bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical and toxicity outcomes with 3D based-HDR surface mold brachytherapy in skin cancer
Authors: Yadavalli Purnachandrarao , Pareek Vibhay , Barthwal Mansi , Bharat Rampukar , Mullassery Shreejesh , Aashita  , Patil Preeti , Sharma Aman , Sharma Daya Nand , Mallick Supriya 
Published: June 2024

ABSTRACT

Introduction:
Surface mold brachytherapy (SMBT) is an established treatment modality in skin cancer, especially in accessible areas, and has shown comparable outcomes to surgery. We have presented our results for the skin tumor treatment with SMBT treated with high-dose-rate (HDR) brachytherapy in terms of clinical outcomes and toxicity at our institute.

Materials and Methods:
In this retrospective analysis, 15 patients with skin cancer were treated with customized tube-based SMBT at our institute between January 2019 and July 2021. The patients were treated using HDR-brachytherapy using Iridium-192. The median dose was 40 Gy in 10 fractions. The dosimetric parameters were assessed, and patients were followed up as per the institutional protocol. All patients underwent individualized CT-based planning. Skin toxicity was assessed using the Dermatology Life Quality Index (DLQI).

Results:
With the majority of the patients being male, the median age was 59 years and the most common site affected was the face (8/15; 53.3%). Among the 15 cases, five were squamous cell carcinoma, nine were basal cell carcinoma, and a single case of sebaceous cell carcinoma. The median depth of invasion was 4 mm, and the median catheter-to-surface distance was 1 mm. The complete response rate among the 10 definitive cases was 90% and partial response in one case. The treatment was well-tolerated with no grade 3-5 toxicities. The median V95% and V90% were 94.8% and 97.1%, respectively. The mean coverage index (C.I.), dose non-uniformity ratio (DNR), and overdose volume index (ODI) were 0.97, 0.13, and 0.05, respectively. After a median follow-up of 12 months, none of the patients had recurrence. On assessment of DLQI, the scores were found to be significant in association with the tumor size and tumor site with scores favoring <2 cm and non-exposed area lesions.

Conclusion:
SMBT is a safe and effective treatment modality for skin tumors providing excellent response and cosmetic outcomes. It is well-tolerated and a non-invasive option for elderly patients with comorbidities and lesions in inoperable areas.
Giant cell tumor of femur with single pulmonary metastasis – yet another curative oligometastasis
Authors: Abraham Abraham P. , Kingsley Pamela A. , Negi Preety , Bedi Harinder S. 
Published: June 2024

ABSTRACT
Giant cell tumor of bone (GCT) is a benign tumor of bone that is known to be locally aggressive rarely metastasizing to distant sites, most commonly to the lungs. The reported pulmonary metastasis incidence is 1 – 9%. We report a case of GCT with solitary pulmonary metastasis who had significant clinical benefit and disease control with sequential application of surgical resection of pulmonary metastasis, local external beam radiation therapy (EBRT), and systemic Denosumab. We wish to highlight that even in metastatic GCT, there is significant clinical benefit in aggressive treatment.
Pneumothorax as a rare presentation in a case of phyllodes tumor of breast with cavitating lung metastasis
Authors: Kaur Tejinder , Chandrashekhara Sheragaru Hanumanthappa , Rastogi Sameer 
Published: June 2024

ABSTRACT
The lung is the most common site of metastases in the case of phyllodes tumor of the breast followed by bone. However, pneumothorax as a presenting complaint in a patient of bilateral cavitating lung metastases from malignant phyllodes tumor of the breast has never been reported to our knowledge. We herein report a case of a 34-year-old female presenting with sudden onset of chest pain in already existing lung metastases who on imaging showed the development of bilateral pneumothorax. We should, therefore, be on the lookout for the potential development of spontaneous pneumothorax in such cases.
Low-dose radiation therapy for COVID-19 pneumonia: Comparison of dosimetry and life-time attributable risk of cancer with conventional AP-PA fields and bone marrow sparing VMAT
Authors: Sharma Daya Nand , Sharma Seema , Gupta Anil , Saini Surendra Kumar , Subramani Vellaiyan 
Published: June 2024

ABSTRACT

Purpose:
Low-dose radiation therapy (LDRT) to lungs did show encouraging results in COVID-19 patients in some clinical trials. However, there has been some concern regarding the long-term risk of radiation-induced cancer (RIC). Compared to the conventional AP-PA field technique, volumetric modulated arc therapy (VMAT) can potentially reduce the dose to the marrow and other organs at risk (OARs) and thus minimize the risk of cancer. We designed a dosimetry study to study if VMAT can reduce the exposure to the marrow and other OAR doses and curtail the estimated life-time attributable risk (LAR) of cancer.

Methods and Materials:
We retrieved the computed tomography scan data of 10 patients (aged 40–60 years, median 48 years) who have been already treated for any malignancy in the region of the thorax. A dose of 1.0 Gy in single fraction was prescribed to both lungs. All the organs were delineated as per the established guidelines. The dosimetry achieved by the two plans was compared to find the difference. Mean OAR doses were used to estimate the LAR for both plans and compared.

Results:
Planning target volume coverage parameters like conformity index and homogeneity index were significantly better with VMAT (P value < 0.05 for all). The mean dose to most OARs was significantly lower with VMAT (P value < 0.05 for all). The mean dose to the marrow was significantly lower with VMAT (59.05 vs 81.9 cGy with P value < 0.05). The overall LAR was significantly lower with VMAT as compared to the conventional plan (0.357% vs 0.398%, P value < 0.05).

Conclusion:
Compared to the conventional technique, VMAT provides better OAR dosimetry for lung irradiation (a prescription dose of 1.0 Gy or more) in COVID-19 pneumonia. VMAT significantly reduces the risk of RIC. We therefore suggest if lung LDRT is used for COVID-19 patients, VMAT is the preferred technique for a prescription dose of ≥1.0 Gy.
Role of external radiation in benign tumors: A clinical outcome and safety audit of 7 years from a tertiary care center in India
Authors: Kapoor Rakesh , Bora Devangana , Khosla Divya , Kumar Narendra , Bahl Amit , Kumar Divyesh , Madan Renu , Chandran Vigneshwaran 
Published: June 2024

ABSTRACT

Purpose:
Radiotherapy (RT) is a well-established modality for treating malignancies, but its role in treatment of benign lesions has not been well explored. Herein, we present a retrospective analysis of a 7-year data regarding the benefit and the safety profile of RT for treating benign tumors in our institute.

Materials and Methods:
Data of 23 patients who received RT for benign tumors from January 2015 to April 2022 were retrieved, and a retrospective analysis was conducted. All the pertinent demographic data, treatment and follow-up data were retrieved. The most common presentations were nasopharyngeal angiofibroma, vertebral hemangioma, paraganglioma, and others. The most common sites of occurrence were head and neck (43%) and paravertebral region (22%). Volumetric modulated arc therapy was the most commonly employed RT technique (39%), followed by three-dimensional conformal RT (34%) and two-dimensional conventional radiotherapy (26%). The median RT dose delivered was 36 Gy (range: 20–54 Gy).

Results:
The median follow-up duration was 53 months (range: 3–120 months). Nine (39%) patients had progressive disease with a median time to progression of 8 months (range: 1–30 months). The median disease-free survival (DFS) was 70 months, while the 1-, 3-, and 5-year DFS rates were 97%, 88%, and 62%, respectively. Four patients (17%) died, all due to disease progression. The 1-, 3-, and 5-year overall survival rates was 97%, 85%, and 50%, respectively. The rate of radiation-induced cancer (RIC) was 0% as none of the patients had developed RIC secondary to radiation.

Conclusion:
RT is a safe and an effective option to manage benign tumors either in an adjuvant setting or in inoperable patients requiring definitive treatment, as well as in a setting to alleviate symptoms, providing excellent survival benefits. However, further prospective studies with much higher sample size are required to establish the absolute benefit and to estimate the risk of RIC, which will further direct for a better utilization of RT in treating benign tumors.
Expression and analysis of CX3CL1 chemokine and CD57+ lymphocytes in oral squamous cell carcinoma and their correlation with clinicopathologic features
Authors: Singh Shivani , Urs Aadithya B. , Kumar Priya 
Published: June 2024

ABSTRACT

Introduction:
CX3CL1 exhibits chemoattraction for T-cells, monocytes, and CD57+ natural killer cells mediating antitumor immunity. The role of CX3CL1 has been studied in tumors of the breast, lung, colon, pancreas, prostate, etc. The current study was undertaken to understand the importance of CX3CL1 and its correlation with CD57+ cells in oral squamous cell carcinoma (OSCC).

Material and Methods:
Seventy-five primary OSCC were staged and histopathologically graded, followed by immunohistochemistry for CX3CL1 and CD57. Mann–Whitney U-test, Kruskal–Wallis test, Post hoc Bonferroni test, and Pearson’s correlation coefficient were applied.

Results:
CX3CL1 assessment within the tumor cells was high in 62.66% of cases, and the CD57 Labeling Index (LI) varied over a wide range of 8.2–111.6. A statistically significant reduction in expression of both CX3CL1 and CD57 was observed with an increase in histologic grade (p = 0.021 and 0.038, respectively).

Discussion:
It is concluded that CX3CL1 and CD57 may be important players in the immune surveillance of OSCC. Further studies with detailed follow-up for the overall survival of patients will help in studying the diagnostic, prognostic, and therapeutic roles of CX3CL1 in OSCC.
Associated Risk Factors and Clinical Outcomes of Bloodstream Infections among COVID-19 Intensive Care Unit Patients in a Tertiary Care Hospital
Authors: Shivalingappa Mahalakshmamma Dasarahalli , Gachinmath Supriya , Narayan Shiva Kumar 
Published: June 2024

Abstract

Introduction:
The COVID-19 infection is an ongoing public health crisis causing millions of deaths worldwide. COVID-19 patients admitted to the intensive care unit (ICU) are more vulnerable to acquire secondary bloodstream infections (sBSIs) which cause a significant morbidity and mortality. Thus, we aim to assess the risk factors of sBSIs and outcomes in COVID-19 ICU patients.

Methods:
One hundred blood culture samples with growth (cases) and other 100 blood culture with no growth(controls) were collected.. All the demographic data, laboratory data and antimicrobial resistance pattern were analysed . Blood culture bottle received in the Microbiology laboratory were loaded into Automated blood culture system. Flagged bottles were processed for final identification by MALDI TOF and automated antibiotic susceptibility testing. Flagged bottles were processed for final identification by MALDI TOF and automated antibiotic susceptibility testing.

Results:
Raised C-reactive protein (CRP) (P = 0.0035), interleukin-6 (P = 0.0404), mechanical ventilation (MV) (P = 0.024), prior antimicrobial exposure (P = 0.002), longer ICU stay with median 11 days (P = 0.022), and higher mortality rate (P = 0.001) were significantly associated with the BSI. A significant proportion of BSIs were Gram-negative bacteria (n = 115) such as Acinetobacter baumannii 38 (33%) and Klebsiella pneumoniae 30 (26%). Monomicrobial organisms in blood yielded a higher proportion in our study 72 (72%). The highest resistance for Acinetobacter species (50) was observed with ceftazidime 29 (96.6%) amikacin 48 (96%), meropenem 48 (96%), cefotaxime 47 (94%), ciprofloxacin 46 (92%), and netilmicin 46 (92%). K. pneumoniae was highly resistant to cefotaxime 29 (96.6%), ceftazidime 29 (96.6%), ciprofloxacin 22 (73.3%), and cefuroxime 21 (70%). Among Gram-positive organisms, Enterococcus species showed that a resistance for high-level gentamicin and penicillin was 66.6%.

Conclusions:
Raised CRP, need of MV, prior antimicrobial exposure, and longer ICU stay should alarm clinicians for BSI. Hence, our study highlights the associated risk factors for BSI and emphasizes adherence to hospital infection control policies and antibiotic stewardship program.
Detection of Chlamydial Heat Shock Protein 60 and 10 Antibody among Female Infertility
Authors: Dhivya Gopi , Sridharan Kopula Sathyamoorthy , Nellepalli Sanjeeva Reddy , Kumar P. Kennedy , Ramesh Arunagiri , Katta Divya 
Published: June 2024

Abstract

Introduction:
Of the many sexually transmitted pathogens, Chlamydia trachomatis is increasingly being associated with long-term sequelae such as infertility, apart from causing genital tract infections. Many inflammatory responses directed against chlamydial infection can cause tubal damage resulting in infertility. For example, chlamydial heat shock protein 60 (cHSP60) and cHSP10 along with humoral immune response. The aim of our study is to detect the presence of immunoglobulin G (IgG) antibodies against Major Outer Membrane Protein (MOMP), cHSP60, and cHSP10 among female infertility.

Methods:
A total number of 230 female infertility patients attending the Outpatient Department of Reproductive Medicine, SRIHER, were included in the study. Detailed history documented in the proforma. Serological detection of C. trachomatis IgG antibody against MOMP, cHSP60, and cHSP10 antibody was done by enzyme-linked immunosorbent assay (ELISA).

Results:

C. trachomatis IgG antibody against MOMP was detected in 15 (6.5%) of 230 females. High seropositivity to cHSP60 antibodies was detected among females of tubal factor infertility (TFI). Our study showed that cHSP60 antibodies (3.4%) were more common than cHSP10 (2.6%).

Conclusion:
Our study suggest cHSP60 or cHSP10 antibody detection by ELISA along with TFI is helpful for diagnosis and early institution of therapy. The accuracy of TFI prediction could be increased by the detection of anti-MOMP and cHSP60 over cHSP10 among secondary infertility than primary. The most probable reason for high seropositivity among secondary infertility patients may be due to repeated infection and chronicity because of longer active sexual life.
Paradoxical Reaction during Treatment of Tuberculous Meningoencephalitis in a Patient with Systemic Lupus Erythematosus
Authors: Versiani Isadora Lemos , Nimer Gabriela Flor , Moura Carolina Braga , Xavier Arthur Ferreira , Gaudio Rodrigo Cutrim , Lopes Fernanda Cristina Rueda , Braune Caroline Bittar 
Published: June 2024

Abstract
Tuberculous paradoxical reaction presents as clinical deterioration during appropriate tuberculosis therapy and is a separate entity from treatment failure and drug resistance. We describe a case of central nervous system paradoxical reaction following tuberculous meningoencephalitis treatment in an immunocompromised patient with systemic lupus erythematosus.
Assessment of Fluoride Release and Recharge of Giomer After Recharge With Two Different Topical Fluoride Materials and Two Durations: An In Vitro Study
Authors: Almuhtady Sura Sulaiman , Al-Naimi Raya Jasim 
Published: June 2024

Abstract

Aims:
The objectives of this study were to determine the fluoride release from a giomer after 24 h, 1 week, and 1 month) and to examine the recharge ability of the giomer after recharge with two different topical fluoride materials and two different durations.

Materials and Methods:
This is an in vitro study that involved the use of 72 specimens of the tested material; the specimens were divided randomly into three main groups (24 h., 1 week, and 1 month group). Each group consisted of 24 specimens, out of which 12 specimens were recharged with fluoride varnish (six specimens for 12 h and six specimens for 24 h.) and 12 specimens were recharged with APF gel (six specimens for 1 min and six specimens for 4 min). First fluoride release was measured from the tested specimens, and then all of the tested specimens were recharged with different topical fluoride materials with different durations. One-way analysis of variance (ANOVA) and Duncan’s multiple range test were used to determine the significant differences among the groups. The statistical results were considered significant at P ≤ 0.05.

Results:
The statistical ANOVAs showed there were no statistical significant variations in the mean values of release of all specimens in the 24-h and 1-week group, but there was a highly statistically significance difference in the mean values of release of all specimens in the 1-month group, and after recharge with FV (12 h; 24 h) and APF gel (1 min; 4 min), there was a highly statistically significance difference in the mean values of fluoride release after recharge in the groups (24 h, 1 week, and 1 month).

Conclusions:
The amount of fluoride released from the giomer was more in the 24-h. group than in other groups. Recharge with APF gel released more fluoride than fluoride varnish. Increasing the time of giomer contact with the recharging material resulted in a greater uptake of fluoride.
Effectiveness of Patchouli Leaf Extract (Pogostemon cablin) with Varying Concentrations as an Acrylic Denture Cleanser against the Growth of Candida albicans: An Experimental Laboratory Study
Authors: Liana Rahmayani , Pocut Aya Sofya , Cut Fera Novita , Poppy Andriany , Ratu Silvia Rahmah 
Published: June 2024

Abstract

Aims:
A removable denture is a prosthesis that can be removed from the patient’s mouth for inspection, cleaning, and repair if damaged and has a positive effect on their quality of life. One of the characteristics of denture from acrylic resin materials is the porous properties that can lead to the accumulation of residual plaque, thereby increasing the number of microorganisms, such as Candida albicans fungi. Infection due to C. albicans can cause inflammation in the mucosa of the oral cavity commonly called denture stomatitis. The purpose of this study was to determine the effectiveness of denture cleaning ability of patchouli leaf extract (Pogostemon cablin) against C. albicans growth on acrylic resin base.

Materials and Methods:
The type of research used is post–test-only control group design to see whether denture cleaners from patchouli leaf extract are effective in inhibiting the growth of C. albicans on acrylic resin bases. C. albicans that has been cultured and then mixing it with a 0.9% NaCl solution until turbidity was obtained that is in accordance with the MacFarland standard or comparable with 1 × 108 CFU/mL. The number of samples in this study were 30 samples with a diameter of 10 mm and a thickness of 2 mm divided into five groups with three different concentrations, namely 25%, 50%, 75%, 0.2% chlorhexidine, and water as a negative control. Statistical analysis tests using univariate test to see the number of C. albicans, one-way ANOVA test to see the effect of soaking and LSD test to see the obstacle.

Results:
The one-way ANOVA test shows a value of P = 0.000. The treatment groups with concentrations of 25%, 50%, 75% and 0.2% chlorhexidine to the water group with a value of P = 0.000, and the least average number of Candida Albicans colonies was found in concentrations of 25% and 50%.

Conclusion:
Immersion of acrylic resin dentures in patchouli leaf extract effectively inhibits the growth of C. albicans, especially at concentrations of 25% and 50%, therefore patchouli leaf extract can be recommended as a denture cleaning agent.
Orthopedic Trauma Epidemiology in Pediatric Patients at a Tertiary Care Trauma Center in North India
Authors: Afaque Syed Faisal , Verma Vikas , Fatima Farhat , Singh Ajai 
Published: June 2024

Abstract

Introduction:
In North India, orthopedic trauma, which refers to injuries affecting the bones, joints, and soft tissues, occurs frequently in pediatric patients. The aim of this study is to investigate the epidemiology, etiology, mechanisms of injury, and outcomes of orthopedic trauma in pediatric patients who are admitted to a tertiary care trauma center located in North India.

Materials and Methods:
This prospective study was carried out over 1 year between January 2019 and December 2019, which included 479 pediatric orthopedic trauma patients between the age group of 0 and 18 years. The collected data were systematically classified and analyzed with respect to the mode of trauma, type of injury, and outcome across various age groups and genders.

Results:
Age of children ranged from 0 to 18 years, of which 298 (62.2%) were male and 181 (37.8%) were female. Most fractures occurred at aged 9–12 years (38.4%) and the trend decreased with age. Fall injuries were the most common mode of trauma (49.9%, n = 239) followed by road traffic accident (29.4%, n = 141). Among operated patients, most injuries were closed (47.2%, n = 138) followed by compound injuries (32.2%, n = 94) and crush injuries (20.6%, n = 60). Sixty-three percentage of patients recovered well with independent functional status, while 30% recovered with supported functional status/residual deformity.

Conclusion:
Orthopedic trauma in pediatric population is growing up and prehospital care is lagging which is more required than adult counterpart. An effective and aggressive management of accident prevention programme is required, which should also include changes in lifestyle and environment, overcoming obstacles such as ignorance, inadequate resources, and illiteracy.
Comparative Analysis of Utility and Efficacy of Ozone Therapy versus Laser Therapy in Periarthritis Shoulder
Authors: Kumar Sunil , Kumar Harish , Singh Prashant Pratap , Kumar Dinesh , Mishra Vyutpanna , Ahmad Ishan 
Published: June 2024

Abstract

Introduction:
Adhesive capsulitis of shoulder due to uncertain etiology of glenohumeral joint characterized by spontaneous onset of pain and reduction in the arc of active and passive movements at glenohumeral joint and essentially normal radiograph. It is considered a self-limiting condition with a natural history of 1–3 years while some have refractory course. Most of adhesive capsulitis patients are successfully treated with nonsurgical treatment such as non-steroidal anti-inflammatory drugs (NSAIDS), oral/intra-articular corticosteroids, and hydrodialtation, among nonsurgical modalities, ozone and laser are newer, safe, and show promising results in adhesive capsulitis management. A current study was done to compare between ozone therapy and laser therapy in terms of efficacy and utility in periarthritis shoulder.

Materials and Methods:
All patients who presented with shoulder pain and stiffness at the orthopedics outpatient department of tertiary care center of rural North India, on the basis of clinical history and examination, those who were diagnosed with adhesive capsulitis and fulfilling the inclusion criteria and exclusion criteria were included in the study, after obtaining proper informed and written consent, cases were randomized into two groups for laser and ozone therapy.

Results:
A total of 55 patients were included in the study, among them, 42 patients (20 patients in the laser and 22 in the ozone group) were followed up to a final follow-up of 6 months and 13 patients lost their follow-up. Disabilities of the arm, shoulder, and hand questionnaire (DASH) score ozone group showed a gradual decline from the preinjection score of 55.68–17.78 at 6 months. In the laser group, there is also a decline in DASH scores from the pretreatment score of 57.56–23.34 at 6 months. Difference in DASH score was insignificant up to 4 weeks across both groups. On follow-up after 4 weeks up to 6 months showed a significant difference in DASH score across both groups. Decline in the ozone group was more as compared to the laser group (P < 0.026).

Conclusion:
Both ozone and laser are safe and effective modalities of treatment of adhesive capsulitis but ozone is more effective in long term.