bluuebunny/crossref_metadata_2025_split huggingface dataset:
The immunohistochemical biomarker B-cell lymphoma-2 expression in malignant and premalignant lesions of the uterine cervix and its association with human papillomavirus infection
Authors: Nayak Prasanta Kumar , Hussain Nighat , Negi Sanjay , Agrawal Sarita , Bagde Nilaj , Mitra Subarna , Singh Vandita 
Published: August 2021

Introduction:
Cervical cancer is one of the leading causes of cancer deaths among women. It results due to human papillomavirus (HPV) infection. Cervical intraepithelial neoplasia (CIN) is the preinvasive condition of cervical cancer. Various objective immunohistochemical (IHC) markers have been studied for cervical cancer. This study is aimed at studying the expression of B-cell lymphoma-2 (Bcl-2) IHC marker among preinvasive and invasive lesions of cervical cancer and its association with HPV infection.

Methodology:
This prospective study was conducted over a period of 1 year in a tertiary care hospital in central India, included 73 women suffering from CIN and cancer cervix. The expression of Bcl-2 and the presence of HPV genotypes were studied.

Results:
Out of 73 patients, 34 had cancer cervix, out of which 15 (44%) had Bcl-2 positivity, 24 had CIN 1, out of which 13 (54%) had Bcl-2 positivity, 10 had CIN 2, out of which 4 (40%) had Bcl-2 positivity and 5 had CIN 3, out of which 3 (60%) had Bcl-2 positivity. No significant difference was found in Bcl-2 positivity among CIN-1, CIN-2, CIN-3, and cancer cervix cases with a Chi-square value of 1.116 and P = 0.77. HPV positivity was found in 41 (56%) out of 73 patients where HPV 16 subtype was the most common (31.5%), followed by HPV 18 (13.7%). No significant association between HPV positivity and Bcl-2 positivity was found with P = 0.34.

Conclusion:
Bcl-2 IHC seems to have variable expression among CIN cases. Although its expression is low among invasive cancer cases when compared with preinvasive lesions, the difference is not significant. Similarly, no significant association was found between Bcl-2 expression and HPV infections.
Expression of oncolong noncoding RNA taurine-upregulated gene-1 in colon cancer
Authors: Abushouk Abdelrahman I. , Kattan Shahad W. , Ahmedah Hanadi T. , Baothman Eshrag , Shaheen Sameerah , Toraih Eman A. , Fawzy Manal Said 
Published: August 2021

Context:
Recent studies confirmed that dysregulation of long noncoding RNAs (lncRNAs) is a potential contributor to the development and progression of colon cancer. However, the prognostic value of these RNA molecules remains controversial.

Aims:
This study aimed to investigate the expression of taurine-upregulated gene-1 (TUG1) lncRNA in colon cancer and its clinical implications.

Subjects and Methods:
A retrospective study on 47 formalin-fixed, paraffin-embedded samples of surgically resected primary colon cancer specimens was done. Total RNA purified from the colon cancer samples and noncancer adjacent tissue sections was quantified by real-time reverse transcription-polymerase chain reaction (qRT-PCR) to assess TUG1 relative expression levels normalized to GAPDH endogenous control. Also, in silico data analysis was applied.

Statistical Analysis Used:
The relative expression levels were calculated using the LIVAK method. The survival rates were assessed using the Kaplan–Meier curves and the Cox proportional model. P < 0.05 was considered statistically significant.

Results:

TUG1expression in the colon cancer specimens was significantly overexpressed (median = 21.50, interquartile range [IQR]: 7.0–209.2; P = 0.001) relative to the noncancerous tissues. In silico analysis confirmed TUG1 upregulation in colon carcinoma (median = 13.92, IQR: 13.5-1432). There were no significant associations between TUG1 expression and clinicopathological characteristics, such as the site, grade, stage, histopathological type, or the rates of lymphovascular invasion and relapse. Similarly, Kaplan–Meir and Cox multivariate regression analyses showed that TUG1 expression could not predict the overall survival and progression-free survival in colon cancer patients of our population.

Conclusions:
This study confirms the overexpression of TUG1 lncRNA in colon cancer tissues. Larger sample size is warranted to further elucidate the specific role of TUG1 in colon cancer.
Association of atopic dermatitis with an increased risk of systemic lupus erythematosus
Authors: Ponvilawan B , Charoenngam N , Wongtrakul W , Ungprasert P 
Published: August 2021

Context:
Previous studies on the association between atopic dermatitis (AD) and systemic lupus erythematosus (SLE) have yielded inconsistent results.

Aims:
To investigate the relationship between atopic dermatitis and systemic lupus erythematosus.

Settings and Design:
Systematic review and meta-analysis.

Materials and Methods:
A systematic review was conducted on EMBASE and MEDLINE databases from inception to March 2020 using a search strategy that consisted of terms related to AD and SLE. Eligible study must be either cohort or case-control study. For cohort studies, they must include patients with AD and comparators without AD, then follow them for incident SLE. For case-control studies, they must include cases with SLE and controls without SLE and examine their prior history of AD.

Statistical Analysis Used:
Meta-analysis of the studies was performed using a random-effect, generic inverse variance method to combine effect estimate and standard error. Funnel plot was used to assess publication bias.

Results:
A total of 21,486 articles were retrieved. After two rounds of review by three investigators, six case-control studies were qualified for the meta-analysis. The case-control study meta-analysis found a significantly increased odds of SLE among patients with AD with the pooled odds ratio of 1.46 (95% CI, 1.05–2.04).

Conclusions:
A significant association between AD and increased odds of SLE was observed by this systematic review and meta-analysis.
Oral Cavity Reconstruction with Pedicled and Free Flaps
Authors: Teli Zahoor Ahmad , Kantharia Rajesh Arvind , Kantharia Shehnaz R. , Vyas Siddharth Mahesh , Bhatt Yogesh , Doshi Piyush 
Published: August 2021

Background:
In Indian subcontinent, oral cavity cancer is the most common cancer in males and the 4th most common in females. Seventy percent of these patients present in advanced stages and resection of these advanced cancers lead to complex orofacial defects requiring primary reconstruction to restore form, function, and cosmesis.

Aim:
This study aims to evaluate the results of pedicled and microvascular free flaps (MFFs) for oral cavity defects following resection of locally advanced oral cancer.

Materials and Methods:
A retrospective analysis of prospectively collected data of patients who underwent composite resection followed by reconstruction with pedicled or MFFs for locally advanced oral cancer from January 2018 to September 2019 was done. The demographic details, primary tumor site, tumor stage, defect type, flap type, and complication rates were analyzed.

Results:
Primary reconstruction was offered to 540 patients with pedicled flaps for 421 patients and MFFs for 119 patients. Patient distribution as per current Tumor, Node, and Metastasis staging was pT1/T2: 91, pT3: 179, and pT4: 270. Reconstruction offered for different oral cavity subsites was – buccal mucosa (n = 374), retromolar trigone (n = 10), alveolus (n = 75), tongue (n = 52), lower gingivobuccal sulcus (n = 11), floor of mouth (n = 4), upper gingivobuccal sulcus (n = 5), and lower lip (n = 9). We classified the types of defects into mucosal (n = 32), mucosal with bone (n = 370), mucosal with bone and skin (n = 101), mucosal with skin (n = 14), skin (n = 3), and central mandibular arch (n = 20). The overall rate of complications in pedicled flaps was 12.11% and MFFs was 20.16%. The success rate for pedicled flaps was 100% and for MFFs was 94.96%.

Conclusion:
In our study, MFF reconstruction had a good success rate with satisfactory functional and cosmetic outcomes.
Prescription Pattern of Drugs in Pediatric Cancer Patients in a Tertiary Care Hospital
Authors: Manjesh P S , Shetty Yashashri C. , Chinnaswamy Girish , Patankar Panini Shrikant 
Published: August 2021

Aims:
The objective of the current study was to evaluate prescription pattern and to assess off-label use of drugs used in treatment of pediatric cancer patients.

Subjects and Methods:
This was a cross-sectional, observational study where patients who presented to the hemato-oncology and solid tumors Outpatient department at a tertiary cancer care hospital were prospectively recruited. Patients of either gender or age between 3 months and 15 years diagnosed with cancer and who has received treatment for at least 6-week duration were included. Demographic details, diagnosis, medication details, and off-label use were analyzed. Prescribing indicators and off-label use were analyzed by descriptive statistics using Microsoft Excel version 2019.

Results:
Of 300 patients recruited, 67% were male and 33% were female, with a median age of 75 months (interquartile range: 42–129 months). One hundred and seventy-one (57%) patients suffered from hematological cancers, while those having solid tumors were 129 (43%). Most common hematological cancer was found to be acute lymphoblastic leukemia – 126/171 (73.68%) and among 129 solid tumor patients, the most common cancer was found to be Ewing's sarcoma (29). A total number of 944 drugs were prescribed in 300 prescriptions studied. Out of 944 drugs prescribed, 346 (36.65%) were anticancer drugs and 598 (63.35%) were concomitant drugs. Most common anticancer drug prescribed in hematologic cancer was found to be vincristine (60/270), and in solid tumors also, it was vincristine in 24/76. Off-label prescriptions were found mainly in solid tumors in 80.26% (61 out of 76 anticancer drugs), whereas for hematological cancers, it was 3.33% only. The most common drug use off label in solid tumors was Cyclophosphamide.

Conclusions:
The study reflects the general pattern of drugs used in the treatment of various pediatric cancers and the extent of unavailability of chemotherapeutic agents – more so in the solid tumors' treatment.
Vocal Fold Leukoplakia
Authors: Swain Santosh Kumar , Panda Swaha 
Published: August 2021

Background:
Vocal fold leukoplakia (VFL) is a term used to document a white patch on the mucosa of the vocal folds. It is caused by prolonged use of smoking, consumption of alcohol, excessive drying, or voice abuse and is considered premalignant lesion of the larynx.

Aim:
The study aims to analyze the demographic and clinical parameters, pathological findings, and management of VFL patients, as well as the incidence of laryngeal cancer among these patients.

Materials and Methods:
We retrospectively collected 92 VFL patients who received treatment during November 2015 to December 2018 and followed up for a minimum period of 2 years up to December 2020. The detail clinical characteristics including endoscopic findings, postoperative pathological findings, and management were assessed from the patient's file.

Results:
The mean age of presentation was 64.3 years, with 52 male and 40 female patients. We found cigarette smoking as the most common etiological factor, which was seen in 45 patients (48.91%) followed by alcohol consumption and laryngopharyngeal reflux. Seventy-seven patients underwent surgery (42: carbon dioxide laser excision and 35: coblation-assisted excision), and rest 15 patients treated conservatively. On postoperative, the different pathological variants encountered were nondysplasia (n = 41); low-grade dysplasia (n = 24); high-grade dysplasia (n = 5); carcinoma in situ (n = 4); and invasive carcinoma (n = 3). Factors such as age (P < 0.001) and morphological types (P = 0.043) have been significantly correlated with pathological grades of VFL.

Conclusion:
The invasive laryngeal cancer detection rate underlying VFL at first diagnosis was 3.90%. The early diagnosis of VFL and treatment are challenge for clinicians to decrease the incidence of laryngeal malignancy. The patient's age and morphological types may guide treatment of VFL due to risk stratifications.
Assessment of knowledge, practice, and level of preparedness of dentists practicing in Nigeria toward COVID-19 pandemic
Authors: Oyedele Titus Ayodeji , Ladeji Adeola M. , Adeyemo Yewande I. , Abah Aderonke A. , Coker Modupe O. 
Published: August 2021

Introduction:
The coronavirus disease pandemic (COVID-19) had a global impact on health sectors including dentistry. As dental services have to be performed and cannot be withheld for a prolonged period, dentists should prepare themselves to understand the disease process and to face future treatment challenges in affected patients to fully resume dental services. There was a need to evaluate the knowledge of dentists on Covid-19 disease process, and readiness in practicing dentistry in this situation.

Aim:
This study aimed at assessing the knowledge, practice, and level of preparedness of dentists in Nigeria towards the COVID-19 pandemic.

Materials and Methods:
An online cross-sectional survey involving dentists practicing in Nigeria was carried out using the SurveyMonkey™ platform. The link for the questionnaire from the platform was forwarded to dentists individually and on platforms of various oral health-care providers. The questionnaires tested for knowledge, practice, and preparedness of the respondents to the COVID-19 pandemic. Their biodata and practice experiences were also collected. Data were electronically retrieved from the SurveyMonkey platform in Excel spreadsheet and analysis was done; statistical significance was established at P ≤ 0.05.

Results and discussion:
A total of 209 dentists participated in the online survey; there were more respondents from the age group of 25 to 34 years. Majority of the participants practiced in the tertiary setting. Over 97% of the respondents first learned about the novel coronavirus through the media; 97.1% agreed that the main mode of spread of severe acute respiratory syndrome coronavirus-2 is through respiratory droplets on close contact, and 91.4% agreed on spread through respiratory droplets on surfaces. Over 35% had no previous training on infection and prevention control (IPC) and 50% of the centers where the respondents practice had no IPC committee. Ninety-nine percent of the respondents have heard about personal protective equipment (PPE), but only 51.5% had PPE in their clinic, while 33.7% of these have had training on the use of PPE. Over 80% of respondents exhibited fear; junior residents were the most fearful, and 67% of respondents from tertiary institutions have limited their procedures during this pandemic.

Conclusion:
This study showed that COVID-19 pandemic poses a new threat to dental practices worldwide and Nigeria in particular. Therefore, the practice of dentistry must evolve in the presence of COVID-19.
Prevalence of burnout and practice-related risk factors among dentists in Saudi Arabia
Authors: Asali Ammar Talal Abdelrahman , Pullishery Fawaz , Ibrahim Nada Mohammed , Tobji Wasmah Waheeb 
Published: August 2021

Introduction:
Dentists are exposed to a high level of stress at the workplace and are at higher risk of experience burnout. Burnout has profound consequences on quality of life, patient care, and also on the health-care system.

Aim:
The present study aimed to assess the prevalence of burnout among dentists and identify its relationship with the work-setting factors in Saudi Arabia.

Materials and Methods:
A cross-sectional online survey was conducted using a pretested and structured questionnaire. A mixture of convenience and snowball sampling was used to collect the responses from dentists using two versions of the 22-item Maslach Burnout Inventory Scale that had three domains: emotional exhaustion (EE), depersonalization (DP), and feeling of decreased accomplishment. Dentists with scores on EE ≥ or DP ≥10 were considered to have the manifestation of burnout.

Results and Discussion:
The prevalence of burnout in dentists was found to be 33.4% and Saudi dentists experienced more burnout than non-Saudi dentist (P < 0.05). Among different dental specialties, prosthodontists and endodontists showed more prevalence than any other specialties (P < 0.05). Dentists who worked in clinical settings and also who worked more than 40 h/week experienced more burnout than others (P < 0.05).

Conclusion:
The prevalence of burnout among dentists working in Saudi Arabia was found to be 33.45%, and it was significantly more among Saudi dentists than expatriate dentists. Occupational burnout among dentists is a serious problem and should be dealt with appropriate interventions such as stress management training, coping up skills, organizational or structural change to reduce workload, and effective use of leisure time activities.
Investigation of fetal absorbed dose in V/Q scan in three trimesters of pregnancy using Monte Carlo simulation
Authors: Vakili Shahabeddin , Shahbazi-Gahrouei Daryoush , Pourasbaghi Parastoo , Raeisi Elham 
Published: August 2021

AbstractThe ventilation/perfusion (V/Q) single-photon emission computed tomography is the first method of diagnosis for pulmonary embolism in pregnant women. This study aimed to calculate the fetal absorbed dose and compare to recommended values in V/Q scan at three trimesters of pregnancy by Monte Carlo simulation (code MCNPX) using simulated phantoms, based on the adult female MIRD phantom. The collection of pregnant women phantoms (that of Stabin) was designed with changes in the MIRD phantom. Source organs were defined for each of the radiopharmaceuticals used in two scans, 133Xe and 81mKr for the lung and bladder and technetium diethylene-triamine-pentaacetate (99mTc-DTPA) aerosol for lung ventilation scan. Also, technetium macroaggregated albumin (99mTc-MAA) for lung ventilation scan, lung, bladder, and liver. Fetal absorbed dose was calculated and evaluated for the administration radiopharmaceuticals using the MCNP simulation output. For 200 MBq 99mTc-MAA, fetal absorbed dose was 1.01–1.97 mGy, which is higher than the values recommended by International Commission on Radiological Protection (ICRP). The same fetal absorbed dose was found for activities of 54 and 70 MBq in the third trimester. For 99mTc-DTPA-aerosol, fetal absorbed dose as a ventilation tracer was within the permitted range. For 133Xe and 81mKr, it was negligible. It is concluded that the fetus received the highest absorbed dose in the third trimester of pregnancy. For this reason, in this period of pregnancy, it is recommended to use the lower administration activity and her awareness must be done.
Targeted alpha-particle therapy in neuroendocrine neoplasms: A systematic review
Authors: Koh Thuan , Bezak Eva , Chan David , Cehic Gabrielle 
Published: August 2021

AbstractNeuroendocrine neoplasms (NENs) are a very diverse group of tumors with a worldwide rise in incidence. Systemic therapy remains the mainstay treatment for unresectable and/or metastatic NENs. 177Lu-DOTATATE, a radiopharmaceutical which emits beta particles, has emerged as a promising therapy for metastatic gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs). However, limited treatment options are available particularly after the failure of 177Lu-DOTATATE therapy. This review aims to identify and summarize the available evidence for, and potential adverse events of, targeted alpha-particle therapy (TAT) in the treatment of metastatic NENs, specifically GEP-NENs. The MEDLINE, EMBASE, SCOPUS, and Cochrane Library databases were searched. Two articles which met the inclusion criteria were identified and included in the review. Putative radiopharmaceuticals that can be considered for metastatic NEN treatment include 225Actinium (225Ac)-DOTATATE and 213Bismuth (213Bi)-DOTATOC. There was evidence of partial response using both radiopharmaceutical agents without significant hematological, renal, or hepatotoxicity. Future studies should consider longer term, randomized controlled trials investigating the role of TAT, in particular, 225Ac-DOTATATE, in the treatment of metastatic NENs.
Interictal 18F- FDG PET/computed tomography brain in a case of frontoethmoidal encephalocele
Authors: Kousik Vankadari , Satish Kandraju , Rao Sai , Rajesh Boyina 
Published: August 2021

AbstractEncephaloceles, also known as meningoencephaloceles, are a group of neurological disorders characterized by herniation of the cerebral parenchyma along with overlying meninges through openings in the skull bone. They can be seen following congenital defect in neural tube closure or acquired defect in the skull bone. We report a case of acquired frontoethmoidal encephalocele presenting with drug-refractory epilepsy. Interictal FDG PET-computed tomography done for lateralization and localization of seizure focus showed right-sided frontoethmoidal encephalocele associated with hypometabolism in the adjacent right frontopolar cortex, concordant with ictal onset on electroencephalogram.
Determination of administered activities for the treatment of Graves' disease with iodine-131: Proposition of a simplified dosimetric procedure
Authors: Soli Idrissa Adamou , Issoufou Djibrillou Moussa , Rahabi Skander , Ali Ada , Adehossi Eric , Bouyoucef Salah Eddine 
Published: August 2021

AbstractThis prospective study included 35 patients suffering from Graves' disease (GD) clinically and biologically confirmed by endocrinologists, sent to the nuclear medicine department of CHU de Bab El Oued, Algiers for iodine-131 therapy. CHU de Bab El Oued is a tertiary hospital located in the center of the capital Algiers. The aim of this study is to propose a simplified dosimetric procedure which will initiate iodine-131 therapy of GD in particular and hyperthyroidism in general in Niger. The determination of the maximum uptake was performed with a Biodex external probe at 2 h, 4 h, and 24 h after the administration of 3 MBq of liquid iodine-131. The iodine-131 activities were determined using the Marinelli formula with a predefined effective half-life (Te) of 5 days and subsequently extrapolated half-life with kaleidagraph software. The statistical analysis was performed using an excel sheet and analyzed using the software package Statistica 10 (stat Soft, Tulsa, USA). the male:female gender ratio was1:4.5 and the mean age was 42.56 years (±7.14). The body mass index was within normal range with a value of 25.25 kg2 (±0.42) and the mean average thyroid mass was equal to 24.05 (±10.53) g. The mean uptake value at 24 h was 43.24% (±17.68%) meanwhile the maximum uptake value was 46.28 (±21.13%). The estimated effective half-life (Te) was 5.44 days (±1.96) days which were different from the predefined Te of 5 days. The mean activity determined with fixed Te and 24 h uptake was 244.45 (±109.2) MBq and the mean activity calculated with both extrapolated Te and maximum uptake was 452.22 (±381.9) MBq. Empirical determination of activity in the treatment of GD gives higher activities (1.5 times) to patients than dosimetric methods based on the determination of extrapolated effective half-life.