bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical features of gastroesophageal reflux disease and erosive esophagitis: Insights from patients undergoing esophagogastroduodenoscopy in resource-limited Ethiopia
Authors: Mengistie Firehiwot A , Shewaye Abate B , Tasamma Abel T , Ayalew Zekarias S 
Published: September 2024

BACKGROUND
Gastroesophageal reflux disease (GERD) is a common disease worldwide with varying clinical presentations and risk factors. Prevalence data for Africa is lacking, but an increasing trend is expected due to demographic and epidemiological transitions. Although endoscopic studies for general gastrointestinal disorders have shown some patients with erosive esophagitis (EE), no studies in Ethiopia have investigated the clinical characteristics, risk factors, and severity of GERD using esophagogastroduodenoscopy (EGD).
AIM
To assess the clinical features of GERD in Ethiopian patients who underwent EGD and determine the severity and risk factors of EE.
METHODS
We conducted a multicenter, retrospective cross-sectional study of 221 patients diagnosed with GERD and endoscopic findings of EE at Trauma Associated Severe Hemorrhage and Amniotic Membrane Stem Cell between January 2019 and August 2022. Data were collected from electronic medical records and phone call interviews. We used descriptive statistics and binary logistic regression analysis with SPSS version 26 to identify the association between variables with a statistical significance set at P value < 0.05.
RESULTS
The mean ± SD age of the patients was 44.8 (± 15.9) years, with a male-to-female ratio of 1.6:1. The most commonly reported symptom was epigastric pain (80.5%), followed by heartburn (43%). Los Angeles (LA)-A EE was diagnosed in 71.1% of patients, followed by LA-B (14.9%), LA-C (7.7%), and LA-D (5.9%). Multivariate analysis showed that age 50 or above, presence of bleeding, and endoscopic findings of duodenitis/duodenopathy were significantly associated with severe EE (P < 0.05). Stricture and Barrett’s esophagus were observed in 4.5% and 1.36% of patients with EE, respectively.
CONCLUSION
Most of the patients had milder EE with fewer complications. However, severe EE was more prevalent in older patients and those with duodenitis/duodenopathy.
B-cell-specific signatures reveal novel immunophenotyping and therapeutic targets for hepatocellular carcinoma
Authors: Xu Ke-Quan , Gong Zheng , Yang Jia-Ling , Xia Chu-Qi , Zhao Jian-Yi , Chen Xi 
Published: September 2024

BACKGROUND
Immunotherapy presents both promises and challenges in treating hepatocellular carcinoma (HCC) due to its complex immunological microenvironment. The role of B cells, a key part of the immune system, remains uncertain in HCC.
AIM
To identify B-cell-specific signatures and reveal novel immunophenotyping and therapeutic targets for HCC.
METHODS
Using the Tumor Immune Single-cell Hub 2 database, we identified B-cell-related genes (BRGs) in HCC. Gene enrichment analysis was performed to explore the possible collaboration between B cells and T cells in HCC. We conducted univariate Cox regression analysis using The Cancer Genome Atlas liver HCC collection dataset to find BRGs linked to HCC prognosis. Subsequently, least absolute shrinkage and selection operator regression was utilized to develop a prognostic model with 11 BRGs. The model was validated using the International Cancer Genome Consortium dataset and GSE76427.
RESULTS
The risk score derived from the prognostic model emerged as an independent prognostic factor for HCC. Analysis of the immune microenvironment and cell infiltration revealed the immune status of various risk groups, supporting the cooperation of B and T cells in suppressing HCC. The BRGs model identified new molecular subtypes of HCC, each with distinct immune characteristics. Drug sensitivity analysis identified targeted drugs effective for each HCC subtype, enabling precision therapy and guiding clinical decisions.
CONCLUSION
We clarified the role of B cells in HCC and propose that the BRGs model offers promising targets for personalized immunotherapy.
The effect of diabetes on the alevel of thyroid gland hormones in patients with uncontrolled type 2 diabetes in Thi-Qar Province,Iraq.
Authors: Saad H Al-Badry 
Published: September 2024

Background: Diabetes mellitus and thyroid dysfunction represent two prominent endocrine disorders frequently encountered in clinical practice. The objective of this research was to examine the prevalence of hypothyroidism among hospitalized individuals diagnosed with type 2 diabetes mellitus, along with its associated factors.
Methods: A total of 120 in patients suffering from type 2 diabetes mellitus were admitted to the metabolic diseases unit. The findings of this investigation indicated a notable elevation of T3 and T4 levels in patients with uncontrolled diabetes (GI) when compared to those with controlled diabetes (GII) and the control group. Conversely, the levels of TSH exhibited a significant reduction in patients with uncontrolled diabetes (GI) relative to both the controlled diabetic patients (GII) and the control group. Utilizing a significance threshold of (P ≤ 0.05), this study revealed a substantial decrease in the concentrations of thyroid hormones, alongside a reduction in thyroid stimulating hormone levels in patients with uncontrolled diabetes when contrasted with the controlled diabetic patients and the control group..
Aims of Study: Evaluation the risk degree of developing of metabolic disorders complications in patients with DM and their prevalence in Thi-Qar province.
Conclusion: It was concluded from this study that there is a clear relationship between high blood glucose levels and low T3 and T4 levels.
Hypersensitivity pneumonitis (HP)- Global and Indian scenario
Authors: Sundaram Padma 
Published: September 2024

Pulmonologists face a challenge in the diagnosis of HP which has multiple clinical phenotypes. In all newly diagnosed interstitial lung disease, HP should always be considered. The current guidelines classify HP into two main criteria based on clinical, radiological and pathological subtypes. They are acute/inflammatory HP and chronic/fibrotic HP. Patients who have a positive exposure history with a typical/classical pattern on HRCT and with BAL lymphocytosis, a diagnosis with high confidence can be made. Additional histopathological sampling should be done after multidisciplinary discussion in patients when an alternative diagnosis cannot be established.
All efforts must be undertaken in patients of HP to identify the environmental inducers and eliminate the source to prevent and minimize exposure to the same and prevent the progression of the disease. Systemic corticosteroids still continue to remain the mainstay of treatment. Randomized clinical trials with existing and/new antifibrotic agents are required for effective management of patients with chronic HP. Lung transplantation offers some hope for patients with chronic progressive HP and patients should be evaluated early for the same
Utility of needle core specimen in improving the diagnostic yield of EBUS TBNA
Authors: Abraham Sujith Varghese , Ameer K. A , Arjun P , Kesavan Vinod Kumar 
Published: September 2024

OBJECTIVES
EBUS-TBNA has become a highly sensitive, minimally invasive, outpatient procedure for the assessment of mediastinal adenopathy. The standard cytological analysis is the preferred modality for diagnosis from EBUS-TBNA and diagnostic value of needle core specimen is less studied. The current study fills the gap by comparing utility of EBUS needle-core specimen histology to EBUS FNA cytology.

METHODS
196 patients who underwent EBUS-TBNA between January 2017 and March 2020 in a single centre were included in the study. Diagnostic yields of two specimen-processing techniques, fixed slides (cytology) and needle core samples (histology) were compared.

RESULTS
The composite diagnostic index had found disease etiology in 176 of the 196 patients. EBUS cytology specimens were diagnostic in 125 cases (63.77%) and needle core specimen histology in 154 cases (78.57%). Combining both increased the yield to 166 (84.69%). Out of the total 186 in which both samples were available, the additional yield of histology samples over cytology samples was 19.351% whereas, that of cytology over histology was only 5.37%. Evaluation of needle core specimen histology is statistically significant over smear cytology in terms of sensitivity, specificity and diagnostic accuracy (p<0.05). Also, combined evaluation of cytology and histology improved the negative predictive value of the test than both considered separate (p<0.05).

CONCLUSION
Procuring needle core specimens for histological analysis improves the overall diagnostic yield of EBUS-TBNA than cytology alone. EBUS TBNA technique has yielded tissue samples adequate enough to perform molecular profiling for targeted therapies in lung cancer and microbiological investigations related to tuberculosis. Keywords: Endobronchial ultrasound, Mediastinal adenopathy, EBUS needle core biopsy, Cytology
Assessment of adherence to inhalers in asthmatics
Authors: Santhakumar Sonia , Kamarunniza Afsana Ibrahim 
Published: September 2024

Background:
Asthma is a chronic disorder which affects the quality of life and causes significant morbidity when uncontrolled. Good control of asthma has now become possible with the advent of preventive inhalers and well-established guidelines. But despite all this, a significant number of patients all over the world still has uncontrolled asthma. Suboptimal asthma control is largely due to poor adherence to inhalers and incorrect inhaler techniques. There are very few studies conducted in India to assess the adherence to inhalers using a validated and easily reproducible questionnaire which simultaneously assess adherence as well as psychometric factors associated with non-adherence.

Materials and Methods:
In this cross-sectional observational single centre study conducted in a tertiary centre in Kerala, India we have assessed the level of adherence to inhalers among 111 patients attending Pulmonology outpatient department between November 2019 to January 2020 using a well-validated Test of adherence to inhalers (TAI) questionnaire.

Results:
The result showed that good adherence to inhaler was seen only in 28.8%of patients, intermediate adherence in 27% and poor adherence in 45%. Overall, 67% of subjects were women, majority of subjects were older than 20yrs. of age and most of them had education of at least tenth standard and all were literate.

Conclusion:
Adherence to inhalers is low among asthmatics. There was a significant relation between TAI score and asthma control test score (ACT). The pattern of adherence was mostly erratic and ignorant types and good inhaler technique were seen in only 22.5%
Analysis of red cell distribution width in patients presented with interstitial lung disease
Authors: Francis Jiss Ann , Arun N.A. , Davis Rennis , Ajith T.A. 
Published: September 2024

Background:
Redcell distribution width (RDW) is a prognostic tool of different clinical conditions and a powerful predictor of mortality in elder adults. Increased RDW values were related to underlying chronic inflammation including interstitial lung disease(ILD). RDW as a biomarker to assess the severity of disease in ILD patients was reported. This study was aimed to evaluatethe change in RDW in ILD patients in late stages of the disease.

Methods:
A retrospective observational study was conducted among patients who died with ILD. Values of RDW during the later stages of disease (close to and 2 months beforedeath)werecollected from medical records. Variations of RDW in patients with or without smoking habits, occupational exposures, and types of ILD were also studied. Data were statistically analysed.

Results:
Forty-two patients died with ILD included. The value of RDW at 2 months before death was 15.4 ±1.8, whereas the valueclose to death was 16.1 ±2.4(p=0.030). The change in RDW values during late stages of ILD is significant. There was no association between RDW value 2 months before death with smoking history(p=0.112) or occupation(p=0.119) or types of ILD(P=0.121). But 86% of people with the smoking history presented with abnormal RDW value (>14.5%) at the time of their first presentation itself. No variation in RDW was found among patients with history of smoking status, occupational exposures, or types of ILD

Conclusion:
Increase in RDW was associated with later stages of ILD. Change in RDW value in later stages of can be used as a biomarker for poor survival.
Anthraco-fibrosis-A masquerader?
Authors: Panwala Mithali , Nair Sharada , Nair V. Kesavan 
Published: September 2024

Introduction
Anthraco fibrosis is a rare condition which has many clinical and radiological features mimicking or masquerading as pulmonary tuberculosis, carcinoma bronchus and silicosis. The biopsy from the lung lesion is the clincher in the diagnosis.

Abstract
We are presenting here a case of anthracofibrosis in a manual labourer who was working in the stone -cutting and tiles industry. He was engaged in the job actively for years though he was having co- morbidities like diabetes mellitus, tuberculosis etc. A heavy smoker with a smoking index of 600, he presented with chronic cough, dyspnoea, chest pain and melena. His investigations showed ECG changes suggestive of coronary artery disease and chest X-ray with right upper lobe cavitation and nodules in both lungs. Bronchoscopy revealed bluish pigmentation and nodules in the air ways and narrowing of the bronch in certain areas suggestive of bronchial stenosis. Bronchoscopic biopsy revealed only chronic inflammatory cells. Subsequently, CT guided tru-cut biopsy from the right upper lobe lesion confirmed features of anthracofibrosis. Though there are lakhs of people in India working in the construction industry with work involving stone and tile cutting etc., reports about anthraco fibrosis have been few and far between. Hence this report.
Pulmonary vasculitis as initial manifestation of Rheumatoid arthritis
Authors: Suhas H S , Sundaram P 
Published: September 2024

Rheumatoid arthritis (RA) is an autoimmune disorder of unknown aetiology that characteristically causes progressive, symmetric erosive destruction of bone and cartilage which can lead to deformities that may be often debilitating.
Although joint involvement is the primary manifestation of rheumatoid arthritis, there have been many instances where it can primarily present with extra articular manifestation in the form of subcutaneous nodule formation, vasculitis, inflammatory changes in the eyes, pericardial involvement and lung involvement.
Involvement of respiratory system may be seen in 30-40% patients of rheumatoid arthritis and in 10% of the patients, involvement of the respiratory system may be the initial manifestation and may precede the articular manifestations. It may present in the form of parenchymal involvement manifesting as interstitial lung disease, airway abnormality or with pleural involvement presenting as pleural effusion and rarely may present as pulmonary vasculitis.
We present a rare case of 60-year-old man presenting with pulmonary vasculitis in the form cavitating nodule with effusion with high levels of anti-cyclic citrullinated peptide (anti CCP) and RA levels.
Predictors of post discharge home oxygen therapy and Bilevel positive airway pressure therapy in stable hypercapnoea
Authors: Kancherla Roopa , Dhanasekaran Senthil , Rajagopal Srinivas , Kattula Dheeraj 
Published: September 2024

Background:
Hospital admission for acute exacerbation of COPD (AE-COPD) accounts for 70% of total costs of COPD treatment, and treatment cost is related to the duration of hospital stay. If post-discharge supportive care is required an extra cost will be added. The objectives of this study are to determine the predictive factors of post-discharge supportive care (Domiciliary oxygen, Bi-level positive airway pressure) in known COPD patients who got admitted with acute exacerbation. This is likely to help the treating physician to prime the family and plan an early discharge of the patient with supportive care instead of waiting for the patient to be off oxygen or BiPAP support.

Methods:
This is a retrospective study done at the pulmonology department of tertiary care hospital from January 2018-Jan 2019. Data sources were electronic medical records and the hospital discharge minimum data set. This study included 89 known COPD subjects who were not on prior supportive care (Long term oxygen therapy or home BIPAP) and were admitted for the management of acute exacerbation. Clinical parameters like symptoms at onset and the duration of symptoms (cough, fever, breathlessness, sputum production),comorbidities, initial blood investigations(complete blood counts, serum creatinine, arterial blood gas analysis, sputum culture reports)radiological findings, treatment details, pulmonary function test were evaluated with appropriate statistical tests. Parameters associated with post-discharge supportive care were evaluated.

Results:
A total of 89 patients were included in the study. Four patients were excluded because of the death. Presence of type II respiratory failure related findings like respiratory acidosis PH (P=0.02), elevated bicarbonate HCO3 (P=0.01), elevated carbon dioxide level PCO2 (p=0.007) in the ABG, and the requirement of non-invasive ventilation (P=0.00), Chest X-ray finding of hyperinflation (P=0.03) and treatment-related variables like prolonged duration of hospitalization (P<0.01) were associated with post-discharge supportive care (Home oxygen therapy and BiPAP support) in univariate analysis. In the multivariate analysis hyperinflation (Odds ratio OR-4.73; 95% confidence interval; 1.37-16.33), noninvasive ventilation (OR-4.9; 95% CI: 1.29-18.47), and prolonged duration of hospitalization (OR-1.32; 95% CI: 1.05-1.66) remained significantly associated with post-discharge home oxygen therapy and home BiPAP therapy.

Conclusion:
This study results conclude that severe disease as marked by hyperinflation on Chest X-ray, presence of type II respiratory failure related changes in the ABG and requirement of non-invasive ventilation, and longer duration of hospitalization predicts the post-discharge supportive care. These findings can help the clinician to prepare for earlier discharge with post-discharge supportive care.
Association between depression and level of asthma control
Authors: Shabna Kader K T , Win Ronald B , Nair Reshmi S , Anil Kumar V T , Nair Sanjeev , Kumari K Anitha 
Published: September 2024

Background and objectives:
Asthma and depression are two highly prevalent chronic diseases in India and worldwide, imposing unacceptable social and economic burdens on the public health care system. Asthma has long been considered an illness in which mood and emotions contribute to poor control of symptoms. The contribution of psychiatric diseases especially, depression towards poor asthma control was not been widely studied in Indian scenario. Therefore, this study was conducted to find out the potential relationship between the level of asthma control and depression in the Indian scenario.

Materials and methods:
This was a case control study with controlled and uncontrolled adult asthma patients as controls and cases, respectively. The sample size calculated was 168 (84 controlled and 84 uncontrolled) asthma patients. Those with concomitant Asthma COPD overlap/diagnosed psychiatric disorders were excluded. Control of asthma was determined using the GINA 2016 adult asthma control tool and depressive symptoms with Patient Health Questionnaire 9. Data analysis was done using Epi Info 7 software.

Results:
Of the 168 asthma patients in this study, 134(79.7%) were females; mean age was 43.8±16years and mean BMI was 23.5±4. Out of the controlled asthmatics 10(11.9%), and out of the uncontrolled asthmatics 44(52.3%) experienced moderate to severe depressive symptoms (Odds Ratio-8; p<0.001). Other factors associated with poor asthma control included poor medication compliance (p<0.001), rhinosinusitis (p=0.004), low socioeconomic status (p=0.005) and FeV1<60% (p=0.001).

Conclusion:
Depression is associated with poor control of Asthma. Various other factors associated with poor asthma control were also determined.
Absolute Eosinophil Count as a marker to differentiate COVID-19 from other short febrile illness
Authors: Sharada Nair C , Nivya Ravi , Arjun Padmanabhan , Sanjeev Nair , Ameer K A 
Published: September 2024

Purpose:
Peripheral blood routine examination results are often abnormal in Covid-19. This study aimed to determine whether absolute eosinophil count can be used as a marker to differentiate covid-19 from other short febrile illness

Materials and Methods:
This was a single-center retrospective descriptive study which studied 1000 laboratory confirmed Covid-19 patients and 300 patients with non-Covid short febrile illness. The peripheral blood routine examination results and relevant demographic parameterson the first day of hospital visit for both groups; and the clinical disease severity category assigned to each patient in the Covid-19 group were obtained from the hospital electronic medical records and analysed at the end of the study using appropriate statistical tools.

Results:
The median AEC was 55 cells/mm3 (13.2-140.4) and 167.57cells/mm3 (83.6-247.4) in the Covid and non-Covid groups respectively (p < 0.001). The median NLR was 2.6 (1.5-5.3) and 2.7 (1.9-4.2) in the Covid and non-Covid groups respectively (p=0.689). Upon comparing mild, moderate and severe clinical disease severity, median AEC was lowest and median NLR was highest in the severe category (p< 0.001)

Conclusion:
A low AEC may help differentiate Covid-19 infection from other short febrile illness when used in conjunction with clinico-radiological features. An initial low AEC and high NLR can predict increased clinical disease severity.
Association of thrombocytopenia with severity and outcome of COVID-19
Authors: Babu Carol Hannah , Huliraj N , Kumar Deepak R , Santhosh Kumari K R 
Published: September 2024

Background:
Laboratory parameters and their association with clinical outcomes in COVID-19 have been an area of focus of researchworldwide. The role of thrombocytopenia in assessing the disease severity and adverse outcome in patients with COVID-19 is not clearly established. The study aims to find the association of thrombocytopenia with the severity and outcome of COVID-19.

Materials and Methods:
This is a retrospective study conducted in the Department of Respiratory Medicine at a tertiary Centre. 120 RT-PCR confirmed COVID-19 patients, 40 from each category,>18 years of age, admitted from July-September 2020 were included. Mann Whitney Test was used to compare the mean Platelet count between survivors and non-survivors in each category. Statistical significance was set at P< 0.05.

Results:
Of 120 COVID-19 patients, 74 were males (61.67%) and the average age in all 3 categories varies from 49.63-to 54.60. There were 87 survivors (72.5%). A statistically significant association was found between low platelet count and the disease severity and mortality in patients with COVID-19 (P< 0.001). The sensitivity of low platelet count at the time of admission in predicting the mortality was 80% in Category C patients with the cut-off value being 1.13 lakh per microliter.

Conclusion:
The degree of thrombocytopenia was more in patients with severe disease and non-survivors than in survivors of COVID-19. Thus, platelet count may serve as a simple and inexpensive biomarker for disease severity and risk of mortality in patients with COVID-19.