bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Timing of Surgery in Pituitary Apoplexy on Continuously Valued Visual Acuity
Authors: Kelly Patrick D. , Fernando Shanik J. , Malenke Jordan A. , Chandra Rakesh K. , Turner Justin H. , Chambless Lola B. 
Published: January 2020

Abstract
Background Pituitary apoplexy is often treated urgently, but this is based on studies which assess vision categorically and dichotomizes the time interval between symptom onset and surgery which may introduce bias in measuring an association between the two.
Objective This study was aimed to assess for a relationship between continuously valued surgery delay and visual acuity recovery after pituitary apoplexy.
Methods In this retrospective study, all patients presenting with symptomatic pituitary apoplexy between 2004 and 2016 were identified from an institutional database. The primary endpoint was visual acuity improvement, measured as the difference in acuity from the pre- to postoperative period, and measured in Logarithm of the Minimal Angle of Resolution (LogMAR) units. Analysis was performed using continuous values of time delay and visual acuity to assess for an underlying association.
Results Thirty-two pituitary apoplexy patients were identified. Visual acuity deficits were reported in 81%. The median visual acuity was 0.35 LogMAR (Snellen's fraction 20/40) preoperatively, and 0.1 (20/25) postoperatively (p < 0.01). The time between symptom onset and surgery was not associated with improvement in visual acuity (p = 0.46). When the time delay and visual outcome were intentionally dichotomized, patients undergoing surgery within 2 days of symptom onset had 0.21 times the odds of a good visual outcome (95% confidence interval [CI]: 0.04–1.05).
Conclusion When assessed as continuously valued measures, the time from symptom onset to surgical intervention and the improvement in visual acuity are not associated, although intentional dichotomization of data produced conflicting results.
Sinonasal Osteosarcoma: Report of 14 New Cases and Systematic Review of the Literature
Authors: Low Christopher M. , Gruszczynski Nelson R. , Moore Eric J. , Price Daniel L. , Janus Jeffrey R. , Kasperbauer Jan L. , Van Abel Kathryn M. , Stokken Janalee K. , Van Gompel Jamie J. , Link Michael J. , Choby Garret 
Published: January 2020

AbstractObjective The objective of this study is to describe the clinical presentation, tumor characteristics, natural history, and treatment patterns of sinonasal osteosarcoma.Methods Fourteen patients who had been treated for osteosarcoma of the nasal cavity and paranasal sinuses at a tertiary care center were reviewed. In addition, a systematic review of the literature for osteosarcoma of the sinonasal cavity was performed.Results In a systematic review, including 14 patients from the authors' institution, 53 total studies including 88 patients were assessed. Median follow-up was 18 months (interquartile range: 8–39 months). The most common presenting symptoms were facial mass or swelling (34%), and nasal obstruction (30%). The most common paranasal sinus involved by tumor was the maxillary sinus (64%), followed by the ethmoid sinuses (52%). The orbit (33%), dura (13%) and infratemporal fossa (10%) were the most common sites of local invasion. The majority of patients underwent surgery followed by adjuvant therapy (52.4%). Increasing age was associated with decreased overall survival rate (unit risk ratio [95% confidence interval (CI)] = 1.02 [1.003–1.043]; p = 0.0216) and T4 disease was associated with decreased disease-specific survival rate (hazard ratio [HR] = 2.87; p = 0.0495). The 2- and 5-year overall survival rates were 68 and 40%, respectively, while 2- and 5-year disease-specific survival rates were 71% and 44%, respectively.Conclusion Sinonasal osteosarcomas are uncommon tumors and can pose a significant therapeutic challenge. Increasing age and T4 disease are associated with worse prognosis. This disease usually warrants consultation by a multidisciplinary team and consideration of multimodality therapy.
Relationship between Recurrence Rates of Rathke's Cleft Cysts and Surgical Approaches to Sellar Reconstruction
Authors: Limb Rebecca , King James 
Published: January 2020

Abstract
Objective The main purpose of this article is to address the question of whether reconstructing the sellar floor following Rathke's cleft cyst excision results in increased rates of recurrence.
Methods and Design A retrospective case series was compiled from medical records and radiological investigations at a single institution over a time period spanning 25 years. Episodes of cyst recurrence were determined from magnetic resonance imaging scans and outpatient encounters. Details regarding surgical procedure and techniques were obtained from operation notes. Perioperative morbidity was also recorded.
Results Twenty-three adult patients were treated surgically for a Rathke's cleft cyst at the study institution between 1992 and 2017. The overall cyst recurrence rate was 48%, with 39% of all patients requiring redo surgery within the timeframe of the study. The mean time to redo surgery for recurrence was 4 years. Cyst recurrence rates were 57% postmicroscopic procedures, and 26% postendoscopic procedures (p = 0.148). In the nonreconstructed group, the recurrence rate was 17%, and in the reconstructed group the recurrence rate was 41% (p = 0.3792). Complications arising after nonreconstructive procedures were delayed cerebrospinal fluid rhinorrhea, pneumocephaly, and multiple episodes of meningitis. All these patients required return to theater for secondary reconstruction of the pituitary fossa floor.
Conclusion The results of this small study suggest that reconstruction of the sellar floor, and microscopic rather than endoscopic techniques, may be associated with a higher rate of Rathke's cleft cyst recurrence. However, these trends did not reach statistical significance. Patients undergoing nonreconstructive procedures may be more prone to certain postoperative complications.
Ictal Bradyarrhythmia in a 2-Year-Old Male with Brainstem Embryonal Tumor
Authors: Garris Jordan , Aungaroon Gewalin , Peariso Katrina 
Published: January 2020

AbstractIctal bradyarrhythmia can be challenging to diagnose when motor features of seizures are absent. Associated bradycardia can involve periods of asystole requiring cardiac pacemaker placement. Here, we report a 2-year-old male with a brainstem embryonal tumor with more than 30 seizures per day manifesting as bradycardia, loss of tone, and decreased responsiveness, followed by vomiting. Associated electrographic changes were localized to the right temporal head region, where the patient's tumor exerted mass effect. The patient was treated with lacosamide at higher doses than previously reported (24 mg/kg/d) and became seizure-free on a combination of this medication with clobazam. Oral albuterol was also used to augment his heart rate as the patient was not a candidate for cardiac pacemaker insertion.
Developmental changes in human fetal kidney
Authors: M. Jayasabarinathan , S. Vijayadevi 
Published: January 2020

Abstract
Aims and objectives : It is necessary to know the normal developmental Anatomy of the kidney to understand certain prenatal disorders like polysystic kidney, hydronephrosis and Wilm's tumour. A detailed description of histological development of kidney is scarce. Therefore the present study is an attempt to further the anatomical knowledge in histogenesis of kidney. Materials & Method : The study was carried out in the department of Anatomy, Mount Zion Medical College, Adoor, Kerala. 30 dead born fetuses (gestational age range from 11 weeks to 3 6 weeks) were utilized for the study. Tissue specimen from the kidneys were stained with Hematoxylin and Eosin and examined under light microscope. Results: Nephrogenic zone was identified up to 34 wks of gestation. Cortex was clearly distinguished from medulla at 14 th wk of fertilization. Different shapes [S & C] of glomeruli were identified in the second trimester. At 24 th wk, proximal convoluted tubule [PCT], distal convoluted tubule [DCT], collecting duct and thin and thick segment of loop of Henle were identified clearly. Conclusion: The pathological conditions of the kidney can be diagnosed at the earliest by understanding the normal histological development of the kidney at various stages. This study would be helpful for understanding the normal histological development of kidney.
A study of sexual dimorphism of human auricle by morphometry and topographical location
Authors: M. Maitreyee 
Published: January 2020

Abstract
Aims and objectives : Features of human body parts or organs or bones have been studied to identify differences in males and females. The present study was performed to assess gender differences in morphometric parameters of auricle of ear; and to see whether there exists any sexual dimorphism in positioning of auricle. Materials and Methods: Measurements were taken on 350 young individuals within the age group of 17-25 years by digital and spreading calipers and recorded in centimeters. The morphometric parameters were auricle length, auricle width, auricle root/attachment, projection of auricle, face height, face width, position of auricle from anterior midline, and position of auricle from posterior midline. The independent t-test was used to test the significance of difference between males and females. Results: The difference in the morphometric parameters showed statistical significance. The indices i.e. 'Position of auricle from posterior midline' [PEP] to face width [FW] index was statistically significant sex-wise, which was less in males than in females; while 'Position of auricle from anterior midline' [PEA] to 'Position of auricle from posterior midline' [PEP] index was also statistically significant sex-wise, which was more in males than in females. Conclusion: There was significant difference in measurements as well as position of auricle in males and females. The two indices related to the position of auricle from the midline may be of value in forensic identification and in fields like surgery, anthropometry, art, and ergonomics. Corresponding landmarks on dry skull may be used to estimate sex in skeleton.
Morphometric study of human fibular incisura in dry bones
Authors: G. Sreedevi , Sangam Muralidhar Reddy 
Published: January 2020

Abstract
Aims & Objectives : Interosseous border of tibia splits distally into anterior and posterior edges. These edges project into anterior and posterior tubercles enclosing a notch called fibular incisura that articulates with the distal fibula forming distal tibio fibular syndesmosis. The aim of the present study was to obtain the morphometric data of fibular incisura that may be helpful for the orthopedic surgeons in ankle reconstructive surgeries and ankle joint replacement. Materials & Method: To describe the morphometry of the fibular incisura, a total of 100 tibia [right 55 and left 45] were obtained from the Department of Anatomy, NRI Medical College, Chinakakani. The width of tibia, width, depth, height of fibular incisura and the length of anterior, posterior incisural tubercles were measured in both right and left tibia using digital vernier calipers. Right and left side para meters were compared using Karl Pearson Coefficient [r value]. Results: Average values for the width, depth and height of the fibular incisura were 16.83mm on the right side and 17.42mm on the left side, 2.85±1.38mm on the right and 2.9±1.57mm on the left side, 38.82±5.8mm on the right side and 38.72±7.68 mm on the left side respectively. While average lengths of anterior and posterior tubercles of the fibular incisura were 13.19±1.96mm, 15.71±2.03mm on the right side and 12.6±1.49mm, 15.66±1.41mm on left side. Thirty-three tibia presented deeply concave [depth>4cm], and sixty-seven had shallow fibular incisura [depth<4cm]. Conclusion: The morphometry and anatomical variability of fibular incisura should be taken to account in assessing radiographs, CT and MRI of talocrural joint.
Modified Team Based Learning: Its feasibility and effectiveness in learning Gross Anatomy
Authors: G. Vinitha , M. Lakshmidevi , Ranganath Priya 
Published: January 2020

Abstract
Aims and Objectives: Knowledge of human anatomy with clear understanding of its clinical applications is important for producing good quality medical graduates. With many newer student centered teaching techniques coming up modified team based learning has been analyzed in this study. Aims: To know 1] Feasibility and utility of modified team based learning [MTBL] in gross anatomy with clinical aspects. 2] Effectiveness of MTBL in understanding gross anatomy and students approach to MTBL. Material and methods: Two traditional gross anatomy lectures were replaced by two MTBL sessions. 250 first year medical students were randomly grouped into 35 teams with 7 students each. During each session, students went through the steps of MTBL - pre class preparation, individual readiness assurance test [IRAT], group readiness assurance test [GRAT] and application exercise. A five point Likert scale questionnaire was given to students to assess their opinion about MTBL activities. After 15 days, a surprise test [ST] was given to assess effectiveness of MTBL sessions. Results: A significant positive correlation was observed between individual student's performance on IRAT and ST, between individual performances from session-1 to session-2, as well as in group performances in first and second session. 57% students strongly agreed that their performance improved working as a team than individually and increased students' ability to use their critical and analytical skills. Conclusion: This study shows that MTBL is feasible and approachable to students. MTBL acts as an important tool in medical education as it has the ability to develop self-learning, higher reasoning skills and team work skills.
Are the first year medicos empathetic?
Authors: Antony Anly , Francis Anu , Kotturan Aaron David , Bhagyam V. 
Published: January 2020

Abstract
Background: Empathy is an essentiality among the medical fraternity. Literature indicates better competency, patient compliance and clinical outcomes in relation to higher levels of empathy. Gender differences in empathy level are universal and various factors influence it. So it's quintessential to understand empathy and its correlates among medicos in India. Aims: To evaluate changes in empathy levels of the M.B.B.S students of a renowned medical college in India, during their course in the first year. Materials and methods: A prospective study was carried out among hundred 1st year medical students [M=34, F= 66] enrolled at a medical college in Kerala during
the academic year 2014 - 2015. Participants completed the Jefferson Scale of Empathy [Student Version].
Results: The mean empathy at the entry & exit points of the study stood at 112 ± 11.39 & 112.07 ± 13.98
respectively. Comparing the male & female population, the females had higher empathy levels. When comparing
the empathy levels at the entry & exit points of the male population, significant decline [p value= 0.001] was
seen. The female population showed a significant increase [p value= 0.001] in their empathy levels over the
same period. Conclusion: There were significant changes in empathy levels of the male & female population,
though discernable changes in the whole population were not evident. This study necessitates further follow up
of the present students, to analyze the changes occurring over the entire period of medical school.
Sirenomelia - Revisited
Authors: Lakshmi Gaddam Vijaya , Abraham Jacob , Benjamin Geena 
Published: January 2020

AbstractSirenomelia, commonly known as mermaid syndrome is a rare congenital condition, featured by fusion of the lower limbs. This represents the most severe form of caudal regression syndrome, in which all the structures from the caudal mesoderm fail to develop properly. There is a marked deformity in the musculoskeletal system at the caudal end of the trunk and lower limbs. It is invariably associated with visceral malformations of the urogenital and gastrointestinal systems like agenesis or hypoplasia of renal tissue, blind termination of the colon, absent external genitalia and imperforate anus. It is usually associated with single umbilical artery. Though association with maternal diabetes has been described, the causative mechanisms remain unclear. The condition is generally fatal, due to associated developmental anomalies ofkidneys and other viscera.
Correlation of histology of placenta with fetal outcome in pregnancy induced hypertension
Authors: Keche Harsha A. , Kazi Shahin 
Published: January 2020

Abstract
Background and aim : Placenta is a mirror of gestational life. It is a vital organ of maintenance of pregnancy. Pregnancy induced hypertension [PIH] is a major cause of maternal & fetal mortality in the developing countries. The aim of present study is to study histological changes ofPIH placenta and to correlate it with foetal outcome. Material and methods : The present study was carried out on 50 normal and 50 PIH placentae. Histological assessment of placentae was done. The histological findings were correlated with fetal outcome. The results were analysed statistically by using z-test and SPSS 17.0. Results : Incidence ofPIH was more in primigravida. Preterm babies, small for gestational age [SGA] babies and perinatal loss was more in PIH. Histological findings like syncytial knots, cytotrophoblastic cellular proliferation, fibrinoid necrosis, villous fibrosis, basement membrane thickening, infarction and calcification when increase in severity fetal outcome [low birth weight babies, low apgar score babies, perinatal loss was more adverse]. Comparison between histological findings of control and PIH group was found statistically significant. Conclusion : PIH affects the placenta which adversely affects the fetal outcome like weight, apgar score and perinatal loss.
Morphometric analysis of hard palate and its clinical importance
Authors: Gujar Subhash M , Oza Sunil G 
Published: January 2020

Abstract
Background & aim: The study ofhard palate is important because of its role in speech articulation. The aim of the present study was to determine the palatine length, breadth and position of greater palatine foramen[GPF]. Material and Method : 50 dried, unsexed skulls from C U Shah Medical College, Surendranagar were studied. Palatine length, breadth & distance of Greater palatine foramen[GPF] to middle maxillary sutures[MMS] were measured with help of vernier caliper. Result : Mean palatine length and breadth were 47.10±3.34mm & 36.26±2.55mm respectively. The distance ofGPF from MMS was 16.55 mm & 16.57 mm on right and left side respectively. The palatine index showed that 68% of the skulls had narrow [Leptostaphyline ], 20% intermediate [Mesostaphyline] & 12% wide [Brachystaphyline] palates. Conclusions : These observations would be helpful for anatomists, anthropologists and also to surgeons for various surgical procedures on hard and soft palates.
The third osseous ambiguous tubercle-A study on Indian population
Authors: R. Sudha , P. Sasikala 
Published: January 2020

Abstract
Background & Aim: Bony prominences on the medial side of the lower end of femur include the adductor tubercle and the medial epicondyle. A third osseous ambiguous tubercle or the Gastrocnemius tubercle is often noted about which there is not much mention in standard textbooks of Anatomy. This tubercle gives attachment to the medial head of gastrocnemius muscle. Its clinical relevance cannot be under estimated particularly in cases of treatment of rupture of medial head of gastrocnemius [Tennis leg] and while raising of Gastrocnemius flaps. Materials and Methods: This study was conducted in150 dry femora and in 10 dissected knee joints [Total femora 160 : 150 dry bones+ 10 cadaveric femora] gross specimens. The presence of gastrocnemius tubercle, supracondylar tubercle, the distances between gastrocnemius tubercle and adductor tubercle, medial epicondyle and condylar margin were measured. Results: The incidence of gastrocnemius tubercle was 55% and was predominantly noted on the right side [63%]. The average distance between the gastrocnemius tubercle and the adductor tubercle was 6 mm, and the average distance between the gastrocnemius tubercle and medial epicondyle was 15 mm. The incidence ofsupracondylartubercle was 71% and in 95% of the bones it was noted above the medial condylar margin. Conclusion: The awareness of the presence of gastrocnemius tubercle and supracondylar bony prominences in the medial side of lower end of femur will be of much use to the Orthopaedic surgeons and Plastic surgeons
Morphometry of talar trochlear surface and its correlation
Authors: Narayanan Suresh , Phalgunan Vljisha , Shankar Nachiket 
Published: January 2020

Abstract
Background and objectives: The morphometry of talus represents its biomechanical role in transmission of body weight. The objective of the study was to find the shape of trochlea and its correlation with other articular surfaces. Methodology: A total of 160 dry Tali of unknown sex were utilised for this study, its trochlear surface length-anterior, middle and posterior breadth [TSL, TSAB, TSMB and TSPB], calcaneal surface length & breadth [CSL and CSB] and navicular surface length & breadth [NSL and NSB] were measured using digital vernier caliper. Trochlear surface angle [TSA] and depth angle [DA] were calculated using image J software. The mean and standard deviation of the parameters were calculated. Side differences between the parameters were calculated by independent sample t test and the strength of association between the parameters was calculated by Pearson's correlation coefficient. Results: The results were trochlear surface length, anterior, middle and posterior breadth [29.6 ± 2.7, 31 ± 2.5, 28.2 ± 2.6 and21.4± 2.1mm], navicular surface length & breadth [29.7 ± 2.5 & 20.5 ± 1.7mm] and calcaneal surface length & breadth [30 ± 2.4 &19.8 ± 1.6mm]. The mean trochlear surface and depth angle were 9.7 ± 3.3 and 156 ± 5.1 degrees. There was significant correlation between the parameters of the articular surfaces. Conclusion: The present study helps in understanding the morphology of talus and the role of articular surfaces in load transmission.
A radiological study of anatomical variants of hallux sesamoids
Authors: Adibatti Mallikarjun , Pitchandi Muthiah , V. Bhuvaneswari 
Published: January 2020

Abstract
Background and Aims: Hallux sesamoid bones forms an integral part of the first metatarsophalangeal joint for stability during weight bearing. Hallux sesamoids are paired bones located on the plantar aspect of the first metatarsal head within the flexor hallucis longus tendon. Hallucal sesamoids vary in shape and size; can be single, double, bipartite and multipartite. Traumatic insult to the hallux sesamoids can lead to fracture & dislocation, while majority of symptomatic hallux sesamoids can be treated non-surgically; certain specific injuries require a high index of suspicion, careful management, and surgical intervention. Hence present study was taken up to know the incidence, presence/absence, number and partition of hallux sesamoid to enlighten the surgeons and radiologists in early diagnosis and treatment of cases presenting with history of trauma, pain and fractures of foot. Methods: Retrospective radiographic study on the incidence, anatomical variants & distribution ofhallux sesamoids inlOOO radiographs ofthe foot. Result: Hallux Sesamoid bones were seen plantar to first metatarsal head in 994 radiographs [99.4%], while the absence ofHallucal sesamoids were noted in 6 radiographs [0.6%], Single Hallucal sesamoid were noted in 9 radiographs [0.9%], medial bipartition was noted in 20 radiographs [2%], lateral bipartition was noted in 15 radiographs [1.5%]. Conclusion: Knowledge regarding hallux sesamoids helps us in differentiating the various conditions arising out of fractures of foot bones with overlapping signs and symptoms, from actual involvement of sesamoid bone itself, which assists in the early diagnosis and management of foot pathologies.