bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modeling of Gamma Index for Prediction of Pretreatment Quality Assurance in Stereotactic Body Radiation Therapy of the Liver
Authors: Kamal Rose , Thaper Deepak , Singh Gaganpreet , Sharma Shambhavi , Navjeet  , Oinam Arun Singh , Kumar Vivek 
Published: July 2024

Purpose:
The purpose of this study was to develop a predictive model to evaluate pretreatment patient-specific quality assurance (QA) based on treatment planning parameters for stereotactic body radiation therapy (SBRT) for liver carcinoma.

Materials and Methods:
We retrospectively selected 180 cases of liver SBRT treated using the volumetric modulated arc therapy technique. Numerous parameters defining the plan complexity were calculated from the DICOM-RP (Radiotherapy Plan) file using an in-house program developed in MATLAB. Patient-specific QA was performed with global gamma evaluation criteria of 2%/2 mm and 3%/3 mm in a relative mode using the Octavius two-dimensional detector array. Various statistical tests and multivariate predictive models were evaluated.

Results:
The leaf speed (MILS) and planning target volume size showed the highest correlation with the gamma criteria of 2%/2 mm and 3%/3 mm (P < 0.05). Degree of modulation (DoM), MCSSPORT, leaf speed (MILS), and gantry speed (MIGS) were predictors of global gamma pass rate (GPR) for 2%/2 mm (G22), whereas DoM, MCSSPORT, leaf speed (MILS) and robust decision making were predictors of the global GPR criterion of 3%/3 mm (G33). The variance inflation factor values of all predictors were <2, indicating that the data were not associated with each other. For the G22 prediction, the sensitivity and specificity of the model were 75.0% and 75.0%, respectively, whereas, for G33 prediction, the sensitivity and specificity of the model were 74.9% and 85.7%%, respectively.

Conclusions:
The model was potentially beneficial as an easy alternative to pretreatment QA in predicting the uncertainty in plan deliverability at the planning stage and could help reduce resources in busy clinics.
Monte Carlo-based Investigation of Absorbed-dose Energy Dependence of Thermoluminescent Dosimeters in Therapeutic Proton and Carbon Ion Beams
Authors: Chattaraj Arghya , Mishra Subhalaxmi , Selvam T. Palani 
Published: July 2024

Background:
The present study is aimed at calculating relative absorbed-dose energy response correction (R) of commonly used thermoluminescent dosimeters (TLDs) such as LiF, Li2B4O7, and Al2O3 as a function of depth in water for protons (50–250 MeV/n) and carbon ion (80–480 MeV/n) beams using Monte Carlo-based FLUKA code.

Materials and Methods:
On-axis depth-dose profiles in water are calculated for protons (50–250 MeV/n) and carbon ion (80–480 MeV/n) beams using FLUKA code. For the calculation of R, selective depths are chosen based on the depth-dose profiles. In the simulations, the TLDs of dimensions 1 mm × 1 mm × 1 mm are positioned at the flat, dose gradient, and Bragg peak regions of the depth-dose profile. Absorbed dose to detector was calculated within the TLD material. In the second step, TLD voxels were replaced by water voxel of similar dimension and absorbed dose to water was scored.

Results:
The study reveals that for both proton and carbon ion beams, the value of R differs from unity significantly at the Bragg peak position and is close to unity at the flat region for the investigated TLDs. The calculated R value is sensitive to depth in water, beam energy, type of ion beam, and type of TLD.

Discussion:
For accurate dosimetry of protons and carbon ion beams using TLDs, the response of the TLD should be corrected to account for its absorbed-dose energy dependence.
Cognitive Rehabilitation Programme (CRP): An Effective Tool Against Mild Cognitive Impairment Among Elderly
Authors: Sharma Shabnam , Kumari Vinay , Phougat Jyoti , Sarin Jyoti 
Published: July 2024

Background:
With a steady increase in life expectancy seen worldwide, age-associated cognitive decline and mild cognitive impairment in old age are major public health challenges.

Objective:
To determine the effectiveness of the Cognitive Rehabilitation Program on cognition parameters in old age people with mild cognitive impairment.

Materials and Methods: Design:
This study was a quasi-experimental design using a non-equivalent control group pretest post-test design.

Setting/Location:
Mullana and Adhoya villages of Ambala, Haryana.

Subjects:
Eighty old age people with mild cognitive impairment.

Intervention:
The pre- and post-interventional cognition parameters were assessed using Addenbrooke’s cognitive examination on Day 1 and Day 29. The cognitive Rehabilitation Program was administered in the experimental group once a day for 28 days.

Outcome Measures:
Dependent variables were cognition parameters.

Results and Conclusion:
In the experimental group, a significant increase in cognition parameters score was observed from Day 1 (62.28 ± 6.23) to Day 29 (63.25 ± 5.10) after administration of the Cognitive Rehabilitation Program. In the comparison group, there was a non-significant decrease in cognition parameters score from Day 1 (56.73 ± 8.24) to Day 29 (55.85 ± 8.90). The post-implementation cognition parameters score of old age people in the experimental group (mean = 63.25) was significantly higher than in the comparison group (mean = 55.85). The mean gain in cognition scores was significantly higher in the experimental group than in the comparison group with a moderate effect size. It is concluded that the cognitive rehabilitation program is an effective tool in improving cognition parameters score among old age people with mild cognitive impairment.
The Spectrum of Neurological Manifestations in Scrub Typhus
Authors: Rehani Varun , Sreen Amit , Anadure RK , Gupta Salil 
Published: July 2024

Background:
Scrub typhus is a mite-borne zoonotic disease caused by Orientia tsutsugamushi and commonly presents with fever, rash, and eschar. Systemic complications develop later in the illness including, meningoencephalitis, pericardial effusion, myocarditis, and pneumonitis. In this article, we will be presenting different neurological manifestations of scrub typhus along with functional outcomes studied at a tertiary care center in New Delhi.

Methods:
This ambispective observational study was conducted at Army Hospital Research and Referral, New Delhi, during January 2018- January 2020. Febrile illness, serologically confirmed as scrub typhus and developing neurological complications were included. A predesigned clinical proforma was recorded for demographics, clinical features, neurological examination, supported with laboratory and/or radiology evaluation, and functional outcomes using the modified Rankin Scale (mRS).

Results:
In our cohort of 7 patients’ majority were male (71%) with mean age at presentation being 42.5 years. Eschar was present in only 2 cases (28%) and a syndromic clinical diagnosis of meningoencephalitis was made in 3 (43%), acute flaccid quadriparesis in 2 (28%); and symptomatic seizure and parkinsonism in 1 patient each (14%). CSF showed lymphocytic pleocytosis with protein elevation in 57% cases. Systemic dysfunction was noted in the form of thrombocytopenia (57%), hyponatremia (42%), elevated transaminases (57%). Symptoms resolved with Doxycycline ± Rifampicin therapy in all cases, with good functional outcomes in majority of (89%) cases.

Conclusion:
Neurological complications in scrub typhus have a wide spectrum involving meninges, encephalon, basal ganglia, cranial, and peripheral nerves. High index of suspicion with early serological testing (ELISA) is a must in undifferentiated fevers. Timely initiation of appropriate therapy leads to good clinical outcomes, in majority of cases with neurological involvement.
Zoster-associated Limb Paralysis: Clinical and Electrophysiological Data of 15 Cases with Segmental Zoster Paresis with the Literature Review
Authors: Aykac Seyma Ciftci , Arı Abdullah , Ozoglan Habibe , Dibek Dilara Mermi , Bademkıran Fikret , Uludag Burhanettin , Çolakoglu Zafer , Oztura Ibrahim , Aydogdu Ibrahim 
Published: July 2024

ABSTRACT

Background:
Herpes zoster (HZ) is a viral disease characterized by skin eruptions and pain in specific dermatomes. Focal motor weakness that appears in the segment of skin eruptions is a rare complication of this infection. Because of the difficulty in clinically diagnosing thoracic or upper cervical motor weakness and due to the pain that causes overlooking of weakness, the true incidence of this complication is not known. In this study, we want to review the clinical presentation of segmental zoster paresis and also discuss electrophysiological findings with the involvement of nerve, plexus parts, or spinal roots.

Methods:
Electromyography records were examined retrospectively from 2010 to 2023 for patients who had HZ-associated limb paresis. Clinical data were reviewed and abstracted, and patients whose clinical limb weakness and sensory deficits conformed to the distribution of peripheral nerve (s) or spinal root and whose electrodiagnostic evaluation corroborated the localization, were included in the series.

Results:
Fifteen patients were included in our study. Ten of them were men and five of them were women. Paresis and neuropathic pain are the main complaints. In all patients, the distribution of paresis was consistent with the area of skin eruptions. C8–T1 in the upper extremity and L5–S1 in the lower extremity are the most commonly involved segments. Electrophysiological findings showed radicular involvement in three cases, brachial plexus in six cases, ulnar nerve in one case, sciatic nerve in two cases, and fibular nerve in three cases. Axonopathy is the main detected pathology in all cases.

Conclusion:
Segmental zoster paresis is a rare complication of cutaneous zona zoster and it affects different nerve segments. Clinicians should be aware of clinical and electrophysiological findings of this disease for the appropriate management of the patients.
A Comparative Study on the Efficacy of Wound Infiltration of Tramadol versus Bupivacaine for Postcesarean Section Pain Control in a Tertiary Hospital in Manila, Philippines: A Double-blind Randomized Controlled Trial
Authors: Bolinao Jamie Marie Nacilla , Morala-Caranto Melissa 
Published: July 2024

ABSTRACT

Background:
In developing countries, postcesarean pain control remains a challenge due to the limited supply of medication and medical equipment. Wound infiltration provides a cost-effective, easy-to-administer postoperative analgesia with a high safety of margin. Several studies suggest that tramadol and local anesthetics have similarities in terms of its action. The study aims to compare the efficacy of tramadol and bupivacaine administered through wound infiltration in postcesarean patients aged 18-40 years old at a tertiary hospital in Manila, Philippines.

Methods:
Using a double-blind randomized controlled trial, study participants for low transverse cesarean section (CS) were allocated to either Group A or Group B. Group A (n = 20) received a local infiltration of 2 mg/kg tramadol diluted to 20 ml of 0.9% saline solution. Group B (n = 20) received a local infiltration of 0.5 ml/kg of 0.25% bupivacaine isobaric diluted to 20 ml of 0.9% saline solution. All wound infiltrations were performed once at the postoperative site to establish cost-effectivity. Pain severity was assessed using the Visual Analogue Scale (VAS) scoring at rest and at movement done by the anesthesiologist at 4, 8, 16 and 24 h post-CS. A significance level of 0.05 was set and P<0.05 was considered statistically significant. Before inclusion in the study, informed consent was secured from the study participants. The research protocol and informed consent were submitted for ethical review and were subsequently approved.

Results:
There is no significant difference between the VAS scores of patients treated with tramadol and those treated with bupivacaine across all times of recording except for VAS scores at movement during the 16th and 24th hours. Results of the study revealed that the VAS scores in the tramadol group are lower at all times than those of the bupivacaine group. In general, it is also observable that the VAS scores are higher when the patient is moving than when at rest. There were no observed effects in breastfeeding and no allergic, cardiovascular or central nervous system side effects were observed among all study participants.

Conclusion:
Because of its mechanism similar to that of local anesthetics, tramadol wound infiltration is a suitable, safe and cost-effective alternative to bupivacaine for pain control after CS.
Comparing prognostic scoring systems in acute pancreatitis: Bedside Index of Severity in Acute Pancreatitis, WL, and Chinese Simple Scoring System Scores
Authors: Güzel Yunus Emre , Çolak Nese , Okuv Ahmet Can , Teymuroğlu Sefer , Teke Muhammet İkbal 
Published: July 2024

Abstract

OBJECTIVES:
Several scoring systems are used to predict prognosis in acute pancreatitis (AP), but their predictive success varies. This study compares the validity of the commonly used Bedside Index of Severity in AP (BISAP) score with the newly developed WL score and the Chinese Simple Scoring System (CSSS) score in predicting mortality and unfavorable prognostic outcomes in AP patients.

METHODS:
This retrospective descriptive study included all AP patients presenting to the emergency department from June 2, 2019, to June 2, 2022. Patient demographics, vital signs, laboratory values, and imaging findings were recorded, and WL, CSSS, and BISAP scores were calculated. The effectiveness of these scores in predicting adverse outcomes and mortality was compared.

RESULTS:
Among 357 patients, 53.2% were male, with a median age of 62 years (interquartile range: 48–75). Area under the curve (AUC) values for 7-day outcomes were 0.956 for WL, 0.759 for CSSS, and 0.871 for BISAP; for 30-day outcomes, AUC values were 0.941 for WL, 0.823 for CSSS, and 0.901 for BISAP; and for poor prognostic outcomes, AUC values were 0.792 for WL, 0.769 for CSSS, and 0.731 for BISAP.

CONCLUSION:
In AP patients, WL, CSSS, and BISAP scores are effective predictors of unfavorable prognosis and mortality. WL score outperforms the CSSS and BISAP scores in predicting 7-day and 30-day mortality and poor prognosis. After WL, BISAP is the second-best system for predicting mortality. For predicting unfavorable prognoses, CSSS is the second-best system after WL. The simplicity of calculating the WL score based on four laboratory parameters makes it a preferable choice.
Comparison of dental force applied during endotracheal intubation with hyper-angulated and macintosh-type video laryngoscopy blades used by emergency medicine trainees: A randomized cross-over manikin study
Authors: Karabacak Ali Rıza , Özturan İbrahim Ulaş , Şefoğlu Ömer Faruk , Doğan Nurettin Özgür , Yaka Elif , Yılmaz Serkan , Pekdemir Murat 
Published: July 2024

Abstract

OBJECTIVES:
This study aimed to compare the effects of Macintosh-type and hyperangulated video laryngoscopy (VL) blades on dental force during endotracheal intubation (ETI) using Glidescope and McGrath VL devices.

METHODS:
In this randomized, crossover, manikin study conducted at a university emergency medicine (EM) program, 65 EM trainees included interns and residents performed 520 intubations using four different VL blades (GlideScope VL with Macintosh-type Mac T3 and hyperangular Lo Pro T3 blades and McGrath VL Macintosh-type MAC 4 and hyperangular McGrath X3 blades) in normal and difficult airway scenarios. The primary outcome of this study was the dental pressure (Newton) exerted during ETI. The secondary outcomes included c-spine motion (degree), intubation success (%), duration (seconds), successful glottic view (%), and intubator comfort (7-point Likert).

RESULTS:
Significant differences were observed in dental force (H(3) = 11.7, P = 0.008), c-spine motion (H(3) = 8.34, P = 0.039), duration (H(3) = 16.56, P = 0.001), and comfort (H(3) = 174.96, P < 0.001) across blade types. Glidescope LoPro T3 provided a significant lower dental force (adjusted P = 0.01), less c-spine motion (adjusted P = 0.031), and shorter intubation duration (adj P < 0.01) than the McGrath Mac 4. First attempt success and intubator comfort were significantly better with all Glidescope blades (z score of 3.7 and 4.7) than with McGrath blades (z score of-4.1 and-4.4).

CONCLUSION:
The Glidescope LoPro T3 blade demonstrated advantages in dental force, c-spine motion, and intubation duration compared with McGrath Mac 4. Overall, the Glidescope blades provided superior comfort and higher first attempt success rates.
Obstructive shock induced by internal thoracic artery injury with traumatic sternal fracture
Authors: Konno Halleluyah , Nitta Masakazu , Watanabe Norihiro , Miyazato Mitsuyuki , Horiuchi Akane 
Published: July 2024

Abstract
Internal thoracic artery (ITA) injuries associated with sternal fractures can lead to shock. Several studies have documented injuries resulting in hemorrhagic shock, yet there is limited reporting on obstructive shock. Opinions differ regarding which is superior between transcatheter arterial embolization (TAE) and open thoracotomy. We report the case of an 80-year-old female patient presented with blunt chest trauma when driving. Her vital signs were normal. However, ultrasonography revealed a hypoechoic anterior mediastinal lesion. Her blood pressure decreased immediately before undergoing a computed tomography (CT) scan. The CT scan showed a sternal fracture, anterior mediastinal extravasation, and dilation of the inferior vena cava. TAE was performed on both internal thoracic arteries, and the patient was transferred to a hospital where an open thoracotomy could be performed. The patient was treated conservatively and discharged without sequelae. Obstructive shock caused by an ITA injury with a sternal fracture can be successfully treated using TAE.
Sporadic Optic Nerve Glioma Causing Bitemporal Hemianopia
Authors: Sharanya R , Shah Virna M. , Ramasamy Rajkumar , Mani Karthik Kumar 
Published: July 2024

Abstract
Primary tumours of the optic nerve are relatively rare. Optic nerve gliomas are usually seen in children under the age of 10 and present with gradual vision loss followed by proptosis. A 19-year-old female presented to our neuro-ophthalmology clinic with chief complaints of disturbances in vision in both eyes and headache. Ocular examination showed best corrected visual acuity (BCVA) of 6/6 in both eyes and visual field analysis revealed bitemporal hemianopia. Urgent neuroimaging was advised and her MRI brain revealed optic pathway glioma involving the intracranial segment of right optic nerve and optic chiasma. Improvement in vision was noted during post-surgical follow-up. We present this case to highlight the importance of visual field examination in a young patient with headache, even with a BCVA of 6/6.
Conjunctival Epithelial inclusion Cyst after Strabismus Surgery: A Case Report
Authors: Khadia Anjali , Moutappa Fredrick , Kannusamy Veena , Lavanya G. S. 
Published: July 2024

Abstract
We present a case of a 26-year-old man with outward deviation of left eye since birth, diagnosed with exotropia underwent squint correction surgery, and later developed a conjunctival cyst. The histopathological findings from the biopsy indicated an epithelial inclusion cyst with retention.
“Blow-in” Fracture of Orbital Roof – A Rare Case Report
Authors: Yogeswari A , Sujatha R , Abrar Mohamed 
Published: July 2024

Abstract
We report a rare case of orbital roof “blow-in” fracture in a 27-year old with concomitant communited fractures of frontal and ethmoid bones. A 27-year-old male presented with a history of assault by unknown persons and sustained injury to the left eye. Computed Tomography (CT) head revealed a blow-in fracture of the orbital roof on the left side with bony fragment displacement noted in the intraconal compartment. Surgical intervention was indicated and performed in order to prevent any visual complications arising due to the displaced bony fragment. The case report is followed by a brief overview of orbital fractures.
Optic Neuritis in the New Millennium
Authors: Hoffman Clarissa M. , Tang Rui , Alryalat Saif A. , Al Deyabat Osama , Alchaki Abdul R. , Lee Andrew G. 
Published: July 2024

Abstract
Optic neuritis (ON) is a common cause of acute visual loss due to optic neuropathy in adults. Although typical demyelinating ON usually recovers, some forms of autoimmune inflammatory ON may result in permanent disability. The relatively recent discovery of novel autoantibodies and their roles in the pathogenesis of ON, including aquaporin 4 (AQP4) in neuromyelitis optica spectrum disorders (NMOSD) and myelin oligodendrocyte glycoprotein (MOG) antibody in MOG-associated disease (MOGAD) has led to paradigm shifts in both the acute and chronic management of ON. We performed a comprehensive literature review to assess current and upcoming perspectives on ON by searching for contemporary articles (from 2015 to 2024) for articles that reported updates in diagnostic tools and methods, such as antibody testing. This monograph reviews these recent advances in the evaluation and management of ON.
Association of Inflammatory Markers and Diabetic Retinopathy
Authors: Dharwadkar Sandhya , Ram Deepa , Ramakrishna Swati , Hegde Shubhratha S. , Shilpa M 
Published: July 2024

AbstractIntroduction:Diabetic retinopathy is a micro-angiopathy, the pathogenesis of which is manifold. Chronic inflammation releasing various mediators has been proposed to cause micro-angiopathy in long-term diabetics. These markers can be easily measured in serum and may serve as a risk factor for progression as well as allow newer modalities of management aimed at this pathology.Aims and Methodology:The aim of the study was to determine the association between different inflammatory markers and diabetic retinopathy. A total of 100 eyes in diabetic patients, 20 each with no retinopathy, mild NPDR, moderate NPDR, severe NPDR, and PDR were included. The serum levels of C-reactive protein (CRP) and absolute neutrophil count were recorded and compared across each of these groups.Results:The mean ANC among these groups, respectively, was 5525, 5162, 5374, 5239, and 5313 (per microlitre), and neither were these raised significantly nor was the difference between groups statistically significant. Mean CRP levels were within normal limits in all groups (2.56, 2.87, 4.06, 5.15, 6.97 mg/dl), although there was a steady increase with each grade of retinopathy, and this was found statistically significant.Conclusion:There was no association between absolute neutrophil count and diabetic retinopathy. Serum CRP levels may guide progression of retinopathy and can be monitored to help management protocols.
Sweet’s Syndrome and Active Retinal Vasculytis: A Case Report
Authors: Das Sujit , Balasubramanian Pradeep 
Published: July 2024

Abstract
Sweet’s syndrome is an uncommon skin disorder of unknown aetiology characterised by fever and painful skin lesions along with marked leucocytosis and elevated erythrocyte sedimentation rate. Women between 30 and 50 years of age are at risk. The most common ocular involvement is conjunctivitis and episcleritis. Here, we present a 39-year-old lady with Sweet’s syndrome who presented with active retinal vasculitis and had dramatic improvement with systemic corticosteroids.