bluuebunny/crossref_metadata_2025 huggingface dataset:
The Structure of Coronal Mass Ejections Recorded by the K-Coronagraph at Mauna Loa Solar Observatory
Authors: Song Hongqiang , Li Leping , Zhou Zhenjun , Xia Lidong , Cheng Xin , Chen Yao
Published: July 2023

Previous survey studies reported that coronal mass ejections (CMEs) can exhibit various structures in white-light coronagraphs, and ∼30% of them have the typical three-part feature in the high corona (e.g., 2–6 R
⊙), which has been taken as the prototypical structure of CMEs. It is widely accepted that CMEs result from eruption of magnetic flux ropes (MFRs), and the three-part structure can be understood easily by means of the MFR eruption. It is interesting and significant to answer why only ∼30% of CMEs have the three-part feature in previous studies. Here we conduct a synthesis of the CME structure in the field of view (FOV) of K-Coronagraph (1.05–3 R
⊙). In total, 369 CMEs are observed from 2013 September to 2022 November. After inspecting the CMEs one by one through joint observations of the Atmospheric Imaging Assembly, K-Coronagraph, and LASCO/C2, we find 71 events according to the criteria: (1) limb event; (2) normal CME, i.e., angular width ≥30°; (3) K-Coronagraph caught the early eruption stage. All (or more than 90% considering several ambiguous events) of the 71 CMEs exhibit the three-part feature in the FOV of K-Coronagraph, while only 30%–40% have the feature in the C2 FOV (2–6 R
⊙). For the first time, our studies show that 90%–100% and 30%–40% of normal CMEs possess the three-part structure in the low and high corona, respectively, which demonstrates that many CMEs can lose the three-part feature during their early evolutions, and strongly supports that most (if not all) CMEs have the MFR structures.
European cuckoo bees of the tribe Dioxyini (Hymenoptera, Megachilidae): distribution, annotated checklist and identification key
Authors: Bogusch Petr
Published: July 2023

Altogether, ten species of cuckoo bees of the tribe Dioxyini have been recorded from Europe, with two species distributed widely in the continent while others are restricted in distribution to only one or several countries in southern Europe. These ten representatives are classified into five genera: Aglaoapis, Dioxys, Ensliniana, Metadioxys and Paradioxys. Dioxys atlanticus is reclassified from a subspecies to a valid species, and new occurrence records of this species are reported. New synonymy is established for Dioxys cinctus = D. montanasyn. nov. The distribution, morphology, ecology and hosts of all species were reviewed from both published and unpublished sources. New red-list categories for each species were created according to the new records of occurrence. An identification key including all ten species and photographs of their whole bodies and main identification characteristics was prepared, and distribution maps for all species were created.
Structural Model of Community Participation in Rural Development in Jambi Province, Indonesia
Authors: Kuswanto Kuswanto , Anderson Irzal
Published: July 2023

This study aims to examine the level of community participation and its enabling factors. The study covered 277 rural communities selected by the area sampling technique, at the district, sub-district, and village levels. The data were analyzed using the SEM-PLS method. The analysis results show that the level of community participation in Jambi Province in village development is influenced by internal community factors, such as socio-economic status and community culture, while community external factors, such as the role of mass media, village head leadership and public services hardly have any significant effect. Community culture variables mediate social media variables and socioeconomic status in determining community participation. Therefore, it is suggested that the government optimize the role of mass media as a medium of information, education and services to strengthen culture. The government must also provide feedback on the community participation in the development in the form of public facilities, economic stability, security and ease of access to education so that it will make it easier for the community to improve their socio-economic status, which in turn will create a good culture of social life. It is necessary to disseminate information within the community about various forms of services to the population that are easily accessible so that the community can feel their role and enjoy benefits of these services.
Notes on Dysderidae (Arachnida, Araneae) of Armenia and Iran, with new species and records
Authors: Kosyan Armine , Zamani Alireza , Marusik Yuri M.
Published: July 2023

New data are provided on dysderid spiders of Armenia and Iran. Dysdera haykanasp. nov. is described based on male specimens collected in Kotayk and Lor provinces, central and northern Armenia. The female of Dysdera nakhchivanica Beydizade, Shafaie & Guseinov, 2018 is described for the first time, and the species is newly recorded from Armenia. Furthermore, new distribution data are provided for Harpactea armenica Dunin, 1989, including the first record of the species from Iran. Photographs and a distribution map are provided for all three species.
La matérialité du texte au service d’une micro-histoire du Rocher aux Vautours (Elkab). (1) L’apport de la stratigraphieطرائق كتابة النّص لخدمة التَّاريخ الجزئي لصخرة النسور (الكاب). (١) إسهام علم طبقات الأرض
Authors: Brémont Axelle
Published: July 2023

Le corpus de gravures rupestres du « Rocher aux Vautours », un large inselberg isolé dans l’arrière-pays d’Elkab, n’a jamais fait l’objet d’une publication complète intégrant à la fois ses nombreuses inscriptions hiéroglyphiques de l’Ancien Empire (dont la traduction et une étude de synthèse ont été publiées en 2001) et ses graffiti figurés, s’étalant de la période nagadienne au début de l’ère chrétienne. La reprise de son étude par la mission conjointe Yale University–Musées Royaux d’Art et d’Histoire de Bruxelles, dirigée par John C. Darnell et Wouter Claes, offre l’occasion d’en reprendre la documentation exhaustive en s’attardant plus particulièrement sur les conditions de réalisation matérielle des gravures. En passant en revue diverses méthodes d’étude (paléographie, application au matériel rupestre des principes de la stratigraphie, analyses de réseau), chacune illustrée par une étude de cas tirée du Rocher aux Vautours, cet article confirme combien l’analyse prosopographique et l’étude des superpositions et de l’économie d’occupation de la surface rocheuse peuvent se compléter et se nourrir l’une l’autre. La particularité des inscriptions hiéroglyphiques du Rocher aux Vautours, très ramassées chronologiquement (Ve dynastie-Première Période intermédiaire) permet même d’envisager une perspective de micro-histoire, afin d’examiner les relations au sein de ce groupe social et leurs pratiques de gravure dans le désert à l’échelle de quelques générations.
Enhancing Visibility: Djehutihotep’s Painter Horamenyankhuمن أجل رؤية أفضل: رَسَّام ﺪﭼحوتي حتب المدعو حورآمون يانخو
Authors: Devillers Alisée , Sykora Toon
Published: July 2023

This paper aims to evaluate the attestations of the people responsible for the creation and decoration of Djehutihotep’s tomb at Dayr al-Barshā. In particular, it focuses on the self-depictions of its senior artist, Horamenyankhu. The self-presentation of this artist is not limited to his choice of titles nor the apparel and attributes with which he depicts himself. It also includes less formal, but by no means less visually potent, artistic and compositional techniques that emphasize his contribution. After examining these aspects, Horamenyankhu’s attestations are framed within the traditions of artistic self-representation. Through these, it becomes possible to evaluate the exceptionality of his case.
Border une allée vers la Douat ? Les divinités sous la forme de sphinx au début de la Troisième Période intermédiaireعلى حدود ممر نحو اﻠ«دوات»؟ الآلهة على شكل أبي الهول في بداية عصر الانتقال الثالث
Authors: Joubert Émil
Published: July 2023

Des représentations de sphinx apparaissent sur quelques cercueils de la XXIe dynastie avant de devenir plus nombreuses par la suite. Elles surprennent par leur multiplication en contexte funéraire et leur nouvelle fonction : plutôt qu’une figure royale, plusieurs sont en effet désignées comme des divinités souvent inaccoutumées à l’aspect qui leur est ainsi donné. Les cercueils externes de Soutymes, Seramon et Taoudjatrâ élaborent ce motif sous la forme d’une frise. Le contexte suggère plusieurs pistes d’interprétation. Les allées de sphinx de la région thébaine sont alors réorganisées, peut-être par des directeurs de travaux tels que Seramon et Soutymes. Les statues y semblent parfois réinterprétées comme des images divines plus accessibles. Leur position à l’entrée des temples se refléterait dans celle des figures de sphinx en bordure des cercueils externes, insistant sur leur caractère liminaire et protecteur.
A Review on Screening, Isolation, and Characterization of Phytochemicals in Plant Materials
Authors: Rajasekar Arvindganth , Deivasigamani Priyadharsini , Amar Godavari , Moorthi Manicka , Sekar Sasikala
Published: July 2023

Plants are documented in the pharmacological manufacturing on their extensive essential diversity by fine such as their broad range of pharmacological activities. The biologically dynamic compounds existing in plants are named phytochemicals or plant secondary metabolites. The screening, isolation, and characterization of phytochemicals involve a multidisciplinary approach, involving knowledge from various scientific fields. Screening involves identifying plant species or parts rich in specific bioactive compounds, using methods like ethnobotanical surveys, traditional knowledge, and literature review. Isolation techniques, such as maceration, Soxhlet extraction, supercritical fluid extraction, and microwave-assisted extraction, are used to separate phytochemicals from complex plant matrices. Chromatographic techniques are used to determine the chemical composition and structural characteristics of isolated compounds. This review deals with the collection of plants, the extraction of dynamic mixtures as of the plant-based materials and its phytochemical screening by qualitative and quantitative analysis methods.
Marine Bioactive Products as Potential Antileishmanial Therapeutics
Authors: Adil Muhammad , Tiwari Pragya , Iqbal Mavara , Kanwal Shamsa , Umar Aisha
Published: July 2023

Leishmaniasis is a vector-borne, protozoal disease affecting a huge number of humans and animals across the world, particularly in developing countries. Recently, chemotherapeutic agents constitute the mainstay of treatment strategies against leishmaniasis. Nevertheless, the clinical effectiveness is compromised by their toxic effects and growing protozoal resistance. Consequently, the exploration and development of relatively safer and more effective, alternative therapeutics are critically required to combat this major health hazard of global significance. Marine habitats are rich in a wide range of chemical substances, with unique structural patterns and diverse pharmacological actions. This chapter describes the pharmacological basis, therapeutic implications, and safety profile of marine bioactive products as potential antileishmanial drugs.
Extending Student (R)esponse to (E)ngagement in a Bilingual Classroom
Authors: Ferraro Marisa
Published: July 2023

The growing diversity of students in schools has raised important questions regarding how students learning English and discipline-content simultaneously succeed academically. This challenge has been exacerbated by disparities in resources among multilingual communities throughout the COVID-19 pandemic. In problematizing the shape of classroom discourse, this chapter examines a middle school language arts lesson that fosters abundant turns at student talk. Two questions are explored in this study: 1) How does the teacher transform from an initiator to facilitator? and 2) What moves allow students to extend response to authentic engagement? Through a systemic functional linguistics analysis, the findings confirmed students (n=11) were afforded abundant opportunities to extend responses, averaging 90% of talk time, yielding high cognitive thinking and sophisticated academic language use. Educators play a critical role in privileging the shape of classroom discourses. Such powerful spaces need to be preserved and thoughtfully planned to equitably empower all students.
Influence of the Lateral Electrostatic Field on the Statistical Distribution of Charge Carriers in a Cylindrical Nanolayer of β-HgS
Authors: Harutyunyan Volodya A.
Published: July 2023

Analytical expressions are obtained for the wave functions and the energy spectrum of charge carriers in the β-HgS nanolayer of a cylindrical core/shell/shell β-CdS/ β-HgS/ β-CdS nanocomposite in the presence of a strong lateral uniform electrostatic field. It is shown that, under the influence of an external field, the position of the chemical potential of the electron-hole subsystem at absolute zero shifts to the bottom of the conduction band of the sample. The displacement value is determined by the intensity of the external field and increases linearly with increasing field. The concentration, internal energy, and heat capacity of the electronic subsystem of the β-HgS layer in the presence of a field are compared with similar values in the absence of a field. Calculations show that under identical conditions, the presence of an external field leads to an increase in the carrier concentration, which in turn leads to an increase in the internal energy and heat capacity of the system of electrons and holes in the layer.
The Finite Element Analysis on the Effects of Overlapping Rate in Low-Energy Laser Shock Peening
Authors: Qin En Wei , Li Wen Li , Shi Fei Fei , Que Yun Jie , Wang Ying , Wang Zhan Shan , Shi Gao Lian
Published: July 2023

Laser shock peening has been widely studied and pioneeringly applied in aerospace industry as a life-extension technology for structured mechanical components. However, in other promising fields such as nuclear power industry, little has been studied concerning such critical issues as long-distance transmission of the laser beam by optical fiber and optimized parameters of typically low pulse energy with micrometer-sized beam spots. In such scenario, the overlapping rate between adjacent small spots plays a critical role in obtaining homogenous residual stress and surface morphology. In this study, a three-dimensional finite element model in AISI 420 martensitic stainless steel has been developed to correlate the residual stress as well as surface morphology with varying overlapping rates. Multiple laser spots are loaded with VDLOAD user subroutine in Abaqus. The residual stress distribution is analyzed with respects of laser shocking and in-depth planes. And the surface morphology is evaluated in terms of depression depth as well as surface roughness. Combined results suggest that the overlapping rate of 61% as an optimized value, which can be used as a basis for future experimental studies and industrial applications.
Utilizzo della fotobiomodulazione con luce blu nel trattamento di ulcere di varia eziologia in pazienti mielolesi: studio di casi
Authors: Pezzuto Carla , Felisi Nadia , Crispini Nadia , Rosso Ilaria
Published: July 2023

Obiettivo dello studio di casi era verificare l’efficacia della fotobiomodulazione con luce blu come terapia per promuovere la guarigione di lesioni cutanee non rispondenti alle terapie convenzionali in pazienti mielolesi. Sono stati trattati 25 pazienti per un totale di 32 lesioni cutanee di varia eziologia, prevalentemente ulcere da pressione di 2°, 3° o 4° grado (rif. classificazione EPUAP/NPUAP), presenti da più di 90 giorni e che non mostravano segni clinici di evoluzione verso la guarigione, già sottoposte a trattamento con medicazioni avanzate per un periodo superiore a 4 settimane presso l’Unità Spinale. Per la terapia di Fotobiomodulazione è stato utilizzato un Dispositivo Medico di classe IIa (EmoLED) che impiega sorgenti LED che emettono luce blu nell’intervallo 410-430nm. Il trattamento con luce blu ha riattivato il processo di guarigione nel 68,7% delle ulcere trattate, con il raggiungimento di un livello di riepitelizzazione media pari al 72,8%. In base alla nostra esperienza preliminare la luce blu è una terapia che può contribuire a ridurre i tempi di cura e di ricovero e al miglioramento della qualità della vita dei pazienti; può essere utilizzata anche in pazienti fragili, in quanto ben tollerata e di rapida esecuzione.
Pregnancy outcomes following supplementation of single dose GnRH agonist to sustain the luteal phase in antagonist fresh embryo transfer cycles: A multicentric prospective cohort study
Authors: Parvathi Devi Tatapudi S V , Gahlot Alka , Sharma Sangita , Choudhary Manisha , Soni Ravikant , Sharma Meeta
Published: July 2023

Objective:

To determine whether a single dose of gonadotropin-releasing hormone (GnRH) agonist administered subcutaneously in addition to the regular progesterone supplementation could provide a better luteal support in antagonist protocol fresh embryo transfer cycles.

Methods:

This prospective, multicentric, cohort study included total 140 women, 70 in each group. Controlled ovarian stimulation was carried out as per fixed GnRH antagonist protocol. The trigger was given with hCG. In vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) was performed and day-3 embryos were transferred. Patients were divided into groups 1 and 2 based on computer generated randomization sheet. Six days following oocyte retrieval, group 1 received 0.2 mg decapeptyl subcutaneously in addition to regular progesterone support while group 2 received progesterone only. Luteal support was given for 14 days to both groups; if pregnancy was confirmed luteal support was continued till 12 weeks of gestation. The clinical pregnancy rate was the primary outcome. The implantation rate, miscarriage rate, live birth delivery rate, and multiple pregnancy rates were the secondary outcomes.

Results:

A total of 140 patients were analysed, 70 in each group. Clinical pregnancy rates (47.1% vs. 35.7%; P=0.17), implantation rates (23.4% vs. 18.1%, P=0.24), live birth delivery rates (41.4% vs. 27.1%, P=0.08), and multiple pregnancy rates (21.2% vs. 16.0%, P=0.74) were higher in group 1 than in group 2. Group 1 had a lower miscarriage rate than group 2 (5.7% vs. 8.6%; P=0.75). However, these differences were not statistically significant between the two groups.

Conclusions:

Administration of a single dose of GnRH agonist in addition to regular natural micronized vaginal progesterone as luteal support in GnRH antagonist protocol cycles marginally improves implantation rates, clinical pregnancy rates, and live birth delivery rates. However, more studies with higher sample sizes are needed before any conclusive statements about GnRH agonist as luteal phase support can be made.
Oxidized palm oil impairs reproductive functions and architectures in female rats
Authors: Modeste Wankeu-Nya , Kengne Inès T , Ateba Benjamin S , Bend Fortune E , Djeumeni Ornela N , Hatho Dominique T , Ngadjui E , Moundipa Paul F , Massoma Dieudonné L , Dongmo Alain B , Pierre Watcho
Published: July 2023

Objective:

To evaluate the effects of three oxidized palm oil diets (OPD) on female rat reproductive function.

Methods:

Forty-four female Wistar rats presenting five consecutive and regular estrous cycles were divided into 4 groups. The rats were fed with: a standard diet, 70% of standard diet+30% oxidized palm oil diet (OPD1), OPD1+5 g of boiled yolk egg (OPD2) and OPD1+10% sucrose (OPD3) for 125 days, respectively. During the feeding period, morphometric, estrous cycle, sexual behavior, gestation, biochemical and histomorphometric parameters were evaluated.

Results:

All OPDs significantly increased abdominal circumference, body mass index and Lee index coupled to an irregularity and lengthening of the estrous cycle. They significantly decreased appetite and consumption behaviours, quantic pregnancy index, fertility rate, implantation sites and index, serum progesterone and high-density lipoprotein levels, increased pre-implantation losses, anti-implantation activities, serum estradiol, triglycerides, total and low-density lipoprotein-cholesterol levels, and impaired brain and ovaries oxidative status. Histomorphometric examinations revealed increases in the number of atresic and primary follicles and decreases in secondary, tertiary, Degraaf, total and corpus luteum follicles in ovaries coupled to a neurodegeneration of hypothalamic anteroventral periventricular neurons in the OPD groups compared to the standard diet group.

Conclusions:

The three OPDs induce obesity and impair the female reproductive function, especially OPD2 and OPD3. These findings contribute to a better understanding of the adverse effects of palm oil bleaching on the reproductive function in female rats, which could be useful in the management of women with obesity-related sexual dysfunction.
Determination of the ovine ovarian reserve during the prenatal and neonatal periods
Authors: Sharum Isam B.
Published: July 2023

Objective:

To determine the ovine ovarian histomorphology and follicular staging at various age periods in Awassi breed.

Methods:

Ovaries were collected from prenatal fetuses [gestational age (95±5) days], neonatal (day 0), and prepubertal ewe lambs (two and four months of age); each age group included six animals. Ovaries (n=12, each group) were dissected and processed for hematoxylin and eosin staining. Stained sections (n=24, each group) were imaged and utilized for histomorphology assessment, follicle measurement, and classification.

Results:

Prenatal ovaries were mainly enriched with primordial follicles accompanied by a lower proportion of primary follicles. In addition to primordial and primary follicles, neonatal ovaries demonstrated a proportion of centrally located multilayered and antral follicles. In comparison with neonatal ovaries, the proportion of multilayered and antral follicles was significantly higher in the ovaries of two-month-old lambs; conversely, the proportion of peripherally situated primordial follicles dramatically declined compared to that of earlier age of lamb. Although there was no statistical variation in the sizes of primordial follicles across groups, the mean diameter of the primary follicle in the prenatal ovaries was substantially smaller than in postnatal ovaries. Compared to the neonatal ovaries, the size of the multilayered and antral follicles in the prepubertal ovaries was substantially larger.

Conclusions:

The earliest follicular developmental stages were established prenatally whereas the advanced growth stages started in the neonatal period and greatly increased in the prepubertal period.
A prospective study of amelioration of cognitive functions following alcohol abstinence in patients with alcohol dependence syndrome
Authors: Endreddy Ananda Reddy , Rajesh CH. Lakshmi , Seshamma VV
Published: July 2023

Background:

Increased intake of alcohol causes changes in the cognitive process, affecting many important functions such as execution, recent memory, and visuospatial abilities. Sometimes changes imparted by alcohol use are irreversible.

Aims and Objectives:

The impairments caused by alcohol abuse are usually underdiagnosed even though they are moderate to severe. To this purpose, we studied the cognitive improvement on abstinence of alcohol use.

Materials and Methods:

The present study was done in 100 patients, whose diagnosis was made as per the International Classification of Disorders-10 as alcohol dependence syndrome. Patients were administered with the scales, the Severity of Alcohol Dependence Questionnaire (SAD-Q), Montreal Cognitive Assessment, Postgraduate Inventory Battery of Brain Dysfunction (PGIBBD), Trail Making Test-B, Digit Span Test, and Digit Vigilance Test. The evaluation of patients was done after 2 weeks of the last alcohol intake and reassessed at the end of the 3rd and 6th months, scores were compared. Analysis of data was done by using mean and standard deviation for continuous variables. The categorical variables were presented as frequency and percentages, and the comparisons between the quantitative data were done by analysis of variance test.

Results:

The cognitive assessment revealed impairments in executive function, short-term verbal memory, recent memory, visuospatial abilities, visual recognition, and processing speed on initial evaluation, and all the values improved in 6 months of abstinence.

Conclusions:

In this study, we found, there was significant impairment in memory, executive function, processing speed, visuospatial and recognition skills, initially, and improvement in cognitive function in alcohol.
Ischemic fasciitis scalp-unusual presentation and location
Authors: John Preeti J. , Mahajan Richa , Kwatra Kanwardeep Singh , Singh Savreet Pal
Published: July 2023

We report a case of ischemic fasciitis in a 34-year-old male patient who presented with hard swelling on the anterior aspect of the scalp measuring 5 × 4 cm. He gave a history of wearing a tight turban constantly for many years. The lesion initially presented as redness of the skin, which gradually became a nodular swelling over 2 years. A computed tomography (CT) scan showed conical solid soft tissue attenuation mass. The operative findings were suspicious of neoplasm. However, the microscopic findings were typical of ischemic fasciitis, that is, a zonal pattern with central hypocellular fibrinoid necrosis surrounded by more cellular areas containing prominent proliferating neovessels and fibroblasts resembling granulation tissue. Ischemic fasciitis of the scalp is extremely rare, the present case occurred as a result of ischemia continuously exerted due to wearing a tight turban. This case highlights the importance of eliciting relevant case history and avoids histological misinterpretation of this pseudo-neoplastic lesion.
To interpret and analyze the changing patterns of histology and direct immunofluorescence findings in membranoproliferative glomerulonephritis
Authors: Nayak Pragnya P. , Pradhan Pranati , Pradhan Dilleswari , Mohapatra Nachiketa , Raman Sarojini , Sahoo Pranabandhu
Published: July 2023

Background:

Membranoproliferative glomerulonephritis has in the recent past been regrouped into immune complex-mediated (ICM MPGN) disease (driven by the classical complement pathway) and complement-mediated (C3GN) disease (driven by the alternative complement pathway) based on pathogenetic role of alternative complement pathway and immunofluorescence deposits. The proposed regrouping lent therapeutic and prognostic support in managing the disease of MPGN.

Aims and Objectives:

The present study is undertaken to study the patterns of MPGN based on histopathological and DIF examination and sub-categorize the cases into mainly complement dominant and immune complex-mediated diseases for better prognostic and therapeutic utility.

Materials and Methods:

This is a prospective observational study carried out in a tertiary care center over a period of 2 yrs. The clinically suspected cases of MPGN were subjected to histopathologic and direct immunofluorescence examination (DIF), and the findings were interpreted in light of complement-mediated and immune complex-mediated MPGN.

Results:

Out of 620 renal biopsies, diagnosis of MPGN was confirmed both on histopathology and DIF in 36 cases accounting for 5.8% of all biopsies. Based on DIF findings, the various groups comprised 20 cases (55.6%) of immune complex deposits, 11 (30.5%) of C3 dominant picture, and 5 (13.9%) of Nil immune deposits. On analysis of the patterns on DIF, 16 cases (80%) of C3 + Ig group and 6 (54.5%) of C3GN group showed predominantly MPGN pattern. Crescentic glomerulonephritis, global glomerulosclerosis, and interstitial fibrosis were markedly observed in C3GN group.

Conclusion:

DIF is of immense prognostic and therapeutic value in managing cases of MPGN.
Burnt out testicular tumor - A case report
Authors: Surapaneni Shri Lakshmi , Nutakki Ramakoteswar R. , Gangadharan Vandana , Gara Rupa K.
Published: July 2023

Spontaneous regression of testicular tumors known as burnt-out tumor of testis is a rare entity and is seen in about 5% of testicular germ cell tumors. It is described as a spontaneously, completely, or partially regressed testicular tumor with or without metastasis in the absence of any treatment. This entity is now included in the 2016 classification of testicular tumors. This is probably only the second case presented in India. High degree of awareness of this entity by the pathologist, clinician, and radiologist is necessary for proper management and survival of the patient.
Comparison of Clinico-pathologic features and outcomes of ANCA negative and ANCA positive pauci immune crescentic glomerulonephritis: A single centre study
Authors: Gupta Pallav , Bhargava Vinant , Malik Manish , Gupta Anurag , Bhalla Anil K. , Gupta Ashwini , Tiwari Vaibhav , Rana Devinder S. , Sapra Ramesh L.
Published: July 2023

Introduction:

Pauci-immune crescentic glomerulonephritis (PICN) is an important cause of rapidly progressive renal failure. 10–40% of PICN cases have ANCA (antineutrophil cytoplasmic antibody) negative serology. The present study compared clinico-pathologic features, Brix’s renal risk score, Berden’s histopathological classes and differences in outcome between ANCAnegative vs ANCA positive PICN patients.

Materials and Methods:

Sixty-one patients of biopsy-proven PICN were studied. Biochemical findings and ANCA serology were recorded. Renal biopsy slides were reviewed along with direct immunofluorescence. Clinical and histological features were compared between ANCA negative and positive PICN using the Man Whitney U test and Chi-square test. Patients were compared for distribution in Berden’s histological classes and Brix’s renal risk categories. Patient and renal survival were compared using Kaplan-Meier survival analysis.

Results:

ANCA negative PICN patients were younger (44.9 ± 16.5 years vs 53.6 ± 15.1 years, P = 0.049). Nasal (0 vs 18%, P = 0.035) and pulmonary involvement (9% vs 38%, P = 0.014) were lower in ANCA negative group. Both ANCA groups had similar renal biochemical profiles, percentage normal glomeruli, 16.3 ± 18.2 vs 21.7 ± 20.4 and percentage glomeruli with crescents, 64.5 ± 28.1 vs 64.3 ± 27.1. Twenty-seven per cent of ANCA negative cases fell in the sclerotic class in Berden’s classification vs just 2.5% in ANCA positive group (p = 0.037) without significant difference in Brix’s renal risk categories (p = 0.329). Thirteen per cent of ANCA negative patients achieved complete remission on treatment compared to 33% in ANCA positive patients. Patient survival and overall probability of progressing to ESRD were similar in the two groups.

Conclusion:

ANCA negative PICN cases present at younger ages. Nasal and pulmonary involvement is uncommon in these patients. Patient survival and progression to ESRD are similar in both ANCA groups.
A comparative analysis of clinicopathological features of HPV-associated and HPV-independent cervical carcinomas based on P16 INK4a immunohistochemistry: A one-year retrospective study
Authors: Chaganti Padmavathi D. , Konkay Kaumudi , Varghese Ann M.
Published: July 2023

The recent WHO classification of female genital tracts recommends cervical carcinomas to be further subtyped as HPV-associated and HPV-independent and accepted p16 immunoreactivity as a surrogate biomarker for HPV testing. This paper presents the clinicopathological spectrum of cervical carcinomas in correlation with p16 immunoreactivity.

Aims and Objectives:

This study aims to evaluate the immunoreactivity of p16 in cervical carcinoma, subtype them into HPV-associated and HPV-independent based on p16 immunoreactivity, and correlate them with clinicopathological features.

Design:

A hospital-based retrospective study of one-year duration was done after ethics approval. A total of 124 cases were identified, and various parameters like the presence of mitosis, lymphovascular invasion, tumor budding, tumor-infiltrating lymphocytes, the pattern of stromal invasion, and the pattern of necrosis were recorded and graded. Immunohistochemistry (IHC) with p16 marker was done in 40 cases, and immunoreactivity was correlated with clinical and histopathological parameters.

Statistical Analysis:

Multivariate analysis was done with Fisher’s exact test, and a P value of <0.05 was considered significant.

Results:

P16 was positive in 36 out of 40 cases which included 35 cases of squamous cell carcinoma (SCC) (keratinizing—14 out of 35 SCC, 11 positive out of these 14, non-keratinizing-21 out of 35 SCC, 20 positive, out of these 21), two cases of adenocarcinoma (both positive), two cases of adenosquamous carcinoma (both positive), and one case of small cell neuroendocrine carcinoma (positive). p16 negative in four cases (10%) (keratinizing type-3, non-keratinizing—1). P value was significant for HPV-independent carcinoma and keratinizing SCC morphology. The P value was not significant when p16 positivity with other parameters.

Conclusion:

HPV-associated were 90%, HPV-independent were 10%.
A case of superficial CD34 positive fibroblastic tumor: Diagnostic challenges and pitfalls
Authors: Dey Soumya , Chatterjee Uttara
Published: July 2023

Superficial CD34 positive fibroblastic tumor (SCPFT) is a recently described soft tissue tumor of intermediate grade with predilection for subcutaneous and superficial fascial planes. Morphological diagnosis of these tumors can be challenging because of overlapping features with other benign and malignant soft tissue tumors of fibroblastic and myofibroblastic origin. A middle-aged man came with a subcutaneous mass in the left thigh. Microscopic examination showed features of an SCPFT comprised of a circumscribed spindle cell tumor with focal striking pleomorphism and bizarre hyperchromatic nuclei. Immunohistochemically (IHC), the tumor cells showed diffuse positivity for CD34 and focally for cytokeratin. Diagnosis of SCPFT on the basis of morphology alone can be challenging. A constellation of clinicoradiological profiles, IHC features, and sometimes molecular studies clinch the definitive diagnosis which can be helpful in avoiding overtreatment and chemotherapy. Here we highlight the diagnostic challenges and pitfalls in a case of SCPFT.
Acute appendicitis the first sign of appendiceal metastasis of an inoperable carcinoma of stomach—A case report and a review of literature
Authors: Lanjewar Dhaneshwar N. , Katharotiya Pooja H. , Lakhani Palak M. , Thacker Mansi M.
Published: July 2023

Appendicitis is the most common cause of the acute abdomen and usually occurs because of the fecalith in adults and lymphoid hyperplasia in childhood. Gastric cancer metastasis to the appendix is a rare condition that might be present with symptoms of acute appendicitis. The English literature describes only thirteen cases of gastric carcinoma metastasizing to the appendix and presenting as acute appendicitis. In this report, we describe the first case of metastatic signet ring cell carcinoma of appendix presenting with clinical features of acute appendicitis.
Hepatocellular carcinoma (HCC) masquerading as hilar cholangiocarcinoma: An unusual presentation of jaundice
Authors: Mundhada Rohit O. , Chopde Amit N. , Kharat Reshma , Rane Swapnil , Goel Mahesh , Patkar Shraddha
Published: July 2023

Jaundice usually occurs in the late stages of hepatocellular carcinoma (HCC). Obstructive jaundice is rarely seen as an initial presentation of HCC, as opposed to cholangiocarcinoma. Various causes of obstructive jaundice in these cases also known as “Icteric HCC” have been described such as tumour thrombi, compression, infiltration or tumours arising from native hepatocytes in the bile duct. We present a case of 74-year-old gentleman with “Icteric HCC” that clinically and radiologically mimicked cholangiocarcinoma for which the patient underwent left hepatectomy with Roux-en-Y hepaticojejunostomy. Histopathology revealed dilated large duct with polygonal sheets of cells of hepatoid morphology which stained diffusely positive for both glypican 3 and Hep-par 1. The epicentre was in the left hepatic duct with no discernible liver lesion and the tumour probably originated from the ectopic hepatocytes within the biliary duct The patient was disease free at 1.5 years of follow up. In conclusion, HCC should be a differential for obstructive jaundice. Patients with such “Icteric HCC” benefit from surgical resection with favourable outcomes. The prognosis in such patients is better than in patients of HCC with jaundice due to hepatic insufficiency.
Multifocal intraosseous pseudomyogenic (epithelioid sarcoma-like) hemangioendothelioma: A rare presentation of an uncommon tumor
Authors: Godkhindi Vishwapriya M. , Monappa Vidya , Mailankody Sharada , Velu Umesh , Mohammed Shuiab M. V. , Banerjee Aisharya
Published: July 2023

Pseudomyogenic hemangioendothelioma (PHE) is an uncommon mesenchymal neoplasm of intermediate malignant potential showing endothelial differentiation. Around 20 cases of primary osseous PHE have been reported to date. A 16-year-old boy presented with complaints of pain in his right leg. Imaging revealed multifocal intramedullary and cortical-based lytic lesions involving long and small bones. Microscopic examination revealed plump, spindled cells arranged in fascicles and admixed “epithelioid” and “rhabdoid” cells sans vasoformative areas. By immunohistochemistry, the lesional cells were reactive for AE1/AE3, CD31, Erg, Fli1, and SMA, while immunonegative for CD34, myogenin, and S100. Nuclear expression of the INI1/SMARCB1 protein was retained. PHE is a rare entity, more so as a primary osseous lesion; therefore, awareness of the presence of this entity in the bone is the key to making a diagnosis. We discuss its clinicopathological features, differential diagnosis, and an attempt a short review of the literature.
A study to compare the performance of students following self-directed learning sessions conducted without online support and self-directed learning sessions conducted with the help of online support in the department of physiology
Authors: Sinha Parthasarathy , Chaudhuri Arunima , Adhya Debasis
Published: July 2023

Background:

Medical students need to develop self-directed learning (SDL) skills to become life-long learners.

Aims:

To compare the performance of students following SDL sessions conducted in the offline mode and SDL sessions conducted with the help of online support in the department of physiology.

Methodology and Participants:

This study was conducted on 200 first-phase MBBS students (Batch 21–22) after taking Institutional Ethical Clearance and informed consent of the participants. Nerve muscle physiology was taught using the two methods of SDL. The assessment was done using multiple choice questions. Pre-test and post-test were conducted for all sessions and ten such sessions were assessed in the present study. Feedback was taken from students and facilitators. Program evaluation was done using Kirkpatrick level 1 evaluation. Pre-test and post-test scores of the same group were compared using the paired t-test and among two groups were compared using an unpaired t-test.

Results:

Students performed significantly better in SDL sessions where online support was better and the performance of female students was significantly better as compared to male counterparts (87.27 ± 7.09 vs. 84.79 ± 8.49; P<0.001**). Students were satisfied with the SDL sessions and more so with online support. Faculty members and students emphasized that online support increased bonding among students as well as bonding with the facilitators.

Conclusions:

Providing online support to medical students was found to have positive effects on learning in the present study. Female students developed better problem-solving attitudes and critical thinking abilities as compared to males and were more motivated in learning.
My five moments of hand hygiene: A cross sectional questionnaire based study on adherence and barriers among nurses in central Kerala
Authors: Madhumitha S. , George Liya Mariam , Meenakshi K. S. , Vinson Alphonsa Clara , Sebastian Shaliet Rose , Benjamin Anoop Ivan
Published: July 2023

Background:

Hospital acquired infections have remained a concern in the field of health care as a major cause of increasing morbidity, mortality and health care costs in healthcare facilities. In the present era of emerging and re-emerging infectious diseases and multidrug resistant pathogens, there is a growing emphasis on basic measures of prevention of infections, like maintaining good hand hygiene. Although The World Health Organization (WHO) has issued guidelines on hand washing procedure with an aim to reduce the prevalence of hospital associated infections, the compliance amongst health care workers is poor.

Objective:

To study the adherence and barriers relating to non-adherence to the five moments of hand hygiene among nursing staff in Central Kerala.

Materials and Methods:

The present cross sectional study was conducted among 360 female nurses using Snowball sampling technique. The quantitative data collected was analysed using the software SPSS version 20. Chi-square test was used for comparison of proportions across groups. Logistic regression analyses were used to find out the determinants of non-adherence. The qualitative data collected was analysed using thematic analysis and classified into themes and subthemes.

Results:

Out of 338 study participants, 304 (90%) reported to be adherent to the 5 moments of Hand Hygiene. The present study found that factors associated with hand hygiene behaviour among study participants were awareness about Hand Hygiene and educational qualification.

Conclusion:

The existing level of non-adherence can be a source for outbreak of hospital acquired infections in the community and hence needs to be addressed.
Diabetes risk assessment among medical students of a medical college in Andhra Pradesh: A cross-sectional study
Authors: Ajaykumar Enibera , Anjanappa Thilak Sura , Sunanda Komera , Pranaya Y.
Published: July 2023

Background:

A major global health concern in the 21st century is diabetes. The prevalence of diabetes in India is 8.3%, and 647,831 deaths were related to diabetes in India. Medical students tend to have a sedentary lifestyle due to academic demands, which makes them more prone to noncommunicable diseases such as diabetes. The study was conducted to assess the risk of type 2 diabetes mellitus and to determine the factors associated with the risk of diabetes among medical students at a medical college in Andhra Pradesh.

Materials and Methods:

A cross-sectional study was conducted among 277 medical students in a medical college in Andhra Pradesh. The Finnish Diabetes Risk Score scale was used to assess diabetes risk, and data were collected through online mode using Google Forms after taking informed consent. Descriptive statistics and the Chi-square test were used, and P < 0.05 was considered statistically significant.

Results:

The risk of acquiring diabetes in the next 10 years was slightly elevated in 46 (16.6%) female students, 7 (2.5%) male students, and moderate risk in 4 (1.4%) female students. There was a significant association between diabetes risk and body mass index, physical activity >30 min, eating veg/fruits daily, history of high blood glucose, and history of diabetes in the family.

Conclusion:

According to the study, one-fifth of students had a slightly elevated or moderate risk of diabetes in the next 10 years.
A study on self-medication in ophthalmic emergencies in the rural population of South India
Authors: Shetty Kiran , Vinay P. G. , Lobo Sarita R J , Vijayaraghavan Lakshmi K.
Published: July 2023

Background:

Self-medication has been defined as the taking of drugs, herbs, or home remedies on one’s own initiative and advice from another person without consulting a medical specialist. The objective of the study was to identify the pattern of self-medication in ophthalmic emergencies in patients attending the emergency department in a peripheral rural setup in south India.

Materials and Methods:

This was a descriptive, cross–sectional, questionnaire-based observational study. The patients selected were above 18 years of age. Informed consent was taken. A questionnaire on the demographic characteristics, level of literacy, history of the ophthalmic condition for which the patient had self-medicated, type of self-medication resorted to , reasons for resorting to ocular self–medication, and the adverse effects reported were all noted in the study.

Results:

The study included 100 subjects. Fifty-three percent were male and 47% were female. Among the 100 subjects, 10% of the individuals were educated above primary school level. Thirty-five percent had only primary school level education and the remaining 55% had not been to a formal school and had no basic education. Among our respondents, the most commonly used self-medication was antibiotic drops (24%), followed by expired medication (23%). 20% used steroid drops. 15% had tried traditional eye medication (TEM). Herbal and other indigenous medications were used by 12% of the responders. 7% used oral nonsteroidal anti-inflammatory drug agents. None of the responders were aware of the adverse effects of self-medication. The most common ophthalmic emergency symptoms faced by our responders were excessive watering (37%), pain (28%), foreign body in the eye (14%), redness and discharge (12%), decreases vision (5%), and pain in the eye (4%). The common reasons given by our responders for not accessing health-care facilities were distance (living far from health-care facilities), advice from family and friends, belief if local healers, lack of finances and poverty, and lack of prioritizing health care. Following self–medication, 30% of the patients had infectious keratitis, 28% had conjunctivitis, 25% had epithelial defects, and 17% glaucoma.

Conclusion:

Irrational long-term use of drugs/traditional eye medicine or even the usage for ophthalmic emergencies can have dangerous visual outcomes. The study highlights the need of effective execution and establishment of high-quality accessible primary eye care services and health-care referral network in rural India.
A study of thyroid function in polycystic ovary syndrome
Authors: Dsouza Susan , Hegde Narasimha
Published: July 2023

Background and Objectives:

Polycystic ovary syndrome (PCOS) is a complex endocrine disorder of multifactorial etiology. PCOS is associated with thyroid dysfunctions ranging from subclinical hypothyroidism, autoimmune thyroiditis, hyperthyroidism, and multinodular goiter. This study evaluated thyroid function in patients with PCOS.

Methods:

This comparative case-control study was done among 186 patients attending the outpatient services of a tertiary care hospital. Patients aged between 18 and 30 years were evaluated; 93 candidates with PCOS were diagnosed using the Rotterdam 2003 criteria and 93 candidates without symptoms or signs of PCOS were selected as controls. Details of symptoms and clinical examination were obtained and their serum thyroid-stimulating hormone and serum-free thyroxine were estimated. Data were statistically analyzed for differences in clinical profile and thyroid function which were compared among the groups.

Results:

The mean age of the participants was 23.65 and 24.83 years in the case and control groups, respectively. The most common features in the PCOS group were hyperandrogenism (79, 85.9%) and oligomenorrhea (66, 71.7%). The mean body mass index in the PCOS group (23.76 kg/m2) was found to be significantly higher as compared to the controls. Thirty-three (34.4%) patients with PCOS were found to have thyroid dysfunction as compared to 7 (7.5%) in the control group. Among PCOS patients, hypothyroidism was more common than subclinical hypothyroidism.

Conclusion:

The occurrence of hypothyroidism and subclinical hypothyroidism was found to be higher in patients with PCOS. Hypothyroidism was more frequent among patients in the PCOS group than in the control group.