bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determine the Arrest Factors in Survival Outcome of Patients with IHCA
Authors: Devi A. Akila , Sundaresan S. , Kanniammal C. , Ramakrishnan T.V. 
Published: August 2024

Introduction:
In-hospital cardiac arrest (IHCA) is a common health problem associated with high levels of mortality. Successful defibrillation is known to improve outcomes in ventricular fibrillation/ventricular tachycardia. However, it has been hypothesized that a period of cardiopulmonary resuscitation (CPR) before defibrillation, increasing the likelihood of successful defibrillation. The order of priority of CPR versus defibrillation therefore remains in contention.

Objectives:
(1) To determine the arrest factors in survival outcome of IHCA. (2) To associate the arrest factors in survival outcome of IHCA with their selected demographic variables.

Materials and methods:
A total of 125 samples were selected and nonprobability purposive sampling technique was used for this study. Arrest factor score was used to assess prognosis of IHCA.

Statistical analysis used:
Descriptive statistics to determine the frequency and distribution, multiple regression analysis to interpret the data, and Chi-square test for associating the variables.

Results:
Percentage distribution of arrest factors determines the cardiac cause 94.4% and noncardiac cause 89.6%, and cardiopulmonary resuscitation was carried for 2 to 4 minutes (2.4%) duration, 5 to 9 minutes (15.2%), 15 to 19 minutes (8.8%), 20 to 24 minutes (17.6%), 25 to 29 minutes (32%), and ≥30 minutes (24%) among patients with IHCA. Frequency and distribution of arrest factors were increased survival outcome 0 (0.0%), moderate survival outcome 33 (26.4%), and decreased survival outcome 92 (73.6%) in survival outcome among patients with IHCA. The P-values corresponding to “total cholesterol level and low-density lipoprotein cholesterol level” at 0.01 level and “triglycerides and smoking” at 0.05 level are highly impacting the “arrest factors scores.”

Conclusion:
Determining cardiac and noncardiac causes can determine the risk of IHCA. Identification and early management and duration of CPR initiate the reversal of IHCA and increase the rate of survival outcome.
Detection of MDM2 gene amplification on tissue microarray-based Fluorescence In-Situ Hybridization (FISH) in well-differentiated and dedifferentiated liposarcomas, displaying a wide morphological spectrum
Authors: Rekhi Bharat , Karnik Nupur , Agrawal Radhika , Shetty Omshree , Patkar Shraddha 
Published: August 2024

Background:
Liposarcomas including atypical lipomatous tumors (ALT)/well-differentiated liposarcomas (WDLPS) and dedifferentiated liposarcomas (DDLPSs) display a histomorphological spectrum with their several diagnostic mimics. Murine double minute 2(MDM2)gene amplification characterizes ALT/WDLPS and DDLPS. Presently, there is no documented study from our subcontinent on the validation of MDM2 gene testing in these tumors.

Material and Methods:
Twenty-eight cases, diagnosed as ALT/WDLPS (n = 5) and DDLPSs (n = 23), along with 10 other tumors were tested for MDM2 gene amplification, using fluorescence in situhybridization (FISH) on tissue microarrays (TMAs). Fourteen cases, diagnosed as ALT/WDLPS and DDLPS, along with 49 other tumors were tested for MDM2 immunostaining. Twenty tumors were tested for p16INK4a immunostaining.

Results:
FISH was interpretable in 25 (89.2%) cases. Among the 20 cases diagnosed as DDLPSs, 19 displayed MDM2gene amplification. Among the 5 cases diagnosed as ALT/WDLPS, four showed MDM2gene amplification. Finally, 19 cases were confirmed as DDLPS and 4 as ALT/WDLPS. Furthermore, 7/19 cases confirmed as DDLPS and all 4 cases as ALT/WDLPS tested for MDM2 immunostaining, displayed its diffuse immunoexpression, while a single case of DDLPS showed its focal immunostaining. None of the 49 control cases displayed diffuse MDM2 immunoexpression. ALL 16 DDLPSs and 4 cases of ALT/WDLPS displayed p16INK4a immunostaining. The sensitivity for diffuse MDM2 immunostaining was 87.5% in cases of DDLPS, 100% in ALT/WDLPS, and specificity was 100%. The sensitivity for MDM2 gene amplification was 94.7% in cases of DDLPS and 100% in cases of ALT/WDLPS. The sensitivity for p16INK4a was 100%.

Conclusion:
This constitutes the first sizable study on MDM2 testing in ALT/WDLPS and DDLPS from our subcontinent using TMAs. MDM2 gene amplification testing continues as the diagnostic gold standard for ALTs/WDLPSs and DDLPSs and is useful in cases of diagnostic dilemmas. Diffuse MDM2 (IF2 clone) and p16INK4a immunostaining, together seem useful for triaging cases for FISH.
Histopathological spectrum of ocular surface squamous neoplasia
Authors: Mishra Dilip Kumar , Taneja Shikha , Singh Vivek , Veena Uppala , Kaliki Swathi 
Published: August 2024

Background:
Ocular surface squamous neoplasia (OSSN) comprises neoplasm arising from the ocular surface, which includes conjunctiva, cornea, and limbus and ranges from mild dysplasia to invasive squamous cell carcinoma.

Purpose:
The aim of this work was to study the spectrum of OSSN based on histopathological analysis. Materials and

Methods:
This was a retrospective cross-sectional study comprising 776 histopathologically diagnosed cases of OSSN from January 2004 to December 2014.

Results:
The mean age of presentation of OSSN was 45 years (median, 45 years; 2 to 87 years) with male preponderance (74%). The most common age group of presentation was 41–60 years (n = 299; 39%). The most common type of OSSN was invasive squamous cell carcinoma seen in 50% (n = 383) eyes followed by severe dysplasia/carcinoma in situin 31% (n = 250) eyes. Tumor infiltration at base was seen in 16% (n = 124), positive margins in 32% (n = 248), scleral infiltration in 14% (n = 109), intraocular extension in 3% (n = 23), and orbital extension in 4% (n = 26) eyes. OSSN was associated with actinic keratosis in 21% (n = 165) cases.

Conclusion:
Based on histopathology, invasive squamous cell carcinoma is the most common form of OSSN in the Asian Indian population.
Evaluation of microsatellite instability in routine examinations of surgical samples
Authors: Wlaszczuk Pawel , Kuzbinska Aleksandra , Dobrosz Zuzanna , Palen Piotr , Pawlicki Krzysztof 
Published: August 2024

Context:
Approximately 20%–30% of colon cancer cases have a hereditary basis. The genetic defect may involve mismatch repair (MMR) genes, which results in microsatellite instability (MSI). MMR-deficient colorectal cancer may occur due to germline mutation (Lynch syndrome) or be a sporadic one. A tumor's histological features, supported by a panel of immunohistochemistry stains, enables pathologists to assess the MMR status, which in turn has beneficial effects on clinical management.

Aims:
We aimed to show the relations between histopathological features identified during routine examinations and MMR genes' mutations.

Methods and Material:
We reviewed retrospectively the material of the Department of Pathology fulfilling the revised Bethesda Guidelines.

Statistical Analysis Used:
We used Chi-square test, Spearman test, and epidemiological analysis.

Results:
For the PMS2 gene, the positive predictive value (PPV) indicates that 91% of cases neither present any histological lesions nor have genetic abnormalities. The negative predictive value (NPV) indicates that only 50% of cases have both histological and genetic changes. For the MSH6 gene, the PPV indicates that 85% of tumors without specific histological features do not have genetic abnormalities.

Conclusions:
We advise universal staining for MLH1, MSH2, MSH6, and PMS2 in every newly diagnosed colon cancer, but due to costly analyses we suggest a protocol for the selection of cases for MMR examinations.
PD-L1 expression in muscle invasive urothelial carcinoma
Authors: Gupta Gurudutt , Pasricha Sunil , Kamboj Meenakshi , Sharma Anila , Nayana NS , Durga Garima , Sharma Anurag , Rawal Sudhir , Meh Anurag 
Published: August 2024

Introduction:
High-grade urothelial carcinoma has a different molecular pathway than superficial low grade urothelial carcinoma, and is characterized by genomic instability. The high tumor mutation burden leads to neoantigen formation, evoking an immune response. The immune response has been keenly studied in last two decades and programmed death ligand-1 (PDL-1) has emerged as acceptable immunohistochemical marker for assessment of response to therapy, prognostication and patient selection for immunotherapy. The targeting of PD-1 and PDL-1 by checkpoint inhibitors (CPIs) is an attractive strategy to unblock the inhibitor and induce cytotoxic cell death. However, the presence of complementary and companion diagnostic testing with multiple PDL-1 assays and platforms for various CPIs make a diagnostic quagmire. Thus, it is the need of hour to harmonize these assays. In this undertaken study we evaluated the concordance in PD-L1 expression between the two PD-L1 clones: SP263 and SP142, in treatment naïve muscle invasive bladder cancer (MIBC).

Methods:
We evaluated Ventana PD-L1 “SP263 and SP142” qualitative immunohistochemical assay using rabbit monoclonal anti-PD-L1 clones in evaluation of PDL-1 immunoexpression on Ventana autostainer platform. The study includes 30 muscle invasive urothelial carcinomas, with 10 of 30 having nodal metastasis.

Results:
SP263 assay was statistically more sensitive than SP142 for tumor cell (TC) scoring (P = 0.0009), whereas SP142 was more sensitive for immune cell (IC) scoring (P = 0.0067). There was no statistical significant discordance for TC or IC scoring between primary tumor and metastatic lymph node.

Conclusion:
PD-L1 testing status can be done on both primary tumor and metastatic site, however in metachronous metastatic setting, testing on recent metastatic site should be preferred. The harmonization of immunoexpression between 2 PD-L1 clones could not be achieved.
Feasibility of Indirect immunofluorescence (IIF) alone as a screening method for antinuclear antibody in connective diseases in India's sub-Himalayan region
Authors: Kalita Deepjyoti , Rekha U Sashi , Raj Anusha K. , Mahanta Putul , Gupta Pratima , Deka Sangeeta 
Published: August 2024

Background:
For the management of connective tissue disorders (CTDs), antinuclear antibody (ANA) testing is essential, both from diagnostic and prognostic points of view. Usually, patterns obtained by ANA-IIF testing correlates to specific autoantibodies as obtained from the test for ENA (by LIA/ELISA, etc.). But to apply these data from western studies, we may need validation in the local population like our subjects in sub-Himalayan (Garhwal region) area where CTDs are common. Also, suppose ANA-IFA pattern's correlation is reliably known in our population, it can minimize the cost of managing CTDs by limiting ENA testing, which is 10 times costlier than ANA-IIF. Hence, this study was undertaken to know the specific autoantibody targets (ENA by LIA) against ANA-IIF patterns in our local population.

Materials and Methods:
In this retrospective cross-sectional work, serum samples of CTDs were tested for ANA by IIF (Euroimmune AG) and ENA by LIA (Euroline ANA-3G) continuously for 36 months. The manufacturer's kit insert was followed, and results were analyzed applying appropriate statistical methods.

Results:
Major ANA-IIF patterns were found to be associated with specific autoantibodies, for example, Nuclear homogenous with dsDNA, nucleosomes, histones; speckled pattern with nRNP/Sm, Sm, SSA/Ro-52, SSB; nucleolar pattern with Scl-70, Pm-Scl 100 and centromere pattern with CENP-B. Anticytoplasmic (ACA) are found to be linked with some ANA negative (by IIF) samples, emphasizing the need for careful observation for ACA especially where ANA is not found.

Conclusions:
In most subjects, specific ENA targets correlated well with ANA-IIF patterns, implying effective cost minimization in CTD management. Similar future prospective studies (with clinical data) can provide a database and reference for our population.
Diagnostic and prognostic utility of SF-1 in adrenal cortical tumours
Authors: Maity Priyanka , Mondal Akash , Das Rhituparna , Sengupta Moumita , Gargari Piyas , Kar Anish , Sarkar Debansu , Mukhopadhyay Satinath , Chowdhury Subhankar , Chatterjee Uttara 
Published: August 2024

Background and Aims:
Superior imaging techniques have increased the recognition of adrenal pathology. Distinguishing benign from malignant adrenocortical tumors is not always easy. Several criteria and immunohistochemical markers have been discovered which help to differentiate between adrenocortical adenoma (ACA) and adrenocortical carcinoma (ACC). Our aim here was to evaluate the diagnostic and prognostic role of steroidogenic factor-1 (SF-1) in adult adrenocortical tumors (ACT) diagnosed using the Weiss criteria. In this cohort, we have also analyzed Ki67 and p53 expression and the extent of agreement between SF-1 and Ki-67.

Methodology:
This was a retrospective, observational study comprising 24 cases of adult ACT over 10 years. Immunohistochemical staining for SF-1, Ki67, and p53 was done in all the cases, and the results correlated with the morphological diagnosis made using Weiss criteria.

Results:
SF-1 was 100% sensitive and 80% specific as a marker of malignancy. Increased SF-1 expression correlated with worse survival. There was a moderate degree of agreement between Ki-67 labeling-index and SF-1 as a marker of malignancy with the kappa coefficient being 0.75. The sensitivity of p53 was lower than Ki67 in diagnosing ACC.

Conclusion:
In adult ACTs, SF-1 has diagnostic significance and prognostic implication. SF-1 is a crucial, dosage-dependent survival factor in ACC. There is a moderate extent of agreement between Ki-67 and SF-1 as a marker of malignancy.
Basal cell carcinoma-clinico-pathological study in Eastern India in correlation with different risk factors
Authors: Jain Chetan , Garg Neha , Singh Sulekha , Chattopadhyay Sarbani 
Published: August 2024

Objectives:
To study the histological variants and mimickers of basal cell carcinoma (BCC) alongwith different risk factors among a group of patients from eastern India.

Methods:
The specimen for the study was sent by the dermatology department for histopathology after skin biopsy.

Results:
Out of 42 patients, 15 patients studied were males and the rest of the cases were females. The male to female ratio was 0.55:1. Maximum (15 cases) cases were in the age group of 50–59 years. Apart from sunlight, chronic arsenic exposure is an important risk factor of BCC. Basal cell hyperplasia and squamous cell carcinoma are the histological differential diagnosis of nodular BCC and basosquamous BCC.

Conclusion:
BCC is a disease of the older age group and with female preponderance in our study. Nodular basal cell carcinoma was the most common histologic type of basal cell carcinoma. The face was the most common site for BCC followed by the scalp. UV radiations and Arsenic do play role in the pathogenesis of BCC. CD10 helps differentiate superficial BCC from basal cell hyperplasia.
Immunohistochemical evaluation of E-cadherin in oral epithelial dysplasia and squamous cell carcinoma
Authors: Sharma Jaishree , Bhargava Manish , Aggarwal Shivani , Aggarwal Ashim , Varshney Anchal , Chopra Disha 
Published: August 2024

Aim:
To evaluate the expression of E-cadherin (E-cad) in oral epithelial dysplasia (OED) and oral squamous cell carcinoma (OSCC).

Material and Method:
Immunohistochemistry was used to detect E-cad expression in 20 cases each of normal oral mucosa, oral epithelial dysplasia and squamous cell carcinoma.

Statistical Analysis Used:
Inferential statistical methods for statistical analysis used were Chi-square test for comparison of the frequency between different severity of dysplasia and OSCC.

Results:
Upon assessing the expression of E-cad in OED and OSCC, increase in E-cad immunoreactivity was seen in early lesions. However, the expression of E-cad decreased significantly as the grade of dysplasia increased.

Conclusion:
We observed a significant decrease in E-cad expression from dysplasia to poorly differentiated squamous cell carcinoma suggesting that loss of expression of E-cad is closely related to carcinoma.
Epstein-Barr virus (EBV) DNAemia in saliva of viral encephalitis and nasopharyngeal carcinoma patients
Authors: Srinivasan Nanditha , Barani Ramya , Manickavasagan M , Srikanth Padma 
Published: August 2024

ABSTRACT
Epstein-Barr virus (EBV) is a lymphotropic virus that causes diseases ranging from a flu-like illness called infectious mononucleosis to nasopharyngeal carcinoma, Burkitt’s lymphoma, and central nervous system (CNS) infection. Detection of EBV DNA is usually done using whole blood samples taken from the patients. We undertook the detection of EBV in blood, cerebrospinal fluid (CSF), and saliva by real-time quantitative PCR in two patients, one with a history of nasopharyngeal carcinoma, and the other having a case of viral encephalitis. EBV was detected only in saliva, whole blood in both patients, and CSF in the second case tested negative. This case series illustrates the importance of testing for EBV DNAemia in saliva by real-time polymerase chain reaction (PCR) to rule in a diagnosis of EBV.
Survey of semen analysis practices in India and need for standardization and improvement
Authors: Kale Sachin , Bathe Sandeep , Agrawal Ranjan , More Purva , Bharadwaj Era 
Published: August 2024

Background and Objectives:
Infertility is a sensitive subject carrying with it economic, social, and psychological implications. Work up of male infertility is often hampered by a lack of infrastructure and facilities, as well as inadequate training of pathology residents. The purpose of this research survey was to evaluate the current status of semen analysis practices and compare them to the standards laid down by the World Health Organization (WHO).

Materials and Methods:
A web-based questionnaire was designed consisting of questions related to semen analysis practices and procedures being followed currently by pathologists in India. A total of 194 pathologists responded. Questions regarding the procedures followed for semen collection, sperm count, volume, normal range, lower normal limit of sperm count, morphology, etc., were included in the survey. These data were recorded. The differences and gaps in the practice with respect to the WHO standards were analyzed.

Results:
The survey revealed that the printed instructions for semen analysis were available with 38.7% of the respondents; 58.8% of the respondents had a separate room for semen collection; 95.9% performed the analysis manually, and; only 4.1% used automated analyzers. Only 53.6 and 52.6% of the respondents were correctly reporting the normal range of semen volume and sperm counts, respectively. Only 19.6% stated as having read the WHO manual and were also practicing its guidelines, while 14.4% had not read the WHO manual even once.

Conclusion:
The present study showed a large gap between the practice of semen analysis by respondents from various parts of India and standard procedures as laid down by the WHO. Many laboratories do not follow the standard instructions. There is a need to improve the quality of practice related to semen analysis in this country through appropriate teaching and training in medical institutions as well as through Continuing Medical Education (CMEs) or regular update programs.
Primary bone solitary B-cell lymphoblastic lymphoma aberrant expression Fli-1 and ERG: A case report
Authors: Chen Huan , Li JiaSi , Huang Yong 
Published: August 2024

ABSTRACT
Primary non-Hodgkin bone lymphoma is a rare disease, and within this category, B-cell lymphoblastic lymphoma (B-LBL) is an even rare clinical entity that has only been reported in small case series or individual case reports. B-LBL can mimic Ewing’s sarcoma both clinically and histologically, leading to misdiagnosis. We present a case of primary B-LBL of the bone in a 7-year-old girl. The tumor cells are uniform and small with a diffuse and infiltrative growth pattern similar to EWS. Immunohistochemical results are positive for CD99, Fli-1, ERG, TDT, PAX5, and CD79α, but negative for leukocyte common antigen, CD3, CD20, and NKX2.2. No other lesions are found on positron emission tomography/computed tomography imaging. Finally, primary solitary bone B-LBL of the right tibia was diagnosed.
Prevalence and clinicopathological features of driver gene mutations profile in BCR:ABL1 negative classical myeloproliferative neoplasm—A single-center study from North India
Authors: Rahman Khaliqur , Biswas Seema , Sharma Akhilesh , Gupta Kusum , Chandra Dinesh , Singh Manish K. , Gupta Ruchi , Mishra Ashish , Kumar Sanjeev , Gupta Anshul , Hasan Faheema , Nityanand Soniya , Kahsyap Rajesh 
Published: August 2024

ABSTRACT

Background:
Recurrent somatic mutations in the JAK2, CALR, and the MPL genes are noted in BCR:ABL1 negative classic myeloproliferative neoplasms (MPN) that includes polycythemia vera (PV), essential thrombocytosis (ET), and primary myelofibrosis (PMF).

Materials and Methods:
Mutation profile and clinical features of MPN cases diagnosed at a tertiary care center in North India are being described. JAK2V617F mutation was screened using ARMS PCR, and CALR mutation was screened using allele-specific PCR followed by fragment analysis. MPL and JAK2 Exon 12 mutations were screened by Sanger sequencing. Some of the samples were also screened using commercial kits based on single-plex RT PCR.

Results:
A total of 378 cases (including 124 PV, 121 ET, and 133 PMF cases) were screened over 6.5 years. JAK2V617F mutation was noted in 90.3%, 61.1%, and 69.2% of cases of PV, ET, and PMF, respectively. In PV, JAK2V617F wild-type cases were associated with a significantly lower age (44 yrs vs 54 yrs; P = 0.001), lower TLC (6.3 vs 16.9; P = 0.001), and a lower platelet count (188 × 109/L vs 435 × 109/L; P = 0.009) as compared to the JAK2V617F mutated cases. CALR and MPL mutations were noted in 17.4% and 12% and 0.8% and 5.3% of ET and PMF cases, respectively. Type 1 CALR mutations were commoner in both ET and PMF. The triple negative cases constituted 20.7% and 13.5% cases of ET and PMF, respectively. In ET, the triple negative cases were found to have a significantly lower median age of presentation (42 yrs vs 52 yrs; P = 0.001), lower median TLC (10.2 × 109/L vs 13.2 × 109/L; P = 0.024), and a higher median platelet count (1238 × 109/L vs 906 × 109/L; P = 0.001) as compared to driver genes mutated cases. In PMF, the triple negative cases were found to have a significantly lower hemoglobin level (7.9 g/dl vs 11.0 gl/dl; P = 0.001) and a significant female preponderance (P = 0.05) as compared to the mutated cases. CALR mutations were found to have a significantly lower median age (43 yrs vs 56 yrs; P = 0.001) and lower hemoglobin (9.6 g/dl vs 11.3 g/dl) as compared to the JAK2 mutations.

Conclusion:
Our data on the driver gene mutational profile of BCR:ABL1 negative MPN is one of the largest patient cohorts. The prevalence and clinicopathological features corroborate with that of other Asian studies.