bluuebunny/crossref_metadata_2025_split huggingface dataset:
A rare case of late developing anti-E antibody in a pregnant female leading to severe hemolytic disease of the newborn: A missed follow-up in COVID-19 epoch
Authors: Sil Suhasini , Kaur Daljit , Singh Poonam , Kumari Dixa , Jain Ashish , Negi Gita 
Published: August 2024

Abstract
With the use of Anti-D prophylaxis for rhesus D-negative pregnant women, other Rh and non-Rh allo-antibodies have become relatively more important. The index case reports severe hemolytic disease of the newborn due to anti-E antibody in a full-term baby boy born to a COVID-19-positive mother. The antibody screening of the mother performed during Booking of pregnancy at 9th week of gestation was negative. Subsequently the mother was lost to follow-up till delivery due to COVID pandemicity. At birth, the baby was icteric but non-hydropic, his direct antiglobulin test (DAT) was strong positive (4+ by column agglutination technology) and required top-up transfusion and phototherapy at Neonatal Intensive Care Unit. Elution of DAT-positive red cells rendered anti-E which could have formed as “late developing” red cell allo-anti-E in the pregnancy. A repeat antibody screening around 28th week gestation is of prime importance to detect any underlying allo-antibody in a multigravida and thus enabling close monitoring of fetus and initiation of early management as desired.
Is every reaction a blood transfusion reaction? An inside story
Authors: Syal Neha , Handa Anjali 
Published: August 2024

Abstract
An adverse reaction is an undesirable response or effect in a patient temporally associated with the administration of blood or blood component. In January 2019, a 55-year-old female patient was transfused packed red blood cell (PRBC) to correct anemia. The patient complained of chills within 5 min, so transfusion was stopped and patient’s blood samples and blood bag were sent to blood center for a reaction workup. The second transfusion was attempted the next day with leukoreduced PRBC, but the patient complained of chills again and hence transfusion was stopped. On 3rd day, transfusion was reattempted with all precautions in the presence of transfusion medicine specialist and the patient again complained of chills. When asked in detail, patient said that she could feel cold blood going through her arm, which made her feel cold. The patient was given additional blankets and her room warmed and transfusion was reattempted after 30 min and completed uneventfully. Medical education has raised the vigilance of physicians regarding adverse reactions but has also created an unwanted alarm, which is difficult to pacify. This leads to relating any discomfort patient experiences during transfusion with an adverse transfusion reaction.
Conservative Management of Odontogenic Myxoma - A Case Report
Authors: Agarwal Srishti , Xavier Soya Alfred 
Published: August 2024

Abstract

Rationale:
This is a 14-year-old girl with odontogenic myxoma of the right posterior mandibular region, which was managed conservatively by intraoral marginal mandibulectomy rather than segmental mandibulectomy.

Patient Concerns:
The patient and her parents were concerned about her aesthetics.

Diagnosis:
The patient came with the complaint of swelling on the right lower back tooth region of the jaw, which was not associated with pain. On palpation, the swelling was bony hard and there was buccolingual expansion. On radiographic examination, there was a sunray appearance. Histopathological examination confirmed it to be an odontogenic myxoma.

Treatment:
Marginal mandibulectomy was done for the patient. The whole procedure was done intraorally and closed using primary closure.

Outcomes:
Postoperatively, the patient was asymptomatic and is on follow-up.

Take-away Lessons:
We can say that odontogenic myxoma can be managed conservatively.
Longitudinally extensive transverse myelitis associated with scrub typhus: A case report
Authors: Kumar Amit , Chetiwal Rajesh , Tanwar Shweta 
Published: August 2024

Rationale:
Longitudinally extensive transverse myelitis (LETM) is a rare inflammatory demyelinating disease predominantly associated with autoimmune and inflammatory disorders. Scrub typhus can cause a variety of neurological complications, which may result in poor recovery and long-term disability. This report reveals a rare linkage between LETM and scrub typhus.

Patient concerns:
A 24-year-old female presented with a history of fever for 10 days associated with progressive quadriparesis. Physical examination revealed bilateral lower limb weakness (grade 0/5) and bilateral upper limb weakness (grade 2/5) with reduced sensation below the T3 dermatome.

Diagnosis:
Scrub typhus presenting with longitudinally extensive transverse myelitis.

Interventions:
Steroid pulse therapy with antibiotics supported by early intensive rehabilitation.

Outcomes:
Complete recovery was achieved.

Lessons:
This case report highlights the importance of considering scrub typhus as a potential cause of LETM in endemic regions, particularly in patients presenting with febrile illness and neurological symptoms.
Patterns of noncicatricial alopecia in children: a cross-sectional study
Authors: Mohamed Essam Elden M. , Abdel-Aleem Hazem L. , Tawfik Yara T. 
Published: August 2024

Background and aim
Hair loss in children is an unpleasant complaint. It represents a challenge for the treating physician, is extremely upsetting to the parents, and has a psychosocial complication for the growing child. Our study aims to clarify the causes and forms of noncicatricial alopecia in a sample of pediatric patients and to identify the common trichoscopic features of each illness.

Patients and methods
This study was conducted on 300 children who attended the outpatient dermatology clinics at Al-Azhar University in Assiut. Their ages ranged between 2 and 18 years old and they complained of scalp disorder and hair loss.

Results
Tinea capitis (TC) was the most common form of pediatric alopecia (136 patients, 45%), while alopecia areata (AA) and marginal traction alopecia were the second most common causes with a frequency of 57 (19%) and 56 (18.7%), respectively. Toxic alopecia was identified in 30 (10%) of the patients, telogen effluvium in 11 (3.7%), while six (2%) patients presented with female pattern hair loss, three (1%) patients had short anagen syndrome and only one patient presented with Trichotillomania. The most common trichoscopic features in patients who had TC were comma hair and short, broken hair, while microexclamation marks were the most common trichoscopy features among AA patients.

Conclusion
TC was the most common cause of pediatric alopecia, followed by AA and marginal traction alopecia. Diagnosis of hair and scalp disorders enhances the diagnostic power beyond basic clinical examination and exposes unique aspects of the diseases, leading to better management.
Transforaminal lumbar interbody fusion in iatrogenic lumbar instability
Authors: Nafea Waleed , Fawzy Mohsen , Elnagar Ahmed 
Published: August 2024

Background
Lumbosacral instability is one of the causes of failed back surgery syndrome, and it is characterized by loss of disc height with translational and in many cases rotational instability in the sagittal plane. Transforaminal lumbar interbody fusion (TLIF) is a modification of posterior lumbar interbody fusion that requires less retraction of the thecal sac and neural element. TLIF corrects most of the pathologies in patients with iatrogenic lumbar instability as it provides rigid stabilization of the spine with high incidence of fusion, decompression of central and lateral recess with facet and disc resection, restoration of disc and foraminal heights together with sagittal plane deformity correction.

Aim
This study was carried out to evaluate the efficacy of TLIF in the treatment of patient with iatrogenic lumbar instability.

Patients and methods
A total of 16 cases were diagnosed as iatrogenic lumbar instability according to the radiological method proposed by Dupuis and colleagues. Sex distribution was nine females and seven males. Plain radiograph (static and dynamic) and MRI with gadolinium enhancement were done for all patients. Single-level transforaminal lumbar interbody fusion (TILF) was performed in 11 cases and double-level TLIF was performed in five cases. Clinical evaluation was made using Oswestry disability index. Patients were examined for occurrence of solid interbody fusion at 9- and 12-month follow-up visits.

Result
A total of 14 patients showed obvious clinical improvement with reduction of their Oswestry disability index from 76.75% preoperatively to 36.9% at 6 month and 22.7% after 1 year. Overall, two cases had shown no clinical improvement: one had deep wound infection and the other had pseudoarthrosis. Solid fusion occurred in 14 (87.5%) cases. One case with pseudoarthrosis was the patient who had developed deep wound infection; the other case was a patient undergoing double-level TILF with pseudoarthrosis at L5–S1.

Conclusion
TLIF is a safe and effective technique in the treatment of patients with postlaminectomy lumbar instability with minimal complication rate.
Management of Lisfranc injuries of the foot
Authors: Elgioushy Ali M. , El Aziz Hassan Mohammed A. , Gaballah Gaballah A.-E. 
Published: August 2024

Background
The term ‘Lisfranc injury’ strictly refers to an injury where one or more of the metatarsals are displaced from the tarsus. The term is more commonly used to describe an injury to the midfoot centered on the second tarsometatarsal joint. The injury is named after Jacques Lisfranc de St. Martin (1790–1847), a French surgeon and gynecologist who first described the injury in 1815. ‘Lisfranc injury’ encompasses a broad spectrum of injuries, which can be purely ligamentous or involve the osseous and articular structures. They are often difficult to diagnose and treat, but if not detected and appropriately managed, they can cause long-term disability.

Aim
The aim of this work was to evaluate the proper management of lisfranc injuries and identify the best method of diagnosis and treatment.

Patients and methods
This is a prospective study that included 15 patients with Lisfranc injures of the foot who presented to the Emergency Department of Al-Azhar University Hospitals (Al Hussein and Sayed Galal Hospitals) between January 2016 and June 2017 and followed up for 3–9 months, with an average of 6 months. Fractures were classified according to the Myerson’s and Hardcastle classification. All patients were treated by emergency surgery by screws or Kirschner wires (K-wires). The American Orthopaedic Foot & Ankle Society (AOFAS) functional scale was used to assess results in the midfoot and patient satisfaction was also evaluated.

Results
After a mean 6 months of follow-up, the mean score on the AOFAS scale was 81.8, with a high level of satisfaction in nearly all patients. The results obtained with screw fixation were similar to those with K-wires.

Conclusion
Like most authors, the best results are obtained by the early reduction and fixation of the injury. The authors rule out nonoperative treatment and favor an ORIF procedure with Kirschner wires and screws, provided that the condition of the soft tissues allows it. The results obtained with K-wires were similar to those found in screw fixation, and anatomic reduction is the main predictor of outcome in patients with Lisfranc fracture dislocations.
Sex-specific versus standard posterior cruciate-substituting total knee prosthesis
Authors: Ebied Ayman M. , Elsayed Hany , Gamal Osama 
Published: August 2024

Background
The introduction of sex-specific (SS) knee prosthesis designs was an approach to offer more sizing options and is based on the anatomic sex differences. These SS components were though to provide better fitting to female femora and consequently improve the clinical outcome.

Materials and methods
In the period between February 2011 and March 2013, a prospective superiority randomized controlled clinical trial was conducted to compare the clinical outcome of SS versus the standard posterior stabilized (PS) knee prosthesis in women. The primary outcome measure was the postoperative range of knee flexion, and the secondary outcome measure was the knee function as reflected on the performance of daily activities. The OXFORD Knee Score, Knee Society Score, and Knee Society Score for function were recorded preoperatively and then at 3, 12 months, and annually thereafter. Female patients with degenerative or inflammatory arthritis who were 50 years or older and their knee deformities were totally articular were included. A total of 64 patients with 80 knees were enrolled in this trial, and 40 knees were allocated to each group. Knees in the SS group had total knee arthroplasty using SS knee prosthesis, with SS femoral component (the experimental group), whereas knees in the PS group had standard PS knee design with standard femoral component (the control group). Equal randomization (1 : 1 ratio) was undertaken according to a computer-generated randomization table.

Results
The mean preoperative knee flexion range of motion (ROM) was 110 and 108° in the SS and PS groups, respectively. At the latest follow-up, the mean postoperative knee flexion ROM was 115 and 113° the SS and PS groups, respectively. The mean improvement in the knee flexion ROM in both groups was 5° (range: 0–25), with no statistically significant difference between the two groups. All knees except one had full extension. No statistically significant difference was observed between the two groups when the OXFORD Knee Score, the Knee Society Score, and the Knee Society Score for function were compared.

Conclusion
No clinical advantage was observed in the ROM or function between knees that received SS knee prosthesis when compared with those who received PS knee implants. The SS total knee arthroplasty though designed to provide better fitting to the female distal femur does not provide any clinical advantage over the standard PS knee prosthesis. A logic question is whether a separate implant is required for women or modifications to the knee prostheses geometry and more sizes are required to accommodate all patients?

Level of evidence
Level II.
Midterm results of modified coracoclavicular ligament repair using suture anchors for acute acromioclavicular joint dislocation
Authors: El-Adawy Moawed F. , El-Herraoui Ahmed A.-S. 
Published: August 2024

Purpose
The aim was to prospectively gauge the clinical and functional patient outcomes of modified coracoclavicular ligament repair and stabilization using suture anchors and disc reduction in management of acute acromioclavicular joint (ACJ) dislocation at a minimum 2 years of follow-up.

Study design
This was a case series, and the level of evidence was IV.

Patients and methods
This study was carried out on 30 consecutive patients who had acute ACJ dislocation Rockwood types III–V in the period between June 2009 and March 2014. Average follow-up was 34.7 (25–75) months. This study was conducted in two tertiary centers: Suez Canal University Hospitals and El-Galaa Military Hospital. All patients were operated within 1 month of injury using an anchor with loaded sutures that was inserted into the dorsal part of coracoid base. The ends of the sutures were then passed through clavicular holes placed at coracoclavicular ligament attachment, and each suture strand was separately tied.

Outcome measures
Patients were evaluated postoperatively for persistence of good reduction, complications, range of motion, and return to preinjury activity level. Visual analog scale was used to assess postoperative pain. The functional outcomes of the shoulder were evaluated by Disabilities of the Arm, Shoulder, and Hand and Constant shoulder scores.

Results
A total of 28 patients (93.33%) returned to work and resumed sports activities. The mean Constant score was 88.2 points. The mean Disabilities of the Arm, Shoulder, and Hand score was 12.2 points.

Conclusion
Treatment of acute ACJ dislocation with coracoacromial ligament repair and stabilization using suture anchors and disc reduction is technically simple and showed encouraging midterm clinical results with a low complication rate.
Supracondylar femoral dome extension osteotomy in treatment of knee flexion deformity
Authors: EL Ghafar KhaledAbd , Diab Ramy A. 
Published: August 2024

Background
Flexion contracture of the knee can happen by different etiologies such as burns and scars, inflammatory conditions such as juvenile rheumatoid arthritis, and neuromuscular disorders such as cerebral palsy, poliomyelitis, and many others. Supracondylar femoral extension osteotomy is widely used in treatment of such type of deformities with good results. Dome osteotomy is a circular-shaped osteotomy. The authors conducted this study to assess the effectiveness of supracondylar femoral dome extension osteotomy (SCDEO) in management of sagital plane deformity in the form of fixed-flexion deformity of the knee.

Patients and methods
Seven patients (11 knees) with knee flexion deformity underwent SCDEO fixed by anatomical locked plate and screws, three patients had a bilateral deformity as sequelae of juvenile rheumatoid arthritis, while four patients as sequelae of poliomyelitis, and three of them had unilateral deformity, while only one patient had bilateral deformity. The knee flexion deformity angle ranged from 20 to 50° with a mean of 32°. Patients were followed up every 2 weeks with monthly radiographies done till full union of the osteotomy, full weight bearing was started at 4 weeks postoperatively, in bilateral cases, the other side was operated after full osteotomy union, and all patients were followed up for 12 months with radiographies to assess the knee flexion deformity angle.

Results
All osteotomies eventually united in the period ranging from 10 to 14 weeks (average 12 weeks), no postoperative infection, nonunion, neurological, or vascular compromise occurred. All of the patients were satisfied regarding improved gait and posture, the total range of knee motion at 12 months postoperatively ranged from 60 to 100° (average 85°). Knee flexion deformity angle measured at 12 months postoperatively ranged from 8 to 15° with an average of 11°. Only one patient with juvenile rheumatoid arthritis showed significant recurrence of the deformity at 12 months of follow-up postoperatively, with flexion deformity angles of 20 and 25° in the right and left knee, respectively, whereas the preoperative flexion deformity angle in this patient was 30 and 35° in the right and left knee, respectively.

Conclusion
SCDEO fixed by anatomical locked plate and screws is an effective means of management of knee fixed-flexion deformity.
Unilateral partial pediculectomy combined with contralateral instrumented fusion in treatment of osteoid osteoma localized in lumbar spine pedicles
Authors: El Zahlawy Hany , Abdelrady Abdelrady M. , Ibrahim Mohamed Z. 
Published: August 2024

Background
Treatment of osteoid osteoma of the spine may be challenging when located in the pedicles.

Patients and methods
Twelve patients with osteoid osteoma located in lumbar spine pedicles were treated via partial pediculectomy to excise the nidus completely combined with contralateral instrumented fusion to prevent instability. Their demographic data, back pain as measured by visual analog scale, and radiographs were recorded and analyzed. The patients were followed up for a period of at least 12 months.

Results
Their mean age was 18.1 years. Nine were males and three females. The mean preoperative visual analog scale was 8. This improved to 2.5 1 month after surgery and 0.83 at the final follow-up (P<0.001). The mean operative time and blood loss were 124 min and 660 ml, respectively. Fusion was obtained in all cases.

Conclusion
When lesions with a relatively large nidus involve the pedicle, partial pediculectomy to access the nidus combined with contralateral instrumented fusion appears to be an effective and justifiable method of treatment.
Updates on the Management of Autoimmune Bullous Diseases
Authors: Choudhary Rajat , Gupta Vishal , Khandpur Sujay 
Published: August 2024

Abstract

Background:
Autoimmune bullous diseases are associated with high morbidity and mortality. Traditionally, systemic corticosteroids and conventional immunosuppressive agents have been the mainstay of treatment, but their broad immunosuppressive effects and long-term complications have prompted the exploration of newer more targeted therapies.

Materials and Methods:
This review explores the evolving landscape of therapeutic options for immunobullous diseases, with a particular focus on pemphigus, bullous pemphigoid (BP), and mucous membrane pemphigoid, by searching PubMed, clinicaltrials.gov, and Cochrane databases for published literature from 2014 to 2023.

Results/Discussion:
We discuss emerging treatments for pemphigus such as B cell modulatory drugs, anti-inflammatory drugs, those inhibiting autoantibody half-life or blister-inducing activity, and stem cell therapy, while offering insights into the level of evidence, potential benefits, and limitations of each approach. The role of biologics and novel therapies like rituximab, omalizumab, and dupilumab in reshaping the management of BP is also discussed.

Conclusion:
The article highlights the need for further research, clinical trials, and comparative studies to determine the most effective and safest treatment options for patients with immunobullous diseases.
Premature Graying of Hair: A Comprehensive Review and Recent Insights
Authors: Poonia Kavita , Bhalla Mala 
Published: August 2024

Abstract

Background:
Hair symbolizes well-being and self-expression, with graying occurring naturally among different racial groups at varying ages. Premature graying has psychological and societal impacts, influencing self-esteem and quality of life. Gray hair usually advances gradually and is permanent, with occasional reports of natural repigmentation. Premature graying of hair (PMGH) results from a complex interplay of genetic, environmental, and cellular factors.

Materials and Methods:
Studies exploring links between gray hair and conditions such as osteopenia, hearing loss, smoking, obesity, dyslipidemia, and cardiovascular disease have yielded mixed results. Despite continuous research into the causes of gray hair, effective, evidence-based treatments are lacking and still need to be improved.

Conclusion:
Herein, we reviewed the causes, mechanisms, risk factors, psychosocial effects, and emerging therapies for PMGH.