervical LN metastasis.
Pilomatricoma Growing at the SARS-CoV-2 mRNA Vaccination Site
Authors: Erkayman Merve Hatun , Güven Melike , Bingöl Merve , Bulut Numan , Demirtaş Rabia
Published: August 2024

A healthy 21-year-old woman was presented to our outpatient clinic with an asymptomatic swelling on her left arm. She reported the administration of two doses of BNT162b2 mRNA vaccination at the lesion site earlier. The pathology report confirmed the diagnosis of pilomatricoma. Previously, needlestick trauma and various immunisations have been attributed to the development of pilomatricoma. We present this case to emphasise the possible association between BNT162b2 mRNA vaccination and pilomatricoma development. The role of persistent inflammation is also discussed.
Clinico-Epidemiologic Attributes of 515 Persons Living With Human Immunodeficiency Virus Infection/Acquired Immunodeficiency Syndrome on Antiretroviral Therapy
Authors: Mahajan Vikram K. , Gupta Mrinal , Sharma Rajni , Shiny TN , Gupta Sarita , Rashpa Rattan S.
Published: August 2024

Objectives:

To study the clinico-epidemiologic attributes of persons living with HIV/AIDS on highly active antiretroviral therapy (HAART).

Methods:

Clinico-epidemiological details, CD4 counts, previous illness and mucocutaneous diseases were studied in 515 persons living with HIV/AIDS on HAART.

Results:

The study comprised 250 (48.5%) males and 265 (51.5%) females aged between 10 and 79 (mean 38.9) years. The 196 (38%) males were drivers, staying-alone laborers/self-employed, and 253 (49.1%) females were homemakers. All were on HAART for one month to 9 years. Heterosexual transmission was noted in 478 (92.8%) individuals. The 274 (53.5%) individuals had 200–350 CD4 cells/mm3 counts, whereas it was <200 cells/mm3 in 88 (17.2%) individuals. Candidiasis (in 48), dermatophytoses (n = 23), herpes labialis (n = 13), herpes zoster (n = 12), seborrheic dermatitis (n = 29), generalized pruritus (n = 22), and xerosis in 20 individuals were the most common dermatoses. Most dermatoses occurred with 200–350 CD4 cells/mm3. Adverse drug reactions from antiretroviral therapy (ART) and concurrent therapies also occurred.

Conclusions:

Although most of our patients had mild HIV-associated dermatoses while on HAART, adverse drug reactions from HAART or concurrent therapies themselves remain a potential risk. Nevertheless, knowledge of these aspects will help planning for comprehensive health care envisaged in the National AIDS Control Program phase IV.
Cytomorphological Spectrum of Malignant Melanoma
Authors: Kaur Ashmeet , Hemrajani Deepika , Harsh Anita , Vijay Urvashi , Wadhwani Deepa
Published: August 2024

Background:

Melanoma is an aggressive malignant tumor with high metastatic potential. FNAC provides a quick and effective tool to diagnose primary and metastatic melanoma cases.

Aims and Objectives:

To document the epidemiological features of malignant melanoma cases attending in a tertiary care centre in India, with special reference to different cytomorphological parameters.

Materials and Methods:

This was a retrospective hospital based study done in the Department of Pathology. 39 cases of malignant melanoma diagnosed on cytology during a period of 3 years were retrieved, reviewed and studied.

Results:

Out of the 39 cases,21 were males(1.16 male:female ratio). The mean age was 53 years. Metastatic cases were more common than primary melanoma cases. Most common site for metastasis was liver followed by inguinal lymph node. Epitheloid was the most common pattern.

Conclusion:

Characterstic melanin pigment although common, is not always present. Thus, cytopathologists must know the various cytomorphological spectrum of features of melanoma.
Role of Trichoscopy in Evaluation of Alopecia Areata
Authors: Sahu Vineet K , Datta Adrija , Sarkar Tanusree , Gayen Tirthankar , Chatterjee Gobinda
Published: August 2024

Background:

Alopecia areata is an autoimmune disorder affecting the hair-bearing sites of the body. Trichoscopy has recently been practiced in the diagnosis of alopecia areata.

Aim:

To elicit trichoscopy patterns in alopecia areata and to find out any correlation of trichoscopic findings with disease severity.

Methods:

Trichoscopy was done on clinically diagnosed cases of alopecia areata and on age and sex-matched controls without hair disorders by using a DL1 dermoscope (magnification: ×10). Observed dermoscopic findings were analyzed to find the correlation with disease severity.

Results:

In total, 87 cases and 60 controls were included in the study with the mean age for cases being 25.47 ± 14.07 years. There was male predominance of cases (51; 58.62%). Alopecia in multiple patches was the most common type (42; 48.27%), and scalp was the most common site of involvement (79; 90.8%). Yellow dots (YD), black dots (BD), broken hairs (BH), circle hair (CH), and tapering hairs (TH) or exclamation hair (EH) were found to be statistically significant findings in alopecia areata as compared to controls. Circle hair was significantly associated with total severity of alopecia areata (P = 0.041). Yellow dots had a positive correlation with the number of episodes of alopecia areata (Spearman's rho = 0.273, P = 0.0106) and mean severity of alopecia tool (SALT) score (P = 0.0130). No significant association was noted between trichoscopic findings and disease activity, family history, disease associations, or nail involvement.

Conclusion:

A constellation of trichoscopic findings helps in establishing the diagnosis of alopecia areata obviating the need for biopsy.
Angina Bullosa Hemorrhagica – A Case Series
Authors: Patigaroo Suhail A. , Sangoo Mushtaq , Maqbool Tabish , Qayoom Seema
Published: August 2024

Angina bullosa hemorrhagica (ABH) is an oral subepithelial blood blister with poorly understood etiopathogenesis, which is not attributable to blood dyscrasias or vesiculobullous disorders. These hemorrhagic bullae spontaneously rupture within minutes to hours, resulting in ragged, often painless, superficial erosions that heal spontaneously within 1 week without scarring. The lesions are usually solitary, and sometimes cause extreme anxiety in patients. Treatment is generally symptomatic. We report a series of four such patients. No treatment was given, except for reassurance and anxiolytics.
Case series on Silvery Hair Syndromes
Authors: Siddiahgari Sirisharani , Soma Santosh Kumar , Penmetcha Chandravathi , Vaddadi Sandhya , Bandi Varshini , Lingappa Lokesh
Published: August 2024

Background:

Silvery Hair Syndromes (SHS), an autosomal recessive inherited disorder, includes Chediak–Higashi syndrome (CHS), Griscelli syndrome (GS), Hermansky–Pudlak syndrome (HPS), and Elejalde syndrome. Associated immunological and neurological defects and predilection for hemophagocytic lymphohistiocytosis (HLH) makes them a distinctive entity in pediatric practice. Thorough clinical examination, bedside investigations such as peripheral blood smear (PBS) and hair microscopy, and bone marrow (BM) examination are inexpensive and reliable diagnostic tools.

Methods:

We report 12 cases with SHS (CHS, n = 06; GS, n = 04; HPS, n = 02).

Results:

8 out of 12 SHS children (CHS-05, GS-03) presented with HLH. Out of 5 cases of CHS with HLH, 2 died, 3rd is stable post-chemotherapy; 4th completed chemotherapy, underwent matched related hematopoietic stem cell transplant (HSCT), and is stable 8 months off treatment. The 5th child completed chemotherapy and is in process of transplant. One CHS child without HLH is thriving without any treatment. Of the 4 GS cases, 3 presented with HLH and received chemotherapy (HLH 2004 protocol). One lost follow-up after initial remission; another had recurrence 7 months off treatment and discontinued further treatment. The third child had recurrence 1.5 years after initial chemotherapy; HLH 2004 protocol was restarted followed by HSCT from matched sibling donor; is currently well, 2.5 years post-transplant. One child with GS had neurological features with no evidence of HLH and did not take treatment. Of 2 children with HPS, one presented with severe sepsis and the other with neurological problems. They were managed symptomatically.

Conclusion:

In SHS with HLH, chemotherapy followed by allogeneic hematopoietic stem cell transplantation is a promising curative option.
De Sanctis-Cacchione Syndrome with Subdural Effusion
Authors: Kapat Aritra , Roy Gourab , Bhattacharjee Angana , Mandal Asok K. , Bala Ashok K. , Podder Indrashis
Published: August 2024

De Sanctis-Cacchione syndrome (DCS) formerly known as xerodermic idiocy is characterised by cutaneous photosensitivity, microcephaly, mental retardation, short stature, hypogonadism, spasticity, peripheral neuropathy and sensorineural deafness. Here in, we present the case of a four and half years old male child with features of severe acute malnutrition (SAM) with a typical bird like facies and sunken eyes who had history of photosensitive pruritic pigmentary skin lesions on sun exposed areas from a very early age of six months. Gross developmental delay, ataxia, microcephaly, short stature, hypogonadism and cachectic wasting were identified on examination and hypertransaminasemia and hypothyroidism were recorded from biochemical profile. Subsequent visual evoked response and brainstem evoked response audiometry revealed anterior visual pathway dysfunction and bilateral profound sensorineural hearing loss. Magnetic resonance imaging of brain yielded subdural effusion with mass effect in addition to cerebro-cerebral atrophy and demyelination. Skin biopsy further detected dysplastic changes and early signs of squamous cell carcinoma (SCC). Although few cases are reported sporadically throughout the world, to our best of knowledge till date only 11 such cases have been reported completely in Indian medical literature which makes our case report the 12th one with distinctive novel association of subdural effusion.
Trichophyton
Authors: Chatterjee Manas , Datta Debatri
Published: August 2024

Trichophyton interdigitale had been regarded as anthropophilic, mainly causing non-inflammatory tinea unguium and tinea pedis. T. mentagrophytes, thought to be zoophilic, were regarded as responsible for more inflammatory dermatophytosis. Indian terbinafine-resistant strains, identified with ribosomal internal transcribed spacer as 'genotype VIII', have recently been termed Trichophyton indotineae based on clinical and mycological features. Some of these have shown selective azole resistance as well. Phenotypic studies have shown some similarities and some differences between Trichophyton indotineae, T. mentagrophytes, and T. interdigitale, which are optimally distinguished with HMG locus analyses as three main genotypic groups containing the type strains of T. indotineae (CBS 146623), T. interdigitale (CBS 428.63), and T.mentagrophytes (IHEM 4268) and having approximate differences in geographic distribution. Trichophyton interdigitale was prevalently isolated from superficial infections on exposed body sites such as the scalp and face, while also feet and nails. Trichophyton mentagrophytes has a similar predilection but are also often found on the trunk and genitals. Trichophyton indotineae is mostly restricted to the trunk and groin. T. indotineae lesions are generally highly inflammatory, strongly associated with tinea cruris, corporis, and faciei and less commonly with fingernail onychomycosis and tinea pedis. They cause papulosquamous, pustular, pseudo-imbricata (tinea faciei), lichenoid, and pityriasis rosea (tinea corporis of the neck) types of lesions and spread rapidly to multiple sites and cause painful lesions with itching or burning. Lipolytic abilities of T. mentagrophytes and T. interdigitale are very similar and are higher than those of T. indotineae, which is associated with a higher prevalence of T. mentagrophytes on the human scalp, which is relatively rich in lipids. Keratin degradation is significantly larger in T. interdigitale due to location (tinea pedis and tinea unguium). Identification of T. indotineae through culture alone may not be sufficient for effective treatment decision-making; genetic analysis for resistance profiles is needed for optimum treatment selection. In India, steroid-induced suppression of local cellular immunity as well as an altered cutaneous microbiome provided a window of opportunity for the unique, multidrug-resistant species Trichophyton indotineae.
Cutaneous Dysbiosis and Dermatophytosis
Authors: Ghosh Aparajita , Panda Saumya
Published: August 2024

The skin, besides being the largest interface between the body and the external environment, also forms an ecological niche which is populated by almost a trillion microorganisms. These, collectively known as the cutaneous microbiome, form a dynamic yet well-controlled system that resists invasion by pathogenic microorganisms, functioning as the so-called ‘microbiological barrier’, modulating the body's immune response, indirectly playing a crucial role in the pathogenesis of several inflammatory diseases. The composition and complexity of the microbiome are yet to be fully understood. The term ‘dysbiosis’ originally was coined in 1908 for a change in the gut microbiome. The potential role of ‘cutaneous dysbiosis’ in human dermatophytic infections, especially in the backdrop of the current epidemic of chronic, recurrent and treatment-resistant dermatophytosis, is understandably a topic of interest. The purpose of this review was to assess all studies using culture-independent methods for analysing the skin microbiome in various dermatophyte infections. The PubMed and Google Scholar databases were searched using the terms ‘microbiome’, ‘dysbiosis’, ‘dermatophytes’, ‘dermatophytosis’ and ‘tinea’. All studies involving the use of standard sequencing methods for the study of the microbiome in various dermatophytoses were included. A total of four studies assessing the local skin microbiome associated with dermatophytic infections were found—one for tinea capitis, one for onychomycosis (in both psoriatic and nonpsoriatic nails) and two studying patients of tinea pedis. The studies determined the microbiological patterns in patients and compared them with healthy individuals using sequencing methods. Significant differences in the species diversity and counts of the various microorganisms between patient and control groups were demonstrated in all. However, cross-sectional design and the absence of pre- and post-treatment data along with a limited sample size were the major limitations in all of them. No data regarding other forms of tinea, most importantly, tinea cruris, corporis, faciei, etc. were found. The existing studies demonstrate a change in the microbiome or dysbiosis associated with cases of dermatophytosis, but are inadequate to determine a causal association. The changes may also be wholly or partly attributed to the effect of the infection. Further longitudinal studies from different regions of the world, also involving other forms of dermatophytosis, are required to provide a clearer insight and a more representative picture.
Clinical and Pathological Features of Persistent Decorative Tattoo Reactions
Authors: Suárez-Peñaranda José M. , Fachal Carmen , Blanco-Bellas Maria , Ginarte Manuel , Monteagudo Benigno , León Alvaro , González-Carril Fernando
Published: August 2024

Persistent, non-infectious medical complications arising from decorative tattoos have increased considerably. They are difficult to characterize clinically, and histopathology shows a wide variety of overlapping patterns, with lichenoid and granulomatous dermatitis being the most common findings. Both clinical and pathological findings are difficult to ascribe to particular ink colour. The findings in 30 biopsies from 28 patients with persistent reactions in decorative tattoos are reported, including immunohistochemical findings.
Screening and Selection of Hispaglabridin B as a Lead Compound in Colon Cancer Treatment
Authors: Malayandi Sankar , Marimuthu Sivasankari , Jayanthi Antonisamy Arul
Published: August 2024

Introduction:

Colon cancer is the third largest cause of cancer-related death according to a survey report by GLOBOCAN 2020. Though several common conditions, including family history and personal health care, are reported as the causes of colon cancer, the real cause of colorectal cancer is unrevealed. Treatment with chemical drugs like 5-fluorouracil in combination with radiation therapy can help to shrink tumor size. Surgical procedures can also be performed at the early stage along with the administration of drugs. However, the available treatment strategies are equally toxic to healthy cells and, in general, are nonspecific. The side effects of chemical drug administration are very devastating. Hence, natural phytochemicals can be a better choice for treating cancer.

Materials and methods:

In this article, in silico screening of plenty of phytochemicals from 200 different plants was performed. Databases such as PubChem, Drugbank, ChemSpider, eMolecules, and Chembank were used for extracting structures of phytochemicals including flavonoids, alkaloids, peptides, steroids, or any other organic compounds, and used as ligands. Vital proteins involved in colon cancer pathways are extracted from the protein data bank based on the output from the KEGG pathway database and Cytoscape network analysis. AutoDockPyRx Python prescription-0.8 was used to predict the possible ligands and their targets using a structure-based drug discovery approach.

Results and Discussion:

Hispaglabridin B showed interaction with a maximum number of target proteins at low binding energies. Swiss target prediction was used to find other potent targets for the selected ligand. The binding pocket analysis showed that hispaglabridin B binds to the same position as the known inhibitor of the target protein. The amino acids involved in the protein and hispaglabridin B interaction were also studied. Polar, hydrophobic, hydrogen bond, and charge-based interactions were dominant between hispaglabridin B and its targets. PASS online was used to check the biological potential of hispaglabridin B. The drug likeliness properties and ADME characteristics of hispaglabridin B were checked using DruLiTo and Swiss ADME, respectively. The toxicity of hispaglabridin B was analyzed using preADMET and was found safe. Hispaglabridin B was not available in the drug bank, and its structure was predicted to be an isoflavonoid. Isoflavanols are polycyclic compounds containing a hydroxylated isoflavone skeleton and an aromatic hetero-polycyclic molecular framework. From the literature, the most abundant source of hispaglabridin B was found to be Glycyrrhiza glabra.

Conclusion:

Hence, it is concluded that hispaglabridin B could be a potential lead for developing an effective colon cancer drug.
Impact of the Drying Techniques on the Functional Properties of Citrus sinensis (Sweet Orange) Fruit − A Review
Authors: Derose J. Shiny , Nagamaniammai G. , Daradkeh Ghazi , Qoronfleh Walid M. , Al-Mahrizi Marwa
Published: August 2024

Citrus sinensis, commonly known as sweet orange, is rich in antioxidants and widely produced worldwide. Sweet orange consists of the water-soluble vitamins C, B1, B2, essential oils, and phenolic components. This fruit is known for its health benefits such as immune booster, digestive aid, anticancer activity, and cardioprotective activity. Its shelf life is low and also it contains high moisture content and so drying of oranges can be done. This review compared the following drying methods: sun drying, spray drying, freeze-drying, microwave drying, inert fluidized bed drying, ultrasonic drying, and infrared drying. Both thermal and nonthermal drying techniques had an influence on the functional properties of the dried orange powder. The comparison of the drying techniques determined relationship between the temperature of the drying process and its subsequent changes on the orange components. At higher drying temperature, it was reported to have a lower color, higher browning effect, lower total phenol content, lower total flavonoid content, and lowered antioxidant activity in dried orange samples. Further studies should be done to determine a method for drying oranges which provides high yield with low power consumption, temperature, and cost.
Soy – Sorghum Milk as a Functional Drink Source of Antioxidants
Authors: Fadly Dzul , Tulaseket Fadila , Rahmawati Rahmawati , Sakriawati M , Putriana Armenia Eka , Septiyanti Septiyanti , Mujahidah Fatimah Fitriani , Wirawanti Ika Wirya , Suherlin Nicen , Febristi Anisa , Muttalib Yuges Saputri
Published: August 2024

Background:

With the increasing need for antioxidants as a support for health, this study was conducted to determine the functional potential of drinks made from soybeans and sorghum by determining organoleptic, proximate, and antioxidant activity properties.

Methods:

In this study, the formulations of soy milk (Glycine max (L.) Merill) added with sorghum (Sorghum bicolor (L.) Moench) were including F1 (100% soy milk), F2 (90% soy milk: 10% sorghum), F2 (80% soy milk: 20% sorghum), and F3 (70% soy milk: 30% sorghum). The organoleptic test consisted of a hedonic test and a hedonic quality test involving 25 semitrained panelists measured using an analogue visual scale (0–10). Antioxidant activity identification was determined through the 2,2-diphenyl-1-picrylhydrazyl (DPPH) method.

Results:

This study found that sorghum’s addition to soy milk significantly affected the hedonic quality value of aroma and texture (P<0.05). Meanwhile, it also significantly affected the protein, fat, and ash content (P<0.05). The addition of 20% sorghum in F2 showed the best characteristics of organoleptic values, with carbohydrate 4.02±2.07%, protein 1.91±0.35%, fat 1.07±1.07%, water 92.74±2.13%, and ash 0.26±0.001%. The addition of sorghum tends to increase the antioxidant capacity of soy-sorghum milk functional drinks. The soy milk products with 20% sorghum possessed antioxidant capability in Half-maximal inhibitory concentration (IC50) about 28.45 ppm and categorized as strong antioxidants.

Conclusion:

Thus, this soy-sorghum milk product potentially being a functional drink source of antioxidants.
Role of Early Maladaptive Schemas and Alexithymia in the Relationship Between Perceived Parenting Styles in Moroccan Psychoactive Substance Users
Authors: Karjouh Khadija , Azzaoui Fatima-Zahra , Boulbaroud Samira , Samlali Wafae Idrissi , Ahami Ahmed
Published: August 2024

Context:

Many studies have reported that inadequate parental styles can contribute to alexithymic symptoms through maladaptive dysfunctional cognitive styles.

Aims:

To investigate the relationship of dysfunctional schemas and recalled parenting attitudes with alexithymia and other symptomatology, as well as to evaluate the effect of early maladaptive schema (EMS) and alexithymia such as moderators and mediators in the relationship between the perceived parenting styles (PS) among patients with substance use disorders (SUDs).

Methods:

The study sample consists of 451 Psychoactive Substance (PAS) users, aged between 13 and 67 years of age. The data collection took place in the addictology center of Rabat, Morocco. The Young Schema Questionnaire-Short Form, the Young Parenting Inventory, the 20-item Toronto Alexithymia Scale (TAS-20), the State-Trait Anxiety Inventory, the Columbia-Suicide Severity Rating Scale, and the Rosenberg Self-Esteem Scale were used. Descriptive statistics tests and hierarchical multiple regression were executed.

Results:

First, the sample was classified into two groups as “alexithymic” (n = 330) and “nonalexithymic” (n = 121) according to the scores obtained from TAS. The analysis showed that the alexithymic group perceived both their attitudes of mother and father negatively, possess more severe EMSs, and women face more difficulties in the emotion regulation, experienced greater EMS than the men group, and the association between parenting and alexithymia was moderated by EMS. On the contrary, the results supported meditational models in which PS are associated with the cognitive schemas, and these, in turn, are related to alexithymia.

Conclusions:

Correlations between childhood experiences and alexithymia in adulthood are mediated by dysfunctional schemas.
Relationship of Serum Cytokine Profile to Steroid Resistance in Demyelinating Neurologic Illnesses
Authors: Markandeyan Devaprasad , Ulaganathan Mabalirajan , Pathak Surajit , Vengalathur Ramesh Ganesan
Published: August 2024

Background and Purpose:

Corticosteroids form main stay of treatment of autoimmune neurological diseases. Immunotherapy with Intravenous Immunoglobulin, Plasmapheresis, biological agents like Rituximab, Infliximab, etanarcept are also used for treatment of patients who are resistant to steroid treatment and in severe cases. This study was aimed to elicit the relationship between serum cytokine levels and steroid resistance which is important for early commencement of other medications.

Methods:

The serum samples of patients who presented with autoimmune neurological diseases were collected and cytokine levels were estimated. The cytokine profile of patients who responded well to steroid treatment was compared with that of steroid nonresponders.

Results:

The steroid unresponsive group had significantly higher serum Interferon gamma and IL-13 levels than steroid unresponsive group.

Conclusion:

when patients present with high serum levels of IL-13 and Interferon Gamma they should be considered for prompt escalation of immunomodulatory therapy.
Preparation and evaluation of sustained release dosage forms for posttransplant care
Authors: Bhupathyraaj Mullaicharam , Ahuja Alka , Halligudi Nirmala , Pole Sushma , Al Balushi Hiba Salim , Al Kaabi Halima Ahmed , Desai Saleem M.
Published: August 2024

Aim:

The purpose of the study was to prepare and characterize microbeads for oral sustained release of tacrolimus.

Design, methodology, and approach:

Tacrolimus-based microbeads were developed by ionic gelation method. Xanthan gum, chitosan, and sodium alginate were used as polymers for aqueous internal phase using calcium chloride as a cross-linking agent. The microbeads were evaluated for morphologic features by scanning electron microscopy, percentage yield, drug entrapment, and in vitro drug release.

Findings and implications:

Microbeads were examined for the effects of various variables in formulation process. The cross-linking reaction between sodium alginate and calcium chloride for being converted into calcium alginate in the formulation process was used in the microencapsulation of tacrolimus core material. The results showed the compatibility of the drug with the polymers in the formulation as observed in Fourier-transform infrared spectroscopy studies. The formulated microbeads showed high percentage yield and drug entrapment efficacy and the optimized formulation showed a delayed release effect following zero-order mechanism of release.

Conclusion:

Ionotropic gelation method was found to be a suitable method for preparing tacrolimus microbead-sustained-release drug delivery system. Chitosan and xanthan gum polymers showed potential in aiding the formulation of sustained release tacrolimus microbeads. Xanthan gum is soluble in water and confers high viscosity at low concentrations. The molecular weight of xanthan gum is more than the chitosan polymer which leads to better sustained release of microbeads prepared with xanthan gum compared to chitosan microbeads. Both chitosan and xanthan gum microbeads followed zero-order-release kinetic models.
Impact of Nurse-Led Stroke Education Program (NSEP) on ADL and SS-QOL among Patients with Stroke and Burden among Caregivers
Authors: Devi Bamini
Published: August 2024

Aim:

To determine the effectiveness of Nurse-Led Stroke Education Program (NSEP) on Activities of Daily Living (ADL) and Stroke-Specific Quality of Life (SS-QOL) among patients with stroke and elicit burden among caregivers.

Method:

A quantitative research method was adopted. Stroke victims and their caregivers who fulfill eligibility criteria were chosen. The sample size was 170 dyads, 85 dyads in the study and 85 dyads in the control groups were recruited by lottery method. NSEP was implemented in the study group dyads. The posttest assessments were taken on days 30, 90, and 180 for both groups.

Results:

The mean scores of ADL in the study and control group during posttest-I, II, and III were significant at P < 0.05. The mean scores of PCS during posttest-I, II, and III showed significance at P < 0.05. MCS mean score during posttest-I, II, and III was significant at P < 0.05. Overall mean scores of SS-QOL in the study group were found to be higher than that in the control group during posttest-I, II, and III at P < 0.01 between groups. The burden mean scores were higher in the control group caregiver than in the study group caregiver during the posttest-I and II at P < 0.01.

Conclusion:

Findings concluded that the combination of interventions like structured teaching, an information booklet on “Life after stroke,” and telephonic reminder and reinforcement has a positive impact on ADL and SS-QOL of patients with stroke and minimized caregiver burden.
Influence of Abdominal Obesity (Waist–Hip ratio) on Memory Consolidation in Adolescent Medical Undergraduates − A Cross-sectional Study
Authors: Rakesh R. , Muthu Prathibha K. , Sundararajan Prem Kumar , Gutta Naresh K.
Published: August 2024

Background:

Waist Hip Ratio (WHR), a measure of abdominal obesity is being co-related with memory consolidation based on its relation with stress and sleep. The objective of the present cross-sectional study was to evaluate the association between WHR and memory consolidation in adolescent medical undergraduates.

Methodology:

An analytical cross-sectional study was conducted in a South Indian medical college. After obtaining ethics clearance, the study was conducted on 42 males and 63 females of 17–19 years of age. WHR was measured according to WHO guidelines using Gulick 2 plus inch tape. Sleep-dependent memory consolidation test was conducted in evening 3:00 pm followed by next morning 9:00 am. WHR between genders was compared using Student t test. The study population was divided into obese and non obese individuals, based on the calculated WHR. Then, the mean memory consolidation test scores were compared using Mann Whitney U test. The correlation between WHR and memory consolidation test scores was evaluated using Pearson’s correlation test.

Results & Discussion:

The average WHR of males (0.845 ± 0.058) was significantly higher than females (0.778 ± 0.051) (P<0.001). The morning session memory consolidation test scores were higher in the normal group when compared to the substantially increased risk for obesity groups, although not statistically significant. WHR showed significant negative correlation with sleep dependent memory experiment scores.

Conclusion:

The relationship between WHR and memory consolidation in the present study highlights the need for an awareness to adopt life style modifications which might not only benefit the general health status but also might have an impact on their memory consolidation and academic performance.
Disseminated epithelial cancers—An autopsy analysis
Authors: Vaideeswar Pradeep , Patil Sachin , Chaudhari Jayashri
Published: August 2024

Background:

Cancer is one of the leading causes of death due to noncommunicable diseases worldwide. Despite increasing public awareness and availability of sophisticated imaging techniques, some cancers evade clinical diagnosis and/or are incidentally encountered at autopsies, often with dissemination.

Aims:

The present study evaluated the disseminated epithelial cancers at autopsy.

Materials and Methods:

This is a retrospective observational 5-year autopsy analysis of disseminated epithelial cancers performed at a tertiary-care hospital. The cases were categorized as (1) clinically diagnosed malignancy, known primary; (2) clinically diagnosed malignancy, unknown primary; and (3) clinically undiagnosed malignancy.

Statistical Analysis:

Nil.

Results:

Dissemination was identified in 66 (57.9%) of the 114 patients with epithelial malignancies. There were 29 patients (43.9%) in category 1, 26 patients (39.4%) in category 2, and 11 patients (16.7%) in category 3, majority of whom were women (38 patients, 57.6%). When all categories were considered together, lung and colorectal carcinomas were the commonest cancers seen in 13 (19.7%) and 8 (12.1%) patients, respectively, in both men and women. Majority of the patients (43 cases, 65.2%) had symptoms produced by metastases, which were the sole manifestations in 13 patients (19.7%). Lungs and liver were the common metastatic sites.

Conclusions:

Cancerous dissemination continues to be a major cause of morbidity and mortality even after considerable improvements in the surgical or nonsurgical treatment modalities. An autopsy study can provide important clinical insights in retrospect.
GP73 level in patients with chronic hepatitis B
Authors: Atilla Aynur , Taşkın Mehmet H. , Kazak Zülay , Aydın Saliha , Kılıç S S
Published: August 2024

Background/Aims:

In this study, we investigated the Golgi protein 73 (GP73) level in Hepatitis B and determined the correlation between Hepatitis B virus (HBV) DNA, alanine aminotransferase (ALT), aspartate aminotransferase (AST) levels, and liver histopathology. Materials and

Methods:

GP73 levels were estimated by enzyme-linked immunosorbent assay in serum samples from patients. Liver biopsy specimens were examined by the same pathologist.

Results:

This study included a total of 127 patients who underwent liver biopsy. Of patients, 85% were HBeAg negative. HBV DNA level was median 134667 IU/mL (2247–170000000 IU/mL), Liver biopsy results revealed a mean Histological Activity Index (HAI) grade of 7.7 ± 3.4 and a mean fibrosis stage of 2.25 ± 1.06 gr/dL. GP73 was as follows: a mean of 14.8 ± 7.9 ng/mL and a median of 12.9 (4.8–50.1) ng/mL. A weak correlation between GP73 level and AST (r = 0.236, P = 0.11), fibrosis stage (r = 0.287, P = 0.002), and HAI grade (r = 0.218, P = 0.016) was noted. No statistically significant correlation was detected between GP73 and ALT (r = 0.16, P = 0.08), HBV DNA (r = 0.13, P = 0.08).

Conclusion:

Although recent studies revealed a strong correlation and increased GP73 levels in accordance with HAI scores and the fibrosis grade of liver, we detected a weak correlation between serum GP73 levels and HAI scores, fibrosis stage, and AST. This may be due to the insufficient number of patients with higher HAI grading and fibrosis staging in our study. Therefore, we concluded that, in cases of low-moderate fibrosis and HAI grading, GP73 seemed not to be useful and a reliable marker to replace liver biopsy.
Imaging and pathological discordance amongst the plethora of breast lesions in breast biopsies
Authors: Archana B , Dev Bhawna , Varadarajan Suresh , Joseph Leena Dennis , Sheela M.C. , Pavithra V. , Sundaram Sandhya , Srinivasan Jai Prakash
Published: August 2024

Introduction:

Imaging-guided breast tissue biopsy has become an acceptable alternative to open surgical biopsy for nonpalpable breast lesions. Discussion of abnormal results of the correlation between imaging and pathological findings can be very challenging as it can assist in decision-making with regard to the further treatment options by arriving at a comprehensive diagnosis.

Materials and Methods:

This was a retrospective study. Radiological data from imaging-guided breast biopsies of 500 patients during a 6-year period was collected and classified by a specialist radiologist as per the BI-RADS format. Histopathology reports were studied and discordance analyzed.

Results:

A total of 500 cases were reviewed. Approximately 33% (168) cases fell into the BI-RADS 3 category, 24.4% (122) into the BI-RADS 4, and 37% (187) into BI-RADS 5 categories. Approximately 50% (n = 250) cases were benign, 2.6% (13) belonged to the high-risk category, and 47.4% (237) were malignant. The number of discordant cases was 12 (2.4%), mostly due to technical factors. Sensitivity of biopsies to detect malignancy was 85%, specificity was 96%, and accuracy of biopsy in diagnosing cancer was 90%.

Discussion:

The "triple assessment" is the most sensitive method for detecting early breast cancer. An effective communication pathway must be established between a clinician, radiologist, and pathologist for surgical excision in discordance as it carries a high prevalence of carcinoma in these lesions.

Conclusion:

In discordant cases, either due to abnormal results of imaging or of abnormal pathological findings, the final decision is based on two concordant findings, out of the three parameters. This involves a multidisciplinary breast conference and an active participation by the pathologist.
Merits and pitfalls of normal saline rehydrated air-dried cervical smears over conventional wet.fixed PAP smears
Authors: Kamble Shilpa A. , Dombale Vijay D. , Shah Forum
Published: August 2024

Background:

Cervical Papanicolaou (PAP) smear is the simplest, minimal invasive, and excellent screening method to reduce the female morbidity and mortality due to cervical carcinoma. Immediate alcohol fixation of the cervical smears is required to preserve nuclear details, delay in alcohol fixation leads to air drying artifacts. Rehydrating of the air-dried cervical pap smear with normal saline can help to overcome these artifacts and also have its own advantages.

Aims:

This study was design to evaluate the effects, merits and pitfalls of normal saline Rehydrated Air-Dried Cervical PAP Smears (RADPS) compared with the Conventional Papanicolaou Smear (C-PAPS).

Settings and Design:

Comparative study.

Methods and Material:

Prospectively paired cervical smears of 100 women, who presented to the outpatient department of gynecology of our institute, were prepared. Alcohol fixed smears were labelled as conventional Papanicolaou smear (C-PAPS) and air-dried smears labelled as rehydrated air-dried PAP smears (RADPS). Eight cytomorphological parameters were considered for comparison and analyzed.

Statistical analysis used:

Chisquare (χ2)/Fisher exact test.

Results:

Clear background with red blood cells (RBC) lysis was noted in 93% of RADPS and 54% of C-PAPS. Cytolysis was observed more in C-PAPS (18%) than in RADPS (08%). Air-drying artifacts observed in 30% of C-PAPS and 08% of RADPS. Cytoplasmic staining (92% of RADPS and 85% of C-PAPS) was superior in RADPS. Cell border, nuclear chromatin, and border were also better appreciated on RADPS as compared to C-PAPS. Statistically significant difference was observed with 3 parameters, i.e., air-drying artifacts, RBC background, and distinct cell borders.

Conclusion:

Rehydration of air-dried smears can be adopted in regular practice, as an alternative or coupled with conventional wet fixation method to overcome the commonly faced problems of air-drying artifacts, especially in rural screening programs.
Three shades of black - secondary thrombotic microangiopathy
Authors: Das Rhituparna , Dasgupta Saugat , Sengupta Moumita , Basu Keya
Published: August 2024

Thrombotic microangiopathy is a group of disorders characterized by microangiopathic hemolytic anemia, thrombocytopenia and organ damage. Wide age distribution and the heterogeneity in presentation demand a deeper understanding into the pathogenesis of TMA. Primary TMA is distinct from TMA associated with secondary causes and remains clinically occult till a precipitating factor aggravates it. The extent and severity of renal damage caused by each of them is also distinct. The first alerting signal could be the presence of schistiocytes on peripheral smear and arteriolar thrombi on light microscopy. Thus in secondary TMA, identification of the underlying disorder is indispensible for targeted management.
Primary breast sarcoma
Authors: Ahuja Manisha , Mallya Varuna , Mandal Shramana , Tomar Reena , Aggarwal Radhika , Khurana Nita , Lal Pawnindra
Published: August 2024

Background:

Primary Breast Sarcomas (PBS) are rare malignancies and seen in less than <1 % of all breast malignancies. PBS are non epithelial, composed of mesenchymal mammary tissue and are difficult to diagnose from other sarcomas arising in breast.

Materials and Methods:

A retrospective study was conducted in the Department of Pathology and slides of breast malignancies over a period of 5 years were reviewed. Out of total 1570 breast malignancies, 5 cases were reported as PBS. Diagnosis was made on the basis of Histopathology and IHC findings.

Results:

Out of total 1570 cases, 5 cases were diagnosed as PBS (i.e. 0.32% of all cases). 3 out of 5 cases were males comprising of 60% of cases and 2 cases were females accounting for 40% of cases. The age group of presentation was 32-65 years with mean age being 48.5 years. A diagnosis of MPNST was rendered in two cases (1=M, 1=F), one each was diagnosed as DFSP (with fibrosarcoma), Leiomyosarcoma and Fibrosarcoma.

Conclusion:

PBS is an extremely rare entity and locally aggressive. It requires diagnosis as its treatment protocol is different.
Pulmonary carcinosarcoma with an aggressive heterologous angiosarcoma component
Authors: Keow Jonathan Y. , Inculet Richard I. , Hammond Robert , Zeman-Pocrnich Cady
Published: August 2024

Pulmonary carcinosarcomas are rare biphasic lung tumors comprised of malignant epithelial and malignant mesenchymal components. The most common heterologous sarcomatous elements are osteosarcoma, rhabdomyosarcoma, and chondrosarcoma; a heterologous angiosarcoma component in a pulmonary carcinosarcoma is exceedingly rare. We report a case of a pulmonary carcinosarcoma containing adenocarcinoma, squamous cell carcinoma, undifferentiated malignant spindle cell, and heterologous angiosarcoma components. The patient, a 64-year-old woman, had initially presented to medical attention with hemoptysis. Although the tumor was thought to be confined to the lung at resection (pT3N0), she developed multiple metastatic foci within 3 weeks of lobectomy and required the evacuation of an intraparenchymal left occipital hematoma secondary to a hemorrhagic intra-axial focus of metastatic carcinosarcoma. She died 6 weeks after her primary lung resection from rapidly progressive metastatic disease. We hope the description and discussion provided herein will further the medical community's understanding of this rare malignancy.