bluuebunny/crossref_metadata_2025 huggingface dataset:
Poor performance of the utility of the serological diagnosis of pulmonary tuberculosis in Nigeria
Authors: Sanmi Emiade , Adeiza Mukhtar A. , Ahmad Abdurrahman E.
Published: September 2021

Introduction

Pulmonary tuberculosis (PTB) is the most common form of tuberculosis. In Nigeria, PTB is diagnosed by sputum smear microscopy. The problems associated with the diagnosis of PTB using sputum smear for acid-fast bacilli and culture has provided an urgent need to assess the utility of serological tools as an adjunctive diagnostic tool in presumptive PTB cases. This study is aimed at testing the diagnostic utility of a specific immunoglobulin G (IgG) serological assay in the diagnosis of PTB.

Patients and methods

A utility study was conducted on 184 participants of which 92 were smear-positive PTB cases and 92 were healthy controls at the TB and Leprosy Centre and Ahmadu Bello University Teaching Hospital, Zaria. Data were collected on age and sex, and both PTB patients and controls were screened for anti-TB IgG antibodies by enzyme-linked immunosorbent assay technique.

Results

The mean age of the participants was 35, and the male-female ratio was 1 : 4. Twenty-one (5.7%) of the PTB patients tested positive for IgG antibodies, and 11 (1.3%) of the controls were positive. The sensitivity of the IgG antibody assay was 18.4%, with the specificity being 92.3%, while the predictive values were 70.8 and 53.1% for positive and negative results, respectively.

Conclusion

The IgG antibody assay is poorly sensitive; serology may not have a role in the diagnosis of PTB in resource-limited settings, but the much higher specificity suggests that it may be useful as an adjunctive diagnostic tool, or for monitoring of patients on treatment for PTB.
Pediatric asthma
Authors: Refat Nezar , Abdel-Hady Abdelgahny Elham , Bahaa Mohammed , El-Fatah Rasha Abd El-Raof Abd
Published: September 2021

Introduction

Asthma is a heterogeneous chronic airway disease that is common in childhood. Childhood asthma is commonly related to other atopic diseases. The potential correlation of allergic sensitization and asthma in children has been contributed to the allergic model of the March.

Aim

The study aims to estimate the age of onset of asthma in children in Minia governorate, in middle Egypt, and also to see the presenting features of bronchial asthma in our locality and compare this with what is present in different parts of the world.

Patients and methods

This study was carried out in the Pediatric and Chest Departments of Minia University hospitals. The study included 100 children with a clear diagnosis of bronchial asthma. Detailed medical history concerned mainly with the respiratory events were recorded between birth and the time of study enrollment. This also included some asthma family history or other allergic disorders (allergic rhinitis, eczema, and allergic conjunctivitis).

Results

In most cases, asthma symptoms started less than 1 year of age (64% of the studied group). Asthma symptoms started between the age of 1.1 and 2 years in 16% of patients and above 6 years of age in only 12% of cases. Overall, 40% of the studied group had a positive family history of bronchial asthma in their mothers and 44% of them had a positive family history of bronchial asthma in their fathers. Only 10% of the studied group had a positive family history of bronchial asthma of both parents.

Conclusion

A great portion of asthmatic children fulfill the criteria of bronchial asthma diagnosis in the first year of their life. Only a small portion of asthmatic children start their asthma after the age of 6 years.
Assessment of different positive airway pressure noninvasive ventilation modalities in patients with overlap syndrome
Authors: Elhabashy Mahmoud M. , Agha Mohammed A. , El-Esdody Ahmed A. , El-Shamy Ahmed M.
Published: September 2021

Background

Overlap syndrome (OS) is a challenging condition with an associated increased mortality. Noninvasive positive pressure ventilation is the main therapy in OS. Tri-level positive airway pressure (Tri-PAP) therapy is a new method of ventilatory support that was proposed to improve breathing during the cyclic breathing phases and correct the hypercapnia.

Objectives

To assess different noninvasive modalities of positive airway pressure including continuous positive airway pressure (CPAP), bi-level positive airway pressure (Bi-PAP), and Tri-PAP in the management of OS.

Patients and methods

This prospective interventional clinical trial was conducted on 45 patients with OS. After confirming the diagnosis of OS, patients were classified into three comparable groups, and in each group, we used one of the following three modalities of noninvasive ventilation: Tri-PAP, Bi-PAP, and CPAP. Arterial blood gas (ABG) was done after the use of the PAP. Data of sleep reports were recorded on each night and then analyzed.

Results

Patients were divided into three equal numbers and comparable groups in whom CPAP, Bi-PAP, and Tri-PAP were applied, correspondingly. Statistically significant improvement was observed regarding sleep parameters (apnea/hypopnea index, oxygen desaturation index, and snoring index) and ABG parameters [pH, partial pressure of carbon dioxide in arterial blood (mmHg), partial pressure of oxygen in arterial blood (mmHg), and arterial oxyhemoglobin saturation (%)] when Tri-PAP was compared with both Bi-PAP and CPAP.
Chestultrasonography versus computed tomography in the diagnosis of pleural effusion (Menoufia experience)
Authors: Drawish Amr A. , ElWahsh Rabab A. , Elgaml Hanan A. , Eldahdouh Samy S.
Published: September 2021

Background

Pleural effusion is a common clinical problem and can arise from many diseases. Several imaging methods such as chest radiograph, ultrasonography (US), and computed tomography (CT) scan are being used to diagnose and detect the etiology of pleural effusion.

Objective

The aim of this work was to compare imaging findings of chest US and CT and the role of chest US in diagnosis of pleural effusion.

Patients and methods

This observational prospective cohort study was done on 70 patients with pleural effusion of determined etiology admitted to the Chest Department, Menoufia University Hospital, in the period between August 2018 and June 2019. We compared between chest US and CT in different types of pleural effusion.

Results

This study showed that pleural septations were detected by US more than CT, and the difference was statistically significant (P<0.05). There was a significant statistical difference in detection of pleural thickening by US over CT (P<0.005). It showed a highly significant statistical difference in the detection of the site of pleural thickening and nodules by US, especially on diaphragmatic pleura (P<0.001). There was also a highly significant statistical difference in the detection of pleural nodules by US over CT (P<0.001). There was a significant difference in the detection of parenchymal lesions by US and CT, where US could see collapse more than CT (P<0.05), but CT detected consolidation patches more than US.

Conclusion

Chest US finding has higher diagnostic accuracy than chest CT finding in the diagnosis of pleural effusion and more sensitive in detection of pleural septations, diaphragmatic pleural nodules, and thickening.
Frailty can predict the outcome of weaning from mechanical ventilation
Authors: Ali Safaa H. , Ezzelregal Hieba G.
Published: September 2021

Context

Frailty is a syndrome characterized by the loss of physical and cognitive reserve causing many complications. The frail critically ill patients are vulnerable to worse clinical outcomes especially those on mechanical ventilation. Few studies have focused on the outcome of mechanical ventilation and frailty.

Aims

To determine the effect of frailty by the clinical frailty scale (CFS) on weaning outcome in mechanically ventilated patients and its effect on hospital stay and mortality.

Settings and design

A descriptive cohort study was conducted.

Patients and methods

Patients 50 years old or more who were admitted to the respiratory ICU of Ain Shams University Hospitals and mechanically ventilated in 17 months duration were included, with exclusion of patients with pulmonary or extrapulmonary expected cause of poor weaning outcome. They were classified according to the CFS into frail and nonfrail and followed up along their total hospital stay.

Statistical analysis

Statistical Package for Social Sciences program software, version 18.0, was used for statistical analysis.

Results

A total of 55 patients were recruited, where 61.8% of them were frail by CFS. Mechanically ventilated frail patients had significantly longer mechanical ventilation days (P=0.035), prolonged weaning time (>7 days) (P=0.006), significantly higher weaning failure (P=0.0001), and significantly longer ICU and total hospital stay (P=0.021 and 0.003, respectively) than nonfrail. Readmission rate and death rate were significantly higher in frail patients (P=0.020 and 0.007, respectively).

Conclusion

Frailty was associated with complicated weaning process, reflected on the period of ICU and total hospital stay.
The application of transthoracic ultrasound in the detection of lung bullae in lung volume reduction (new technique)
Authors: Rezk Nasef Abd-Elsalam , Radi Ahmed Abd-Elgawad , Batouty Nihal M. , Shehta Mohammed , Hadidy Tamer A.El , Morsy Nesreen E.
Published: September 2021

Background

Bronchoscopic lung volume reduction (LVR) is a promising and effective treatment option in severe chronic obstructive pulmonary disease. This study was conducted at Mansoura University Hospitals aiming to assess diagnostic accuracy of transthoracic ultrasound (US) in detection of lung bullae in LVR.

Patients and methods

A total of 22 cases with emphysema were included in the study. They were divided into two groups: the study group included 12 cases who underwent US, whereas the control group included the remaining 10 cases that underwent computed tomography. All cases were subjected to history taking, examination, and routine investigations. Bronchoscopic LVR was performed for all cases.

Results

Postintervention complications such as fever and pain were statistically better in study group, whereas modified Medical Research Council and GOLD did not differ between the two groups before or after treatment. No statistically significant difference was detected between the two groups regarding volumetry, oxygen saturation, 6 min walk test, and pulmonary functions. We found a significant improvement of GOLD classification, modified Medical Research Council, 6 min walk test, forced expiratory volume in 1 s, and forced vital capacity in the study group. Moreover, a significant decrease of oxygen saturation in study group was detected. Volumetry showed a significant decrease in both groups when comparing preintervention and postintervention values.

Conclusion

Transthoracic US is valuable in detection of bullae during LVR, and ethanolamine oleate is safe and effective in LVR with minimal tolerable self-limited complications.
Heterotaxy syndrome with left atrial isomerism and polysplenia is a unique entity
Authors: El-Helbawy Rana , Elmahalawy Ibrahim , Agha Mohammed A.
Published: September 2021

A state of a patient with heterotaxy syndrome with polysplenia was indiscriminately diagnosed through visualized estimation (computed tomography and pelviabdominal ultrasound) regardless of the pathological state. This syndrome depends on a diversity of anomalies of design and morphology of thoracoabdominal organ configuration. Imaging studies are the foundation in diagnosis.
The effect of neutrophil-lymphocyte ratio in patients with COPD in Sohag University Hospital
Authors: Alkhayat Khaled , Abdelhameed Rasha , Gadallah Doaa
Published: September 2021

NLR has also been evaluated as diagnostic and prognostic marker in COPD. Chronic inflammation in COPD resulting in the recruitment of the lymphocytes and neutrophils. Which, once activated, release neutrophil elastase, cathepsin G, proteinase-3, matrix metalloproteinase (MMP)-8 and MMP-9, and myeloperoxidase (MPO), which contribute in the pathophysiological mechanisms of emphysema and COPD.

Aim of study

Evaluate the NLR as a biomarker that can detect the severity and duration of COPD in patients with acute exacerbation and frequency of future exacerbation; we thus monitored NLR in COPD to evaluate it as a biomarker in patients and investigated its association with a variety of clinical aspects of COPD.

Methodology

It was a prospective observational study that was carried out among COPD patients with acute exacerbation and asymptomatic persons (controls). The study included 67 participants, 38 cases were COPD patients while 39 cases were healthy controls who were older than 40 years. The study was conducted among patients who admitted to chest department of Sohag University Hospital during period between February 2019 to January 2020, after the approval of the ethical committee and written consents where taken from the participants. Patients were diagnosed to have COPD according to the GOLD. The following laboratory investigations were done: complete blood count (CBC) inflammatory markers as neutrophil-lymphocyte ratio (NLR), were evaluated.

Results

The mean age of the studied COPD cases was 63.5(7.8) years and the mean age of the controls was 60(6.5) years. All the studied COPD cases and the matched controls were males. Compared to controls the levels of neutrophil, lymphocyte, basophil, eosinophil, NRL and platelet were significantly higher among the studied COPD cases. There was significant positive correlation between levels of leucocytes, neutrophils and NLR and duration of exacerbation. While, lymphocytes level was inversely associated with duration of exacerbation.

Conclusions

The present study demonstrates that NLR is associated with mortality and duration exacerbations, in COPD patients. For predicting exacerbations, we estimated the threshold of NLR to be 1.3 at baseline.
Prevalence of pulmonary tuberculosis in the District Bannu, Khyber Pakhtunkhwa, Pakistan
Authors: Khan Muhammad Ashraf
Published: September 2021

Aim/Objectives/Background

Pulmonary tuberculosis is one of the major threats to human health and is the leading cause of death worldwide. Mycobacterium tuberculosis causes the disease in humans. The present study deals with to determine the prevalence of pulmonary tuberculosis in the general population of district Bannu.

Patients and methods

All 745 registered and suspected patients of the pulmonary tuberculosis were diagnosed during the study period by sputum smear microscopy. The data were collected from the tuberculosis (TB) control register at the national tuberculosis control center at Khalifa Gul Nawaz (KGN), Teaching Hospital, Bannu, from January through December 2018. The data were classified into six age groups (in years) including <5, 5–14, 15–30, 31–45, 46–60, and >60. Percentage case positivity was determined for both sex and age groups.

Results and Conclusions

The number of positive cases of the disease were 133 (17.85%) out of 745 patients enrolled for diagnosis of the disease. Females represented 57.14%, whereas males accounted for 42.86% of the disease. The highest prevalence of disease occurred in the age group 46–60 y (34.59%), followed by 15–30 y (29.32%), >60 y (19.55%), 31–45 y (12.03%), and 5–14 y (4.51%). Age group <5 years demonstrated no positivity. As a whole, age group ≥15 years demonstrated 95.49% positivity, and females showed a higher or equal rate of pulmonary TB than males in all the months except January and February. Females, age group 46–60 years, as well as individual aged ≥15 years were the predominant groups regarding the prevalence of disease. The disease was prevailed in people of age ≥5 years, and it mainly occurred in the months of summer. When grouped into similar age groups, females predominated at all the age groups, except age group 5–14 years.
Psychosocial impact of COVID-19 pandemic on healthcare workers in India & their perceptions on the way forward - A qualitative study
Authors: Chakma Tapas , Thomas Beena E. , Kohli Simran , Moral Rony , Menon Geetha R. , Periyasamy Murugesan , Venkatesh U. , Kulkarni Ragini Nitin , Prusty Ranjan Kumar , Balu Vinoth , Grover Ashoo , Kishore Jugal , Viray Maribon , Venkateswaran Chitra , Mathew Geethu , Ketharam Asha , Balachandar Rakesh , Singh Prashant Kumar , Jakhar Kiran , Singh Shalini , Devi Rekha , Saha Kalyan B. , Barde Pradeep , Singh Ravinder , John Denny , Mishra Bijaya Kumar , Yadav Jeetendra , Agarwal Sumit , Rao Vishnu Vardhana , Panda Samiran
Published: September 2021

Background & objectives:

The healthcare system across the world has been overburdened due to the COVID-19 pandemic impacting healthcare workers (HCWs) in different ways. The present study provides an insight into the psychosocial challenges faced by the HCWs related to their work, family and personal well-being and the associated stigmas. Additionally, the coping mechanisms adopted by them and their perceptions on the interventions to address these challenges were also explored.

Methods:

A qualitative study was conducted between September and December 2020 through in-depth telephonic interviews using an interview guide among 111 HCWs who were involved in COVID-19 management across 10 States in India.

Results:

HCWs report major changes in work-life environment that included excessive workload with erratic timings accentuated with the extended duration of inconvenient personal protection equipment usage, periods of quarantine and long durations of separation from family. Family-related issues were manifold; the main challenge being separated from family, the challenge of caregiving, especially for females with infants and children, and fears around infecting family. Stigma from the community and peers fuelled by the fear of infection was manifested through avoidance and rejection. Coping strategies included peer, family support and the positive experiences manifested as appreciation and recognition for their contribution during the pandemic.

Interpretation & conclusions:

The study demonstrates the psychological burden of HCWs engaged with COVID-19 care services. The study findings point to need-based psychosocial interventions at the organizational, societal and individual levels. This includes a conducive working environment involving periodic evaluation of the HCW problems, rotation of workforce by engaging more staff, debunking of false information, community and HCW involvement in COVID sensitization to allay fears and prevent stigma associated with COVID-19 infection/transmission and finally need-based psychological support for them and their families.
Comparison of the effects of rutaecarpine on molecular subtypes of breast cancer
Authors: Cokluk Erdem , Ozman Zeynep , Eskiler Gamze Gamze , Ozkan Asuman Deveci , Sekeroglu Mehmet Ramazan
Published: September 2021

Objective:

Natural compounds have gained considerable attention in recent years due to disadvantages and properties of current chemotherapy drugs in cancer therapy. In addition, the impact of these compounds is specific for each type and/or subtypes of cancer due to different treatment response. Rutaecarpine, an alkaloid obtained from Evodia Rutaecarpa Chinese herb, has anticancer activity by inhibiting topoisomerase and/or cyclo-oxygenase-2 levels. However, the effectiveness of rutaecarpine has not been well known in breast cancer in terms of subtype. Therefore, we investigated the potential therapeutic effects of rutaecarpine on two different subtypes of breast cancer cells.

Materials and Methods:

The cytotoxic and apoptotic effects of rutaecarpine on MCF-7 and MDA-MB-231 cells were analyzed by WST-1, Annexin V, cell cycle, and acridine orange staining.

Results:

WST-1 results indicated that rutaecarpine significantly inhibited the growth of both cancer cells for 48 h (P < 0.05). In addition, rutaecarpine treatment caused apoptotic cell death through chromatin condensation and nuclear blebbing and G0/G1 arrest in both breast cancer cells. However, the efficacy of rutaecarpine was more profound in MCF-7 cells than MDA-MB-231 cells.

Conclusions:

Consequently, rutaecarpine has a potential therapeutic effect on breast cancer. However, the effectiveness of rutaecarpine is dependent on the subtype of breast cancer.
Magnetic resonance imaging for the study of mediastinal adenopathies in lung cancer
Authors: Pereiro-Brea Tara , de Alegría Anxo Martínez , Valdés Luis , Golpe-Gómez Antonio , Carreira-Villamor José Martín , Ruano-Raviña Alberto
Published: September 2021

Background:

Lung cancer is the second most common cancer in both men and women. Mediastinal lymph node involvement in these patients, determined by imaging tests, indicates prognosis and modifies therapeutic attitude.

Purpose:

The aim of this study was to analyze the diagnostic capacity of magnetic resonance imaging (MRI) in the study of the mediastinum in comparison with conventional tests (computed tomography [CT] and positron-emission tomography [PET] or PET/CT scans), taking histology as the gold standard.

Materials and Methods:

An observational study was conducted on 16 patients with suspicion of primary lung cancer (June 2016 through December 2018). We studied their demographic characteristics and used CT, PET, or PET/CT scans and MRI (diffusion-weighted imaging-MRI sequence) to examine mediastinal disease and compare MRIs diagnostic yield and percentage agreement to that of conventional tests.

Results:

As compared to CT and PET scanning, MRI displayed a very low sensitivity and a specificity of 90 and 88%, respectively; positive predictive value was 0.67 (both) and negative predictive value (NPV) was 0.28 and 0.22, respectively. MRI showed a high degree of agreement in lymph node diagnosis when compared with histology (91.2%; P = 0.001): specificity in this case was high (E = 0.94), as was the NPV (NPV = 0.97).

Conclusions:

The results of this study would appear to indicate that MRI could play a relevant role in mediastinal staging of lung cancer. More prospective, multicenter studies are, however, needed to be able to draw up firm recommendations about the role of MRI and its place in lung cancer staging.
Intensity modulated radiotherapy in anal canal squamous cell carcinoma
Authors: Das Avipsa , Arunsingh Moses , Bhattacharyya Tapesh , Prasath S Sriram , Balakrishnan Arun , Mallick Indranil
Published: September 2021

Objective:

Concurrent chemoradiotherapy (CCRT) is the standard curative treatment option for nonmetastatic anal squamous cell carcinoma (SCC). Intensity modulated radiotherapy (IMRT) can reduce doses delivered to bowel and skin and reduce toxicities associated with conventional fields. Here, we present our institutional data on dosimetry, toxicity, and clinical outcomes with IMRT for anal cancer.

Materials and Methods:

We analyzed 23 patients of anal SCC treated with curative-intent CCRT/radiation therapy alone, utilizing IMRT, between August 2011 and December 2016. The standard prescription dose was 54 Gy/27Fr/5.5 weeks, delivered in two phases, and concurrent chemotherapy with 5-fluorouracil and mitomycin-C. Acute and late toxicities and dosimetric data were compiled and analyzed.

Results:

The median age was 65 years. Fourteen (60.7%) patients had Stage IIIC disease. Eighteen patients received concurrent chemotherapy. No patient had any treatment breaks. Grade 3 acute perianal dermatitis was recorded in 11 (47.8%) patients. Proctitis, diarrhea, and cystitis were limited to Grade 1 in 73.9%, 47.8%, and 8.6% patients, respectively. The only late Grade 2+ toxicities were gastrointestinal toxicities in 4 (17.4%) patients. Twenty (87%) patients had complete response at 6 months. The 3-year local control, nodal control, and distant metastases-free survival were 85.9%, 86.6%, 84.7%, respectively, with 3-year disease-free survival and overall survival of 63.4% and 81%, respectively.

Conclusion:

In this report on IMRT in anal cancer from India, treatment was well tolerated with lower acute toxicity than reported in other prospective studies. Long-term results are at par with other published studies.
Comparison of fast-neutron contamination of different models of Siemens medical linacs with CR-39 film
Authors: Aftabi Nafiseh , Yazdi Mohammad Hadi Hadizadeh , Ghorbani Mahdi , Abdollahi Sara
Published: September 2021

Background:

Nowadays, radiotherapy has an important role in the treatment of cancer. The use of medical linacs in radiotherapy can have risks for patients. When radiotherapy is performed with photons with energies higher than 8 MeV, due to the photonuclear reaction of photons with various components in the head of the accelerator, the neutron is produced. This imposes an unwanted neutron dose to the patient. The purpose of this study is evaluation and comparison of fast-neutron contamination with increasing of field size and depth for Siemens Primus (15 MV), Siemens Primus Plus (18 MV), and Siemens Artiste (15 MV) linacs.

Materials and Methods:

Neutron dosimetry was carried out with CR-39 films, as a fast-neutron dosimeter, using chemical etching technique. Measurements were performed in depths of 0.5, 2, 3, and 4 cm and source-to-surface distance of 100 cm. Field sizes were 10 cm × 10 cm and 30 cm × 30 cm.

Results:

The results of measurements showed that, with increasing depth, equivalent dose is reduced. In addition, fast-neutron equivalent dose decreases with increasing the field size.

Conclusion:

Siemens Primus Plus had the highest neutron contamination in comparison with the two other linacs. Deeper tissues receive less fast-neutron doses. In radiation therapy with high-energy photon beams, neutron dose delivered to the patients should be taking into account.
Evaluation of hepatitis B virus, hepatitis C virus, and human immunodeficiency virus seroprevalence in patients with diffuse large B cell lymphoma and Hodgkin's lymphoma
Authors: Mert Duygu , Merdin Alparslan , Ceken Sabahat , Dal Mehmet Sinan , Ertek Mustafa , Altuntas Fevzi
Published: September 2021

Backgrounds:

Non-Hodgkin's lymphoma and Hodgkin's lymphomas (HL) are lymphoid neoplasms. Hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) are viruses that could proliferate in lymphoid tissues. These viruses may cause lymphoproliferative diseases. The aim of this study was to evaluate the seroprevalence of HBV, HCV, and HIV in patients with diffuse large B-cell lymphoma (DLBCL) and HL, to compare the relationship between these two disease groups and to determine the relationship between the three viruses and their characteristics.

Materials and Methods:

The study was a retrospective study. Patients who were followed up in hematology and hepatitis outpatient units between January 01, 2012, and May 01, 2019, were included in the study.

Results:

A statistically significant relationship was observed between the disease groups in terms of hepatitis B surface antigen (HBsAg), hepatitis B core (HBc) IgG antibody, hepatitis B e antigen (HBeAg), and anti-HBe seropositivities (P = 0.004, P = 0.006, P = 0.041, and P = 0.014, respectively). There was also a statistically significant relationship between the disease groups in terms of anti-HCV seropositivity (P = 0.029). HBsAg, anti-HBc IgG, HBeAg, anti-Hbe, and HCV seropositivity rates were higher in patients with DLBCL than in patients with HL.

Conclusion:

These findings suggest that there may be a relationship between hepatitis viruses and DLBCL. Evaluation of HBV and HCV infections in these patients before starting treatment is thought to be beneficial in initiating antiviral prophylaxis to prevent reactivation in seropositive cases. In addition, care should be taken for the development of lymphoma in the follow-up of HCV and HBV infections.
Clinical and histopathological profile of dysembryoplastic neuroepithelial tumor
Authors: Gupta Pooja , Siraj Fouzia , Malik Akanksha , Shankar K. B.
Published: September 2021

Introduction:

Dysembryoplastic neuroepithelial tumor (DNT) is a rare benign brain tumor predominantly involving children and young adults. Histologically, it corresponds to WHO Grade I tumors; however, it may masquerade aggressive neural tumors such as oligodendroglioma, oligoastrocytoma, pilocytic astrocytoma, and ganglioglioma. The literature on clinical, radiological, and pathological spectrum of DNT is described mostly in the form of case reports, with only a few case series reported till date.

Methods:

A retrospective review of files with diagnosis of DNT (2016 to 2018) was made in the Department of Pathology, National Institute of Pathology, New Delhi. A total of ten cases were retrieved, and their clinical, radiological, and histopathological features were reviewed and studied. Special stains and immunohistochemistry were done, wherever required.

Results:

The mean age was 14.8 (±7.9) years, with a male-to-female ratio of 1.5:1. The most common mode of presentation was recurrent, intractable seizures. The most common site of lesion was parietal lobe followed by temporal and frontal lobes of the brain. On histology, mucoid matrix admixed with floating neurons and oligodendrocyte-like cells was a consistent feature; however, the presence of specific glioneuronal elements was observed in only a few cases.

Conclusions:

DNT is a benign, low-grade, nonrecurrent neuroepithelial neoplasm. It is important to differentiate this rare entity from other mimickers, as it is surgically curable and carries an excellent prognosis without the need for adjuvant chemotherapy and radiotherapy. The study helps to enrich the clinicopathological aspects of this rare but important entity.
Relative effect of Malayer Shahani and Asgari grapes seed extract on inducing apoptosis in human leukemia cells
Authors: Rahimi Maryam , Pakravan Narges , Babaei Arash , Mohammadi Mitra , Atafar Elham
Published: September 2021

Background:

Previous studies have suggested that consuming fruit and vegetable can lower the risk of several cancers, including breast, colorectal, and lung cancers.

Aims:

The present study aims to investigate the in vitro anticancer effects of Shahani and Asgari grape seed extract (GSE) grown in Malayer City of Iran on HL-60 cancer. However, to the best of the author's knowledge, it is the first time in this study that the antiproliferative effect of Shahani and Asgari GSE is compared.

Materials and Methods:

Shahani and Asgari GSE Was extraction white method of Liquid/liquid extraction with ethyl acetate. Then assessing cytotoxic activities of Shahani and Asgari GSE on the HL-60 cells was tested using MTT assay.

Results:

The results show that compared with the control group, seed extract of both Shahani and Asgari at the various concentrations (25, 50, 100, and 200 μg/ml) had a significantly inhibitory effect on HL-60 cell proliferation that was dose dependent. However, Shahani GSE at different concentrations (50, 100, and 200 μg/ml) indicated a significantly higher inhibitory effect compared to Asgari GSE. In addition, GSE can induce cell cycle arrest at G0/G1 cells. Furthermore, GSE of Asgari and Shahani remarkably increased the induction of HL-60 cell apoptosis depending on its dose. However, at the concentration of 200 μg/ml, GSE induced cell necrosis rather than apoptosis.

Conclusion:

Seed extract of both Shahani and Asgari at the various concentrations had a significantly inhibitory effect on HL-60 cell proliferation that was dose dependent.
Diagnostic reference levels for computed tomography examinations in pediatric population - A systematic review
Authors: Priyanka  , Kadavigere Rajagopal , Sukumar Suresh , Pendem Saikiran
Published: September 2021

Computed tomography (CT) has vital role in diagnosis of various pathologies using cross sectional images. Besides the advantages of CT in pediatric radiology, radiation dose has a significant adverse effect as children are more vulnerable than adults. Establishing Diagnostic Reference levels (DRLs) will determine unusual increase in radiation doses and therefore helps in optimizing the radiation dose by maintaining optimum diagnostic image quality. The objective of the review is to explore the literature on DRLs in pediatric CT examinations and techniques that have been used to establish them. Detailed search was done in PubMed-Medline, Scopus CINAHL, Web of Science, and the Cochrane Library databases to find studies that have established DRLs for pediatric CT examinations. The Preferred Reporting Items for Systematic Review and Meta-Analyses methodology was used to assess the relevant articles. The articles which assessed DRLs in pediatric CT examinations were included. A total of 501 articles were identified, of which 21 articles were included after a detailed screening process. Our review showed increased in pediatric patient dose surveys across the world and also increased in awareness for establishing DRLS among pediatric CT examinations. The review also demonstrated wide variation in DRLs and also deviation in the scanning techniques, protocols used and categorization methods used for establishing DRLs. As the pediatric population is more sensitive to radiation, the current review emphasizes the need for optimization of protocols and international standardization for establishing DRLs to facilitate a more feasible way of comparison of dose globally across CT sites.
Diagnostic potential of differentially regulated microRNAs among endometriosis, endometrioid ovarian cancer, and endometrial cancer
Authors: Kumari Priti , Sharma Indu , Saha Subhas Chandra , Srinivasan Radhika , Minhas Priyanka
Published: September 2021

Background:

There is an increased risk of developing endometrioid ovarian and endometrial cancer in patients with endometriosis and there are no definitive diagnostic biomarkers available for these three associated diseases. Therefore, we evaluated the diagnostic potential of differentially expressed microRNAs (miRNAs) from the tissue samples of endometriosis, endometrioid ovarian cancer, and endometrial cancer to establish them as biomarkers for these diseases.

Materials and Methods:

Ten samples of each, i.e., endometriosis, endometrioid ovarian cancer, endometrial cancer and control healthy endometrium were enrolled after obtaining ethical clearance. Differential expression of miR-16, miR-20a, miR-99b, miR-125a, miR-143, and miR-145 and some of their target genes, i.e., vascular endothelial growth factor (VEGF), hypoxia inducible factor 1A (HIF1A), cyclooxygenase 2 (COX2), and tumor necrosis factor (TNF) were quantified using quantitative reverse transcription polymerase chain reaction. Receiver operating characteristic (ROC) curve analysis was performed to predict the diagnostic potential.

Results:

miR-16 and miR-20a were significantly downregulated, whereas miR-99b, miR-125a, and miR-143 were significantly upregulated in all three diseased samples. miR-145 was significantly upregulated in endometriosis and endometrioid ovarian cancer but significantly downregulated in endometrial cancer. mRNA levels of VEGF, HIF1A, COX2, and TNF were significantly increased in all three diseased samples as compared to control samples. ROC curve analysis revealed that for endometriosis, miR-99b, and miR-125a were giving highest area under curve (AUC) (0.950 and 0.733, respectively), for endometrioid carcinoma of ovary miR-143 was giving highest AUC (0.933) and for endometrioid endometrial cancer miR-16 (AUC = 0.815), miR-99b (AUC = 0.920), and miR-145 (AUC = 0.985) were found to be best predictors.

Conclusion:

These findings suggest that these miRNAs can act as good predictors and discriminators of these three diseases and might serve as potential biomarkers for them.
The Scrotum Narrates the Inside Story…
Authors: Goel Prabudh , Bajpai Minu , Dalal Jagjit
Published: September 2021

Pyoscrotum is rarely encountered in neonates and is secondary to a local pathology such as neglected torsion or epididymo-orchitis. Pyoscrotum from an intra-abdominal pathology is possible in the presence of a patent processus vaginalis and has been rarely reported in the context of acute appendicitis. We report our experience with a case of antenatal bowel perforation presenting postnatally after an absolutely asymptomatic “honeymoon” period.
Surgical Management of Adnexal Masses in the Pediatric and Adolescent Age Group
Authors: Luthra Meera , Kumar Chiranjiv
Published: September 2021

Context:

Adnexal masses in girls represent a wide pathological spectrum. We performed a retrospective analysis of clinical and diagnostic aspects of adnexal masses in girls.

Aims:

To analyze the clinical characteristics and surgical management of adnexal masses in children and adolescents.

Settings and Design:

Retrospective observational analysis from 2000 to 2020.

Subjects and Methods:

This analysis was performed on 28 children under the age of 17 years with adnexal masses who were managed by us at tertiary care centers of Delhi-NCR. Patients were analyzed based on their age at the time of admission, their presenting complaints, clinical and radiological findings, tumor markers, management, and follow-up.

Results:

The age ranged between newborn and 17 years. Abdominal pain, nausea with vomiting, and abdominal lump was the most common presenting complaints. Pelvic ultrasound with or without color Doppler done in all patients and computed tomography, magnetic resonance imaging was performed in seven patients preoperatively. Adnexal masses were unilateral in 26 (92.85%) patients and bilateral in 2 (7.15%) patients. Five babies had antenatal diagnosis of ovarian cysts. Serum alpha fetoprotein (AFP) and beta-human chorionic gonadotropin (b-HCG) were normal in all 19 tested patients. Cancer antigen 125 (CA-125) was raised in three ovarian tumors out of 9 tested patients. Laparoscopy was performed in 23 out of 28 patients (30 ovaries). Ovarian cyst torsion was present in 50% patients. Ovarian cystectomy was done in 10 (33.3%) patients. Six (20%) ovaries were saved by detorsion of the ovary and deroofing of the cyst with or without ovarian biopsy. Oophorectomy was done in five (16.7%) patients. Salpingo-oopherectomy had to be done in seven (23.3%) patients. Histopathology revealed functional nonneoplastic lesions in 18 cases (66.7%), benign neoplastic lesions in 8 cases (29.6%), and malignant neoplastic lesion in 1 case (3.7%).

Conclusions:

Adnexal masses in children are generally benign. AFP, b-HCG, and CA-125 in ovarian torsion are within normal limits. Urgent surgery is required if torsion is established. The ovary should be preserved wherever possible.
Does Preoperative Function Affect the Outcome Following Pyeloplasty in Poorly Functioning Kidneys among Pediatric Population?
Authors: Rudrawadi Sharanbasappa , Kochhar Gaurav , Shekhar P. Ashwin , Laddha Prateek Jugalkishore
Published: September 2021

Aim:

To determine the efficacy and outcome of pyeloplasty in poorly functioning kidneys in the pediatric population and whether pyeloplasty could be offered as an upfront procedure in such patient population, instead of nephrectomy.

Materials and Methods:

A retrospective data analysis of 83 patients who underwent pyeloplasty in poorly functioning kidneys from 2010 to 2015 was performed. Success was defined based on improvement in symptoms, stable or improved function, and better drainage on post-operative Tc-99m Diethylene Triamine Pentaacetic acid scan instead of DTPA scan renography done after 3 months and yearly thereafter.

Results:

Eighty-three patients with a mean age of 6.8 ± 2.88 years with poor function on isotope renogram (<30%) were included in the study. Three patients were excluded in view of postoperative outflow obstruction. Out of the remaining 80 patients, 56 were male and 24 were female. They were divided into two groups based on preoperative differential renal function (DRF), Group I (n = 26) having preoperative DRF of <10% and Group II (n = 54) having preoperative DRF of 10%–30%. All patients underwent laparoscopic dismembered pyeloplasty with ureteral stenting. The mean DRF improved from 7.58 ± 2.39 to 29.71 ± 5.16 postoperatively in Group I. However, in Group II, DRF improved from 20.81 ± 5.68 to 37.25 ± 7.11 postoperatively. At a follow-up of 24 months, the overall success rate was 98%.

Conclusion:

Pyeloplasty gives good intermediate-term results even in extremely poorly functioning kidneys and an upfront pyeloplasty instead of nephrectomy should be offered to all pediatric patients irrespective of preoperative function.
Isolated Renal Mucormycosis in Children
Authors: Anand Sachit , Kainth Deepika , Dhua Anjan Kumar , Sehgal Mehak , Bajpai Minu , Das Prasenjit , Kandasamy Devasenathipathy
Published: September 2021

Isolated renal mucormycosis is rare in children. A case of 3-month-old infant presenting with right-sided flank lump and fever is being reported. Investigations revealed a nonfunctioning right kidney with intrarenal abscesses and a low percent-frequency of T-cells. He made an uneventful recovery following surgery and systemic antifungal therapy. Compared to the other forms of deep mucormycosis, a review of literature suggests favorable prognosis in children with isolated renal involvement.
Head-and-Neck Solid Tumors in Children
Authors: Manogaran Ravi Sankar , Mandelia Ankur , Bhuskute Govind , Mathialagan Arulalan
Published: September 2021

Objectives:

The aim of this study was to review the clinical profile, management, and outcome of solid tumors in the head-and-neck region in children at our institute.

Methods:

We retrospectively reviewed children with head-and-neck solid tumors who were treated jointly under the departments of Pediatric Surgery and Otorhinolaryngology at our institute between 2016 and 2019.

Results:

In the study period, 10 children (6 males, 4 females) with a median age of 9.5 years (range 5 days–16 years) were treated by our unit. The patients had four tumors arising from the parotid, 2 from nose/naso-pharynx, 1 each from the tongue, submandibular gland, para-pharyngeal space, and infratemporal fossa. A majority (90%) of the patients underwent complete surgical excision of the tumor, preserving the loco-regional neurovascular structures to minimize postoperative morbidity. Malignant lesions were seen in 4 patients (2 rhabdomyosarcoma, 1 primitive neuro-ectodermal tumor, 1 mucoepidermoid carcinoma) and 6 patients had benign pathology (3 pleomorphic adenoma, 2 mature teratoma, 1 schwanomma). Additional therapy with chemotherapy and local radiotherapy was required in 3 out of 4 patients with malignant pathology. The median follow-up duration is 15 months. At last follow-up, all patients are alive and 9 out of 10 patients (90%) are disease-free.

Conclusion:

Our experience highlights rare and difficult tumors in the head-and-neck region in children. These tumors are not commonly managed by the pediatric surgeon in routine practice. The paper outlines the multi-modality management of these tumors, which is essential for an optimal outcome.
Synchronous Development of Hemiscrotal Tissue in the Orthotopic and Ectopic Locations in Association with other Urological Anomalies
Authors: Sharma Kanika , Dhua Anjan Kumar , Goel Prabudh , Anand Sachit , Bajpai Minu
Published: September 2021

Ectopic scrotum is a rare form of congenital scrotal anomaly that is rarely encountered in pediatric surgical practice. Herein, we report an infant with a unilateral ectopic suprainguinal scrotum associated with undescended testis and multicystic dysplastic kidney. The case is reported in view of rarity of this anomaly in the general pediatric population.
One-Stage Bilateral Lobectomy in an Infant with Bilateral Congenital Lobar Emphysema
Authors: Sawant Vishal , Prabhudesai Sumant , Sawant Bharati , Das Sujoy
Published: September 2021

We report a 4-month-old baby presenting with bilateral congenital lobar emphysema. A two-staged bilateral lobectomy was planned, but bilateral lobectomy had to be performed as a single-staged procedure. Data are scarce on the appropriate approach to children with bilateral involvement. Both single-staged and two-staged procedures have shown variable success.
Protein-Losing Enteropathy Associated with Thrombotic Microangiopathic Features Revealing Hirschsprung's Disease in a Child
Authors: Nassih Houda , Mahir Nahid , Taher Fatima , El Qadiry Rabiy
Published: September 2021

We report the case of a 4-year-old boy with protein-losing enteropathy, leading to severe malnutrition. Associated thrombotic microangiopathic features made diagnosis difficult and challenging.
Cowper's Syringocele
Authors: Gazula Suhasini , Varunkumar M. , Praveena D. L. , Kumar P. Manoj , Swaminathan Maithreyi
Published: September 2021

Cowper's syringocele is a condition caused by dilatation of the main duct of Cowper's gland. It is a very uncommon cause of urethral obstruction. Closed type causes urinary obstruction. The aim of this article is to report a case of closed type syringocele causing new-onset urinary obstruction in a 10-year-old boy.
Measurement of Body Temperature in Postsurgical Children
Authors: Jasani Mitul , Jasani Alpa , Shah Anirudh , Shah Amar
Published: September 2021

Context:

Postoperative fever is known to occur after all surgical procedures irrespective of the type of anesthesia. Thermometry devices that work without touching or disturbing the child seem to be appreciated more than the conventional skin contact thermometers. However, whether this technology is reliable to be adapted for routine pediatric surgical care is debatable.

Aims:

The aim of this study was to study the accuracy of infrared nonskin contact digital thermometer (IRT) compared to the skin contact digital thermometer (DT) and mercury in glass thermometer (MT).

Settings and Design:

A prospective cross-sectional study was done in postoperative patients at a pediatric surgical center over a period of 3 months.

Subjects and Methods:

The forehead temperature was recorded with IRT. This was followed by recording the temperature in one armpit by DT and the other armpit by MT. Readings were promptly documented.

Statistical Analysis Used:

A sample t-test was done which gave the P value and mean. Linear regression analysis was carried out to find correlation coefficients. Bland–Altman test was used to access the concordance between all readings.

Results:

We found a strong correlation between temperature readings taken by DT (mean = −0.03, r = 0.07, slope = −0.04) and IRT (mean = 0.89, r = 0.091, slope = −0.14). However, on comparison of results with the MT, there are wider limits of agreement with the IRT (−0.31–2.09) in comparison to DT (−0.66–0.59).

Conclusion:

Skin contact digital thermometer are more accurate and suitable for checking body temperature as compared to infrared nonskin contact digital thermometer in postoperative pediatric patients.