bluuebunny/crossref_metadata_2025_split huggingface dataset:
A mysterious skin rash outbreak over Pescadores Islands in Taiwan Strait: An airborne contact dermatitis by Euproctis taiwana revealed by ultrastructure mapping
Authors: Lin I-Ming , Hsu Tsung-Jen , Su Hung , Lin Chia-Hua , Chiang Yeo-Wan , Shiea Jentaie , Liao Hung-Chang , Kuang Sheng-Chieh , Lan Jui , Lee Chih-Hung 
Published: July 2024

Abstract

Background:
A mysterious skin rash (papular lesions) outbreak broke out for unknown reasons in Taiwan’s Pescadores Islands in mid-autumn 2021, causing much anxiety in the population already nervous about the ongoing COVID-19 epidemic.

Objectives:
We conducted a field survey for possible culprit agents.

Methods:
Skin samples were taken with rapid-glue adhesives from the affected skin. Electron microscopy from the skin samples as well as caterpillar seta was performed. Additional neurotransmitter analysis by mass spectrometry (MS) was conducted on the skin samples.

Results:
A field survey found a large increase in caterpillars, Euproctis taiwana, in September 2021, the warmest September in recent years. Electron microscopy performed on superficial skin samples (3–6 cells thick) of affected and healthy skin (n = 5 and 3, respectively) and caterpillar setae revealed ultrastructural similarities between setae spurs (0.15–0.2 μm) and tiny pits (0.2 μm) on the affected skin as well as similar vegetative debris (0.75 μm) on both setae and affected skin. MS showed large increases in tyrosine, serine, and histamine, known mediators of arthropod insult.

Conclusion:
The co-occurrence of E. taiwana population growth, excessive warming, and strong monsoon winds may lead to this unusual autumn outbreak in late September. The lifting of COVID-19-related travel restrictions against earlier that month probably exacerbated it.
Cutaneous metaplastic synovial cyst in the buttock: A comprehensive analysis of etiologic, clinical, ultrasonic, and pathological aspects
Authors: Tsai Li-Cheng , Hsu Chih-Jung 
Published: July 2024

Abstract
Cutaneous metaplastic synovial cyst (CMSC) is a rare cutaneous cystic lesion, which frequently occurs subsequent to trauma or surgery, forming through the reparative and healing process. It is often misdiagnosed as foreign body granuloma or recurrent epidermoid cyst. Histologically, it is characterized by a cystic structure with multiple villous projections pointing toward the cystic space, lined by cells resembling hyperplastic synovium. To date, only 32 cases have been reported in the English literature. In this article, we present two cases of CMSC with distinctive clinical features and ultrasonic findings. Furthermore, we found only three case reports of CMSC in the gluteal region. All of these cases were elderly patients and developed CMSC at the medial aspect of the buttock. Based on their unique clinical and ultrasonic characteristics, we propose that CMSC in the buttock may be considered a distinct subgroup within CMSC, demonstrating a spectrum of degenerative diseases along with ischiogluteal bursitis.
Evaluation of ultrasound-guided suprazygomatic maxillary nerve block in functional endoscopic sinus surgery for postoperative pain relief: A randomised controlled trial
Authors: Neupane Adhip , Jain Divya , Arora Suman , Gandhi Komal , Singla Varun , Goel Nitika , Virk Ramandeep Singh , Mohindra Satyawati 
Published: July 2024

Background and Aims:
Postoperative pain can impede functional recovery and delay hospital discharge after functional endoscopic sinus surgery (FESS). The study aimed to assess the efficacy of ultrasound (USG)-guided suprazygomatic maxillary nerve block (SZMNB) for postoperative pain in FESS.

Methods:
Forty-eight adult patients between 18 and 65 years of age with American Society of Anesthesiologists physical status I and II and scheduled to undergo FESS were enroled in this randomised controlled study. Patients were randomly allocated to either receive USG-guided SZMNB with general anaesthesia (n = 24) or general anaesthesia alone (n = 24). The numerical rating scale (NRS) pain score in the immediate postoperative period was recorded as the primary outcome. A total of 24 h postoperative rescue analgesic consumption, surgeon satisfaction score, postoperative haemodynamics, and postoperative complications were noted as secondary outcomes.

Results:
The median (interquartile range) of the NRS pain score in the immediate postoperative period was 0 (0-0.25)[95% confidence interval (CI): 0, 0.08] in the block group compared to 2 (1.75-3) [95% CI: 1.60, 2.40] in the control group, P < 0.001]. Pain scores were significantly reduced at all time intervals till 24 h after surgery (P < 0.001). None of the patients required rescue analgesia in the block group. In contrast, eight patients required diclofenac 75 mg intravenous as rescue analgesia within 1 h of surgery and ten patients within 1–6 h of surgery in the control group. Other secondary outcomes were comparable between groups (P > 0.05).

Conclusion:
The USG-guided SZMNB provides excellent postoperative analgesia for patients undergoing FESS without significant side effects.
Assessing the appropriateness and completeness of ChatGPT-4’s AI-generated responses for queries related to diabetic retinopathy
Authors: Subramanian Brughanya , Rajalakshmi Ramachandran , Sivaprasad Sobha , Rao Chetan , Raman Rajiv 
Published: July 2024

Objective:
To evaluate the appropriateness of responses generated by an online chat-based artificial intelligence (AI) model for diabetic retinopathy (DR) related questions.

Design:
Cross-sectional study.

Methods:
A set of 20 questions framed from the patient’s perspective addressing DR-related queries, such as the definition of disease, symptoms, prevention methods, treatment options, diagnostic methods, visual impact, and complications, were formulated for input into ChatGPT-4. Peer-reviewed, literature-based answers were collected from popular search engines for the selected questions and three retinal experts reviewed the responses. An inter-human agreement was analyzed for consensus expert responses and also between experts. The answers generated by the AI model were compared with those provided by the experts. The experts rated the response generated by ChatGPT-4 on a scale of 0–5 for appropriateness and completeness.

Results:
The answers provided by ChatGPT-4 were appropriate and complete for most of the DR-related questions. The response to questions on the adverse effects of laser photocoagulation therapy and compliance to treatment was not perfectly complete. The average rating given by the three retina expert evaluators was 4.84 for appropriateness and 4.38 for completeness of answers provided by the AI model. This corresponds to an overall 96.8% agreement among the experts for appropriateness and 87.6% for completeness regarding AI-generated answers.

Conclusion:
ChatGPT-4 exhibits a high level of accuracy in generating appropriate responses for a range of questions in DR. However, there is a need to improvise the model to generate complete answers for certain DR-related topics.
Kaplan’s Dislocation in a Child with Delayed Presentation: A Case Report
Authors: Keshkar Sanjay , Biswas Subhanwita 
Published: July 2024

Abstract
Kaplan’s dislocation is a rare occurrence, particularly in children. We encountered a case of Kaplan’s dislocation of the index finger in an 8-year-old child who presented 18 days post-injury. The child was managed through open reduction using a dorsal approach. At 7 months of follow-up, the patient exhibited a good functional outcome. This case is noteworthy not only for its rarity but also to highlight that it can occur in children and that even in cases with delayed presentation, open reduction (preferably via a dorsal approach) can yield favorable outcomes with proper follow-up.
Adductor Canal Block + Local Infiltration Versus Local Infiltration Alone in Post-Operative Pain Management in Total Knee Replacement
Authors: Venugopal Shyam Gopal , Mohan Vijaya , Abraham Aril , Antony Aleena 
Published: July 2024

Abstract

Background:
Adductor canal blocks (ACBs) are an emerging concept for post-operative pain management in total knee replacement (TKR). The present study was designed to evaluate the duration of analgesia, patient satisfaction, use of opioids, pain score, and ease of ambulation after ACB + intra-articular local infiltration for TKR surgery and compare it with local infiltration alone.

Materials and Methods:
This retrospective observational study included a total of 260 cases of TKR selected as per inclusion/exclusion criteria. All patients underwent surgery under spinal, epidural, or general anesthesia. For post-operative analgesia, intra-articular local infiltration of a cocktail [12.5 mL of 0.5% sensocaine + 2 mL ketorolac + 0.5 mg adrenaline + 95 mL normal saline] was administered to all patients, with some patients also receiving ACB (15 mL of 0.2% ropivacaine + 1 mcg/kg dexmedetomidine) by random selection. Thus, two groups of patients were formed: (i) those who received ACB and local infiltrative analgesia and (ii) those who received only local infiltrative analgesia. The two groups were matching in terms of demography, comorbidities, and complexity of osteoarthritis.
Variables were compared between these two groups by using outcome measures, including (i) time to attain SLR (straight leg raise), (ii) the total amount of opioid doses given in 24 h, (iii) the pain score by visual analogue score (VAS) at 24 h, (iv) success of early ambulation, and (v) complications.

Results:
Out of the 260 cases of TKR, 126 were of Group 1 and 134 were of Group 2. In the local infiltration alone group, the average VAS at 24 h was 3.8, the average amount of opioid doses given in 24 h was 1.54, the average time of ambulation was 3 h post-surgery, and the average time to attain SLR was 3 h post-surgery. In the adductor canal plus local infiltration group, the average VAS was 3.32, the average amount of opioid use was 0.9, the average time for ambulation was 3 h post-surgery, and the average time to attain SLR was 3 h post-surgery. No major complications were noted in either group.

Conclusion:
According to our study, ACB is certainly a useful tool in reducing the post-operative pain and increasing ambulation and patient satisfaction. However, a larger study is required to establish its effectiveness conclusively.
Pathology of Spinal Tumours
Authors: Nath Chinmay , Chatterjee Sankha 
Published: July 2024

AbstractSpinal tumours are uncommon lesions, but they may cause significant morbidity and mortality. Majority of the spinal tumours are metastatic, that is, spread from tumours in other organs, which are mostly seen in older patients. Primary sarcomas involving the spinal column are rare. Benign tumours and tumour-like lesions of the musculoskeletal system are mostly seen in young patients. Spinal tumours can be subdivided into primary tumours, which are rare, and secondary tumours or metastases, which are much common. Primary vertebral tumours may be benign or malignant. Common benign spinal tumours include osteoid osteoma, osteoblastoma, osteochondroma, aneurysmal bone cyst and giant cell tumour. There are many malignant primary spinal tumours such as- osteosarcoma, chondrosarcoma, and chordoma, Ewing’s sarcoma, plasmacytoma and multiple myeloma. However, all of them, except multiple myeloma, are rare. Intraspinal tumours may be extradural or intradural. Common intradural extramedullary tumours include meningioma, schwannoma and intradural neurofibroma, whereas astrocytoma, ependymoma and haemangioblastoma are a few examples of intradural intramedullary tumours.
A case report on locally advanced squamous cell carcinoma in permanent perineal urethrostomy: A surgical conundrum!!
Authors: Paighan Nitin Madanrao , Goel Hemant Kumar , Makkar Arun 
Published: July 2024

ABSTRACT
Primary urethral cancer is a rare condition often manifesting in the sixth decade of life and is typically associated with urethral stricture disease. A 65-year-old male, a known case of stricture urethra, underwent perineal urethrostomy 10 years back. He presented with a growth at the urethrostomy site and the biopsy revealed squamous cell carcinoma. Magnetic resonance imaging of the pelvis revealed that the lesion extended into the penile and prostatic urethra with possible involvement of the corpus spongiosum, bulbospongiosus, and the bladder neck. Radical cystectomy, penectomy, scrotectomy, and bilateral orchiectomy with ileal conduit were performed. At 18-months of follow-up, the patient is recurrence-free.
Change of the suprapubic catheter: Not always safe!
Authors: Kanbur Ajay S. , Pushkar Shrivastava , Maheshwari Pankaj N. 
Published: July 2024

ABSTRACT
Suprapubic catheterization (SPC) is a commonly used technique for urinary bladder drainage. As an SPC may be needed for long term, the catheter needs to be changed every 2–6 weeks. Change of SPC is a simple and a safe outpatient procedure. Presented here are three unusual complications that occurred when changing the SPC catheter such as catheter getting misplaced up the ureter, balloon extruding outside the urethra and one case of bowel perforation. It is possible that greater awareness of risks and use of a proper technique could have prevented all three complications.
Descriptive epidemiology of prostate cancer in India, 2012–2019: Insights from the National Cancer Registry Programme
Authors: Sankarapillai Jayasankar , Krishnan Sathishkumar , Ramamoorthy Thilagavathi , Sudarshan Kondalli Lakshminarayana , Mathur Prashant 
Published: July 2024

ABSTRACT

Purpose:
This study describes the epidemiology, clinical extent at diagnosis, and treatment modalities for prostate cancer in India.

Methodology:
This study is a secondary analysis of primary prostate cancer data sourced from the National Cancer Registry Programme. Data from population-based cancer registry for the period 2012–2016 were used to estimate the incidence rates, including crude incidence rate (CR), age-adjusted incidence rate (AAR), age-specific rate, and cumulative risk. Trends in the AAR were assessed using join-point regression. Hospital-Based Cancer Registry data from 2012 to 2019 were used to describe the clinical extent of the cancer at diagnosis and the treatment modalities.

Results:
The incidence of prostate cancers was higher in urban registries such as Delhi, Kamrup Urban, and Mumbai (AAR of 11.8 per 100,000, 10.9 per 100,000, and 9.7 per 100,000, respectively). Prostate cancer incidence showed a rise after the age of 50, with a notable acceleration after age 64. The overall annual percentage change for prostate cancer incidence from 1982 to 2016 was 2.6. Around 43.0% of all prostate cancers were diagnosed at the distant metastatic stage. Surgery and radiotherapy, either as standalone treatments or in combination with other modalities, contributed to the treatment of 78.5% of localized cancer, 74.2% of locoregional cancer, and 57.2% of distant metastatic stage of prostate cancer.

Conclusion:
There is heterogeneity in the incidence of prostate cancer, as evidenced by urban registries. Additionally, there is a need for downstaging the disease, without risking overdiagnosis.
The cost-effectiveness of reusable flexible ureteroscopes: An institutional audit
Authors: Khedekar Pranalee G. , Viswaroop S. Bobby , Arul M. , Gopalakrishnan Ganesh , Kandasami S. V. 
Published: July 2024

ABSTRACT

Introduction:
A flexible ureteroscope (FU) is an important tool in the urologist’s armamentarium. This study aims to check the durability and cost-effectiveness of conventional FU.

Methods:
The institution registry of damaged FU over the last 7 years was reviewed. A total of 17 flexible scopes were used. The data of 13 scopes (11 Storz fiberoptic and 2 Seesheen digital) are included in this study. A total of 1905 cases were performed. The cost of scope, duration of use, number of cases done by each scope, and nature of damage were evaluated. We compared the cost-effectiveness of conventional scopes with published costs on disposable scopes.

Results:
The mean number of cases done by fiberoptic scope was 159 (range 25–334). The total cases done by 2 digital scopes were 135 and 25. The mean life of fiberoptic and digital scopes was 17 (range 4–31) and 8 months, respectively. The mean cost of fiberoptic scope was Indian Rupee (INR) 338,951 ($4082.7221) and INR 525,000 ($6323.7138) for digital scope. The cost per case for reusable scope is calculated by dividing the mean cost of FU by the mean number of cases done. The reprocessing cost of INR 527 was then added. Thus, the average cost per procedure for fiberoptic and digital FU was INR 2658.76 and INR 7089.50, respectively. We compared this cost with a projected cost of disposable FUbased on today’s market data, which ranged from INR 60,000 to 107,427.

Conclusions:
The reusable scopes are durable, cost-effective, and an excellent option for high case-load institutions.
Intravesical bupivacaine in reducing catheter-related bladder discomfort and lower urinary tract symptoms after transurethral surgery: A randomized controlled trial
Authors: Purushothaman Jithesh , Kalra Sidhartha , Dorairajan Lalgudi Narayanan , Selvarajan Sandhiya , Sreerag K. S. , Aggarwal Deepanshu 
Published: July 2024

ABSTRACT

Introduction:
The objectives of this study were to investigate the efficacy and safety of intravesical bupivacaine instillation in reducing catheter-related bladder discomfort (CRBD) and lower urinary tract symptoms (LUTS) after transurethral surgery.

Methods:
The study enrolled 100 American Society of Anesthesiologists (ASA) grade I–III patients aged ≥18 years undergoing transurethral resection of the prostate or transurethral resection of the bladder tumor, randomly assigned to Group B (intravesical bupivacaine) or Group S (saline). Double blinding was employed. Independent variables included demographics, surgery type, ASA grade, and intervention details. Dependent variables comprised CRBD severity, Patient Perception of Bladder Condition (PPBC), Pelvic Pain Urgency Frequency (PUF), Visual Analog Scale (VAS) for pain, need for additional analgesics, and International Prostate Symptom Score (IPSS). SPSS version 19 was used for analysis with a significance level of P < 0.05. Side effects such as hematuria were also recorded.

Results:
Group B reported significantly lower “moderate” CRBD immediately (2% vs. 40%, P < 0.001) and at 12 h (0% vs. 18%, P = 0.003) post-instillation compared to Group S and also required fewer additional analgesics (4% vs. 46%). The PPBC at catheter removal also favored Group B (P = 0.003) and day 1 (P < 0.001). The PUF scores were also significantly lower in Group B at catheter removal (P = 0.001) and at day 1 (P = 0.028). The IPSS was also significantly lower in the Group B on day 1 (P = 0.003) and 7 (P = 0.001). The VAS scores also favored the Group B consistently and although the side effects were higher in Group B but this was not statistically significant.

Conclusion:
Intravesical bupivacaine administration has the potential to alleviate CRBD and postoperative LUTS following lower urinary tract transurethral electrosurgery. The study’s findings underscore the importance of personalized pain management strategies in optimizing the patient comfort during the postoperative recovery.
The impact of sestamibi scan on clinical decision-making for renal masses: An observational single-center study
Authors: Yong Courtney , Tong Yan , Tann Mark , Sundaram Chandru P. 
Published: July 2024

ABSTRACT

Introduction:
We aimed to determine whether sestamibi scan changes management of renal masses.

Methods:
All patients undergoing sestamibi scan for renal masses between 2008 and 2022 at a single center were retrospectively reviewed. Data were gathered on patient demographics, pre- and postoperative creatinine, sestamibi scan parameters, and cross-sectional imaging characteristics. Outcomes included whether the patient underwent renal mass biopsy or surgical resection and the final pathological diagnosis if tissue was obtained from biopsy or resection. Data regarding postbiopsy as well as postoperative complications were also collected. The odds ratio (OR) for surgery or biopsy based on sestamibi result was calculated.

Results:
Forty-three patients underwent sestamibi scan from 2008 to 2022, with 10 scans consistent with oncocytoma and 33 with nononcocytoma. The mean tumor size at initial presentation was 4.0 ± 1.8 cm with a median RENAL score of 7 (range: 4–11). For patients with sestamibi scans negative for oncocytoma, the OR for surgery was 12.5 (95% confidence interval [CI]: 2.1–71.2, P = 0.005), and the OR for biopsy was 0.04 (95% CI: 0.005–0.39, P = 0.005). Conversely, for patients with sestamibi scans positive for oncocytoma, the OR for surgery was 0.28 (95% CI: 0.03–2.4, P = 0.24) and the OR for biopsy was 24.0 (95% CI: 2.6–222.7, P = 0.005). Creatinine at the last follow-up was similar between patients with positive and negative sestamibi scans. No patients experienced complications from surgery or biopsy. The median follow-up was 19 months (range: 2–163).

Conclusions:
A sestamibi scan positive for oncocytoma led to increased use of renal mass biopsy for confirmation. Sestamibi scans that were negative for oncocytoma were more likely to result in surgical resection without biopsy.
Comparison of Optical Biometry and Scheimpflug Device Keratometric Readings Accuracy in Predicting Intraocular Lens Power in Cataract Surgery
Authors: Khorsheed Mehtab Ameer , Tawfeeq Firas Nazar , Issa Ammar Fouad 
Published: July 2024

Abstract

Background:
A correct preoperative intraocular lens (IOL) power measurement in cataract surgery depends on accurate assessment of axial length (AL), anterior segment parameters, and using the suitable formula for the calculation of the power.

Objectives:
To determine the accuracy of IOL power calculations using keratometric measurements of the IOL Master compared to the Pentacam and to determine whether the results obtained can be used interchangeably in clinical practice in calculating IOL power in routine cataract surgery.

Patients and Methods:
In this prospective study, the biometric data including AL, keratometric readings, and anterior chamber depth (ACD) were obtained by both the IOL Master 500 and Pentacam Scheimpflug devices added to these measures the white-to-white (WTW) distance by IOL Master and central corneal thickness by Pentacam and calculation of the IOL power using SRK/T formula for the enrolled patients who undergone uneventful cataract surgery with IOL implantation. Postoperatively, spherical equivalent refraction was measured and the mean arithmetic error and the mean absolute error (MAE) for both keratometric readings were calculated to compare the accuracy between them in calculating the IOL power.

Results:
The study evaluated 57 eyes of 57 patient, the mean K value for the IOL Master was 43.92 (D) ± 1.5 (standard deviation [SD]) and the mean K value for the Pentacam was 43.77 (D) ± 1.7 (SD) (P = 0.62), ACD values between the two groups, was 3.19 ± 0.44 mm measure by IOL Master compared to 3.22 ± 0.48 mm in Pentacam (P = 0.769), with a very strong positive correlation between the two values (r = 0.995, P < 0.001). MAE for the IOL Master was 0.230 (D) ± 0.187 (SD), while for the Pentacam was 0.255 (D) ± 0.204 (SD), with no statistically significant differences between two devices’ values (P = 0.54).

Conclusions:
Pentacam Scheimpflug measured keratometric and ACD data had good correlation with IOL Master data with good interchangeability between two devices readings in measuring the IOL power in routine cases of cataract surgeries.