bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bone metastases
Authors: Hui Monalisa , Balu B. , Uppin Shantveer G. , Uppin Megha S. , Chandrasekhar P. , Rao K. Nageshwara , Bhattarcharjee Suchanda , VijayaSaradhi M. , Krishna Y. Vamshi 
Published: May 2024

Objective:
To analyze the clinicopathological features of metastatic bone tumors over a period of two decades and identify the primary site of malignancy in metastasis of unknown origin.

Materials and Methods:
A total number of 365 cases were included in the study. The clinical features and location of the tumors were noted. The histopathological features of all the cases were studied. Immunohistochemistry (IHC) was done either to categorize or confirm the primary diagnosis using organ specific/organ restricted markers.

Results:
A total 712 bony sites were involved by metastasis in 365 patients, of which spine was the most commonly affected. Metastasis was the initial presentation in 69.5% patients. The primary site was known in 220 patients and almost half of them were detected after the diagnosis of metastasis. IHC was used as adjunct to suggest the possible origin in cases with unknown primary in 27.4%. Among the metastatic carcinoma, adenocarcinoma was the most common histological subtype with thyroid being the most frequent primary site of origin followed by lung and breast.

Conclusion:
More than two-third of cases in surgical pathology practice present as initial manifestations. Detection rate of primary depends on extent of metastatic work-up and IHC with organ specific/organ restricted markers to facilitate treatment with bone targeting agents.
Diagnostic efficacy of neutrophil to lymphocyte ratio (NLR) in oral potentially malignant disorders and oral cancer
Authors: Singh Shruti , Singh Jaya , Ganguly Roop , Chandra Shaleen , Samadi Fahad M. , Suhail Shaista 
Published: May 2024

Background and Aims:
Inflammation is considered to be the seventh hallmark of cancer and plays a pivotal role in all stages of tumor development. Systemic inflammatory responses in particular neutrophil to lymphocyte ratio (NLR) have garnered immense attention of current researchers and its role is well proven in various solid malignancies. Its prognostic role in oral cancer have been extensively studied. However, its diagnostic role is yet to be explored. The current study aims to investigate diagnostic utility of NLR in oral potentially malignant disorders and oral cancer, when compared to normal subjects.

Methods:
A total of 150 subjects were involved in the study, a total of 2.5 ml of blood was drawn from the median cubital vein of the patient in an EDTA vial and hematological parameters were assessed using Erba-Transasia B7256 Autoanalyzer and reassessed manually by two experts.

Statistical Analysis:
The NLR values were recorded and tabulated as Mean ± S.D. and comparisons were analyzed using Kruskal Wallis and Mann Whitney post hoc U test. ROC curve analysis was performed to estimate cut-off values.

Results:
The NLR values when compared between the 3 groups were statistically significant (P < 0.001). The cut off value between disease and normal subject was 2.33, while the cut-off value between potentially malignant and malignant condition is 3.20.

Conclusion:
NLR can be a valuable diagnostic adjunct in oral cancer and potentially malignant disorders of oral cavity.
Effect of megaloblastic anemia on hemoglobin A2 and diagnosis of β-thalassemia trait
Authors: Sahoo Sulagna , Sahu Nageswar , Das Palash , Senapati Urmila 
Published: May 2024

Context:
β-thalassemia trait is usually diagnosed by raised hemoglobin A2 (HbA2). The presence of megaloblastic anemia can cause an increase in HbA2 and create a diagnostic dilemma. Here, we have analyzed the effect of vitamin B12 and folic acid supplementation on HbA2 and diagnosis of β-thalassemia trait in cases of megaloblastic anemia with raised HbA2.

Materials and Methods:
Cases of megaloblastic anemia with raised HbA2 on high-performance liquid chromatography (HPLC) were supplemented with vitamin B12 and folic acid. Post-treatment evaluation was done after 2 months. Cases showing adequate hematological response were subjected to statistical analysis. Based on post-treatment HbA2 value, the cases were diagnosed as normal, borderline raised HbA2, or β-thalassemia trait. Pre- and post-treatment values of red cell parameters and HbA2 were analyzed.

Results:
There was a significant decrease in HbA2 value after vitamin B12 and folic acid supplementation. The diagnosis was changed in 70.97% of the cases after treatment. The chance of inconclusive diagnosis was decreased from more than 50% to less than 10%. Pre-treatment mean corpuscular volume (MCV) and HbA2% showed a significant difference between the thalassemic and normal groups.

Conclusions:
Megaloblastic anemia can lead to false-positive diagnosis of β-thalassemia trait on HPLC. Repeat HPLC should be done after adequate supplementation of vitamin B12 and folic acid in cases of megaloblastic anemia with raised HbA2. Red cell parameters are not helpful to suspect β-thalassemia trait in presence of megaloblastic anemia. However, HbA2% on HPLC can be a useful parameter to suspect or exclude β-thalassemia trait in cases of megaloblastic anemia.
Detection and evaluation of the presence of the BRAF V600E mutation in ameloblastomas in an Indian population
Authors: Goes Cassandra F. , Spadigam Anita , Dhupar Anita , Carvalho Karla M. , Cota Jochima , Syed Shaheen 
Published: May 2024

Introduction:
Ameloblastoma is a benign epithelial odontogenic neoplasm that constitutes approximately 1% of all oral tumors and about 9 to 11% of all odontogenic tumors. They are slow-growing, locally invasive, and demonstrate a potential for metastasis and malignant transformation. The molecular pathogenesis of ameloblastoma is attributed to aberrant activity of the signal transduction pathways relating to developmental stages of odontogenesis including the mitogen-activated protein kinase (MAPK) pathway. The BRAF V600E mutation was identified as the most frequently mutated gene in this neoplasm. Studies have shown that use of BRAF inhibitors in patients diagnosed with ameloblastomas led to a significant reduction in tumor volume.

Aims:
To detect the expression of BRAF V600E mutation in ameloblastomas in an Indian population using immunohistochemistry. To compare the difference in the occurrence of the BRAF V600E mutation between mandibular and maxillary cases.

Materials and Methods:
Thirty-three formalin-fixed paraffin-embedded tissues of histopathologically proven cases of ameloblastoma were assessed for the BRAF V600E mutation by immunohistochemistry using the BRAF V600E monoclonal antibody. Patient data such as age, sex, anatomical site, recurrence were documented.

Statistical Analysis:
The statistical analysis was performed using the Pearson Chi-square test and Student's t-test.

Results:
The present study revealed a high expression of the BRAFV600E mutation in mandibular cases of ameloblastoma among Indians irrespective of the age, sex, site, recurrence or histological pattern.

Conclusions:
The identification of this driver mutation opens the possibility of an adjuvant therapeutic modality to reduce the significant facial disfigurement and morbidity following surgical management.
MCM3 proliferative index is worthier over Ki-67 in the characterization of salivary gland tumors
Authors: Raja Ritika , Shetty Devi Charan , Chandrakanta  , Juneja Saurabh , Tandon Ankita , Gulati Nikita 
Published: May 2024

Background:
Salivary gland tumors bear uncanny characteristics of being different based on their morphological aspects rather than the presence of clear demarcation. This ambiguity in the spectrum from benign to malignant salivary gland neoplasms while categorizing the neoplasm is having inherent pitfalls. The present study was, therefore, designed to characterize benign and malignant salivary gland tumors based on their proliferative indices.

Materials and Method:
Study samples comprised of 97 cases of histopathologically confirmed benign and malignant salivary gland tumors. The cases were immunohistochemically assessed for MCM3 and Ki-67 expressions and the molecular characterization was performed based on the findings.

Results:
The majority of benign and malignant salivary gland tumors were from the parotid gland, (51.2%) and (42.4%), respectively. Overall mean labeling index of MCM3 was higher i.e., (5.60 ± 3.99) in comparison to Ki-67 i.e., (2.82 ± 3.14) with P = 0.05 using paired t-test. Besides, malignant salivary gland neoplasms represented a higher mean score of MCM3 and Ki-67 than benign neoplasms.

Conclusion:
The requirement of a novel marker has led to the use of MCM3 which has a characteristic role in the entire spectrum of the cell cycle. The present study highlighted the extrapolation of MCM3 over Ki-67 for diagnosis and for true characterization of biologic behavior of salivary gland pathologies which may, in turn, influence the treatment modality employed for such lesions.
MiR-216b inhibits gastric cancer proliferation and migration by targeting PARK7
Authors: Zhu Guo-Min , Chen Shao-Qin , Jiang Qun-Guang , Cao Yi , Guo Yi , Ye Li-Qin 
Published: May 2024

Objective:
Postoperative recurrence and metastasis of gastric cancer is still a difficult problem in medical field. About 60% of patients with advanced gastric cancer die from peritoneal metastasis, which has become one of the main causes of death of gastric cancer patients. To elucidate the molecular mechanism of peritoneal metastasis of gastric cancer can help us better early diagnosis and improve treatment measures.

Methods:
This project intends to validate the above hypothesis from three different levels of tissue, cell, and animal models by means of fluorescence quantitative PCR, Western blot, double Luciferase Report Analysis and immunohistochemical detection, and to further explore the molecular mechanism of peritoneal metastasis of gastric cancer.

Results:
Our previous studies have shown that PARK7 promotes peritoneal metastasis of gastric cancer through PI3K/Akt signaling pathway, but its specific regulatory mechanism remains unclear.

Conclusion:
Our preliminary study showed that the expression of microRNA-216b in gastric cancer tissues with peritoneal metastasis was significantly lower than that in patients without peritoneal metastasis, while the expression of PARK7 was the opposite.
Histopathological changes in lungs of patients with fatal COVID 19 infection: A series of 15 cases
Authors: Medhi Pranita , Dowerah Swagata , Barman Nabajit , Singh Mridul 
Published: May 2024

ABSTRACT

Introduction:
The predominant pathology noted in the lungs of patients dying of COVID-19 is reported to be diffuse alveolar damage (DAD). Other studies have identified microthrombi to be a prominent finding of lung injury in patients affected by COVID-19. We describe the lung histopathological findings in fifteen cases of COVID-19 who died from the disease with the aim of reporting the microscopic changes in the lungs of patients dying from this disease.

Materials and Methods:
Lung tissues from fifteen consecutive autopsy cases of COVID-19 were studied for gross and microscopic features. The case history of the deaths was noted, and the information was analyzed. The lung damage seen was graded on a semiquantitative scale on the basis of the percentage of tissue involved.

Results:
Gross examination of the lungs showed multiple foci of consolidation mainly in the lower lobes of the lungs as the most commonly encountered finding. The other significant pattern was congested and edematous lungs with areas of consolidation. Microscopic assessment of lung sections showed 8 out of the 15 cases showing changes of the exudative phase of diffuse alveolar damage, whereas two cases were in the proliferative phase. Hyaline membranes were one of the common findings along with intra-alveolar edema and interstitial edema. Four cases showed changes in organizing phase. Other findings were microthrombi formation, fungal abscesses, dilated and collapsed alveoli, intra-alveolar hemorrhage, and acute neutrophilic pneumonia.

Conclusion:
DADand interstitial pneumonitis were the most striking features in our autopsy study. Features of different phases of diffuse alveolar damage were seen to coexist in the same patient indicating the temporal heterogeneity of the ongoing lung injury in these patients.
SPS(Kayexalate)/CPS(K-Bind) crystals in the gastrointestinal tract-An experience from a tertiary center
Authors: Ail Divya A. , Prakash Arjun , Damle Aditi , Karottue Swathi , Paulose Roopa R. 
Published: May 2024

Introduction:
Kayexalate (Sodium Polystyrene Sulfonate/SPS) and K-bind (Calcium Polystyrene Sulfonate/CPS) are cation exchange resins, commonly used for treatment of hyperkalaemia. SPS/CPS induced injury of the gastrointestinal tract(GIT) is rare, can be potentially life threatening but is under-recognized. This study aims to increase awareness of pathologists and clinicians of this under-reported complication of a drug commonly used to treat hyperkalaemia.

Materials:
Study population comprised patients with SPS/CPS (Kayexalate or its analogues) crystals identified in gastrointestinal specimens from 2017-2019 at a tertiary care centre. Clinical details, relevant investigations, imaging and endoscopic findings, patient follow up details were obtained from the hospital electronic information system.

Results:
A total of 10 patients with SPS/ CPS crystals in the GIT were encountered over 2 years. Male to female ratio was 9:1, with mean age 66.5years (range 52-82 years). Eight cases were mucosal biopsies and 2 were resection specimens. Additional pathology (tumours, colonic perforation) was present in 80% of patients. The characteristic morphological appearance of the CPS/SPS crystals on H&E stains were supported by special stains -Periodic acid Schiff(PAS) and Acid fast Bacilli(AFB). In all cases, the treatment history with SPS/CPS for hyperkalaemia was obtained only after the histological examination. Most common etiology of hyperkalaemia encountered was chronic kidney disease(CKD)/ Acute on chronic kidney disease.

Conclusion:
It is important for pathologists to recognise the presence of these crystals especially in small biopsies as early feedback to clinicians can help in appropriate management and avoidance of more serious adverse outcome. To the best of our knowledge, this is the first series of 10 consecutive cases of SPS/CPS crystals encountered in gastrointestinal tract to be reported from India.
Quest to develop a standard screening method for urothelial carcinoma using liquid-based cytology (The Paris System) and CK20
Authors: Jain Kavita , Datta Chhanda , Sengupta Moumita , Pal Dilip Kumar , Chatterjee Uttara 
Published: May 2024

ABSTRACT

Background:
Bladder cancer, the most common malignancy of the urinary tract is a leading cause of morbidity and mortality. But cystoscopy, which is till now the mainstay of screening, is an invasive, high-cost method with low sensitivity especially for flat lesions.

Aim:
To find a non-invasive and effective screening method with liquid-based cytology (LBC) using The Paris System (TPS) and CK20 immunocytochemistry.

Materials and Methods:
It was a prospective study including the patients with clinical or cystoscopic diagnosis of urinary bladder space occupying lesions (SOL). Both conventional (CC) and liquid-based cytology slides were prepared from urine samples. Slides were evaluated by two trained pathologists and categorized according to TPS guidelines. CK20 immunocytochemistry (ICC) was also performed. Consequent formalin-fixed paraffin embedded sections were blindly examined by another pathologist and was taken as gold standard for comparison.

Statistical Analysis:
All the statistical analysis were done using MedCalc version 15.8 [Mariakerke, Belgium: MedCalc Software 2015].

Results:
The study included 150 cases with a mean age of 62.4 years. Five cases revealed unsatisfactory smears. Rest of the cases were categorized as the following: 18.1% as NH-GUC, 8% as LGUN, 22.1% as AUC, 15.4% as SH-GUC, 32.9% as HGUC. Kappa value of CC and LBC were strong (0.854). LBC alone showed very low specificity (58%) and PPV (74.8%) which improved on application of ICC (specificity: 97.4%, PPV: 96.3%).

Conclusion:
We conclude that CK20 ICC offers potential for accurate, non-invasive detection and surveillance of bladder cancer and is a better tool when combined with liquid-based cytology, reported using The Paris System.
Malleus Relocation in Ossicular Reconstruction by Using Autologous Incus
Authors: Al Dhahli Zaina Khalfan , Naik Jagdish Zoivont , Al Saidi Yousuf 
Published: May 2024

Context:
Malleus relocation is a technique in ossiculoplasty invented by Robert Vincent to make malleus at the same line of stapes. This study will use this technique with modification by using autologous incus instead of prosthesis for reconstruction.

Aims:
The objective of this study was to report the method of malleus relocation with auto-incus in ossiculoplasty in cases with chronic suppurative otitis media.

Settings and Design:
A retrospective study was done at Al-Nahdha Hospital tertiary referral center.

Subjects and Methods:
This is a study of 12 patients (out of 150 patients who underwent ossiculoplasty surgery done in the department) from 2012 to 2019 for chronic otitis media. This means that all patients had malleus relocation technique with use incus for reconstruction except one patient where malleus relocation done with use of prosthesis instead of incus which was absent. Audiometric assessment included pre- and postoperative audiometric evaluation using conventional audiometry. Air-bone gap, bone-conduction thresholds, and air-conduction thresholds were measured.

Statistical Analysis Used:
Data were collected and analyzed in SPSS version 21. Confidence interval, mean, and median are used to calculate the pre- and postoperative ABG.

Results:
Eleven patients underwent malleus relocation with incus interposition. The mean postoperative air-bone gap is 11, and 66.6% of cases had ABG less than or equal to 20 dB. The mean AC postoperative is 21, and 66.7% of cases show improvement of more than 20 dB.

Conclusions:
Malleus relocation with auto-incus ossiculoplasty showed in this study is safe and gives a good hearing outcome.
Assessment of hearing loss in temporal bone fractures
Authors: Abhishek M. , Kaleeswaran Revathishree , Srinivasan K. 
Published: May 2024

Introduction:
Thirty percent to seventy percent of skull fractures in adult head trauma patients is due to temporal bone fractures and is caused due to road traffic accidents (RTAs). Temporal bone fractures are more commonly associated with hearing loss.

Objective:
The objective of this study is to assess the type and the amount of hearing loss in temporal bone fractures.

Methodology:
A 3-month retrospective study was conducted at the department of ear, nose, and throat in a tertiary care center. Fifty patients, diagnosed as cases of temporal bone fractures with hearing loss were included in the study. The patients with temporal bone fractures were categorized into two groups-otic-capsule sparing (OCS) and otic-capsule violating (OCV) fractures, and hearing loss was evaluated with Pure tone audiogram (PTA).

Results:
OCS fractures were more common (64%) than OCV. Conductive type of hearing loss was commonly associated with OCS, whereas sensorineural hearing loss was more common in OCV fractures. The average degree of hearing loss ranged from 20 to 68 db. The correlation was statistically significant for temporal bone fractures (OCS and OCV) with respect to hearing loss (P < 0.00001). Other complications such as external auditory canal filled with blood, perforation of tympanic membrane, and hemotympanum were also observed in our study.

Conclusion:
Temporal bone fractures are most commonly due to RTAs and are frequently associated with severe brain injury. Classifying temporal bone fractures as OCS and OCV fractures correlates well with the severity of hearing loss, and conductive hearing loss was the most common type hearing loss.
Association between Hearing Loss and Dementia in Elderly
Authors: Sinha Devika , Aroor Rajeshwary , Bhat Vadisha Srinivas , Saldanha Marina , Kamath P Srinath D , Kotian Shashank 
Published: May 2024

Background:
Long standing hearing-loss often leads to the setting in of dementia as hearing-loss. In this study, elderly population were screened for hearing-loss and dementia using Hindi-Mental State Examination.

Aims:
To know the association between the dementia and Hearing loss Method 206 participants in the age group of 60-80 years (110 were females and 96 were males) were subjected to audiological evaluation and dementia screening using HMSE dementia scoring scale and it was compared with hearing level.

Results:
Out of 206 subjects, 110 were females and 96 were males. Right ear hearing-loss was seen in 147 cases and left ear in 130 cases. 48 individuals had no hearing-loss, 39 participants had unilateral hearing-loss and 119 participants had bilateral hearing-loss. Most common type of hearing-loss observed was mild hearing-loss 124 participants had no dementia, 82 had dementia. 60 had mild cognitive impairment and 22 had severe cognitive impairment. 49 out of 82 participants with dementia had bilateral hearing-loss. As the hearing handicap percentage increases from 1-100, dementia score decreases. But it was not statistically significant. More number of men were affected with hearing-loss but more number of female participants had dementia.

Conclusion:
Hearing-loss is more common in men in elderly population but dementia is more commonly seen in females.
Determination and comparison of antimicrobial activity of aqueous and ethanolic extracts of Amorphophallus paeoniifolius on periodontal pathogens: An in vitro study
Authors: Nayak Aarati , Sowmya B. R. , Gandla Harish , Kottrashetti Vijaylakshmi , Ingalagi Preeti , Srinivas V. Sai Chandini 
Published: May 2024

Abstract

Background:
People globally are turning to herbal products to reconnect with nature. Cost efficacy and minimal side effects are the reasons for this changeover. This study assessed the effect of Amorphophallus paeoniifolius as an antimicrobial agent against Porphyromonas gingivalis, Prevotella intermedia, and Fusobacterium nucleatum.

Aim:
To determine and compare the antimicrobial activity of aqueous and ethanolic extracts of A. paeoniifolius on periodontal pathogens.

Materials and Methods:
Aqueous and ethanolic extracts of A. paeoniifolius were tested against the standard strains of the selected bacteria. Minimum inhibitory concentrations (MIC) and minimum bactericidal concentration (MBC) were used. These tests assessed the lowest concentrations of test agent, either by showing a lack of turbidity or by no or few bacterial growth colonies, respectively. In this study, tetracycline hydrochloride was used as the control group.

Results:
Aqueous and ethanolic extracts of A. paeoniifolius showed antibacterial activity at various concentrations against the selected organisms. While assessing the MBC, the aqueous and ethanolic extracts of A. paeoniifolius and tetracycline hydrochloride exhibited bactericidal activity against F. nucleatum at all concentrations. The ethanolic extract of Amorphophallus paeoniifolius and tetracycline hydrochloride showed bactericidal action, whereas the aqueous extract exhibited bacteriostatic action against P. gingivalis. The aqueous and ethanolic extracts of A. paeoniifolius showed bacteriostatic action, whereas tetracycline hydrochloride showed bactericidal action against P. intermedia.

Conclusion:
Both aqueous and ethanolic extracts of A. paeoniifolius showed antibacterial activity against standard strains of P. gingivalis, P. intermedia, and F. nucleatum. The ethanolic extract showed a significant antibacterial effect against the selected microorganisms when compared to the aqueous extract of A. paeoniifolius.