bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prospective study of sequential volumetric changes of parotid gland in early oropharyngeal carcinoma patients treated by intensity-modulated radiation therapy: An institutional experience
Authors: Patel Pooja Nandwani , Goyal Sumit , Shah Anand , Gohel Mehul , Suryanarayana Unnikrishnan 
Published: September 2019

Abstract
Aims and Objectives: During course of radiation therapy, anatomical variations occur risking overdose of parotid gland. We tried to quantify volume of parotid gland and mean dose to parotid gland after every 10 fractions (#). Materials and Methods: We conducted the prospective study from July 2016 to May 2017 in 25 patients of early-stage oropharyngeal carcinoma. Patients had Karnofsy Performance Score of 80–100, median age was 54 years, and 18 patients were males. Patients were planned with intensity-modulated radiation therapy planning with dose as 66 Gy/30# to planning target volume (PTV) including primary and 54 Gy/30# to PTV-nodal including elective neck irradiation. After each 10#, replanning was done, and variations in parotid volume were studied including Dmean(mean dose to parotids) and D50(the dose delivered to 50% of volume). Other tumor characteristic like PTV of primary was also assessed and minimum PTV volume covered by 95% isodose line was kept as 95%. Results: Average parotid volumes decreased by the mean value of 10% and 6% for the left and right parotids, respectively, and PTV of primary target decreased by mean of 13%. The difference in Dmeandoses to parotid glands was 32% and 42% and difference in D50dose was 30% and 35% on the left and right side, respectively. Conclusions: The parotid volumes differ considerably during adaptive planning done after every ten fractions. These differences in parotid volumes and doses received to parotid glands play a significant role in the risk of xerostomia observed during later follow-up.
Estrogen receptor, Progesterone receptor, and human epidermal growth factor receptor-2 status in breast cancer: A retrospective study of 5436 women from a regional cancer center in South India
Authors: Kumar Rekha Vijay , Panwar Dipti , Amirtham Usha , Premalata Chennagiri Srinivasmurthy , Gopal Champaka , Narayana Suma Mysore , Patil Okaly Geetha Vikram , Lakshmaiah K. C. , Krishnamurthy S. 
Published: September 2019

Abstract
Aim: The aim of the study was to analyze the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2) status over 7 years in South Indian women with breast cancer. Further analysis of a subgroup was done to study clinically defined subtypes and the role of preanalytical factors in needle core biopsies (NCBs) and excised specimens. Materials and Methods: This was a retrospective study from January 2010 to December 2016. Patients diagnosed with invasive breast cancer and available immunohistochemistry (IHC) reports of ER, PR, and HER2 status were analyzed. The cases for the year 2016 were analyzed further to observe the impact of preanalytical factors on the IHC staining patterns and surrogate status. Results: A total of 5436 patients were included with a median age of 48 years. Among these, 65% were ≤ 55 years. The overall incidence of hormone receptor (HR)-positive patients was 48%; HER2 positive, 15%; and triple-negative breast cancer (TNBC), 37%. The incidence of HR positive, HER2 positive, and TNBC were 45%, 16%, and 39% and 53%, 13%, and 34% in patients <56 years and over 55 years, respectively (P < 0.001). There was an increase in HR positivity and decrease in TNBCs over time. There was no significant difference in the staining patterns in NCBs and excised specimens. Conclusion: With time, there is an increase in hormone-positive tumors which may be attributed to better IHC techniques and tissue handling. There was no statistical difference in the patterns of ER, PR, and HER2 immunostaining in core biopsy and excised specimens.
Clinical outcome study of crizotinib in immunohistochemistry-proven echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase fusion gene among Indian patients with adenocarcinoma lung
Authors: Batra Ullas , Aggarwal Mohit , Jain Parveen , Goyal Pankaj , Yadav Abhishek , Maheshwari Udip , Mehta Anurag 
Published: September 2019

Abstract
Aims: The anaplastic lymphoma kinase (ALK) Break Apart FISH Probe Kit and Ventana anti-ALK (D5F3) CDx immunohistochemistry (IHC) assay are the Food and Drug Administration-approved companion diagnostic for targeted therapy with the ALK inhibitor crizotinib in lung cancers. The aim of this study was to assess the efficacy and safety of twice daily crizotinib tablet (250 mg) in IHC-proven echinoderm microtubule-associated protein-like 4 (EML4)-ALK fusion gene among Indian patients with adenocarcinoma lung in the routine clinical practice. Subjects and Methods: Patients with nonsmall cell lung cancer (NSCLC), adenocarcinoma histology, whose tumors were found to be positive for EML4-ALK fusion gene using IHC, were considered for this study. IHC analysis was performed using a Ventana automated immunostainer (Benchmark XT). Detection was performed using Optiview DAB detection and amplification kit. Results: A total of 25 NSCLC adenocarcinoma patients were included in the study. There were 14 (56%) women and 10 (44%) men with a median age of 53 years. All patients had Stage IV disease at the time of initiation of crizotinib therapy. One patient achieved complete response and 20 achieved response rate (PR) for an overall PR of 84%. The median progression-free survival (PFS) was 11.8 months and median overall survival (OS) was 20.6 months. Two (8%) patients experienced severe hepatotoxicity requiring permanent discontinuation of crizotinib therapy. Conclusions: A very high PR, PFS, and OS achieved in our study population indicates that IHC can accurately identify EML4 ALK fusion gene mutations in lung adenocarcinoma patients who are responsive to ALK inhibitors such as crizotinib. IHC should be considered as a cost-effective alternative to FISH, especially in low-resource countries.
Outcomes of carcinosarcoma in a tertiary care institution in India
Authors: Cherian Anne George , Thomas Anitha , Sebastian Ajit , Sebastian Tunny , Thomas Vinotha , Chandy Rachel G. , Peedicayil Abraham 
Published: September 2019

Abstract
Background: Carcinosarcoma is a rare malignancy, and reports are often mixed along with other sarcomas. The literature on uterine carcinosarcoma per se is sparse. Aims: This study aims to evaluate the demography, survival, and optimal treatment strategy of uterine carcinosarcoma. Settings and Design: A tertiary care center in India. The study design was descriptive with survival analysis. Materials and Methods: The medical records of all 18 patients admitted with uterine carcinosarcoma between January 2011 and December 2015 were reviewed. Baseline characteristics and outcomes were studied. Survival analysis was done using the Kaplan–Meier method and compared between treatment groups using the Log-rank test. Results: The total number of uterine malignancies operated in our center over this time period was 311 of which 18 were carcinosarcomas (5.7%). Median age of presentation was 61 years (36–77 years). Most women (94%) were postmenopausal and 67% of them presented with postmenopausal bleeding. Over half of the patients (56%) presented late (Stage III or IV). Only 11 (61%) had adjuvant treatment and 7 patients had expired at the time of follow-up. The median survival was 284 days (95% confidence interval 107–461). Patients who received adjuvant therapy did better compared to those who did not (P = 0.036). Conclusions: Carcinosarcomas are aggressive tumors of postmenopausal women who present with bleeding or discharge per vaginum. In spite of adequate surgical staging followed by adjuvant therapy, survival remains poor. Improvements in early detection and optimal therapy need to be made.
Prognostic factors and outcomes in anaplastic gliomas: An institutional experience
Authors: Valiyaveettil Deepthi , Malik Monica , Joseph Deepa , Ahmed Syed Fayaz , Kothwal Syed Akram 
Published: September 2019

Abstract
Background: There is lack of clear evidence and treatment guidelines for anaplastic gliomas (AGs) with very few studies focusing exclusively on these patients. The aim of the study was to analyze the clinical profile and survival in these patients. Materials and Methods: Patients of AGs treated with radiation and concurrent ± adjuvant chemotherapy from January 2010 to December 2015 were analyzed. Statistical analysis was done using SPSS version 20 software. Results: A total of 100 patients were included in the study. The median age was 35 years (range 6–68 years). Eighty-four patients had follow-up details and were included for survival analysis. The 5-year overall survival (OS) was 58%. Age, presentation with seizures, and focal neurological deficit were not found to significantly influence survival. The 5-year survival for oligodendroglioma and astrocytoma was 69% and 52%, respectively. Patients with Karnofsky Performance Score (KPS) of ≥70 had a significantly better 5-year OS (65%) as compared to those with KPS <70 (33%) (P = 0.000). The use of adjuvant temozolomide (TMZ) showed longer 5-year OS of 67.7% compared to 36% in patients who did not receive adjuvant chemotherapy (P = 0.018). Patients receiving both concurrent and adjuvant TMZ showed longer 5-year OS (68.5% vs. 40%, P = 0.010). Twenty-two patients had recurrence with average time to recurrence being 37 months. Fourteen patients underwent salvage surgery and two patients received reirradiation. Conclusions: OS significantly correlated with KPS and receipt of concurrent and adjuvant chemotherapy with TMZ. Therefore, adjuvant radiation with concurrent and adjuvant TMZ should be the standard of care for AGs.
Estrogen receptor and progesterone receptor status of breast cancer patients of eastern India: A multi-institutional study
Authors: Chatterjee Koushik , Bhaumik Gautam , Chattopadhyay Bhargab 
Published: September 2019

Abstract
Context: There is a paucity of any significant data on the estrogen receptor (ER) and progesterone receptor (PR) status of breast cancer patients from the eastern part of India. Aims: This study aims to document the ER and PR status of breast cancer patients in the eastern Indian population, as catered by two premier tertiary care hospitals in Kolkata. Subjects and Methods: All breast cancer patients registered between January 1, 2013 and December 31, 2015, in the Departments of Oncology, of IPGMER and SSKM Hospitals and R. G. Kar Medical College and Hospital, Kolkata, who had at least undergone a core biopsy or surgery, were analyzed retrospectively for documentation of their ER and PR status, using the 2010 American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) interpretation guidelines. Results: Over a period of 3 years, a total of 927 patients were included for the study. A total of 825 (89%) patients had their ER and PR data available for evaluation. ER and PR positive was seen in 312 (37.82%) patients, ER and PR negative in 399 (48.36%) patients, ER positive and PR negative in 71 (8.6%) patients, and ER negative and PR positive results was found in 43 (5.21%) patients. Conclusions: This is the first multi-institutional documentation of ER and PR status from eastern India, having a modest number of patients and one of the earliest documentations using the latest ASCO/CAP interpretation guidelines. These findings resemble the data from the south and also reiterate the fact that majority of the Indian breast cancer patients are still ER and PR negative in spite of the changes in the interpretation guidelines.
Diagnosis of Bacterial Vaginosis by Conventional Methods in the Patients at a Tertiary Care Hospital
Authors: Prakash Ved , Mishra Prem P , Agrawal Lata , Premi HK 
Published: September 2019

ABSTRACT

Background
Bacterial vaginosis (BV) is highly prevalent among women especially in reproductive age group but it is found also in other age groups. Bacterial vaginosis is a great health concern in India because of its complications. Most of the healthcare centers in India are not well-versed in advance diagnostics for BV.

Aim
To assess the utility of conventional methods for diagnostic evaluation of BV in the patients of different age groups.

Materials and methods
In this 1 year cross-sectional study, the vaginal swabs were collected from women with signs and symptoms of BV like complaints of vaginal discharge, odor, itching, back ache, etc. attending the department of obstetrics and gynecology of a tertiary care hospital in Western UP. These specimens are subjected to vaginal pH determination and are sent to department of microbiology for Gram stain, wet-mount and whiff test. Amsel's criteria were used for confirming BV.

Results
A total of 206 women included in the study, n = 63 (29.61%) were found to be having BV based on Amsel's criteria. The mean age of the females were found to be 30.77 years. The most affected age group was found to be 26 to 35 years, n = 33 (54%). The vaginal pH was significantly higher in n = 61 (29.61%) women with BV. Vaginal discharge was prevalent in n = 108 (52.43%) women. Presence of clue cells and positive whiff test were found to be in n = 63 (30.58%) and n = 61(29.61%).

Conclusion
The characteristics of vaginal discharge, vaginal pH determination, clue cells and whiff test is relatively easier conventional methods for diagnosis of women with BV where better facilities are lacking. These tests are suitable for screening women with BV and in formulating the treatment to check the complications.

How to cite this article
Mishra PP, Prakash V, Agrawal L, Premi HK. Diagnosis of Bacterial Vaginosis by Conventional Methods in the Patients at a Tertiary Care Hospital. Int J Adv Integ Med Sci 2016;1(1):1-3.
Tuberculosis of Buccal Mucosa: Is it a Fading Entity?
Authors: Sharma Shilpam , Srivastava Abhinav 
Published: September 2019

ABSTRACT
The recent spurt in the incidence of tuberculosis (TB) in developing as well as developed countries along with a global anti-tubercular drug resistance, calls for awareness for the diagnosis of TB in unusual form and at unusual sites. Extrapulmonary TB in head and neck may infect palate, uvula, buccal mucosa, tonsils, lips, tongue, maxilla and mandible. Tuberculous lesions of oral cavity have become so infrequent that it is virtually a forgotten disease and may pose a clinical diagnostic challenge. Therefore, all lesions in these areas should be investigated keeping a high level of suspicion for the diagnosis of TB.

How to cite this article
Srivastava A, Mohan C, Sharma S. Tuberculosis of Buccal Mucosa: Is it a Fading Entity? Int J Adv Integ Med Sci 2016;1(1):27-29.
Atypical Cases of Blowout Fracture with Retained Naso-orbital Foreign Bodies: Case Series and Review of Literature
Authors: Pant Bhawana , Gaur Sanjay , Sharma Tusshar 
Published: September 2019

ABSTRACT
An orbital blowout fracture is a fracture of any wall of the orbit, including the medial, lateral, posterior, the floor, or the roof. The most common injury site is the floor or the medial wall. Any blow to the face or eye, especially the orbital rim, can cause this injury. Vision threatening complications like permanent diplopia and cosmetically unacceptable enopthalmos make this an important injury to be identified quickly. Here, we present two atypical cases of orbital blowout fractures with retained nasoorbital foreign bodies where mechanism of injury was different but resulted in permanent vision loss due to delay in diagnosis. These type of injuries need prompt management including proper radiological diagnosis and treatment.

How to cite this article
Pant G, Gaur S, Sharma T. Atypical Cases of Blowout Fracture with Retained Naso-orbital Foreign Bodies: Case Series and Review of Literature. Int J Adv Integ Med Sci 2016;1(1):38-41.
Pattern of Pulmonary Tuberculosis in HIV Positive Patients
Authors: Bansal Sanjay , Tiwari Vijayesh K , Khan Mohammed J 
Published: September 2019

ABSTRACT
Tuberculosis is the most common opportunistic infection and cause of mortality in patients with human immunodeficiency virus (HIV). The main aim of this study was to find out the relation, clinical profile, and outcome of pulmonary tuberculosis (PTB) in HIV patients. A total of 35 patients with HIV-PTB coinfection who visited the Rohilkhand Medical College and Hospital for 1 year were enrolled in this study. The pattern of PTB in HIV patients was studied by the help of history, symptoms, chest X-ray, tuberculin skin test, CD4 cell count, and the presence of other opportunistic infection.

How to cite this article
Tiwari VK, Bansal S, Kumar A, Kumar A, Khan MJ. Pattern of Pulmonary Tuberculosis in HIV Positive Patients. Int J Adv Integ Med Sci 2016;1(2):46-48.
Comparative Study of Endoscopic Septoplasty vs Conventional Septoplasty
Authors: Srivastava Abhinav , Yadav Akanksha 
Published: September 2019

ABSTRACTNasal obstruction due to deviated nasal septum (DNS) is a common problem encountered by otolaryngologists. A variety of surgical procedures have been tried in the treatment of the same. This study was conducted to evaluate the outcomes and complications of endoscopic and conventional septoplasty. This prospective, randomized study was conducted on 50 patients with symptomatic DNS, 25 of whom underwent conventional septoplasty, and the rest underwent endoscopic septoplasty. It was found that it is easier to correct posterior deviations and isolated spurs with endoscopic septoplasty with less complications and good results.How to cite this articleYadav A, Mohan C, Srivastava A. Comparative Study of Endoscopic SeptoplastyvsConventional Septoplasty. Int J Adv Integ Med Sci 2016;1(2):49-51.
Ascariasis presenting as Acute Abdomen: A Rare Case
Authors: Agrawal Ranjan , Kumar Parbodh , Mohan Nitesh 
Published: September 2019

ABSTRACT
Ascaris lumbricoides is a common intestinal parasite found in humans prevalent in countries with low socioeconomic status. The disease can occur in all age groups but is more common in preschool-aged children. It causes significant medical, surgical, and social complications. Reported complications include small intestinal obstruction, volvulus, and intussusception. Obstruction of the intestinal tract by a mass of A. lumbricoides is one of the serious and lethal complications.
We present herein a case of A. lumbricoides infestation in a 7-year-old girl, presenting as acute abdomen. Prompt surgical intervention saved the child.

How to cite this article
A grawal R, K umar P, M ohan N . Ascariasis presenting as Acute Abdomen: A Rare Case. Int J Adv Integ Med Sci 2016;1(2):75-78.
A Rare Case of Vallecular Cyst
Authors: Gangwar Anil , Kuchhal Vaibhav , Srivastava Priyanshu 
Published: September 2019

ABSTRACT
Vallecular cyst is an uncommon but potentially dangerous condition causing stridor and has been associated with sudden airway obstruction resulting in death due to its anatomical location in neonates. It may also present with feeding problems resulting in failure to thrive. Endoscopic laryngoscopy is necessary to visualize vallecular cyst when suspected clinically. Other conditions leading to neonatal stridor should be ruled out, such as laryngomalacia and other laryngotracheal abnormalities. Marsupialization with a CO2 laser is the most successful treatment. We report a case of a 6-month-old male infant referred to our ear, nose and throat department of Dr. Susheela Tiwari Hospital, Government Medical College, Haldwani, for the evaluation of inspiratory stridor, feeding difficulty, suprasternal retraction, and failure to thrive. The patient was misdiagnosed and treated conservatively by a pediatrician. On rigid laryngoscopic examination, an anteriorly displacing cystic mass on the tongue base on the left side was detected. The cyst was removed intoto using bipolar cautery. Immediately after surgery, inspiratory stridor, suprasternal retraction, and feeding difficulty improved gradually. One week later, follow-up rigid laryngoscopy showed no abnormal finding except episodic influx of epiglottis.

How to cite this article
Gangwar A, Kuchhal V, Srivastava P. A Rare Case of Vallecular Cyst. Int J Adv Integ Med Sci 2016;1(2):88-90.
Long-range terrestrial laser scanning measurements of annual and intra-annual mass balances for Urumqi Glacier No. 1, eastern Tien Shan, China
Authors: Xu Chunhai , Li Zhongqin , Li Huilin , Wang Feiteng , Zhou Ping 
Published: September 2019

Abstract. The direct glaciological method provides in situ observations of
annual or seasonal surface mass balance, but can only be implemented through
a succession of intensive in situ measurements of field networks of stakes
and snow pits. This has contributed to glacier surface mass-balance
measurements being sparse and often discontinuous in the Tien Shan.
Nevertheless, long-term glacier mass-balance measurements are the basis for
understanding climate–glacier interactions and projecting future water
availability for glacierized catchments in the Tien Shan. Riegl
VZ®-6000 long-range terrestrial laser scanner
(TLS), typically using class 3B laser beams, is exceptionally well suited
for repeated glacier mapping, and thus determination of annual and seasonal
geodetic mass balance. This paper introduces the applied TLS for monitoring
summer and annual surface elevation and geodetic mass changes of Urumqi
Glacier No. 1 as well as delineating accurate glacier boundaries for 2
consecutive mass-balance years (2015–2017), and discusses the potential of
such technology in glaciological applications. Three-dimensional changes of
ice and firn–snow bodies and the corresponding densities were considered for
the volume-to-mass conversion. The glacier showed pronounced thinning and
mass loss for the four investigated periods; glacier-wide geodetic mass
balance in the mass-balance year 2015–2016 was slightly more negative than in
2016–2017. Statistical comparison shows that agreement between the
glaciological and geodetic mass balances can be considered satisfactory,
indicating that the TLS system yields accurate results and has the potential
to monitor remote and inaccessible glacier areas where no glaciological
measurements are available as the vertical velocity component of the glacier
is negligible. For wide applications of the TLS in glaciology, we should use
stable scan positions and in-situ-measured densities of snow–firn to
establish volume-to-mass conversion.
Contrast and word order: A case study on the history of Portuguese
Authors: de Andrade Aroldo , Galves Charlotte 
Published: September 2019

Several studies have observed that older Romance languages had more frequent object-verb order than their modern counterparts. This article explores the idea that contrast is crucial to understand the shift to verb-object order, as part of a more encompassing notion of boundedness, which has been frequently associated with the V2 parameter. To do so, we first show that some fronting constructions involving demonstratives were available in Old and Classical Portuguese, but not in Modern Portuguese, as a consequence of the existence of a KP projection hosting contrastive items of different sorts acting as delimitators. Second, we present some changes between Old and Classical Portuguese: (i) a decrease in fronted objects with demonstratives; (ii) an increase in the frequency of null subjects; and (iii) a small decrease in the frequency of frame setters. We propose that these shifts are to be attributed to an information-structural change correlated with a syntactic change concerning the position of complementizers and verb movement in subordinate clauses. To wit, while Old Portuguese was a symmetrical relaxed C-V2 language, Classical Portuguese was an asymmetrical one, which is reflected in terms of a reduced left periphery of subordinate clauses in the latter, in which KP cannot be projected. The article presents some implications of this account for the derivation of basic word order patterns and of clitic interpolation in Old Portuguese and for the loss of V2 in the history of Portuguese. These results suggest that the connection between boundedness, contrast and V2 grammars can be profitably explored in Old Romance languages.