bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immune Complexes and Complement in Serum and Synovial Fluid of Rheumatoid Arthritis Patients
Authors: Mijušković Zoran , Rackov Ljiljana , Pejović Janko , Živanović Sandra , Stojanović Jelica , Kovačević Zoran 
Published: October 2009

Immune Complexes and Complement in Serum and Synovial Fluid of Rheumatoid Arthritis PatientsRheumatoid arthritis (RA) is predominantly an intraarticular inflammatory and autoimmune disease that involves different autoantibodies and effector mechanisms. The aim of the study was to determine the utility of Circulating Immune Complexes (CIC) and complement components (C3c, C4) as possible markers for the disease activity in laboratory diagnostics. In a cross-section study 59 patients, according to the clinical criteria, were categorized into two groups: group with moderate (MA, n=24), and group with severe activity (SA, n=35) of RA. The concentration of CIC, C3c and C4 in sera (S) and synovial fluids (SF) was examined by an immunonephelometric method in both groups and compared with values in the control group (n=15) of patients with lesions of the menisci. Obtained results showed that there was no statistical significance in the values of C3c and C4, in both biological fluids, among all tested groups. Significant differences were found in the levels of CIC in both fluids, while testing the parameters (× ± SD, IU/mL) in the sera of groups with SA and MA of RA: 7.43 ± 13.40; 3.01 ± 2.92 (p<0.05) and SF: 13.47 ± 21.1, 5.33 ± 7.53 (p<0.001), respectively. These differences were higher between the group with SA and CG. Results for the concentrations of CIC were significantly higher in SF compared to sera: in the RA group with SA by 77% and group with MA by about 82%. These data could provide a confirmation of the hypothesis about local, intraarticular autoantibodies and subsequent CIC production. It can be concluded that the examination of CIC concentration in serum, and where it is possible in SF, is a useful marker of disease activity in RA patients, in contrast to the tested components of the complement. This statement does not exclude their consumption within immune effector mechanisms, but elicits the possibility that lower molecular fragments (C3d, C4d), as well as the novel activation products, could be better disease activity markers in RA patients.
Significance of Serum Lactate Dehydrogenase and its Isoenzymes During Post-Burn Follow-Up
Authors: Ahmad Riaz , Nazam Nazia , Khan Arshad , Alam Mumtaz 
Published: October 2009

Significance of Serum Lactate Dehydrogenase and its Isoenzymes During Post-Burn Follow-UpThe present study aims to evaluate the role of lactate dehydrogenase (LDH) isoenzymes in thermal burns. A total of 18 patients of both genders with 20 to 50% total burn surface area (TBSA), admitted to the Burn Ward of JN Medical College and Hospital was assessed. These patients were subjected to general and systemic examinations. The sera collected at day 1, 2, 5 and 10 during follow-up of burn patients were used for LDH quantitation. PAGE profiles showed significant differences in the levels of LDH isoenzymes in all the burn subjects (P=0.05). Software analysis of gel-scans showed the presence of five isoenzyme bands of which LDH-1 and -2 are the least contributors. During follow-up, it was observed that the ranking of LDH isoenzymes approaches control values at day 2 in 20% TBSA patients, while in the remaining cases it occurs at day 5. 3D-densitograms indicated high activity of LDH in 50% of TBSA patients even at day 10; however, the relative ranking of these isoenzymes was similar to control values (LDH-4>- 5>-3>-1>-2). We were of the opinion that the high activity of LDH enzyme is due to the enzyme-immunoglobulin-G (LDH-IgG) complex, but surprisingly we did not observe this complex in 50% of burn patients at any of the durations. Therefore, it is suggested that LDH isoenzymes play a role in the pathophysiology of the disease and can be an asset to ascertain the invisible tissue damage. Moreover, the high activity of LDH in 50% of burns is due to some unknown mechanism and not due to the binding of LDH with IgG.
A Study of FNAC of Cervical Lymph Nodes
Authors: Shakya G , Malla S , Shakya KN , Shrestha R 
Published: October 2009

Background: Fine Needle Aspiration Cytology (FNAC) is a reliable and least expensive method suitable for developing countries like Nepal for the investigation of lymphadenopathy. Knowledge about the pattern of lymphadenopathy is useful in pathological reporting as well as in many clinical settings with diagnostic dilemma. This is a baseline study to investigate the pattern of cervical lymphadenopathy by lymph node FNAC in Nepalese population. Methods: A retrospective study was conducted by critically analyzing the case reports on cervical lymph node FNAC from three years' records (July 2005 to June 2008) at the National Public Health Laboratory, Teku, Kathmandu. Review of all cytological reports were done according to standard guidelines and the diagnosis was classified and correlated with patients' age and ethnicity to explore the pattern and association. Results: Of 508 cervical lymph node FNAC cases, 50.4% was reactive non-specific, 22.4% was tubercular, 4.8 % malignant, 10% chronic granulomatous and the remaining was acute suppurative (12.4%). Highest incidence of malignancy was seen in the fifth decade (50%). Whereas, tubercular lymphadenopathy was found with increasing frequency through childhood (10.5%) and adolescence (21.7%) to young adulthood (30.4%), probably indicative of waning immunity of BCG vaccination. Ethnic groups comprising of Tamang, Sherpa and Bhote had the highest incidence of malignant as well as tubercular lymphadenopathy. Conclusion: The relationship of malignant and tubercular lymphadenopthy with age and ethnicity deserves further study. Efforts at preventing tubercular and early diagnosing malignant lymphadenopathy and reducing morbidity in general will find great usefulness in such associations. Key words: Cervical Lymphadenopathy, Fine Needle Aspiration Cytology, Pattern DOI: 10.3126/jnhrc.v7i1.2267 Journal of Nepal Health Research Council Vol. 7, No. 1, 2009 April 1-5
Clinical and Demographic Profile of Patients Receiving ECT in an Institute
Authors: Sherchan S , Joshi D 
Published: October 2009

Background: Despite being an effective and safe treatment for severe psychiatric disorders, the use of electroconvulsive therapy (ECT) in different countries and different institutions has been uneven. More-over, in developed countries its use has clearly shown a declining trend. Methods: This retrospective study using ECT case record book has sought to find out the clinical and demographic profile of patients receiving ECT at the Mental Hospital in Lagankhel, Lalitpur and also to determine the trend of its use in last 10 years. Two ECT case record books which covered the time period from 1999 to 2008 were studied. Retrospective data necessary for this study was collected from those records. Results: The total number of ECT received in the year 1999 was 902 while it was 242 in the year 2008. The number of patients receiving ECT in the year 2008 was 44 patients with the diagnosis of acute psychosis and schizophrenia while only 20 patients with the diagnosis of affective disorder (mania and depression) out of total 64 patients. Conclusion: The study showed declining trend of the use of ECT in the state Mental Hospital as in developed countries but in contrast to affective disorder, acute psychosis and schizophrenia were the predominant clinical conditions where ECT was used. Key words: Direct/Unmodified, Electroconvulsive Therapy, Psychiatric disorders, Psychotropic medications DOI: 10.3126/jnhrc.v7i1.2272 Journal of Nepal Health Research Council Vol. 7, No. 1, 2009 April 10-13
Pregnancy Outcome of Single Previous cesarean Section
Authors: Jha M 
Published: October 2009

Background: The main aim of this study is to determine the maternal and fetal outcome of pregnancy among women with one previous caesarean section at term in relation to vaginal delivery, post partum complication, neonatal complication like low Apgar score, fetal weight and admission in special baby unit. Methods: This is a prospective and descriptive study done in a sample size of 100. Inclusion criteria were term pregnancy, single live fetus with cephalic presentation with one previous caesarean section. During study period total number of obstetric admissions was 3546 and 115 cases were admitted with previous one caesarean section. Result: Out of 100 cases, 31 cases had vaginal delivery and 69 cases had caesarean section. Among 31 vaginal deliveries, 24 cases had spontaneous vaginal delivery and 7 had assisted delivery with vacuum, main indication of vacuum delivery was to cut short the second stage of labor that was in 5(71.43%) cases. Among 69 caesarean section cases, 51 had emergency caesarean section and 18 had elective caesarean section and cephalopelvic disproportion was the main indication in both the groups. Most common complication was scar dehiscence and postpartum hemorrhage. There were two still births in each group and one minute APGAR score was slightly better in caesarean section. Conclusions: Patients with previous caesarean section are at high risk of repeat emergency or elective caesarean section. About one in three patients with previous caesarean section delivered vaginally. In the present study postpartum hemorrhage was the commonest complication, which was found in caesarean section, and only one puerperal pyrexia was seen in case of vaginal delivery. Key words: Cephalopelvic disproportion, Premature rupture of membrane, Septicemia, Vacuum delivery DOI: 10.3126/jnhrc.v7i1.2275 Journal of Nepal Health Research Council Vol. 7, No. 1, 2009 April 25-28
Laparoscopic Evaluation of Chronic Pelvic Pain in Women
Authors: Chhetri S , Khanna S , Poonam A , Sen B 
Published: October 2009

Background: Chronic pelvic pain is a common and significant disorder of women. Often the etiology of chronic pelvic pain is not clear. Methods: A descriptive hospital based study was done which included 55 women with chronic pelvic pain of more than six months duration. Ultrasonography and diagnostic laparoscopy were performed in all patients. These patients also had a psychological assessment with the SRQ (Self Reporting Questionnaire). The various causes of pelvic pain were assessed. Result: The mean age of women presenting with chronic pelvic pain was 37.1 ± 2.3 years. Ultrasonography detected abnormality in only 21 (38.2%) patients. The most common pathology detected was ovarian cysts in seven patients. Diagnostic laparoscopy was able to detect pathology in 45 (81.8%) patients. Pelvic adhesions was the most common cause of chronic pelvic pain which was present in 16 (29%) of the women, followed by PID (pelvic inflammatory disease) in seven (12.7%), endometriosis in five (9.1%), pelvic congestion in four (7.2%), pelvic tuberculosis in four (7.2%), fibroid uterus in four (7.2%), ovarian cysts in four (7.2%) and parafimbrial cyst in one patient. No abnormality on laparoscopy was detected in 10 (18.2%) patients. When evaluated for associated psychological illness it was detected in 24 (43.6%) patients. Results: Chronic pelvic pain is a common problem and presents a major challenge to health care providers because of its unclear etiology, complex natural history, and poor response to therapy. Diagnostic laparoscopy is thus an important tool in the evaluation of women with chronic pelvic pain. Key words: chronic pelvic pain, laparoscopy, ultrasonography. DOI: 10.3126/jnhrc.v7i1.2279 Journal of Nepal Health Research Council Vol. 7, No. 1, 2009 April 45-48
Hymenolepis dimunata Infection in a Child of 14 month
Authors: Thakur NK , Mishra SK , Neupane GP , Jha A 
Published: October 2009

We report a case, a 14 month old male child who presented with fever and diarrhea for a month. It was diagnosed as a case of H dimunata infection, which is a sole parasite of rat. Very few cases of such infection have been reported in Nepal. The treatment is done with either Niclosamide or Praziquantel, but the main concern is about the diagnosis of the condition. Since, H dimunata is a sole rat parasite, it is hardly ever thought about a cause of the diarrhea. Key words: Diarrhea, H dimunata, Niclosamide DOI: 10.3126/jnhrc.v7i1.2294 Journal of Nepal Health Research Council Vol. 7, No. 1, 2009 April 49-51
Adjustable shunt valve–induced magnetic resonance imaging artifact: a comparative study
Authors: Toma Ahmed K. , Tarnaris Andrew , Grieve Joan P. , Watkins Laurence D. , Kitchen Neil D. 
Published: October 2009

Object
In this paper, the authors' goal was to compare the artifact induced by implanted (in vivo) adjustable shunt valves in spin echo, diffusion weighted (DW), and gradient echo MR imaging pulse sequences.

Methods
The MR images obtained in 8 patients with proGAV and 6 patients with Strata II adjustable shunt valves were assessed for artifact areas in different planes as well as the total volume for different pulse sequences.

Results
Artifacts induced by the Strata II valve were significantly larger than those induced by proGAV valve in spin echo MR imaging pulse sequence (29,761 vs 2450 mm3 on T2-weighted fast spin echo, p = 0.003) and DW images (100,138 vs 38,955 mm3, p = 0.025). Artifacts were more marked on DW MR images than on spin echo pulse sequencse for both valve types.

Conclusions
Adjustable valve–induced artifacts can conceal brain pathology on MR images. This should influence the choice of valve implantation site and the type of valve used. The effect of artifacts on DW images should be highlighted pending the development of less MR imaging artifact–inducing adjustable shunt valves.
Capillary telangiectasias: clinical, radiographic, and histopathological features
Authors: Sayama Christina M. , Osborn Anne G. , Chin Steven S. , Couldwell William T. 
Published: October 2009

Object
Brain capillary telangiectasias (BCTs) are small, clinically benign, angiographically occult lesions that are usually incidental findings. Large capillary telangiectasias have not been reported previously as most BCTs are very small. Symptomatic BCTs are also rare, with few reports in the literature. The authors review the clinical manifestations, imaging, and histopathological characteristics of BCTs to further elucidate the diagnostic and clinical features of these vascular malformations.

Methods
The authors completed a retrospective radiological review of all cases of BCTs in the neuroradiology database at the University of Utah involving patients treated between January 1993 and December 2007. The MR imaging scans were reviewed, and the BCT was measured in 2 dimensions. They arbitrarily chose > 1 cm to define a large BCT as a majority of these lesions were smaller than that. The medical chart and the electronic database were used to gather each patient's clinical information.

Results
One hundred thirty patients were identified in the archived neuroradiology database of capillary telangiectasias. Cases involving 105 patients with definite capillary telangiectasias were reviewed, and from these, 7 patients were identified to have a large capillary telangiectasia measuring > 1 cm. Upon further review, 2 of these patients were identified as having symptoms likely related to their capillary telangiectasia. These 2 cases are reported in the article. No patients with smaller BCTs were found to have symptoms related to their lesion.

Conclusions
Brain capillary telangiectasias are small vascular malformations that rarely cause symptoms. They are often overlooked on imaging because of their clinically benign nature; however, they have been misdiagnosed as glial tumors in the past. Specific MR imaging sequences (T1-weighted postcontrast and gradient refocused echo) are valuable in aiding diagnosis, as histopathological diagnosis is often not possible. These cases highlight that BCTs can cause symptoms, a finding that may actually be related to the size of the lesion (28.6% of large BCTs in this series were symptomatic, whereas none of the small ones were).
Content and Criterion Validity of the Preliminary Core Dataset for Clinical Trials in Fibromyalgia Syndrome
Authors: CHOY ERNEST H. , ARNOLD LESLEY M. , CLAUW DANIEL J. , CROFFORD LESLIE J. , GLASS JENNIFER M. , SIMON LEE S. , MARTIN SUSAN A. , STRAND C. VIBEKE , WILLIAMS DAVID A. , MEASE PHILIP J. 
Published: October 2009

Objective.Increasing research interest and emerging new therapies for treatment of fibromyalgia (FM) have led to a need to develop a consensus on a core set of outcome measures that should be assessed and reported in all clinical trials, to facilitate interpretation of the data and understanding of the disease. This aligns with the key objective of the Outcome Measures in Rheumatology (OMERACT) initiative to improve outcome measurement through a data driven, interactive consensus process.Methods.Through patient focus groups and Delphi processes, working groups at previous OMERACT meetings identified potential domains to be included in the core data set. A systematic review has shown that instruments measuring these domains are available and are at least moderately sensitive to change. Most instruments have been validated in multiple languages. This pooled analysis study aims to develop the core data set by analyzing data from 10 randomized controlled trials (RCT) in FM.Results.Results from this study provide support for the inclusion of the following in the core data set: pain, tenderness, fatigue, sleep, patient global assessment, and multidimensional function/health related quality of life. Construct validity was demonstrated with outcome instruments showing convergent and divergent validity. Content and criterion validity were confirmed by multivariate analysis showing R square values between 0.4 and 0.6. Low R square value is associated with studies in which one or more domains were not assessed.Conclusion.The core data set was supported by high consensus among attendees at OMERACT 9. Establishing an international standard for RCT in FM should facilitate future metaanalyses and indirect comparisons.
Persistent Subepithelial Haze in Thin-flap LASIK
Authors: Hafezi Farhad , Seiler Theo 
Published: October 2009

PURPOSE:To report persistent subepithelial haze in two patients following femtosecond LASIK associated with creation of a thin flap.METHODS:Subepithelial haze was assessed by slit-lamp photography, high-resolution Scheimpflug imaging, and corneal confocal microscopy.RESULTS:Two patients showed distinct subepithelial haze and reduced corrected distance visual acuity at 3 months after LASIK with a thin-flap generated by a femtosecond laser. The extent of haze was documented, and haze was treated topically with steroids for up to 12 weeks. The haze was localized approximately 20 to 40µm below Bowman's layer and dissolved slowly during the 3 months of treatment. At 6 months after surgery, uncorrected visual acuity was 20/20.CONCLUSIONS:Subepithelial haze formation represents a new potential complication in thin-flap LASIK. [J Refract Surg.2010;26:222–225.]
Changing pattern of bronchogenic carcinoma : A statistical variation or a reality?
Authors: Shetty CM , Lakhkar BN , Gangadhar VSS , Ramachandran NR 
Published: October 2009

AbstractOBJECTIVES:
To document the various CT appearances of bronchogenic carcinoma with histopathologic correlation, to identify changing trend in the radiographic pattern of bronchogenic carcinoma, if any and to evaluate the role of CT in staging of bronchogenic carcinoma was also evaluated.
MATERIALS AND METHODS
A prospective study of 81 patients over a period of 2 yrs with clinical and or radiological suspicion of bronchogenic carcinoma and confirmed histopathogical diagnosis was undertaken with CT of the thorax using 10 mm collimation sections from the level of lung apices to the diaphragm and routinely included the adrenals.
RESULTS :
Squamous cell carcinoma is the most common histologic subtype followed by adenocarcinoma and small cell carcinoma. There was a definite male preponderance with smoking being the most common risk factor. Adenocarcinoma is presenting predominantly as central tumor( 70.5% ) Squamous cell carcinoma is presenting predominantly as peripheral tumor (52.7% ) .
CONCLUSION
Computed tomography is the modality of choice for evaluating bronchogenic carcinoma because of its better spatial resolution. CT provides precise characterization of the size, contour, extent and tissue composition of the suspicious lesion. If the lesion represents a bronchogenic carcinoma, CT serves as a part of the staging process to assess the extent of the disease. The radiologic presentation of adenocarcinoma and squamous cell carcinoma is showing a changing pattern. In our study, adenocarcinoma is presenting predominantly as a central tumor and Squamous cell carcinoma is presenting predominantly as a peripheral tumor. This relative increase in the percentage of centrally located adenocarcinoma is a statistical variation or a reality needs to be evaluated further.
Doppler findings In castleman disease - A rare case
Authors: Raniga S , Shah C , Shrivastava A , Amin P , Patel P 
Published: October 2009

Abstract
Castleman′s disease is a rare, benign disease of unknown cause that induces reactive lymph node hyperplasia. It has two histologic subtypes: hyaline vascular and plasma cellular. A definitive diagnosis necessitates tissue biopsy. A specimen may be even misdiagnosed as lymphoma in frozen section. Surgery is the treatment of choice for the solitary form, whereas chemotherapy, radiotherapy, and steroids are proposed for the multicentric type. When this condition affects the neck, it usually presents as a solitary neck mass. Multiple neck masses are an uncommon presentation of Castleman disease affecting the neck. Most Castleman′s disease lesions appear as nonspecific, well-defined hypoechoic masses on sonography. Sonography remains useful for the evaluation of cervical and axillary Castleman′s diseases, in which the depiction of prominent peripheral vessels and penetrating feeding vessels on Doppler sonograms can suggest the diagnosis of this uncommon disease. Castleman′s disease of the neck on CT and MRI scan has been described as well-circumscribed homogeneous mass lesion with moderate to intense enhancement.
"Osteomyelitis of mandible"-a rare presentation of osteopetrosis
Authors: Ahmad I , Abbas S Z , Haque F , Rashid M , Ahmad S A 
Published: October 2009

AbstractOsteopetrosis is a rare metabolic disease. Dental abnormalities may be attributed to the pathological changes in osteopetrosis. Patients with disease seem to be especially susceptible to osteomyelitis of mandible. A 9 yrs old girl presented with complaints of jaw swelling on left side with multiple discharging sinuses since last seven months. The radiograph of left mandible (oblique lateral view) showed periodontal involvement of associated molars with loss of lamina dura with small sequestrum with irregularity and erosions of the mandibular cortical margins. The patient was diagnosed as a case of osteopetrosis with superadded mandibular osteomyelitis.