bluuebunny/crossref_metadata_2025_split huggingface dataset:
C-reactive Protein to Albumin Ratio as a Predictor of Infectious Etiology in Patients Admitted to General Medicine: A Single-center Prospective Observational Study
Authors: Sarma Arup Kumar , Das Ashabari , Thakuria Bandana , Saikia Priyam 
Published: December 2024

Background and Aim:
Procalcitonin (PCT) is widely used to predict progression to sepsis, but PCT is expensive, time-consuming, and may not be routinely available, whereas parameters such as total leucocyte count (TLC), neutrophil and lymphocyte percentage, C-reactive protein (CRP), and albumin are routinely done as initial workup of patient. Recently, CRP to albumin ratio (CAR) has received a great deal of attention as a marker of inflammation. Hence, we aimed to evaluate CAR ratio as a predictor of likelihood of progression to sepsis and to compare the ability of CAR and neutrophil to lymphocyte ratio (NLR) for the prediction of likelihood to progression of sepsis.

Materials and Methods:
We selected 64 patients above 12 years of age with clinical suspicion of sepsis and in whom PCT level was available in first 48 h. TC, neutrophil, lymphocyte, CRP, and albumin were also obtained as part of routine investigation and NLR and CAR were calculated. We evaluated the diagnostic performance of each of these parameters through area under the receiver operating characteristics curve.

Results:
It was seen that in patients of CAR > 40, an infectious cause was very likely. High levels of CAR could predict progression to sepsis (P < 0.001) and CRP alone also showed similar results (P < 0.0131). In contrast, TLC, neutrophil, lymphocyte, NLR, and albumin alone were found to be poor predictors of infective etiology and likelihood of progression to sepsis.

Conclusion:
CAR ratio is a good predictor of likelihood of progression to sepsis in patients presenting with clinical features of possible infection and its predictive power is better that NLR.
Study the Utility of S100 Protein and Vimentin as a Marker for Neoplastic Myoepithelial Cells in Salivary Gland Neoplasms
Authors: Munish Kanika , Gupta Mamta , Bansal Rani 
Published: December 2024

Background and Aim:
Complexity of salivary gland tumors (SGTs) is attributed to the presence of myoepithelial component. S100P and vimentin can serve as potential markers in staining the neoplastic myoepithelial cells (NMECs), thus helping in understanding the origin of various SGTs. The study aimed at identifying the NMECs with the help of vimentin and S100 protein and correlating its expression in tumors.

Materials and Methods:
The study included 32 cases of primary SGTs. Expression of S100P and vimentin was analyzed in NMECs and luminal cells in different tumors. The expression was recorded as positive/negative and weak/strong intensity of staining. Positivity in ductal/acinar (luminal) cells was documented in cases with positive staining. Descriptive data analysis was done.

Results:
Pleomorphic adenoma (PA) was the most commonly diagnosed tumor, and all cases showed positive expression for vimentin and S100 in NMECs. Vimentin was also positive in adenoid cystic carcinoma (ACC), intraductal papilloma, and PA component of carcinoma ex PA. S100 was positive in NMECs in intraductal papilloma, lymphoepithelial cyst, ACC, secretory carcinoma, and PA component of carcinoma ex PA. Both markers showed negative expression in mucoepidermoid carcinoma and Warthin tumor.

Conclusion:
Expression of vimentin and S100 in NMECs explains the histogenesis and varied morphological patterns of different SGTs. Immunohistochemical staining can enhance the accuracy and act as a helpful tool in differential diagnosis of SGTs with overlapping morphological features.
Predictive Factors of Mortality in Chronic Obstructive Pulmonary Disease Subjects: A Monocenter Prospective Observational Study in Algeria
Authors: Fettal Nadia , Siali Nadjet , Chaker Mahammed , Ketfi Abdelbassat 
Published: December 2024

Background and Aim:
To assess the prevalence of mortality and identify predictive factors for mortality in chronic obstructive pulmonary disease (COPD) subjects, we conducted a prospective and observational study of a cohort of COPD patients, followed over 3 years. In addition to providing appropriate therapeutic care for each stage of the disease, we annually conducted clinical evaluations (assessing dyspnea, body mass index [BMI], comorbidities, and exacerbations) and functional assessments (spirometry and the 6-minute walk test [6MWT]) for our patients.

Materials and Methods:
Over a 3-year period, we conducted a prospective and observational study of a cohort of patients with COPD. Clinical evaluation (dyspnea, assessed using the modified Medical Research Council [mMRC] scale, BMI, comorbidities, and exacerbations) and functional evaluation (spirometry and 6MWT) were conducted annually. A threshold of three exacerbations per year was established to identify frequent exacerbators. In addition, we assessed the quality of life using the COPD Assessment Test questionnaire.

Results:
Our series consists of 132 men and 3 women, with an average age of 61 ± 9 years. Smoking is found in 95% with an average consumption of 50 P/A. The average stage of dyspnea according to mMRC was 1.8 ± 0.7 and the average BMI was 22.1 ± 3.7 kg/m2. Comorbidities were recorded at 64% with a predominance of cardiovascular factors. The functional outcomes were as follows: the mean postbronchodilator forced expiratory volume in 1 s was 58.25% ±15%, the mean distance covered in 6 min was 366 ± 107 m, and the mean Body Mass Index, Airflow Obstruction, Dyspnea, and Exercise Capacity (BODE) index was 2.7 ± 1. The mortality rate during our follow-up period was 12.6%. Univariate analyses have shown a significant relationship between mortality and the factors traditionally recognized as factors of COPD severity: age, Global Initiative for Chronic Obstructive Lung Disease stage, dyspnea stage, 6MWT, frequency of exacerbations, BMI, and comorbidities. However, in multivariate analysis, mortality is significantly correlated with three factors (BODE index, 6MWT, and frequency of exacerbations).

Conclusion:
Mortality among COPD patients in stable condition remains high despite adequate therapeutic care. This mortality rate is very significantly linked to the frequency of exacerbations.
Anti-inflammatory potential of black cumin seed oil and its nanoemulsion formulation against lipopolysaccharide-induced liver injury in mice
Authors: Haffez Hesham , Hosni Rehab , Swidan Shady A. , Amin Hatem K. 
Published: December 2024

Objective:
To evaluate the anti-inflammatory effect of black cumin seed oil (BCSO) and its nanoemulsion on lipopolysaccharide (LPS)-induced liver injury in mice.

Methods:
LPS-induced acute liver injury mouse model was used to evaluate the effects of BCSO and its nanoemulsion formulation on liver function. Hepatic inflammatory markers including Toll-like receptor 4 (TLR4), interleukin(IL)-1β, heme-oxygenase 1, BAX, and BCL-2 were assessed using real-time PCR. Additionally, protein levels of reduced glutathione, tumor necrosis factor-α, and IL-6 were measured using ELISA, and histological analysis was performed. Indomethacin was used as a standard positive control for comparison.

Results:
BCSO reduced LPS-induced liver injury and exhibited strong anti-inflammatory effects by downregulating the expression of TLR4, IL-1β, IL-6, tumor necrosis factor-α, and heme-oxygenase 1. Additionally, BCSO demonstrated antioxidant properties by increasing reduced glutathione protein levels and decreasing key apoptotic markers BAX and BCL-2 in hepatocytes. The nanoemulsion formulation further enhanced these anti-inflammatory, antioxidant, and anti-apoptotic effects, and histological examination confirmed this effect. Combining BCSO with indomethacin at a lower dose improved efficacy, thereby reducing its potential side effects.

Conclusions:
The investigation reveals the anti-inflammatory impact of BCSO and its nanoemulsion formulation on LPS-induced liver oxidative stress, inflammation, and apoptosis.
Primary Breast Osteosarcoma: A Case Report and Literature Review
Authors: Tsai Tsung-Han , Huang Hsuan-Ying , Su Yu-Li 
Published: December 2024

Abstract
Primary breast osteosarcomas are rare. We report an unusual case of a 58-year-old female presenting with a right breast lump for 1 month. Mammography showed an ill-defined, heterogeneous, and coarse calcification measuring 4 cm over the upper inner quadrant of the right breast. She received an upfront partial mastectomy after core needle biopsy showed osteoid-like tissue with the presence of atypical cells and some multinucleated giant cells. The final pathology revealed Grade 3 extraosseous osteosarcoma, osteoblastic type. Four cycles of adjuvant doxorubicin and cisplatin followed by radiotherapy were given due to the close surgical margin. She has since been free of recurrence for 3 years.
Dramatic Response to Enfortumab Vedotin in Soft-tissue Metastases from Urothelial Carcinoma: A Case Report
Authors: Wu Ming-Hsuan , Wang Chung-Chieh , Hsueh Fu-Jen 
Published: December 2024

Abstract
Soft-tissue metastasis from urothelial carcinoma is a rare but advanced disease entity. We report a patient with muscle-invasive bladder cancer who experienced rapid disease recurrence following radical surgery and adjuvant platinum-based chemotherapy. Despite further treatment with taxane-based chemotherapy and immune checkpoint inhibitors, the patient developed diffuse soft-tissue metastases, including in the skin, muscles of the extraocular area, extremities, and trunk. Salvage treatment with enfortumab vedotin (EV) was administered along with local radiation therapy to the orbital metastasis for better symptom control. Unexpectedly, the soft-tissue metastases showed a dramatic response after the first cycle of EV. However, after two cycles of EV treatment, the skin and extremity muscular metastases progressed, while the extraocular metastasis remained controlled. Four months after EV treatment, the patient died due to systemic progression and infection.
Gastric wall endometriosis: A case report
Authors: Chou Meng Chieh 
Published: December 2024

Abstract
Endometriosis affects 6% of women of reproductive age. About 10% of cases occur in extrapelvic locations, with gastric endometriosis being very rare. Typical symptoms include cyclical or chronic epigastric pain, especially in endometriosis patients, though most are nonspecific. We report a case of gastric endometriosis in a woman of reproductive age with a history of Cesarean section.
Efficacy of plant extract in chronic low back pain: A meta-analysis
Authors: Li Chen-Pi , Tsai Ru-Yin , Yu Jui-Ting , Huang Shin-Chuan , Liu Fang-Ling , Lin Sheng-Yi 
Published: December 2024

Abstract

Background:
Chronic low back pain (CLBP) impacts quality of life and healthcare reliance.

Objectives:
We systematically reviewed randomized controlled trials (RCTs) on the use of plant extracts to treat CLBP according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.

Methods:
Four databases (i.e., PubMed, Scopus, Web of Science, and The Cochrane Library) were searched for published studies. We searched databases up to July 2024. Seven RCTs were analyzed. The study has been registered in PROSPERO (number: CRD 42024570674).

Results:
Plant extracts alone or combined with massage significantly reduced pain, particularly when applied to multiple meridian points.

Conclusion:
Plant extracts are a promising nonpharmacological treatment option for CLBP. One potential mechanism is through their interaction with multiple meridian pathways, which may enhance pain relief. This possible relationship between meridian involvement and therapeutic efficacy warrants further investigation to better understand the long-term benefits and underlying mechanisms of plant extract therapy.
Osteochondroma of the Scapula in a 12-year-old Girl: An Unusual Case Report
Authors: Raja Kunne Bharath , Rao K. L. Jagadishwar 
Published: December 2024

Abstract
Osteochondromas are benign bone lesions composed of medullary and cartilaginous bone covered by hyaline cartilage, generally occurring near the growth plate. They are usually solitary and can be sessile or pedunculated. The presence of medullary and cortical bone with the continuity of the tumor is pathognomonic for osteochondroma. We report the case of a 12-year-old girl who was brought to the hospital by her mother with a painful slow-growing mass over the left scapula, with no limitations to the range of movements. On examination, a 4 cm × 3 cm × 4 cm hard, ovoid swelling with irregular margins was noticed and palpated over the dorsal aspect of the scapula. The patient was managed with surgical excision and histopathology confirmed the diagnosis of osteochondroma. Postoperative follow-up, the patient had full range of movements at the shoulder joint without any discomfort. In conclusion, scapular exostoses are rare, and symptomatic patients can be managed with surgical excision of the tumor.
Analysis of a Safe and Fasttrack L Prakash (LPR) Method of Reduction for Anterior Shoulder Dislocation
Authors: Kishore V. , Babu A. K. Rajesh , Venkatesh D. 
Published: December 2024

Abstract

Introduction:
Anterior dislocation was the most common type of shoulder dislocation often encountered in emergencies. Many methods were described by authors for reduction, which involves either traction or sedation or some assistance, but they were not without iatrogenic complications. A universally acceptable and ideal method is not yet concluded. Dr L. Praksh (LPR) introduced a new method for reduction which is quick, safe, painless and does not require traction or sedation or assistance and without any complications. This study aims to analyze and safety of the LPR technique.

Materials and Methods:
This was a prospective study conducted in two different institutes by the same author and team. All the cases of acute anterior shoulder dislocation and dislocation with associated greater tuberosity fractures were diagnosed, and necessary details were recorded and reduced by the LPR method. A maximum of two attempts were tried on difficult patients. No traction, no sedation, and no assistance were followed during the maneuver. Time taken for reduction, complications if any were recorded.

Results:
Among 64 patients included in the study, 48 (75%) were male, 16 (25%) were female. The mean age was 37.5 (range 17–65) years. Associated greater tuberosity fractures were seen in 8 (12.5%) patients. LPR method successfully reduced shoulder dislocation in 63 (98.4%) patients, among them 2 (3%) reduced in second attempt. The average time taken for reduction was 3–4 min. No complications were recorded.

Conclusion:
L. Prakash (LPR) method of reduction for anterior dislocation of the shoulder is a FastTrack method which is safe, effective, near ideal and without complications even in associated greater tuberosity fractures.
Functional Outcome of Lateral End Clavicle Fractures Treated with Precontoured Lateral End Clavicle Plates Verses Clavicle Hook Plate – A Comparative Study
Authors: Lingaraju K. , Chand Mohd Ejazul Haq , Kashikar Girishastri 
Published: December 2024

Abstract

Background:
Lateral end clavicle fractures are common to end up in nonunion if not surgically treated, many interventions are advised for the surgical management of lateral end clavicle fractures. Precontoured lateralend clavicle locking plates (PLCLP) and clavicle hook plates (CHPs) are among the commonly used techniques; nonetheless, no single procedure is deemed to be the benchmark treatment. Thus, the aim of the study is to compare the functional outcome of lateral end clavicle fractures treated with precontoured lateral end clavicle plates verses CHP.

Objectives:
This study involves evaluating the functional outcome of lateral end clavicle fractures treated with precontoured lateral end clavicle locking plates verses CHP.

Materials and Methods:
In 20 patients with lateral end clavicle fractures 10 patients were treated with open reduction and internal fixation with precontoured lateral end clavicle locking plate and 10 patients treated with CHP at the Department of Orthopaedics MMCR and I, Mysore, from December 2020 to May 2022 with age from 18 years to 65 years. Clinical assessments for functional outcome were performed at 3 weeks, 12 weeks and 24 weeks interval and results were analyzed using the Constant and Murley score.

Results:
Twenty patients were followed for 6 months the mean Constant–Murley score, and in the PLCLP group were, 82.1 ± 5.2, at 12 weeks postoperatively. Scores were significantly better than those in the HP group 72.5 ± 4.1 (P < 0.05). At 24 weeks postoperatively, mean Constant–Murley score was 90 ± 4 in the PLCLP group and 80 ± 5 in the CHP group. Functional outcome is better and lesser complications among the group treated with precontoured lateral end clavicle locking plates compared to the group treated with CHP.

Conclusion:
Open reduction and internal fixation with precontoured lateral end clavicle locking plates provide better functional outcomes and fewer complications than those treated with CHP in treating lateral end clavicle fractures.
Role of Titanium Elastic Nailing in the Surgical Management of Fracture Shaft Femur in Pediatric Patients
Authors: Gupta Abhishek , Sharma Govind 
Published: December 2024

Abstract

Introduction:
Orthopedic surgeons treat femur shaft fractures more frequently in children. Pediatric femoral shaft fractures (FSFs) can be surgically stabilized using a variety of techniques, such as rigid intramedullary nailing, compression plating, and external fixation. An internal splint that shares the load and facilitates both mobilization and alignment maintenance would be the perfect therapy tool. The purpose of this research is to determine the function of TENS in the fixation of children patients’ femur shaft fractures.

Materials and Methods:
This prospective research had been done in our hospital’s orthopedic department. Fifty patients, aged 5 to 15 years, who had femur shaft fractures were surgically managed with TENS. The patients were monitored clinically as well as radiologically for 6, 12, and 24 weeks, or until the fracture healed.

Results:
Flynn’s scoring system was employed to assess the clinical outcomes, assigning a score of excellent for 40 patients (80%), satisfactory for 10 patients (20%), and poor for none of the patients. Bone union took an average of 10.78 weeks.

Conclusion:
TENS is an easy, less time-consuming, and effective way to treat pediatric shaft femur fractures. It has several benefits, including a short recovery period, fewer hospital stays, early mobilization, and a low rate of complications.
Impact of Myo-Inositol-Chiro Inositol Combination on the improvement of Polycystic Ovary Syndrome Condition
Authors: Hussein Zuhair Assi , Majeed Maysaa Jalal , Al-Anbari Lubna Amer 
Published: December 2024

Abstract

Background:
Inositol was previously classified as a vitamin, but it is not one as it is produced by the body. It plays a role as a second messenger of insulin in several insulin-dependent processes, including polycystic ovarian syndrome (PCOS) and metabolic syndrome.

Objective:
This study aims to determine the impact of myo+ D-chiro inositol treatment on gut hormones insulin-like peptide 5 (ILP5) and phosphodiesterase 9 (PDE9) inhibitors, as well as determine if it improves the metabolic profile and the state of PCOS.

Materials and Methods:
The research conducted by the University of Baghdad’s College of Medicine was authorized by the ethics committee. In the study, 50 obese women without PCOS, and 50 obese women with PCOS were enrolled, and they were then treated with 2000 mg of myo-inositol (MI) and 50 mg of D-chiro inositol (DCI) in a 40:1 ratio for 3 months while having their vital signs and laboratory tests checked both before and after the treatment. We examined fasting glucose, insulin, ILP5, PDE9 inhibitor, free testosterone, dehydroepiandrosterone, the homeostatic model assessment index, and pretreatment and posttreatment. From February 2022 to the end of August 2022, participants in the study visited the Infertility Unit at the Higher Institute for Infertility Diagnosis and Assisted Reproductive Technologies at Al-Nahrain University in Baghdad, Baghdad, Iraq. Participants in this research completed questionnaires to indicate their consent for the study to record information on women.

Results:
The results revealed that after administering the treatment to polycystic ovary patients, a significant decrease in their weight and an improvement in insulin resistance markers were observed, as well as a decrease in the levels of ILP5 (171.53 ± 22.55 vs. 83.60 ± 18.94), and an increase in the levels of phosphodiesterase9 enzyme (7.17 ± 1.58 ng/mL vs. 8.16 ± 1.37 ng/mL).

Conclusion:
This study concludes that MI–DCI could be proposed as a potential therapeutic approach for the treatment of women with polycystic ovaries, showing a positive effect on correcting PCOS symptoms and infertility.
Association between Single Nucleotide Polymorphisms rs3757318 and Vitamin D Deficiency in Iraqi Breast Cancer Patients
Authors: Hade Istikrar M. , Al-Khafaji Ahmed S. K. , Lafta Fadhel M. , Qaddoori Yasir B. 
Published: December 2024

Abstract

Background:
Multiple single-nucleotide polymorphisms (SNPs) located in the intergenic region between estrogen receptor 1 and CCDC170 (especially at rs3757318) are thought to be associated with breast cancer risk. additionally, the serum level of vitamin D is believed to be linked to different aspects of breast carcinogenesis.

Objectives:
To assess the potential association between rs3757318 SNP and breast cancer pathogenicity, specifically in relation to serum vitamin D levels.

Materials and Methods:
For addressing this issue, 100 subjects were enrolled in this work, including 50 female patients diagnosed with breast cancer recruited from the Oncology Hospital, Baghdad, Iraq and 50 apparently healthy women with no malignancies as a control group. The serums level of vitamin D was measured for breast cancer patients and healthy controls groups, whereas, CCDC170 rs3757318 SNP genotypes were assessed using TaqMan SNP genotyping and utilizing genomic DNA extracted from the participants.

Results:
Vitamin D levels were shown to be significantly reduced (P < 0.001) in breast cancer patients than that of the healthy controls (6.604 vs. 22.268, respectively). In respect to the CCDC170 gene rs3757318 SNP genotypes frequency, the mutant genotype (AA) was only identified in the investigated breast cancer patients (O.R. (C.I.) = 1.69 (0.86–2.07)) and this seems to confer the increased risk of breast cancer susceptibility.

Conclusion:
Overall, the findings of the present study suggest an association between the reduced vitamin D levels and CCDC170 gene rs3757318 SNP genotypes frequency in breast carcinogenesis.