bluuebunny/crossref_metadata_2025 huggingface dataset:
Adenoid ameloblastoma with dentinoid: A rare hybrid odontogenic tumor
Authors: Chettiankandy Tabita J. , Sachdev Sanpreet S. , Kende Prajwalit P. , Sardar Manisha A. , Saju Reshma
Published: January 2024

Background:

Adenoid ameloblastoma with dentinoid (AAD) is a hybrid odontogenic tumor comprising histopathological presentation of ameloblastoma (AM) and adenomatoid odontogenic tumor (AOT) along with extracellular dentinoid material.

Case Presentation:

A 35-year-old female reported an asymptomatic swelling in the left mandibular posterior region. Histopathological examination revealed composite features of AM with AOT along with dentinoid material, which stained positively with Van Gieson and trichrome stains.

Conclusion:

The present case report serves to add further to the modicum of literature reports pertaining to AAD, which may gain recognition as a distinct entity in future World Health Organization (WHO) classification of odontogenic tumors.
Adult acute megakaryoblastic leukemia with persistent diarrhea and extreme thrombocytosis: A very unusual case
Authors: Aslan Nevin Alayvaz , Gülten Gülsün
Published: January 2024

Acute megakaryoblastic leukemia (AML-M7) is rarely seen in adult patients and patients usually present with cytopenias. Here we discuss diagnostic challenges and pathologic features in a patient with AML-M7 who presented with thrombocytosis and diarrhea. A 63-year-old male patient presented with persistent diarrhea lasting for 2 months, fatigue, and thrombocytosis. The diagnostic workup included a stool analysis, endoscopy colonoscopy, and imaging studies; however, these studies did not reveal any possible etiology. The hematologic evaluation included peripheral blood smear, bone marrow aspiration and biopsy, flow cytometry, and cytogenetic analysis. Eventually, according to pathologic and flow cytometric findings, a diagnosis of AML-M7 was made. Diagnosis of AML-M7 may be challenging, especially in adult patients with atypical presentation. Patients with megakaryoblastic leukemia respond poorly to standard induction regimens and they should be advised to participate in a clinical trial.
Glucose-6-phosphate dehydrogenase deficiency with coinherited Gaucher disease: A rare association
Authors: Parakh Nupur , Sharma Kusha , Sharma Sunita , Chatterjee Priti , Singh Varinder
Published: January 2024

Anemia coexisting with Gaucher disease (GD) is often associated with non-hemolytic processes. Few cases of GD with autoimmune hemolytic anemia have been reported. However, literature on GD with concomitant nonimmune hemolytic anemia is scarce. A 1-year 6-month-old male child presented in 2018 with complaints of palpable mass in left upper abdomen, fever, cough, and vomiting. On examination, he had pallor, hepatosplenomegaly of 2 cm and 8 cm below costal margin, respectively. A clinical diagnosis of hemolytic anemia was suspected. Complete blood count revealed Hb---6.7 g/dL, TLC---8.9 × 103/μL, platelet count---180 × 103/μL. Peripheral smear showed predominantly microcytic hypochromic anemia with moderate degree of anisocytosis, many nucleated red blood cells, few schistocytes, polychromatophils and corrected reticulocyte count 7.89%. S. Bilirubin was 1.1 mg/dL. Hb high-performance liquid chromatography (HPLC) of the child and his parents was within normal limit. Hematological work up revealed negative results for direct Coombs’ test, osmotic fragility test, and sickling test. Test for Glucose-6-phosphate dehydrogenase deficiency was positive (39 units/trillion RBC, normal 146--376). He was transfused intermittently and given steroids to manage his anemia. He was on regular follow up during which his blood counts revealed persistent anemia and thrombocytopenia. In view of this, bone marrow was performed to exclude myelofibrosis. Aspirate smears were cellular and showed normoblastic erythroid hyperplasia. Numerous large histiocytes with basophilic fibrillary cytoplasm exhibiting “crumpled tissue paper” appearance were seen. Similar findings were seen on bone marrow trephine biopsy. Genetic testing revealed pathogenic variations in the GBA gene. Beta glucosidase enzyme levels were low while chitotriosidase was raised (1109.19 nmol/hr/mL). A final diagnosis of G6PD with GD was made. The present study shows rare association of GD with Glucose-6-phosphate dehydrogenase deficiency.
Significance of histopathological features in the diagnosis of Budd–Chiari syndrome on liver biopsies
Authors: Prasad Pallavi , Singh Anurag , Singh Alka , Mishra Prabhaker , Krishnani Narendra
Published: January 2024

Background:

Budd–Chiari syndrome (BCS) requires a constellation of clinical, imaging, and histological findings for diagnosis. Liver biopsy serves as a tool for confirming the diagnosis, even though the histological characteristics are not pathognomonic.

Aims:

To determine which constellation of morphologic findings could aid in establishing a diagnosis of BCS in clinically suspected cases.

Materials and Methods:

A 5-year retrospective observational study was conducted. The clinical, laboratory, and histological findings of liver biopsies in patients with a clinical diagnosis of BCS were studied. Cases were segregated into two groups on the basis of the number of histological features present. A scoring system was then devised to assess the efficacy of the histological findings in diagnosing BCS.

Statistical Analysis Used:

The continuous variables were compared using the Mann–Whitney U-test, and categorical variables were compared using the Fisher-exact test.

Results:

The common histopathological findings were the presence of red blood cells in the space of disse (100%), peri-portal fibrosis (97.1%), sinusoidal dilation (97.1%), portal inflammation (67.6%), centrilobular necrosis (61.8%) and pericellular/sinusoidal fibrosis (61.8%). Comparison between the two groups showed that centrilobular necrosis, lobular inflammation, portal inflammation, central vein fibrosis, and pericellular/sinusoidal fibrosis were significant parameters. No correlation was found between the clinical and laboratory parameters and the two groups.

Conclusions:

The liver biopsy features in BCS are often nonspecific, and no single feature in isolation is characteristic. A constellation of features (centrilobular necrosis, lobular inflammation, portal inflammation, central vein fibrosis, and pericellular/sinusoidal fibrosis), when present together, indicate the possibility of BCS.
Sclerosing angiomatoid nodular transformation of spleen: A rare case report
Authors: Rajpoot Jyoti , Jain Manjula , Singh Kanika , Singh Aparna , Sarohi Monica , Tyagi Vikas
Published: January 2024

Sclerosing angiomatoid nodular transformation (SANT) is a reactive non-neoplastic, rare vascular lesion of the spleen. The histology shows multiple angiomatoid nodules surrounded by proliferative stroma. A 31-year-old lady presented with an abdominal mass for 6 months. Contrast-enhanced computed tomography (CECT) abdomen was suggestive of hemangiopericytoma/hemangioendothelioma. An open splenectomy was performed, and the resected specimen was sent for histopathology examination. The gross examination showed a bosselated mass present at the lower pole of the spleen measuring 8 × 8 cm with peripherally located coalescing red-brown nodules embedded in a dense fibrous stroma on the cut surface. On microscopy, multiple circumscribed angiomatoid nodules comprising irregular slit-like vascular channels lined by plump endothelial cells were seen embedded in dense sclerotic stroma. Because of the lack of specific diagnostic features, it is difficult to diagnose SANT clinically and radiologically. However, the typical histopathological findings are a clue in clinching the diagnosis.
Clinicopathological analysis of sclerosing angiomatoid nodular transformation in the spleen
Authors: Wei Shufei , Han Yongliang , Hou Yingyong , Wang Liangliang
Published: January 2024

Background:

Splenic sclerosing angiomatoid nodular transformation (SANT) is a rare benign nodular lesion in the red medulla of the spleen. In the past, SANT has not been consistently recognized as the name for this condition and was often misdiagnosed for other conditions. In recent years, SANT has been acknowledged by most scholars as multiple reports have been published.

Aim:

To assess the clinicopathological features of SANT to identify the histological characteristics of SANT to improve diagnosis and clinical treatment.

Materials and Methods:

We assessed 25 cases of SANT diagnosed at Zhongshan Hospital affiliated with Fudan University from September 2014 to October 2021, including 14 men and 11 women, aged 24–62 years old.

Results:

Fourteen cases were complicated with benign tumors of the liver, pancreas, kidney, uterus, and prostate. One case was complicated with renal clear cell carcinoma, and one was complicated with hepatocellular carcinoma. The gross neoplasm is multinodular and well defined. Histologically, angiomatoid nodules are composed of fattened, round, or irregular blood vessels, with or without red blood cells in the lumen, with unequal red blood cell extravasation, and fibrocytes around the nodules. The hemangiomatous nodules were positive for CD31 and CD34, while the vascular wall smooth muscle cells and fibrocytes around the nodules were positive for SMA.

Conclusion:

The diagnosis of SANT requires a combination of immunohistochemical and histological features, and early splenectomy is crucial for treatment.
Poorly differentiated biphasic synovial sarcoma of the vulva, displaying SS18::SSX1 fusion and weak to absent (mosaic) INI1/SMARCB1 immunostaining: A rare case with literature review
Authors: Rekhi Bharat , Bhatia Sheenal , Shetty Omshree , Maheshwari Amita
Published: January 2024

Synovial sarcoma (SS) is rarely documented in the female genital tract, especially confirmed by molecular testing for SYT::SSX translocation and TLE1 immunostaining. A 62-year-old lady presented with a progressively increasing lump and pain over her right groin, for 6-month duration. Radiologically, a well-defined, solid-cystic mass was seen involving the right labia with necrotic areas, sparing the underlying muscles and the overlying skin. She underwent a biopsy followed by a surgical excision. Histopathologic examination revealed a spindle cell sarcoma, including tumor cells exhibiting a prominent hemangiopericytomatous pattern. There were focal areas of epithelial differentiation (pseudoglandular) along with areas of round cell morphology and increased mitoses (poor differentiation) in the resected specimen. Immunohistochemically, the tumor cells were diffusely positive for TLE1, patchily positive for pan keratin (AE1/AE3) and EMA, the latter more in the areas of epithelial differentiation, while negative for CD34, SMA, desmin, S100P, and SOX10. INI1/SMARCB1 showed a characteristic weak to absent (mosaic) staining pattern. Furthermore, the tumor displayed SS18::SSX1 fusion by RT-PCR. This constitutes one of the few reported cases of vulvar SS, confirmed by molecular testing and the first documented vulvar SS showing a mosaic pattern of INI1/SMARCB1 immunostaining. A review of the literature and diagnostic implications are presented herewith.
Hybrid tumor of central giant cell granuloma and trabecular juvenile ossifying fibroma of the mandible: A rare event in the oral cavity with a review on pathogenesis
Authors: Bishen Kundendu Arya , Prajapati Rajesh Kumar , Singh Himanshu , Rehani Shweta
Published: January 2024

Hybrid tumors are rare lesions having features of multiple diseases in one lesion. A hybrid tumor of central giant cell granuloma (CGCG) and central ossifying fibroma (COF) shows the presence of microscopically large areas with CGCG character and large areas with COF features inside a single clinical lesion, separated by a transition zone. A rare type of COF is juvenile ossifying fibroma (JOF)-trabecular variant in the mandible. We present a unique and rare case of a hybrid tumor of the CGCG-JOF-trabecular variant in the mandible of a 14-year-old female which initially diagnosed with CGCG. The ambiguous pathogenesis of hybrid tumors and giant cells is reviewed. The goal of this article is to highlight the importance of careful clinical, radiological, and histopathological examination of each case to prevent misdiagnoses and recurrences. Similar and other cases must be reported in order to better understand the interrelationship between these hybrid lesions and their biological behavior.
Facial cutaneous phaeohyphomycosis in an immunocompetent individual
Authors: Rana Neha , Sagar Tanu , Saxena Sonal , Chaudhary Kanika
Published: January 2024

Fungal infection is a rare condition in immunocompetent individuals, and it is associated with high rates of morbidity and mortality. We report on a case of cutaneous phaeohyphomycosis in healthy 25-year-old man. Based on the clinical findings, the case was first thought to be cervico-facial actinomycosis, but Alternaria was identified on the culture after debridement. Simple surgical excision resulted in the complete cure without administration of systemic antifungals.
Study of the association of the known prognostic variables with EGFR expression in head and neck squamous cell carcinomas
Authors: Jadhav Toyaja , Malik Ajay , Kashif Ahmed Waheed , Shelly Divya , Mishra Prabhashankar S. , Baranwal Ajay Kumar , Sahu Rajesh
Published: January 2024

Context:

Head and neck squamous cell carcinomas (HNSCCs) are the sixth most frequent malignancy in the world. Epidermal growth factor receptors (EGFRs) are members of Erb B family of receptors. EGFR is known to act as a driver of tumorigenesis in various carcinomas. Over expression of EGFR in HNSCC is associated with poor prognosis and resistance to radiotherapy. It is a useful prognostic marker, marker for response to therapy, and also a therapeutic target.

Aim:

To study the association of the known prognostic variables with EGFR expression in HNSCCs and to correlate it with the clinical outcome

Settings and Design:

Cross-sectional observational study.

Materials and Methods:

A total of 170 patients of HNSCC were evaluated for EGFR expression and followed up for at least two years, with correlation of EGFR expression with various histopathological factors and their clinical outcome.

Statistical Analysis Used:

Chi-square test.

Results:

The expression of EGFR in HNSCC in this study population was 88.82%. Statistical significance was noted between EGFR reactivity and age of the patient, its histological grade and perineural invasion. Statistical significance was also noted between EGFR reactivity and recurrence of malignancy as well as the site of recurrence.

Conclusion:

EGFR expression in patients with HNSCC is a poor prognostic biomarker and has a comparatively lower survival outcome as compared to non-EGFR expressing HNSCC cases. Hence, it will be helpful for all those patients diagnosed with HNSCC to ideally undergo an additional EGFR immunohistochemical evaluation, which, in turn, will help the oncologists in management of the tumor with anti-EGFR therapy combined with radiotherapy, to obtain a better response and a survival outcome.
Fibroblastic reticular cell tumor of eyelid: Rare case report and review of literature
Authors: Mishra Pragnya P. , Madan K , Biswas Siddhartha , Rao Anuradha Calicut Kini
Published: January 2024

Fibroblastic reticular cell tumours (FRCT) originate from the fibroblastic reticular cells (FBRC) which are histiocytic cells, belonging to the dendritic cell family. These tumours are extremely rare, with only a few cases reported in literature. Histomorphologically, they resemble follicular dendritic cell sarcoma (FDCS); however, they differ immunophenotypically. Extranodal presentations are rare. We report a case of malignant FBRC tumour of the left eyelid, in a 23-year-old woman, who had presented with a recurrent swelling over left lower eyelid. Microscopy revealed an ill circumbscribed tumour composed of oval to spindle cells in storiform pattern, sprinkled with lymphocytes. Immunohistochemistry was performed and diagnosis of FRCT was offered. To the best of our knowledge, this is the first report of malignant FBRC tumour arising in the eyelid region. Here we present this extremely rare case with review of the available literature.
A Comparative Study of Duloxetine with Pregabalin as a Preemptive Analgesic in Lumbar Spine Surgery: A Prospective Randomized Study
Authors: Arman S. M. , Usmani Hammad , Siddiqui Obaid Ahmad , Sheikh Kulsum , Amir Syed Hussain
Published: January 2024

Background:

Preemptive analgesia is a method of administration of drugs prior to surgery involving blocking noxious stimuli across the perioperative period. It involves blocking the pain pathway preemptively before injury-induced hypersensitivity manifests.

Objective:

To compare the analgesic efficacy of duloxetine with pregabalin as preemptive analgesic in lumbar spine surgeries.

Design:

Randomised, double-blinded, prospective study.

Methods:

Fifty patients of both sexes between 18-55yrs undergoing elective lumbar spine surgery were randomly allocated into two groups, group P and group D of twenty-five patients each. Group P received 75 mg pregabalin once daily for three days, followed by 150 mg pregabalin daily for the next four days till the day of surgery. Group D received 20 mg duloxetine once daily for three days, followed by 40 mg duloxetine twice daily for the next four days till the day of surgery.

Outcome Measure:

Both the groups were primarily evaluated in terms of time for request of 1st rescue analgesic and total intraoperative analgesic requirement in terms of fentanyl boluses required; among other parameters.

Results:

The time for request of 1st rescue analgesic postoperatively was significantly longer in the pregabalin group (396 ± 267.77 min) than in the duloxetine group (218.4 ± 96.9 min), P = 0.003. Pregabalin recipients required considerably less rescue analgesics in terms of dosage, P = 0.006. Also, pregabalin exhibited better postoperative pain control than duloxetine as reflected by NRS comparative scores. No statistical difference was appreciated in terms of intraoperative fentanyl requirement, intraoperative hemodynamic control; nausea and sleepiness.

Conclusion:

Pregabalin is more efficacious as a preemptive analgesic than duloxetine in lumbar spine surgery.
Anomalous Great Cardiac Vein Mistaken for Left Main Coronary Artery Aneurysm in a Case of Anomalous Left Coronary Artery Arising from the Main Pulmonary Artery
Authors: Middha Rahul , Guleria Munish , Tanwar Rekha , Arora Suryansh , Bhatt Dheeraj Deo , Taneja Anil , Singh Tamanna Veer
Published: January 2024

Anomalous coronary venous drainage is rare and likely to be under-reported, with many cases found incidentally in cardiac imaging and autopsy studies. It may also occasionally have an important clinical implication. We report a rare case of anomalous great cardiac vein bypassing the coronary sinus to drain directly into the left brachiocephalic vein in a patient with anomalous left coronary artery arising from the main pulmonary artery. This anomalous course resulted in a misdiagnosis of coronary aneurysm on echocardiography.
Reversible Constrictive Pericarditis: Implications for Management in India
Authors: Riyaz Mirza Shohiab Ur , Devakiruba D. Nathaniel Samson , Krupa Jesu , Vimla Leena Robinson , Thomson Viji Samuel
Published: January 2024

Tuberculosis is the most common etiology for constrictive pericarditis in developing part of world, but a certain diagnosis may remain obscure. Reversal of constrictive physiology is possible if antitubercular therapy (ATT) and steroids are administered in early stage of disease and only few case reports are available indicating the role of ATT alone in reversing constriction.
Long-term outcomes of single-incision laparoscopic colectomy for right-sided colon cancer utilising a craniocaudal approach
Authors: Miyasaka Mamoru , Kitashiro Shuji , Takahashi Mamoru , Okawa Yuki , Sekiya Sho , Saikawa Daisuke , Teramura Koichi , Hayashi Satoshi , Suzuki Yoshinori , Matsumoto Joe , Kawada Masaya , Kawarada Yo , Kaga Kichizo , Okushiba Shunichi , Hirano Satoshi
Published: January 2024

Introduction:

This study aimed to evaluate the short- and long-term outcomes of single-incision laparoscopic colectomy (SILC) for right-sided colon cancer (CC) using a craniocaudal approach.

Patients and Methods:

The data of patients who underwent SILC for right-sided CC at our hospital between January 2013 and December 2022 were retrospectively collected. Surgery was performed using a craniocaudal approach. Short- and long-term operative outcomes were analysed.

Results:

In total, 269 patients (127 men, 142 women; median age 74 years) underwent SILC for right-sided CC. The cases included ileocaecal resection (n = 138) and right hemicolectomy (n = 131). The median operative time was 154 min, and the median operative blood loss was 0 ml. Twenty-seven cases (10.0%) required an additional laparoscopic trocar, and 9 (3.3%) were converted to open surgery. The Clavien–Dindo classification Grade III post-operative complications were detected in 7 (2.6%) cases. SILC was performed by 25 surgeons, including inexperienced surgeons, with a median age of 34 years. The 5-year cancer-specific survival (CSS) was 96.1% (95% confidence interval [CI] 91.3%–98.2%), and CSS per pathological disease stage was 100% for Stages 0–I and II and 86.2% (95% CI 71.3%–93.7%) for Stage III. The 5-year recurrence-free survival (RFS) was 90.6% (95% CI 85.7%–93.9%), and RFS per pathological disease stage was 100% for Stage 0–I, 91.7% (95% CI 80.5%–96.6%) for Stage II and 76.1% (95% CI 63.0%–85.1%) for Stage III.

Conclusions:

SILC for right-sided CC can be safely performed with a craniocaudal approach, with reasonable short- and long-term outcomes.
Spillage of endoscopic tattoo before laparoscopic colectomy: A case report and literature search
Authors: Baig Sarfaraz Jalil , Varma Aishwarya
Published: January 2024

Endoscopic tattooing with India ink is a common practice before the laparoscopic resection of polyps/tumours. Sometimes, due to inadvertent intramuscular instead of submucosal injection, it may lead to peritoneal spillage precluding the laparoscopic approach and warrant open resection. There are a few reports of post-operative abdominal sepsis. We report a case where spillage led to open conversion due to poor visibility and post-operative abdominal sepsis necessitating a change of antibiotics and prolonged hospital stay. Surgeons should be aware of these complications from this apparently innocuous step. We also did a review of the literature to see how this can be prevented and what alternative approaches have been developed.
Laparoscopic repair of iatrogenic celiac artery injury during median arcuate ligament release: A retrospection and tips at troubleshooting
Authors: Shenoy Ganesh , Thomas Marina , Ramesh B. S.
Published: January 2024

Median arcuate ligament (MAL) syndrome or celiac artery (CA) compression syndrome previously treated mainly by vascular surgeons using the open approach is now being increasingly performed by general surgeons with training in advanced laparoscopy. Although this approach has all the advantages of minimal access surgery, the procedure is fraught with serious complications like injury to major vascular structures during dissection. Vascular injury by far is the major cause of conversion to open procedure. Herein, we report a laparoscopic repair of iatrogenic CA injury by intra-corporeal suturing during MAL release. We also elaborate the causes, the preventive measures that can be applied to avoid such catastrophic occurrences in future. To the best of our knowledge, this is the first report of a laparoscopic repair of CA bleed during MAL release.
Laparoscopic choledochal cyst excision and biliary reconstruction in patients with previous surgery/ intervention: Feasibility and outcome
Authors: Ojha Sunita , Bharadia Lalit , Sharma Ravi , Bansal Rajiv Kumar , Chaturvedi Anupam
Published: January 2024

Introduction:

The aim of the study was to evaluate the feasibility and outcome of laparoscopic surgery in complicated choledochal cyst (CDC) with previous interventions (laparotomy or biliary drainage).

Patients and Methods:

Patients with CDC who underwent surgery from July 2014 to July 2019 were evaluated. CDC without previous interventions (Group A) was compared with CDC that had previous interventions (Group B) to assess the feasibility and outcome of laparoscopic surgery.

Results:

In 5 years’ period, 38 patients were operated for CDC. The mean age was similar in both groups (3.78 ± 2.27 in Group A and 4.08 ± 2.73 in Group B). Out of six CDC with previous intervention (Group B), five patients were previously managed at other institutions as follows: (1) Laparoscopic cholecystectomy and endoscopic retrograde cholangiopancreatography (ERCP) stenting. (2) Laparotomy for biliary peritonitis and ERCP. (3) Percutaneous drainage of the large cyst. (4) Laparoscopic cholecystectomy. (5) ERCP stenting. (6) Percutaneous drainage for biliary ascites. All patients underwent laparoscopic CDC excision and hepatico-duodenostomy. The mean duration of surgery was 160.3 ± 17.22 in Group A and 169.2 ± 17.5 in Group B (P = 0.258). None required intraoperative blood transfusion. None had a bile leak. Drain was removed at 4.47 ± 0.98 in Group A, while at 4.17 ± 0.75 days in Group B (P = 0.481). There was statistically no significant difference in feed starting time or length of stay. In follow-up of 6 months–3 years, all patients are asymptomatic.

Conclusions:

Laparoscopy in complicated CDC with previous intervention is technically tedious but is feasible. The procedure is safe and delivers a good outcome.
A novel technique to identify midline during endoscopic thyroidectomy
Authors: Kataria Kamal , Garg Richa , Saini Vikram , Yadav Pritam , Preet Sehaj , Virwadia Yashwant , Nelson T
Published: January 2024

Endoscopic thyroidectomy is a minimally invasive surgical approach that has become popular due to its cosmetic advantages and reduced post-operative discomfort. Central to the success of this procedure is the accurate identification of the midline, which becomes a challenge in endoscopic surgeries. We propose a novel method of using methylene blue, a Food and Drug Administration-approved dye, which offers the ability to clearly mark the midline, enhancing orientation and reducing the potential for injury to critical anatomical structures. Although using methylene blue has many benefits, there are drawbacks, including the requirement for intraoperative ultrasonography. Continued research and clinical experience will be critical in improving and extending its use in the field of thyroid surgery.
Reflux Symptom and Sign Instrument: A New Instrument to Diagnose Pediatric Laryngopharyngeal Reflux
Authors: Rachmawati Elvie Zulka Kautzia , Hermani Bambang , Tamin Susyana , Hegar Badriul , Surono Agus , Harahap Alida , Kusumayati Agustin
Published: January 2024

Introduction:

Laryngopharyngeal reflux (LPR) is commonly found in children, usually connected to airway problems. LPR remains controversial as no standardized diagnostic instrument. Diagnostic tools available have been validated mostly in adults, i.e. Reflux Symptom Index (RSI) and reflux finding score (RFS).

Objective:

The objective of the study was to obtain a cost-effective, simple, convenient, noninvasive instrument with good diagnostic outcome.

Methods:

We compared RSI and RFS with esophageal double probe 24-h pHmetry results. A total of 29 children were recruited, aged 5–18 years. The inclusion criterion was phlegmy throat, frequent odynophagia, sensation of a lump in the throat, throat clearing, choking episodes, hoarseness, and chronic cough for at least 4 weeks. The subjects underwent nasopharyngolaryngoscopy and pHmetry insertion. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated using three scenarios.

Results:

The Reflux Symptoms-Sign Instruments (RSII), consisting of frequent throat clearing, annoying cough, choking, vocal cords abnormalities, and subglottic edema has a cutoff score of 4 and demonstrated 75% sensitivity, 77% specificity, 80% PPV, and 71% NPV.

Conclusions:

The RSII has shown a good diagnostic result in diagnosing LPR in children.
Enhanced Parent-child Interaction and Language Development during COVID-19 Quarantine in Children with Cochlear Implants
Authors: Alsari Nada A. M. , Najmaldeen Ghada T. A.
Published: January 2024

Objectives:

The study aimed to assess how the COVID-19 quarantine affected parent-child interaction (PCI) in children with cochlear implants (CI) and to investigate the role of parental knowledge in the early language development for these children.

Methods:

We conducted our survey primarily utilizing social media platforms such as Facebook, Twitter, and LinkedIn to recruit participants. A total of 40 parents took part in the study, with a majority being females (70%) under the age of 44 years. Most of the children with CIs (87.5%) were under the age of 10 years. Around 67.5% (n = 27) received bilateral implants, while 32.5% of children had unilateral CI The parents filled out a questionnaire which had five domains, and responses related to demographic information, PCI, and the child’s communication skills were recorded.

Results:

Our statistical analysis, using paired t-tests, revealed a significant and positive impact of the quarantine period on both PCI (P = 0.001, t = 6.50) and the communication skills of the children (P = 0.001, t = 3.77). A simple linear regression analysis indicated that parental knowledge did not significantly affect PCI (R
2 = 0.003; P = 0.73). PCI accounted for 14% of the variation in children’s communication skills (P = 0.01).

Conclusions:

In conclusion, our study sheds a light on the impact of the COVID-19 quarantine on the quality of PCI in children with CIs. The findings underscore the resilience and adaptability of both parents and children facing challenging circumstances. Notably, the increased quality and duration of time spent together allowed for enhanced PCI and subsequently led to improvements in the communication skills of the children.
A meta-analysis of alveolar bone grafting using bone substitutes in cleft lip and palate patients
Authors: Putri Indri Lakhsmi , Fabian Pascalis , Wungu Citrawati Dyah Kencono
Published: January 2024

In individuals with cleft lip and palate (CLP), an alveolar bone graft (ABG) is carried out for alveolar cleft closure. Several sources for ABG include autologous bone, xenologous bone, and alloplastic substitutes. Autologous bone has been the preferred source for ABG. Alloplastic substitutes might serve as an alternative. This study aimed to compare the outcomes between autologous and alloplastic as sources for ABG. This study made use of eight web databases. Randomized control trials (RCTs) and non-RCTs were included. CLP patients with alveolar cleft with imaging studies, computed tomography (CT scan) and/or cone beam CT scan, and bone graft volume within 6–12 months postintervention were selected. Bone graft volume within 6–12 months postintervention was assessed. Three studies met the inclusion criteria. After 6–12 months of follow-up, there were no statistically significant differences in bone graft volume between autologous and alloplastic bone grafts (fixed-effect model estimate value = 0.21; confidence interval − 0.301–0.730; P = 0.414). The limitations include small research sample sizes, a high likelihood of bias among included studies, and different alloplastic materials from each included study. Autologous and alloplastic bone grafts showed similar effectiveness in alveolar bone grafting. Further clinical trial studies with bigger sample sizes and similar interventions are needed as evidence for future reviews.
High-intensity aerobic exercise training improves exercise capacity, dyspnea, and fatigue in patients with severe asthma using triple inhaler
Authors: Jao Lun-Yu , Hsieh Po-Chun , Wu Yao-Kuang , Tzeng I-Shiang , Yang Mei-Chen , Su Wen-Lin , Lan Chou-Chin
Published: January 2024

Objectives:

Asthma is a chronic respiratory disease that affects millions of people worldwide and causes severe symptoms such as wheezing, coughing, and breathing difficulty. Despite modern treatments, 3%–10% of patients develop severe asthma, which requires high-dose medications, and they may still experience frequent and severe symptoms, exacerbations, and psychological impacts. This study aimed to investigate the effects of high-intensity aerobic exercise training (HIAET) in patients with severe asthma.

Materials and Methods:

Patients with severe asthma were recruited, and cardiopulmonary exercise tests, dyspnea, and leg fatigue scores were performed before HIAET. Participants underwent a 12-week hospital-based HIAET, which involved exercising twice weekly to reach 80% of their peak oxygen uptake (VO2).

Results:

Eighteen patients with severe asthma underwent HIAET, which resulted in significant improvement in peak VO2 (1214.0 ± 297.9–1349.4 ± 311.2 mL/min, P = 0.004) and work rate (80.6 ± 21.2–96.2 ± 24.8 watt, P < 0.001) and decrease in dyspnea (5.1 ± 1.8–4.1 ± 1.2, P = 0.017) and fatigue scores (5.2 ± 2.3–4.0 ± 1.2, P = 0.020) at peak exercise. No significant changes were observed in spirometry results, respiratory muscle strength, or circulatory parameters.

Conclusion:

HIAET can lead to improved exercise capacity and reduced dyspnea and fatigue scores at peak exercise without changes in spirometry, respiratory muscle strength, and circulatory parameters.
Enhancing Agricultural Sustainability with Deep Learning: A Case Study of Cauliflower Disease Classification
Authors: Pradhan Nihar Ranjan , Ghosh Hritwik , Rahat Irfan Sadiq , Naga Ramesh Janjhyam Venkata , Yesubabu Mannava
Published: January 2024

The pivotal role of sustainable agriculture in ensuring food security and nurturing healthy farming communities is undeniable. Among the numerous challenges encountered in this domain, one key hurdle is the early detection and effective treatment of diseases impacting crops, specifically cauliflower.This research provides an in-depth exploration of the use of advanced DL algorithms to perform efficient identification and classification of cauliflower diseases. The study employed and scrutinized four leading DL models: EfficientNetB3, DenseNet121, VGG19 CNN, and ResNet50, assessing their capabilities based on the accuracy of disease detection.The investigation revealed a standout performer, the EfficientNetB3 model, which demonstrated an exceptional accuracy rate of 98%. The remaining models also displayed commendable performance, with DenseNet121 and VGG19 CNN attaining accuracy rates of 81% and 84%, respectively, while ResNet50 trailed at 78%. The noteworthy performance of the EfficientNetB3 model is indicative of its vast potential to contribute to agricultural sustainability. Its ability to detect and classify cauliflower diseases accurately and promptly allows for early interventions, reducing the risk of extensive crop damage.This study contributes valuable insights to the expanding field of DL applications in agriculture. These findings are expected to guide the development of advanced agricultural monitoring systems and decision-support tools, ultimately fostering a more sustainable and productive agricultural landscape.
Nutrition interventions and clinical outcomes of pregnant women with gestational diabetes mellitus: More than meets the eye
Authors: Sinha Sony , Nishant Prateek , Sinha Ranjeet Kumar , Morya Arvind Kumar , Prasad Ripunjay
Published: January 2024

In the retrospective study by Luo et al regarding clinical outcomes in gestational diabetes mellitus (GDM), the results are statistically significant in favour of the benefits of individualized nutrition interventions enumerated therein. The study has provided important evidence to improve maternal and child health in the Asian population. The methods, however, appear to have considerable limi-tations, wherein the time point of diagnosis of GDM, severity of GDM, selection bias, compliance to therapy, important maternal covariates, observable microvascular abnormalities and the confounding effect of added insulin have not been considered. We have provided suggestions to improve the external validity of the study, including the use of Equator Network reporting guidelines and inclusion of overweight and obese patients in future studies.
Predictive value of bilirubin and serum γ-glutamyltranspeptidase levels in type-2 diabetes mellitus patients with acute coronary syndrome
Authors: Chen Jie , Zhang Wan-Chao , Tang Xiao-Qiang , Yin Ruo-Han , Wang Tao , Wei Xiao-Yu , Pan Chang-Jie
Published: January 2024

BACKGROUND

Cardiovascular disease is a major complication of diabetes mellitus (DM). Type-2 DM (T2DM) is associated with an increased risk of cardiovascular events and mortality, while serum biomarkers may facilitate the prediction of these outcomes. Early differential diagnosis of T2DM complicated with acute coronary syndrome (ACS) plays an important role in controlling disease progression and improving safety.

AIM

To investigate the correlation of serum bilirubin and γ-glutamyltranspeptidase (γ-GGT) with major adverse cardiovascular events (MACEs) in T2DM patients with ACS.

METHODS

The clinical data of inpatients from January 2022 to December 2022 were analyzed retrospectively. According to different conditions, they were divided into the T2DM complicated with ACS group (T2DM + ACS, n = 96), simple T2DM group (T2DM, n = 85), and simple ACS group (ACS, n = 90). The clinical data and laboratory indices were compared among the three groups, and the correlations of serum total bilirubin (TBIL) levels and serum γ-GGT levels with other indices were discussed. T2DM + ACS patients received a 90-day follow-up after discharge and were divided into event (n = 15) and nonevent (n = 81) groups according to the occurrence of MACEs; Univariate and multivariate analyses were further used to screen the independent influencing factors of MACEs in patients.

RESULTS

The T2DM + ACS group showed higher γ-GGT, total cholesterol, low-density lipoprotein cholesterol (LDL-C) and glycosylated hemoglobin (HbA1c) and lower TBIL and high-density lipoprotein cholesterol levels than the T2DM and ACS groups (P < 0.05). Based on univariate analysis, the event and nonevent groups were significantly different in age (t = 3.3612, P = 0.0011), TBIL level (t = 3.0742, P = 0.0028), γ-GGT level (t = 2.6887, P = 0.0085), LDL-C level (t = 2.0816, P = 0.0401), HbA1c level (t = 2.7862, P = 0.0065) and left ventricular ejection fraction (LEVF) levels (t=3.2047, P = 0.0018). Multivariate logistic regression analysis further identified that TBIL level and LEVF level were protective factor for MACEs, and age and γ-GGT level were risk factors (P < 0.05).

CONCLUSION

Serum TBIL levels are decreased and γ-GGT levels are increased in T2DM + ACS patients, and the two indices are significantly negatively correlated. TBIL and γ-GGT are independent influencing factors for MACEs in such patients.
Torque Converter Dynamic Characterization Using Torque
Transmissibility Frequency Response Functions: Locked Clutch
Operation
Authors: Jurmu Luke , Robinette Darrell , Blough Jason , Reynolds Craig
Published: January 2024

A unique torque converter test setup was used to measure the torque
transmissibility frequency response function of four torque converter clutch
dampers using a stepped, multi-sine-tone, excitation technique. The four torque
converter clutch dampers were modeled using a lumped parameter technique, and
the damper parameters of stiffness, damping, and friction were estimated using a
manual, iterative parameter estimation process. The final damper parameters were
selected such that the natural frequency and damping ratio of the simulated
torque transmissibility frequency response functions were within 10% and 20%
error, respectively, of the experimental modal parameters. This target was
achieved for all but one of the tested dampers. The damper models include
stiffness nonlinearities, and a speed-dependent friction torque due to
centrifugal loading of the damper springs. Recommendations include further
testing to separate the coulomb friction mechanism from the viscous damping
mechanism, testing with the torque converter operating in open mode, and tests
on a series of customized dampers with centrifugal pendulum absorber
hardware.
PEMODELAN JUMLAH KASUS DEMAM BERDARAH DENGUE DENGAN MENGGUNAKAN MODEL AUTOREGRESSIVE DISTRIBUTED LAG
Authors: Nurdiansyah Denny , Sulistiawan Agus
Published: January 2024

This study aims to model dengue hemorrhagic fever (DHF) cases with an autoregressive distributed lag (ARDL) model to investigate significant predictor variables in Bojonegoro Regency. The selected predictor variables are the percentage of poverty, population, health facilities, and health workers. A research design with a quantitative approach was used to investigate the predictor variables in dengue cases with the ARDL model and the help of EViews. Stationarity, cointegration, classical assumptions, parameter significance, and model goodness assessment, namely R-square, MSE, AIC, and SBC, were tested. The research data source is secondary data, namely annual data from the reports of the Central Bureau of Statistics and the Health Office in Bojonegoro Regency from 2008 to 2022. The test results show only cointegration in the response variable, so the ARDL model is applied, but the lag distribution is only done on the response variable. In testing the significance of the parameters, it was found that an increase in the health workforce significantly affected the decrease in the number of DHF patients. At the same time, the other predictor variables were not significant
CONCEPT OF MUKHA SWASTHYA (ORAL HYGIENE) WITH AYURVEDIC PER-SPECTIVE
Authors: Biswas Tushar , Dubey Pawan , Chowdhury Kanchan
Published: January 2024

Background: Mukha is an Anga who is exposed to several risk factors on a regular basis, hence Mukha Swasthya (oral hygiene) is becoming more and more significant. Tobacco chewing, smoking, and other habits have increased the prevalence of oral cavity diseases. In Ayurveda, Dantdhawana, Kavala, Gandusha, and various other remedies are mentioned to maintain Mukha Swasthya. Ayurvedic classical texts prescribe Dan-tadhwana by Datuna (Chewing Sticks) in the morning and after every meal to prevent mouth ailments. Kavala comprises swishing a certain oil or herbal decoction in the mouth for a particular duration, whereas Gandusha involves retaining a larger quantity of liquid in the oral cavity for a longer period of time. Both treatments pro-mote comprehensive cleansing by eliminating dirt, pollutants, and potentially hazardous germs from the mouth and throat.
Material and Method: This review paper has been taken from different Ayurvedic classical textbooks, Text-books of Swasthavritta, and various modern and Ayurvedic research papers from PubMed, Google scholar, SCI etc.
Discussion: Ayurveda defines Dantdhawana vidhi as routine oral hygiene maintenance procedure in Dinachar-ya, including Kavala, Gandusha etc. Similar to this, modern practices like tooth brushing and gargling help to maintain oral hygiene to become healthy and free of diseases. These practices enhance dental health, reduce plaque formation, prevent cavities, alleviate halitosis, and promote gum health. Dantadhawana with its antimi-crobial, anti-inflammatory, and tissue-strengthening properties, may contribute to improving oral hygiene and gum health. On the other hand, in Kavala and Gandusha, the swishing action and the prolonged contact of the liquid with the oral tissues enhance the absorption of these beneficial compounds, aiding in the removal of pathogens and the restoration of oral balance.
Result: A vital sign of general health, happiness, and quality of life is good oral health. Dental caries, periodon-tal disease, tooth loss, oral cancer, orodental trauma, noma, and congenital impairments including cleft lip and palate are just a few of the illnesses and problems it covers. In Charaka Samhita, Dantadhawana is mentioned as the subset of Dincharya, whereas it was referenced by Acharya Sushruta in the section on cures (Chikista Sthana) and Ashtanga Hridaya primarily mentioned its preventive aspects. In various studies, it is found that Dantadhawana makes natural whitening of teeth, improves oral hygiene, Strengthen teeth and gum. Whereas Kavala and Gandusha help in reduction of harmful bacteria, makes breathe fresh, enhances oral health, nourish oral tissues.
An Exploration of the Lived Experiences and Psychological States of Migrants and Refugees
Authors: Akef Zainab , Poyrazli Senel , Quintero Isabel
Published: January 2024

UNHCR reports that about 82.4 million individuals were forcibly displaced as they attempted to avoid persecution, conflict, or human rights violations in their home countries. In addition to traumatic experiences, refugees encounter stressors such as low income, reduced social support, and language barriers. This qualitative study aimed to explore the impact of pre-migration trauma and political detainment on mental health outcomes and living conditions. A total of eight interviewees participated in video conferencing interviews. A non-probability convenience sampling using the snowballing technique was utilized to identify participants. Data were analyzed using an inductive approach for thematic analysis. The software Dedoose was used to come up with codes and the research team refined the codes into distinct themes. Four themes emerged from data analysis: extrinsic barriers, symptoms of psychological distress, coping and help-seeking behaviors, and interpersonal relationships. Results of the study show the intensity and difficulty of experiences faced by participants and the toll it takes on their mental state and family life. The results highlight a lack of resources available to refugees in the United States and a suggestion to further the research efforts for this understudied population.
Paraprofessionals in a Special Education Setting: A Qualitative Exploration of Their Perceptions
Authors: Max Chana , McCoy-Dailey Keisha
Published: January 2024

Paraprofessionals support teachers and students in the classroom. Their roles and responsibilities vary; however, their goal is always to improve student achievement. The purpose of the study was to fill a gap in the literature related to special education paraprofessionals’ perceptions, attitudes, and beliefs on the support and trainings they receive prior to and during their job as a paraprofessional for students in a special education setting. Generic qualitative methodology was used to capture the thoughts, experience, and perceptions of 42 paraprofessionals across the United States. Data collection included an eight-question online questionnaire. Results of the study revealed five patterns including (a) paraprofessionals are coming in with some training, (b) their ongoing training is not always consistent, (c) the biggest areas of struggle are addressing challenging behavior, (d) their education does not always prepare them for the responsibilities in the classroom, and (e) further support is needed for them to fulfil their responsibilities. After further analysis and synthesis, the five patterns were then condensed into two overarching themes which included paraprofessional training deficits and need for behavior support training. These findings are significant to school leaders and educators in order to properly support paraprofessionals in their roles of ensuring student learning and success.