bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of immunohistochemistry in diagnosing round-cell tumours affecting the oral and maxillofacial regions
Authors: Kaur Harpreet , Mishra Deepika , Kakkar Aanchal , Roychoudhury Ajoy 
Published: September 2024

Background:
One of the most challenging spectra of lesions in the oral and maxillofacial region (OMFR) are round-cell tumours (RCTs). They show a considerable degree of overlap in microscopy and immunophenotypes. The main aim of this study is to analyse the spectrum of RCTs encountered in the oral and maxillofacial regions. We emphasise the role of immunohistochemistry (IHC) which in conjunction with histological, clinical, and imaging findings is necessary for their correct characterisation. The secondary objectives are to discuss differential diagnosis, workflow, and diagnostic algorithm for round-cell lesions affecting the OMFR.

Methods:
Formalin-fixed, paraffin-embedded sections of RCTs were retrieved from the archives of the Department of Oral Pathology (January 2018 to March 2020). These cases were analysed by three pathologists independently by evaluating haematoxylin and eosin-stained sections, and immunohistochemical markers employed to characterise these lesions.

Results:
Under the spectrum of RCTs, 11 cases (0.53%) were diagnosed with a predominance of non-Hodgkin lymphoma (55%) followed by Ewing sarcoma (18%). The remaining were Langerhans cell histiocytosis (9%), neuroendocrine carcinoma (9%), and sinonasal undifferentiated carcinoma (9%). Except for one case, in all cases, the final diagnosis was established with the use of adjunctive IHC.

Conclusion:
RCTs can pose a diagnostic challenge for inexperienced oral pathologists. Thorough knowledge of the differentials of RCT occurring in oral and maxillofacial is helpful. An algorithm-based diagnostic approach incorporating the clinical, imaging, and histomorphological findings and immunohistochemical evaluation can help in minimizing diagnostic confusion and errors.
Expression of anti - Apoptotic survivin in odontogenic keratocyst, adenomatoid odontogenic tumor and ameloblastoma
Authors: Latha H. Aparna , Prakash A. Ravi , Kanth M. Rajini , Reddy A. Vikram Simha , Sreenath G. , Vidya Karanam S. 
Published: September 2024

Background:
The process of odontogenesis is complex involving epithelial–mesenchymal interactions, along with the molecular signalling pathways triggering the initiating process. The triggering factors and cells precisely involved in the pathogenesis of odontogenic cysts and tumors are unknown. There is a vast array of biomarkers used to stain different sites, thereby helpful in diagnosing and evaluating the prognosis of these cysts and tumors. In the following study, Anti Apoptotic survivin expression patterns were assessed quantitatively in 48 samples (12 each) of Reduced Enamel Epithelium, Adenomatoid Odontogenic Tumor, Odontogenic Keratocyst and Ameloblastoma.

Aim:
The Aim of this study is to assess the anti-apoptotic survivin expression in Reduced Enamel Epithelium, Adenomatoid odontogenic tumour, Odontogenic Keratocyst and Ameloblastoma.

Materials and Methods:
The present study is carried out with 12 samples in each group. Routine hematoxylin and eosin staining was performed for confirmatory diagnosis. Later Immunohistochemistry was performed using survivin antibody. Survivin protein expression was analyzed using the parameters like location, intensity, percentage of cells positivity with survivin protein and extent of staining. With the help of Olympus BX 43 microscope, with ProgRes microscope camera, the 48 slides obtained were examined. The region of interest was selected in each slide and number of cells positively stained was counted. Data was analyzed using SPSS software version 23. Descriptive for scale data, results were analysed by using ANOVA with Chi-square test for intergroup comparison.

Results:
The results showed significant P value <0.05. Expression of survivin was highest in Ameloblastoma, followed by Odontogenic keratocyst, Adenomatoid odontogenic tumor, and Reduced Enamel Epithelium.

Conclusion:
Survivin was involved in the inhibition of apoptosis as well as the detailed understanding of the biological behaviour of odontogenic cysts and tumours, thereby increasing therapeutic approaches.
A study on H-score threshold for p16ink4a immunoperoxidase expression in squamous cell tumours of oral cavity
Authors: Singh Ravindra Pratap , Verma Surendra Kumar , Ganesh Rajesh Nachiappa , Raman Arthy , Natarajan Girija , Kasthuri D , Krishnan B 
Published: September 2024

Background:
Validity of various detection methods used are likely contributing factor to this wide variation of prevalence of HPV (0-73%) by using GP5/GP6/MY09/MY11 (L1) primer. PCR is a sensitive method but does not identify transcriptionally active High-risk Human papillomavirus and also does not indicate whether the virus is isolated from malignant tumour cells and non-neoplastic cells. P16ink4a Immunohistochemistry is a highly sensitive and Cost-effective surrogate marker for transcriptionally active high-risk HPV for oral cancer. Objective The aim of the present study was to evaluate the H-SCORE of p16 expression in the surface epithelial tumour sites of a large cohort of squamous cell carcinoma (SCC), severe dysplasia (SD). we sought to determine whether the p16 algorithm is reliable in Oral cavity SCC and severe dysplasia (SD).

Materials and Methods:
This study used Immunohistochemistry in archival Formalin-fixed paraffin embedded specimens for assessment of p16 protein expression, cytoplasmic and nuclear staining intensity was categorized based on score (range, 0-3) and presence of tumour cell staining (0-100%).

Results:
The majority of positive cases had low H-score of p16 staining except 3/161 (1.8%) cases of tongue SCC had positive for p16 with diffuse moderate staining with ≥2 scores. There were no significant differences in the distribution of demographic, exposure and histopathological characteristics between patients with and without P16 expression.

Conclusion:
The present study demonstrated that p16 expression is a reliable HPV marker in the lateral border of the tongue with tonsil involvement but no other sites of the oral cavity. Further p16 IHC detection is required in large cohort of all sites of tongue squamous cell carcinoma studies to validate the marker of HPV.
Functional Outcome of Surgical Management of Mid-diaphyseal Clavicle Fractures Treated by Plate Osteosynthesis
Authors: Ramalingam Selvaraj , Kumar K. Arvind , Dhivaakar V. , Santhosh M. S. 
Published: September 2024

Abstract

Introduction:
Clavicle fractures make up 5% to 10% of all fractures. They result from direct high-energy trauma to the bone or falls on the lateral side of the shoulder. In recent years, clavicle fractures have become more common, and their surgical treatment has increased proportionally. Therefore, a proper understanding of anatomy, mechanism of injury, and radiographic interpretation form the basis of a good outcome. Fractures treated with open reduction and internal fixation (ORIF) will have a good functional and radiological outcome. This study is aimed to evaluate the mid-diaphyseal clavicle fractures treated with ORIF.

Materials and Methods:
In this prospective study, 30 patients who had mid-diaphyseal clavicle fractures according to Allman’s classification underwent ORIF from June 2020 to June 2022. All patients were followed up for 6 months and an assessment of the outcome was done.

Results:
Out of 30 patients treated, overall excellent to good outcomes were obtained in 26 patients. No statistical significance was noted between age, sex, mode of injury, and different method of fixation on functional outcome. Overall, the meantime of the fracture union was 16 weeks. Five patients developed complications in our study, surgical site infection in one patient, shoulder stiffness for two patients, implant failure for one patient, and hardware irritation in one patient.

Conclusion:
Anatomical reduction and stable fixation are essential to good fracture union. It helps in early mobilization of the shoulder, preventing stiffness, and is associated with great patient satisfaction. Earlier the fracture union better the functional outcome.
The Clinical Outcome of Transforaminal Lumbar Interbody Fusion and Laminectomy for Single-level Lumbar Canal Stenosis with Grade 1 and 2 Spondylolisthesis
Authors: Sharma Ashok , Suthar Tarachand , Mathur Mudit , Mittal Vishnu , Sharma Shiv Bhagwan , Mehta Gaurav 
Published: September 2024

Abstract

Background:
Lower back pain is a common cause of disability that affects mobility and quality of life in both adult and elderly patients. Initial management of lower back pain includes anti-inflammatory drugs, analgesics, physiotherapy, and epidural steroid infiltration. Despite multiple attempts of conservative management, if a patient develops refractory radicular pain with or without neurologic deficit and claudication, surgery is indicated. The two main approaches to surgical intervention include decompression (laminectomy only) and decompression with fusion (transforaminal lumbar interbody fusion [TLIF]).

Materials and Methods:
The study was done under the Department of Orthopedics at SRG Hospital, Jhalawar (Rajasthan, India), between May 2019 and November 2022. In this randomized study, we compare the clinical outcome of TLIF and laminectomy for single-level lumbar canal stenosis with Grade 1 and 2 spondylolisthesis. Forty patients with single-level lumbar canal stenosis with Grade 1 and 2 spondylolisthesis were randomly divided into two equal groups. Patients in both the groups were followed up for 2 years.

Results:
In this study, we also noted estimated amount of blood loss, procedure time, time taken for ambulation, length of hospitalization, and demography. The Oswestry Disability Index scores improved significantly postoperatively. The modified MacNab criteria suggest the outcomes rated as excellent/good rate of 90% in TLIF and 85% in laminectomy.

Conclusion:
We evaluated that TLIF procedures are associated with slightly more significant improvement in clinical outcomes in all of the scoring systems that were applied; TLIF provides early ambulation but higher cost of treatment and longer hospital stay compared to laminectomy. Laminectomy procedures are associated with lesser economic burden, lesser hospital stays, lesser blood loss, and shorten surgical duration compared to TLIF.
Clinical Outcome of Medial Meniscal Posterior Root Tear Repaired by Arthroscopic Transtibial Pull-through Technique in a Middle-aged Population – A Case Series
Authors: Ramalingam Selvaraj , Kumar K. Arvind , Duraisamy Gopinath , Bush P. Stephen 
Published: September 2024

Abstract

Introduction:
Patients with partial meniscectomy for MMPRTs still develop early osteoarthritis, have poor clinical outcomes, and have a high arthroplasty rate at a follow-up of 8 more than 5 years.

Aim:
The aim of this study was to evaluate the clinical outcome of medial meniscal posterior root tears treated with arthroscopic transtibial pull-through technique in a middle-aged population.

Materials and Methods:
Patients with medial meniscus posterior root tears admitted to our facility between 2020 and 2022 were included in this study. The patients were subjected to radiological evaluation of X-rays preoperatively. All the patients were followed for 1 year and assessed using the Tegner Lysholm score.

Results:
Ten patients with medial meniscal posterior root tears were included in this study. We observed that eight patients who underwent posterior meniscal root repair had excellent results, and two patients had good results.

Conclusion:
Arthroscopic repair of posterior meniscal root tear shows a significant improvement in clinical outcome.
Open Reduction and Internal Fixation of Volar Barton Fracture: A Clinical Study
Authors: Ansari Afzaal Rafeeq , Rawat Ashok , Aman Utsav 
Published: September 2024

Abstract

Introduction:
A Barton’s fracture is a compression injury with a marginal shearing fracture of the distal radius. The management of volar Barton’s fractures either by operative or conservative means is a difficult problem. The objective of the study is to assess the functional and clinical outcome of open reduction and internal fixation (ORIF) by buttress T-plate in the treatment of volar Barton’s fracture of the wrist.

Materials and Methods:
Between March 2019 and January 2022, a total of 20 cases of volar Barton’s fracture were operated at Prasad Institute of Medical Sciences, Lucknow. Henry’s approach was used to open the fractures and AO system was used to classify the fractures. The cause of injury was road traffic crash in 15 cases and fall in 5. All cases were type B3 with 10 B3.3, 5 B3.2, and 5 B3.1 subtypes. All cases underwent surgery within the 1st week of injury.

Results:
All cases were assessed clinically and radiographically after a mean follow-up duration of 18 months (range 6–36 months). Fracture healed after 7–10 weeks (mean 8.8 weeks). Based on Mayo’s Wrist Score criteria, the results were excellent in 12 cases, good in 6, and fair in 2. Mild osteoarthritis developed secondary to trauma in one case. There was no neurovascular deficit in any of 20 cases.

Conclusion:
ORIF of volar Barton’s fracture with buttress T-plate can restore articular congruity and stability to achieve good results.
Scapular Osteochondroma: A Unique Site in 50 Years Old: An Unusual Case
Authors: Sauhta Ravi , Makkar Dheeraj 
Published: September 2024

Abstract
Osteochondromas are benign bone tumors that mainly affect the metaphysis of long bones. We describe a 50-year-old patient who presented with a ventral scapular osteochondroma that limited her shoulder movement and induced paresthesia during sleep. The swelling was accompanied by pain and an inability to execute her professional obligations for the preceding 4 months. There were no neurological abnormalities. Computed tomography scan revealed a mushroom-shaped mass with cortical and medullary components near the scapula’s lateral angle. We carried out the surgery using the lateral decubitus position, general anesthesia, and the axillary approach. We describe a unique location and age range in which osteochondroma manifests. Because the risk of malignancy grows with age, we underline that osteochondroma should be considered a differential diagnosis in both unusual locations and age groups. Second, patients should be monitored clinically and radiographically following excision.
Demographic-Based Algorithm Used to Predict the Implant Sizing in Total Knee Arthroplasty
Authors: Rajan Sunil , Jain Saurabh , Dhosariya Chetan Singh 
Published: September 2024

Abstract

Background:
Prediction of the accurate implant improves preparedness for surgery and helps to reduce intraoperative difficulties. Conventionally, the prediction of implant sizes by preoperative templating is improper owing to a variable degree of accuracy. We correlated patients’ demographic features of gender, weight, height, and body mass index (BMI) with the size of the implants used in total knee arthroplasty (TKA) so as to formulate an algorithm between the implant size and these parameters.

Materials and Methods:
Demographic variables from the records of all patients who underwent TKA of the same type were reviewed for gender, weight (in kg), and height (in cm). Intraoperatively, the size of femoral and tibial components was noted and correlated with the demographic variables, and linear regression was used to formulate an equation to predict the sizes depending on demographic variables.

Results:
Two hundred and three primary total knee replacements in 146 patients were included in the study. The mean age, weight, height, and BMI were 66.13 years (range: 46–89 years), 74.69 kg (range: 44–104 kg), 156.078 cm (range: 130–181 cm), and 30.796 kg/cm
2
(range: 18.59–49.88), respectively. The mean size of the femoral and tibial components used was 2.99 (range: 1–5) and 2.52 (range: 1–4), respectively. Both femoral and tibial components correlated significantly with gender, weight, and height only and not with BMI.

Conclusion:
Demographic profiles can predict the component size accurately, and it is a reliable, accurate, inexpensive, time-efficient, and safe means to predict the final implant size.
Outcome of Different Preemptive Analgesia Modalities in Patients Undergoing Total Knee Replacement Surgeries: A Prospective Randomized Study
Authors: Vaidya Narendra , Pawar Gourav S. , Gadekar Anup P , Patil Nilesh A. , Kutemate Pravin Rameshrao , Kolhapure Mohit 
Published: September 2024

Abstract

Introduction:
Many analgesic innovations are used to reduce the level of pain post total knee replacement (TKR) surgeries; however, none has been proven to be the optimum choice till now. The use of preemptive analgesia (PA) is still a controversial topic; however, still, it has managed to prevent altered pain perception and pain amplification after surgery. Hence, the objective of this study was to assess the pain score in patients undergoing TKR using different preemptive anesthesia modalities.

Materials and Methods:
A total of 105 patients were enrolled in the study and were equally divided into three groups. Group 1 and Group 2 were given tablet pregabalin 75 mg, tablet paracetamol 1 g, and tablet aceclofenac 100 mg orally 1 day before surgery, and on the day of surgery, before incision, Group 1 received injection paracetamol 1 g and injection dexamethasone 8 mg intravenously; Group 2 received injection paracetamol 1 g, injection dexamethasone 8 mg, injection tramadol 50 mg, and injection MgSo4 1 g intravenously; And Group 3 received only iPACK.

Results:
The average Visual Analog Scale score was the least in Group 2, followed by Group 1 and Group 3 (P < 0.001). The average Ropivacaine dose and postoperative Ropivacaine duration were the least in Group 2, followed by Group 1 and Group 3 (P < 0.001). Patients in Group 2 were able to mobilize early compared to Group 1, whereas patients in Group 3 took more time for mobilization compared to Groups 1 and 2. Tourniquet pain was least in Group 2, followed by Group 1 and Group 3.

Conclusion:
PA was found to reduce the severity of pain and inflammation after knee replacement surgery, resulting in reduced development of chronic pain after surgery. As well significant relief from tourniquet pain was seen, which ultimately helped the patient in early mobilization.
Is your blood bag safe for transfusion? Bacterial screening of donor blood and its components: An essential infection control tool for safe transfusion practice
Authors: Jindal Sonal , Agarwal Saurabh 
Published: September 2024

Introduction:
Transfusion-associated bacterial sepsis is still a major public health concern that has received little attention. Data on bacterial contamination of blood are scarce, despite rising demand for blood transfusions. Blood bags intended for transfusion should be free of microorganisms.

Aim:
The aim of the study was to assess the prevalence, identify the microorganisms involved in bacterial contamination of donor blood and blood components and determine blood products most likely to be contaminated, received in microbiology laboratory for sterility testing.

Settings and Design:
The study was carried out in the department of microbiology in association with the transfusion medicine department of tertiary care hospital in Western Uttar Pradesh from January 2023 to June 2023.

Methodology:
A total of 87 cellular blood components were tested aerobically for bacterial contamination using the BD BACTEC™ FX 40 automated culture system. For incubation, culture vials that showed positive signals were subcultured onto a set of solid media followed by bacterial identification and antimicrobial susceptibility testing.

Results:
The overall prevalence rate was 14.9% (whole blood 18.75%, platelets 14.2%, packed cells 13.3% and fresh frozen plasma 10.5%). The contaminants were Aeromonas
hydrophila, Sphingomonas
paucimobilis, Escherichia
coli, Coagulase-negative Staphylococcus spp., Pseudomonas
aeruginosa, Delftia
acidovorans, and Candida
albicans.

Discussion:
The bacterial contamination in blood products suggests the patient who receives blood products is at risk of developing infection. Implementing proper blood transfusion policies, donor screening and technical staff training will all help to reduce the contamination rate of blood and blood components.

Conclusion:
Bacterial contamination of blood bags indicates a potential risk of healthcare-associated infection. Microbiological Sterility testing for donor blood bags in blood banks should be used as mandatory infection control Tool for Quality assurance.
Clinical Implications of ECG in Patients Presenting to ED with Drug-overdose and Organo-phosphorous Poisoning
Authors: Selvan Jagadesha , Hazra Darpanarayan , Chandy Gina M. , Ganesan Priya 
Published: September 2024

ABSTRACT

Background:
Drug overdose and organo-phosphorous (OP) poisoning are one of the most common forms of deliberate self-harm (DSH) in our society. Some drugs and OP compounds have well-described electrocardiographic (ECG) manifestations in the event of toxicity. This study aims to determine the clinical implications of an electrocardiogram (ECG) in patients with an alleged history of DSH (drug overdose and/or OP poisoning) presenting to the ED.

Methodology:
We conducted this retrospective study over one and a half years (October 2018 to April 2020). Demographical data, clinical presentations, and ECG findings were extracted from the hospital’s electronic database, coded, and analyzed.

Results:
Our study population included 364 (0.32%) patients with DSH (OP poisoning and drug overdose), of which the majority (n-224; 61.5%) had presented with a drug overdose. The mean age of the cohort was 33.9 (SD: 13.1) years, with a female preponderance (n-222; 60.9%). The most common presenting complaints were vomiting (n-180; 49.5%), other gastrointestinal complaints (n-146; 40.1%), and giddiness (n-122; 33.5%). At the presentation to ED, the majority had a qSOFA ≥2 (n-212; 58.3%). The most common drugs noted to be consumed singly included benzodiazepines (n-42, 11.5%), paracetamol (n-38; 10.4%), and tricyclic antidepressant (n-20; 5.5%). Polydrug intoxication was seen in 68 (18.7%), and co-ingestion with OP was seen in 26 (7.2%) patients. ECG changes (QTc prolongation) were noted in 187 (51.4%: p-value 0.003) patients. All patients were advised to be admitted after initial stabilization and emergency management; however, 73 (20.1%) patients left the ED against medical advice. During their hospital stay, seven (1.9%) patients succumbed to their illness.

Conclusion:
Middle-aged female patients are more prone to DSH, with gastrointestinal complaints as the most common presenting symptom. In patients with drug overdose or OP poisoning, ECG changes (QTc prolongation) were noted in the majority of the study population.
PENGGUNAAN METODA FUZZY TSUKAMOTO UNTUK MENENTUKAN PRODUKSI BARANG ELEKTRONIK
Authors: Auliana Sigit , Mansyuri Umar 
Published: September 2024

The Tsukamoto method is one of the methods in the decision-making system in which every consequence of the IF-THEN rule must be represented in a fuzzy set with a monotonous membership function. The application of the Tsakamoto Method in a Decision Support System determines the production of electronic goods so that demand for goods is fulfilled using a decision support system. In this study there are 4 processes used, namely the process of fuzzification, the process of inference/evaluation of rules, composition/aggregation, and defuzzification.The conclusion with the Fuzzy Tsakomoto method in the Decision Support System for determining electronic goods according to demand, can facilitate the process of making reports