bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comprehensive Simulation Study of Polymer Enhanced CO2 Injection in Light Oil Reservoirs
Authors: Laochamroonvorapongse Rapheephan , Srisuriyachai Falan , Chewaroungroaj Jirawat , Srisuriyon Jantakan , Henglai Puntira
Published: February 2024

Water-Alternating-Gas (WAG) injection has been widely implemented to improve volumetric sweep efficiency from gas injection alone. However, the WAG still suffers from gravity segregation, especially in thick and heterogeneous reservoirs with large well spacing. This study aims to investigate suitable Enhanced Oil Recovery (EOR) injection strategies for light oil reservoirs in Southeast Asia. The new injection techniques, such as Polymer-Alternating-Gas (PAG) and co-injection of CO2 with water/polymer, are also included.

The study uses the real geological model in Thailand's oilfield and the INTERSECT software to fully integrate the physics modeling of fluid composition and polymer properties. The reservoir oil is characterized based on actual PVT data and has a viscosity of 0.3 cP at reservoir conditions. The injection strategies performed in this study are water, polymer, CO2, WAG, PAG, co-injection of CO2 and water, and co-injection of CO2 and polymer. The sensitivity of CO2 injection rate, WAG sequences, and polymer concentration on recovery efficiency are also investigated.

Various EOR injection strategies are evaluated by using the history-matched model and compared with a waterflood case. The continuous CO2 injection at 4 MMscf/D yields an additional oil recovery factor of approximately 2.7%. The co-injection of CO2 with water and polymer can recover the oil additionally from waterflood by 3.0% and 2.9%, respectively. The benefit of co-injection methods is that the water/polymer co-injection helps maintain reservoir pressure after gas breakthrough at producers. Due to the reservoir dipping, the CO2 injection from updip location is promising because of the gravity-assisted effect. From the sensitivity analysis, the increase in CO2 injection rate from 4 to 8 MMscf/D results in propagation of gas farther from injection wells, leading to an additional RF gain of 0.6%. The different WAG injection sequences can be implemented at each WAG injector to fully utilize the gas compressor and maintain the constant volume of gas injection.

This study examines the existing and new CO2-EOR injection techniques for multi-layered light oil reservoirs with dipping. The pre-selected injection strategies can be further investigated in the optimization study of oil recovery and CO2 storage.
Experimental Investigation of the Effectiveness of Cement Expansion Additives for Improved Abandonment of High Rate Gas Wells
Authors: Amra A.
Published: February 2024

Cement expansion tests performed on slurries used in cementing and abandoning of Oil and Gas Wells are done to ensure no micro-annuli develop post cement setting which leads to gas bubbles (seepage) on surface post abandonment – this was the case in one abandoned Well from few decades back.

Industry use API ring mold testing to ensure cement expands post setting to overcome cement shrinkage issue. To ensure best in class, industry leading abandonments, Operator performed – in additional to API Test – additional extensive cement expansion testing in the Operator lab. Testing utilized novel advanced cement expansion measurement setups which simulate cement setting at downhole conditions of pressure and temperature using small and large cement plug sizes.

This study calculated permeabilities of various cement abandonment plugs recipes with different expansion additives. Results were then compared to API ring mold testing for same slurries at surface and downhole conditions. Comparison concluded that expansion results obtained from API ring tests didn't match testing performed at STCA. In another words, Cement Expansion Additives which showed acceptable expansion percentage with API ring mold test, proved to result in permeability below NORSOK abandonment thresholds, and not to always yield the required expansion pressures when tested in the large-scale downhole conditions’ setup.

Hence API ring mold tests which are widely utilized by the Oil and Gas industry are not fully representative of downhole conditions and give inaccurate representation of cement expansion and sealing ability.
Ending With a High Note: Striving for Safe and Resilient Well Abandonment Through Geomechanics-Driven Cap Rock Restoration Study
Authors: Zulkipli Siti Najmi Farhan , Shah Jamari M
Published: February 2024

Well abandonment is the last stage of well management life cycle post production cease and well shut in. Estimating field potential during the early appraisal stage, sustaining and enhancing the well productivity throughout the active producing years become the critical agenda to meet production target. Well healthiness and performance issues are easily identified through surveillance and well diagnostics surveys which continue till the end of well life including during well abandonment campaign if required. Reservoir pressure is one of the critical parameters monitored during this period to indicate production drive. The importance of pressure data will be emphasized during well abandonment stage together with cap rock evaluation for well barrier assessment.

Pressure survey during drilling execution and throughout production period till abandonment is used as critical input to evaluate the cap rock strength. Initial reservoir pressure with full gas evacuation from the reservoir are assumed to happen to determine the minimum setting depth for the cement plug where the gas line intersects with fracture gradient line. Competent cap rock interval must be identified below this threshold depth to allow for safe and adequate natural barrier in case of pressure increase. Pressure depletion element is also factored in the assessment of reservoir rock to further sensitive the depth range to set the cement plug.

Results indicate that out of 12 wells evaluated only one well requires cement squeeze directly into the existing perforation following the conventional well abandonment approach while the rest of wells are assured through the cap rock restoration assessment without any completion string below top packer removal required. This has translated to project cost optimization of USD 8 million. Systematic workflow process honouring the cap rock and geomechanics concepts are formulated as best practices for future project replication. In addition, systematic tabulation of pressure record, legacy cement bond log profile and well intervention history provide an elusive overview if any cement remedial job is required to re-establish the well barrier. A comprehensive track record allows few millions dollars of cost savings by eliminating additional cement bond log run and any new data acquisition run.

In conclusion, cap rock restoration technique backed with geomechanics-driven pressure analysis is able to provide for safe and reliable well abandonment portfolio. Doing the right analysis using the right data for the right application will help to strengthen technical integrity of subsurface evaluation work and ensure a more responsible way of abandoning the well for good.
Multiphase Hydrate Kinetics Model Extends Offshore Oil and Gas Field Operability
Authors: Davis I. M. , Makogon T. Y. , Khuraidah M. A.
Published: February 2024

An offshore oil and gas field undergoing a major production increment relies on a constant supply of Monoethylene Glycol (MEG) as protection against hydrate blockage risk. MEG supply pump trip would initiate an emergency shut down of the entire production system, both gas and oil. Novel hydrate research on hydrate growth rate was applied to estimate the survival time from loss of MEG to full pipeline blockage.

Hydraulic multiphase flow assurance transient modelling of both associated and nonassociated offshore gas gathering system was utilizing the novel hydrate kinetic module tuned to lab data for gas-dominated production systems. Analysis was performed considering different periods of total MEG loss and reinstatement, to predict hydrate formation volumes and hold-up within the gas network. In addition, periods of MEG under injection were considered, along with effects on ramp-down and subsequent ramp-up. Additional sensitivities were performed considering the ambient temperatures and changes to hydrate equilibrium curves. Finally, modelling parameters including hydrate cohesive/adhesive forces and prediction of entrainment of water were considered to ensure robust conclusions.

Temporary but complete MEG loss shows that hydrates begin to appear soon after MEG disruption, and hydrates tend, predominantly, to deposit on the pipe wall. The risk of a complete pipeline blockage after an 8-hour MEG disruption will depend on pipeline diameter and gas flowrate and composition. Small diameter flowlines transporting lean gas (no condensate phase), tend to accumulate hydrate faster due to the absence of the oil layer, giving greater contact between gas and water phase. Larger diameter trunk lines do not show any significant hydrate accumulation even after an extended level of MEG disruption. In most cases, hydrate accumulation will be eliminated during re-start of the MEG injection. The analysis allows identification of pipelines most at risk of hydrate blockage, and allows development of operating procedures to protect the system if loss of MEG occurs. Overall, it allows the specification of less conservative shutdown conditions and eliminates the potential loss of total field production by loss of MEG supply.

The analysis is based on experimental hydrates research from the University of Western Australia and is the first model developed specifically for gas dominated production fluids. It represents a previously unavailable methodology to predict evolution and distribution of hydrate phase within both fluid and pipe wall, time required for hydrates to first appear with loss of inhibition; the duration of hydrate accumulation to grow to a dangerous level and time for dissociation on restoration of MEG supply.
Application of a Flow Improver to Increase Production, Reduce Operating Cost and Carbon Emission at a Mature Oilfield
Authors: Phan T. , Yunus I. , Said A. , Mohamed W. , Makled M.
Published: February 2024

Production at the Neag-2 fields in the Western Desert of Egypt had been constrained by limited flow and pressure challenge in the multiphase pipeline that transferred produced fluids from Neag-2 fields to Neag-1 processing facility. The pipeline had a maximum allowable operating pressure of 47 bar and had been operated at a limited flow rate of about 14,000 barrels/day to maintain pressures at 40-41 bar to ensure pipeline integrity. Therefore, it was desired to have an effective chemical solution to reduce the pipeline pressure to 35 bar or less to allow the pipeline to transfer more production volumes from more wells with a target flow rate of 15,000 BPDs or higher. This paper presents laboratory test results to identify and recommend a flow improver that is effective in reducing pressure loss in a multiphase pipeline with high water cut and high TDS water. The results of a 10-day field trial showed that co-injection of both the flow improver FI-A at 24 ppm and the incumbent oil DRA at 10 ppm yielded the best performance with the pipeline pressure reduced to 34 bar and flow rate increased to 16,436 BPDs. Both values are exceeding target KPIs of pressure and flow rate, 15% increase compared to the corresponding baseline values. The trial results proved that flow improvers can be used to increase throughput of existing pipelines, eliminate bottle necks of production systems in mature fields to maintain or increase production, reduce operating cost, and provide ESG benefits in term of materials usage and carbon emission reduction.
Cardiac Papillary Fibroelastoma
Authors: Siddiqui Areeba , Rehman Sameer
Published: February 2024

Background:

Cardiac fibroelastomas are exceedingly rare etiologies of stroke, increasingly recognized with better diagnostic modalities. Surgical excision is the only curative option; however, timing of heparinization for cardiac bypass remains a challenging decision.

Objective:

We present a case of a 56-year-old female, diagnosed with multiple posterior circulation strokes and a left atrial mass, who successfully underwent anticoagulation and resection in 1 week.

Material and Methods:

MRI of the brain demonstrated numerous embolic-looking posterior circulation strokes. Transthoracic echo was negative for atrial pathology; a transesophageal echo revealed a left atrial mass, histologically consistent with papillary fibroelastoma.

Results:

Resection was delayed for up to 1 week to allow safe heparinization. We present a unique case of embolic stroke of undetermined source (ESUS) arising from a histologically rare tumor.

Conclusion:

We make the case for extensive workup for evaluation of posterior circulation strokes, including TEE, as well as timely resection of cardiac tumors.
Comparative Study of Risk Factors and Cognitive Profile of Small- and Large-Vessel Vascular Dementia – A Clinic Based Study
Authors: Bhat Ashwani , Das Goutam , Mukherjee Adreesh , Mukherjee Diptasree , Gangopadhyay Goutam , Biswas Atanu
Published: February 2024

Background:

Vascular dementia (VaD) is a clinically heterogeneous entity. There is a dearth of studies for comparison of the cognitive profile of cerebral small-vessel disease (SVD) with large-vessel disease.

Objective:

We planned to evaluate and compare the cognitive profile of SVD and large-vessel VaD and evaluate various risk factors associated with them.

Materials and Methods:

Patients of VaD were recruited after excluding mixed and ambiguous cases. Patients were classified into SVD and large-vessel VaD and analyzed for their clinic-epidemiological and cognitive profiles.

Results:

Among 76 patients, 48 (62.5%) have SVD and 28 (37.5%) have large-vessel disease. Hypertension (93.4%) was the commonest risk factor, followed by smoking (34.21%), hyperlipidemia (26.31%), and diabetes mellitus (DM, 22.36%). Hypertension (P < 0.05) and DM were common in SVD, whereas smoking, hyperlipidaemia, and cardiac diseases were common in large-vessel disease. Attention (77.1% vs 25%), executive function (68.8% vs 28.6%), and calculation (58.3% vs 32.1%) were significantly more impaired in SVD compared to large-vessel disease, whereas visuoperceptual (21.4% vs 6.3%), praxis (28.6% vs 4.2%), and gnosis (14.3% vs 2.1%) were significantly more impaired in large-vessel disease than in SVD. Disruption of frontal-subcortical connection was responsible for the cognitive profile in SVD, but in large-vessel disease, it resulted from the cumulative loss of function from different lesions.

Conclusions:

Despite having common vascular risk factors, few are more common in SVD than in large-vessel disease. The different clinical and cognitive profile is due to the diverse anatomical lesions in these two subclasses of VaD.
Survey of Family Satisfaction with Patient Care and Decision Making in Neuro-Intensive Care Unit- A Prospective Single Center Cross Sectional Study from an Indian Institute of Neurosciences
Authors: Bharadwaj Suparna , Umamaheswara Rao G S , Hegde Arjun , Chakrabarti Dhritiman
Published: February 2024

Background:

Quality of health care is a major issue. Providing care that accommodates individual patient preferences and values is termed patient-centered care.

Objectives:

In this study, we assessed family satisfaction (FS) with intensive care unit (ICU) care and family satisfaction with decision making in the care of critically ill neurological/neurosurgical patients.

Materials and Methods:

The FS-ICU questionnaire was used to assess family satisfaction. Data were analyzed using frequency tables and rates.

Results:

Of the 154 FS-ICU questionnaires analyzed, the overall satisfaction rate with care was 59.97, with information needs was 56.52, and with decision making was 59.46. Lower satisfaction rates among families may be due to the highly morbid nature of neurological illness in their kin or due to differences in socioeconomic factors.

Conclusions:

Periodic audit of the FS questionnaire is useful in assessing the quality of health care in the neuro-ICU. Efforts to incorporate suggestions of study subjects may improve FS with patient care and decision making.
A Rare Case of Neurosyphilis Presenting As Normal Pressure Hydrocephalus Syndrome
Authors: Baskar Dipti , Taallapalli AVR. , Kishore Pratik , Arshad Faheem , Kulanthaivelu Karthik , Nashi Saraswati , Rajendran Srijithesh P , Kulkarni Girish B , Alladi Suvarna
Published: February 2024

Neurosyphilis, a chronic infection of the nervous system by Treponema pallidum can present in all stages of syphilis. Recently, it is found that neurosyphilis presents with novel manifestations. Here, we report a young patient who had neurosyphilis presenting as Normal Pressure Hydrocephalus (NPH) with bilateral optic atrophy. The patient showed improvement with treatment for neurosyphilis. Hence, it is evident that in young patients presenting with NPH and associated features, secondary etiologies should be investigated.
A Modified Technique to Harvest Integrated Zygomatic Arch-Temporal Bone Flap
Authors: Tianzhi Zhao , Yingwu Shi , Zijian Yang , Yingxi Wu , Yafei Xue , Yunze Zhang , Bao Wang , Yan Hu , Feng Xue , Shunnan Ge , Shiming He , Yan Qu
Published: February 2024

Background:

In skull base surgery, zygomaticectomy is an effective method to increase surgical exposure and reduce brain retraction. However, the traditional zygomaticectomy methods are complicated and more invasive.

Objective:

To improve the procedure of zygomaticectomy, we introduced a modified technique to harvest integrated zygomatic arch-temporal bone flap.

Subjects and Methods:

A modified technique to section the zygomatic arch integrated with the temporal bone flap was described in the present work. This technique was applied in eight skull base lesion patients. The improved surgical angle was measured using Osirix software.

Results:

The surgical exposure is satisfied and no temporal lobe contusion or severe complications occurred in the patients. An increased surgical angle was obtained by zygomatic arch removing, with a mean value of 13.31°.

Conclusions:

This integrated zygomatic arch-temporal bone flap technique achieved increased exposure, decreased temporal lobe retraction, and minimal bone loss, leading to better cosmetics and functional reconstructions.
Neglected Case of Primary Intraorbital Hydatid Cyst
Authors: Kumar Manoj , Harsh Viraat , Prakash Anand , Sahay Chandra B , Kumar Anil
Published: February 2024

Background:

Hydatid cyst is a parasitic infection caused by Echinococcus granulosus and human is an accidental host. Liver and lungs are the most widely recognized organ of association but relatively low in other organs. Orbital involvement of the hydatid cyst is rare.

Case Description:

The case was a 47-year-old lady presented in the late stage of disease when corneal ulcer had developed and with complete vision loss along with headache, proptosis, and pain in the left eye. Cystic lesion in the retro-orbital region of the left eye was revealed by Computed tomography scan and magnetic resonance imaging. The patient underwent surgery. Hundreds of daughter cysts were seen intraoperatively and cyst wall sent for histopathological examination to confirm the diagnosis. The patient was further treated with albendazole for 3 months.

Conclusion:

Although hydatid cyst is uncommon, it ought to be considered in the differential diagnosis of cystic lesion of orbital locale, more so in the endemic territories.
Presentation of Mucopolysaccharidosis As Very Early Onset Schizophrenia Like Illness in Psychiatry Settings
Authors: Hatila Sangeeta , Solanki Gunjan
Published: February 2024

Schizophrenia is very rare before the age of 13, which is known as very early onset schizophrenia. There are few reports which document cases of schizophrenia before 5 years of age. Childhood onset schizophrenia has more chronic course characterized by sever social and cognitive consequences and increased negative and disorganization symptoms. Although diagnostic criteria of schizophrenia according to DSM5 are same as of adult onset but it's very difficult to explore psychopathology such as delusion and hallucination which depend upon cognitive development of the child. Further, the diagnosis of early onset schizophrenia is difficult because of similarity with neurological and metabolic disorder of childhood. This warrants comprehensive evaluation of such cases by multidisciplinary team consisting pediatrician, neurologist and psychiatrist.
Refractory obsessive–compulsive disorder with symptoms regressing after thalamic infarction
Authors: Erbay Lale G. , Erbay Mehmet Fatih , Kamışlı Suat , Demirbay Sümeyye , Ünal Süheyla
Published: February 2024

Obsessive compulsive disorder (OCD) is a common neuropsychiatric disorder involving predominantly the cortico-striato-thalamo-cortical loop. Although it is usually associated with various disorders of basal ganglia and thalamus, it is difficult to say what kind of impairment causes this situation exactly. Structural brain lesions may be one of the rare causes of refractory psychiatric symptoms. Analysis of such type of cases gives an idea about the neurobiology of psychiatric diseases. In this manuscript, we presented a case of refractory OCD with symptoms regressing after thalamic infarction and discussed with relevant literature.
Primary Headache in Behçet's and Neuro-Behçet's Disease
Authors: Beton Ozlem Ergin , Yucesan Canan
Published: February 2024

Background:

Behçet's disease (BD) is a multisystem vasculitis, which can involve the central nervous system, the gastrointestinal tract, the blood vessels, the joints, and the lungs. Neurological involvement is about 5%, but the headache is common in these patients.

Objective:

This study aimed to investigate whether differences exist in the onset and types of primary headaches between patients with BD without neurological involvement (BWoNI) and patients with neurological involvement, that is, neuro-Behçet's disease (NBD).

Materials and Methods:

A total of 136 consecutive BD patients (98 BWoNI and 38 NBD) were evaluated and compared.

Results:

Primary headaches beginning before and after the onset of BD were found in 27.6 and 48.1% of BWoNI patients, respectively, and in 10.5 and 34.2% of NBD patients, respectively. The start of primary headaches was more frequent after then before the onset of BD in each group and overall. The primary headache types were similar in both BWoNI and NBD patients.

Conclusions:

The primary headache starts more frequently after then before the onset of BD, and characteristics of primary headaches were similar in both BWoNI and NBD patients.
An Uncommon, Extensive Involvement of Hydatid Cyst—Cervical Spine to Brachial Plexus
Authors: Bishnoi Ishu , Sachdeva Deepashu , Mujal Bhagya , Sorout Sunil , Arora Ruhani , Singh Pradhaman
Published: February 2024

Introduction:

Hydatid cyst usually involves liver and lung. But it has been reported in uncommon locations like the spine and brain. There are few reports of cervical spine to brachial plexus. This report is about such extensively involved hydatid cyst management.

Case Report:

A 32-year-old male had complaints of neck pain, left-hand weakness, and atrophy. MRI of cervical spine and thorax revealed a multicystic lesion involving the cervical spine, vertebrae, brachial plexus, and lung apex. The lesion was removed in two stages.

Discussion:

Due to scarcity of literature, dense adhesions with dura and surroundings, risk of rupture, anaphylactic shock, and its management require proper planning. Excision of cervical, followed by plexus lesion, might help. Long-term use of albendazole prevents recurrence as suggested by other reports.

Conclusion:

Extensive spinal hydatid cyst is exceptionally challenging. These behave like malignant lesions. To get the best results, surgical planning is as essential as medical management.
A Modified Manual Compression Technique for the Treatment of Traumatic Pseudoaneurysm of Superficial Temporal Artery
Authors: Chandralekha Baruah , Tripathy Taraprasad , Phukan Pranjal , Lynser Donboklang
Published: February 2024

Traumatic Pseudoaneurysm of Superficial temporal artery (STA) is an uncommon entity. Surgical management is the treatment of choice, and endovascular management is also equally feasible particularly for the proximal STA aneurysm. The manual compression for the treatment of STA aneurysm is also described, but it has a high chance of failure. We report a case of traumatic pseudoaneurysm of STA in a pregnant female, successfully treated with a modified manual compression technique.
Human to Humanoid
Authors: Singh Daljit , Wadhwa Rachna , Daljit Tanshi
Published: February 2024

Background:

Neuroethics is a subsection of ethics which allows us to express our concerns with advances in neurotechnology, threat to human race, our freedom of expression, autonomy, and justice.

Objectives:

Aim of the review is to familiarize readers about the concept of neuroethics and alarming threats with newer neurotechnology and to sensitize them about our responsibilities as neuroscientists.

Materials and Methods:

Systematic literature search was conducted from 2010 to 2021 in PubMed to look at previously published review articles related to neuroethics. Relevant filters were added addressing autonomy and consent. Of the 426 articles, only 12 addressed the issue of autonomy and neuroethics and two on consent and neuroethics.

Results and Conclusions:

International literature has expressed limited concern on the scope of neuroethics. Newer threats are getting added on with advancing technology, and as neuroscientists, we all need to understand and educate neuroscientists about our social responsibilities in curtailing an out-of-reach situation for the mankind.
Thirteen-and-a-half Syndrome Secondary to the Brainstem Cavernoma
Authors: Gosal Jaskaran Singh , Khatri Deepak , Das Kuntal Kanti , Gajbhiye Sanjog , Mehrotra Anant , Jaiswal Awadhesh Kumar , Behari Sanjay
Published: February 2024

Background:

“Thirteen-and-a-half” is a newly described clinical syndrome characterized by the combination of the one-and-a-half syndrome with fifth and seventh cranial nerve nuclei involvement (11/2 + 5 + 7 = 131/2). To the authors' knowledge, this is the first report of the thirteen-and-a-half syndrome secondary to pontine cavernoma and, overall, only the second reported case of this syndrome in the literature till date.

Case Report:

A 20-year-old man presented with the clinical features suggestive of the thirteen-and-a-half syndrome, explained radiologically by pontine cavernoma. We operated him using a suboccipital transvermian approach and he is doing well at 2.5 years follow-up. Interestingly, his one-and-a-half syndrome has partially improved to left horizontal gaze palsy.

Conclusion:

The clinical appreciation of the thirteen-and-a-half syndrome precisely localizes the lesion to ipsilateral dorsal pontine tegmentum. Neurosurgeons must be aware of the newly described “one-and-a-half- plus” syndromes as they help in a better understanding of pathoanatomy caused by different disease processes in the brainstem.
Comparison between Oblique Lumbar Interbody Fusion (OLIF) and Minimally Invasive Transforaminal Lumbar Interbody Fusion (MISTLIF) for Lumbar Spondylolisthesis
Authors: Chandra Vemula V R , Prasad Bodapati C M , Hanu Tammireddy G , Kale Pavan G
Published: February 2024

Background:

Lumbar interbody fusion has gained popularity for the treatment of spondylolisthesis in recent years. Both procedures have their own advantages and disadvantages.

Objective:

The aim of this study was to compare the clinical and radiological outcomes of MIS TLIF and OLIF in terms of visual analog score, Oswestry Disability Index, Intraoperative blood loss, and various other parameters.

Material and Methods:

This is a retrospective matched-pair comparative analysis between two groups who underwent Single level either OLIF or MISTLIF for spondylolisthesis operated from January 2017 to January 2020 at a Single institute by a Single surgeon.

Results:

Statistically there is no difference in various preoperative parameters between the two groups. The intraoperative blood loss is 112.5 mL in OLIF, and 144.6 mL is MISTLIF. The duration of surgery in OLIF is 4.41 h and 3.16 h in MISTLIF. The mean duration of the requirement of postoperative analgesia is 3 months after OLIF and 5 months after MISTLIF. The time taken for returning to regular activities is less in OLIF than MISTLIF.

Conclusions:

Although both OLIF and MISTLIF have almost equivalent outcomes, OLIF is better than MISTLIF in having lesser intraoperative blood loss and achieving better lordotic correction.
Short term evaluation of right ventricular longitudinal strain in children post balloon pulmonary valvuloplasty
Authors: Wagdy Reham , El-Gandour Mamdouh , Mohsen Aly A.
Published: February 2024

Background

Children with isolated severe valvular pulmonary stenosis (sPS) are considered under chronic right ventricle (RV) pressure overload. Little is known about the needed duration for reverse remolding in pediatrics.

Objective

The study aimed to compare RV function and longitudinal strain in children before and 3 months after balloon pulmonary valvuloplasty (BPV).

Patients and methods

Thirty-seven children with sPS indicated for BPV were recruited. All patients underwent RV evaluation by Tissue Doppler (TDI) and speckle-tracking echocardiography. RV free-wall longitudinal strain (RV-FW), global RV strain (RV-4C), and global LV strain (GLS-LV) were studied one day before the procedure, 3 months postintervention, and compared with 37 healthy children enrolled as controls. Patient demographic and hemodynamic data during cardiac catheterization was collected.

Results

Successful BPV of 37 cases (mean age 3.2±4.9 years) showed a significant reduction in transpulmonary gradient from 89.2±23.9 mmHg to 16.1±8.4 mm Hg immediately postprocedure. The RV-FW and RV-4C of patients with sPS and GLS-LV were significantly lower than the control group (P=0.001), respectively. A significant rise of RV-FW and RV-4C occurred 3-month postintervention (−17.5±3.8 vs. 27.4±4.4) and (−15.3±3.8 vs. −23.9±3.9, P=0.001), respectively, and became insignificantly different from the control group. GLS-LV is positively correlated to RV-FW (r=0.342, P=0.038). Cases aged less than 1 year showed a significant rise of RV strains 24 h postprocedure.

Conclusion

Improvement of RV longitudinal strains of children is highly possible within 3 months of successful BPV up to normalization especially for infants below the age of one year.
Screening of iron deficiency anemia in children with chronic functional constipation
Authors: Metwally Rasha H.
Published: February 2024

Background

Iron deficiency anemia (IDA) is one of the most common nutritional deficiencies worldwide. Constipation is one of the most common gastrointestinal disorders in childhood.

Aim

To screen for IDA or iron deficiency (ID) among children with chronic functional constipation (CFC).

Patients and methods

It was a prospective study. Two groups of children in the age range of 1–15 years were collected for 6 months from June 2022 to December 2022 at Alexandria University gastroenterology clinic. Children who fulfilled Rome IV criteria of CFC were assigned to CFC group. Children who did not have constipation were considered as the control group. Complete blood count, serum iron, total iron binding capacity, and serum ferritin were done for both groups. Data were fed to the computer and analyzed using IBM SPSS software package version 20.0. Quantitative data were described using range (minimum and maximum), mean, standard deviation, and median.

Results

Hemoglobin levels, serum ferritin and serum iron were significantly lower in the CFC group when matched with the control group. ID and IDA were significantly higher in the CFC group. The longer days of constipation were correlated with significantly lower hemoglobin, serum iron, and serum ferritin.

Conclusion

CFC causes mild IDA or ID. The longer the days of CF, the lower values of hemoglobin, iron and ferritin are present. ID and IDA are more common in the CFC group.
Study of coagulase-negative staphylococci in hospital-acquired neonatal sepsis
Authors: Eldegwi Marwa , Abu-Elmagd Nehal El-Sayed , Darwish Ahmad , Ghaleb Sara , El-Shabrawy Walaa O. , El-Sayed Eman
Published: February 2024

Background

Coagulase-negative staphylococci (CoNS) has become increasingly prevalent as the leading cause of late-onset bacteremia in neonatal ICUs. Diagnosing CoNS septicemia poses challenges because this bacterium commonly resides on the skin, leading to potential contamination of blood culture samples. Therefore, this study aimed to identify the bacterial causes of sepsis in neonates who exhibit clinical signs of the condition, also to assess the methicillin susceptibility of CoNS through both phenotypic and molecular methodologies.

Materials and methods

This study was carried out at Mansoura University Children Hospital. Blood samples were obtained and directly cultured using the BACT/ALERT system. All isolates were identified using BD Phoenix system. CoNS isolates were subjected to a disk diffusion susceptibility test with cefoxitin 30 µg, serving as an initial screening test to identify methicillin resistance. Automated antibiotic susceptibility was done using BD Phoenix system followed by PCR testing to detect the presence of the mecA gene in resistant CoNS isolates.

Results

Among all the isolated micro-organisms, Klebsiella pneumoniae and CoNS were found to be significantly higher in early-onset sepsis and late-onset sepsis, respectively. Staphylococcus epidermidis constituted 30% of the isolates, with Staphylococcus haemolyticus and Staphylococcus hominis each accounting for 20%, while other Staphylococcus species made up the remaining 20%. Among the identified CoNS, 47.4% tested positive for the mecA gene. The presence of the mecA gene was significantly associated with a higher incidence of late-onset sepsis (P=0.033).

Conclusion

CoNS are the predominant culprits behind late-onset sepsis in hospitalized newborns. Notably, the presence of the mecA gene was significantly linked to a higher occurrence of late-onset sepsis. Our study has uncovered a concerning surge in antibiotic resistance genes within our community. This underscores the urgency of implementing an active antibiotic surveillance program and exploring alternative therapeutic strategies to effectively combat neonatal sepsis.
A Hospital-based Study to Assess Various Laboratory Parameters for Prediction of Severity of COVID-19 Disease at the Time of Admission at a Teaching Tertiary Hospital
Authors: Patel Ruchik , Patel Swati , Chaudhary Aditya , Patel Rahi , Bodalia Aaryaman
Published: February 2024

Background:

The main aim of this study was to determine the association between various laboratory parameter values at the time of admission with the severity classification of COVID-19 infection. Secondarily, this study also determined the cutoff value of associated laboratory parameters with the severity of infection at the time of admission. This study evaluated the association of laboratory parameters and other factors with the severity of COVID-19 infection (mild, moderate, and severe).

Methodology:

This study analyzed 170 adult patients with symptomatic COVID-19 infection hospitalized between July 2020 and December 2020 at a teaching tertiary care center in South Gujarat. All the patients selected in the study had a positive polymerase chain reaction test result of SARS-CoV-2. Laboratory parameters and clinical details of patients were recorded.

Results:

A total of 170 COVID-19-infected hospitalized patients were analyzed. The serum ferritin levels were 1.12 times higher in severe patients compared to mild category patients and 1.006 times higher in severe patients compared to moderate category patients, as determined using multinomial logistic regression. The requirement of invasive positive pressure ventilation (IPPV), BIPAP, and nonrebreathing mask at admission was substantially linked with patients in the severe and moderate categories (P < 0.0001). Compared to the mild category, the need for IPPV was 534.9 (95% confidence interval [CI]: [21.93–13022.20]) times greater in the severe category, and 50.41 (95% CI: [3.034–837.55]) times higher in the severe individuals. In addition, this study also evaluated the cutoff value for serum ferritin was identified at ≤276.35 ng/mL for mild, 276.35–473.5 ng/mL for moderate, and ≥473.5 as severe COVID-19 infection at the time of admission.

Conclusion:

Early ferritin estimation could be used to assess the severity and categorization of COVID-19 infection at the time of admission itself and can be of immense benefit in the treatment of the disease.
Occupationally Acquired Hepatitis C Virus Infection in Health-Care Workers: A Case Report and Review of Literature
Authors: Rupali Priscilla , Alexander Hanna , Abraham Priya , Eapen C. E.
Published: February 2024

The incidence of occupational health exposures to the risk of blood-borne pathogens is common yet underreported in health-care workers in India. These occur despite necessary precautions and training in often trying real-world circumstances. Indian health community reports very few occupational exposures and national guidelines with regard to postexposure monitoring or detection of acute hepatitis C virus infection are not available. We describe a case where acute hepatitis C infection was detected early due to intensive monitoring postneedlestick injury where prompt initiation of direct-acting antivirals led to a rapid response with no seroconversion.
Jejunal calcifying fibrous tumor: A jigsaw puzzle with a pool of diagnostic dilemma
Authors: Raj Akshi , Singh Madhuri , Buch Archana C. , Gurwale Sushama
Published: February 2024

Calcifying fibrous tumor (CFT) is a very rare benign fibroblastic tumor featuring a wide anatomical distribution and mimicking various spindle cell tumors. CFT has been documented in soft tissues, gastrointestinal tract (GIT), neck, adrenal glands, and pleura. Within the GIT, it is reported in the stomach, small bowel, large intestine, stomach, esophagus, and appendix. The occurrence of CFTs in the gastrointestinal tract presents a diagnostic dilemma, firstly due to the rarity of the lesion and secondly, due to the occurrence of a variety of other stromal lesions in the gastrointestinal tract with histological features that overlap with CFT. In the jejunum, it is extremely rare. We present one such rare case of jejunal CFT at an unusual age, complicated by jejuno-jejunal intussusception resulting in acute intestinal obstruction.
Hepatic and perihepatic PEComas: A study describing a series of five rare cases
Authors: Vijayanirmala P , Yadav Rajni , Goyal Surbhi , Barwad Adarsh , Bhowmik Subham , Malik Rohan , Pal Sujoy , Sharma Raju , Sakhuja Puja , Das Prasenjit
Published: February 2024

Background:

Perivascular epithelioid cell tumors (PEComas) encompass a group of rare mesenchymal neoplasms, with dual melanocytic and muscular differentiation. Hepatic PEComas are rare and difficult to diagnose, and their behavior is still unclear.

Materials and Methods:

Herein, we report a total of five cases of hepatic and perihepatic PEComas over a period of the last 5 years from our and collaborating center’s archive. A detailed histological evaluation was done. A comprehensive panel of immunohistochemical stains was used and fluorescence in-situ hybridization analysis was performed for the TFE3 gene using break-apart probes.

Result:

All these patients were women, with an average age of presentation of 44 years. The lesions were in the right hepatic lobe: three cases, the left hepatic lobe: one case, and gastrohepatic ligament: one case. The preoperative clinicoradiological diagnoses were hepatocellular carcinoma (HCC), focal nodular hyperplasia, hemangioma, metastasis, and gastrointestinal stromal tumor, respectively. Surgical excision was performed in four cases with no further adjuvant therapy. Histopathological examination and subsequent immunophenotyping revealed a diagnosis of PEComa. Fluorescence in-situ hybridization analysis was performed for TFE3 gene rearrangement in four cases.

Conclusions:

This series highlights the fact that accurate histological diagnosis of hepatic or perihepatic PEComas is important to prevent unnecessary aggressive treatment, unlike primary hepatocellular carcinomas or hepatoid/epithelioid metastatic tumors.
Syringoid eccrine carcinoma of the nipple in a male patient with lymph node metastasis: A case report
Authors: Sable Mukund , Sahoo Nibedita , Panigrahi Chinamyee , Mishra Pritinanda , Kumar Pradeep
Published: February 2024

Syringoid eccrine carcinoma of nipple is an extremely rare neoplasm of adnexal origin with variable clinical appearance and diverse histologic findings. Syringoid eccrine carcinoma (SEC) is often a diagnostic dilemma due to its morphology and presentation. Usually, these malignancies arise as non-ulcerated nodules or plaques in the head & neck region including the trunk. They are locally aggressive and have an infiltrative growth pattern with a propensity for metastasis. SEC is characterized by syringoma-like tadpole morphology with ductular differentiation and predominant desmoplasia. Immunostaining in SEC is variable and this variability is believed to arise from the tumor’s ability to differentiate along multiple routes including sweat secretory and or ductal differentiation. Here we present a rare case of SEC/ syringomatous carcinoma of nipple in a 51-year-old male breast with associated axillary lymph node metastasis. As per English literature, this is the second case of SEC in nipple of male patient.
Correlation between intestinal stem cell niche changes and small bowel crypt failure in patients with treatment-naïve celiac disease
Authors: Das Prasenjit , Battu Sudha , Mehra Lalita , Singh Alka , Ahmad Muzaffar , Agarwal Ashish , Chauhan Ashish , Ahmad Anam , Vishnubhatla Sreenivas , Gupta Siddhartha Datta , Ahuja Vineet , Makharia Govind
Published: February 2024

Objectives:

We hypothesized that crypt failure in the small bowel results in villous flattening in patients with celiac disease (CeD). We investigated whether alterations in the stem cell niche (ISC) are responsible for this phenomenon.

Materials and Methods:

We included 92 duodenal (D2/3) biopsies from treatment-naive patients of CeD and 37 controls. All underwent screening for serum anti-tissue transglutaminase and endoscopic upper small bowel biopsy. Immunohistochemical markers were used to investigate ISC niche alterations, including LGR5 for crypt basal cells (CBC), Bmi1 for position 4+ cells, β-Defensin for Paneth cells, R-spondin1 as WNT activator, transcription factor-4 as WNT transcription factor, BMP receptor1A as WNT inhibitor, fibronectin-1 as periepithelial stromal cell marker, H2AX as apoptosis marker, and Ki67 as proliferation marker. We also analyzed IgA anti-tTG2 antibody deposits by using dual-color immunofluorescence staining.

Results:

We found that in biopsies from patients with treatment-naive CeD with modified Marsh grade 3a–3c changes, the epithelial H2AX apoptotic index was upregulated than in controls. LGR5+ crypt basal cells were upregulated in all modified Marsh grades compared to controls. However, the Ki67 proliferation index, expressions of WNT-activator RSPO1, and position-4 cell marker Bmi1 did not significantly alter in patients’ biopsies as compared to controls (P = 0.001). We also observed depletion of pericrypt stromal fibronectin-1 in patients with CeD compared to controls. In addition, we identified IgA anti-TG2 antibody deposits in pericrypt stroma.

Conclusions:

Our data suggests that ISC niche failure is a plausible hypothesis for villous flattening in patients with CeD, resulting from pericrypt IgA anti-TG2 antibody complex-mediated stromal depletion.
Staphylococcal scalded skin syndrome in neonate: Another face of CA-MRSA
Authors: Rizwana M Mohamadiya , Shanmugapriya S , Sudha M Jaya , Appalaraju B , Ramesh S
Published: February 2024

Staphylococcal scalded skin syndrome (SSSS), also known as Ritter’s disease, in its severe form occurs predominantly in infants and children. It is caused by infection with group II (often phage group 71) Staphylococcus aureus. The foci of infection include nasopharynx, less commonly umbilicus, urinary tract, superficial abrasion, conjunctivae, and blood. Staphylococci are non-motile, non-spore-forming, catalase-positive, gram-positive cocci that appear predominantly as grape-like clusters. Although this organism is frequently a part of normal human microbial flora, it can cause significant opportunistic infections under certain conditions such as when extremes of age groups are involved, the presence of indwelling medical devices, and intravenous (iv) drug abuse. Staphylococcus aureus may cause a variety of infectious manifestations ranging from relatively benign skin infections to life-threatening systemic illnesses. SSSS caused by S. aureus strains produces exfoliative toxins which result in the development of blisters, erythema, and desquamation. Here, we present a case of an 11-day-old neonate who was diagnosed with SSSS. The causative agent responsible for this syndrome was identified as methicillin-resistant Staphylococcus aureus (MRSA). The molecular characterization of the gene Panton-Valentine leukocidin (PVL) was done by polymerase chain reaction (PCR) and was detected positive for PVL which is a distinctive virulence factor seen almost in all of the community-acquired MRSA strains. The patient was discharged after parenteral clindamycin therapy with almost complete resolution of symptoms.
Highly cellular leiomyoma – A great histopathological masquerader of endometrial stromal sarcoma
Authors: Garikapati Kavitha , Sharmila Vijayan , Joshi Prashant , Bharti Jyotsna N.
Published: February 2024

Leiomyoma is the most common benign uterine tumor, whereas endometrial stromal tumors are rare uterine tumors with limited clinical experience. The distinction between highly cellular leiomyoma and endometrial stromal sarcoma can pose a diagnostic challenge to the pathologists as both these tumors have considerable overlapping features on histology.
Psychiatric comorbidities and breast cancer: A study from Jammu region of UT of J&K, India
Authors: Mir Mehak T. , Kumari Rashmi , Gupta Rajiv K. , Sharma Rahul , Gul Naveed , Langer Bhavna
Published: February 2024

ABSTRACTS

Background:

Breast cancer is the most common cancer among females of all age groups. The diagnosis of cancer itself has a menacing impact on the psychosocial health of an individual leading to various psychiatric comorbidities. This can impact the overall prognosis of cancer patients.

Objectives:

To study the prevalence of psychiatric comorbidities among female breast cancer patients and to assess its association with sociodemographic and clinical factors among these.

Materials and Methods:

A cross-sectional hospital-based study was conducted for a period of 1 year in the Regional Cancer Centre. All females in the age group of 18 years and above, who were confirmed to have breast cancer were included in the study. A self-designed proforma was administered to elicit information about sociodemographic and clinical details of the study subjects. Hospital Anxiety and Depression Scale (HADS) and Perceived Stress Scale (PSS) were used to assess the prevalence of psychiatric comorbidities like depression, anxiety, and stress among these subjects. Data thus obtained were analyzed using the Statistical Package for the Social Sciences (SPSS) Software.

Results:

A total of 205 subjects were included in the study. The mean age was reported as 49.25 ± 11.44 years, most of these were married homemakers residing in nuclear families in rural areas. Prevalence of depression, anxiety, and stress was found to be 60%, 73.17%, and 83.41%, and these were significantly associated (P < 0.05) with residence, number of living children, visits per month to hospitals, time since diagnosis, and type of treatment received.

Conclusion:

There is a high risk of psychiatric comorbidities among breast cancer female patients and an urgent need for effective strategies to prevent these.