bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and Risk Factors of Cognitive Impairment and its Effect on Quality of Life
Authors: Al-Hindawi Ahmed , Al Tabaa Louai Wael , Gebril Ali Ahmed Ali , Waly Yousef , Shelig Mohamed , Hussain Muhammed , Al-Sabti Ali 
Published: August 2024

Objectives:
Examine the prevalence of cognitive impairment within Wave 1 of the Irish Longitudinal Study on Aging (TILDA) cohort and its relationship with comorbidities and lifestyle factors. The effect of cognitive impairment on quality-of-life scores was also investigated.

Methods:
A secondary cross-sectional analysis of data from Wave 1 of the TILDA cohort was undertaken.

Results:
Prevalence of cognitive impairment ranged between 5.8% and 51.2%, depending on the instrument used (Mini-Mental State Examination [MMSE] and Montreal Cognitive Assessment [MoCA], respectively). Having hypertension (odds ratio [OR] 1.68; 95% confidence interval [CI] 1.36–2.08), being a past or current smoker (OR 1.25; 95% CI 1.01–1.55) and having low physical activity (OR 2.04; 95% CI 1.64–2.53) increased the odds of being classified as cognitively impaired (MMSE <25). Similarly, being obese (OR 1.31; 95% CI 1.17–1.47), having hypertension (OR 1.42; 95% CI 1.27–1.57), and having diabetes (OR 1.71; 95% CI 1.40–2.09) increased the odds of cognitive impairment (MoCA <26). High cholesterol was associated with a protective effect (OR 0.79; 95% CI 0.63–0.98) under MMSE <25 classification while, problematic alcohol behavior reduced the odds of being classified as cognitively impaired using MoCA <26 by 35% (OR 0.65; 95% CI 0.55–0.76). Depression was not associated with increased odds of cognitive decline. Lastly, mean quality of life (QoL) scores decreases as severity of cognitive impairment increases from normal to moderate cognitive impairment (P < 0.001).

Conclusions:
Several modifiable risk factors for cognitive decline were identified, including smoking, low physical activity, hypertension, diabetes, and obesity. Policies aimed at reducing the prevalence of these risk factors in the population might reduce the impact of cognitive decline on public health.
Dietary Approaches and Nutritional Complexities of Autism Spectrum Disorder
Authors: Ahmad Abdul Momin Rizwan , Intikhab Anosh , Abid Juweria , Iqbal Sehar 
Published: August 2024

Background:
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by poor social interaction, repetitive behavior, learning difficulties, cognitive issues, and unusual eating patterns. Different factors including genetic and environmental variables have been identified to increase the risk of developing ASD.

Objective:
The main objective of the present review is to investigate the dietary approaches and modifications to reduce the intricacies related to ASD.

Results:
Studies included in this review suggested that abnormalities in the gut microbiota are involved in the pathogenesis and severity of the disease. Medical nutrition therapy for ASD consists of excluding harmful food components such as gluten, casein, processed foods, and excessive sugars and increasing the consumption of omega-3 fats, vitamins and minerals, probiotics, and antioxidants. Furthermore, awareness regarding food labels might help to avoid food allergens in diet.

Conclusion:
Active dietary treatments including the use of dietary supplements and elimination of processed foods appear to reduce the complexities of ASD. Furthermore, support of health care professionals and adopting public health approaches might help to prevent adverse outcomes related to ASD. Future research is required to determine the prevalence of ASD and related outcomes in low/middle income countries as this area is highly neglected.
Effect of Morinda citrifolia L. Mouthwash on Periodontal Health in Type 2 Diabetes Mellitus Patients − A Randomized Controlled Trial
Authors: Shashikumar Pratibha , Nisha Swet , Das Debanjan , Debanth Krishnendu , Kanthal Lakshmi Kanta , Pattanayak Suman 
Published: August 2024

Introduction:
Patients with diabetes mellitus need regular dental visits for maintenance of periodontal health. The treatment regimen usually consists of nonsurgical periodontal therapy (NSPT) in gingivitis and mild to moderate periodontitis, followed by oral hygiene reinforcement and maintenance therapy. Recently, the use of herbal/traditional medicine as an adjunct to NSPT has been tried as a beneficial agent in achieving better periodontal health status in diabetic patients. The present study evaluated the effect of Morinda citrifolia L. mouthwash in the maintenance of periodontal health in patients with type 2 diabetes with chronic periodontitis (ChP).

Materials and methods:
Systemically healthy subjects without periodontitis were recruited as control (group A) (n = 24). Twenty-four subjects with ChP were allotted in group B. A total of 48 patients with ChP and type 2 diabetes mellitus were enrolled and randomly allocated as group C (n = 24) and group D (n = 24). The subject was instructed to rinse with M. citrifolia mouthwash twice daily. Clinical periodontal outcomes measured were plaque index (PI), gingival index (GI), clinical attachment level (CAL), bleeding on probing (BOP), probing depth (PD) at baseline, 1 month, and 3 months posttherapy. Salivary total antioxidant capacity (TAOC) was also measured at baseline and 3 months.

Results:
Clinical parameters PI, GI, CAL, BOP, and PD reduced significantly in groups B, C, and D posttreatment 3 months follow-up. However, the intergroup comparison did not show any significant difference (P > 0.05). Salivary TAOC level was higher in groups B, C, and D when compared with healthy control group A and it was significantly reduced in all the three groups B, C, and D post 3 months therapy (P < 0.05). Intergroup comparison of salivary TAOC levels between groups B, C, and D did not show any significant difference (P > 0.05).

Conclusion:
The daily rinsing with M. citrifolia mouthwash did not show any added benefits in ChP with type 2 diabetes mellitus; however, its further nutritional benefits need to be assessed by larger multicenter interventional studies.
Salivary microbial dysbiosis may predict lung adenocarcinoma
Authors: Roy Partha , Sarma Anupam , Kataki Amal Ch. , Rai Avdhesh Kumar , Chattopadhyay Indranil 
Published: August 2024

Background:
Adenocarcinoma is a more common type of Non-small cell lung cancer (NSCLC). Lung cancer showed a statistically significant increment in the Kamrup Urban district of Assam, Tripura, Sikkim, and Manipur of India. The goal of our pilot study is to identify non-invasive microbial biomarkers to detect lung adenocarcinoma (LAC).

Material and Methods:
DNA extraction from saliva samples of five LAC patients and five healthy controls was performed by Qiagen DNeasy blood and tissue kit using Lysozyme (3mg/ml) treatment. 16S rRNA genes of distinct regions (V3-V4) were amplified from saliva DNA by PCR. Paired-end sequencing targeting the V3-V4 region of the 16S rRNA gene has been performed on the Illumina MiSeq platform. Raw sequences were analyzed using the QIIME(Quantitative Insights Into Microbial Ecology) software package.

Results:
Our preliminary results showed that Rothia mucilaginosa, Veillonella dispar, Prevotella melaninogenica, Prevotella pallens, Prevotella copri, Haemophilus parainfluenzae, Neisseria bacilliformis and Aggregatibacter segnis were significantly elevated in saliva of LAC which may serve as potential non-invasive biomarkers for LAC detection. Functional prediction analysis showed that bacterial genes involved in glycosyltransferase, peptidases, amino sugar, and nucleotide sugar metabolism, starch and sucrose metabolism were significantly enriched in LAC.

Conclusion:
These salivary bacteria may contribute to the development of LAC by increasing expression of glycosyltransferase and peptidases. However to understand their role in pathobiology, studies are required to perform in large cohort.
Role of CTLA4 immunohistochemistry in the diagnosis of colon cancers
Authors: Narayanan Vishnu , Pavithra V , Dhanapal Divya , Sundaram Sandhya , Narayanan C. D 
Published: August 2024

Background:
There are a wide range of diagnostic markers for colorectal cancers like detection of mutated KRAS, TP53, and APC genes. However, genetic and immunological factors have also been attributed to the cancer prognosis. The present study was carried out to evaluate the expression of CTLA-4 in colorectal cancers.

Methods:
This cross-sectional study was carried out among 30 resected specimens of colorectal cancer. Paraffin blocks were made on samples from tumor areas along with adjacent normal areas. Immunohistochemistry for CTLA-4 was done on the sections along with controls. Gross findings were recorded from the blocks. Blocks with section containing normal epithelium and tumor were chosen for immunohistochemistry.

Results:
Overexpression of CTLA-4 was observed in 43.3% of the tumors. There was a significantly high tumor infiltration among those specimens showing overexpression of CTLA-4. The observed difference was statistically significant (P < 0.05). On comparing the grade of the tumor with intensity of CTLA4 uptake, it was observed that majority of the well-differentiated tumors (66.7%) had an intensity of 1+ whereas majority of the poorly differentiated tumors had an intensity of 3+ (66.7%).

Conclusion:
The present study has demonstrated overexpression of CTLA-4 in colorectal cancer specimens, and also highlighted the potential scope for anti-CTLA-4 agents like Ipilimumab in cancer therapy. The need for further evaluation to examine five-year survival with such immunotherapies is essential to document candid therapeutic recommendations for colorectal cancers.
Morphological study of the spectrum of lesions encountered in the heart and coronaries on autopsy
Authors: Siddiqui Md Ibrahim , Mahanta Anita A , Umesh S R , Neeha Saara , Andola Sainath K 
Published: August 2024

Background and Objectives:
This research study has been carried out to study the various morphological changes in the heart in medicolegal autopsies and to compile data for the frequency of heart diseases found in autopsy cases.

Methods:
The present study comprised 430 medicolegal autopsy cases. Details of the cases were entered in a proforma prepared for the study. The heart was fixed in 10% formalin, and then, opened along the flow of blood. The findings were based on gross and microscopic examinations.

Results:
Out of 430 adult hearts, 211 (49.0%) cases showed 253 cardiac lesions; 35 (8.1%) cases of coronary atherosclerosis and 196 (45.5%) aortic atherosclerosis were noted; 7 cases of ischemic lesions (1.6%) were identified; 12 (2.7%) cases of hypertrophy; 2 cases of valve calcification; and 1 of cardiomyopathy were noted.

Conclusion:
In the present study, among medicolegal autopsies, atherosclerotic disease was the most frequently encountered lesion followed by hypertrophy. The incidence of atherosclerosis was found to be 47.6%. This study shows the high prevalence of atherosclerosis in the population.
Differential expression of CK7, CK20, CDX2 in intestinal and pancreatobiliary types of preriampullary carcinoma
Authors: Sree Udayagiri D. , Prayaga Aruna K. , R. Reddy V. Venkat , Rukmanghadha N. , Chowhan Amit K. , Phaneendra B. V. 
Published: August 2024

Context:
Incidence of periampullary carcinoma is low, approximately 0.5–2% of all gastrointestinal malignancies. Histologic subtyping has a prognostic bearing. The purpose of this study is to differentiate periampullary carcinomas based on immunohistochemistry (IHC) by using cytokeratin 7 (CK7), cytokeratin 20 (CK20), caudal type homeobox 2 (CDX2).

Aims:
To analyze the usefulness of IHC as single/panel of markers that included CK7, CK20, and CDX2.

Settings and Design:
This was a prospective study done from January 2017 to September 2018.

Subjects and Methods:
A total 50 pancreaticoduodenectomy specimens were evaluated and classified as intestinal (INT) and pancreaticobiliary (PB) types based on their morphological and immunohistochemical features, respectively. The morphologic subtypes, expression of IHC markers were correlated with different histologic parameters.

Statistical Analysis:
Chi-square test was used to study the association between different IHC markers with histologic parameters. Probability (P) values <0.05 were regarded as statistically significant.

Results:
The expression of CK7, CK20, CDX2 were studied in 50 cases to classify them as INT and pancreatobiliary subtypes. CK7 has high sensitivity (88.2%), CDX2 has high specificity (96.4%), CK20+/CDX2+ has both high sensitivity (94.2 percent) and specificity (89.2 percent) in differentiating INT from pancreatobiliary subtypes. The morphologic subtypes showed correlation with two variables (tumor grade, pathologic T stage). CK20 and CK20/CDX2 expression showed a positive correlation with tumor grade, pathologic T staging, and lymphovascular invasion.

Conclusions:
In conclusion, morphological classification can significantly discriminate histologic types, IHC plays a moderate role. However, the combined expression of CK20 and CDX2 is helpful in subtyping.
Anaplasia in childhood rhabdomyosarcoma
Authors: Ahuja Manisha , Tomar Reena , Thakur Shruti , Mallya Varuna , Mandal Shramana , Khurana Nita , Sarin Y. K. 
Published: August 2024

Background:
Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children. Anaplasia is a rare phenomenon seen in childhood RMS. The most common histologic subtype was Embryonal followed by Alveolar and spindle subtype.

Design:
A total of 11 cases of pediatric RMS were selected from January 2017 to June 2019 presenting at various sites. Out of 11 cases, 2 were further diagnosed as Embryonal, 2 as Alveolar, 2 as Pleomorphic, 1 as Spindle subtype and rest 4 as RMS-NOS based on morphology. All cases were positive for Desmin. The presence of cells with lobated, hyperchromatic nuclei at least three times larger than the tumor cell (anaplastic cells) was selected as the main criterion to diagnose Anaplasia.

Results:
Out of the total 11 cases, anaplasia was seen in 7 cases. Out of these seven, five cases showed Focal Anaplasia (FA) (71.4%) and 2 cases showed Diffuse Anaplasia (DA) (28.6%). Out of 2 cases of Embryonal RMS one exhibited focal anaplasia (50%). One case of Spindle RMS showed diffuse anaplasia, 2 cases of pleomorphic RMS showed focal anaplasia. Out of 3 cases of RMS- NOS, 2 exhibited focal anaplaisa and one displayed Diffuse anaplasia. Both Alveolar RMS had no features of anaplasia.

Conclusion:
Presence of Anaplasia is a frequent observation in pediatric RMS. Anaplasia is often under reported in pediatric RMS. Pathologist should be more aware of this rare phenomenon.
Evaluation of immunocytochemistry on destained giemsa stained smears as an alternative to conventional technique
Authors: Kushwaha Pritika , Pandey Toshali , Agarwal Radhika , Singh Meeta , Jain Shyama , Mishra Anurag 
Published: August 2024

Introduction:
Protocol for immunocytochemical (ICC) staining in May-Grünwald Giemsa (MGG)–stained smears has been difficult to establish. It is the need of the hour to be able to use prestained slides for ICC in specific cases to deliver timely diagnoses and reduce inconvenience to patients.

Aims and Objectives:
To evaluate and compare the use of MGG-stained smears for the purpose of ICC, after de-staining and saline rehydration to that of routine standard ICC.

Materials and Methods:
A prospective study was conducted on 40 FNAC samples: 25 cases of breast disease and 15 cases of reactive lymphoid hyperplasia known to express pancytokeratin and leukocyte common antigen (LCA)/CD45, respectively. Air-dried smears of each case were stained by standard MGG stain and after the report was dispatched, one smear was selected and sent for ICC. The smears were analyzed to determine the overall result and grade each smear semi-quantitatively with respect to staining-intensity, stain-localization, staining-uniformity, counter-staining, and background-staining.

Observations and Results:
The proposed protocol was inferior to conventional ICC in all the parameters, more pronounced in pancytokeratin than LCA/CD45. Only 8% of air-dried smears stained for pancytokeratin showed optimal stain intensity (as opposed to 44% of wet-fixed smears), whereas only 14.3% of air-dried smears were optimally stained for LCA (as opposed to 85.7% of wet-fixed smears).

Conclusion:
The proposed protocol of de-stained Giemsa smears as an alternative to conventional technique for ICC was unsuccessful in giving satisfactory results.
An audit of frozen sections for suspected gastrointestinal malignancies in a tertiary referral hospital in India
Authors: Jadhav Akshaya S. , Deodhar Kedar K. , Ramadwar Mukta , Bal Munita , Kumar Rajiv , Goel Mahesh , Saklani Avanish , Shrikhande Shailesh V. 
Published: August 2024

Background:
Frozen Sections (FS) are used to assess margins, for staging, and primary diagnosis. FS guide intraoperative treatment decisions in oncological gastro-intestinal tract surgeries and further management of the patients.

Aim:
To analyze the distribution, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of frozen sections in gastrointestinal pathology in our institution during the period of 3 years (2016–2018).

Material and Methods:
This study was an audit to determine the accuracy of FS reports by comparing them with the paraffin section (PS) reports. The FS diagnoses and their PS diagnoses were noted in 1704 gastrointestinal surgeries during the period from 2016 to 2018. Discrepancies were noted and slides of discrepant cases were reviewed to determine the cause. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated using the standard formulae.

Results:
Out of 1704 cases, correct diagnosis on frozen section was made in 1649 cases (96.77%), 20 (1.17%) were deferred cases, and 35 (2.05%) were discrepant cases. The commonest discrepancies were seen in the primary diagnosis of the gall bladder and gastrectomy margins. The commonest causes for discrepancies were interpretation errors and technical errors. Sensitivity was 91.71%, specificity was 99.69%, positive predictive value was 98.84%, negative predictive value was 97.68%, and accuracy was 97.92%.

Conclusion:
FS diagnosis is a reliable guide to surgeons for intraoperative management. Studying deep cuts and careful sampling at frozen sections will help reduce discrepancies.
Acute panmylelosis with myelofibrosis - A rare case report with review of literature
Authors: Dahiya Surbhi , Kotwal Jyoti , Langer Sabina , Saraf Amrita , Prakhar Pallavi , Gupta Deepika , Gupta Nitin , Arya Vandana 
Published: August 2024

ABSTRACT
Acute panmyelosis with myelofibrosis (APMF) corresponds to <1% cases of acute myeloid leukemia, which could be an underestimation due to missed diagnosis. Due to its rapidly fatal course, it warrants a timely and correct diagnosis. We present a case of a 44-year male who came with a short history of fever, generalised weakness, revealed pancytopenia with occasional circulating blast in the peripheral blood smear. Bone marrow aspirate was dry tap,biopsy revealed panmyelosis with myelofibrosis with increased (22%) blasts. Flowcytometric immunophenotyping, cytogenetics and molecular tests were undertaken. Together with clinical details, immunophenotypic profile, cytogenetics and molecular studies, the diagnosis of Acute panmyelosis with myelofibrosis was made and managed accordingly. 32 The WHO 2017 describes APMF as an acute panmyeloid proliferation with increased blasts (≥20% in the bone marrow or peripheral blood) and accompanying marrow fibrosis. APMF is rare with poor prognosis thus, must be differentiated especially from Acute megakaryoblastic leukemia to arrive at the correct diagnosis which will help reduce/prevent the early mortality by providing timely chemotherapy followed by upfront hemopoietic stem cell transplantation.
Correlation between Ki-67 labeling index and mitotic index in Head and neck squamous cell carcinoma
Authors: Deepa Das C. K , Balakrishnan Sunitha 
Published: August 2024

ABSTRACT

Background:
Proliferative activity of any tissue or neoplasm can be determined by its growth rate by mitotic count or by using antibodies directed against specific antigens like Ki-67. The usefulness of Ki-67 in head and neck cancers has been debated for the past 20 years; however, no study has definitively resolved this controversy.

Aim:
Assess the correlation between Ki-67 expression and mitotic index in head and neck squamous cell carcinoma.

Materials and Methods:
This cross-sectional study was performed in 66 histologically proven cases of Head and Neck Squamous cell carcinoma (SCC) received in a histopathology laboratory and satisfied the specified criteria. Tumor was graded. Mitotic and Ki67 labeling index was calculated. Statistical analysis was performed using appropriate techniques to determine the correlation coefficient.

Results:
A statistically significant difference in the Ki67 labeling index (LI) between the grades of the tumor proper was noted (P = 0.040). An increase in the mean mitotic index with histological grade was noted, which was statistically significant in the proliferating margin (P = 0.037). A statistically significant positive correlation was noted between Ki67 LI and mitotic index in tumor proper (r = 0.263, P = 0.033) and proliferative margin (r = 0.364, P = 0.003).

Conclusion:
Mitotic index, a rapid and affordable tool for assessing cellular proliferation, becomes more relevant and practically effective when used in conjunction with Ki-67. Combined analysis of the two indices can be useful in the early diagnosis of possibly malignant lesions and in predicting tumor behavior.
Molecular stratification of high-grade urothelial carcinoma by immunohistochemistry with its histomorphological and clinical correlation
Authors: Gupta Gurudutt , Gupta Rajee , Pasricha Sunil , Sharma Anila , Durga Garima , Kamboj Meenakshi , Tripathi Rupal , Mehta Anurag 
Published: August 2024

Introduction:
Urothelial carcinoma poses a significant cause of morbidity and mortality. The recent classification of Tumors of Urinary System by World Health Organization fourth edition) has elucidated its molecular subtypes and its associated prognostic significance.

Methods:
We used immunohistochemistry marker expression (CK5/6, CK20, CD44, EGFR) as a surrogate marker, to stratify 150 cases of high-grade urothelial carcinoma into the intrinsic molecular subtypes. A correlation was also done with immunohistochemical markers p53, p21, E-cadherin and Ki-67.

Results:
On subtyping, 47.3% cases were basal, 42.7% luminal and 10% remained unclassified. We did not find GATA3 useful for molecular stratification in our study. Muscle invasion was seen in 59% of basal and 31% of luminal subtype (P = 0.016). Squamous differentiation was most commonly associated with basal subtype (P < 0.001). EGFR expression was seen in 62% of basal and 38% of luminal subtype (P = 0.014), and thus can be used as an additional marker for molecular stratification. Overexpression of p53 was seen in 64% cases of muscle invasive and 36% of non-muscle invasive high-grade carcinomas (P < 0.0001). An inverse relationship was observed between p53 and p21 immunoexpression (r = –0.494) (P < .0001). The overall survival at 1- and 2-year interval was more in the luminal subtype, suggesting an early mortality in basal group, (P = 0.827), and at 6 years both the groups had almost similar results.

Conclusion:
High-grade urothelial carcinoma is challenging in terms of therapeutic strategy. Increased understanding of underlying molecular basis helps identifying targetable treatment options, and newer biomarkers will enhance predictive and prognostic stratification.