bluuebunny/crossref_metadata_2025 huggingface dataset:
Rare case of late acute corneal hydrops in a 35-year-old patient post-corneal collagen cross-linking
Authors: Wairagade Nikhilesh , Chandure Nikhil , Surana Shruti
Published: April 2024

This case report describes a 35-year-old male presenting with acute corneal hydrops 10 years after uneventful corneal collagen cross-linking done for keratoconus in the left eye. During the follow-up periods, the patient was noted to have several episodes of severe allergic conjunctivitis with eye rubbing that were treated accordingly, but the patient was noncompliant and progression of keratoconus was suspected on topography. There are no reported cases of acute corneal hydrops in cross-linked corneas. We suspect allergic conjunctivitis and eye rubbing may be a risk factor associated with possible progression of keratoconus after cross-linking.
Metastatic anorectal melanoma presenting with bilateral orbital mass – A rare case
Authors: Agrawal Sahil , Meel Rachna , Pushker Neelam , Kashyap Seema , Kumar Nikhil , Tyagi Parag , Bajaj Mandeep S
Published: April 2024

Due to the increased longevity of patients and advances in diagnostic modalities, an increase in the prevalence of patients with orbital metastasis is being observed. Here, we report a lady in her 40s who presented with complaints of painless protrusion of the left eyeball with restricted motility and reduced vision. She gave history of surgery for hemorrhoids. Based on clinical and imaging findings, a diagnosis of orbital metastasis was made. Thorough systemic evaluation revealed the primary tumor to be a melanoma of anorectal origin with widespread metastasis. An orbital surgeon should keep high suspicion for metastasis while working up cases of orbital malignancy, especially in the elderly population.
Extranodal, nasal, natural Killer T-cell lymphoma of the lacrimal gland: A case report
Authors: López-Posada Mariana , Calle-Vásquez Carlos A.
Published: April 2024

Natural killer T-cell lymphomas involving the lacrimal gland are extremely rare. The prognosis of this type of lymphoma is poor, with 12-month mortality rates over 87%. In this case report, we present a patient with an isolated compromise of the right lacrimal gland by an extranodal, nasal, natural killer T-cell lymphoma treated with stereotactic radiotherapy with a free event follow-up of 12 years, an uncommonly long survival.
Central retinal vein occlusion with concurrent paracentral acute middle maculopathy secondary to honeybee sting
Authors: Kakarla Peeyusha , Rijey Joash , Reddy YC Venugopal , Manechala Upendra Babu
Published: April 2024

We report the case of a 45-year-old male who presented with complaints of sudden decreased vision in the right eye (RE) associated with redness and lid swelling. He gave a history of honeybee stings 1 week ago to the right periorbital area. On examination, the patient’s best-corrected visual acuity in RE was 4/60. The anterior segment examination was normal. However, fundus examination and imaging revealed central retinal vein occlusion (CRVO) with paracentral acute middle maculopathy (PAMM) and macular edema. The patient’s routine blood tests were negative for any abnormalities that could have caused the vascular occlusion. The patient was prescribed topical steroids and advised to receive an intravitreal injection of ranibizumab. However, 2 weeks later, the patient returned with improved visual acuity and resolution of macular edema. His transient hypercoagulable state could have been the cause of his ocular symptoms. Few cases of central retinal artery occlusion (CRAO) secondary to bee venom have been reported, but none with CRVO and associated PAMM.
Case Report: Choroidal osteoma: Bone in the eye
Authors: Summaiyya Umme , Sharma Nikita , Narde Harpreet K
Published: April 2024

We share a case of a 16-year-old girl who presented with blurring of vision in her left eye since 1 year, with fundus examination suggestive of choroidal osteoma. The detailed clinical, complimentary examinations, and multimodal imaging – fundus photo, optical coherence tomography, fundus fluorescein angiography, and B-scan ultrasonography – of the case are discussed. Choroidal osteoma is a rare benign ossifying tumor of unknown etiology characterized by mature bone replacing choroid, more commonly unilateral and predominantly affecting young females, typically manifesting in the teenage years or in the early 20s. Although choroidal osteoma is a rare benign tumor, accurate diagnosis is important because it is similar to amelanotic choroidal melanoma and metastatic choroidal carcinoma which require treatment and it is important to keep patients under observation for early detection of treatable choroidal neovascularization and other complications.
Can caterpillar cilia penetrate the retina
Authors: Ramesh Arpitha , Dubey Nidhi , Minija CK , Ramanjulu Rajesh
Published: April 2024

A 36-year-old male presented with recurrent episodes of redness in the right eye following vigorous eye rubbing since 3 months, treated with on and off steroid eyedrops elsewhere. On examination, his best corrected visual acuity was 6/6 in both eyes with normal anterior segment. A cilia-like structure was noted on fundoscopy along the temporal periphery with clumps of vitreous exudates surrounding it. Pars plana vitrectomy was performed to remove the hair, which was seen adherent to and penetrating through the retina. On follow-up at 3 months, there were no episodes of inflammation noted.
Snakebite hemotoxin-induced unilateral retinopathy: Case report and review of the literature
Authors: Ramachandar Hemanth , Temkar Shreyas , Shah Aahan , Agarwal Disha , Deb Amit K
Published: April 2024

Ocular manifestations of snakebite depend on the nature of envenomation. Neurotoxic venoms usually cause neurological manifestations such as ptosis and external ophthalmoplegia, whereas hemotoxic poisons cause hemorrhagic manifestations such as hemorrhagic retinopathy and arterial occlusions. However, most of the ocular manifestations present bilaterally. We report a unique case of a female in her 5th decade presenting with unilateral snakebite hemotoxin-induced retinopathy in the form of subretinal and preretinal hemorrhages presenting 5 days after the snakebite. She was managed conservatively. Preretinal and subfoveal bleed gradually resolved with fair visual recovery. Anatomical differences in the vasculature between the two eyes along with some degree of venous occlusion in the left eye might have contributed to such an asymmetrical presentation.
Choroidal metastasis in a patient with myxoid liposarcoma of the gluteal region – A case report
Authors: Kaushal Bhavsar , Thamotharan Manishikaa , Biswas Jyotirmay
Published: April 2024

We describe a rare case of choroidal metastasis from myxoid liposarcoma of the gluteal region in a 62-year-old male patient. Metastasis developed 1.5 years after excision and radiotherapy of primary tumor. He presented with defective vision in the left eye with subretinal elevated mass lesion temporal and inferior to the macula with overlying retinal detachment. Metastatic workup revealed cervical spine and lung metastasis with pleural effusion. Patient was advised palliative chemotherapy and local radiation therapy.
Acute central serous chorioretinopathy after prolonged application of topical minoxidil: A case report and review of the literature
Authors: Walinjkar Jaydeep A , Patel Afroz Q , Sundaram Natarajan
Published: April 2024

We report a case of a young man aged 38 years who complained of seeing a black spot in front of his left eye Oculus sinister (OS) for 5 days. He had been applying minoxidil topically for the treatment of androgenic alopecia for 8 months. Both eyes’ Oculus uterque (OU) anterior segments were within normal limits. The OS posterior segment showed subretinal fluid (SRF) in association with a serous pigment epithelium detachment (PED). He was diagnosed with acute central serous chorioretinopathy (CSCR) secondary to the prolonged use of topical minoxidil. He was advised to cease minoxidil application as a first line of treatment. He followed up for 3 months, the SRF was observed to decrease at every follow-up, and the best-corrected visual acuity (BCVA) improved from 6/9, N6 to 6/6, N6. CSCR associated with topical minoxidil use is a rare entity, and a treating dermatologist must counsel the patient regarding the same while initiating the treatment.
Serum brain-derived neurotrophic factor level and its relation with cannabis use disorder and schizophrenia: A cross-sectional exploratory study in patients at a tertiary care hospital
Authors: George Aishwariya Brigit , Gupta Abhishek , Jain Raka , Sood Mamta , Sarkar Siddharth
Published: April 2024

BACKGROUND:

Brain-derived neurotrophic factor (BDNF) has considerable relevance in neural growth and differentiation. It has been evaluated as a biomarker for individuals with various psychiatric disorders such as substance-related disorders and psychotic disorders.

OBJECTIVE:

The present study explored differences in the levels of BDNF (in serum) among subjects using cannabis (with and without schizophrenia).

METHODS:

This cross-sectional observational study compared the serum BDNF level in male subjects aged 18–45 years. Four groups of 20 subjects each were included: individuals with tobacco use disorder only, patients having schizophrenia, patients with cannabis use disorder, and finally patients with comorbid cannabis use disorder and schizophrenia.

RESULTS:

The BDNF levels were found to be significantly different across the four groups. The BDNF levels in subjects with concurrent schizophrenia and cannabis use disorder were higher than each of the other three groups (cannabis use disorder, schizophrenia, and tobacco use disorder only).

CONCLUSION:

We find that BDNF may be higher when cannabis use disorder and schizophrenia co-occur, as compared to either of the conditions alone. The findings should be interpreted with caution due to the low sample size and potential confounders.
Is intravoxel incoherent motion magnetic resonance imaging useful for predicting hepatocellular cancer recurrence and invasion of the peritumoral zone after transarterial chemoembolization?
Authors: Zhao Xinyao , Wen Qingqing , Wang Junying , Dou Weiqiang , Zhang Guowei , Shi Hao
Published: April 2024

Purpose:

We evaluated the potential role of intravoxel incoherent motion (IVIM) in predicting the therapeutic response and peritumoral invasion in patients with hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE).

Materials and Methods:

We enrolled 47 patients previously treated with TACE between January 2018 and December 2021. We evaluated the IVIM-derived metrics [apparent diffusion coefficient (ADC), D, D*, f] in the TACE-treated, peritumoral, and parenchymal areas of the liver.

Results:

The ADCtaceand Dtacevalues (1.13 ± 0.22 × 10−3m2/s vs 0.95 ± 0.13 × 10−3mm2/s, 1.28 ± 0.27 × 10−3mm2/s vs 1.07 ± 0.3 × 10−3mm2/s,P< 0.05) were higher in the non-progressing groups than in the progressing groups in the TACE-treated areas. Dptrepresented the D values in the peritumoral area, which can distinguish between the progressive and non-progressive groups with an AUC of 0.73. The Dstdvalues, which represent the D values in the peritumoral area normalized by the D values in the liver parenchyma in the non-progressing groups (1.10 ± 0.14 × 10−3mm2/s), were higher than those of the progressing groups (0.93 ± 0.17 × 10−3mm2/s).

Conclusion:

The ADCtace, Dtace, Dpt, and Dstdvalues reflect the changes in the microstructure of the progressive and non-progressive groups after TACE treatment, showing robust diagnostic performances in predicting the therapeutic response and peritumoral invasion.
Study on the differential diagnosis of benign and malignant breast lesions using a deep learning model based on multimodal images
Authors: Du Yanan , Wang Dawei , Liu Menghan , Zhang Xiaodong , Ren Wanqing , Sun Jingxiang , Yin Chao , Yang Shiwei , Zhang Li
Published: April 2024

Objective:

To establish a multimodal model for distinguishing benign and malignant breast lesions.

Materials and Methods:

Clinical data, mammography, and MRI images (including T2WI, diffusion-weighted images (DWI), apparent diffusion coefficient (ADC), and DCE-MRI images) of 132 benign and breast cancer patients were analyzed retrospectively. The region of interest (ROI) in each image was marked and segmented using MATLAB software. The mammography, T2WI, DWI, ADC, and DCE-MRI models based on the ResNet34 network were trained. Using an integrated learning method, the five models were used as a basic model, and voting methods were used to construct a multimodal model. The dataset was divided into a training set and a prediction set. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of the model were calculated. The diagnostic efficacy of each model was analyzed using a receiver operating characteristic curve (ROC) and an area under the curve (AUC). The diagnostic value was determined by the DeLong test with statistically significant differences set at P < 0.05.

Results:

We evaluated the ability of the model to classify benign and malignant tumors using the test set. The AUC values of the multimodal model, mammography model, T2WI model, DWI model, ADC model and DCE-MRI model were 0.943, 0.645, 0.595, 0.905, 0.900, and 0.865, respectively. The diagnostic ability of the multimodal model was significantly higher compared with that of the mammography and T2WI models. However, compared with the DWI, ADC, and DCE-MRI models, there was no significant difference in the diagnostic ability of these models.

Conclusion:

Our deep learning model based on multimodal image training has practical value for the diagnosis of benign and malignant breast lesions.
Enhanced recovery after surgery for percutaneous CT-guided microwave ablation of lung tumors: A single-center retrospective cohort study
Authors: Peng Huajian , Wang Meijing , Lu Shuyu , Liu Jun , Zhang Yanan , Fu Zongwang , Li Changqian , Huang Yihua , Guo Jianji , Xu Zhanyu , Yang Nuo
Published: April 2024

Background:

The feasibility and safety of enhanced recovery after surgery (ERAS) for percutaneous computed tomography (CT)-guided microwave ablation (MWA) for treating lung nodules remain unclear.

Methods and Materials:

A total of 409 patients with lung tumors treated at the Department of Thoracic Surgery, First Affiliated Hospital of Guangxi Medical University from August 2020 to May 2023 were enrolled. Perioperative data, including baseline characteristics, operation time, postoperative pain score (visual analog scale [VAS]), hospitalization expenses, postoperative complications, total hospital stay, and patient satisfaction, were observed and recorded.

Results:

No perioperative mortality occurred in either group and complete ablation was achieved in all patients. Patients in the ERAS group had significantly shorter hospital stays (P< 0.001), reduced operation times (P= 0.047), lower hospitalization expenses (P< 0.001), lower VAS scores (P< 0.001), and fewer complications (P= 0.047) compared with the traditional group.

Conclusions:

ERAS for percutaneous CT-guided MWA (ERAA) is safe, effective, and feasible for the treatment of lung nodules.
Immunostimulatory effects of thermal ablation: Challenges and future prospects
Authors: Liu Peng , Wei Zhigang , Ye Xin
Published: April 2024

This literature explores the immunostimulatory effects of thermal ablation in the tumor microenvironment, elucidating the mechanisms such as immunogenic cell death, tumor-specific antigens, and damage-associated molecular patterns. Furthermore, it outlines critical issues associated with thermal ablation-induced immunostimulatory challenges and offers insights into future research avenues and potential therapeutic strategies.
Safety and clinical efficacy of microwave ablation combined with percutaneous vertebroplasty in the treatment of multisegmental spinal metastases
Authors: Wang Zhilong , Zuo Taiyang , Lin Wenli , Liang Yining , Jiang Fangzhou , Li Yibing
Published: April 2024

Objective:

To evaluate the safety and efficacy of microwave ablation (MWA) combined with percutaneous vertebroplasty (PVP) in the treatment of multisegmental (2–3 segments) osteolytic spinal metastases.

Materials and Methods:

This study comprised a retrospective analysis of data from 20 patients with multisegmental (2–3 segments) osteolytic spinal metastases who received MWA combined with PVP. The visual analog scale (VAS) score, Oswestry Disability Index (ODI) score, Quality of Life Questionnaire-Bone Metastases 22 (QLQ-BM22), and local recurrence before and after the operation were measured. The occurrence of complications was observed to evaluate safety.

Results:

All operations were completed successfully with no serious complications. Transient nerve injury occurred in two cases, but recovered after symptomatic treatment. The bone cement leakage rate was 13.9% (6/43). The mean baseline VAS scores were 7.25 ± 0.91 before treatment and 7.25 ± 0.91, 3.70 ± 1.12, 2.70 ± 0.73, 2.40 ± 0.68, 2.25 ± 0.71, and 2.70 ± 0.92 at 1 day, 1 week, 1, 3, and 6 months after treatment; all values were significantly lower (P< 0.001). The mean baseline ODI score decreased from 56.90 ± 9.74 before treatment to 41.90 ± 7.09, 38.10 ± 7.93, and 38.80 ± 10.59 at 1, 3, and 6 months after treatment, respectively; all values were significantly lower (P< 0.001). The average QLQ-BM22 baseline score decreased from 54.10 ± 5.36 before treatment to 44.65 ± 5.22, 43.05 ± 4.78, 42.30 ± 4.06, and 42.15 ± 5.47 at 1 week, 1, 3, and 6 months after treatment; all values were significantly lower (all P < 0.001). The postoperative survival time of all patients was >6 months. In three patients, four vertebral segments recurred 6 months after operation.

Conclusion:

MWA combined with PVP is a safe and effective treatment for multisegmental osteolytic vertebral metastases that can effectively relieve pain, improve spinal function, improve quality of life, and delay tumor progression. However, it is a long operation, necessitating good preoperative preparation and effective intraoperative pain relief measures.
Radiotherapy for patients with esophageal cancer aged 80 years or older: A 16-year experience
Authors: Zhai Tiantian , Huang Ruihong , Zhan Yizhou , Xu Liangyu , Yu Yuanxiang , Guo Longjia , Chen Jianzhou , Su Chuanghuang , Chen Chuangzhen
Published: April 2024

Purpose:

Radiotherapy (RT) plays an important role in esophageal cancer (EC) patients aged ≥80 years. However, the survival modality and prognostic factors remain poorly understood. Thus, this study aimed to evaluate the tolerance and long-term overall survival (OS) of patients aged ≥80 years who were diagnosed with EC and underwent definitive RT.

Materials and Methods:

A total of 213 consecutive patients with EC over 80 years old who were treated with curative intent RT between February 1999 and December 2015 at our institution were retrospectively reviewed. The clinical prognostic variables were analyzed against OS in univariate analyses using log-rank tests and in a multivariate model using Cox regression proportional hazards analysis.

Result:

The median patient age was 82 (range: 80–94) years. Atotal of 192 patients (90.1%) completed the definitive RT (median: 60 Gy, range: 50–72 Gy), and 11 patients had grade 4 or higher acute toxicity, including esophagitis, a cardiac event, infections, and sudden death. Atotal of 168 deaths (78.9%) were observed with a median follow up of 47 months (range: 0-153 months). The OS rates were 50.3%, 17.6%, and 13.2% at 1, 3, and 5 years, respectively. Multivariable analysis identified that tumors located in the cervical and upper thorax, a shorter tumor lesion, RT treatment of 50–60Gy, and a better response to treatment were the factors associated with longer OS.

Conclusion:

Definitive RT could be considered as an effective treatment for patients with EC who are older than 80 years, and 50–60 Gy seems to be a reasonable dose for these patients.
Somnolence Revealing Bilateral Thalamic Stroke in a Patient with Vertebral Artery Dissection
Authors: Mnaili Mohamed Amine
Published: April 2024

ABSTRACT

Bilateral thalamic infarcts are rare presentations of stroke. They are the result of a complex combination of risk factors and a predisposing vessel distribution. The artery of Percheron, characterised by a single arterial trunk that irrigates both paramedian thalamic regions, can be occluded as a result of embolic diseases leading to bilateral paramedian thalamic infarcts. We describe a 35-year-old male patient with no relevant medical history who was admitted to hospital with somnolence lasting for 1 week. The scans revealed symmetric bilateral paramedian thalamic hypodensity consistent with bilateral thalamic stroke. Bilateral thalamic infarcts are unusual presentations of posterior circulation stroke; once they are diagnosed by an adequate neuroimaging protocol, further evaluation to define the cause is necessary.
Impact strength of heat-cured acrylic resin after immersion in tobacco leaf (Nicotiana tabacum L.) effervescent tablets: An experimental study
Authors: Kristiana Dewi , Parnaadji Rahardyan , Adena Afif Surya , Wulan Happy Ramadhani
Published: April 2024

Aim:

To determine the effect of immersing heat-cured acrylic resin on tobacco leaf extract (TLE) effervescent tablets 75% on the impact strength.

Materials and Methods:

This research used an experimental design. Rectangular acrylic resin with a size of 60 mm × 12 mm × 3 mm, according to American Standards for Testing and Materials, was used. The samples were divided into three groups: immersed in distilled water as a negative control group, immersed in a solution of TLE effervescent tablets with a concentration of 75%, and immersed in commercially available dental cleansers as a positive control group. The immersion of the samples was carried out for 16 days which was equivalent to cleaning 30 min per day for 2 years. TLE effervescent tablets were compared with commercially available dental cleansers. Next, the impact strength of the sample was tested.

Results:

The one-way analysis of variance test results showed a P-value <0.005, that is, a significant difference in each treatment group’s impact strength of heat-cured acrylic resin denture bases. The results of the post hoc test (least significance difference; LSD) showed that there is no significant difference in the impact strength of immersed acrylic in 75% TLE effervescent tablets with aquades compared to denture commercially available dental cleansers.

Conclusions:

75% TLE effervescent tablets as a denture cleanser have the effect of reducing the impact strength of heat-cured acrylic resin type with a soaking time of 16 days, which is equivalent to cleaning 30 min per day for 2 years. The limitation of this research is the type of heat-cured acrylic used only from one brand, maybe different brands will give different results, so further testing is needed to prove it.
Comparative evaluation of third-generation LED-light curing units and their effect on bulk-fill composites—An in vitro study
Authors: Puri Aakansha , Prathap M S , Jayaprakash K , Sreegowri  , Jose Jeslee A
Published: April 2024

Aim:

Comparing the effectiveness of third-generation light-emitting diode light-curing devices and their impact on bulk-fill composites is the primary purpose of this study.

Materials and Methods:

In vitro investigation was carried out on a total of 32 samples of two bulk-fill composites. Four groups (n = 8) were formed. Half of the specimens of Tetric® N-Ceram Bulk Fill and Palfique Bulk Flow composites were randomly selected and cured from top with Bluephase® N LED light curing unit (LCU), and the remaining half with FlashMax P3 WS 4W LED LCU, following instructions provided by the manufacturer. The samples were assessed for degree of conversion (DoC) and microhardness after being submerged in distilled water solution and kept in an incubator for 24 h at 37°C. The two LED LCUs were compared. Standard deviation and mean were used to describe the data. Utilizing the Kruskal–Wallis test, the groups were compared. The independent sample t test was used to evaluate the differences in values between the top and bottom surfaces, and the Bonferroni post hoc test was used for multiple comparisons. The DoC and microhardness were correlated, and this was evaluated using Pearson’s correlation test.

Results:

The mean values for both parameters were statistically different when the two composites were cured with the LED-LCUs. Both the bulk-fill composites showed better mechanical properties when cured with Bluephase N® LED-LCU.

Conclusions:

Bluephase N® LED-LCU showed better performance than FlashMax P3 WS 4W. The bulk-fill composites showed significant differences in both parameters when cured with the two LED-LCUs.
Perceived barriers in digitalizing oral health promotion: Phenomenological study among Malaysian dental public health specialists
Authors: Luai Amirul Faiz , Radzi Nawwal Alwani Mohd , Sabri Budi Aslinie Md
Published: April 2024

Aim:

The ascent of digital health promotion, encompassing telemedicine, teledentistry, mHealth, eHealth, mOralHealth, and social media, underscores the necessity for its adoption in advancing health promotion. Identifying barriers in digitalizing health promotion aids in overcoming obstacles and facilitating the effective integration of digital technologies for improved healthcare and health outcomes. Hence, this study aims to identify barriers to digitalizing oral health promotion among Malaysian dental public health specialists.

Materials and Methods:

Eight dental public health specialists from different ministries in Malaysia participated in the interviews using semi-structured questionnaires. The interviews were transcribed and analyzed using NVivo software.

Results:

Thematic analysis identified three major themes with 19 sub-themes, totaling 51 occurrences across the interviews. Among these three major themes, the availability of a supportive environment or infrastructure was the most discussed among the respondents. Among all sub-themes, respondents perceived those facilities, resources, and infrastructure (n = 6); and poor internet connection and stability (n = 6) as significant barriers to adopting and implementing digitalized oral health promotion.

Conclusions:

This study provides a distinctive contribution to stakeholders, offering insights into the impediments hindering dental students and professionals from embracing digital health promotion. The study findings can be utilized as a guide to facilitate the integration of digital dentistry and address the related issues within a broader context, guided by existing regulatory frameworks.
Evaluation of IL-1β and CRP mRNA expression levels by RT-PCR in postorthodontic treatment patients with temporomandibular joint disorders: a cross-sectional Study
Authors: Ismah Nada , Bachtiar Endang Winiati , Purwanegara Miesje Karmiati , Tanti Ira , Mardiati Endah
Published: April 2024

Abstract

Aim:

Temporomandibular joint disorder (TMD), which affects the masticatory muscles, temporomandibular joint, and surrounding tissues, can manifest as inflammation. This study aims to explore the expression levels of the inflammatory biomarkers, interleukin (IL)-1β and C-reactive protein (CRP), in TMD patients who have undergone orthodontic treatment.

Materials and Methods:

Buccal swabs from 105 postorthodontic treatment patients were analyzed using real-time polymerase chain reaction to assess the expression levels of IL-1β and CRP in each group after messenger ribonucleic acid extraction. Patients were also examined using the Diagnostic Criteria for TMD (DC/TMD) to determine if they met the criteria for a TMD diagnosis. The TMD group was subdivided into three categories based on the DC/TMD.

Results:

The study included 37 patients who did not develop TMD (group 0) and 68 participants who developed TMD after orthodontic treatment, including 17 with pain-related TMDs (group 1), 29 with intra-articular TMDs (Group 2), and 22 with combined pain-related and intra-articular TMDs (group 3). CRP expression was higher than IL-1β in groups 1 and 2, and IL-1β expression was higher than CRP in group 3. The Kruskal–Wallis test showed that IL-1β and CRP expression levels in groups 1, 2, and 3 were not statistically different. Sex and adult age had considerable effects on the occurrence of TMD in patients after orthodontic treatment.

Conclusions:

Higher IL-1β expression was found in postorthodontic treatment patients with more complex TMD. This study strengthens the evidence of inflammation through IL-1β and CRP expression in individuals with TMD, especially after orthodontic treatment
Hypertension Management in Pre- and Post Percutaneous Coronary Intervention Patients: An Expert Opinion of Cardiologists from India
Authors: Kumar Arram Sreenivas , Kumar Viveka , Shah Chetan P. , Kasturi Sridhar , Birla Ashish , Revankar Santosh , Yadav Neeraj Kumar
Published: April 2024

Introduction:

Despite recent advancements in hypertension management, a significant portion of the population in India still has uncontrolled blood pressure (BP), particularly post percutaneous coronary intervention (PCI). This paper fulfils the gap between post-PCI and hypertension management, ensuring hypertension is well-controlled before, during, and after PCI.

Methods:

Cardiologists (interventional, n = 256; noninterventional, n = 336) throughout India who treated hypertensive patients, post PCI were invited to participate in a survey and virtual meetings. The perception and practices in managing these patients and strategies to improve BP control were captured.

Results:

Out of 593 cardiologists, 57.5% opined that heart failure (HF) was more common in patients with hypertension indicated for PCI. The target BP after PCI for patients aged <65 years and >65 years was recommended to be 121–130/80 mmHg by 39% of experts while 131–140/90 mmHg by 33.2% of experts, respectively, with a target heart rate of 60–80 bpm. Angiotensin II receptor blockers (ARBs) were considered the most effective antihypertensive agent in different comorbid conditions. Metoprolol and bisoprolol were the most preferred cardio-selective beta-blockers for both post-PCI and HF. A combination of ARBs and beta-blockers after the intervention was suggested in hypertensive patients with coronary artery disease and diabetes mellitus (57.0%), stroke (41.1%), and HF (44.9%).

Conclusions:

Managing BP and heart rate in patients with hypertension post-PCI is important. In monotherapy, ARBs followed by beta-blockers and angiotensin-converting enzyme inhibitors, were the most preferred antihypertensive agents in these patients with different comorbid conditions. While a combination of ARB and beta-blocker was preferred in patients with PCI and multiple comorbidities.
Hippocampal characteristics among children with calcified neurocysticercosis
Authors: Rohilla Seema , Tyagi Shristi , Bala Kiran , Kaushik Jaya Shankar
Published: April 2024

Abstract

Aim:

The aim of this article is to describe the hippocampal characteristics among children with calcified neurocysticercosis (cNCC).

Materials and Methods:

This cross-sectional study was conducted among children with epilepsy aged 3–14 years diagnosed with cNCC. Patients showing evidence of cNCC, with prior serial imaging evidence of active NCC, were enrolled. Eligible participants were subjected to magnetic resonance imaging (MRI)-based protocol and sleep-deprived electroencephalography. Hippocampal characteristics on the MRI were described.

Results:

A total of 31 children with mean (SD) age of 10.3 (3.2) years with cNCC were enrolled in the study. We observed that 42% (13/31) of children with cNCC had borderline (10–20% difference in the volumes of right and left hippocampi) (n = 8) or clear (>20% difference) (n = 5) hippocampal atrophy. Among 31 children with cNCC, 27 (87.1%) had nidus within the lesion and 21 (67.7%) had perilesional gliosis.

Conclusion:

Children with cNCC are at risk of seizure recurrence on tapering anti-seizure medications. Our study with limited sample size revealed that hippocampal atrophy and perilesional gliosis are prevalent among children with cNCC, predisposing them to the risk of epilepsy.
Successful Stem Cell Mobilization and CD34+ Cell Collection in a Poor Mobilizer: A Case Report Utilizing a Combination of Recombinant Growth Colony Stimulating Factor, Recombinant Human Growth Factor, and Plerixafor
Authors: Najafabadi Maliheh Kazemi , Moghaddas Azadeh , Karimifar Mozhgan , Darakhshandeh Ali
Published: April 2024

Diffuse large B-cell lymphoma is the most prevalent form of non-Hodgkin’s lymphoma that is usually treated with chemoimmunotherapy. If the disease proves refractory or recurrent, the primary treatment approach involves high-dose chemotherapy with bone marrow transplantation. The collection of peripheral blood stem cells before transplantation plays a vital role in the treatment process, necessitating the mobilization of blood stem cells from the bone marrow to the peripheral blood. Despite using standard methods such as granulocyte colony-stimulating factor (G-CSF), chemotherapy, and plerixafor, some patients cannot collect an optimal count of CD34+ cells for transplantation. Managing these patients with poor mobilization poses significant challenges. In this article, we present a case of a poor mobilizer patient who achieved prosperous mobilization by using recombinant human G-CSF, recombinant human growth hormone, and plerixafor.
Pleural effusion guidelines from ICS and NCCP Section 1: Basic principles, laboratory tests and pleural procedures
Authors: Christopher Devasahayam J. , Gupta Richa , Thangakunam Balamugesh , Daniel Jefferson , Jindal Surinder K. , Kant Surya , Chhajed Prashant N. , Gupta K B , Dhooria Sahajal , Chaudhri Sudhir , Chaudhry Dhruva , Patel Dharmesh , Mehta Ravindra , Chawla Rakesh K. , Srinivasan Arjun , Kumar Arvind , Bal Shakti K. , James Prince , Roger Jebin S , Nair Avinash A. , Katiyar S K , Agarwal Ritesh , Dhar Raja , Aggarwal Ashutosh N. , Samaria J K , Behera Digambar , Madan Karan , Singh Raj B , Luhadia S K , Sarangdhar Nikhil , Souza George D’ , Nene Amita , Paul Akhil , Varghese Vimi , Rajagopal T V , Arun M , Nair Shraddha , Roy Dhivya A , Williams Benjamin E. , Christopher Shona A. , Subodh Dhanawade V. , Sinha Nishant , Isaac Barney , Oliver Ashwin A , Priya N , Deva Jedidiah , Chandy Sujith T. , Kurien Richu Bob
Published: April 2024

Pleural effusion is a common problem in our country, and most of these patients need invasive tests as they can’t be evaluated by blood tests alone. The simplest of them is diagnostic pleural aspiration, and diagnostic techniques such as medical thoracoscopy are being performed more frequently than ever before. However, most physicians in India treat pleural effusion empirically, leading to delays in diagnosis, misdiagnosis and complications from wrong treatments. This situation must change, and the adoption of evidence-based protocols is urgently needed. Furthermore, the spectrum of pleural disease in India is different from that in the West, and yet Western guidelines and algorithms are used by Indian physicians. Therefore, India-specific consensus guidelines are needed. To fulfil this need, the Indian Chest Society and the National College of Chest Physicians; the premier societies for pulmonary physicians came together to create this National guideline. This document aims to provide evidence based recommendations on basic principles, initial assessment, diagnostic modalities and management of pleural effusions.
Prevalence of frailty among chronic respiratory disease patients
Authors: Ramanathan RM PL , Muthusamy Sivaguru , Kumar Krishna J , Krishnan Anusuya
Published: April 2024

Background:

Although frailty is one of the aging syndromes, it can occur at a younger age and in individuals with organ diseases. Identifying frailty and pre-frailty in patients with chronic respiratory diseases (CRDs) is an emerging assessment in the field of pulmonary medicine and rehabilitation. The aim of this study was to find out the prevalence of frailty among chronic respiratory disease patients.

Methods:

A single centre cross-sectional survey study with a total population of 381 patients, adults aged 18–90 years presenting to the pulmonology OPD was included based on the inclusion and exclusion criteria. Primary data collected were demographics, medical history, including comorbidities, use of long-term oxygen therapy (LTOT), BiPAP (Bilevel Positive Airway Pressure), previous hospital admissions, medication history and frailty assessment were done using the Fried frailty index.

Results:

Univariate analysis showed that sex, ECHO abnormality, patients using LTOT, BiPAP, home nebulizers and patients who did not attend the pulmonary rehabilitation programme had a significant association with frailty. Multivariate analysis showed that female sex, LTOT use and older age were significantly associated with frailty.

Conclusion:

Frailty is frequent in CRD patients regardless of age. The prevalence of frailty has an association with female sex, patients using LTOT, and home BiPAP.
A review of paediatric cataract surgery techniques and practices: Past, present and future
Authors: Isawumi Michaeline A. , Ademola-Popoola D.S.
Published: April 2024

Background: The management of paediatric cataract has always been unique, challenging and complex for ophthalmologists. The pursuit of expertise to enhance outcomes for affected children has driven the scientific and ophthalmic community, from the years preceding Christ to the present-day 21st century, to refine surgical techniques for visual restoration in these children. Methods: This is a review article looking into the evolution, historical progression and advancement of cataract surgical techniques in children through extensive online literature search utilising internet search engines, journals, textbooks, PubMed, Cross-references, ResearchGate, Medscape and Web of Science. Search terms used included “history of Paediatric Cataract Surgery,” “Paediatric cataract surgical techniques,” “Couching,” “Discission,” “Irrigation & Aspiration’, ‘Phacoemulsification’, ‘Femtolaser’, Visual rehabilitation and Optic capture”. Results: The management of paediatric cataract has witnessed remarkable transformation over the years. The historical context illustrates a continuous dedication towards improving visual outcome. Refined techniques have culminated in diverse array of methods and practices used to take care of unique or specific challenges encountered in the care of paediatric cataracts. Conclusion: This article highlights the various methods employed to achieve the goal of visual restoration in paediatric cataract cases by considering factors such as the age of the child, the extent and impact of cataract and advancements in technology. Therefore, it provides insight into the ongoing efforts to enhance the quality of life for children affected by cataract.
Animal models of hypertension: A concise review
Authors: Sharma Chetan , Badyal Dinesh K.
Published: April 2024

Hypertension (HTN), a prevalent cardiovascular disorder, poses a significant global health burden. Understanding the intricate mechanisms underlying HTN is crucial for developing effective therapeutic strategies. Experimental animal models play a pivotal role in HTN research, providing valuable insights into the pathophysiology, etiology, and potential treatment options. This concise review examines the various animal models employed to study HTN, highlighting their strengths, limitations, and contributions to our understanding of this complex condition.
A case report on bortezomib-induced paralytic ileus
Authors: Mohan M. Manish , Kuriyan Lidiya Anna , Philip Chepsy C. , Jesurun R. S. Jacob , Krishnan Prakash
Published: April 2024

Bortezomib is the first anticancer proteasome inhibitor used in the initial treatment of multiple myeloma in combination with cyclophosphamide and dexamethasone. Subcutaneous and intravenous forms of bortezomib are available. The common adverse drug reactions (ADRs) associated with bortezomib include peripheral neuropathy, fatigue, neuralgia, dizziness, diarrhea, constipation, and abdominal pain. Paralytic ileus is a rare ADR of bortezomib. We report the case of a patient with multiple myeloma who developed paralytic ileus and presented with abdominal distension and constipation; all of which resolved with medical attention once the medication was stopped, indicating a clear causal link.
Laminectomy Decompression and Posterior Stabilization in Spinal Cord Injury American Spinal Injury Association Impairment Scale B due to Spondylolisthesis Grade II
Authors: Perdana I Gede Sukma Okta , Ramayadnya Anak Agung Gede Agung Wahyu , Aryadi I Putu Hendri , Noor Arnanda
Published: April 2024

Spinal cord injury (SCI) is considered a serious neurological condition since it frequently causes significant morbidity and long-term disability. Physical trauma of the spine is the leading cause of SCI. It is also associated with other spinal anomalies, such as spondylolisthesis; a condition where the upper vertebra segment slips over the underlying vertebra and causing neurological symptoms. We report a case of a 40-year-old male patient who was admitted with cervical pain and weakness of all extremities as the chief complaint. One week before admission, he fell from the tree with his neck hitting the ground first. Physical examinations showed a prominent neurological deficit. Cervical spondylolisthesis was confirmed by an imaging test. Because of this condition, he underwent surgical decompressive laminectomy and posterior stabilization. Surgical intervention is the standard therapy for traumatic SCI. The goal of surgical intervention is realigning the spinal column, restoring spinal stability, and relieving the spinal cord’s compression due to bony or ligamentous structures. Although cervical SCI due to spondylolisthesis is a rare issue, it is one of the life-threatening cases. Therefore, early diagnosis and intervention are needed to prevent further injury and improve neurological functions. This study aimed to share one example of an SCI case with appropriate treatment, which mostly had a good neurological outcome.
The Use of Antiepileptic Drug for Postcranioplasty Seizure: A Systematic Review and Meta-analysis
Authors: Putra Kevin Kristian , Niryana I Wayan
Published: April 2024

Introduction:

Cranioplasty, a common procedure following craniectomy, aims to repair cranial defects resulting from various causes, including trauma and raised intracranial pressure. Despite its routine application, cranioplasty is associated with complications, notably seizures. The incidence of postcranioplasty seizures (PCS) and the role of antiepileptic drug (AED) prophylaxis remain underexplored. This meta-analysis aims to evaluate the impact of AED prophylaxis on both early and late PCS.

Methods:

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we conducted a systematic literature search on PubMed, Europe PMC, ClinicalTrials.gov, and EMBASE, yielding 1292 articles. Eligibility criteria included randomized clinical trials (RCTs) in English reporting PCS incidence with or without AED prophylaxis. The risk of bias was assessed using Cochrane’s RoB 2 tool. Statistical analysis employed RevMan 5.4 software.

Results:

Of the initially identified articles, two RCTs met the inclusion criteria, involving a total of 497 cases. AED prophylaxis significantly reduced the risk of early PCS (risk ratio [RR]: 0.15, confidence interval [CI]: 0.06–0.37, P < 0.0001), with no heterogeneity (I
2 = 0%, P = 0.78). However, there was no significant difference in late PCS incidence between the intervention and control groups (RR: 0.32, CI: 0.06–1.56, P = 0.16). No significant differences in abnormal liver function or blood test results were observed between groups.

Conclusion:

AED prophylaxis significantly reduces the risk of early PCS following cranioplasty, but its effectiveness in preventing late PCS remains uncertain. Further studies are warranted to determine optimal AED regimens and address the limitations of the current meta-analysis.
Characteristics of Patients with Epidural Hemorrhage in Head Injury at a RSUP Prof. Dr. I.G.N.G Ngoerah in 2022
Authors: Zohor Ammar , Maliawan Sri , Niryana I Wayan , Wardhana Wisnu
Published: April 2024

Introduction:

Head injury is a condition of brain disorder that often occurs in Indonesia and 2 out of 100 head injury cases are epidural hematoma (EDH), which is intracranial hemorrhage where there is an accumulation of blood between the dura mater and internal tabula. Therefore, it is necessary to review the characteristics of epidural hemorrhage. This study aims to determine the characteristics of EDH patients in head injuries at RSUP Prof. Dr. I. G. N. G Ngoerah in 2022.

Materials and Methods:

This study used a retrospective descriptive method. The data were collected through medical records of epidural hemorrhage patients in 2022 at Prof. Dr. I. G. N. G Hospital, then analyzed descriptively using SPSS version 26.

Results:

From 88 cases obtained, most of them were male (79.5%), including the age group of adolescents and young adults with an age range of 15–24 years (35.2%). The most common case was mild head injury with a Glasgow Coma Scale of 14–15 (47.7%), bleeding volume in the interval 0–25 cc (60.2%), and found without midline shift (54.5%). Most patients had linear fractures (80.7%) and the majority of patients had bleeding in the temporal region (40.3%). Furthermore, more patients received conventional management (51.1%) than patients with craniotomy surgery (48.9%).

Conclusion:

In this study, adolescent male patients predominated. Mild head injury was the most common case with a bleeding volume of 0–25 cc without midline shift. Linear fracture and bleeding in the temporal region was the most characteristic result of epidural bleeding with nonoperative management found in most of the patients.
Double Trouble – An Anterior Clinoidal Meningioma with a Concurrent Right MCA Aneurysm
Authors: Akbulut Bilal Bahadır , Erol Anıl , Bölük Mustafa Serdar , Yurtseven Taşkın , Biçeroğlu Hüseyin
Published: April 2024

Although meningiomas and cerebral aneurysms are common intracranial pathologies, their coexistence in one patient is rare. We present a case of right anterior clinoid meningioma that has a concurrent right middle cerebral artery (MCA) aneurysm. A 55-year-old female complaining of right-sided visual loss was admitted to our department after magnetic resonance imaging (MRI) revealed a right anterior clinoid meningioma that was extending to sella turcica and expanded superiorly, compressing the optic chiasm. With a plan of transnasal transsphenoidal endoscopic excision, a preoperative computed tomography angiogram was obtained, per our protocol. This revealed an incidental 3 mm right MCA bifurcation aneurysm. Due to the possibility of postoperative aneurysm bleeding, the patient was operated on with a right-sided pterional craniotomy. After 5 days of postoperative follow-up, the patient was discharged without complications. The histopathological analysis confirmed the diagnosis of psammomatous meningioma. This case underlines the importance of preoperative planning and being vigilant for incidental findings that might cause fatal consequences.