bluuebunny/crossref_metadata_2025_split huggingface dataset:
EMERALD: Emergency visit audit of patients treated under medical oncology in a tertiary cancer center: Logical steps to decrease the burden
Authors: Joshi Amit , Patil Vijay M. , Noronha Vanita , Ramaswamy Anant , Gupta Sudeep , Bhattacharjee Atanu , Bonda Avinash , Chandrakanth M. V. , Ostwal Vikas , Khattry Navin , Banavali Shripad , Prabhash Kumar 
Published: January 2018

Abstract
Background: We are a tertiary care cancer center and have approximately 1000–1500 emergency visits by cancer patients undergoing treatment under the adult medical oncology unit each month. However, due to the lack of a systematic audit, we are unable to plan steps toward the improvement in quality of emergency services, and hence the audit was planned. Methods: All emergency visits under the adult medical oncology department in the month of July 2015 were audited. The cause of visit, the demographic details, cancer details, and chemotherapy status were obtained from the electronic medical records. The emergency visits were classified as avoidable or unavoidable. Descriptive statistics were performed. Reasons for avoidable emergency visits were sought. Results: Out of 1199 visits, 1168 visits were classifiable. Six hundred and ninety-six visits were classified as unavoidable (59.6%, 95% CI: 56.7–62.4), 386 visits were classified as probably avoidable visit (33.0%, 95% CI: 30.4–35.8) whereas the remaining 86 (7.4%, 95% CI: 6.0–9.01) were classified as absolutely avoidable. Two hundred and ninety-seven visits happened on weekends (25.6%) and 138 visits converted into an inpatient admission (11.9%). The factors associated with avoidable visits were curative intention of treatment (odds ratio - 2.49), discontinued chemotherapy status (risk ratio [RR] - 8.28), and private category file status (RR – 1.89). Conclusion: A proportion of visits to emergency services can be curtailed. Approximately one-fourth of patients are seen on weekends, and only about one-tenth of patients get admitted.
Epidemiology of cancer in young in central India: An analysis of rural cancer hospital data
Authors: Gupta Novak , Chitalkar Prakash , Mishra Renu , Punia Ankur 
Published: January 2018

Abstract
Background: Cancers in teenage and young adults (TYAs), though an increasing cause of mortality in our country, have been scarcely studied. The lack of studies of TYAs can significantly affect the outcomes of the youth in the prime of their lives. Aims: The aim of this study was to study the type of cancers in the TYA at a rural cancer center in central India. Design and Methods: A prospective study in the department of medical oncology, from the period of January 2013 till March 2016, was done. Data regarding socioepidemiological factors were collected for new cancer patients between the age group of 15–30 years in semi-structured questionnaire and from the hospital records. Cancers were classified according to the Birch classification. The cases were analyzed according to the epidemiological profile, classification of cancer, and age-wise distribution using descriptive analysis. Results: In this study, out of 5221 cancer patients, TYAs accounted for 327 (6.26%) with 189 males and 138 females (M: F– 1.37:1). The maximum cases were seen in 25–30 years' age group. Carcinoma was the most common malignancy (54.74%) with an increase from 19.56% in the 15–19 years' age group to 64.82% in the 25–30-year-old patients. Conclusion: The present study gives a glimpse of the TYA cancers in the central India. More than half of the young cancer patients suffer from carcinomas with about half of these being head and neck cancers.
Oncology gold standard® practical consensus recommendations for the use of monoclonal antibodies in the management of squamous cell carcinoma of head and neck
Authors: Babu Govind , Bahl Ankur , Bhattacharya G. S. , Bhowmik K. T. , Dattatraya P. S. , Ghadyalpatil Nikhil , Karandikar S. M. , Kulkarni Padmaj , Sridharan Nithya , Parikh Purvish , Prabhash Kumar , Raja T. , Rajasundaram S. , Subramanian S. , Talapatra Kaustav , Vaid Ashok 
Published: January 2018

AbstractWe present the 2017 Oncology Gold Standard Practical Consensus Recommendation for use of monoclonal antibodies in the management of advanced squamous cell carcinoma of head neck region.
Short message service prompted mouth self-examination in oral cancer patients as an alternative to frequent hospital-based surveillance
Authors: Vaishampayan Sagar , Malik Akshat , Pawar Prashant , Arya Kavi , Chaturvedi Pankaj 
Published: January 2018

Abstract
Introduction: Oral squamous cell carcinoma (OSCC) are amongst commonest cancer in the Indian sub-continent. After treatment, these patients require frequent followup to look for recurrences/second primary. Mouth Self Examination (MSE) has a great potential in all levels of prevention of oral cancer. However, the compliance to self-examination has been reported as poor. Mobile phone is a cheap and effective way to reach out to people. Short Message Service (SMS) is extremely popular can be a very effective motivational and interactive tool in health care setting. Methodology: We aimed to identify in adequately treated OSCC patients, the influence of health provider initiated SMS on the compliance to the MSE and to establish the efficacy of MSE by comparing patients' MSE interpretation via replies to the SMS with that of the experts' opinion on clinical examination status during follow up. Conclusion: We conclude that MSE can be very useful in adequately treated OSCC patients for evaluating disease status. All treated OSCC patients must be adequately educated for MSE as an integral part of treatment & follow-up protocol by the health provider facility. Health provider generated SMS reminders do improve motivation and compliance towards MSE but don't seem to reduce dropouts in follow up for large and diverse population like that in India.
Adolescents and young adults: A study of distribution of cancer at ages 15–39 years in a tertiary care hospital from North India: Epidemiological considerations
Authors: Kakkar Neha , Gupta Ajay , Sharma Neeraj Kumar , Agarwal Prachi , Kaur Jaspreet 
Published: January 2018

Abstract
Purpose: This study aimed to analyze cancer pattern among adolescents and young adults (AYA) in a tertiary care center in North India. Materials and Methods: A retrospective study from January 2011 to December 2014 was undertaken on AYA cancer patients (aged 15–39 years). Results: Totally 1077 cases of AYA cancers were identified for analyzing the frequency and pattern of cancer distribution. The most common cancer was head and neck (32%) followed by breast (14.2%). The distribution pattern was observed to be varying in different age groups with lymphoma, leukemia, bone tumors, and sarcomas in adolescents while carcinomas being more frequent in young adults. Conclusion: Cancer distribution patterns are distinct among AYA in terms of epidemiology and biology.
Male breast cancer: A retrospective review of clinical profile from a tertiary cancer care center of India
Authors: Ram Dharma , Rajappa Suhas K. , Selvakumar Veda P. , Shukla Himanshu , Goel Ashish , Kumar Rajeev , Kumar Kapil 
Published: January 2018

Abstract
Aim: Present study was done with an aim to analyse the clinicopathological and survival characteristics of male breast cancer patients. Methods: We did a retrospective review of our database and analysed total 27 patients who presented to breast oncology unit of Rajiv Gandhi cancer centre and research institute from January 2010 to April 2016. Results: Most common stage at presentation in our study was in stage II. The median follow up was 32.75 months. The actuarial 5-year survival was 92.30% and DFS was 76.30%. Only hormone receptor status was found as a significant prognostic variable among the prognostic factors studied for disease free survival. Conclusions: Carcinoma breast in male is a relatively rare disease and management principles are translated from our understanding of breast cancer in women. A relatively early stage at presentation is a contrasting finding of our series which may be responsible for a significantly better actuarial 5 year survival rates.
Tolerance and adverse event profile with sorafenib in Indian patients with advanced hepatocellular carcinoma
Authors: Ostwal Vikas , Gupta Tarachand , Chopra Supriya , Lewis Sherly , Goel Mahesh , Patkar Shraddha , Shetty Nitin , Ramaswamy Anant 
Published: January 2018

Abstract
Background: The current standard of treatment for advanced hepatocellular cancer Hepatocellular carcinoma (HCC) is Sorafenib. Data regarding its tolerance and adverse event profile in Indian patients is scarce. Materials and Methods: The primary aim of this analysis was to assess the adverse events (Grade 3 and Grade 4 as per CTCAE v4.0) and requirements for dose reduction with sorafenib in advanced HCC. Details of consecutive patients started on 800 mg/day dosing were obtained from a prospectively maintained database (over a period of 6 months) and analyzed. Results: Thirty-nine patients were available for inclusion in the study. Median age was 58 years (range: 20–75). All patients were classified as Barcelona clinic liver cancer C. Common side effects seen were liver dysfunction (38.5%), hand-foot-syndrome-rash (HFSR) (Grade 2 and 3-25.6%), fatigue (Grade 2 and Grade 3–10.3%), and diarrhea (7.7%). Dose reduction was required in 43.6% of patients. Drug interruptions/cessation was required in 38.5% of patients within the first four months of treatment. Nearly 41% of patients required cessation of sorafenib due to intolerable side-effects while 28.2% stopped sorafenib due to progressive disease. At a median follow-up of 4.9 months, median event-free survival (EFS) was 4.20 months (95% confidence interval: 3.343–5.068). Conclusion: A higher incidence of liver dysfunction and HFSR is seen in Indian patients as compared to published data. A significant proportion of patients required cessation of sorafenib due to adverse events in our series. However, EFS remains on par with that seen in larger studies with sorafenib in advanced HCC.
Clinicopathological and molecular epidemiological study of lung cancer patients seen at a tertiary care hospital in Northern India
Authors: Singh Randeep , Rohtagi Nitesh 
Published: January 2018

Abstract
Aims: The primary objective of this study was to estimate the clinicopathological and molecular profile of lung cancer patients along with the evaluation of their clinical characteristics at a tertiary care hospital in Northern India. Subjects and Methods: A total of 421 patients with lung cancer histology who were treated at Max Super Speciality Hospitals were included in the study. The study protocol conforms to the ethical guidelines of the 1975 Declaration of Helsinki and permission was obtained from the Ethics Committee before the start of the study. Clinical characteristics and molecular profiling data were collected from the patient's medical records. Results: There were 330 (78.4%) men and 91 (21.6%) women with a median age of 62 years (range: 30–93 years). Of the 421 patients, 388 (92.2%) patients had the nonsmall cell lung cancer (NSCLC) histology whereas 33 (7.8%) patients were of SCLC histology. Histology and gender had a significant association with NSCLC and SCLC (P < 0.05). Epidermal growth factor receptor (EGFR) and echinoderm microtubule-associated protein like 4-anaplastic lymphoma kinase (EML4-ALK) fusion gene testing was done in 120 and 93 patients, respectively. Of the 120 patients, 24 (20%) cases were positive for EGFR mutations whereas EML4-ALK fusion gene was present in 8 (8.6%) out of 93 patients. Conclusions: Our study confirms the importance of molecular testing in the NSCLC patient subgroup with an aim to identify the exact molecular targets that can benefit from the newer generation of targeted therapies.
Percutaneous fixation of acute scaphoid fractures
Authors: Yassin Ismail , El-Nahas Mohammad , Awadallah Mostafa 
Published: January 2018

Objective
The aim of this study were to determine whether the functional outcome of the evaluation of the effectiveness of percutaneous retrograde (volar) approach of insertion of cannulated Herbert's screw to stabilize acute scaphoid fractures and to evaluate the functional outcome after this minimally invasive operative management of this problematic fracture.

Background
Scaphoid fracture is the most common carpal fracture. It accounts for ∼60–90% of carpal and 11% of hand fractures. Scaphoid fracture is a common fracture affecting mainly young active people during their work or while participating in sports activities.

Patients and methods
This is a retrospective observational study of patients undergoing surgery for percutaneous fixation of acute scaphoid fracture. In our study, 12 patients with less than 14-day-old fractures were fixed percutaneously by Herbert's screw and reviewed for a minimum of 12 months (average of 24 months). The functional outcome of this method was assessed.

Results
Fracture union was achieved in 11 (91.6%) cases at a mean of 8.29 weeks (6–12 weeks), whereas one case was ununited.

Conclusion
This study proves that fixation of acute scaphoid fractures results in predictable satisfactory union rate and functional outcome. Moreover, it proves that percutaneous Herbert's screw insertion carries no risk of damage to soft tissues or vascular supply.
Cerebrovascular reactivity and neurogenic inflammation in migraine
Authors: Maabady Manal H. , Saed Ghada , El-Said Seham , Saif Eldeen Eman M. 
Published: January 2018

Background
The exact mechanism of migraine is still unknown; however, it is believed to be a neurovascular disorder, where the cerebral vascular reactivity is malfunctioning. Although several studies have found alterations in velocity of blood flow and in cerebral vasomotor reactivity of intracranial arteries in migraineurs in headache-free periods, as well as during migraine attacks, the results are inconclusive. Another theory of migraine is the neurogenic inflammation involving the release of various vasoactive neuropeptides, which evoke a cascade of events that have a role in migraine attacks.

Aim of work
To evaluate the role of both vascular and inflammatory theories in migraine with and without aura.

Objective
The objective of this study was to examine the cerebrovascular reactivity to repetitive flash stimulation during interictal period of migraine and determine the serum levels of transforming growth factor β-1 (TGFβ-1) as an inflammatory mediator in migraine with and without aura.

Patients and methods
The changes in peak systolic volume (PSV) of both middle cerebral and posterior cerebral arteries in response to repetitive flash stimulation were evaluated by transcranial Doppler in 35 migraineurs (23 patients with aura and 12 without aura), during interictal period, and in 25 age-matched and sex-matched apparently healthy control participants. Moreover, serum levels of TGFβ-1 were determined in both the patients and control participants.

Results
The middle cerebral artery in migraineurs shows significant increase in PSV after flash stimulation in comparison with control participants who showed a habituation in PSV levels in response to stimulation. In posterior cerebral artery, compared with normal participants, migraineurs showed significant increase in PSV measures and PSV changes at the beginning and after the end of stimulation. The lack of habituation is significantly pronounced in patients with migraine with aura, in comparison with those without aura. Regarding TGFβ-1 serum levels, they were significantly higher in migraineurs than control participants. Moreover, patients with migraine without aura show significantly higher serum levels of TGFβ-1 in comparison with patients with migraine with aura.

Conclusion
Lack of habituation of the cerebrovascular response in migrainers might contribute to a disturbance in the metabolic homeostasis of the brain that might induce migraine attacks. Neurogenic inflammation has a role in migraine attacks.
Effect of female increased body mass index on intracytoplasmic sperm injection outcome
Authors: Shehata Mohamed 
Published: January 2018

Background
BMI is calculated by dividing the weight in kilograms by height in meters squared (kg/m2). It is known that the reproductive potential in obese women is decreased and to be associated with suboptimal outcomes after assisted reproductive technologies.

Objective
The aim of this study was to evaluate the effect of increased BMI on pregnancy outcome in women undergoing intracytoplasmic sperm injection (ICSI) cycle.

Patients and methods
This retrospective study was conducted on 200 Women at Assisted Reproductive Technology Unit, International Islamic Centre for Population Studies and Research (IICPSR), Al-Azhar University. Data were recruited from patient files at IICPSR from January 2013 to December 2015, who had ICSI trial during this period. Patients who were included in the study were subdivided into two groups according to BMI − first group: normal-weight women with BMI between 18 and 24.9 kg/m2 (100 cases); secondgroup: overweight and obese women weighing at least 25 kg/m2 (100 cases). The outcomes in the two groups were demonstrated in all stages of ICSI.

Results
The duration of infertility was progressively higher as BMI increased. Basal luteinizing hormone, follicle-stimulating hormone, and estradiol levels were higher in group 2 than in group 1. Higher total doses of gonadotropin were required in group 2 to obtain equivalent ovarian response than in group 1. No significant difference was observed on ovarian response and embryonic parameters. Serum estradiol level on ovulation triggering day was significantly higher in group 2. Ovarian hyperstimulation and cycle outcome were not significantly different between both groups.

Conclusion
Overweight and obesity appear to have independent adverse effects on ovarian response to stimulation and outcomes in women undergoing ICSI.
Prognostic factors of brainstem infarction in a sample of Egyptian patients
Authors: El-Zayat Sayed A. , Abd El-Hamid Tarek M. , Sobh Khaled M. , Abd El-Aziz Ahmed F. , Mohamed Mohie EL-Din T. , Attia Mahmoud S. 
Published: January 2018

Background
Ischemic brainstem stroke is estimated to constitute 10% of all first ischemic brain strokes. Because the brainstem is involved in almost all of the important functions of the central nervous system, brainstem infarction (BSI) is relatively dangerous with a high mortality. Early prediction of the severity and degree of disability and identification of high-risk patients are critical for the treatment of patients with BSI.

Objective
This study aimed to evaluate patients with BSI in terms of clinical, laboratory, and radiological factors to study the outcomes of these patients.

Patients and methods
Patients were admitted at the Stroke Unit and Internal Neurology Department of Al-Azhar University Hospitals (Al-Hussein and Sayed Galal Hospitals), over a period of 6 months, from 1 December 2016 to 30 May 2017, with a diagnosis of acute BSI, confirmed by computed tomography brain and MRI brain with diffusion. The study included 31 patients and were subjected to clinical, laboratory, radiologic assessment (by computed tomography brain and MRI brain with diffusion), and assessment of severity by the National Institute of Health Stroke Scale (NIHSS) score at the time of admission and discharge. The modified Rankin Scale (mRS) score at discharge was used to divide patients into three groups: patients with mRS less than or equal to 2 were considered to have achieved a good outcome, those with mRS greater than 2–5 were considered to have achieved a poor outcome, and those who died had mRS equal to 6.

Results
Overall, 14 (45.2%) patients had a good prognosis, 13 (41.9%) patients had a poor prognosis, and four (12.9%) patients died. Dysphagia, vomiting, cranial neuropathy, and high NIHSS score on admission were associated with a poor outcome. There was no relationship between the outcomes of the studied patients in relation to age, sex, hypertension, atrial fibrillation, diabetes mellitus, ischemic heart disease, high lipid profile, smoking, previous cerebrovascular stroke, obesity.

Conclusion
Dysphagia, vomiting, cranial neuropathy, and high NIHSS score were associated with a poor prognosis.
Prospective, comparative, randomized, and controlled study of endotracheal intubation conditions without muscle relaxant in children receiving general anesthesia
Authors: Hegazy Abdelazim A. T. 
Published: January 2018

Introduction
Intubation without the need for a muscle relaxant is a common practice in pediatric patients. Many drugs are used; sevoflurane and propofol are used to improve the intubation score and to decrease the usage of a muscle relaxant and avoid its side effects.

Aim
This study aimed to compare intubation conditions and hemodynamic responses to two induction regimens, without a muscle relaxant using an anesthetic, sevoflurane versus propofol, in children, who required general anesthesia.

Patients and methods
A prospective controlled study was carried out on 90 patients with ASA physical status I and II scheduled for elective pediatric day case surgeries. Patients were divided into three equal groups of 30 patients each. The patients in the S group received inhalational induction sevoflurane. The P group received 3 mg/kg propofol intravenously. The C group received 2 mg/kg succinylcholine after 3 mg/kg propofol intravenously as a control group; maintenance was performed by inhalation using sevoflurane after intubation in all groups. The intubation conditions, hemodynamic parameters (heart rate, peripheral oxygen saturation) induction time, and recovery time were all recorded and statistically analyzed.

Results
With respect to the intubation conditions, no patient in any of the two groups (S and P groups) needed rescue a muscle relaxant for intubation. The S group showed more acceptable and excellent intubation conditions versus the propofol groups (100 and 96.7%, respectively). The heart rate was comparable in all groups at all readings; except during intubation, reading was highly significantly low in the sevoflurane group. Induction time was longer in the sevoflurane group than in the other groups. The recovery time was short in the S group than in the propofol group.

Conclusion
Endotracheal intubation without neuromuscular blocking agents in pediatric patients undergoing day case surgeries was achieved with no severe respiratory or hemodynamic adverse events by using propofol (3 mg/kg) or sevoflurane 8% at induction and then reduced to a maintenance level after intubation.
A novel 12 bp deletion within goat &lt;i&gt;LHX4&lt;/i&gt; gene significantly affected litter size
Authors: Yan Hailong , Zhang Fei , Wang Ke , Liu Jinwang , Zhu Haijing , Pan Chuanying , Qu Lei 
Published: January 2018

Abstract. The LIM homeobox transcription factor 4 (LHX4) gene plays a critical role in regulating the development of the pituitary and the secretion of growth hormone (GH) and prolactin (PRL) associated with reproduction. Thus this gene may affect litter size. Herein, the aim of this study is to detect the novel insertion/deletion (indel) within the LHX4 gene as well as to test its association with litter size in 1149 Shaanbei white cashmere goats. Herein, a novel 12 bp indel (NC_030823.1:g.60001011_60001022delGGGGAGGAGGGG) was firstly found, which was located in the first intron. Meanwhile, three genotypes were detected in Shaanbei white cashmere goats, and the allelic frequencies of I and D were 0.593 and 0.407, respectively. Interestingly, the genotype distributions between mothers of single-lamb (n = 895) and multi-lamb (n = 254) groups within Shaanbei white cashmere goats were significantly different, implying that the 12 bp indel might affect the litter size. Furthermore, the association analysis was carried out to find out that the 12 bp indel was significantly associated with litter size in the analyzed goat population (P  <  0.05). The litter sizes of genotype DD and ID individuals were superior to those of genotype II (P  <  0.05). These findings suggest that this locus could be considered as a genetic marker for goat breeding, enriching the research category of functional genome of goats.