bluuebunny/crossref_metadata_2025_split huggingface dataset:
Soluble transferrin receptor and soluble transferrin receptor/log ferritin index in coronavirus disease 2019
Authors: Abdalla Abdalla E. , Doha Saad A. , Nashaat Soliman M. , Alaa El-Din Abdel-Hamid S. , Mohammed Saad A. , Hebat-Allah Nashaat H. 
Published: December 2024

Background
The coronavirus disease 2019 (COVID-19) pandemic impacted a huge number of people worldwide, with high morbidity and mortality. Consistent findings indicated a potential role of iron parameters, hyperferritinemia, and ferroptosis in the pathogenesis of multiorgan failure, and it might serve as a new treatment target. However, no single reliable marker of iron homeostasis exists, as all traditional parameters are influenced by inflammation. Studying soluble transferrin receptor (sTfR) and sTfR/log ferritin takes advantage of the reciprocal relationship between the two variables influenced by iron deficiency and may provide a better understanding of the iron derangement that occurs in COVID-19 infection.

Aim
To assess the pattern of hepcidin, sTfR, and sTfR/log ferritin index in COVID-19 patients, its association with disease severity, complications, and mortality, as well as its validity to be used as a biomarker for complications, severity, and mortality.

Patients and methods
It is a case–control study conducted at Suez Canal University Hospital. A 100 participants were selected and divided into two groups: a study group (50 adult COVID-19 patients) and a control group (50 healthy blood donor volunteers). Clinical data were obtained using a questionnaire, clinical examination, laboratorty, and radiological tests. All participants were tested for iron parameters: serum iron, total iron binding capacity, transferrin saturation percentage, ferritin, sTfR, and serum hepcidin.

Results
COVID-19 patients showed a statistically significant higher sTfR, hepcidin, and sTfR/log ferritin index (P<0.0001) and statistically significant lower serum iron and total iron binding capacity (P<0.001). High sTfR was associated with higher mortality 58.1% and a lower percentage of recovery 41.9%. The relative risk of fatal outcome in the high sTfR subgroup is 4.07 times that in the normal sTfR subgroup.

Conclusion
sTfR level and sTfR/log ferritin index are significantly elevated in COVID-19 infection. They could be considered significant biomarkers correlated to the severity, complications, and outcome of COVID-19 infection and add clinical value to predict disease progression among COVID-19 patients.
Interleukin-6 and tumor necrosis factor-α levels in chronic lymphocytic leukemia: correlation with patients’ characteristics and outcome
Authors: Al-Adl Menna , Elwasefy Shereen Ahmed , Youssef Magdy M. , El-Said Afaf , Refaat Sherif , EL-Sebaie Ahmed , Badawy Heba K. 
Published: December 2024

Background
Chronic lymphocytic leukemia (CLL) is a malignant disease of the blood characterized by the proliferation of mature B-lymphocytes in the bone marrow and lymphoid tissues. The altered functions of innate immune elements and adaptive immune factors are interconnected in CLL and are decisive for its onset, evolution, and therapeutic response. This study aimed to investigate the correlation between serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels and outcomes in CLL.

Patients and methods
Serum IL-6 and TNF-α levels were measured by enzyme-linked immunosorbent assay from 100 Egyptian patients newly diagnosed with CLL and 100 age-matched and sex-matched healthy individuals. Cytokine levels were correlated with clinical features and the response after receiving chemotherapy.

Results
Serum IL-6 and TNF-α levels were significantly higher in CLL patients than controls (median, 49 vs. 6.2 ng/l and median, 38.5 vs. 4.16 ng/l, respectively). A significant association was found between IL-6 and TNF-α levels and abnormal karyotyping, advanced disease stage, higher white blood cells, lymphocyte count, β2 microglobulin, and lactate dehydrogenase concentrations (P<0.001 for each). No significant difference between the responder and nonresponder patients after receiving chemotherapy was noticed regarding both IL-6 and TNF-α levels.

Conclusion
Serum IL-6 and TNF-α levels were correlated with advanced CLL stage and worse prognosis but were related to the patient’s outcome after receiving chemotherapy.
Assessment of renal function in long-term surviving children after hematopoietic cell transplantation
Authors: Sallam Dina E. , Mohamed Wafaa E.I. , Ahmed Abdel-Rahman H. , Taha Sara E.A.-F. , Matbouly Safa 
Published: December 2024

Background
Hematopoietic stem cell transplantation (HSCT) is the standard therapy for many disorders, however long-term complications post-HSCT in pediatrics remain a significant concern, where a pre-existent subclinical kidney damage, the use of nephrotoxic medications, or consequences of primary disease carry the hazard of acute kidney injury (AKI) and chronic kidney disease (CKD), which could be devastating complications, therefore identification of risk factors, prompt diagnosis, and treatment of CKD is vital for secure HSCT. So, we aimed to assess the kidney function to detect the development of CKD in our pediatric patient, using different formulas to measure the estimated glomerular filtration rate (eGFR).

Patients and methods
A prospective cross-sectional study was conducted at the Bone Marrow Transplantation Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt, where we included all available HSCT long-term survivors, who underwent HSCT during the period between 2011 and 2018. A detailed medical history and complications were collected from patient’s medical records, while clinical examination with measurement of serum creatinine, and Cystatin C (CysC) were done to determine eGFR, and hence CKD, using different methods; bedside Schwartz and Cockcroft Gault formulas (according to the age), serum CysC, and Chronic Kidney Disease in Children (CKiD) Creatinine-Cystatin C-based CKiD equation (CKiD-eGFR CysC formula).

Results
We included 23 pediatric HSCT survivors, with a mean (±SD) age of 14.35 (±5.27) years. Most of our patients were diagnosed with aplastic anemia (43.5%) and beta-thalassemia major (26.1%), where HSCT, 87% was allogeneic, 4.3% cord blood; meanwhile 8.7% was autologous. The most common reported complications were AKI (56.5%), and acute Graft-versus-host disease (43.5%), meanwhile, CKD was reported in 4/23 (17.4%) according to serum creatinine bases formulas, and one (4.3%) patient according to serum cystatin C, and two (8.6%) patients based on CKiD-eGFR CysC formula. CKD was linked to the conditioning regimen by Cyclophosphamide and antithymocyte globulin, the use of vancomycin and aminoglycoside, and the history of AKI.

Conclusion
CKD is not uncommon complications post-transplantation, and is strongly correlated to the previous conditioning regimen, antimicrobials, and history of AKI. The accuracy and early diagnosis of CKD necessitated the use of combined equations of eGFR calculation. CKD Controllable measures are needed to prevent renal insult in children post-transplantation.
Genetic analysis of driver mutations in classical myeloproliferative neoplasms – a study from a South Indian Tertiary Care Center
Authors: Pai Usha K.N. , Sankarankutti Ragitha T. , Rafi Aboobacker M. , John Mithun C. , Raj Soumya , Earali Jerry , Raveendran Suresh K. 
Published: December 2024

Background
Despite being one of the most populated and diverse countries in the world, there is a paucity of data on the prevalence of driver mutations in classical myeloproliferative neoplasms (MPN) in India.

Aim
In the present study, we aimed to analyze somatic driver mutations such as JAK2, CALR, and MPL in classical MPNs in a South Indian Tertiary Care Center.

Patients and methods
Out of 185 suspected MPN patients screened, based on WHO 2016 criteria, 72 MPN patients were included in this study. JAK2V617F and MPL mutations were screened using an allele-specific PCR assay. JAK2 exon 12 and CALR exon 9 mutations were screened by PCR Sanger sequencing.

Results
In the present study, JAK2V617F mutation was detected in 88.8% of polycythemia vera, 66.6% of essential thrombocythemia, and 53.3% of primary myelofibrosis (PMF) cases. CALR mutations were observed in 16.6% of essential thrombocythemia and 13.3% of PMF patients. In addition to the common type 2 mutation, we identified a rarely reported type 2-like mutation (c.1154_1155insATGTC) in a PMF patient. The identified mutations were mutually exclusive. We observed an absence of JAK2 exon 12 and MPL mutations in our study participants.

Conclusion
In the present study, we observed JAK2 and CALR mutations in 77.7 and 5.5%, respectively, in classical MPNs. We identified a rare CALR type 2-like mutation in a PMF patient, a first report from India.
Efficacy of vitamin D supplementation on clinical outcomes of children with sickle cell disease
Authors: Ebeid Fatma S.E. , Sallam Sara F.A. , Mostafa Salwa , Gohar Ahmed M.S. , Tolba Marwa W. , Adly Amira A. 
Published: December 2024

Background
Vitamin D deficiency (VDD) is a common nutritional burden among children with sickle cell disease (SCD).

Aims
To measure VD levels in children with SCD and to assess the safety and efficacy of its supplementation on clinical outcomes.

Patients and methods
This follow-up prospective study recruited 50 children and adolescents with SCD at their steady state. Patients were clinically assessed and had their complete blood count, liver and kidney function tests, serum ferritin, and serum 25-hydroxyvitamin D level assessed. Patients with VDD were treated with oral VD supplementation (6000 units daily) for 3 months and reassessed.

Results
A high prevalence of VDD (46%) is found in children with SCD. Those with VDD had statistically significant higher frequencies of fracture (P=0.023), joint and bone pain (P=0.001), sickle crisis (P=0.004), hospital admission (P=0.019), and infections (P=0.042). There was a statistically significant negative correlation between pretreatment VD levels and the number of crises (P=0.043). After VD supplementation, there was a statistically significant improvement in VD level (P≤0.001) and a reduction in the number of crises (P≤0.001) and hospital admission rate (P≤0.001).

Conclusion
The high prevalence of VDD in young SCD patients highlights the importance of early VD supplementation that improves their clinical outcomes without affecting their safety.
Rare bleeding disorders in girls and adolescent females with bleeding symptoms
Authors: Mokhtar Galila M. , Ramzy Mina E. , Mohammed Walid E. , Fadel Michael , Ebeid Fatma S.E. , Tolba Marwa W. 
Published: December 2024

Background
Females with rare bleeding disorders who suffer from mild bleeding symptoms and extra bleeding symptoms related to menstruation are usually delayed in their diagnosis, necessitating early evaluation for an underlying bleeding diathesis based on clinical suspicion.

Objectives
We aimed to assess the frequency of rare bleeding disorders among female children and adolescents presenting with bleeding symptoms and to evaluate their health-related quality of life.

Patients and methods
Sixty females with bleeding symptoms younger than 18 years old were recruited and were subjected to detailed medical assessment and evaluation of different bleeding symptoms using the ISTH-BAT, the menstrual pictogram for assessing menstrual blood loss in pubertal females, and the Arabic version of the pediatric quality of life multidimensional fatigue scale. Laboratory investigations are tailored according to the institutional guidelines.

Results
The median age of the studied population was 8.25 years and 48.3% had a positive family history of bleeding. The mean age of presentation/diagnosis of Von Willebrand disease and Glanzmann disease were 6.1/8.2 and 5.3/7.6 years, respectively. Forty-five females had inherited bleeding disorders, and 15 had acquired ones. The most common diagnosis was Von Willebrand disease (30%), followed by Glanzmann disease (18.3%). The most common acquired disorder was aplastic anemia (13.3%). There was a higher ISTH-BAT total score in those with inherited disorders than in those with acquired disorders (P=0.006).

Conclusion
Adolescent females who present to a tertiary pediatric or gynecology service with bleeding manifestations should be screened for underlying bleeding disorders.
Screening for extended blood grouping in children with transfusion-dependent beta thalassemia
Authors: Elfadaly Heba E. , Elagamy Osama A. , Eldegwi Marwa , Elhawary Eslam E. 
Published: December 2024

Background
Beta-thalassemia is the most common genetic disorder that causes chronic hemolytic anemia. Transfusion therapy and iron chelation are the cornerstones in the management of thalassemia.

Aim
To screen children with transfusion-dependent beta-thalassemia for the presence of minor blood groups.
Patients and methods
This cross-sectional study was carried out on 30 children on transfusions for at least a year.

Results
Nine (30%) patients were negative for RH and 21 (70%) were positive. Ten children had type A blood, twelve had type O blood, five had type B blood, and three had type AB blood. Four (13.33%) patients tested positive for minor blood group antigens, whereas 26 (86.67%) tested negative. Two children tested positive for e-antigen, one for the Kell antigen, and one for the Fya antigen. Five (16.67%) patients tested positive for minor blood group antibodies and 25 (83.33%) tested negative. There was a robust relationship between the frequency of blood transfusions and minor blood group antibodies. There was a significant correlation between patients’ minor blood group antibodies and their RH phenotype.

Conclusion
This study highlights the importance of considering minor blood group antibodies in managing blood transfusions for children with thalassemia. Positive minor blood group antibodies are associated with a need for more frequent transfusions. However, ABO blood group and minor blood group antigens themselves did not significantly affect transfusion frequency in this study.
An Observational Study Comparing Laminoplasty versus Lateral Mass Screw Fixation in Multilevel Cervical Compressive Myelopathy
Authors: Sarathy R. Partha , Bansal Sumit , Sekar Arunkumar , Patnaik Ashis , Sahu Rabi Narayan 
Published: December 2024

Abstract

Background:
The management of multilevel degenerative cervical myelopathy (DCM) is still controversial. Patients with DCM can be treated nonsurgically or surgically, depending on symptom progression, severity, and radiological characteristics. Surgical treatment can be performed using either an anterior or posterior approach or both in some circumstances, each with a unique set of indications and limitations.

Objective:
The objective of the study was to compare the outcomes of laminoplasty (LP) and laminectomy with lateral mass fixation (LMS) in multilevel DCM.

Material and Methods:
Patients with cervical compressive myelopathy operated by posterior approach between January 2021 and December 2023 were included. Outcomes were assessed with a modified Japanese Orthopaedic Association score (mJOA), Nurick grade, neck disability index (NDI), and Ishihara score (cervical curvature index [CCI]).

Results:
Forty patients were included of which 16 patients underwent LP and 24 patients underwent LMS. Significant improvement was noted postoperatively in both the groups in mJOA score, Nurick grade, and NDI. No gross improvement was seen in CCI. Operative time and implant cost per level were significantly less in LP. Recovery rates were comparable in all the measured parameters, namely mJOA score, Nurick grade, NDI, and Ishihara index in both groups.

Conclusions:
LP and lateral mass fixation lead to significant clinical improvement with no significant worsening in cervical lordosis. LP had less operative time with a better range of cervical motion and a cost-effective procedure in patients without cervical deformity while LMS was found to be more appropriate for kyphotic/deformed cervical spine.
A Case of Osteoid Osteoma of a Rib Masquerading as Painful Scoliosis
Authors: Sha I. Ibad , Majeed Ibrahim S. , Kurian Nishant 
Published: December 2024

Abstract
Osteoid osteoma (OO) is a benign bone tumor that typically affects the long bones of the lower extremities. Rare cases of rib involvement present with atypical symptoms, such as painful scoliosis, which can complicate diagnosis. Here, we describe a case of a 10-year-old girl who presented with scoliosis and back pain initially misattributed to idiopathic scoliosis. Comprehensive radiologic assessment ultimately revealed an OO in the rib, which was successfully treated with computed tomography-guided radiofrequency ablation (RFA). This case highlights the necessity of thorough diagnostic evaluation for atypical presentations of scoliosis and supports the use of RFA as an effective treatment for rib OO.
The Role of Electrosurgery in the Management of Orthodontic Treatment-Induced Inflammatory Gingival Enlargement: A Report of Three Cases
Authors: Sharma Himani , Deka Jagriti , Thakur Srishti , Kashid Amit 
Published: December 2024

Abstract
Orthodontic treatment, while beneficial for correcting dental alignment and improving oral health, can sometimes lead to complications such as inflammatory gingival enlargement (IGE). This condition, characterised by the overgrowth of gingival tissues, can cause discomfort and aesthetic concerns and impede oral hygiene, potentially leading to further periodontal issues. Electrosurgery has emerged as an effective treatment modality for managing this condition. This report examines the use of electrosurgery in three cases of orthodontic treatment-induced IGE, highlighting its efficacy, advantages and outcomes.
Odontogenic Keratocyst: Theory of Its Origin
Authors: Dhanrajanijani Parmanand 
Published: December 2024

Abstract
Generally, it is believed odontogenic keratocyst (OKC) originates from remnants of the dental lamina. However, a tooth is generally not missing and, therefore, they are believed to originate from additional remnants of the lamina not involved in tooth formation. A case of an OKC arising in the mandible 4 years after the removal of a wisdom tooth is presented to discuss its likely origin. This present case might be one in which the remnants of dental lamina might have stirred up in developing OKC post-removal of wisdom tooth.
Postthoracotomy Pain: The Unanswered Question Yet – A Clinical and Technical Report
Authors: Singh Dewan Roshan 
Published: December 2024

Abstract
Thoracotomy which is a major surgical procedure of making an incision through the thoracic wall in order to gain access to the thoracic organs, is a cornerstone of diagnosis and management of numerous cardiopulmonary disorders. Nonetheless, most essential area of patient care, postoperative pain management, presents several obstacles. Published literature shows that about three-quarters of the thoracotomy patients reported immediate pain or discomfort during the early postoperative period, and up to 30%–50% patients might even develop chronic pain that has implications on their health related quality of life. Consequently, the causes of continued pain after thoracotomy are numerous and range from the intricacy of the procedure, patients’ tolerance to pain and diseases among others. Pain control is essential to avoid the risk of the deterioration of lung function, poor patient mobilization, and prolonged hospital stay. It is therefore undoubted that if pain continues for a long period, one may develop chronic pain syndromes that drag down the quality of life even further. In attempts to resolve these problems, different types of analgesic measures have been attempted. Some interventional procedures have been reported recently to be useful: Fascial plane blocks, which interfere with the flow of pain messages. Routes such as thoracic paravertebral block, intercostal nerve block, serratus anterior plane block, pectoral nerve block, and the retrolaminar block give variable levels of anesthesia in the required area. Some newer blocks such as the rhomboid intercostal and serratus sparing (RISS) block seem to provide a wide complete analgesia of the posterior and lateral chest walls. Thus, in an intermediate-term pain management strategy, fascial plane blocks can be used together with medications such as paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs). It is a kind-of medicine that is frequently used because of its effectiveness accompanied by a tendency to produce minimal side effects and interact well with opioids without posing the risks inherent in the application of NSAIDs. They have significant analgesic and anti-inflammatory properties thus decreasing the dependence on opioids. Their use, therefore, comes with a lot of precautions due, prompt for example per both gastrointestinal bleeding and renal impairment, hence, requires patient spotlight and assessment. Therefore, in enhancing postthoracotomy pain regime, a multimodal approach that includes the use of fascial plane blocks in combination with paracetamol and prudent use of NSAID can improve the recovery process and henceforth the patient’s outcomes without subjecting the patients to adverse effects.
Dr ALM’s Medico Legal Series-Part 4-Sponge Left Inside the Abdomen-Gross Medical Negligence (Sweta Khandelwal vs Dr. A.K. Jain & 2 Ors. on 3 June, 2022, NCDRC, NEW DELHI Revision Petition NO. 1989 of 2016)
Authors: Sundaram Alagappan Meenakshi 
Published: December 2024

Abstract
Foreign body left peroperatively in the abdomen is a nightmare for the surgeon and prevention is always better than cure. Cesarean delivery (LSCS) was conducted on Sweta Khandelwal at Delhi. The patient was discharged though her condition was not good. She approached the doctor again, but she was sent back stating that everything was fine. Her sutures were removed, but she was not feeling well. She again visited the doctor who told her that it was a problem of indigestion. On September 23, 2012, she developed unbearable abdominal pain, and her abdomen was swollen. She was admitted in a different hospital in Delhi and was operated. During the operation, the doctors found infected sponge and 1.5 l of pus in the pouch of Douglas (POD). She was discharged in good condition. Thus, being aggrieved by the alleged carelessness of the doctors, the patient filed a complaint before the National Commission. The National Commission found the Doctors are grossly negligent and directed to pay Rs. 5 lakh to the patient within 6 weeks from the receipt of copy of the orders, failing which the doctors shall be liable to pay 7% interest till its realization.