bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Case Series Analysis of Basal Cell Carcinoma (BCC): Not the Deadliest but Certainly the Most Destructive Form of Skin Cancer
Authors: Sharma Aditya , Khanna Ritika , Khanna Parul , Khanna Rahul , Khanna Seema 
Published: December 2024

Introduction:
Basal cell carcinoma (BCC) is the most commonly prevalent variety of skin cancer worldwide. The primary aim of the study was to see the epidemiological, demographic profile, and different variants of BCC along with the outcomes posttreatment in such patients seen in the tertiary healthcare center at our institute, keeping in mind the rising trends in BCC.

Materials and Methods:
This is a retrospective analysis of 12 patients in whom facial region-related BCC was surgically excised. The details of each patient, including age, gender, BCC type, location, defect size (cm), type of reconstruction, esthetic outcome, and recurrence, were analyzed. Over the course of 2 years (January 2022–December 2023), a total of 12 individuals were diagnosed with BCC and received treatment. With an average age of 66 years (range: 61–70 years), there were 4 males and 8 females.

Results:
We evaluated the outcomes in the patients who underwent surgical excision for BCC involving the facial region at the surgery department of our tertiary healthcare centre. All our patients responded well to the surgical procedures, i.e., wide local excision of the tumor, and experienced no problems associated with anesthesia or any other systemic complications. Postoperatively, no hematomas or wound site infections were observed in any of the patients. Our patients were followed up for 18 months. During this period, no patient reported graft or flap loss. No patient experienced a recurrence of the tumor or similar lesions. Functionally, the margin was stable and well-aligned.

Conclusion:
The diagnosis and characterization of BCC must be based on the clinical, imaging, and histopathology features of the tumor mass in addition to the patient’s characteristics. BCC treatment seeks to achieve the best cosmetic results, especially in critical areas like the face, while minimizing side effects and increasing patient satisfaction. Future research may use the clinical and epidemiological data gathered in this study as a reference.
Varied Presentations of Basal Cell Carcinoma and Its Management with Reconstruction of Defects: An Experience from a Tertiary Healthcare Centre
Authors: Prakash Gautam , Jain Vaibhav , Sharma Aditya 
Published: December 2024

Introduction:
Basal cell carcinoma (BCC) originates in the basal layer of the epidermis and spreads slowly, usually locally before metastasizing. Adequate margins of excision during surgery are curative. Reconstruction of facial abnormalities resulting from excision is crucial yet difficult.

Materials and Methods:
A literature review was conducted to determine the most prevalent guidelines guiding the best reconstruction of postexcisional defects on the face, and a retrospective review of hospital records for patients treated for BCC of the face at our institute during the previous 3 years, which ranged from September 2020 to September 2023, was carried out. The records of 28 patients with BCC over the face who underwent surgical management including reconstruction at our hospital were identified and details were recorded. The details of each patient including age, sex, BCC type, location, defect size (cm), type of reconstruction, and esthetic outcome were analyzed.

Results:
All patients responded well to the surgical procedures and experienced no problems associated with anesthesia or any other systemic complications. Postoperatively, no hematomas or wound site infections were observed in any of the patients. There were no cases of graft loss, and all flaps fully survived.

Conclusion:
After BCC is excised, reconstruction of face abnormalities in various facial esthetic units is crucial. Important factors influencing esthetic results include the surgeon’s skill level, the patient’s preference, and the location and size of the defect. Better results can be achieved with more recent reconstructive techniques, such as freestyle perforator flaps, but expertise from the operator is paramount.
Evaluation of some microRNAs dysregulation in obesity and obesity-related hypertension
Authors: Nabawy Mai , Gouda Weaam , Afify Mie , Hamimy Waleed I. , Hozayen Walaa G. , Abdelmaksoud Mohamed D.E. , Mosa Tamer , Ahmed Amr E. 
Published: December 2024

Background
MicroRNAs (miRNAs) are implicated in regulating obesity, but clinical trials have yielded conflicting results.

Objective
This study aimed to investigate the relationships between circulating levels of miRNA-221 and miRNA-222 in obesity and hypertension-related obesity in humans. This may shed light on the pathogenic pathways controlling obesity and provide noninvasive molecular indicators to identify and predict the disease. The relationships between circulating levels of the above miRNAs and variables related to adiposity and lipid profiles were further investigated.

Patients and methods
Using a quantitative real-time P technique, the expression levels of circulating miRNAs were determined in serum samples from 65 obese patients (35 without and 30 with hypertension) and 45 age-matched and sex-matched normal-weight individuals.

Results and conclusion
MiRNAs (221 and 222) have been shown to be differentially expressed in the sera of obese patients compared to controls. In addition, obese hypertensive patients were shown to have higher serum levels of miRNA-222 and miRNA-221 than healthy controls. Serum miRNA-221 was correlated with BMI, cholesterol, triglycerides, and low-density lipoprotein cholesterol. Thus, circulating levels of miRNA-221 and miRNA-222 inease in obesity and obesity-associated hypertension. These miRNAs may serve as markers for obesity and obesity-induced hypertension.
Unsuspecting Plaque on the Forearm: A Diagnostic Challenge
Authors: Shetty Ramith P. , Bhat M. Ramesh , Dsouza Myfanwy Joanne , Fernandes Michelle S. 
Published: December 2024

Abstract
Microcystic adnexal carcinoma (MAC) is a rare, slow-growing, locally aggressive malignant, and recurring appendageal tumor. Prolonged UV exposure, immunosuppression, and radiotherapy are a few frequently associated risk factors. MAC classically presents as an asymptomatic skin coloured plaque on the face. The key to diagnosis is a deep-sectioned biopsy. Surgical modalities are the first line of treatment.
Effect of National Accreditation Board for Hospital-Recommended Trainings on Patient Care Standards: A Comparative Study Based on the National Quality Assurance Standards Guidelines in a Tertiary Health-care Institute
Authors: Singh Vikram , Singh Arvind Kumar , Kulshrestha Manish Raj , Singh Dimpi , Khan Adeeba , Singh Mridu 
Published: December 2024

Abstract

Background:
The National Quality Assurance Standards (NQAS) have been developed keeping in specific requirements for public health facilities as well global best practices. Standards are primarily meant for providers to assess their quality for improvement through predefined standards and to bring up their facilities for certification.

Objectives:
To study the effect of National Accreditation Board for Hospitals (NABH)-recommended training on patient care standards based on NQAS guidelines.

Materials and Methods:
The research was conducted at a tertiary-level teaching institute and medical care center in North India. The institute has multiple blocks, few have undergone training for NABH standards, and few have not due to administrative reasons. Only the NABH-trained blocks underwent accreditation process through NABH and provided an opportunity to study whether there is a difference in patient care standards between NABH-trained staff and nontrained staff. It was a checklist-based observational study.

Results:
The evaluation covered seven key areas in intensive care unit (ICU) and wards in both NABH-trained and nontrained hospital blocks: patient rights, inputs, support services, clinical services, infection control, quality management, and outcome. The compliance percentage of ICU and wards was measured for NABH-trained and nontrained hospital blocks. NABH-trained blocks in both areas showed better compliance adhering to standards as compared to nontrained blocks for all seven key areas.

Conclusion:
The study findings indicate that NABH-recommended training showed positive impact on patient care standards as per the NQAS guidelines. The NABH-trained hospital block exhibited superior compliance with various domains including patient rights, inputs, support services, clinical services, infection control, and quality management.
Dynamics of Covid-19 Vaccine-Hesitancy among Primary Health Care Workers in an Urban City in India: An Exploratory Study
Authors: Ali S. Sana , Iyer Gowri , Mahajan Hemant , Kannuri Nanda Kishore 
Published: December 2024

Summary
The health-care workers (HCWs) were one of the vulnerable populations prioritized during the COVID-19 vaccination (COVISHIELD and COVAXIN) campaign. We aimed to estimate vaccine hesitancy and explore influencing factors among 238 HCWs in 21 Urban Primary Health Centres (UPHCs) across Hyderabad during June and July 2021. We used a semi-structured questionnaire and the SAGE determinants of vaccine hesitancy to determine factors underlying vaccine hesitancy and acceptance. A thematic framework was developed to unpack the factors that shaped the perceptions about the COVID-19 vaccine. We found a 17% hesitancy rate, primarily due to concerns about “vaccine-safety.” HCWs were susceptible to misinformation, potentially shaping their views on COVID-19 vaccines. Despite regulatory approval, one in six HCWs in Hyderabad’s UPHCs delayed or refused vaccinations, citing limited “vaccine-safety” information. This underscores the urgent need to address HCW vaccine hesitancy early, given its potential impact on general vaccine acceptance.
Profile of Falls and Its Associated Factors among Adults with Visual Impairment: A Cross-sectional Study from a Tertiary Eye Hospital
Authors: Sachidanandam Ramya , Narayanan Anuradha 
Published: December 2024

Abstract

Background:
Falls among adults with visual impairment (VI) are underreported or underrepresented compared to elderly falls.

Objectives:
To report falls among the young, middle-aged, and elderly adults with VI.

Materials and Methods:
This cross-sectional study recruited subjects from a tertiary eye care center with VI aged ≥18 years based on clinical records. Occurrence and characteristics of falls in the past year were obtained over telephone. Falls and fear of falling were considered the primary and secondary outcomes, respectively.

Results:
Of the 888 subjects, 18% (n = 160) reported having fallen at least once, and among them, 45.6% (n = 73) had multiple falls. Overall, fallers were more among the “young” (21.1%) than the “middle-aged” (16.0%) and the “elderly” (17.3%). Risk of falling was more among the blind (odds ratio (OR): 7.1; 95% confidence interval [CI]: 2.8–18.4, P < 0.001) than other categories of VI. Retinitis pigmentosa (RP) (OR: 4.4; 95% CI: 1.5–12.9, P = 0.007) and glaucoma (OR: 3.5; 95% CI: 1.3–9.8, P = 0.016) showed increased risk of falls. Overall “fear of falling” was reported by 11.3% (n = 100), out of which 30% (n = 48) were by fallers. Side vision difficulty was predominantly associated with falling, followed by staircase and night vision difficulties as perceived by subjects. Most of the falls happened outdoors and overall 38.8% had an injury after falls.

Conclusion:
This study reported unique trend of increased occurrence of falls among the young with VI compared to older age groups. RP and glaucoma being peripheral vision loss causing diseases and increased severity of VI were more associated with falls and fear of falling.
A Case Report on Rare Neck Liposarcoma of Dedifferentiated Type
Authors: Srivastava Swati , Fatima Zikki Hassan , Qayyumi Burhanuddin 
Published: December 2024

ABSTRACT
Liposarcoma of the head and neck is a rare, life-threatening but largely treatable malignancy. However, in the case of dedifferentiated liposarcoma (DDLPS), a higher rate of recurrence has been observed which is approximately 40%. These malignancies require critical assessment through imaging, histopathological, and immunohistochemical expertise. In this report, we present the case of a 54-year-old male with a large mass measuring 30 cm × 30 cm × 25 cm on the supraclavicular region. Biopsy with immunohistopathological examination diagnosed it as DDLPS, a low grade with Cyclin-dependent kinase 4 and mouse double minute 2 homolog gene amplification. The tumor was treated by wide excision of the neck mass followed by adjuvant radiotherapy. The patient is on follow-up and is disease-free for 1.5 years. This report pays extra attention over minute details and the challenges associated with the surgical management and histological features of this variant.
Periodontal Microsurgery: Systematic Review and Meta-analysis
Authors: Kalburgi Veena , Bhole Shravani 
Published: December 2024

ABSTRACT
Conventional surgeries involve larger areas including more soft- and hard-tissue manipulation which results in greater postoperative edema, inflammation, and pain. Microsurgery is an advanced surgical technique in which normal vision is enhanced through magnification of ×10 or more performed under a surgical microscope. Application of microsurgical principles is to achieve passive and primary wound closure. This systematic review was carried out in accordance with the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Microsurgery was observed to be better following different periodontal surgeries when compared to the parameters of recession depth, recession width, and clinical attachment level. However, inconclusive evidence was seen for the variables of probing depth and width of keratinized tissue. The study found that the microsurgical approach resulted in less postoperative pain and discomfort compared to the macrosurgical method. The microsurgical instrument tools contributed to improved wound stabilization and better flap adaptation. When deciding between macrosurgical and microsurgical procedures, it is important to consider factors such as treatment outcomes, logistics, cost, and patient-centered parameters.
Evaluating the Analgesic Efficacy of Conventional versus Ultrasound-guided Bilateral Superficial Cervical Plexus Block in Thyroid Surgeries: A Randomized Controlled Trial
Authors: Gautam Shivani , Guria Sushil , Krishna Bhavya 
Published: December 2024

ABSTRACT

Objectives:
Thyroid surgery is a painful procedure for which bilateral superficial cervical plexus block (BSCPB) can be given to potentially reduce postoperative pain. Ultrasound guidance provides real-time visualization of anatomical structures, needle movement, and accurate deposition of local anesthetic in close proximity to nerves, thus making the procedure safer and more effective. Our aim was to compare the analgesic efficacy of ultrasound-guided versus the landmark technique of BSCPB in patients undergoing thyroid surgeries.

Materials and Methods:
Sixty patients (19–64 years) undergoing thyroid surgeries were divided into two groups – Group US (n = 30): patients undergoing ultrasound-guided BSCPB and Group LM (n = 30): patients undergoing landmark technique for BSCPB. Visual Analog Scale (VAS) pain score at 0, 2, 4, 6, 12, and 24 h, total fentanyl requirement during the intraoperative period, time taken to first rescue analgesia demand, and total tramadol consumption during the first 24 h postoperatively were compared among the two groups.

Results:
In Group US, there was less intraoperative fentanyl requirement (102.07 ± 18.96 μg vs. 113.33 ± 22.65 μg in group LM, P - 0.037), lower VAS pain score at 0, 2, 4, 6, and 12 h (P = 0.03, <0.001, 0.017, 0.046, and 0.048, respectively), longer time taken to first rescue analgesia demand (491.23 ± 123.43 min vs. 291.00 ± 119.77 min in LM group, P < 0.001), and lesser total tramadol consumption during first 24 h postoperatively (51.67 ± 6.34 mg vs. 75.83 ± 24.11 mg in Group LM, P < 0.001).

Conclusions:
We conclude that ultrasound-guided BSCPB is more effective than landmark technique for reducing pain both intra and postoperatively in patients undergoing thyroid surgery.
Comparative Evaluation of the Efficacy of Different Solvents on the Removal of Endodontic Bioceramic Sealers: An In vitro Study
Authors: Alamoudi Ruaa A. 
Published: December 2024

ABSTRACT

Background:
Bioceramic-based root canal sealers are recently utilized in endodontic treatments as materials for root canal obturation. Ensuring the complete removal of these materials during root canal retreatment is essential for proper disinfection. This investigation was carried out to evaluate the effectiveness of D-limonene, 10% formic acid, and 20% hydrochloric acid as solvents in retreating teeth previously filled with gutta-percha and AH Plus or bioceramic sealers.

Materials and Methods:
A total of 108 single-rooted human premolars underwent initial root canal treatment using ProTaper rotary file system. Nonsurgical retreatment was then performed using ProTaper retreatment files. The interaction between the tested sealers and solvents was examined under a stereomicroscope. ImageJ software was also used to precisely evaluate the areas covered by residual root canal obturating material. Mann–Whitney and Kruskal–Wallis tests were used to identify significant differences between the groups at a significance level of 0.05.

Results:
The results revealed that none of the solvents were successful in completely removing the sealers. However, greater retreatability was observed in case of AH Plus sealer characterized by the presence of less remnants as compared to bioceramic sealers.

Conclusions:
These findings indicate that D-limonene can effectively dissolve resin-based sealers, but not bioceramic sealers. Irrespective of the solvents used, complete elimination of BC and BCH sealers could not be accomplished. This suggests that bioceramic-based sealers significantly caused the retention of more residual material than resin-based sealer after their removal with different solvents.
Comparison of caudal bupivacaine and dexmedetomidine with caudal bupivacaine and intravenous dexmedetomidine for postoperative analgesia in children: A randomized controlled trial
Authors: Singh Kuldeep , Bajaj Jeetendra , Bathla Sapna , Mehta Khushboo 
Published: December 2024

Abstract

Background and Aims:
Caudal block is a part of multimodal analgesic regimen to alleviate pain in pediatric patients undergoing variety of surgeries. This study compares the effectiveness of caudal versus intravenous dexmedetomidine as an additive to caudal bupivacaine for prolonging analgesia in children posted for elective lower abdominal surgeries. The level of sedation and hemodynamic effects through both routes were also compared.

Material and Methods:
Ninety-six children (aged 1–8 years) of either gender scheduled for elective lower abdominal and pelvic surgeries were prospectively enrolled and randomized into two groups of 48 each: Group A (caudal bupivacaine + caudal dexmedetomidine) and Group B (caudal bupivacaine + intravenous dexmedetomidine). The postoperative pain was monitored using the Face, Legs, Activity, Cry, Consolability (FLACC) scale, and sedation was assessed using the Ramsay sedation scale (RSS).

Results:
The degree of analgesia was comparable in both groups in the initial hours after surgery. Significantly higher FLACC scores were seen in Group B at 8 h (P- 0.016), 12 h (P < 0.001), and 16 h (P < 0.001), with 89.58% patients needing two rescue analgesic doses. RSS was higher in Gr=oup A till 12 h postsurgery.

Conclusion:
Caudal dexmedetomidine with bupivacaine provides improved analgesia after 8 h of surgery in comparison to caudal bupivacaine with intravenous dexmedetomidine in children undergoing lower abdominal surgeries.
Ecological impact of anesthesia: Analysis of sevoflurane consumption as a greenhouse gas
Authors: Giulia Scandurra , Carmen Cristea , Philippe Dony 
Published: December 2024

Abstract

Background and Aims:
According to the World Health Organization, climate change represents a threat to global health. Healthcare activities must understand their ecological impact and reduce their environmental footprint. Decreasing greenhouse gas emissions is a major health priority, to which all healthcare establishments should commit. We sought to understand whether anesthesiologists were aware of the impact of sevoflurane consumption on climate and whether they were inclined to implement eco-friendly strategies.

Material and Methods:
We assessed the knowledge of anesthesiologists about sevoflurane consumption and its impact on climate change. Overall, 152 anesthesiologists from Belgium, France, and Italy answered our questionnaire in April 2024. The database from the computerized anesthesia protocol was used to evaluate the average annual sevoflurane consumption at our Belgian institution between January 2015 and March 2022. The sevoflurane quantities used were obtained from information provided by the ventilator after each procedure. Potential savings were based on scientific recommendations regarding anesthesia ventilator settings. The analysis was based on the comparison between these data.

Results:
With optimized sevoflurane consumption conditions, the emission of 36.156 tons of CO2 could have been avoided, corresponding to 144,623 Km driven per year. The financial impact calculated was a saving of 533,525€ over 8 years. The survey highlighted that anesthesiologists were ready to embrace eco-friendly practices to reduce global pollution.

Conclusions:
We must invest in information and awareness-raising for anesthesiologists from the start of their medical training so that we can move toward a more eco-responsible practice to achieve major ecological and economic benefits.
Perioperative outcomes in patients with symptomatic versus asymptomatic previous COVID-19 infection undergoing neurosurgical treatment (post–COVID-19 study)
Authors: Bansal Sonia , Giribabu Parthiban , Sriganesh Kamath , Shukla Dhaval 
Published: December 2024

Abstract

Background and Aims:
The long-term effects of coronavirus disease 2019 (COVID-19) infection (long-COVID) are being increasingly recognized. The long-COVID effects are more likely in individuals who were symptomatic than asymptomatic during their previous COVID-19 infection. The data on perioperative outcomes of patients undergoing elective neurosurgery long after their recovery from COVID-19 infection is lacking. The primary objective of this study was to compare the perioperative outcomes after elective neurosurgery between patients who were symptomatic and those who were asymptomatic during their previous COVID-19 infection. The secondary objectives were to compare the earlier COVID-19 characteristics and the perioperative pulmonary profile during current surgery between these groups.

Material and Methods:
This prospective observational study was performed in adult patients undergoing elective neurosurgery with history of previous COVID-19 infection. Data was collected regarding previous COVID-19 infection (symptoms, hospitalization, treatment, complications, etc.) and current perioperative characteristics (pulmonary profile, perioperative complications, hospital stay, mortality, etc.).

Results:
A total of 50 patients were recruited during the study period, of which 35 (73%) patients were symptomatic during previous COVID-19 infection (two patients were excluded). The mean duration between current surgery and previous COVID-19 infection was 7 months. Patients symptomatic during earlier COVID-19 infection were females, older, and had a lower oxygen level during current surgery. There was no difference between symptomatic and asymptomatic groups in adverse perioperative outcomes such as desaturation, pulmonary or extrapulmonary complications, or non-extubation.

Conclusion:
The perioperative outcomes of patients undergoing elective neurosurgery with previous mild to moderate symptomatic COVID-19 infection may not be different from those of patients with asymptomatic COVID-19 infection.