bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of diagnostic capability of macular ganglion cell complex vs retinal fiber layer thickness in primary open angle glaucoma patients of Indian origin
Authors: Srivastava Arpit , Sharma Vikas , Kapoor Gaurav , Kamal V K B Muthu , Baranwal Vinod K , Singh Ankita 
Published: July 2024

Purpose:
Comparison of diagnostic capability of macular ganglion cell complex thickness vs. retinal nerve fiber layer (RNFL) thickness in patients of primary open-angle glaucoma (POAG).

Settings and Design:
This cross-sectional observational study was carried out between June 2021 and October 2022 at a tertiary care hospital in North India.

Methods:
A total of 118 eyes were included in the study with 30 control and the rest 88 eyes with POAG were divided into three groups based on visual field loss Group 1 (30 eyes): early field loss with mean deviation (MD) < −6 dB; Group 2 (30 eyes): moderate field loss with MD −6 to −12 dB; and Group 3 (28 eyes): severe field loss with MD > −12 dB. Optical coherence tomography (OCT) scans to measure RNFL loss and ganglion cell inferior plexiform layer (GCIPL) loss were taken for each patient.

Statistical Analysis Used:
Categorical variables were analyzed using either the Chi-square test or Fisher’s exact test. A receiver operating characteristics analysis was calculated to determine optimal cut-off values of superior, inferior, and average GCIPL and RNFL for determining the severity of field loss as compared to controls (30 normal eyes).

Results:
In the mild field loss group the sensitivity of superior, inferior, and average GCIPL was 86.7, 96.7, and 96.7%, respectively. Similarly, the specificity was 96.7, 93.3, and 100%, respectively. In the same group, the sensitivity of superior, inferior, and average RNFL was 70, 93, and 66%, respectively. Similarly, the specificity was 46.7, 83.3, and 70%, respectively. In the moderate and severe groups, the results were comparable.

Conclusion:
The sensitivity and specificity of GCIPL loss are significantly better than that of RNFL parameters in the mild field loss group.
Role of IgG avidity in eyes with active Toxoplasma retinochoroiditis
Authors: Lakhmawar Pratik , Kelgaonkar Anup , Patel Anamika , Khalsa Ashish , Basu Soumyava 
Published: July 2024

Purpose:
To study the role of Toxoplasma IgG avidity in evaluating the stage of systemic infection during manifestation as toxoplasma retinochoroiditis and its clinical implications in eastern India.

Methods:
Retrospective chart review of Toxoplasma retinochoroiditis cases with Toxoplasma serology for IgG, IgM, and IgG avidity.

Results:
Included in this study were 17 eyes of 17 patients who had active retinitis located in the macula (14), mid-periphery (2), or periphery (1). They were either primary lesions (12) or reactivations (5). All the cases had Toxoplasma IgG positive; one case had IgM positivity, while all the cases had high IgG avidity values. IgG avidity had a positive correlation with the duration of symptoms.

Conclusion:
We observed high IgG avidity values in active retinochoroiditis in both primary ocular Toxoplasmosis and reactivation subgroups. These results indicate a late ocular manifestation after initial systemic infection with a possible incubation period ranging from 5 weeks to 5 months.
Nerve Sheath Tumours In and Around Spine—A Series of 50 Cases
Authors: Sulaiman Saad , Pillai Suresh S , A. Akashdeep A , Nambiar Harilal V 
Published: July 2024

Abstract

Background:
Nerve sheath tumours in and around the spine, especially in the junctional zones, are a challenging endeavour for the surgeon, because of the difficulty in approaching these structures as well as their close proximity to the major vessels and nerves. Most of these tumours are benign in nature. They are usually very slow growing, and hence the tumour may be detected very late in its clinical course unless it compresses or encircles any of the major neurovascular structures early in its course. The surgical results after the excision of these tumours are excellent. Most of the patients get completely cured by prompt treatment. Here we present a series of 50 nerve sheath tumours in and around the spine operated over a period of 21 years.

Materials and Methods:
A retrospective study was done for 50 patients who underwent an operation for nerve sheath tumours in and around the spine, over a period of 21 years. Patient’s clinical and radiological data were extracted from the Medical Record Department (MRD) of our hospital and analysed.

Results:
Out of the 50 cases of nerve sheath tumours, 40 patients (80%) were of schwannoma and 10 patients (20%) were of neurofibroma. Overall, 10 patients had dumbbell tumours (neurofibroma+schwannoma). The mean age group was between 4th and 6th decade. Patients were followed up for a minimum of 1 year and a maximum of 20 years period. All of these tumours were benign except one patient who had a malignant neurofibroma of the C-8 nerve root. 15 out of 50 patients presented with paraparesis, 5 with paraplegia and another 5 with quadriparesis. All these patients had complete neurological recovery after surgical removal of the tumours.

Conclusion:
This case series brings out the nuances in the management of nerve sheath tumours in and around the spine and their results.
Correlation between Quality of Evidence and Number of Citations in Top 100 Cited Hallux Valgus Articles
Authors: Panchbhavi Vishank Ved 
Published: July 2024

Abstract

Background:
The measurement of a scientific article’s impact has frequently relied on the quantity of citations it garners. Analyzing citations can be instrumental in identifying influential work within medical specialties. This study aims to elucidate the metrics and levels of evidence pertaining to articles concerning Hallux valgus.

Materials and Methods:
This study conducted an extensive review of the 100 most-cited articles concerning “hallux valgus” and “bunion” by performing electronic database searches. Each article underwent a thorough examination, encompassing factors such as the number of citations, publication type, journal specialty, authorship, country of origin, publication year, level of evidence, and total sample size.

Results:
The citations for the reviewed articles ranged from 68 to 424. These 100 most-cited articles were found across 24 different journals, covering a spectrum from general to more specialized subspecialty journals. Around 45% of these articles were published in Foot & Ankle International. In terms of the level of evidence, the majority of articles (34 of 100) were classified as level V. Additionally, a significant number of articles were categorized as case series (n = 28) and expert opinions (n = 19). The median sample size for experimental studies was 44. Notably, only 3 of the 100 articles qualified as randomized controlled trials.

Conclusions:
The median year of publication for the most-cited articles, 2003, indicates a requirement for more recent studies investigating hallux valgus. The scarcity of articles with high evidence levels (1 or 2) and the small median sample size highlight the lack of scientifically robust research on hallux valgus. Furthermore, the analysis reveals a weak positive correlation (r = 0.149) between the strength of evidence and the number of citations in the top 100 articles related to hallux valgus.
Surgical Management of Metastatic Spine Fracture
Authors: Samanta Sudipta , Mukhopadhyay Kiran Kumar 
Published: July 2024

AbstractThe spine is a very frequent site of metastasis from solid tumors. World Health Organisation estimated an exponential increase of 29.4 million new cases of cancer in 2040. The incidence of solid tumors metastasizing to the spinal column is from the breast, prostate, kidney, and lung. The need for treatment lies in different factors, and proper evaluation of the disease requires a “multidisciplinary team” approach. The MDT contains tumor surgery, oncology medicine, tumor radiotherapy, radiology, and pathology departments.
Current Concepts in the Surgical Management of Metastases to the Spinal Column
Authors: Shamim Parvez , Ahmed Abrar , Nath Chinmay 
Published: July 2024

Abstract
Spinal metastasis is a common malignant bone tumour that often causes compression of the spinal cord and nerve roots. It has a high mortality rate and is primarily treated palliatively. A multidisciplinary approach is recommended. The treatment methods include surgery, minimally invasive treatment and radiotherapy, each having its own clinical effects, advantages and limitations.
Investigating the Diagnostic Value of MRI in the Diagnosis of Rotator Cuff Tears Compared with Findings from Arthroscopy or Open Surgery
Authors: Parhamfar Mohammad , Dehghani Mohammad , Shirazinejad Somaye , Hooshmandi Mohammadali 
Published: July 2024

Abstract

Introduction:
Rotator cuff tear is amongst the most common shoulder diseases and a principal reason for orthopaedic consultations. Currently, magnetic resonance imaging (MRI) is one of the most common diagnostic methods for rotator cuff tears and has been compared with direct observation methods, such as arthroscopy and open surgery, in this study.

Materials and Methods:
The present study is a cross-sectional analytical type conducted retrospectively from the beginning of 2018 to the end of 2020 in Al-Zahra and Kashani Hospitals in Isfahan, Iraq, covering 86 patients including 54 men and 32 women with criteria for rotator cuff tear who underwent MRI and subsequently arthroscopy or open surgery. MRI images were interpreted by a radiology specialist, and physical examinations, arthroscopy and surgery were performed by two orthopaedic specialists, calculating sensitivity, specificity, accuracy, positive predictive value and negative predictive value for rotator cuff tears.

Results:
A total of 29 cases of partial tear and 37 cases of complete tear were observed, with sensitivity, specificity, positive predictive value, negative predictive value and accuracy obtained as 93.9%, 60%, 88.6, 75% and 86%, respectively.

Conclusion:
MRI is a highly reliable diagnostic tool for diagnosing rotator cuff tears, although correlation with clinical symptoms and physical examinations is essential for this diagnosis.
Distal Radioulnar Joint Instability in Distal Radius Fractures Managed with Volar Locking Plates
Authors: Singh Param Jit , Jain Sanjay , Barwar Nilesh , Das Lakshman , Bhat Burhan , Kumar Pankaj Sharma 
Published: July 2024

Abstract

Introduction:
Distal radioulnar joint (DRUJ) injuries are the most common cause of residual wrist disability after fractures of the distal radius. There is a lack of consensus regarding the diagnosis of these injuries along with their management when being accompanied by a fracture of the distal radius. The present prospective study aimed to assess the effect of the involvement of DRUJ on the outcome of distal radius fractures. The study also evaluated the role of clinical and radiographic indices in the diagnosis, management and outcome of these injuries.

Materials and Methods:
This prospective study involved 51 patients aged >18 years with distal radius fractures treated using volar plating. The intra-operative assessment was done clinically using a piano key or ballotment test after fixation of distal radius fracture using K-wire stabilisation. The mean follow-up was 24 months. The patients were all clinically evaluated using the Modified Gartland and Werley scoring system. Radiographically, we calculated the dorsal/volar tilt, radial inclination, radial height and the ulnar variance.

Results:
A total of 44 patients with distal radius fractures were managed with the volar plate. The mean age was 45 years (range = 18–77; SD = ±13.6). The majority were men. The maximum cases were found to be of 2R3C type of AO/OTA fractures. Axial instability was observed in 12 cases, with 5 having negative and 7 showing positive axial instability. No statistically significant correlation was identified between the instability of the DRUJ and the overall outcome of distal radius fractures treated with volar plating (P = 0.241). However, a significant association was observed between fractures involving the base of the ulnar styloid (US) and the final clinical outcome (P = 0.023). The mean modified Gartland and Werley score was calculated at 6.09 ± 5.36, and 28.9% of cases suffered from loss of dorsiflexion.

Conclusion:
The present study revealed that it is important to recognise DRUJ instability in both axial and anteroposterior (AP) planes through clinical and radiological parameters. US base fractures cause DRUJ instability and also create a negative impact on the outcome of distal radius fracture fixed with volar plating. Ulnar variance is a good marker for checking instability in the AP plane by ballotment test. We found that in cases of DRUJ instability, fractures of the ulnar base should be examined and fixed if needed.
Primary Ewing sarcoma/primitive neuroectodermal tumors of the kidney: Case series of eight cases from a single center with follow-up details
Authors: Pathak Niramya J. , Singh Abhishek G. , Surwase Pavan J. , Agrawal Sahil A. , Ganpule Arvind P. , Sabnis Ravindra B. , Desai Mahesh R. 
Published: July 2024

ABSTRACT

Introduction:
We aim to share the experience of a single center in the management of eight cases of renal primitive neuroectodermal tumor (PNET) which are uncommon, aggressive tumors. The objectives were to study the presentation of the disease, the treatment offered and its outcomes, and the comparison of the treatment with published literature.

Methods:
The single-center renal PNET data of all patients were retrospectively reviewed from 2011 to 2022. Renal PNET was seen in eight patients. Minimum follow-up period of 1 year was required.

Results:
Male-to-female ratio was 7:1. The mean age was 26.5 years. All were locally advanced tumors on presentation. One patient had an inferior vena cava thrombus, one patient had metastases on presentation, and two patients had tumor extending to paranephric space. The diagnosis was made by histopathology supported by immunohistochemistry showing CD99 positivity. All patients were treated with radical nephrectomy, followed by chemotherapy in all and radiotherapy in three patients. Two patients expired at 3½ and 6 years after surgery, the remaining six are alive at a median follow-up period of 34.5 months.

Conclusion:
Renal PNET is an uncommon renal tumor which is aggressive and requires multimodal therapy for prolonged survival.
Do Indian men have similar oncological outcomes with abiraterone plus androgen deprivation therapy in the setting of metastatic hormone-sensitive prostate cancer? A prospective observational study
Authors: Mandal Swarnendu , Tarigopula Vivek , Kumaraswamy Santosh , Das Manoj Kumar , Tripathy Sambit , Barik Kalandi , Nayak Prasant 
Published: July 2024

ABSTRACT

Introduction:
Combination of abiraterone with androgen deprivation therapy (ADT) has better survival outcomes than ADT alone in metastatic Hormone-sensitive prostate cancer (mHSPC) in the Western population. In this prospective (Clinical Trials Registry-India [CTRI] registered) observational study, we present the comparative oncological outcomes of ADT alone and ADT + abiraterone in Indian patients, which is not available currently.

Methods:
This study (CTRI-number-CTRI/2020/07/026545) included newly diagnosed mHSPC patients from January 2020 to June 2023 in a tertiary care hospital, urology department. Patients fulfilling inclusion criteria were advised ADT with abiraterone (A + ADT), and those not affording received ADT monotherapy (ADT). The primary endpoint was overall survival (OS). Secondary outcomes included prostate-specific antigen (PSA) decline >90%, radiographic progression-free survival (rPFS), and PSA progression-free survival (pPFS).

Results:
Out of 278 patients with mHSPC, 163 patients were excluded and 115 were analyzed (ADT = 40 vs. A + ADT = 75). After a median follow-up of 20.3 months, 11 of 40 (27.5%) in ADT-only arm and 15 of 75 (20%) in ADT + abiraterone arm had died (Hazard-ratio of death 0.72; 95% confidence interval 0.68–0.88; P < 0.001). A PSA decline of >90% was seen in 85% in the ADT alone group and 93.3% in the ADT + abiraterone group. Significantly better outcomes of the ADT + abiraterone were seen in the secondary endpoints of rPFS (P < 0.001) and pPFS (P < 0.001). The OS benefit was 28% reduction in risk of death in our study versus 37% and 38% in STAMPEDE and LATITUDE, respectively. pPFS and rPFS were also poorer in Indian subsets.

Conclusions:
Abiraterone with ADT improves OS, PSA response, rPFS, and pPFS in the Indian population akin to the Western data but with poorer OS, rPFS, and PSA progression-free survival on comparison.
Glans cap-preserving dorsal inlay-free graft augmentation technique for reconstruction of meatal stenosis and fossa navicularis strictures: Analysis of short-term functional outcomes
Authors: Enganti Bhavatej , Nanavati Prashant , Madduri Vijay Kumar Sarma , Wani Amish , Chiruvella Mallikarjuna 
Published: July 2024

ABSTRACT

Introduction:
Meatal stenosis and fossa navicularis strictures (FNSs) are commonly caused by lichen sclerosus and instrumentation. We present the technique and short-term functional outcomes of glans cap-preserving dorsal inlay-free graft augmentation for the reconstruction of meatal stenosis and FNS.

Methods:
This retrospective study analyzed patients with meatal stenosis and FNS who underwent glans cap-preserving dorsal inlay-free graft augmentation at our institute since 2019. The surgical technique included a ventral subcoronal approach, preservation and mobilization of the glans cap, a ventral midline urethrotomy incision over the stricture, and a dorsal midline meatotomy incision extending to the proximal normal urethral mucosa at the fossa navicularis, followed by dorsal inlay graft augmentation. During the follow-up, patients were periodically assessed for symptom scores, urinary flow rates (UFRs), and patient-reported outcomes.

Results:
A total of 26 patients with a mean age of 45 ± 15 years were assessed. The predominant cause of stricture was lichen sclerosus (n = 15; 58%). The mean stricture length was 3.8 ± 0.5 cm, 73% had a circumcised phallus, and an oral mucosa graft augmentation was performed in 22 (85%) patients. Notable postoperative complications included intractable meatal hemorrhage (n = 1) and glans suture granuloma (n = 1), which required intervention. At a mean follow-up of 40 months, there were four failures, of which one patient required redo-urethroplasty. The remaining patients (n = 22; 85%) showed improved symptom scores (P < 0.05), UFRs (P < 0.05), and satisfactory patient-reported outcomes.

Conclusion:
Glans cap-preserving dorsal inlay-free graft augmentation is a safe and feasible technique with satisfactory short-term functional outcomes for the management of meatal stenosis and FNS in carefully selected patients.
The Rate of Anti-measles Immunoglobulin M Positivity among Children with Skin Rash and Fever in Diyala Province
Authors: Hasan Abdulrazak SH. , Salman Raghad E. , Saleh Mohammad K. , Noaman Nadhim G. , Ali Alyaa Y. , Rashid Hiba H. , Zaidan Noor I. 
Published: July 2024

Abstract

Background:
Measles is an extremely contagious disease characterized by generalized maculopapular rash, fever, cough, coryza, and conjunctivitis. It is caused by the measles virus.

Objective:
The objective of this study was to explore the anti-measles immunoglobulin (Ig) M positivity rate among children with clinical suspicion of having measles.

Subjects and Methods:
This is a cross-sectional study carried out in Diyala Province, Iraq, from November/2020 to October/2021. A total of 425 blood samples were collected from children (≤14 years of age): 90 from patients who were clinically suspected as having measles (18 were vaccinated with measles vaccine and 72 were not); 270 from measles-vaccinated children, including those children who received all recommended vaccines in the Iraqi Expanded Program of Immunization (IEPI); and 65 from nonvaccinated children, including those children who received none of the vaccines in the IEPI. Enzyme-linked immunosorbent assay (ELISA) kits for the detection of anti-measles IgM were used.

Results:
The results found that 14 (15.6%) of clinically suspected children were positive for anti-measles IgM antibody versus 76 (84.4%) who were negative. Whereas, only one (1.5%) of the unvaccinated children was positive, and all vaccinated children were negative. Thus, clinically suspected patients had a significantly higher positivity rate compared to other study groups (P = 0.0001). Similarly, the mean ± standard deviation of anti-measles IgM concentration was significantly higher compared to other study groups (P = 0.0001).

Conclusion:
About one-sixth of patients clinically comparable to measles in Diyala Province actually had measles, most of them were unvaccinated, and the anti-measles IgM ELISA technique was a good marker for exploring measles cases.
Blood Lead Level among Chronic Kidney Diseases Patients Attended Medical City Hospital in Baghdad 2022
Authors: Fadhil Aseel Hussein , Al-Rubaey Mazin Ghazi 
Published: July 2024

Abstract

Background:
Lead is a highly toxic metal. Multiple lead exposures produce serious poisoning and sometimes fatality because lead builds up slowly in the exposed body. Signs of repeated exposure to lead are high blood pressure, numbness or tingling of the extremities, memory loss, anemia, and kidney dysfunction.

Methods:
A cross-sectional study was conducted involving patients with chronic kidney disease (CKD) who attended to medical city hospital. The study was conducted from January 2 to May 31, 2022. Inclusion criteria were by involved adults ≥30 years old with CKD of both genders. Glomerular filtration rate (GFR) was measured for all patients according to the Cockcroft-Gault equation. Whole blood samples were taken to measure lead levels in the Toxicology Center of Baghdad Medical City. The collection of data was done by interview using a special questionnaire. Verbal consent was taken as an ethical issue by each participant in the study.

Results:
A total of 315 CKD patients were involved. The mean blood lead level was 24.62 μg/dL, the range was between 15 μg/dL, and 33 μg/dL for both genders, which is higher than the cut point of 10 μg/dL depended in this study. About 38.4%, and 30.8% of patients had GFR (15–29 mL/min/1.73 m2), and (<15) mL/min/1.73 m2 and they were considered as stage 4 and 5 CKD patients, respectively.

Conclusions:
Lead level in blood and GFR had a significant association.
The Association between Refractive Errors and Congenital Ptosis
Authors: Khudhair Nadheer Hashim , Hasan Loay Mahmod 
Published: July 2024

Abstract

Background:
Children with congenital ptosis need to be carefully assessed for refractive errors and visual function to identify and treat amblyopia which occurs in 20% of congenital ptosis, small amount of which is attributed to ptotic eyelid occluding the pupil.

Objectives:
The objective is to determine the frequency of refractive errors and its associations among children with congenital ptosis.

Patients and Methods:
Case–control study of 60 patients with congenital ptosis (79 eyes) and 60 patients without ptosis (control group) (72 eyes). Conducted in Ibn Al-Haithem Eye Teaching Hospital in Baghdad from April 2020 to May 2021. The main outcome measures were relative congenital ptosis, presence, and types of refractive errors.

Results:
Significant association was obtained between children with ptosis and average spherical and cylinder refractory error. Among 60 cases (79 eyes) of congenital ptosis, refractive errors were present in 26 eyes (32.9%) with the astigmatisms as the most common refractive errors (18.9%), followed by hypermetropia (8.9%) and myopia (5.1%).

Conclusions:
Children with congenital ptosis in our environment have greater refractive errors, early ophthalmic evaluation and timely treatment of these conditions may help prevent the irreversible visual impairment in case of congenital ptosis.