bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pattern of care and clinical outcome of patients with carcinoma endometrium and the impact of central histopathological review on management: A tertiary cancer centre experience
Authors: Verma Rakhi , Gandhi Ajeet K. , Rastogi Madhup , Mishra Vachaspati K. , Sharma Vikas , Agarwal Akash , Shukla Saumya , Khurana Rohini , Hadi Rahat , Srivastava Anoop K. , Husain Nuzhat 
Published: October 2024

Abstract

Purpose/Objective:
Endometrial carcinoma (EC) is the third most common gynecological malignancy in India. Recent PORTEC-3 analysis emphasized the role of central histopathological review. We aimed to retrospectively analyze the demographic and histopathological characteristics of EC patients treated at our institute and assess the impact of the central histopathological review on management and also analyze clinical outcomes in this cohort of patients.

Materials and Methods:
Data of 75 EC patients treated at our center between 2013 and 2022 were retrieved from our departmental archives. Patients were analyzed for demographic details, histopathological findings, details of surgery and histopathology (HPE), results of a review of HPE, adjuvant treatment details, and clinical outcomes. All patients with HPE outside of our institute were reviewed at our center prior to initiation of treatment. In cases of discordance, patients were discussed in the multidisciplinary tumor board for the final treatment decisions. Patients were staged as per International Federation of Gynaecology and Obstetrics 2018.

Result:
The median age was 57 years (range: 37-74 years). Twenty-seven patients with HPE reported from the outside center were reviewed at our institute and changes were observed in 26 patients (96.3%). HPE review changes were observed in terms of histological grade, histological type, myometrial invasion, and lymph node involvement in five (18.5%), three (11.1%), seven (25.9%), and three (42.8%), respectively. HPE review leads to changes in the management of 19/26 patients. Stage distribution was I: II: III in 48 (64%): 9 (13.3%): 18 (24%) patients, respectively. The median external beam radiotherapy dose was 50 Gray (range: 45-50.4 Gray at 1.8-2 Gray per fraction). The median brachytherapy dose for patients treated with brachytherapy alone was 7 Gray each for three sessions and in combination with EBRT was 6 Gray each in two sessions. At a median follow-up of 51 months (range: 6-116 months), seven (9.3%) patients developed distant metastasis, two (2.7%) patients had local plus distant metastasis, and two (2.7%) patients had local recurrence. The overall survival and disease-free survival rates at 3 years were 93.5% and 86.7%, respectively.

Conclusion:
EC patients treated at our center have excellent local control rates with a combination of external beam radiotherapy and brachytherapy. The central histopathological review may result in changes impacting patient management and should be routinely done prior to initiation of treatment in EC.
Effect of radiation dose rates and cisplatin on cytogenetic damage in rats receiving head–neck radiotherapy
Authors: Unal Dilek , Kiraz Aslihan , Aydogan Serhat , Sarica Zeynep Soyer , Celik Harun , Akay Ebru , Eroglu Celalettin , Kaplan Bunyamin 
Published: October 2024

ABSTRACT

Background:
We aimed to investigate effect of radiotherapy (RT) applications with different dose rates on cytogenetic damages, which focused on micronucleus (MN) formation, and evaluate how this damage varies by cisplatin in rats receiving head–neck RT.

Material and Methods:
Thirty-six Sprague Dawley rats were divided into five groups. The first and second groups were irradiated at a dose rate of 300 monitor unit/minute (MU/min) and 600 MU/min, respectively. The third group was irradiated at a dose rate of 300 MU/min and given cisplatin. The fourth group was irradiated at a dose rate of 600 MU/min and given cisplatin. The fifth group received neither irradiation nor cisplatin (control group). One thousand polychromatic erythrocytes were scored, and MN frequency in polychromatic erythrocytes was determined for each rat.

Results:
There was a significant difference among five groups in terms of the number of MN (p: 0.001). The number of MN was significantly higher in the 600 MU/min + cisplatin group (fourth group) compared to the control group [9.5 (1.0–23.0) vs. 1.5 (1.0–2.0), respectively]. It was also significantly higher in 600 MU/min + cisplatin group (fourth group) compared to 300 MU/min group (first group) [9.5 (1.0–23.0) vs. 2.0 (1.0–3.0), respectively]. On the other hand, there was no significant difference among other groups.

Conclusions:
Our findings suggest that RT given at a higher dose rate causes more cytogenetic damage, and this damage is increased by concurrent administration of cisplatin.
Mammary analogue secretory carcinoma involving submandibular gland: Diagnostic pitfall with review of literature
Authors: Dhankar Nimisha , Verma Nidhi , Agarwal Abhinav , Mehar Ravi , Pasricha Sunil 
Published: October 2024

ABSTRACT
Mammary analogue secretory carcinoma (MASC) is a recently defined entity among salivary gland tumors. MASC bores a striking resemblance to secretory carcinoma of breast along with the characteristics of ETV6–NTRK3 translocation. Hence, the entity was designated as MASC and was formally included in the 4th edition of World Health Organization classification of head and neck tumors in 2017. To the best of our knowledge, around 12 cases of MASC have been described in the Indian literature. MASC commonly involves parotid gland (70%). Involvement of submandibular gland is still rarer (7%). Prognosis of MASC is comparable to other low grade salivary gland malignancies; however, aggressive behavior has also been reported in few cases. This case is one of the very few reported cases describing MASC with detailed clinical, cytology, and microscopy findings along with special stains and immunohistochemistry.
Idiopathic multicentric Castleman disease
Authors: Chaudhari Vipul , Thakkar Simran Jatin , Padwal Namita , Karnik Niteen 
Published: October 2024

ABSTRACT
An elderly man presented with fever and chills for six months, associated with loss of appetite and weight loss, bilateral edema, and non-tender inguinal lymphadenopathy. The left-sided testicle was bulky, firm, and non-tender. Investigations revealed anemia, leukopenia, elevated erythrocyte sedimentation rate, and hypergammaglobulinemia. Ultrasound of the abdomen revealed multiple enlarged necrotic lymph nodes in the periaortic, preaortic, precaval, and bilateral pelvic regions. Fine-needle aspiration cytology (FNAC) of the inguinal nodes showed no acid-fast bacilli (AFB). However, excision biopsy revealed lymphoid tissue with effacement of architecture by diffuse proliferation of mature plasma cells, suggestive of the plasma cell variant of multicentric Castleman disease. Due to suspicion of neoplastic testicular enlargement, the patient underwent bilateral orchidectomy, and histopathology showed hematocele with atrophy of the testis and secondary involvement of the testicular parenchyma by plasma cell variant of Castleman disease.
SALL4 and C-kit positive malignant extrarenal rhabdoid tumor of the pelvis in a child: A diagnostic and therapeutic challenge
Authors: Pahwa Saloni , Pasricha Sunil , Kapoor Gauri , Jajodia Ankush , Koyyala Venkata Pradeep Babu , Mehta Anurag 
Published: October 2024

ABSTRACT
Extrarenal rhabdoid tumors (ERRTs) are highly aggressive pediatric tumors with very few cases reported in the literature. These tumors, similar to their renal counterparts, are characterized by inactivating mutations of the SMARCB1/INI-1 gene, a member of the SWI/SNF chromatin remodeling pathway. Diagnosis of ERRTs appears challenging owing to its rarity, varied morphological profile with a higher tendency for rhabdoid differentiation, and overlapping features with other SMARCB-1 deficient tumors. Here, we report a case of ERRT in the pelvis of a three-year-old child with an unusual expression of SALL4 and C-kit on immunohistochemistry. A complete immunohistochemical workup might help in differentiating ERRTs from other SMARCB1/INI1-deficient soft tissue tumors. The expression of stem cell markers in the presented case also suggests that these tumors might originate from or share similarities with embryonic stem cells or germ cells.
Application of the Milan System of reporting salivary gland cytopathology and assessing its use as a risk stratification tool
Authors: Pandey Neha , DasNayak Goutami , Dash Kanakalata , Senapati Urmila , Rout Khageswar 
Published: October 2024

ABSTRACT

Introduction:
The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was proposed by American Society of Cytopathology and International Academy of Cytology to standardize reporting system ensuring uniformity and better communication between clinicians and cytopathologists.

Aims and Objectives:
1. To categorize salivary lesions as per MSRSGC. 2. To establish diagnostic accuracy of MSRSGC and calculate risk of malignancy for each diagnostic category.

Materials and Methods:
An ambispective study was conducted over 5 years including 45 FNAC cases of salivary lesions. The cases were categorized according to Milan System, and diagnostic accuracy of MSRSGC was established. Risk of malignancy for each category was calculated.

Results:
The patients’ age ranged from 13 to 77 years with maximum swellings in parotid (53.3%) followed by submandibular (15.6%) and submental (2.2%). Histopathological follow-up was done in all cases. The number of cases in each category was as follows: category I: 03 (6.7%), category II: 06 (13.3%), category III: 4 (8.9%), category IVA: 25 (55.6%), category IVB: 04 (8.9%), category V: 02 (4.4%), and category VI: 01 (2.2%). The calculated ROM was as follows: category I: 0%, category II: 0%, category III: 0% category IVA: 8.0%, category IVB: 25%, category V: 50%, and category VI: 100%. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy with (without) indeterminate categories for malignancy were 88.9%(96.9), 66.7%(50.0), 94.1%(94.1), 50.0%(66.7), and 85.7%(91.9), respectively.

Conclusion:
MSRSGC is an effective and standardized reporting system for categorization and risk stratification of salivary swellings which helps in enhancing patient care.
Correlation of new two-dimensional geometrical parameters to lung and heart dose-volume parameters in breast cancer radiation therapy
Authors: Bahador Maryam , Soltaninejad Simin , Mobasheri Mosayyeb 
Published: October 2024

ABSTRACT

Objective:
To develop new two-dimensional geometric parameters for pulmonary and cardiac dose estimation in left-sided breast cancer radiation therapy without dose-volume histogram (DVH).

Methods:
On the CT image of 90 patients with left breast cancer, treatment planning was performed using two opposed tangent fields with/without supraclavicular. The field-in-field technique and 6MV photons were used. From DVH dosimetric parameters of mean dose, Vx (x (Gy) =5, 10, 15, 20, 30, 40, 50) were calculated, and from heart and lung outlines on the beam’s eye view, new geometric parameters of percent of lung area in tangent and supraclavicular fields (%area of the lung in the tangent (ALT), %ALS) and percent of heart in tangent field (%area of the heart in the tangent (AHT)) were measured. Correlation, regression, and diagnostic performance by receiver operating characteristic curve (ROC) were investigated for statistical analysis.

Results:
The Pearson coefficient between %ALT and Vx (x = 10, 15, 20, 30, 40) show strong correlation in patient treatment with only opposed tangents (>0.85) and weaker in treatment by opposed tangents with supraclavicular (0.56-0.88), the %ALS indicate weak correlation (<0.5) and %AHT show strong correlation (0.93-0.98). The regression analysis shows a positive relation between %ALT and mean dose (R2 = 0.8), V20Gy (R2 = 0.9) in the lung (tangent treatment), and between %AHT and mean dose (R2 = 0.9), V20Gy (R2 = 1.0) in the heart. The ROC analysis shows by %ALT <20.3 for treatment by just opposed fields, %ALT <22.1% for treatment tangents with supra, and %AHT <11.6%, practical lung and heart dose constraints are addressed.

Conclusion:
The proposed geometric parameters could replace previous one-dimensional maximum and central distances for predicting doses to lung and heart.

Advances in Knowledge:
This study presents simple geometric parameters that could estimate pulmonary and cardiac dose in left breast cancer treatment from a 2D radiograph.
Jumping translocation of 3q21 in a patient with acute myeloid leukemia and poor clinical outcome
Authors: Belnekar Mamta , Virulkar Shital , Tulpule Sameer , Kar Bibhas 
Published: October 2024

ABSTRACT
Jumping translocation (JT) is a cytogenetic event in which a donor chromosomal segment is translocated to two or more recipient chromosomes. We describe a case of a 75-year-old female patient diagnosed with acute myeloid leukemia (AML) with monocytic differentiation having acquired JT involving 3q21→3qter as a donor chromosomal segment with 12 different recipient chromosomes. Each abnormal clone had monosomy 7 and trisomy 8. Patients with JT have an adverse outcome, a high risk of disease progression, and an unfavorable prognosis. This is the sixth case of JT involving 3q21 and the first case having 12 different recipient chromosomes (15 chromosomal segments) along with monosomy 7 in all abnormal clones reported in the literature.
Psychological Stress in Parents Delivering Preterm Child and Effects of Psychological Intervention on Them
Authors: Desai Shweta Shaileshbhai , Prakash R. Harihara , Mehta Jigar N. , Mahida Ankur 
Published: October 2024

Background:
Mothers and fathers may experience negative emotions as a result of an unusual early delivery and giving birth to high-risk newborns who require hospitalization in the neonatal intensive care unit (NICU) adds layers of stress on them. Hence, a variety of psychological and emotional services are required.

Aim:
The aim of this study was to identify common stressors in both parents of preterm children in the NICU and determine the effect of psychological intervention in the form of acceptance and commitment therapy (ACT) on stress in both parents.

Materials and Methodology:
A total of 60 parents of preterm children were randomly assigned to Intervention Group A and Control Group B. Group A received five sessions of ACT and routine counseling, while Group B received only routine nursing staff counseling. The Parental Stress Scale: Neonatal Intensive Care Unit (PSS: NICU) was used for pre- and postassessments to measure the parents’ stress levels on the 1st and 5th days, respectively.

Results:
Mothers’ stress levels in the NICU are significantly higher when they have a higher socioeconomic status, a higher education level, and a length of stay of more than 6 days, but significant stress is not found in fathers. ACT, when used along with routine counseling, is effective in reducing stress in both parents.

Conclusion:
ACT can be combined with routine counseling to help parents cope with depression, anxiety, and stress associated with preterm birth in the NICUs.
Impact of Home Stimulation on the Motor Development of Malnourished Toddlers: A Cross-sectional Study
Authors: Malhi Prahbhjot , Menon Jagadeesh , Bharti Bhavneet , Sidhu Manjit 
Published: October 2024

Objectives:
The objectives of the study are to investigate the relationship between malnutrition (as measured by stunting), motor development, and early parental stimulation during the critical preschool years.

Methodology:
The sample comprised of 150 mother-child dyads. Children with a history of any chronic illness or disability were excluded. The StimQ (Toddler version) questionnaire was used to assess parental stimulation. Motor development was measured by the motor development scale of the Developmental Assessment Scales for Indian Infants. Stunting was measured by the height-for-age Z-score (2 standard deviation [SD] or more below the World Health Organization standard) and this was used as a proxy measure for malnutrition.

Results:
Among the 150 children studied, 38.7% were stunted and 36.7% were wasted. Overall, the motor development quotient was 91.11 (SD = 14.57) and one-fifth (19.3%) of the sample had a delay in the motor domain. Stunting was positively associated with delayed motor developmental status (t = 2.84, P = 0.005). The motor delayed group, relative to the normal developing preschool children, had significantly lower total StimQ scores as well as on all the subscales. Multiple stepwise linear regression analysis indicated that two variables, namely total StimQ score and extent of stunting, were significantly related to the motor quotient score and explained 23.3% variance (F = 23.68, P = 0.0001), even after controlling for socioeconomic factors.

Conclusions:
Primary care pediatricians are ideally suited to integrate the promotion of maternal-child responsive interactions, psychosocial stimulation, and child nutritional rehabilitation programs in their clinical practice to foster healthy child development, especially in the context of resource-poor settings.
Intrathecal Fentanyl versus Intrathecal Dexmedetomidine as an Adjuvant to Isobaric Levobupivacaine 0.5% in Elective Cesarean Sections: A Randomized Control Trial
Authors: Basith Mohamed , Govindan Dilip Kumar , Prasad T. Krishna , Hanan Amin , Priyadharsini K Soundarya 
Published: October 2024

Background:
When a cesarean section is performed, it is crucial to have access to good postoperative analgesia. To achieve this, adjuvants are added along with local anesthetics as it has a synergistic action to improve its duration and quality. Alpha-2 adrenoceptor agonists and opioids such as dexmedetomidine and fentanyl, respectively, are used for their sedative, analgesic, and perioperative sympatholytic and cardiovascular stabilizing effects with reduced anesthetic requirements. The purpose of this research is to evaluate the effects of intrathecal fentanyl versus dexmedetomidine combined with levobupivacaine on postoperative analgesia and hemodynamic changes.

Materials and Methods:
This is a prospective randomized control trial, among 50 patients undergoing elective cesarean section. Group 1 will receive 0.5% levobupivacaine 2 ml + fentanyl 25 mcg and Group 2 will receive 0.5% levobupivacaine + dexmedetomidine 5 mcg. Duration of analgesia and onset and duration of sensory-motor block, perioperative analgesic requirements, sedation, and hemodynamic stability were compared. The data were entered into Microsoft Excel and analyzed using SPSS 16.

Results:
The baseline characteristics such as age and gender, weight, height, and body mass index were not statistically significant in both the groups. Duration of analgesia was significantly longer in the dexmedetomidine group than the fentanyl group. The mean time of onset of motor block in the group, for which dexmedetomidine was 14.23 ± 1.85 min and it was found to be much earlier than the local anesthetic group. All the patients in the dexmedetomidine group had a Visual Analog Scale (VAS) score of 0 (no pain) at the end of 4 h. In contrast, only 21 patients in the fentanyl group had a VAS score of 0, and four patients had a VAS score of 2, indicating mild pain requiring no treatment.

Conclusion:
The study showed that both fentanyl and dexmedetomidine as an adjuvant to levobupivacaine in cesarean section showed a longer duration of analgesia with increased sedation score and lesser pain score. When comparing the both, dexmedetomidine to the levobupivacaine has a more effective effect on postoperative pain management than fentanyl.
Evaluation of Turmeric extract for human spermatozoa morphology assessment in combination with haematoxylin
Authors: MP Rubina , Sukesh  , V Soumya , TK Mohammed Safeer , KB Riyas Basheer 
Published: October 2024

Introduction: This study aims to assess the effectiveness of utilising Turmeric extract as a sustainable alternative to synthetic Eosin dye in the commonly employed Haematoxylin and Eosin (H and E) staining method for analysing human spermatozoa morphology. While H and E staining yields high-quality results, the synthetic nature of Eosin raises concerns about its environmental impact. By exploring the use of Turmeric extract as a substitute, this research aims to provide a more eco-friendly solution without compromising the staining quality. Method: A solution of Turmeric extract, comprising 15 grams per 100 ml, is formulated using 70% alcohol. This alcoholic extract is substituted for Eosin in the process of H and E staining. In the experiments, two sets of semen smears are prepared. One set is subjected to H and E staining, while the other set undergoes staining with Haematoxylin and Turmeric (H and T). The quality of staining on each slide is assessed based on various parameters, including the background of the smear, as well as the distinct sections of the sperm, namely the head, neck, body, and tail. Result and conclusion: Turmeric confers a unique coloration to the stained spermatozoa, yielding a vivid and distinguishable visual effect that contrasts with the conventional pink staining achieved through the use of Eosin. In both staining techniques, the morphology of the spermatozoa is clearly observable and distinguishable, albeit with Eosin providing enhanced contrast and sharpness. The exceptional staining capacity of Turmeric paves the path for the exploration of natural alternatives to supplant synthetic dyes.
Comparative pharmaceutical evaluation of different samples of Yellow orpiment (Haratala) and Ayurvedic mineral formulation (Rasamanikya)
Authors: Wadnerwar Nilima Narayanrao 
Published: October 2024

Background: The present work aimed to study the Physical and Physico-chemical Properties of raw Haratala (Yellow Orpiment), processed Haratala, and its self-prepared formulation Rasamanikya with different market preparations of Rasamanikya by using advance methods such as ICP-AES (qualitative and quantitative analysis), XRD and FEGSEM so that the particle size and elemental content can be estimated and compared in all the samples. This is an attempt to study the classical method of preparation as well as effect of purification process on the constituents of the drug and their size. Methods: Raw Patra Haratala (Orpiment) and three different samples of Rasamanikya were procured from authentic sources. Shodhana (purification) of Haratala was conducted by two different methods. Rasamanikya was prepared from the Haratala processed by two different methods. All the eight samples were subjected to physicochemical analysis, ICPAES, XRD and FEGSEM. Results: Arsenic content is decreased in all the samples except CSH in comparison with ASH. In ICPAES, number of elements is reduced in CSH, KSH and RMCSH in comparison with ASH whereas it is increased in RMKSH, RMMSA, RMMSB, and RMMSC. XRD analysis reveals that Average Crystal Size is minimum in RMMSA and maximum in RMMSC. Average Lattice Strain is minimum in ASH and maximum in RMMSC. Orpiment was detected in all the samples except RMKSH, RMMSB and RMMSC. FEG SEM indicates that the gross particle size of all the samples varies from 1um to 100nm at resolution ranging from 200 to 100000 magnifications. The nanoparticles are visualized at 50000 to 100000 magnifications. Conclusion: Advanced techniques like ICPAES, XRD and FEGSEM are very helpful in estimating the heavy metal content and particle size in Ayurvedic medicine. It is necessary from safety point of view. Small size particles increase the absorption of the drug in the body which causes increase in the bioavailability and potency of the drug. Hence the dose of the formulation may be reduced. Thereby the untoward effects of the high doses can be avoided.