bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Performance of the American Thyroid Association (ATA) and American College of Radiology (ACR-TIRAD) Thyroid Nodule Risk-Stratification Systems in Determining High-Risk Nodules, and the Correlation of Site, Size, and Autoimmunity with High-Risk Features
Authors: Hussein Ibrahim H. , Altemimi Mahmood T. , Alidrisi Haider A. , Almomin Ammar M. Saeed , Alibrahim Nassar T. , Hamza Muqdam A. , Imran Husam J. , Zaboon Ibrahim A. , Alhamza Ali H. , Nwayyir Hussein A. , Mansour Abbas A. 
Published: December 2024

Abstract

Introduction:
Neck ultrasonography (US) and fine-needle aspiration (FNA) biopsy are usually used to evaluate thyroid nodules. This study aimed to evaluate the performance of two popular thyroid imaging reporting systems in detecting thyroid malignancy and to evaluate the correlation between thyroid autoimmunity, nodule site, and size in the development of malignancy.

Methods:
This prospective study was conducted from January 2019 to July 2021 in Basrah, Iraq. The American Thyroid Association (ATA) and American College of Radiology-Thyroid Imaging Reporting and Data (ACR-TIRAD) systems were used to evaluate the malignant potential of 143 thyroid nodules in 131 patients.

Results:
The sensitivity and positive predictive value (PPV) of the ATA system for detecting malignancy were 96% and 20.8% for low-risk and 100% and 4.3% for high-risk nodules, respectively. ACR-TIRAD sensitivity and PPV were 84% and 22.1% for low-risk and 80% and 4.2% for high-risk nodules, respectively. The specificity and negative predictive value (NPV) of the ATA system for detecting malignancy were 11.6% and 92.3% for low-risk and 10.5% and 100% for high-risk nodules, respectively. The ACR-TIRAD specificity and NPV were 28% and 87.8% for low-risk and 26% and 96.9% for high-risk nodules, respectively. The strength of the correlation between FNA performed across different Bethesda categories and age, sex, nodule size, and positive thyroid peroxidase (TPO) antibodies were 0.25, 0.01, 0.22, and 0.4, respectively.

Conclusion:
Both systems are effective; however, adopting TI-RADS stratification results in fewer biopsies being performed for thyroid nodule assessment. Only sex was found to be significantly correlated with FNA performance in thyroid-nodule evaluation.
Glucagon, rather than Glucagon-Like Peptide 1, Mediates Higher Post-Lunch Glucose Excursions during Breakfast Skipping in Asian Indian Patients with Uncontrolled Type 2 Diabetes Mellitus
Authors: Chauhan Yash V. , Hakke Mahesh D. , Sanamandra Prudwiraj , Gada Jugal V. , Misra Sukirti , Rahate Sachin S. , Varekar Namrata , Palekar Anagha V. , Varthakavi Premlata K. , Bhagwat Nikhil M. 
Published: December 2024

Abstract

Introduction:
The effect and mechanism of skipping breakfast on glycemic control in type 2 diabetes mellitus (T2DM) in Asian-Indians is unknown.

Methods:
Cross-over, within-group study recruiting 5 habitual breakfast eaters (BE) and 5 habitual breakfast skippers (BS) with uncontrolled T2DM (HbA1c 7-9%). Patients underwent testing after three days of following their usual breakfast habits and after seven days of crossing over to the other arm. Fasting values and incremental area under the curve (iAUC0-180) of post-lunch levels of glucose, insulin, C-peptide, glucagon-like peptide 1 (GLP-1), and glucagon were measured. Continuous glucose monitoring (CGM) parameters assessed were area under the curve (AUC0-180) of post-meal glucose values, 24-hour average blood glucose (ABG), time in range (TIR), and glycemic variability.

Results:
BS led to significantly higher fasting (133.5 ± 34.5 mg/dl vs 110 ± 31.50 mg/dl, P = 0.009) and peak post-lunch (214.6 ± 35.07 mg/dl vs 175.4 ± 39.26 mg/dl, P < 0.001) plasma glucose, and HOMA-IR (3.05 ± 3.89 vs 2.03 ± 1.76, P = 0.007) as compared to BE. Post-lunch iAUC0-180 during BS was significantly higher for plasma glucose (7623 ± 2947.9 mg/dl × min vs 1922.4 ± 1902.1 mg/dl × min, P < 0.001), insulin (2460 ± 1597.50 mIU/ml × mins vs 865.71 ± 1735.73 mIU/ml × mins, P = 0.028), C-peptide (418.4 ± 173.4 ng/ml × mins vs 127.8 ± 117.1 ng/ml × mins, P < 0.001) and glucagon (7272.7 ± 4077 pg/ml × mins vs 4568.8 ± 2074.9 pg/ml × mins, P = 0.044) as compared to BE, while GLP-1 (1812.7 ± 883 pmol/l × mins during BS vs 1643 ± 910 pmol/l × mins during BE, P = 0.255) did not significantly differ between the two visits. CGM revealed a higher post-lunch AUC0-180 during BS. There was no difference in post-dinner AUC0-180, ABG, TIR, or glycemic variability.

Conclusion:
Skipping breakfast led to higher post-lunch glucose excursions, possibly due to higher glucagon excursion and increased insulin resistance.
Performance of Vasopressin Stimulated Bilateral Inferior Petrosal Sinus Sampling in Corticotropin Dependent Cushing’s Syndrome with Negative or Equivocal 3 Tesla Contrast Enhanced Magnetic Resonance Imaging of Pituitary
Authors: Shivnani Puneet , Kasliwal Rajeev , Goyal Gourav , Sharma Jyoti , Balani Utkarsh , Gupta Pankaj , Sharma Bhawani S. , Yadav Dinesh , Mishra Vineet , Sharma Surendra K. 
Published: December 2024

Abstract

Introduction:
Corticotropin releasing hormone (CRH)-stimulated bilateral inferior petrosal sinus sampling (BIPSS) is the most accurate procedure in the differential diagnosis of adrenocorticotropic hormone (ACTH)-dependent Cushing’s syndrome (CS) with a sensitivity of 88–100% and a specificity of 67–100%. However, CRH is not available globally currently. We undertook this study of BIPSS using lysine vasopressin (LVP) as an agent to stimulate the release of ACTH from corticotrophs. Our objective was to assess the accuracy of LVP-stimulated BIPSS in differentiating Cushing’s disease (CD) from ectopic ACTH syndrome (EAS) with negative or equivocal 3T contrast-enhanced MRI (CEMRI).

Methods:
Seventeen patients with clinically and biochemically confirmed ACTH-dependent CS with equivocal or negative CEMRI pituitary underwent BIPSS using LVP as a stimulating agent.

Results:
Of seventeen patients who underwent BIPSS, nine patients had a raised central-to-peripheral ACTH ratio and were classified as having CD that was confirmed on histopathology following transsphenoidal sinus surgery. Remaining eight patients, who did not show a raised central-to-peripheral ACTH ratio, were classified to have EAS. All patients with EAS underwent contrast-enhanced computerised tomography of the neck, chest, and abdomen and/or Gallium 68 DOTANOC positron emission tomography/computerised tomography. Seven out of eight patients demonstrated solitary pulmonary nodule in the lung (bronchial carcinoid), and one patient had a mass in the thymus (thymic carcinoid).

Conclusion:
BIPSS using LVP confirmed the source of ACTH excess correctly in all the patients with ACTH-dependent CS without the loss of specificity.
Anaesthetic management of a child with Wolf–Hirschhorn syndrome
Authors: Das Priyanka , Subramanian Shalini 
Published: December 2024

Abstract
Wolf–Hirschhorn syndrome (WHS) is a malformation syndrome that is characterised by a partial deletion of the short arm of chromosome 4 and is known to occur in about one per 50,000 births. Ophthalmic manifestations are common in patients with WHS, who often require corrective surgery under general anaesthesia. Managing the airway, titration of the anaesthetic medications while vigilant monitoring and controlling the haemodynamics during the surgery can be difficult. Further, presence of various anomalies, concurrent seizures, predisposition to cardiac failure and post-operative occurrence of malignant hyperthermia pose anaesthetic challenges in patients with WHS. We present the case of an 11-month-old child with WHS posted for multiple ophthalmological procedures and the challenges faced while administering anaesthesia for the same.
A successful pregnancy with severe male and female factor infertility treated with laser-assisted thinning
Authors: Pandit Subhendu , Sharma Prashant , Magdum Hrishikesh , Gulati Rachna , Ahuja Manish Singh 
Published: December 2024

Abstract
Lifestyle changes have brought about a surge in the incidence of infertility due to both male and female factors. Although newer treatment modalities continue to boom, maternal age, in vitro culture conditions and cryopreservation affect the elasticity and thinning of the zona, which may affect hatching and subsequent implantation – keeping the rates of success low. Assisted hatching using lasers is said to have provided additional support for hatching and implantation in fresh and frozen in vitro fertilisation and intracytoplasmic sperm injection-embryo transfers cycles. Here, we report one such case where a couple reported with inability to conceive for 8 years after marriage and successfully managed with assisted reproductive techniques (laser thinning) for both male and female factor infertility.
Hypertriglyceridaemia-induced pancreatitis – A diagnostic and therapeutic challenge
Authors: Manavalan Savitha , Murali Sudhinder , Vidyasagar Sudha , Begum Sabika 
Published: December 2024

Abstract
Hypertriglyceridaemia is a known but relatively rare cause of acute pancreatitis. It requires a high level of clinical suspicion to be diagnosed. We report a 43-year-old male with type 2 diabetes mellitus, diagnosed initially to have alcoholic pancreatitis not responding to conservative management. Serum triglycerides (TGs) were high, and this caused pancreatitis. Following lipid-lowering measures, including insulin infusion, the TG level came down and the patient improved. This case highlights the need to rule out hypertriglyceridaemia as a cause of pancreatitis, as the treatment of this entity is different.
Fulminant necrotising fasciitis complicating upper limb arteriovenous fistula access for haemodialysis
Authors: Davulury Sri Satyavathi , Bhan Vinod 
Published: December 2024

Abstract
Necrotising fasciitis is an aggressive soft-tissue infection with high mortality rates, which needs emergent medical and surgical approach for better results. It is known to occur in drug abusers, immunosuppressed individuals, malignancy, renal failure and in malnourished individuals. It is also described in femoral artery puncture following cardiac catheterisation and access-related complications from secondary infection in pseudoaneurysms following femoral punctures. We report the rare occurrence of upper limb dialysis access with pseudoaneurysms of the cephalic vein with necrotising fasciitis resulting in fulminant gangrene.
Efficacy and Duration of Biological Therapies among Saudi Patients with Psoriasis
Authors: Alsuwaidan Sami N. , AlMuqrin Abdullah M. , Qadoumi Tala A. , Aldosari Batal M. , AlAjlan Abdulmajeed M. 
Published: December 2024

Background:
The long-term efficacy of biological agents in a Saudi population differs from other populations.

Purpose:
We studied 12 patients with moderate-to-severe psoriasis undergoing biological treatment to assess the long-term efficacy of these medications in the Saudi Arabian population.

Methods:
This retrospective study includes 12 patients diagnosed with moderate-to-severe psoriasis. The patients were followed up in a dermatology clinic in Riyadh, Saudi Arabia, from January 2019 to January 2020. Patients’ demographic data, psoriasis type, duration of biologic treatment, side effects, duration of remission and presence or absence of other medical conditions, and previous or concomitant medications were recorded.

Results:
Six adalimumab-treated patients sustained remission over 5–8 years, with relapses observed in two cases due to treatment nonadherence. Two other adalimumab-treated patients sustained remission for 10–11 years. Two adolescent boys receiving etanercept maintained remission for 3–6 years. A patient with guttate psoriasis who was initially resistant to adalimumab and etanercept was then managed with methotrexate. An adult female, maintained on infliximab infusions for a decade, is currently in remission.

Conclusion:
Genetic factors can influence treatment response. Data from larger datasets can support genetic research to personalize biological treatments.
Assessment of the Current Level of Oral Health Knowledge among Adolescents in Lucknow, India: A Questionnaire-based Study
Authors: Pradhan Shreya , Saha Sonali , Yadav Gunjan , Dhinsa Kavita , Giri Soni , Sinha Shubham 
Published: December 2024

Introduction:
Adolescents are at a critical stage in life where habits formed can impact long-term health, including oral health. As valued members of society, it’s important to teach them healthy living. Poor oral hygiene, sugary diets, and neglecting regular dental care are common issues faced by teenagers, leading to problems like cavities and gum disease. Educating adolescents about the importance of good oral hygiene practices, such as brushing, flossing, and regular dental checkups, is essential for preventing future dental issues. However, limited research has been conducted on oral health knowledge among adolescents in India.

Aim:
The aim of this study was to assess the current level of oral health knowledge among adolescents in Lucknow, India.

Material and Methods:
Seven hundred and sixty-four children aged 13–16 years, enrolled from 6 government and private schools in Lucknow, were randomly chosen to participate in cross-sectional research. Responses were gathered for the survey using a custom-created self-administered questionnaire.

Results:
Out of 27 questionnaires, only 2 items were statistically significant. In response to the “importance of teeth,” a significantly higher proportion of females (6.4%) responded as “appearance” as compared to males. In response to the “ideal frequency of cleaning teeth,” a significantly higher proportion of females (70.5%) responded as “twice a day” as compared to males. This finding was significant when considering gender (P < 0.05). Most of the youngsters (84.7%) were conscious of the connection between good dental health and general well-being. About 50.9% of the kids were unaware of undergoing any fluoride-related procedures. About 50.3% of respondents were aware that dental plaque can cause tooth decay, whereas nearly 53.4% of respondents were unaware of it. When asked to describe a dental sealant, roughly 22.6% of respondents were able to do so successfully, whereas 41.5% of them said they had no idea.

Conclusions:
Teenagers in Lucknow have inadequate knowledge, attitudes, and practices around oral health. Dental health education programs and other didactic activities should be designed to pique student’s attention and achieve societal acceptability as a top goal.
Infant and Child Oral Health Risk Status and Quality of life Correlated to Behavioral Habits of Parents or Caregivers: A Survey in Lucknow
Authors: Giri Soni , Saha Sonali , Yadav Gunjan , Dhinsa Kavita , Jaiswal Karishma , Dey Jerry 
Published: December 2024

Introduction and Aims:
This study aimed to evaluate the knowledge and awareness of parents and caregivers about potential oral health risk factors and quality of life (QoL) in preschool age children (3–30 months). Infant oral health care is the foundation on which a life time of preventive education and dental care can be built up to help acquire optimal oral health into child and adulthood. Early childhood caries (ECC) is a special form of dental caries characterized by rapid progression on smooth tooth surfaces soon after eruption and has adverse effects on the dentition and quality of the child’s life. Further, the life of parents of children with ECC is also affected in terms of emotional and financial distress.

Materials and Methods:
The survey was conducted in 384 children aged between 3 and 30 months at various pediatric clinics in Lucknow city. The questionnaire used was divided into two phases: in phase I, evaluation of potential oral health risk factors was done using a self-administered questionnaire (information regarding infant feeding practice, children’s oral hygiene habits, and risk behaviors [e.g., sharing cutlery, tasting of baby food, nightly using of baby bottles with sugared beverages or sugared pacifier], and knowledge about caries) and in phase II, QoL will be assessed using early childhood QoL (ECQoL).

Results:
Data analysis showed that about 64.80% accepted that they share utensils with their child. More than half of respondents (53%) agreed to taste the food before giving to child. Furthermore, majority (91.40%) reported that children were breastfeeding. Furthermore, majority (87.70%) did not report the usage of dental floss for their child. Majority (40.70%) were reported to breastfed their child for 6 months to 1 year duration. Moderate level (61.9%) of oral health-related knowledge was observed. Mean child impact score, mean family score, and mean oral healthECQoL scores were significantly high among those who showed low level of oral health-related knowledge.

Conclusions:
It can be concluded from the survey that knowledge and awareness on information, health education, and health promotion are lacking throughout respondent parents, and this can potentially increase the oral health risk status of their children.
A Randomized Controlled Clinical Trial to Evaluate the Efficacy of Rohitaka (Tecomella undulata) in the Management of Shwetpradar w.s.r. Trichomonas Vaginitis
Authors: Singh Neelam Kumari , Khuntia Bipin Bihari , Das Arun Kumar 
Published: December 2024

Introduction:
Trichomonas vaginitis (TV) is one of the most common sexually transmitted infections found in day-to-day practice and caused by protozoa. It increases the risk of complications such as pelvic inflammatory disease, human immunodeficiency virus, cervical cancer, and infertility. Based on high prevalence, risk factors, increased complication, and antibiotic resistance, there is a need to develop an alternative effective treatment. It shares many characteristics with Kaphaj yonivyapada (KY) described in Ayurvedic texts. The classical text describes the usage of Rohitaka moola Kalka along with water in Shwetpradar.

Aim:
This study aims to evaluate the efficacy of Rohitaka mula churna (RC) (Tecomella undulata) in managing KY.

Material and Methods:
A total of 100 patients were selected randomly, among the women having Yonigata shweta–picchilstrava, vulval itching, and symptoms and signs of TV. RC 3 g twice daily was given to 50 patients for 15 days, and the remaining 50 participants received metronidazole (M) tablets 200 mg thrice daily for 7 days as a standard control drug. Subjective and objective parameters scores were used to compare the results before and after therapy.

Results:
The mean age of the participants was 32.92 ± 2.3 years. In the trial group, 6% of individuals showed mild improvement, 66% of participants showed moderate improvement, and 28% of participants showed marked improvement. In the control group, most patients (78%) experienced moderate improvement, followed by mild improvement (16%), and finally, marked improvement in symptoms and signs was seen by 6% of people. The trial group had a significant effect on the consistency of discharge, itching, and inflammation of the vagina compared to the control group. Over 68.98% of relief was found in the trial group across all assessing parameters, compared to 60.20% in the control group across all assessing parameters.

Conclusions:
A highly significant (P < 0.001) effect was observed in both the trial and control group on the parameter odor, dyspareunia, burning micturition, cervix congestion, strawberry appearance, and punctate hemorrhagic spot. During the follow-up period, no recurrence of symptoms and adverse drug reactions was observed. RC was clinically equally effective compared to the standard drugs in managing the signs and symptoms of KY.
The tricuspid annular plane systolic excursion/PASP ratio’s accuracy and validity in assessing the right ventricular function: A narrative review
Authors: Sercelik Alper , Askin Lutfu 
Published: December 2024

Abstract
The tricuspid annular plane systolic excursion (TAPSE) (transthoracic apical two-chamber stretch) and pulmonary artery systolic pressure (PASP) ratio is a measure of cardiac function that is used to assess left ventricular systolic function. PASP is typically measured using a catheterization procedure, in which a small tube is inserted into a blood vessel and advanced to the pulmonary artery. A TAPSE/PASP ratio higher than 0.36 mm/mmHg has been shown in several studies to be a good sign of normal or generally well-maintained right ventricular function. It is important to note that the TAPSE/PASP ratio should be interpreted in the context of other clinical findings and should not be used as the sole indicator of cardiac function. A decrease in the TAPSEpulmonary arterial systolic pressure (PASP) ratio (i.e., (RV)-arterial uncoupling), which quantitatively depicts the function of the RV, was detected in patients with heart failure. In pulmonary arterial hypertension patients, TAPSE/PASP is linked to hemodynamics and functional class. In diseases impacting right cardiac function, the TAPSE/PASP may also be beneficial. The purpose of this review is to demonstrate how the TAPSE/PASP impacts how the (RV) functions. We believe that this is the first review on the topic written.
Predictive value of gemstone spectral imaging for chemotherapy response in colorectal cancer liver metastases: A retrospective study
Authors: Ning Hou-Fa , Qin Yun-Long , Yue Kui-Tao , Wang Shuai , Shao Wei-Guang , Wang Guang-Zhi 
Published: December 2024

Abstract

Background:
Accurate and timely assessment of tumor response after chemotherapy is crucial in clinical settings. The aim of this study was to explore the feasibility of Gemstone Spectral Imaging (GSI) for early assessment of chemotherapy responses in patients with colorectal cancer liver metastasis (CRCLM).

Materials and Methods:
From October 2012 to October 2018, 46 patients (28 males and 18 females) with CRCLM received GSI followed by chemotherapy were retrospectively reviewed. The patients were divided into a response group (n = 32) and a nonresponse group (n = 14) according to the tumor response to chemotherapy. The iodine concentration images and virtual monoenergetic images (VMIs) with an optimal contrast-to-noise ratio at the arterial phase (AP) and portal venous phase (PVP) were obtained by GSI viewer. The iodine concentration value and computed tomography (CT) value on VMIs and slope of spectral attenuation curves of all lesions were compared. A logistic regression analysis was used to determine the predictor of chemotherapy response.

Results:
The difference of extrahepatic metastasis (P = 0.001), CT value on 68 keV VMIs at the AP (P = 0.005) and PVP (P = 0.001), slope of CT value attenuation curves at the AP (P = 0.013) and PVP (P = 0.001), and iodine concentration value at PVP (P = 0.003) between the response and nonresponse groups were statistically significant. The CT value of the 68 keV VMIs (OR: 1.206; 95% confidence interval [CI]: 1.021–1.425, P = 0.027) and the iodine concentration value at PVP (OR: 1.952; 95% CI: 1.034–3.684, P = 0.039) were independent prognostic factors for predicting chemotherapy response.

Conclusion:
Baseline GSI may help predict the response to chemotherapy and provide a good tumor-response indicator through single-energy CT value of 68 keV at the PVP and iodine concentration.