bluuebunny/crossref_metadata_2025_split huggingface dataset:
Retinal Nerve Fiber Layer and Macular Ganglion Cell Layer Thickness in Subjects Suffering from Diabetes Mellitus: An Observational Study
Authors: Gharat Anujja , Potdar Nayana Anil , Tabani Salma Mohd Iqbal , Fakhri Burhanuddin Kaidjoher , Rathod Darshana B. , Choksi Twinkle 
Published: December 2024

Purpose:
The purpose of this study was to investigate the relationship of retinal nerve fiber layer (RNFL) and ganglion cell–inner plexiform layer (GCIPL) thickness in between normal healthy eyes and those affected by diabetes mellitus (DM) and also associate it with the extent of the disease.

Materials and Methods:
This hospital-based observational case-control study was conducted at a major tertiary health care center to investigate the relationship of RNFL and GCIPL thickness using spectral-domain optical coherence tomography (SD-OCT). A total of 124 eyes were studied out of which 62 belonged to diabetic subjects and 62 were normal homogenous controls. Among the diabetics, 30 eyes had mild-to-moderate diabetic retinopathy (DR) and 32 eyes had no DR.

Results:
The peripapillary RNFL thickness was significantly thinner in the eyes of patients with DR compared to controls. Furthermore, it was significantly thinner when compared to the eyes of diabetic subjects with no DR. No significant statistical difference was observed when comparing RNFL thickness in diabetic subject’s eyes without DR and controls. Significant GCIPL thinning was noted in eyes with DR compared to control eyes. Furthermore, it was significantly thinner when compared to the eyes of diabetic subjects without DR. No statistical difference was observed when comparing GCIPL thickness in diabetic subjects’ eyes without DR and controls. No significant correlation was obtained of glycated hemoglobin with either RNFL or GCIPL thickness in the diabetic patients’ group. A multiple linear regression model showed DR status and duration of diabetes as the best explanatory variables for GCIPL loss in diabetic eyes.

Conclusion:
The results show that both processes, the visible diabetic microvascular changes and neurodegeneration as studied clinically by SD-OCT, are late complications of DM and are closely linked. Thus, a complex neurovascular interaction occurring simultaneously is an early event in the pathogenesis of DR.
Effect of axial elongation on anterior scleral thickness in myopia
Authors: Yan Hui , Li Jie , Wang Cheng , Mei Cai-Qiu 
Published: December 2024

Objective:
This study aimed to investigate the effect of axial elongation on anterior scleral thickness (AST) in myopia.

Methods:
The convenience sampling method was used to select 122 patients without ocular or systemic diseases affecting ametropia in Ya’an People’s Hospital between March 2020 and January 2022. According to the diopter and axial length (AL), the patients were divided into an emmetropia group (32 cases), a low-to-moderate myopia group (40 cases), and a high myopia group (40 cases). Relevant data were collected and analyzed.

Results:
The AST of the four diameter lines was highest at the scleral process and measured. The results, in descending order, were as follows: temporal side (716.45 ± 65.55 μm), lower side (692.32 ± 74.76 μm), nasal side (671.54 ± 61.76 μm), and superior side (550.76 ± 51.34 μm). There was a correlation between the AL and the average AST of the four diameter lines. The correlations, from highest to lowest, were as follows: the mean AST of the nasal side (r = −0.455, P < 0.001), the mean AST of the upper side (r = −0.431, P < 0.001), the mean AST of the lower side (r = −0.402, P < 0.001) and the mean AST of the temporal side (r = −0.363, P < 0.001). Age was associated with the average AST of the upper, nasal, and temporal sides. The correlations, from highest to lowest, were as follows: the average AST of the upper side (r = 0.545, P < 0.001), the average AST of the temporal side (r = 0.422, P < 0.001), and the average AST of the nasal side (r = 0.411, P < 0.001). There were significant differences in AST among the three groups at 0, 1, 2, 3, 4, 5, and 6 mm from the scleral bulge (P < 0.05). AST was positively correlated with age and negatively correlated with AL (R
2
= 0.432, F = 231.73, P < 0.05).

Conclusion:
The thickness of the sclera changed with the AL and measurement position. AST was negatively correlated with the AL and positively correlated with age. Compared with emmetropia and low-to-moderate myopia, the anterior sclera in cases of high myopia was thinner. Myopia affects not only the thickness of the posterior sclera but also the AST.
A Single-Center Review of Cases to Understand the Indian Polyvalent Antivenom Use in Hump-Nosed Pit Viper Bites in South India
Authors: Abraham Siju V. , Paul Sarah , Paul Martin V. , Davis Clint , Rafi Aboobacker Mohamed , Suseel Appu , Mathew Deo , Kassyap C. K. , Chathappan Rajeev Punchalil 
Published: December 2024

Abstract

Introduction:
India, with nearly 60 venomous snake species, has just one commercially available antivenom, the Indian polyvalent antivenom (IPAV). The hump-nosed pit viper (Hypnale
hypnale), an indigenous venomous snake, causes considerable morbidity and at time mortality for which we have no commercially available antivenom. However, most clinicians rely purely on the clinical syndromes and end up using the available IPAV for H. hypnale envenomation.

Methods:
Between April 2017 and December 2022, we reviewed 41 cases of H. hypnale envenomation, comparing clinical and laboratory profiles of patients who received IPAV with those who did not.

Results:
Local signs of envenomation were seen in 39 (95.12%) cases, with the most common being edema or swelling at the bite site. Eight (19.5%) patients developed coagulopathy, and two developed renal failure during their hospital stay. Among the 39 envenomated individuals, 13 received polyvalent snake antivenom. Over half of those receiving antivenom had hypersensitivity reactions. Patients who received antisnake venom (ASV) had increased intensive care unit stay, duration of hospitalization, and hospital expenses as compared to patients who did not. There was one death among the patients who received antivenom.

Conclusion:

H. hypnale viper envenomation is associated with local and systemic signs of envenomation, with coagulopathy being a common complication. Administering the current polyvalent antivenom to victims of H. hypnale bites did not reduce the morbidities or prevent mortality; instead, it exposes them to additional risks associated with ASV administration.
A study of acute transfusion reactions at a tertiary care center: a retrospective analysis
Authors: Dey Damayanti R. , Dhote Shweta W. , Lad Subhangi Y. , Gupta Sonal S. 
Published: December 2024

Abstract

Background:
Blood transfusion refers to the therapeutic use of blood products, and while often lifesaving, it carries a variety of potential complications. Ensuring access to safe and sufficient blood is a critical component of healthcare, leading to the development of hemovigilance. Hemovigilance is essential for improving patient safety by learning from errors and implementing system-wide changes to prevent their recurrence. A comprehensive assessment of adverse events is the primary goal of hemovigilance.

Aim:
To assess the frequency and types of acute transfusion reactions (ATRs).

Objectives:
(1) To examine the types of ATRs related to the specific blood components transfused. (2) To analyze ATRs based on different clinical parameters.

Materials and Methods:
A retrospective analysis was conducted over 3 years, evaluating all transfusion reactions reported to the Department of Immunohematology and Blood Transfusion at Mahatma Gandhi Mission College and Hospital, Navi Mumbai. Reactions were assessed according to the institution’s established protocol. Statistical analysis was performed using IBM Statistical Package for the Social Sciences version 20, with significance at P < 0.05.

Results:
During the study period, 22,188 blood component units were issued, of which 38 (0.174%) resulted in an ATR. Febrile non-hemolytic transfusion reactions (FNHTR) accounted for 31 cases (81.58%), allergic transfusion reactions for six cases (15.79%), and one case (2.63%) involved an immunologic hemolytic transfusion reaction caused by alloantibodies. Among the reported ATRs, 37 (97.36%) were associated with packed red cells (PRC), while 1 (2.64%) occurred with fresh frozen plasma (FFP).

Conclusion:
FNHTR was the most common ATR, followed by allergic reactions. These findings highlight the importance of continuous monitoring and strict adherence to standard protocols in blood transfusion practices to enhance patient safety.
Vitamin D and HbA1c levels in newly diagnosed type 2 diabetes mellitus
Authors: Kiran Baligumba Ramu , Kumar Venoor Shreyas , Preeti Giri Premkumar , Kumar Venoor Ajith , Vikas Bheemappa Raja 
Published: December 2024

Abstract

Background:
This study examined the correlation between 25-hydroxyvitamin D [25(OH)D] and glycated hemoglobin (HbA1c) levels in male and female patients diagnosed with type 2 diabetes mellitus (T2DM).

Design:
Hospital-based cross-sectional study.

Materials and Methods:
This study was conducted in the Department of General Medicine at Rajarajeswari Medical College and Hospital, Bengaluru, Karnataka, India, with the Institutional Ethics Committee approval. Each participant admitted to the hospital as an inpatient or outpatient underwent a thorough medical history review, physical examination, and relevant diagnostic tests. Vital signs, including pulse rate and blood pressure, were recorded as part of the general examination. Additionally, detailed assessments and investigations evaluated participants for potential vitamin D deficiency.

Results:
The mean age of participants was 59.46 ± 11.06 years, with an observed trend of increasing vitamin D deficiency with age. No significant association was found between gender and HbA1c or vitamin D levels. The average HbA1c level was 9.75% ± 2.05, while the mean vitamin D level was 23.44 ng/mL ± 8.26. A negative correlation was identified between serum vitamin D and HbA1c levels, with a correlation coefficient of −0.53 and a P value of <0.01.

Conclusion:
The study confirmed an association between vitamin D deficiency and elevated HbA1c levels in T2DM patients, with variations observed between male and female subjects.
Freeze-all cycles for normal responders: Is this way forward?
Authors: Sharma Satish , Mhatre Shalaka , Jadhav Ashwini , Lad Nikita 
Published: December 2024

Abstract

Background:
The freeze-all approach has gained traction in in vitro fertilization (IVF) practices, and this study explores its benefits for normal responders.

Aims and Objectives:
The study evaluates whether the freeze-all strategy is advantageous in normal responders, irrespective of ovarian response.

Materials and Methods:
A retrospective study was conducted at a private IVF center, analyzing 225 oocyte retrieval cases and 170 frozen embryo transfers performed between January 2023 and February 2024. All patients underwent controlled ovarian stimulation using a gonadotropin-releasing hormone antagonist regimen, with the freeze-all policy applied. Fresh embryo transfers were postponed, and all embryos were cryopreserved. Frozen–thawed embryo transfers (FET) were performed in subsequent cycles.

Results:
The implantation rate for cleavage-stage FETs was 13.79%, whereas for blastocyst-stage transfers, it was 31.61%. The clinical pregnancy rate was 43.75% for cleavage-stage and 47.40% for blastocyst-stage FETs.

Conclusion:
The freeze-all approach can enhance IVF outcomes. However, an individualized treatment plan is essential for optimizing results, as there are currently no noninvasive clinical methods to determine, which patients would benefit most from a freeze-all strategy.
A large submucosal pedunculated fundal fibroid presenting as a vaginal mass: a rare case report
Authors: Dasila Priyank Singh , Shah Maitri , Thamke Pratima 
Published: December 2024

Abstract
This study reports the clinical outcomes of a 47-year-old female, para 1, living 1, abortion 1, with a previous lower segment cesarean section, who presented with a history of vaginal spotting and weight loss over 6 months. Both ultrasonography and magnetic resonance imaging indicated a mass originating from the lower uterus and cervix, likely of neoplastic origin. Upon vaginal and speculum examination, a soft, round cystic mass was detected, filling the vaginal cavity, making cervical evaluation impossible. However, histopathology and fluid cytology confirmed the mass as benign. An exploratory laparotomy revealed a large submucosal pedunculated fibroid originating from the fundus and extending into the vaginal cavity. The fibroid was removed, and a hysterectomy was performed. This case highlights a rare presentation of a submucosal fibroid as a vaginal mass. It underscores the importance for gynecologists to recognize this complication to avoid delays in diagnosis and prevent unnecessary morbidity and mortality.
A study on the expression of Her2/neu in malignant epithelial ovarian tumors
Authors: Bhardwaj Amit Kumar , Bhaskar Vanita , Nayak Rashmi , Chandrakar Anubhav , Bombeshwar Vikas , Kailashiya Vikas 
Published: December 2024

Abstract

Background:
Ovarian cancer poses a considerable challenge in surgical treatment, often requiring careful and complex approaches. A review of the literature highlights a wide range of Her2/neu overexpression or amplifications in ovarian tumors, with reported rates between 8% and 66%. This variability may be associated with chemotherapy resistance and poor treatment outcomes, thereby playing a significant role in prognosis.

Objective:
We aimed to study the expression of Her2/neu in malignant epithelial ovarian tumors using immunohistochemistry.

Materials and Methods:
This descriptive, observational (cross-sectional) study was conducted in the Department of Pathology at Pt. Jawaharlal Nehru Memorial Medical College, Raipur, Chhattisgarh, India, from August 2022 to December 2023, over 18 months. Seventy cases of malignant epithelial ovarian tumors were included. The immunohistochemical analysis assessed the expression pattern of the Her2/neu protein in these tumors.

Results:
Among the 70 cases, the majority were serous carcinomas (n = 47, 67.2%), with low-grade serous carcinoma (n = 24, 34.3%) being slightly more common than high-grade serous carcinoma (n = 23, 32.9%). Fourteen cases (20%) were mucinous cystadenocarcinomas, and nine (12.9%) were endometrioid carcinomas. The mean age of the study population was 52.58 ± 2.80 years, with the highest proportion of cases (n = 25, 35.7%) observed in the perimenopausal age group (40–50 years). Her2/neu positivity was observed in 15 cases (21.4%) of the 70 malignant epithelial ovarian tumors.

Conclusion:
Her2/neu protein overexpression was found in 21.4% (n = 15) of cases. No statistically significant association was observed between Her2/neu overexpression and the histological subtype or the age of the patients.
Nanotechnology in cancer: advancements in treatment and detection—a review
Authors: Parthasarathi Abhirami K. , Karabsanawar Someshwar S. , Acharya Prajnashree 
Published: December 2024

Abstract
Cancer, characterized by the rapid growth of abnormal cells capable of invading surrounding tissues and metastasis, is a leading cause of mortality worldwide. Conventional treatments such as chemotherapy and immunotherapy often encounter challenges such as limited specificity, drug resistance, and significant side effects. Nanotechnology offers promising advancements in both cancer treatment and diagnosis. Nanoparticles (NPs) represent a breakthrough in cancer treatment because they target tumors precisely, improve drug delivery, and enhance imaging techniques. These nanoscale materials have the potential to reduce side effects and overcome drug resistance, thus boosting the therapeutic effectiveness. Additionally, NPs play a critical role in early cancer detection and metastasis imaging. This review examines how nanotechnology enhances cancer cell eradication, supports immunotherapy, and advances drug delivery systems. Ongoing research in nanoparticle production and multifunctional nano-platforms highlights the potential of nanomedicine to transform cancer therapy, paving the way for personalized and highly effective treatment approaches.
Clinical case series on presentations of krait bite envenomation
Authors: Yakub Shireen Faruque , Ghodke Babita , Puvvadu Lakshmi Monika , Nirmal Apoorva , Patil Ravi 
Published: December 2024

Abstract
Neurotoxicity is the most peculiar feature of krait envenomation. A patient presenting to the emergency room with complaints of snakebite followed by acute neuromuscular weakness and progressive respiratory involvement should ring a bell for neurotoxic snakebite. The progression of symptoms, muscle involvement and weakness, respiratory worsening, and recuperating post administration of antivenom and acetylcholinesterase inhibitors can vary widely. Delays in diagnosis and administration of treatment are linked to increased mortality rates. In this report, we present cases of krait envenomation, highlighting differences in their management based on each patient’s presentation. All three cases were confirmed krait bites—in two cases, the bystanders had killed and brought the snake to the emergency room, where it was identified as a krait on arrival. Meanwhile, in the third case—based on symptoms, treatment was initiated, and krait was identified a couple of hours later.
Paecilomyces keratitis: a case report
Authors: Choudhury Debapriya Das , Ubale Milind , Baranwal Rimjhim , Nanoty Vaibhavi , Patel Mayuri 
Published: December 2024

Abstract
Ocular trauma involving vegetative matter is the most common cause of keratitis in ophthalmic practice in India, with many cases resulting in fungal keratitis or corneal ulceration. Here, we present a case of fungal keratitis due to Paecilomyces lilacinus that was successfully managed with oral and topical antifungal therapy, avoiding surgical intervention. The patient, a female, presented with a corneal abscess, conjunctival congestion, and persistent pain in her right eye after sustaining an ocular injury from vegetative matter. Based on the clinical signs, a provisional diagnosis of fungal keratitis was made, and treatment with 5% natamycin eye drops was initiated. Potassium hydroxide mount findings indicated fungal hyphae, leading to the addition of oral voriconazole due to suspected deuteromycosis. Fungal culture confirmed the presence of P. lilacinus. Gradually, the patient improved with antifungal therapy over a month without surgical intervention.
Hymenolepis nana: a case report of an intestinal helminthic infection from Northern India
Authors: Singh Sangeeta , Sen Manodeep , Raj Nikhil , Singh Riddhi , Agarwal Jyotsna 
Published: December 2024

Abstract

Hymenolepis nana (H. nana), known as the dwarf tapeworm, is an intestinal helminth. This report highlights a case of H. nana infection in a young female from Northern India who presented with abdominal pain and achieved a favorable outcome following antiparasitic treatment. An 18-year-old female from a rural community in Kothara village, Baharaich, Uttar Pradesh, India, was diagnosed with H. nana infection. She exhibited mild iron deficiency anemia and granulocytosis but remained largely asymptomatic despite a moderate infection burden. While H. nana infections are often asymptomatic, prompt treatment is essential. Without intervention, the infection can spread within isolated rural populations. Therefore, incorporating H. nana screening into routine evaluations for intestinal parasites and treating even asymptomatic cases is vital to prevent further transmission.
Identification of risk for work-related musculoskeletal disorders in jewelry die makers using rapid entire body assessment – A cross-sectional study
Authors: Raut Harshika , Sawant Nikita Vishnu , Karajgi Asmita 
Published: December 2024

Abstract:

CONTEXT:
Ergonomics means laws of work. The jewelry die makers are mold makers with the job demand of attaining sustained static posture with inconsistent time duration and repetitive work. Thus, they are more prone to develop musculoskeletal disorders. Rapid entire body assessment (REBA) is a widely used tool for ergonomic assessment of workplace postures. This study used the REBA scale to evaluate postures and identify potential ergonomic risks associated with postures and movements. Analysis of work posture will help to identify areas for improvement in the work environment.

AIMS:
The aim of the study was to assess the risk of developing work-related musculoskeletal disorders in jewelry die makers.

SETTINGS AND DESIGN:
This was a descriptive, cross-sectional study conducted at Chinchani village, Palghar district.

SUBJECTS AND METHODS:
Two hundred and nine adult males between the age group of 18 and 60 years who had completed a training period of 6 months and working as jewelry die makers in a home-based setting were included, and their working postures were assessed using the REBA scale. Jewelry die makers already diagnosed with musculoskeletal or neurological conditions or part-time workers and those using computers for their jobs were excluded from the study. Demographic data and additional work-related information were collected using a self-made questionnaire by interview method. Two subject experts validated the self-made questionnaire before its application.

STATISTICAL ANALYSIS USED:
The components of the self-made questionnaire, such as work posture, total hours of sustaining work posture, number of breaks during work hours, and areas of discomfort while sustaining work posture, were analyzed. Detailed neck, trunk and leg analysis, arm and wrist analysis were interpreted using the scoring method of the REBA Employee Assessment Worksheet.

RESULTS:
According to the REBA score, 163 of 209 participants fall under medium-risk work posture, 38 fall under high-risk work posture, but unexpectedly, 53% reported no discomfort, which indicates that many of them are unaware of their faulty work posture. Only 8 participants indicate low-risk work posture.

CONCLUSIONS:
The study concludes that few jewelry die makers are at high risk and require immediate medical attention and intervention, whereas the majority are at medium risk. This suggests the necessity of investigation and action for a change in work posture when assessed using the REBA scale. A rare number of participants are at low risk.
Periodontal microsurgery: Achieving unprecedented levels of precision – A narrative review
Authors: Leslie C. Cynthia , Vijayarangan Anitha , Elumalai Agila 
Published: December 2024

ABSTRACT
Magnification in periodontics can transform clinical notions of surgical periodontal treatment. With the introduction of contemporary technological advancements, like microsurgery, periodontology has experienced exponential growth. Microsurgery is linked to better visual perception, ergonomic advantages, lower patient complications, faster healing, and increased patient acceptability in periodontal therapy. When minimally invasive surgical procedures are paired with periodontal microsurgery, a clinician’s accuracy in manipulating tissues is enhanced, providing the most predictable outcome. This review aims to highlight the advantages of periodontal microsurgery, including improved diagnostic ability, treatment quality, and patient outcomes. It also addresses the role of microsurgery in periodontal plastic surgery, which involves the use of microsurgical instruments and techniques for microsurgical knot tying. The review concludes that microsurgery provides substantial benefits over conventional surgery, enhancing patient acceptability and outcomes.