bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Nurse-Led Stroke Education Program (NSEP) on ADL and SS-QOL among Patients with Stroke and Burden among Caregivers
Authors: Devi Bamini 
Published: August 2024

Aim:
To determine the effectiveness of Nurse-Led Stroke Education Program (NSEP) on Activities of Daily Living (ADL) and Stroke-Specific Quality of Life (SS-QOL) among patients with stroke and elicit burden among caregivers.

Method:
A quantitative research method was adopted. Stroke victims and their caregivers who fulfill eligibility criteria were chosen. The sample size was 170 dyads, 85 dyads in the study and 85 dyads in the control groups were recruited by lottery method. NSEP was implemented in the study group dyads. The posttest assessments were taken on days 30, 90, and 180 for both groups.

Results:
The mean scores of ADL in the study and control group during posttest-I, II, and III were significant at P < 0.05. The mean scores of PCS during posttest-I, II, and III showed significance at P < 0.05. MCS mean score during posttest-I, II, and III was significant at P < 0.05. Overall mean scores of SS-QOL in the study group were found to be higher than that in the control group during posttest-I, II, and III at P < 0.01 between groups. The burden mean scores were higher in the control group caregiver than in the study group caregiver during the posttest-I and II at P < 0.01.

Conclusion:
Findings concluded that the combination of interventions like structured teaching, an information booklet on “Life after stroke,” and telephonic reminder and reinforcement has a positive impact on ADL and SS-QOL of patients with stroke and minimized caregiver burden.
Influence of Abdominal Obesity (Waist–Hip ratio) on Memory Consolidation in Adolescent Medical Undergraduates − A Cross-sectional Study
Authors: Rakesh R. , Muthu Prathibha K. , Sundararajan Prem Kumar , Gutta Naresh K. 
Published: August 2024

Background:
Waist Hip Ratio (WHR), a measure of abdominal obesity is being co-related with memory consolidation based on its relation with stress and sleep. The objective of the present cross-sectional study was to evaluate the association between WHR and memory consolidation in adolescent medical undergraduates.

Methodology:
An analytical cross-sectional study was conducted in a South Indian medical college. After obtaining ethics clearance, the study was conducted on 42 males and 63 females of 17–19 years of age. WHR was measured according to WHO guidelines using Gulick 2 plus inch tape. Sleep-dependent memory consolidation test was conducted in evening 3:00 pm followed by next morning 9:00 am. WHR between genders was compared using Student t test. The study population was divided into obese and non obese individuals, based on the calculated WHR. Then, the mean memory consolidation test scores were compared using Mann Whitney U test. The correlation between WHR and memory consolidation test scores was evaluated using Pearson’s correlation test.

Results & Discussion:
The average WHR of males (0.845 ± 0.058) was significantly higher than females (0.778 ± 0.051) (P<0.001). The morning session memory consolidation test scores were higher in the normal group when compared to the substantially increased risk for obesity groups, although not statistically significant. WHR showed significant negative correlation with sleep dependent memory experiment scores.

Conclusion:
The relationship between WHR and memory consolidation in the present study highlights the need for an awareness to adopt life style modifications which might not only benefit the general health status but also might have an impact on their memory consolidation and academic performance.
Disseminated epithelial cancers—An autopsy analysis
Authors: Vaideeswar Pradeep , Patil Sachin , Chaudhari Jayashri 
Published: August 2024

Background:
Cancer is one of the leading causes of death due to noncommunicable diseases worldwide. Despite increasing public awareness and availability of sophisticated imaging techniques, some cancers evade clinical diagnosis and/or are incidentally encountered at autopsies, often with dissemination.

Aims:
The present study evaluated the disseminated epithelial cancers at autopsy.

Materials and Methods:
This is a retrospective observational 5-year autopsy analysis of disseminated epithelial cancers performed at a tertiary-care hospital. The cases were categorized as (1) clinically diagnosed malignancy, known primary; (2) clinically diagnosed malignancy, unknown primary; and (3) clinically undiagnosed malignancy.

Statistical Analysis:
Nil.

Results:
Dissemination was identified in 66 (57.9%) of the 114 patients with epithelial malignancies. There were 29 patients (43.9%) in category 1, 26 patients (39.4%) in category 2, and 11 patients (16.7%) in category 3, majority of whom were women (38 patients, 57.6%). When all categories were considered together, lung and colorectal carcinomas were the commonest cancers seen in 13 (19.7%) and 8 (12.1%) patients, respectively, in both men and women. Majority of the patients (43 cases, 65.2%) had symptoms produced by metastases, which were the sole manifestations in 13 patients (19.7%). Lungs and liver were the common metastatic sites.

Conclusions:
Cancerous dissemination continues to be a major cause of morbidity and mortality even after considerable improvements in the surgical or nonsurgical treatment modalities. An autopsy study can provide important clinical insights in retrospect.
GP73 level in patients with chronic hepatitis B
Authors: Atilla Aynur , Taşkın Mehmet H. , Kazak Zülay , Aydın Saliha , Kılıç S S 
Published: August 2024

Background/Aims:
In this study, we investigated the Golgi protein 73 (GP73) level in Hepatitis B and determined the correlation between Hepatitis B virus (HBV) DNA, alanine aminotransferase (ALT), aspartate aminotransferase (AST) levels, and liver histopathology. Materials and

Methods:
GP73 levels were estimated by enzyme-linked immunosorbent assay in serum samples from patients. Liver biopsy specimens were examined by the same pathologist.

Results:
This study included a total of 127 patients who underwent liver biopsy. Of patients, 85% were HBeAg negative. HBV DNA level was median 134667 IU/mL (2247–170000000 IU/mL), Liver biopsy results revealed a mean Histological Activity Index (HAI) grade of 7.7 ± 3.4 and a mean fibrosis stage of 2.25 ± 1.06 gr/dL. GP73 was as follows: a mean of 14.8 ± 7.9 ng/mL and a median of 12.9 (4.8–50.1) ng/mL. A weak correlation between GP73 level and AST (r = 0.236, P = 0.11), fibrosis stage (r = 0.287, P = 0.002), and HAI grade (r = 0.218, P = 0.016) was noted. No statistically significant correlation was detected between GP73 and ALT (r = 0.16, P = 0.08), HBV DNA (r = 0.13, P = 0.08).

Conclusion:
Although recent studies revealed a strong correlation and increased GP73 levels in accordance with HAI scores and the fibrosis grade of liver, we detected a weak correlation between serum GP73 levels and HAI scores, fibrosis stage, and AST. This may be due to the insufficient number of patients with higher HAI grading and fibrosis staging in our study. Therefore, we concluded that, in cases of low-moderate fibrosis and HAI grading, GP73 seemed not to be useful and a reliable marker to replace liver biopsy.
Imaging and pathological discordance amongst the plethora of breast lesions in breast biopsies
Authors: Archana B , Dev Bhawna , Varadarajan Suresh , Joseph Leena Dennis , Sheela M.C. , Pavithra V. , Sundaram Sandhya , Srinivasan Jai Prakash 
Published: August 2024

Introduction:
Imaging-guided breast tissue biopsy has become an acceptable alternative to open surgical biopsy for nonpalpable breast lesions. Discussion of abnormal results of the correlation between imaging and pathological findings can be very challenging as it can assist in decision-making with regard to the further treatment options by arriving at a comprehensive diagnosis.

Materials and Methods:
This was a retrospective study. Radiological data from imaging-guided breast biopsies of 500 patients during a 6-year period was collected and classified by a specialist radiologist as per the BI-RADS format. Histopathology reports were studied and discordance analyzed.

Results:
A total of 500 cases were reviewed. Approximately 33% (168) cases fell into the BI-RADS 3 category, 24.4% (122) into the BI-RADS 4, and 37% (187) into BI-RADS 5 categories. Approximately 50% (n = 250) cases were benign, 2.6% (13) belonged to the high-risk category, and 47.4% (237) were malignant. The number of discordant cases was 12 (2.4%), mostly due to technical factors. Sensitivity of biopsies to detect malignancy was 85%, specificity was 96%, and accuracy of biopsy in diagnosing cancer was 90%.

Discussion:
The "triple assessment" is the most sensitive method for detecting early breast cancer. An effective communication pathway must be established between a clinician, radiologist, and pathologist for surgical excision in discordance as it carries a high prevalence of carcinoma in these lesions.

Conclusion:
In discordant cases, either due to abnormal results of imaging or of abnormal pathological findings, the final decision is based on two concordant findings, out of the three parameters. This involves a multidisciplinary breast conference and an active participation by the pathologist.
Merits and pitfalls of normal saline rehydrated air-dried cervical smears over conventional wet.fixed PAP smears
Authors: Kamble Shilpa A. , Dombale Vijay D. , Shah Forum 
Published: August 2024

Background:
Cervical Papanicolaou (PAP) smear is the simplest, minimal invasive, and excellent screening method to reduce the female morbidity and mortality due to cervical carcinoma. Immediate alcohol fixation of the cervical smears is required to preserve nuclear details, delay in alcohol fixation leads to air drying artifacts. Rehydrating of the air-dried cervical pap smear with normal saline can help to overcome these artifacts and also have its own advantages.

Aims:
This study was design to evaluate the effects, merits and pitfalls of normal saline Rehydrated Air-Dried Cervical PAP Smears (RADPS) compared with the Conventional Papanicolaou Smear (C-PAPS).

Settings and Design:
Comparative study.

Methods and Material:
Prospectively paired cervical smears of 100 women, who presented to the outpatient department of gynecology of our institute, were prepared. Alcohol fixed smears were labelled as conventional Papanicolaou smear (C-PAPS) and air-dried smears labelled as rehydrated air-dried PAP smears (RADPS). Eight cytomorphological parameters were considered for comparison and analyzed.

Statistical analysis used:
Chisquare (χ2)/Fisher exact test.

Results:
Clear background with red blood cells (RBC) lysis was noted in 93% of RADPS and 54% of C-PAPS. Cytolysis was observed more in C-PAPS (18%) than in RADPS (08%). Air-drying artifacts observed in 30% of C-PAPS and 08% of RADPS. Cytoplasmic staining (92% of RADPS and 85% of C-PAPS) was superior in RADPS. Cell border, nuclear chromatin, and border were also better appreciated on RADPS as compared to C-PAPS. Statistically significant difference was observed with 3 parameters, i.e., air-drying artifacts, RBC background, and distinct cell borders.

Conclusion:
Rehydration of air-dried smears can be adopted in regular practice, as an alternative or coupled with conventional wet fixation method to overcome the commonly faced problems of air-drying artifacts, especially in rural screening programs.
Primary breast sarcoma
Authors: Ahuja Manisha , Mallya Varuna , Mandal Shramana , Tomar Reena , Aggarwal Radhika , Khurana Nita , Lal Pawnindra 
Published: August 2024

Background:
Primary Breast Sarcomas (PBS) are rare malignancies and seen in less than <1 % of all breast malignancies. PBS are non epithelial, composed of mesenchymal mammary tissue and are difficult to diagnose from other sarcomas arising in breast.

Materials and Methods:
A retrospective study was conducted in the Department of Pathology and slides of breast malignancies over a period of 5 years were reviewed. Out of total 1570 breast malignancies, 5 cases were reported as PBS. Diagnosis was made on the basis of Histopathology and IHC findings.

Results:
Out of total 1570 cases, 5 cases were diagnosed as PBS (i.e. 0.32% of all cases). 3 out of 5 cases were males comprising of 60% of cases and 2 cases were females accounting for 40% of cases. The age group of presentation was 32-65 years with mean age being 48.5 years. A diagnosis of MPNST was rendered in two cases (1=M, 1=F), one each was diagnosed as DFSP (with fibrosarcoma), Leiomyosarcoma and Fibrosarcoma.

Conclusion:
PBS is an extremely rare entity and locally aggressive. It requires diagnosis as its treatment protocol is different.
Significance of CD47 expression in endometrial carcinoma
Authors: Sahin Nurhan , Coban Ganime , Unver Nurcan , Arici Dilek S. , Kilic Gokhan , Toluk Ozlem 
Published: August 2024

Objectives:
CD47 is a membrane protein that belongs to the immunoglobulin superfamily and regulates macrophage phagocytosis negatively. As CD47 expression at the cancer cell membrane would inhibit the phagocytic activity of immune cells, it is connected to an unfavorable prognosis in leukemia and malignancies of various solid organs. Materials and

Methods:
In this study, retrospectively evaluated 72 patients who had been diagnosed with endometrial carcinoma at Pathology Department and had undergone total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH + BSO) and/or lymphadenectomy. CD47 expression was evaluated in tumorous and nontumor areas in all patients considering cytoplasmic and membranous brown staining in cells. The proportion of expression was evaluated as well as the intensity and an “h score” was obtained. This score was compared with known prognostic parameters.

Results:
CD47 expressions showed a statistically significant correlation with tumor grade (P < 0.05); however, no significant relationship was observed with myometrial invasion depth and lymph vascular invasion status (P = 0.923 and P = 0.754, respectively).

Conclusions:
As with other tumors, anti-CD47 antibody may be an alternative treatment option in patients with high-grade endometrial carcinoma.
Crystallizing galactocele: A rare case report and review of literature
Authors: Verma Nisha , Gaur Nimish , Awasthi Shivali , Bajaj Varun , Sharma Surabhi , Mahajan Saurabh 
Published: August 2024

ABSTRACT
Crystallizing galactocele is an uncommon condition that produces a viscous, chalky substance on fine needle aspiration cytology. (FNAC). Both the diagnosis and the management of this illness include the use of FNAC. Here, we discuss the case of a 25-year-old nursing woman who experienced left breast edema lump for two years. The upper outer quadrant of the leftt breast was involved by the hard, small, non-tender, and movable enlargement. The lesion’s FNAC produced a thick, milky, and chalky substance. Numerous semi-transparent crystals of various sizes and shapes with angulated edges could be seen in cytological smears against a background of granular and amorphous proteinaceous material. A diagnosis of crystallizing galactocele was made on the basis of the patient’s clinical history of lactation and characteristic cytological findings. Due to the rarity of this condition—to the best of our knowledge, less than ten cases of crystallizing galactocele have been documented in medical literature.
Low expression of DUSP4 expression predicts unfavorable prognosis in gallbladder adenocarcinoma
Authors: Jee Seungyun , Sim Jongmin , Bang Seongsik , Park Hosub , Myung Jaekyung , Paik Seung Sam , Choi Dongho , Kim Yeseul , Kim Hyunsung 
Published: August 2024

Background: Dual specificity phosphatase 4 (DUSP4), which regulates the mitogen activated protein kinases, has emerged as a tumor suppressor gene in several human malignancies.

Aims and Objectives:
In this study, we investigated the clinicopathologic significance and the prognostic role of DUSP4 in gallbladder adenocarcinoma. Materials and methods: DUSP4 expression was evaluated immunohistochemically in tissue microarray from 110 gallbladder adenocarcinoma samples and scored by H score system. The cut off (H score <170) was determined by ROC curve analysis. Results: Low expression of DUSP4 expression was observed in 57 (51.8%) out of 110 gallbladder adenocarcinoma samples. Low expression of DUSP4 expression was significantly associated with high histologic grade (P = 0.017), high pT stage (P = 0.002) and high AJCC stage (P = 0.007). Kaplan Meier survival curves revealed that patients with low expression of DUSP4 expression had significantly worse cancer specific survival (P = 0.024, log rank test). However, there was no significant association between DUSP4 expression and recurrence free survival.

Conclusions:
In conclusion, gallbladder adenocarcinoma with low expression of DUSP4 expression was associated with adverse clinicopathologic characteristics and poor patient outcome.patient outcome.
Histomorphological evaluation of placenta in SARS-CoV-2 patients
Authors: Umar Sana , Petwal Snigdha , Joshi Chitra , Raja Minali , Upreti Shashi 
Published: August 2024

Background:
SARS-CoV-2 has emerged as a major pandemic of the century and little is known about the impact of maternal infection on placental histopathology. Histopathologic examination of placental tissue can contribute to significant information regarding the pathophysiology of the disease and how it affects the fetal outcome.

Materials and Methods:
This was a cross-sectional study conducted at the Department of Pathology, Government Doon Medical College and Hospital, Dehradun, on the placenta of 50 coronavirus disease 2019 (COVID-19)-positive pregnant females confirmed by reverse transcriptase-polymerase chain reaction (RT-PCR) from August 2020 to October 2020. Fifty term historical placentas were taken as control. Placenta sections were fixed in formalin, processed into paraffin blocks, stained with hematoxylin and eosin (H and E) stain, and visualized for any abnormality.

Results:
The most prominent histological finding in the placenta of pregnant women affected by COVID-19 was chorangiosis, which is a feature of fetal vascular malperfusion seen in 28 (56%) cases. Other features included maternal vascular malperfusions (MVM) such as villous crowding and agglutination in 12 (24%) cases. Tenney–Parker change was seen in 13 (26%) patients. Intervillous fibrinoid deposition and intervillous hemorrhage were seen in 37 (74%) patients and 7 (14%) patients showed significant calcification. Other findings observed were less common.

Conclusion:
Infection with SARS-CoV-2 may be associated with a significant impact on fetal and maternal circulation causing features of fetal and maternal malperfusion such as chorangiosis, villous crowding, and agglutination. Indicating that the infection could cause a potential rise in the risk of adverse perinatal outcomes such as intrauterine fetal growth retardation, preterm birth, or stillbirth.
Dimensional Distribution of Anxiety and Depression in College Students in a Rural Setting: Relationship with Stress, Well-being, and Quality of Life
Authors: Kar Nilamadhab , Das Mithila , Kar Brajaballav , Rath Namita , Kar Shreyan 
Published: August 2024

Background:
Information about the anxiety and depression of students in rural areas of India is scant. We evaluated stress, coping strategies, quality of life (QOL), and well-being of students along with the dimensional and categorical distribution of anxiety and depression in a cross-sectional study in a rural college.

Materials and Methods:
It was an online questionnaire-based survey using the Patient Health Questionnaire-9 for depression, general anxiety disorder-7 for anxiety, and the WHO-5 Well-Being scale for well-being. Stress in the previous month, nature of stress, coping strategies, and QOL on a scale of 1 (worst) to 10 (best) were also assessed.

Results:
The dimensional distribution of anxiety and depression suggested the pervasiveness of these problems among students. Categorically, a considerable proportion of students had clinical levels of anxiety (32.2%), depression (40.3%); and 24.8% of students had both of them. Stress in the past month was reported by 34.2% of students, which was linked significantly with the severity of anxiety and depression. Common stressor were financial problems, family-, career-, and job-related issues. Stress, anxiety, and depression were negatively correlated with well-being and QOL. Many coping strategies were reported; more than half of the students found helping others, creative hobbies, hoping for the best, music, talking to others, yoga and exercises, prayer, and religious activities helpful.

Conclusions:
The results highlight the pervasive presence of anxiety and depression in college students, which are linked to stress, and have an impact on their well-being and QOL. These require specific attention for management.
Risk Factors for Stable and Intimate Interpersonal Relationships: A Qualitative-quantitative Methodology
Authors: Faridmarandi Behrooz , Komasi Saeid 
Published: August 2024

Abstract

Introduction:
The concept of intimacy in interpersonal relationships is transforming in the non-Western developing countries.

Objectives:
We designed two independent studies, the first of which aimed at a phenomenological investigation of dynamic processes and risk factors involved in both stable and intimate interpersonal relationships using a qualitative methodology to extract representative themes and concepts. In the second study, we aimed to validate one of the emergent themes (i.e., detachment manifestations) using a quantitative methodology.

Materials and Methods:
Thematic and content analysis methods were used to identify the experiences and perspectives of seven nonclinical and four clinical adults through semi-structured interviews (study I). After designing a measurement inventory of detachment manifestations (MINDs) based on one of the two largest extracted themes, we tested both the reliability and construct, criterion, and convergent validities of the inventory using exploratory structural equation modeling, Pearson correlation coefficients, and t-test in study II including the nonclinical (n = 205) and clinical (n = 156) samples.

Results:
All qualitative concepts are covered by two core themes including detachment mechanisms and manifestations. The detachment manifestation is a valid construct with a ten-factor structure measured by the MINDs, which is significantly correlated with other valid instruments.

Conclusion:
The present findings support the criterion validity of MINDs to distinguish clinical from nonclinical samples. Although the present report empirically supports the concept of detachment manifestations assessed by the MINDs with an acceptable reliability and validity, future reports will attempt to both identify other concepts involved in interpersonal relationships and revalidate the detachment mechanisms and manifestations across cultures.