bluuebunny/crossref_metadata_2025 huggingface dataset:
Loss of Motor Evoked Potential in the Exposure Stage of Scoliosis Surgery in a Patient with Kyphoscoliosis
Authors: Vijay Vani , Thomas Anoop , Menon Sajesh K
Published: February 2024

Somatosensory-evoked potential and motor-evoked potential (MEP) are used during complex spinal surgeries to ensure the neurological integrity of the patient. Here, we report a case of a patient with type 3 thoracolumbar scoliosis whose surgery was stopped due to loss of signal in the neuromonitoring over the right lower limb in the exposure stage, before instrumentation and manipulation. The patient had right lower limb weakness and hence the surgery was abandoned. The same abnormality was present when we tried surgery for the second time. Surgery was aborted and the potentials recovered and the patient woke up without disability. In summary, this case illustrates that changes in MEPs can occur even at early stages in more vulnerable cases and is to be looked for to avoid disability.
Subacute Sclerosing Panencephalitis
Authors: Prasad Chandrajit , Netravathi M , Kulanthaivelu Karthik , Bhat Maya D , Pendharkar Hima
Published: February 2024

Background:

Subacute sclerosing panencephalitis (SSPE) is a rare entity characterized by a protracted course and progressive neurological deterioration.

Objective:

We present patterns of diffusion restriction in eight cases of SSPE, a seldom described imaging attribute.

Methods:

A retrospective analysis was performed on the clinical and neuroimaging data obtained from records of patients with proven SSPE. Patients whose magnetic resonance imaging (MRI) showed evidence of diffusion restriction were included in the analysis. MRI was performed on 3 T and 1.5-T clinical MR systems. Imaging characteristics were reviewed and tabulated by two neuroradiologists.

Results:

Eight SSPE patients (seven men, one woman; age range: 5–15 years; mean age: 11 years) diagnosed and managed at our institute were included in the analysis. Restricted diffusion was evident in the basal ganglia (n = 3), corpus callosum (n = 2), white matter (n = 2) and in bilateral middle cerebellar peduncles (MCP) (n = 2). One patient had diffusion restriction in the genu of the corpus callosum and bilateral frontal cortical white matter. None of the diffusion-restricted lesions showed contrast enhancement or susceptibility. Six cases fulfilled the diagnostic criteria for fulminant SSPE (fSSPE). The extent of neuroparenchymal involvement was greater in this subset of patients.

Conclusions:

Restricted diffusion in SSPE, hitherto infrequently described, can indeed occur in both grey and white matter structures and in both supratentorial and infratentorial compartments. Parenchymal diffusion restriction in SSPE possibly reflects an early time point in the clinical evolution. A greater extent of parenchymal diffusion restriction may portend a rapid downhill course, possibly qualifying for fSSPE.
Utilization of smart technology for pediatric cardiac consultations in acute care settings: Pediatricians’ perspective
Authors: Bakr Asmaa , Rakha Shaimaa
Published: February 2024

Objectives

Smart technology (ST) is starting to be integrated into cardiology medical practice. Therefore, this work aims to assess the extent of ST utilization among young pediatricians in acute pediatric cardiology consultations.

Methods

Between December 2021 and May 2022, a survey was distributed online to pediatricians linked to emergency services regarding pediatric cardiology consultations. The questionnaire was formulated to gather demographic data of participants, ST devices, and applications used. Questions explored cardiac diseases and acute presentations where ST was used. Pediatrician’s perspective of the benefits, outcome, limitations, and drawbacks of this consultation form was investigated.

Results

Smartphones were the most used ST device 83/85 (97.65%) for acute cardiac consultation in pediatrics, especially messaging applications such as WhatsApp (92.94%); none of participants chose emails or simple short message service. The most accurately transferred data were vitals, laboratory results, and electrocardiogram. Arrhythmia was reported as the disease benefits the most from ST consultations. Starting supportive therapy was the highest immediate benefit from pediatricians’ perspectives. Although it could not impact mortality, ST was thought to shorten the waiting time for consultations by 65 (76.47%). The major ST limitation was network coverage difficulties (50.58%), and possible consultation delay was the significant drawback in acute settings.

Conclusion

Smartphones are widely utilized for pediatric cardiac consultations in acute conditions, especially messaging applications. Most acute cardiac consultations are performed for heart failure and arrhythmia in children with the high benefit of shortening the waiting time for preliminary cardiac specialized opinion. However, several concerns about the limitations and drawbacks of ST use in acute cardiac specialty consultations warrant further research and organization.
Bone mineral density among β–thalassemic children: age and sex comparative study
Authors: Abozid Saad S. , Elalfy Omar , El-Feky Said S. , Samir Hekmat , Abdelghafour Reem A. M. , Abdallah Tarek M. A.
Published: February 2024

Background

Parathyroid function and bone mineral density (BMD) in β–thalassemia major (β-TM) patients are provided. Some recent suggestions are presented about the cellular and structural changes in thalassemia bones.

Aim

The current work aims to study BMD and related mineral and hormonal profiles in β-TM cases and its relation to the sex and age strata of the patients.

Patients and methods

The study includes 30 healthy control and 55 β-TM patients who were divided into subgroups according to age and sex. Parathormone (PTH), ferritin, and calcium were investigated. The dual-energy radiography absorptiometry were used to the assessment of BMD.

Results

Serum ferritin level was as expected significantly elevated in β-TM cases. Serum PTH was significantly lower in β-TM cases when matched with healthy control. Serum calcium was within normal in β-TM. BMD of lumber spine in β-TM was markedly detracted when matched with the healthy normal group. 76% of our cases showed reduced BMD.

Conclusion

BMD is reduced in 76% of β-TM. PTH is reduced in all age strata of β-TM.
Neurodevelopmental outcome after nosocomial sepsis in preterm neonates: a retrospective cohort study
Authors: Hasan Ayman G.H. , Khashaba Mohamed T. , Abdel-Fattah Abdel-Hady E.-G. , Eltantawi Noha T.
Published: February 2024

Background

Nosocomial infections (NIs) are associated with significant mortality affecting up to 56% of all infants, as well as long-term morbidity, prolonged hospital stay, and increased healthcare costs.

Objective

This study aimed to compare neurodevelopmental outcomes at 18 months of age in preterm infants exposed to nosocomial sepsis (NS) during neonatal ICU admission with the outcomes in unexposed preterm infants.

Study design

This was a retrospective study in the follow-up clinic of the neonatal ICU of a tertiary hospital.

Participants

Preterm infants who met the criteria were divided into: group A exposed to NS and group B not exposed to NS.

Intervention

All infants were examined across the three domains of neurodevelopment: cognitive function, language, and motor function. The examination was done at 18 months of corrected age, using the Bayley Scales of Infant and Toddler Development (III).

Outcome

The neurodevelopment of preterm infants at 18 months of age.

Results

Among the 61 former preterm infants at 18 months of age, who met the criteria, 31 were exposed and 30 were not exposed to NS. Male infants, low birth weight, and low APGAR score were significantly higher in the nosocomial group. Gram-negative organisms accounted for 60% of cases. Staphylococci accounted for 16.7% of the cultures. The neurodevelopmental delay was more in the sepsis group than in the nonsepsis group in all functions examined, and the difference was significant, and sepsis cases accounted for about 2/3 of the cases that had neurodevelopmental impairment.

Conclusion

This study showed that neurodevelopmental impairment was significantly increased in neonates who developed NI despite treatment with effective antibiotic therapy.
Shining a Light on TORCH Infections in Pregnancy
Authors: Gopalakrishnan Ram , Kandikuppa Ravi Teja
Published: February 2024

TORCH infections continue to present to clinicians as a diagnostic and therapeutic problem. There is a great need for awareness regarding prepregnancy serology screening tests, vaccination, and safety measures to prevent these infections which cause serious fetal sequelae, particularly rubella and varicella zoster being vaccine-preventable diseases. Serology testing for these infections along with immunoglobulin G avidity testing should be more commonly available. In this review, we discuss the evaluation needed prepregnancy, during pregnancy if there is a suspected infection, and treatment of TORCH infections.
The Current State of Adult Immunization in India: Challenges and Opportunities
Authors: Ramabhadran Madhumitha , Ramasubramanian Venkatasubramanian
Published: February 2024

Immunization has been a quintessential part of preventive health saving millions of lives from Vaccine preventable diseases. Adult immunization has also been accepted as an important intervention mandated by immunosenescence and newer co-morbidities faced by adults. However, there has been little headway in establishing adult immunization as an integral aspect of health care for older adults in India. There have been several challenges identified for this scenario. Apart from limited guidelines for vaccinating adults, poor awareness, limited access, vaccine hesitancy and expense play an important role. Though customized guidelines for the Indian population is warranted along with improving awareness about vaccines in the adult population, access to care through adult vaccines are mandatory to establish a functional system. Apart for reiterating vaccines that are most useful for the Indian adults, this commentary outlines the various facets of setting up an adult vaccine clinic in the Indian context.
Evaluation of taste score and fungiform papillae quantification using digital image analysis in COVID-19 patients with smell and taste dysfunction
Authors: Srikantaiah Vidya Chikkarahalli , Bilimale Anil Somashekara , Doddawad Vidya Gowdappa , Marulaiah Srinath Kenkere , Gowdappa Hathur Basavana , Shankaregowda Ranjitha , Madhu Basavegowda , Thotambailu Amulya Manohar , Achar Raghu Ram
Published: February 2024

Background:

The COVID-19 pandemic which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has created a major global health crisis in recent years. Despite this, there have been few studies that have utilized reliable methods to assess changes in taste and smell perception. Therefore, our study aims at the number of fungiform papillae and objective measures of taste perception relationship among COVID-19 patients with olfactory and gustatory disorders.

Materials and Methods:

This was a cross-sectional analytical study in which 57 COVID-19 patients were recruited who confirmed the dysfunction of taste and smell. Objective assessment of the sense of taste was evaluated using four different standardized solution preparations, and the scores were given according to the patient's statements. Digitalized quantification of fungiform papillae was counted. The data were analyzed with the Pearson's correlation coefficient using the SPSS version. 23 [Licensed JSSAHER, Mysuru, Karnataka, India], and the level of significance was set at <0.001.

Results:

In terms of altered or reduced taste and smell, male patients exhibited a higher incidence compared to females. Compared to the sour taste, a substantial number of COVID-19 patients have displayed a notable decrease in their ability to taste sweet, salty, and bitter flavors. However, a statistically significant positive correlation was observed between taste scores and fungiform papillae density (r = 0.518, P < 0.001).

Conclusion:

Our Study demonstrated that the quantitative evaluation of taste perception and the count of fungiform papillae can serve as important indicators of SARS-CoV-2 infection, and could potentially help in the early detection and treatment of COVID-19 patients, as reduced taste function is a significant marker of the disease.
Relationship between periodontal disease and obstructive sleep apnea in adults: A systematic review
Authors: Bianchi Edoardo , Segù Marzia , Toffoli Andrea , Razzini Geremia , Macaluso Guido Maria , Manfredi Edoardo
Published: February 2024

The purpose of this systematic review was to evaluate whether there are scientific evidence regarding the association between periodontitis and obstructive sleep apnea (OSA) in adults. An electronic search was performed on MEDLINE/PubMed for prospective and retrospective longitudinal studies, cohort studies, and case–control studies conducted in human adults affected by both OSA and periodontitis. Two reviewers extracted the data using a custom Excel spreadsheet. A methodological assessment of the quality of the studies was performed using the Newcastle–Ottawa Scale. Fourteen studies were included. All studies evaluated the association between periodontitis and OSA. None of the studies evaluated the cause–effect relationship. Eleven studies found a significant positive relationship between periodontitis and OSA, whereas three found no statistically significant association. Several study limitations were observed, such as lack of standardization of study groups, diagnosis of periodontitis and OSA, and differences in study design. Evidence of a plausible association between periodontitis and OSA was found. The possible relationship could be explained by systemic inflammation, oral breathing, and the comorbid relationship attributable to common risk factors. Observational and randomized controlled studies are needed to clarify the mechanism of interaction between the two conditions.
Effect of polishing versus glazing of CAD-CAM ceramics on wear and surface roughness of opposing composite resin
Authors: Khoramian Esfahani Mina Sadat , Ahmadi Ghazaleh , Esmaeili Behnaz
Published: February 2024

Background:

This study aimed to assess the effect of polishing versus glazing of computer-aided design-computer-aided manufacturing (CAD-CAM) ceramics on depth of wear and surface roughness of opposing composite resin.

Materials and Methods:

This in vitro study was conducted on 40 Z250 composite and 40 CAD-CAM ceramic specimens including Celtra Duo, Vita Mark II, e.max CAD, and Vita Suprinity ceramics. All ceramic specimens were roughened by a fine-grit bur after primary glazing to simulate an adjusted surface in the clinical setting. They were then randomly assigned to two subgroups and underwent reglazing or polishing. All composite and ceramic specimens underwent profilometry after surface treatment and prior to the wear test, and the results were recorded quantitatively. Composite specimens were then subjected to 120,000 wear cycles against ceramic specimens in a chewing simulator, and the depth of wear was measured by a scanner. Data were statistically analyzed by repeated measures two-way analysis of variance (ANOVA) and one-way ANOVA (α = 0.05).

Results:

Comparison of the surface roughness of composite specimens before and after the wear test revealed significant differences in both glazed Suprinity (P = 0.048) and Vita Mark II (P = 0.026) ceramics groups. The change in surface roughness after the wear test (compared with baseline) was significant in glazed (P = 0.000) and polished (P = 0.013) Vita Mark II and polished Suprinity (P = 0.037) ceramics, but this change was not significant in other ceramics (P > 0.05). The depth of wear after the wear test was not significantly different among the ceramic and composite subgroups (P > 0.05).

Conclusion:

Assessment of depth of wear and surface roughness of composite specimens showed that the polishing kits of CAD-CAM ceramics can serve as a suitable alternative to reglazing.
Multicystic renal dysplasia, a histomorphological spectrum: Seven years experience from a tertiary care hospital
Authors: Gupta Kanika , Mandal Shramana , Mallya Varuna , Singh Meeta , Khurana Nita , Sarin Yogesh K.
Published: February 2024

Objectives:

Multicystic dysplastic kidney (MCDK) is defined as the presence of multiple noncommunicating cysts of various sizes, detected sonographically, without evidence of functioning renal parenchyma on dimercaptosuccinic acid renal scan. It has an incidence of 1:4000 live births. They are more commonly diagnosed in boys, usually on the left side, but may also be bilateral. There is the presence of primitive ducts surrounded by fibromuscular connective tissue. These are because of the disturbed connection of the ureteric bud with renal blastema and abnormal division at the stage of metanephros, resulting in an abnormal metanephros differentiation.

Materials and Methods:

Thirty cases of MCDK were included to study their histomorphology along with their clinical features. Cases were retrieved from the last seven years (2015–2021) from the Department of Pathology, Maulana Azad Medical College.

Result:

Age ranged from 10 days to 18 years. The cases were between 1 years and 5 years of age. Six out of 30 cases (20%) were infants with three of them being neonates. Twenty-one cases were males. All the cases had unilateral kidney involvement with the left kidney being involved in 20 out of 30 cases. Twenty-eight cases underwent nephrectomy in view of small contracted nonfunctional kidneys with one of them being horseshoe shaped. Five cases had associated hydronephrosis (two ipsilateral and three bilateral). One case had Hirshprung’s disease, four had anorectal malformation, two had posterior urethral valves with vesicourethral reflux, one had duplex moiety, and one had undescended testes. On histopathological examination, all of them showed the presence of immature disorganized tubules surrounded by a collarette of immature mesenchymal stroma. One of the cases showed osteoid formation and four had areas of immature cartilage. Normal kidney parenchyma was seen at the periphery in four cases.

Conclusion:

This series has been presented to highlight the various histomorphological features of MCDK. MCDK can be managed conservatively in most of cases due to autoinvolution and, hence, needs to be differentiated from other close differentials like polycystic kidney disease, cystic nephroma, and cystic partially differentiated nephroblastoma in order to avoid unnecessary surgical intervention.
Papillary glioneuronal tumor: A rare case with recent updates as per 2021 CNS WHO 5th classification
Authors: Mehrotra Bandana , Bhargav Mithlesh , Kapoor Ashok , Pandey Shubhi , Brij Saumya , Gopal Vaibhav R.
Published: February 2024

The papillary glioneuronal tumor is a WHO grade 1, rare neuronal-glial tumor and comprises 0.02% of all CNS tumors. Histologically, it is a mixture of glial and neuronal components showing a pseudopapillary pattern with hyalinized vessels. PGNT is considered a low-grade neoplasm, and surgical excision has been curative in most cases. In this paper, we report a new case of papillary glioneuronal tumor in a 44-year-old male having a divergent presentation, to analyze it due to the rarity of its occurrence as per the latest classification.
Comparison of molecular analysis results determined by next-generation sequencing to immunohistochemical indicators and clinicopathological parameters in prostate adenocarcinomas
Authors: Balta Merve Çırak , Erdoğdu İbrahim Halil , Oktay Esin , Çulhac Nil
Published: February 2024

Background:

Prostate cancer is a common cancer in males, frequently leading to mortality. Multiple genetic factors play roles in prostate cancer pathogenesis. Demonstration of pathological pathways and customised treatment options have been possible with next-generation sequencing.

Aim:

In this study, we aimed to evaluate the relationships of the changes in the prostate cancer pathways genes with the pathological, immunohistochemical and the clinical parameters.

Study Design:

Retrospective cross-sectional study.

Materials and Methods:

Among the prostate needle biopsy materials investigated in Adnan Menderes University Faculty of Medicine, Department of Pathology, thirty-one cases, who had been analysed using the next-generation sequencing system, were included in this study.

Results:

As a result of statistical analysis, a significant relationship was found between the pathogenic mutation detected in androgen receptor and Breast Cancer Gene 2 genes and tumour volume. In all cases with a pathogenic mutation in the androgen receptor gene, a pathogenic mutation in the Protein Tyrosine Phosphatase and Tensin Homolog gene was also observed and a significant relationship was found between them. Castration resistance was observed in cases with high tumour volume, and a statistically significant difference was found. A statistically significant relationship was found between tumour volume and Ki-67 expression. In addition, a significant relationship was observed between the castration resistance and Ki-67, c-erbB2 expressions. A statistically significant relationship was found between Ki-67 and c-erbB2.

Conclusion:

Regarding prognosis prediction and treatment, identifying the molecular changes in genes playing roles in prostate cancer with next-generation sequencing is very important.
Identification of hub genes and pathogenesis in Kawasaki disease based on bioinformatics analysis
Authors: Cao Min , Zhang Zhenhu , Liu Qian , Zhang Yuda
Published: February 2024

Background:

The aim of this study was to explore new biomarkers of Kawasaki disease (KD) and provide evidence for clinical diagnosis and treatment.

Materials and Methods:

Gene Expression Omnibus (GEO) datasets GSE68004 and GSE73461 were downloaded, and the differentially expressed genes (DGEs) were taken, along with DEGs enrichment analysis and protein interaction network. Finally, five algorithms in CytoHubba plug-in were applied to obtain hub genes.

Results:

In this study, 32 Co-DEGs were identified, and these genes mainly participated in neutrophil degranulation, neutrophil activation involved in immune response, and negative regulation of cytokine production involved in immune response; meanwhile, they were primarily enriched in starch and sucrose metabolism, fatty acid metabolism, autophagy and apoptosis, ferroptosis, and other pathways. Combined with the results of PPI and CytoHubba, 13 key genes were selected as follows: S100A12, HK3, HP, MMP9, MCEMP1, PYGL, ARG1, HIST2H2AA, ANXA3, HIST2H2AC, HIST2H2AA3, GYG1, DYSF.

Conclusions:

These 13 key genes may mediate the occurrence and development of KD through various processes such as immune regulation, inflammatory response, glucose metabolism, autophagy, and apoptosis, which provide valuable references for the diagnosis and treatment of KD.
Disseminated multiloculated peritoneal inclusion cysts: Bubble trouble in belly
Authors: Osama Md A. , Aggarwal Aditi , Rao Seema , Yadav Amitabh , Verma Ritu
Published: February 2024

Multiloculated peritoneal inclusion cysts, usually arise from peritoneal mesothelium lining the serous cavity of the abdomen, pelvis and retroperitoneum. These lesions can be incidentally found on imaging or during surgery, and confirmation of the diagnosis is done by radiological imaging, histomorphology and immunohistochemical findings. Although fewer than 200 cases of solitary peritoneal inclusion cysts have been reported, their occurrence in a disseminated fashion has hardly ever been described in literature. Herein, we report a case of multiloculated peritoneal inclusion cysts that involved the whole abdominal and pelvic cavity and were successfully treated with surgery.
Knowledge, attitudes, and practices toward COVID-19 and its prevention among medical and dental students in an educational institution in Telangana
Authors: Deshpande Preeti U. , Basavaraju Anuradha , Veerapu Nagapraveen , Akula Ashish
Published: February 2024

Background:

Coronavirus disease 2019 (COVID-19) emerged as a global pandemic, threatening millions of lives worldwide. Everyone was overwhelmed by the plethora of information from different sources, creating confusion, misconceptions, and panic in the community.

Aims:

This study aimed to estimate the knowledge, attitudes, and practices (KAP) among medical and dental students toward COVID-19 and to identify factors influencing them.

Materials and Methods:

A cross-sectional study was conducted among undergraduate students enrolled in MBBS and BDS courses, and KAP scores were calculated using a self-administered questionnaire. The statistical analysis was done by unpaired t test and one-way analysis of variance.

Results:

MBBS students had higher KAP scores when compared with BDS students. Knowledge gaps were discovered in the areas of COVID-19 transmission through blood, World Health Organization (WHO)-designated variants of concern, disinfectant usage, and mandatory vaccination. A majority (91.33%) of the students had a positive attitude toward COVID-19. Better knowledge and practice scores were significantly associated with vaccinated students and those who trusted government website resources.

Conclusion:

Curriculum modifications and creative teaching strategies can fill the lacunae in the KAP scores. Medical and dental students, as torchbearers of the healthcare fraternity, can play a critical role in raising awareness during public health emergencies.
A serious warning: A case report on localized amyloidosis of the oral cavity
Authors: John Sharon , Subba Priyambadha , Aramugam Aravindhan , Gupta Shalini , Khanna Richa
Published: February 2024

Amyloidosis is a relatively rare condition with an array of complex pathophysiology. Localized amyloidosis is a rare and benign condition that practically never results in any clinical repercussions in the head and neck area. Multiple soft nodules of the tongue, lip, and cheek are the most commonly described defining characteristics of localized oral amyloidosis. These nodules originate due to the proliferation of abnormally folded protein aggregates in the body’s extracellular tissue compartments, which destroy organ structure and function. Herein, we address the case of a female infant aged one with a smooth nodule in the labial mucosa who was diagnosed with primary localized amyloidosis. When a patient is diagnosed with amyloidosis of the oral mucosa, the possibility of systemic amyloidosis or an underlying plasma cell dyscrasia must be ruled out. Surgical treatment may be beneficial for eliminating any functional impairment if primary localized amyloidosis is established.
Lipoblastoma of the lip
Authors: Cota Jochima , Borkar Richa R. , Savalkar Jitisha J. , Chalakkal Paul , Spadigam Anita
Published: February 2024

Lipoblastomas are benign tumors arising from embryonic white fatty cells that continue to proliferate and develop during the postnatal period. It commonly affects children 3 years of age or younger, with the neck being the most frequent site in the head and neck region. Only 10% of cases are seen at 10 years or above. The etiopathogenesis of lipoblastomas is linked to polysomy and rearrangement of chromosome 8q11–13 with or without the involvement of the pleomorphic adenoma gene 1 (PLAG1) gene. Here, we report one of the first cases of lipoblastoma of lip in a 10-year-old boy with atypical immunohistochemical features and the need for thorough clinical and histopathological evaluation of cases with atypical findings. The novel pathogenetic mechanism of lipoblastoma from the cluster of differentiation 34-positive (CD34+) stem cells has also been discussed.
Safety and efficacy of indigenously developed Ruthenium-106 eye plaque for brachytherapy of a spectrum of ocular tumors: A case series
Authors: Kumar Sonali Vinay , Kumar Ashok , Semwal Manoj K. , Mishra Sanjay Kumar
Published: February 2024

Various treatment modalities are available for treatment of ocular tumors, which include chemotherapy, laser, and radiotherapy (external beam radiation therapy or brachytherapy). Brachytherapy using plaque applicator is preferred over external beam radiation therapy when the tumor is well localized, as this therapy delivers radiation dose to the tumor with lower doses to normal tissues in the vicinity. However, plaque therapy is expensive and beyond the reach of many poor patients in India. The Bhabha Atomic Research Center (BARC) recently introduced an indigenous Ruthenium-106 plaque to make brachytherapy treatment available and affordable to all needy patients in India. In the present case series, we report our experience using the indigenous Ru-106 plaque for the treatment of a spectrum of ocular tumors.
Cytomorphological analysis of effusion fluids for detection of malignant cells in a tertiary care hospital in northern India
Authors: Sharma Shikha , Asotra Sarita , Asotra Sehar
Published: February 2024

ABSTRACTS

Introduction:

All body cavities are lined by monolayered mesothelial cells and contain a minimal amount of fluid for lubrication and for protecting the underlying viscera. The peritoneal, pleural, cerebrospinal, sputum, urine, and pericardial fluids comprise the major chunk of body fluids.

Material and Methods:

The study was conducted in the Department of Pathology of a tertiary care hospital in northern India, over a period of 1 year, from January 2021 to December 2021. A total of 241 samples were included in the study.

Results:

Out of the 241 samples studied, 99 were peritoneal fluid, 94 were pleural fluids, 29 were CSF, and 18 were sputum samples. Maximum number of patients affected were in the age group of 41–50 years. Female preponderance was seen with male to female ratio of 1:1.7. A total of 143/241 cases (59.33%) were of transudative nature and 98/241 (27.8%) cases were exudative. Out of 241 cases, 43 (17.84%) were neoplastic, 190 (78.83%) were non-neoplastic, four (1.65%) were suspicious for malignancy, and four (1.65%) were where no opinion was possible. Peritoneal fluid was the most frequently encountered fluid accounting for 99 cases (41.07%). Adenocarcinoma was the most common malignancy accounting for 29 cases (67.44%) out of 43 malignant effusions in the present study.

Conclusion:

Cytological evaluation of body fluids is of significant utility in diagnostic medicine as it allows us to distinguish between benign and malignant etiologies and at the same time offers rapid diagnosis and staging of metastatic disease.
Diagnosing lung cancer at a younger age and with male dominance: Comparison of Turkish patients with United States patients
Authors: Tas Faruk
Published: February 2024

ABSTRACTS

Background:

The risk of lung cancer (LC) increases with an older age and is most frequently diagnosed among patients aged 65–74 years with an increasing women ratio over the years in the United States (US).

Aim:

This study aimed to demonstrate the age and gender distribution of Turkish LC patients at diagnosis over the past 10 years.

Material and Methods:

A total of 5,201 LC patients who had been admitted to the Institute of Oncology, a tertiary referral center, from January 2011 to December 2020 were included in the study.

Results:

The median age at diagnosis was 62 years. This was 9 years younger than that of the US patients according to surveillance, epidemiology, and end results program data from 2015 to 2019, showing that the median age at diagnosis was 71 years. The distribution curve of the age-specific incidence ratios significantly shifted to the left compared to the American data. The majority of the patients were men (79.2%); women were 20.8%. These values were quite different from the US patients; the distribution of gender was nearly identical, with 51.8% for men and 48.2% for women according to American Cancer Society data from 2011 to 2020. The changes in the ratios of Turkish and US LC patients by sex were identical over the years; although the proportion of men has been in a downtrend, the proportion of women has been in an uptrend in both countries.

Conclusion:

Turkish LC patients are diagnosed at younger ages and male-dominant compared to LC patients from the US, and this portends a significant health problem. Therefore, efforts to quit smoking must be increased.
Ewing’s sarcoma masquerading as an odontogenic infection
Authors: Hamid Rizwan , Gaur Ambika , Gupta Sunita , Garg Ritu
Published: February 2024

Ewing’s sarcoma (ES) is a small, blue, malignant, round cell tumor of unknown origin. ES is the fourth most common malignant bone tumor, whereas among children, it is found to be the second most common primary malignant bone tumor after osteosarcoma. Swelling is usually the first clinical presentation, followed by pain. ES is an aggressive tumor showing rapid growth and metastasis with complex diagnosis. Because mandibular involvement is rare, it can be misdiagnosed as an odontogenic infection/tumor. We report an unusual case of ES in a 13-year-old female treated for an odontogenic infection before a diagnosis of ES was finally made to make the clinicians aware of this rare entity. Emphasis is also given that ES and odontogenic infections/tumors can masquerade each other with delays in diagnosis and the possibility of devastating results.
Is lifelong follow-up necessary for low-risk papillary thyroid carcinoma? Case series and a review of the literature
Authors: Bahçecioğlu Adile Begüm , Erdoğan Murat Faik
Published: February 2024

Late recurrences of papillary thyroid carcinoma (PTC) are seen rarely, especially for low-risk PTC. However, there are cases of late metastasis described in the literature, even four decades after the first treatment. We presented three low-risk PTC cases with late recurrences. In the first case, recurrence with distant organ metastasis without locoregional disease occurred 36 years after the first treatment. Recurrences in second and third cases were seen with lateral neck metastasis without central (skip metastasis), 17 and 10 years after the primary treatment. Initial treatment was ideal, and all three were followed with a complete response for years, after recurrences were diagnosed and appropriate treatments were administered. Increasing frequency of low-risk PTC increases medical costs of these patients. Thus, some suggest shortening the follow-up period not only because the increasing health burden but also because of the rarity of late recurrences as well. Some authors suggest that dynamically risk-stratified (DRS) low-risk thyroid cancer patients having excellent response to treatment after 5 years of follow-up can be discharged to primary care. Primary care facilities may follow patients with unmeasurable Thyroglobulin (Tg) levels; however, our cases suggest continuing thyroglobulin measurements (annual or at least every few years) for the exceptional but possible late recurrences.
Recent updates on the role of phytochemicals in the treatment of glioblastoma multiforme
Authors: Sharma Pramita , Mondal Himel , Mondal Shaikat , Majumder Rabindranath
Published: February 2024

ABSTRACTS

Glioblastoma multiforme (GBM) is a malignant type of glioma. This malignant brain tumor is a devastating disease and is often fatal. The spectrum of illness and poor prognosis associated with brain tumors extract a terrible toll on patients and their families. The inoperability of these tumors and resistance to radiation and chemotherapy contribute to the fatal outcome of this disease. Thus, scientists are hunting for the new drug candidate and safer chemoprevention, especially the phytochemicals that possess potent anti-tumor properties. We have summarized the cellular and biochemical impacts of different phytochemicals that can successfully encounter GBM via induction of apoptosis and active interference in different cell and molecular pathways associated with GBM in brain tumors. The in silico predictive model determining the blood–brain barrier permeability of the compound and their potential druggability are discussed in the review.
Extraprostatic extension in multiparametric MRI; Is presurgical detection possible?
Authors: Ayaz Muzaffer , Gülseren Yıldız , İnan İbrahim , Ok Fesih , Kabaalioğlu Adnan , Yıldırım Asıf
Published: February 2024

ABSTRACTS

Introduction:

Extraprostatic extension (EPE) is one of the important factors affecting the prognosis of prostate cancer (PCa). Therefore, preoperative evaluation of the presence of EPE is essential in multiparametric magnetic resonance imaging (mpMRI) examination. However, for the evaluation of mpMRI, objective criteria are needed to detect EPE, especially microscopic EPE.

Aim:

To evaluate the efficacy of 1.5T MRI using lesion length (LL) and tumor-capsule contact length (TCL) in detecting EPE in PCa.

Methods:

A total of 110 patients who underwent radical prostatectomy due to PCa were enrolled. Preoperative MR images were evaluated retrospectively by two independent observers who did not know the histopathological results. The observers evaluated LL and TCL. The radiological findings, including lesion location, were verified using histopathological mapping.

Results:

Multiparametric MRI examination of the prostate demonstrated low sensitivity (Observer 1; 40.4% and Observer 2; 40.4%) but high specificity (Observer 1; 96.6% and Observer 2; 84.5%), with significant differences for detecting EPE (Observer 1, P < 0.0001; Observer 2, P = 0.003). The increased PI-RADS score correlated positively with the increased EPE rate (P < 0.0001 for both observers). The mean LL and TCL values were statistically significantly higher in patients with EPE than in patients without EPE. The TCL was a significant parameter for EPE, with high sensitivity and low for both observers. For both observes the cutoff value of LL for EPE was 14.5 mm, and the cutoff value of TCL for EPE was 9.5 mm. Histopathological LL value (28 ± 12,3 mm) was higher than radiological LLs (Observer 1; 22,14 ± 10,15 mm and Observer 2; 19,06 ± 8,61).

Conclusion:

The results revealed that 1.5T MRI demonstrated low sensitivity and high specificity in detecting EPE. The LL and TCL may be indirectly beneficial in detecting EPE. Considering the radiological underestimation of LL may be helpful before PCa surgery.
Prognostic importance of PD-L1 expression in bladder cancer patients
Authors: Durur Sumeyye , Uzun Hakkı , Bedir Recep , Nalkiran Ihsan , Nalkiran Hatice Sevim
Published: February 2024

ABSTRACTS

Background:

PD-L1/PD-1 molecules are known as important mediators in immune-escape mechanisms of tumors. PD-L1 is highly expressed in various malignancies, including bladder cancer. However, the prognostic value of PD-L1 in bladder cancer patients remains controversial.

Aim:

To investigate the prognostic significance of PD-L1 expression in tumor tissues of bladder cancer patients.

Subjects and Methods:

RNA was isolated from FFPE tumor tissues of 48 bladder cancer patients using the monophasic phenol and guanidine isothiocyanate method. Total RNA was converted to cDNA and gene expression levels were analyzed by qRT-PCR. The differential expression levels of the PD-L1 gene between tumor grade and cancer stage groups were analyzed by independent student’s t-test and one-way ANOVA.

Results:

Statistically significantly increased PD-L1 expression was observed in the high-grade tumor group (p < 0.05). No significant difference in PD-L1 expression was found among pTa, pT1, and pT2 groups. In addition, the difference in overall survival was not significantly different between groups.

Conclusion:

The results showed that high PD-L1 expression in bladder cancer was associated with tumor aggressiveness and grade. Despite the inability of the qRT-PCR to show the PD-L1 expression at different locations of tumor tissue, evaluation of PD-L1 mRNA expression by qRT-PCR, which is a highly sensitive and specific assay, appears to be a robust approach. Furthermore, these findings may contribute to a rationale for recommending anti-PD-L1 immunotherapy as an alternative to standard therapy for bladder cancer patients who are most likely to benefit from it.
Oral malignant melanoma – Clinical presentation with immunohistochemical analysis
Authors: Gunasekaran Nandhini , Ajay Ashwini , Ahmed Sahanaz Praveen , Arumugam Hemalatha
Published: February 2024

Oral melanoma is a rare malignancy with poor prognosis because of its invasive and metastasizing tendencies. It is derived from the melanocytes and is clinically asymptomatic initially but in later stages may show ulceration, pain, bleeding, tooth mobility, and parasthesia. Because of its silent progression, diagnosis is often delayed leading to poor survival rate. This article presents the clinical, histopathological, and immunohistochemical findings of a rare case of melanoma involving the maxilla and also highlights the importance of dental professionals in maintaining a high degree of surveillance for all oral pigmented lesions.
Lymphoepithelial carcinoma of the larynx: A clinical report with pooled analysis and review of published cases
Authors: Nath Jyotiman , Sarma Gautam , Das Ankita , Das Kishore , Kakati Lopamudra
Published: February 2024

ABSTRACTS

Lymphoepithelial carcinoma (LEC) of the larynx is a rare tumor comprising 0.2% of all laryngeal neoplasms. To our knowledge, less than 50 cases of LEC of the larynx are reported in the literature. The lack of specific guidelines leads to uncertainty on this rare entity’s diagnosis, treatment, and follow-up. The association of Epstein–Barr virus as a predisposing factor of LEC has been proposed in a few reports. Although the occurrence of LEC in the larynx is infrequent, it is essential to differentiate it from squamous cell carcinoma. Immunohistochemistry should be performed to demonstrate cytokeratin expression. It is a very aggressive tumor with high metastatic potential; however, it is hard to comment on the disease outcome of LEC of the larynx because only case reports are available in the literature. Here, we report a case of LEC of the larynx (CK +ve, CD 45 –ve, and EBER-ISH –ve) in a 49-year-old male. Initially, the patient was planned for surgery but defaulted. He reported back after 4 months, and there was clinicoradiological disease progression. Because of the unresectable status and poor general condition, he received palliative radiotherapy only. Additionally, we have conducted a pooled analysis of the individual cases of LEC of larynx available in the literature to understand the clinical behavior to optimize the treatment of these patients.
Evaluation of treatment responses among subgroups of breast cancer patients receiving neoadjuvant chemotherapy
Authors: Dagıstanli Sevinc , Sonmez Suleyman , Bulut Nilufer , Kose Ali Mertcan
Published: February 2024

Background:

Breast MRIs are helpful for determining treatment plans, responses, and prospective survival analyses. In this retrospective cross-sectional study, we compared the preoperative MRI treatment response to neoadjuvant chemotherapy (NAC) administration with the postoperative pathological response in breast cancer patients.

Materials and Methods:

We analyzed data from 108 hospitalized patients receiving NAC between 2020 and 2022. We used MRI to evaluate the treatment response to NAC in patients with locally advanced breast cancers who had not received any prior treatment. We recorded the longest diameter of the primary tumor and the numbers of secondary tumors and axillary lymph nodes. In addition, we examined the correlation between the MRI response rate and pathological specimen results.

Results:

In our subgroup analyses, we found the best pathological response in patients with luminal B (Ki-67 index >14%) breast cancer and positivity for both hormone receptor and HER-2 markers. After comparing the pathological and radiological treatment responses in tumors and lymph nodes, the sensitivities were 90.3% for the pathological assessment and 42.8% for the radiological assessment, while the accuracies were 84.2% for the pathological assessment and 61.1% for the radiological assessment.

Conclusion:

Using MRI techniques and sequence intervals and examining the histopathological characteristics of tumors may help increase the accuracy of the pathological complete response.
Outcomes of Sterotactic Body Radiotherapy (SBRT) for pelvic lymph node recurrences after adjuvant or primary radiotherapy for prostate cancer
Authors: Gamsiz Hakan , Sager Omer , Uysal Bora , Dincoglan Ferrat , Demiral Selcuk , Ozcan Fatih , Colak Onurhan , Dirican Bahar , Beyzadeoglu Murat
Published: February 2024

Background:

There is a paucity of data on the management of recurrent lymph nodes after primary or adjuvant radiotherapy (RT) for prostate cancer (PCa). In this study, we report our tertiary cancer center experience with stereotactic body radiotherapy (SBRT) for the management of pelvic lymph node recurrences after adjuvant or primary RT for PCa.

Materials and Methods:

Patients who underwent SBRT for pelvic lymph node metastases from PCa between 2013 and 2019 were retrospectively assessed for local control (LC), androgen deprivation treatment-free survival (ADT-FS), and toxicity outcomes. The primary endpoint was LC and ADT-FS. The secondary endpoint was late treatment toxicity.

Results:

Twenty-two lesions of 18 patients receiving SBRT for pelvic lymph node recurrences for PCa between February 2013 and March 2019 were evaluated. At a median follow-up duration of 29.5 months (range: 9–54 months), LC was 95.5% vs. 90.2% at 1 and 2 years, respectively. Ten patients received palliative ADT following SBRT after a median period of 14.5 months (range: 6–31 months). ADT-FS was 72.2% and 54.3% at 1 and 2 years, respectively. Comparative analysis of biologically effective dose (BED) values revealed that higher BED10 values were associated with higher ADT-FS (P = 0.008). ADT-FS was 55.6% and 88.9% for BED10 <50 Gy and for BED10 >50 Gy, respectively (P = 0.008). Assessment of late toxicity outcomes revealed that the most common toxicity was urinary toxicity and fatigue; however, no patient had ≥ grade 3 toxicity.

Conclusion:

Our tertiary cancer center experience confirms the safety and efficacy of SBRT for the management of pelvic lymph node recurrences from PCa.
A rare case of peritoneal metastases from oropharyngeal squamous cell carcinoma in a young male after completion of chemoradiotherapy
Authors: Aggarwal Abhishek , Jindal Gunjan , Gupta Shubhangi , Ruchandani Manisha
Published: February 2024

Distant metastases are frequent in head and neck squamous cell carcinomas (HNSCC), but they are limited to some organs like lungs, bone, mediastinum, liver and brain. Peritoneal metastases (PMs) from HNSCC are extremely rare. A 28-year-old chronic smoker and alcoholic was diagnosed with squamous cell carcinoma of oropharynx. Patient was admitted and was given six cycles of concurrent chemo and radiotherapy (CCRT) and was discharged. Two months later, he presented with abdominal pain and lump. Contrast-enhanced CT revealed ascites, peritoneal implants and subcutaneous deposit which were proved to be metastases by histopathology. The present case is the seventh reported case of PM from HNSCC. • Patients of HNSCC shall be screened for distant metastases. • Differential diagnosis of HNSCC needs consideration when encountered with peritoneal metastases. • Research is required to understand the basis of PM in HNSCC while on CCRT to suggest management modifications.
Intraoral neurofibroma: A case report with emphasis on immunohistochemical markers
Authors: Sathiyamoorthy Mounika , Vasanthi V , Gunasekaran Nandhini , Vinay G
Published: February 2024

A neurofibroma is a benign peripheral nerve sheath tumor. They occur in combination with neurofibromatosis or as a solitary mass. Intraoral neurofibromas pose diagnostic difficulties, suggesting the appropriate use of diagnostic markers and clinical knowledge. Here, we report a case of intraoral neurofibroma in a 57-year-old female who reported with the complaint of painless growth in the lower left back tooth region for the past three years. Based on the clinical features, provisional diagnosis of traumatic fibroma was made. However, histopathology proved it to be a benign spindle cell lesion; upon further investigation by immunohistochemistry, it was diagnosed to be a case of neurofibroma.