bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and Etiological Profile of Hypercalcemia in Hospitalized Adult Patients and Association with Mortality
Authors: Sulaiman Shabna , Mukherjee Soham , Sharma Sadhana , Pal Rimesh , Bhadada Sanjay Kumar 
Published: August 2024

Background:
The etiology of hypercalcemia varies according to the clinical setting. Hitherto, data on the prevalence and profile of hypercalcemia in hospitalized Asian–Indian patients are limited. Hence, we conducted a prospective observational study to determine the prevalence and etiological profile of hypercalcemia in hospitalized Asian–Indian patients and its association with 6-month mortality.

Materials and Methods:
We conducted a prospective observational study wherein all the patients (aged >12 years) admitted to the general medicine wards of a tertiary care hospital in North India between January 1, 2016, and June 30, 2017, were screened. Finally, patients with sustained hypercalcemia (defined as corrected serum total calcium ≥10.4 mg/dl documented twice at least 24 h apart) were included in this study. These patients were followed up throughout the hospital course and thereafter till 6 months from the date of discharge.

Results:
Out of 9902 patients, 150 patients had sustained hypercalcemia (prevalence 1.5%). The most common cause of hypercalcemia was malignancy (41.3%), followed by primary hyperparathyroidism (PHPT, 32.7%). Vitamin D intoxication was responsible for hypercalcemia in 8.7% of patients; 2.7% of patients had hypercalcemia of advanced chronic liver disease. Nevertheless, a definite etiology could not be identified in 7.3% of the patients with hypercalcemia. At the end of 6 months of follow-up, the cumulative mortality rate was 28%. Underlying malignancy and higher calcium levels were the significant determinants of mortality.

Conclusions:
The prevalence of hypercalcemia in Asian–Indian patients admitted to a tertiary care hospital was 1.5%. The most common etiology was malignancy, followed by PHPT.
Normative Data for Modified Ferriman-Gallwey Score and the Prevalence of Hirsutism in Young South Indians
Authors: Josyula Nitya N. , Guttula Sahithi , Lakkudi Shilpa , Reddy Sagar , Shanthaiah Dhananjaya M. , Sarathi Vijaya 
Published: August 2024

Abstract

Introduction:
The modified Ferriman-Gallwey score (mFGS) cut-offs to define hirsutism vary with ethnicity, whereas no such cut-offs are established for Indian women. Well-conducted studies that report the prevalence of hirsutism in Indian women are limited. Hence, this study was conducted to report the prevalence of hirsutism and population-specific cut-offs for mFGS in South-Indian women.

Methods:
In this cross-sectional, community-based study, adult women in reproductive age (18–40 years) were screened for hirsutism by two trained medical students. Hirsutism was assessed using the mFGS and case record file.

Results:
A total of 453 women were included in the study [age: 22.15 ± 5.27 years; body mass index (BMI): 22.5 ± 3.58 kg/m2]. The median (IQR) mFGS was 1(0-3); only eight participants (1.8%) had mFGS ≥8, and all these eight women had at least another PCOS-related feature (irregular menstrual cycles and/or topical therapy-resistant acne). The median (IQR) mFGS in the PCOS phenotype group (n = 52), non-PCOS-phenotype group (n = 401), non-obese group (<25 kg/m2), non-PCOS-phenotype group (n = 322), obese group (≥ 25 kg/m2), non-PCOS-phenotype group (n = 79), overweight group (BMI: 23–25 kg/m2), non-PCOS-phenotype group (n = 74), normal BMI group (<23 kg/m2), and non-PCOS-phenotype group (n = 248) were 4 (1–6), 1 (0–2), 1 (0–2), 2 (1–3), 1 (0–2), and 1 (0–2), respectively. The 97.5th centile mFGS in all groups except the PCOS phenotype group and the obese and non-PCOS phenotype groups was 5.

Conclusion:
We propose a new mFGS cut-off of 5 in the South-Indian population for evaluation of hirsutism, and the prevalence rates of hirsutism in the South-Indian population were 1.8% and 9.9% using mFGS of ≥8 and ≥5 to define hirsutism, respectively.
Corneal stromal changes following simple limbal epithelial transplantation on Scheimpflug densitometry: Early results
Authors: Jain Mayur , Gupta Nidhi , Lohchab Monica , Gour Abha , Sangwan Virender S , Singh Bhupesh 
Published: August 2024

Context:
Chemical injury to eyes causes limbal stem cell deficiency (LSCD), which leads to conjunctival epithelium and underlying stromal changes. Simple limbal epithelial transplant helps to restore corneal epithelium and corneal stromal clarity. These changes are documented in this prospective eye study.

Purpose:
To report the changes in epithelial/stromal (E/S) reflectivity ratio and corneal stromal densitometry following simple limbal epithelial transplantation (SLET) in patients with unilateral chemical burn-induced LSCD.

Methods and Material:
It is a prospective imaging study of cornea before and after SLET. Corneal densitometry with Pentacam and epithelial and stromal reflectivity on anterior segment optical coherence tomography were analyzed for five patients (n = 5 eyes), who underwent autologous SLET for unilateral chemical burn-induced LSCD.

Statistical Analysis Used:
Mann–Whitney U-test and Pearson correlation.

Results:
A significant improvement in E/S reflectivity was noted at 1 month (P < 0.05) after SLET, and this was maintained until the end of 6 months. The densitometry measurements decreased in the entire cornea at every level, that is, anterior, central, and posterior cornea. However, the values did not normalize till the last follow-up at 6 months.

Conclusions:
A trend of normal corneal epithelization exists in eyes undergoing SLET. Densitometry at all the levels, the anterior, central, and posterior cornea, also decreases after SLET. SLET improves visual outcomes in LSCD eyes not only by epithelization but also by reducing stromal scarring.
Decoding glaucoma module premium edition
Authors: Ramesh Prasanna Venkatesh , Parthasarathi Sathyan , Ramesh Shruthy Vaishali , Devadas Aji Kunnath , Ray Prajnya , Rajasekaran Ramesh 
Published: August 2024

Background:
Traditional methods for neuroretinal rim width measurement in spectral domain optical coherence tomography (SD-OCT) employs the Bruch‘s membrane opening (BMO) as the anatomical border of the rim, referenced to a BMO horizontal reference plane, termed as “Bruch’s Membrane Opening-Horizontal Rim Width” (BMO-HRW). BMO-HRW is defined as the distance between BMO and internal limiting membrane (ILM) on the horizontal plane. In contrast, the Spectralis OCT (Heidelberg Engineering, Germany) employs a new parameter called “Bruch’s Membrane Opening–Minimum Rim Width” (BMO-MRW) with Glaucoma Module Premium Edition (GMPE). GMPE provides a novel objective method of optic nerve head (ONH) analysis using BMO, but the neuroretinal rim assessment is performed from the BMO to the nearest point on the ILM, rather than on the horizontal reference plane. It is the BMO-MRW and is defined as the minimum distance between the BMO and ILM in the ONH.

Purpose:
In this video, anatomy of the ONH and GMPE is decoded from a neophyte user’s point of view, as to why BMO-MRW is more important than the traditional BMO-HRW for glaucoma evaluation.

Synopsis:
The GMPE concepts are depicted in a novel dynamic (Clinical vs OCT Vs Histology) screenplay, detailing the below focal points with 2D & 3D animations: True Margin of ONH, Bruch’s Membrane (BM), Histology Vs OCT, BMO, Bruch’s Membrane Opening-Minimum Rim Width, Bruch’s Membrane Opening-Minimum Rim Width Versus Bruch’s Membrane Opening-Horizontal Rim Width, Alpha, Beta, Gamma Zone of ONH in OCT, Anatomic Positioning System, Impact of Fovea Bruch’s Membrane Opening Centre Axis.

Highlights:
This video also highlights, how with the advent of Anatomic Positioning System, scans were able to align relative to the individual’s Fovea-to-BMO-center (FoBMOC) axis at every follow-up, for accurately detecting changes, as small as 1 micron in BMO-MRW, thus creating a new world in diagnosing glaucoma and detecting glaucomatous progression with precision.

Video link:

https://youtu.be/6RqF5guAziw
Estimation of pupil size at iris plane and its magnification after cataract surgery
Authors: Camellin Umberto , Camellin Massimo , Prantera Marcello , Di Pietro Roberta , Ponzetto Francesca , Aragona Pasquale 
Published: August 2024

Abstract

Purpose:
To estimate the pupil size (at the iris plane) under photopic (PPH) and scotopic (PS) conditions after phacoemulsification with intraocular lens (IOL) implantation.

Methods:
This retrospective observational cohort study included 190 virgin eyes from 190 patients who underwent cataract surgery with IOL implantation. Data collected with Aladdin (Topcon), AS-OCT MS-39 (CSO), and iTrace (Tracey) were SimK, mean pupillary power at 6 mm (MPP), anterior chamber depth (ACD), lens thickness (LT), axial length (AL), lens rise (LR), PPH and PS before and after surgery at 30 days, dysfunctional lens index, and opacity grade. The position of the postoperative iris plane (PIP) was measured manually with MS-39, and a multivariate regression formula was developed to predict it. Statistical analysis was performed using Statistical Package for Social Science (SPSS) (IBM).

Results:
The mean and standard deviations were 42.61 ± 3.20 D for MMP at 6 mm, 3.35 ± 0.37 mm for ACD, 3.89 ± 0.18 mm for PIP (P < 0.01), 4.55 ± 0.42 mm for LT, 0.43 ± 0.24 mm for LR, and 25.91 ± 3.03 mm for AL. The mean preoperative and postoperative topographic pupil magnification was 12% and 14.22%, respectively (P < 0.01). Despite an increase in magnification, the postoperative pupil was smaller than the preoperative one both for scotopic and photopic conditions: The larger the preoperative pupil, the more it tends to reduce in the postoperative period.

Conclusions:
Analysis of the preoperative topographic pupil alone is not sufficient for a correct indication of the optical zone and total diameter of IOL to be implanted but must be correlated with biometric data. The topographic pupil, therefore, undergoes a change in magnification from the preoperative period to the postoperative period. Furthermore, the real pupil presents a modification and, in most cases, tends to be smaller postoperatively in both photopic and scotopic conditions.
Isolated IgG4-related disease of terminal ileum: Report of a rare case and review of literature
Authors: Bhowmik Subham , Bhattacharjee Hemanga K. , Abraham Joyner , Sharma Raju , Das Prasenjit 
Published: August 2024

ABSTRACT

Background:
Among the class of immune-mediated diseases, immunoglobulin G4-related diseases (IgG4-RDs) are of particular interest due to their occurrence in a vast number of organ systems with varied presentations. Isolated bowel involvement in IgG4-RD is, however, very rare.

Case Report:
A 54-year-old woman presented with acute-onset colicky abdominal pain located in the right lower quadrant for the past 6 months with abdominal distention. Abdominal contrast-enhanced computed tomography (CECT) depicted short-segment symmetrical and circumferential thickening of distal ileal loops and the ileocecal junction with accompanying mesenteric lymphadenopathy, raising the possibilities of ileocecal tuberculosis or Crohn’s disease, or malignancy. A right hemicolectomy was performed, and the histological examination revealed it to be an isolated ileal IgG4-RD. After a one-year follow-up, no radiological or clinical recurrence or related symptom was noted.

Conclusion:
This is the second reported case of isolated ileal IgG4-RD to the best of our knowledge, and IgG4-RD should be kept in mind even when the patient presents with segmental bowel thickening along with common possibilities such as tuberculosis or Crohn’s disease in this anatomical region.
Expression of stem cell biomarker CD44 in oral squamous cell carcinoma and its association with lymph node metastasis and TNM staging
Authors: Chakraborty Satadruti , Suresh T. N. , Azeem Mohiyuddin S. M. 
Published: August 2024

ABSTRACT

Background:
Oral squamous cell carcinoma (OSCC) is one of the most prevalent cancers in the world. OSCC is a highly invasive lesion frequently having soaring morbidity as well as substantial mortality, attributed to resistance to therapy, metastasis, and recurrence driven by specific populations of cancer stem cells (CSC). The evidence of the association of expression of stem cell biomarker CD44 and metastatic potential of the tumor is inconclusive in OSCC and hence needs further evaluation.

Objectives:
To determine the immunohistochemical expression of CD44 in OSCC and to find its association with lymph node metastasis and TNM staging.

Materials and Methods:
One hundred and five histologically proven cases of OSCC were studied. Histopathological parameters like depth of invasion, presence of lymph node metastasis, grading, and TNM staging were done according to the new AJCC staging criteria. Both intensity and proportion of CD44 expression were recorded.

Results:
The mean age observed in this study was 52.59 years with a male: female ratio of 1:3.76. Forty-nine cases (46.6%) showed a depth of invasion of more than 10 mm. Fifty-two out of one hundred and five cases (49%) had nodal involvement. TNM staging was 5.7%, 7.6%, 44.7%, and 42% for stages I, II, III, and IV, respectively. The majority of the cases (87.5%) showed CD44 expression in the tumor. There was a significant association between the CD44 expression and lymph node metastases (P < 0.001). Higher CD44 expression was seen in stages III and IV (P < 0.001).

Conclusion:
CD44, a stem cell biomarker is significantly associated with higher TNM stage and lymph node metastases. This may be useful in predicting the tumor behavior in the small biopsy.
Ampullary mixed neuroendocrine non-neuroendocrine neoplasm (MiNEN) is an exceptionally rare case presenting as abdominal pain
Authors: Meedimale Santhosh , Panda Soumya S. , Mohanty Subhashis , Mohanty Swati S. , Biswas Ghanashyam 
Published: August 2024

ABSTRACT
Mixed neuroendocrine non-neuroendocrine neoplasm (MiNEN) is a rare tumor of the gastrointestinal tract with both neuroendocrine and non-neuroendocrine components accounting for 30% of the tumor volume each. We describe the case of a 51-year-old gentleman who presented with a complaint of abdominal pain. On upper gastrointestinal endoscopy (UGIE), a superficial ulcer over the ampulla with antral gastritis was noted and the biopsy was suggestive of neuroendocrine tumor grade 1. A pylorus-preserving pancreatoduodenectomy was performed, and the histopathology examination of the resected sample has an adenomatous component of 33% and the rest (67%) is a neuroendocrine component. This was confirmed by neuroendocrine markers (synaptophysin, chromogranin, and CD56) with Ki-67 of 4–5%. Hence, the diagnosis of ampullary MiNEN intermediate grade was established. Ampullary location of this tumor is extremely rare and is usually aggressive in nature with frequent distant metastasis. The treatment option for such low-prevalence cancers is not yet standardized, suggesting future clinical research for the same.
Clinical Features of Candida Catheter-related Bloodstream Infections and Persistent Infections Associated with Early Catheter Reinsertion: A 6-year Retrospective Study
Authors: Kobayashi Takehito , Nakamura Itaru , Machida Masaki , Watanabe Hidehiro 
Published: August 2024

Introduction:
Catheter-related persistent Candida infections (CRPCI) may develop after Candida catheter-related bloodstream infections (CRBSI) due to colonization of the newly inserted catheter. However, the optimal timing for new catheter insertion remains controversial. The aim of this study was to determine the clinical features of CRBSI due to Candida species and CRPCI. This was a retrospective study conducted in a teaching hospital in Japan.

Methods:
We retrospectively collected clinical information on hospitalized patients diagnosed with Candida CRBSIs by catheter tip culture from 2015 to 2020. CRPCI was defined as the growth of the same Candida species from the tip culture of a newly inserted catheter after the onset of a Candida CRBSI. The Chi-squared and Fisher’s exact tests were used to compare differences between the case and control groups.

Results:
Sixty-three cases of Candida CRBSI were collected. Fifty-four (85.7%) received total parenteral nutrition. CRPCI developed in 12 (48%) patients of the 25 in whom cultures of newly inserted catheters were performed. Despite antifungal therapy in these patients, persistent fungemia incidence was significantly higher (50.0% vs. 9.1%, odds ratio = 10.0, P = 0.033). The mean number of days from removal of infected catheter to reinsertion was significantly shorter for patients with CRPCI (0.27 days vs. 3.08 days, P = 0.038).

Conclusions:
Total parenteral nutrition may be a major risk factor in the development of Candida CRBSI. CRPCI often leads to persistent fungemia. Early insertion of a new catheter after removal of an infected catheter may be a risk factor for CRPCI.
Impact of Interproximal Features on Marginal Bone Level Changes of Autograft, Allograft, and Xenograft after Functional Loading: A Retrospective Study
Authors: Win Kaung Zaw , Pimkhaokham Atiphan , Kaboosaya Boosana 
Published: August 2024

Abstract

Aim:
This study aims to investigate the marginal bone level changes (MBLCs) concerning interproximal features of posterior implant-supported single crowns using different bone grafts.

Materials and Methods:
This retrospective study included 27 patients requiring 46 dental implants using autograft, allograft, or xenograft between January 2007 and December 2016. MBLCs were assessed using digital periapical radiographs at 3 months (T1), 12–15 months (T2), and 21–24 months (T3) after prosthesis delivery. The influence of interproximal features, such as embrasure surface area, emergence angle, and horizontal distance to adjacent teeth/implants, was assessed. Secondarily, age, gender, diabetes and smoking, arch distribution, implant locations, implant characteristics, average gonial angle, antagonist type, clinical crown-to-fixture ratio, retention method, and nearby tooth/implant were considered. Wilcoxon signed-rank test, Mann–Whitney U tests, and Kruskal–Wallis tests were employed with statistical significance set at a P value of <0.05.

Results:
The results revealed that mean MBLCs at T3–T1 were similar (autograft 0.5 ± 0.47 mm, allograft 0.51 ± 0.35 mm, and xenograft 0.57 ± 0.42 mm). There were significant increases in MBLCs associated with EA ≤ 30° in autograft (P = 0.04), and HD ≤ 3 mm in allograft (P = 0.03). Mesial/distal MBLCs showed no significant differences, except in cases with HD ≤ 3 mm in the distal area of autograft (P = 0.03). Regarding secondary factors, significant differences in MBLCs emerged between autograft and xenograft in the molar area (P = 0.03), and between premolar and molar areas within the xenograft group (P = 0.01).

Conclusion:
This study concludes that interproximal features, EA ≤ 30° and HD ≤ 3 mm, markedly influenced MBLCs for specific types of bone grafts. Furthermore, MBLCs exhibited a direct relationship with the posterior placement of dental implants.
Laser-assisted Root Canal Filling Removal of Lower Incisors – A Micro-CT Study
Authors: Dogandzhiyska Violeta , Tsenova-Ilieva Irina , Raykovska Miriana , Karova Emilia 
Published: August 2024

Abstract

Aim:
To compare the efficiency of root canal filling removal from oval-shaped root canals with high-energy Er:YAG laser and additional instrumentation with a rotary Ni-Ti XP-Endo Finisher R system.

Materials and Methods:
The in vitro study was accomplished on 12 freshly extracted single-rooted mandibular incisors with one straight oval-shaped root canal, shaped with XP-Endo Shaper 30/.04 and obturated by using the warm vertical condensation technique subjected to further endodontic orthograde retreatment. Group 1: the first retreatment was carried out using a high-energy Er:YAG laser (n = 12). Group 2: the additional retreatment of the same specimens was performed with the XP-Endo Finisher-R system (n = 12). The effectiveness of the retreatment techniques was evaluated by a threefold micro-CT examination. The amount of the remaining root canal filling material was analyzed by Mann–Whitney U test and Friedman tests.

Results:
A significant decrease in the quantity of the root canal filling was found following the first and after the second retreatment, compared to the initial values in all examined sections (P < 0.001). Within groups, additional application of the Ni-Ti system resulted in no significant removal of the filling materials (P > 0.05).

Conclusions:
None of the systems resulted in complete root canal filling removal. Despite the improved results after the application of the supplementary retreatment protocol, none of the root canal walls were completely clean in the apical area. The high-energy Er:YAG laser and XP-Endo Finisher R rotary system can be successfully used in endodontic orthograde retreatment under relevant operating parameters.
Health-care Professionals’ Perspectives on Ultrasound Evaluation of Arteriovenous Hemodialysis Fistula: A Narrative Review
Authors: Fu Chung-Ming , Leong Foong-Fah , Chung Sheng-Ying , Lee Wen-Chin 
Published: August 2024

Abstract
Arteriovenous hemodialysis fistulas play a critical role in maintaining life on hemodialysis. With the growing use of Doppler ultrasound in nephrology, its utility has expanded to improve the prognosis and quality of life of patients receiving hemodialysis. On a fistula care team, different health-care professionals, including nephrologists, dialysis technicians, and surgeons or vascular interventionalists, require different information. This review article comprehensively explains how Doppler ultrasound evaluation can be beneficial in the management of arteriovenous fistulas from different perspectives of health-care professionals. The article also introduces the pathophysiology of arteriovenous fistula disease and provides a thorough introduction to the use of Doppler ultrasound for the evaluation of arteriovenous fistulas and their associated diseases, addressing the need for a comprehensive understanding among ultrasound practitioners.
Comparison of two different volumes of 0.5%, ropivacaine used in ultrasound-guided adductor canal block after knee arthroplasty: A randomized, blinded, controlled noninferiority trial
Authors: Govil Nishith , Tripathi Mukesh , Goyal Tarun , Bhardwaj Bharat B. , Krishna Vamshi , Choudhury Arghya K. 
Published: August 2024

Background and Aims:
The aim of this study was to establish noninferiority of 10 mL of 0.5% ropivacaine as compared to 20 mL of 0.5% ropivacaine; for choosing right dose in adductor canal block (ACB) after knee arthroplasty (KA), this trial was conducted.

Material and Methods:
Forty patients undergoing bilateral KA with postoperative ultrasound-aided ACB were randomized: Group A patients received 20 mL 0.5% ropivacaine in the right limb and 10 mL 0.5% ropivacaine in the left limb. Group B patients received 10 mL of 0.5% ropivacaine in the right limb and 20 mL of 0.5% ropivacaine in the left limb. Catheter is positioned for intermittent boluses every 12-h up to 48 h.

Results:
In the final analysis (excluding six patients) based on split-body design between Group I (comprising 34 limbs which received 20 mL of 0.5% ropivacaine) and Group II (comprising 34 limbs which received 10 mL of 0.5% ropivacaine), baseline demographic data were collected. Length of the limb from anterior superior iliac spine (ASIS) to the base of the patella was comparable between two groups: Group I (in cm; 149 ± 1.63) versus Group II (in cm; 149.5 ± 1.51) (P = 0.49, 95% CI of – 1.98 to 0.98). Primary outcomes, that is, quadriceps muscle strength, show a significant difference (P < 0.025) at various timeline. Secondary outcome pain scores and degree of knee flexion at various time intervals showed no significant difference. There was zero incidence of fall of the patient and no significant complication due to catheter was reported leading to discontinuation of catheter use in both groups.

Conclusion:
10 mL of 0.5% ropivacaine is noninferior to 20 mL of 0.5% ropivacaine in providing postoperative analgesia with preserved quadriceps muscle strength.