bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multilocular cystic renal oncocytoma—Awareness of an unusual morphologic variation
Authors: Jagdale Rakhi V. , Pol Jaydeep N. 
Published: May 2024

Background:
Renal oncocytomas are benign epithelial tumors usually detected incidentally. They are typically solid, well-circumscribed, homogenous, mahoganybrown with a central stellate scar. Sometimes, they can have cystic degenerationand rarely present as a multilocular cyst which can be mistaken for other cystic renal carcinomas.

Methods:
We describe a case of incidentally detected multilocular cystic renal oncocytoma having an unusual gross appearance of multiloculation with perinephric fat invasion. The tumor exhibited tubulocystic architecture posed a diagnostic dilemma. Detailed study of multiple sections coupled with immunohisto chemistry helped elucidate the diagnosis. Till date, only eight cases of multicystic renal oncocytoma have been reported in the English literature.

Conclusions:
We emphasize the importance of awareness of this unusual morphologic variation to ensure correct diagnosis.
COVID-19-associated mucormycosis – ”The Black fungus” with associated invasive aspergillosis and actinomycosis infection: Series of 5 cases in the Indian scenario
Authors: Menia Reetika , Raychaudhuri Sujata , Agarwal Charu , Taneja Juhi 
Published: May 2024

ABSTRACTCOVID-19 caused by SARS-CoV-2 has been studied and reported widely since November 2019, after its first case was detected in Wuhan, China. It has proven to be a fatal disease worldwide. COVID-19 causes severe disease in patients with immunosuppression and has always been associated with high mortality in such patients. Immunocompromised patients are always at a higher risk of getting co-infections too, and the same is true with COVID-19. It predisposes to the development of many fungal infections of which, mucormycosis is one of the most common ones, especially in the Indian population where a large group of the population is predisposed to diabetes mellitus. India has the world’s largest population of diabetic patients; therefore, the prevalence of COVID-19-associated mucormycosis (CAM) is also the highest in India. Also, the use of corticosteroids over a long duration of time predisposes the patients to the development of mucormycosis owing to immunosuppression. Hypoxia, low total leukocyte count, and high ferritin are the other predisposing factors that lead to the growth of mucormycosis associated with COVID-19. Here, we present five cases within a span of 2 months, of mucormycosis-associated COVID-19 with mixed infections of aspergillosis and actinomycetes. Four cases had mucormycosis with aspergillosis and one with mucormycosis with Actinomyces. Three patients recovered fully after being treated with intravenous amphotericin B; however, unfortunately, two of our patients could not be saved.
The effect of different diagnostic timings and types of placenta accreta on the pregnancy outcome
Authors: Xu Rongli , Cai Lihong , Xu Shuxia , Yan Jianying 
Published: May 2024

Objectives:
To explore the effects of maternal and fetal outcomes after different diagnostic timings of placenta accreta and its types.

Methods:
We retrospectively collected the clinical information of 1178 pregnant women with placenta accreta in Fujian Maternity and Children Health Hospital from January 2012 to January 2017. According to the different diagnostic timings of placenta accreta, they were divided into groups of prenatal diagnosis and postpartum diagnosis; and according to the types of placenta accreta, they were divided into groups of accreta group, increta group, and percreta group.

Results:
1. Women with antenatal diagnosis more often had placenta previa and history of previous cesarean section. 2. Women with antenatal diagnosis had a higher rate in blood loss and blood transfusion. 3. The rate of blood loss, blood transfusion, infection, disseminated intravascular coagulation (DIC), secondary laparotomy, hysterectomy had statistically significant differences (P < 0.05) in different types of placenta accreta. The deeper of placenta accreta, the higher the incidence of complications.

Conclusion:
It is important to pay attention for risk factors of the placenta accreta, then improve prenatal diagnostic rate of the placenta accreta and its types, which can forecast the severity of illness to improve maternal and fetal outcomes.
Affiliation and essence of SARS CoV2 (COVID-19) on blood parameters of infected patients
Authors: Karuna Veer , Vivek Vir , Verma Nidhi , Singh Ravinder 
Published: May 2024

Background:
Till date, SARS CoV2 (COVID-19) is a pandemic viral infection in the world with the main and strong impact on respiratory airway, but this virus can affect any system of the human body.

Aims:
This research is aimed to dictating the effect of SARS CoV2 infections on hematological, biochemical, and arterial blood gas parameters by using their mean values.

Settings and Design:
This retrospective study was included a total no. of 97 SARS CoV2 positive patients from 27 March to 15 May 2020. All positive patients were consented and took all the significant details.

Materials and Methods:
We review the total 97 COVID-19 positive patients after obtaining all the hematological and other relevant clinical data from laboratory and medical records. The subjects were tabulated into three categories named; admitted (Gp A), discharged (Gp B), and expired (Gp C) patients and compared their hematological, biochemical parameters, and arterial blood gas analysis by using blood or serum and processed by proper methods.

Statistical Analysis:
The data was cleaned, edited, checked for completeness, and processed then entered in SPSS version 20 statistical software.

Results:
Blood samples were collected of all positive patients. Most of the patients had X-ray changes. Blood parameters showed that patients who were expired (Gp-C) suffered from anemia, lymphopenia, leucoytosis, neutrophilia, and thrombocytopenia with high ALT, pCO2 and low pO2 than admitted and expelled patients.

Conclusions:
Result from this study provides that WBC count, absolute lymphocyte count, neutrophil count, and pO2 were independently associated and an important forecaster of mortality from SARS CoV2. All healthcare provides to regularly monitor above parameters indicators of COVID-19 infected patients to improve their quality of life and to reduce the risk of mortality rate.
Comparison of pathological response of standard chemoradiotherapy versus short course radiotherapy in rectal carcinoma: A pilot study
Authors: Nagarjun Bangalore Rammohan , Shah Ashini , Gami Amisha , Gandhi Jahnavi , Parikh Ankita , Modi Viraj 
Published: May 2024

ABSTRACT

Introduction:
Neoadjuvant chemoradiation (CRT) is standard of care for locally advanced rectal cancer. However short course radiotherapy (SCRT) was developed for the benefit of a shorter treatment duration and early surgical intervention which also helped in reducing the case burden to the hospital. SCRT is routinely practised in European countries, Indian experience with the SCRT is limited and hence a pilot study was conducted to compare the morphological difference and pathological response between SCRT and CRT.

Objectives:
A) Evaluate the morphological changes and pathological response between SCRT and CRT. B) Compare the pathologic response with outcome between SCRT and CRT. Materials and Methods: All rectal cancer patients in clinical stage II and III diagnosed during 2016 to 2020, who underwent SCRT or CRT were selected. Altered histopathologic findings due to therapy such as tumor cell morphology, necrosis and stromal response along with pathological response between the study groups were compared along with the outcome.
Results: Ten (12.6%) patients were subjected to SCRT and 69 (87.4%) patients underwent CRT. Morphological changes such as necrosis was noted in nine (90%) and eight (11.5%) cases in SCRT and CRT group respectively. Pathologic complete response (pCR) was noted in 12 (17.5%) cases of CRT only. Near complete response was seen in one (10%) and 14 (20.5%) cases of SCRT and CRT respectively. Despite lower rates of pCR in SCRT, no difference in survival or outcome was noted between the two study groups.

Conclusion:
pCR as expected is less in patients who received SCRT, despite this the outcome during follow up was similar in both the groups. Indian data is very limited and large multi-centre studies should be carried as SCRT offers an advantage of early definitive surgical intervention in addition to shorter duration of hospitalisation when compared with CRT.
Isolation and morphology of circulating tumor cells by cell block technique in breast cancer
Authors: Agrawal Nandini , Punia Rajpal S. , Handa Uma , Attri Ashok K. 
Published: May 2024

Background:
Circulating tumor cells (CTCs) are cells present in the blood stream that are antigenically or genetically similar to a specific tumor type and are markers of tumor diagnosis, prognosis, residual disease and metastasis. The ever-increasing burden of breast cancer globally warrants the incorporation of this all-inclusive marker in the diagnostic repertoire using the simplest of techniques.

Aims:
To identify CTCs in peripheral blood by cell block (CB) technique in cases of breast cancer diagnosed on fine-needle aspiration (FNA) or core needle biopsy (CNB) and to correlate their presence with nodal metastasis.

Material and Methods:
This study was conducted in the Department of Pathology, at a tertiary care hospital. Peripheral blood samples from a total of 30 cases of primary breast carcinoma diagnosed on FNA or CNB without prior neoadjuvant chemotherapy were analyzed using the CB technique.

Results:
The age ranged between 29-74 years with the most common presenting complaint being a palpable, single, unilateral breast lump. CTCs were detected in 2 (6.7%) cases with a <5 cell cluster with both the cases being grade I breast carcinomas and also displaying nodal metastasis.
Chromophobe renal cell carcinoma with massive sarcomatoid differentiation
Authors: Neagu Anca-Iulia , Neagu Marius , Stefanopol Ioana Anca , Nechita Aurel 
Published: May 2024

ABSTRACT
Chromophobe renal cell carcinoma (CRCC) is a distinct subtype of renal cell carcinoma with unique histological, immunohistochemical, cytogenetic, and ultrastructural features, which usually has a favorable clinical course, with only a small percentage of patients developing recurrence, metastasis, or death due to its complications. Sarcomatoid differentiation can occur in any subtype of renal cell carcinoma and currently represents the transformation into a higher degree of malignancy, its presence being associated with a reserved prognosis, with a reported incidence of average survival of less than 1 year after diagnosis. In this study, we present an unusual case of CRCC with massive sarcomatoid differentiation, which infiltrated the left adrenal gland and was surgically resected. The histological features of this tumor as well as a brief review of literature are presented.
Fibroblast growth factor receptor 1 protein (FGFR1) as potential prognostic and predictive marker in patients with luminal B breast cancers overexpressing human epidermal receptor 2 protein (HER2)
Authors: Amina Belhadj , Lynda Addou Klouche , Sonia Seddiki , Adel Belhadj , Jelloul Benammar H. , Miloud Medjamia , Tewfik Sahraoui 
Published: May 2024

Context:
Breast cancer is the most common cause of cancer mortality among women worldwide. It is a heterogeneous disease partly responsible for treatment failure in luminal B patients. Deregulation of fibroblast growth factor signaling has been found and its therapeutic/prognostic value is explored.

Aims:
Most of the research has studied the FGFR1 gene while our study explored its protein expression by immunohistochemestry and examined the association with clinicopathological features, different molecular subtypes and survival.

Subjects and Methods:
Formalin-fixed and paraffin-embedded samples of invasive breast carcinomas were used to analyze FGFR1 expression. FGFR 1 was scored by percentage and intensity of cell cytoplasm staining, correlations were investigated and survival curves were constructed.

Statistical Analysis Used:
Chi-square test was used to assess the relationship between the marker expression and the clinicopathological characteristics. Overall specific survival curves were estimated using the Kaplan-Meier method and statistical significance was assessed using the log-rank test.

Results:
FGFR1 was associated at different staining threshold cut-offs with tumor size (P = 0.002), infiltrating lymph node (P = 0.022), distant metastasis (P = 0.003), positive estrogen receptor (P = 0.000), HER2 overexpression (P = 0.044) and luminal phenotypes (P = 0.026). The results also emphasize FGFR1 correlation expression with distant metastasis in luminal B tumors (P = 0.035) but not with luminal A and with overexpressed HER2 protein in both luminal tumors. FGFR1 expression affect luminal B patients survival with poor outcome.

Conclusions:
FGFR1 expression may serve as a prognostic and predictive factor in luminal breast cancers, it can also be considered as a potential therapeutic target in luminal B cases.
Prognostic implications of CD-57 expression in oral squamous cell carcinoma cases
Authors: Kumar Santosh , Chandra Akhilesh , Agrawal Rahul , Singh Priyanka , Pallavi Meetu 
Published: May 2024

ABSTRACT
Natural killer (NK) cells are one of the most important effector T -lymphocytes having antitumor effect. Only a few studies are present in the literature, correlating the expression of cluster of differentiation 57 (CD-57) in NK cells in oral squamous cell carcinoma (OSCC). To analyze the effect of the presence of NK cells in the stroma of OSCC and their effect on the tumor progression and prognosis. A retrospective study was performed over 122 OSCC patients who had undergone surgical treatment between 2014 and 16. Wax blocks were obtained and subjected to immunohistochemical (IHC) analysis for CD-57 expression. Patients were followed up for 3 years and 100 cases were finally included in the study and divided into three groups. The association between variable were studied through the Chi-square test, Kruskal–Wallis test, and Mann–Whitney U test. A total of 91% of cases showed positive staining for CD-57. Maximum positive expression (96.6%) was observed in the patients who were alive and without recurrence (Group-II) as compared to dead patients (Group-I) and in well-differentiated squamous cell carcinoma (WDSCC) cases (96.8%) than in poorly differentiated cases. Also, the mean CD-57 positive cells count was found to be highest in Group-II and WDSCC cases. A significant correlation was observed between CD-57 expression and patients’ health status. As the expression of CD-57 increased in the tumor stroma of OSCC, the chances for the patient to be alive were increased; therefore, it may serve as a good prognostic marker.
Type 1 Tympanoplasty with and Without Mastoidectomy in Children
Authors: De Almeida Gustavo Antunes , Correia Filipe , Pimentel João , Escada Pedro 
Published: May 2024

Objective:
Assessment of the surgical benefit in children of a canal wall up mastoidectomy with Tos Type 1 tympanoplasty over Tos Type 1 tympanoplasty alone in patients with chronic suppurative otitis media (CSupOM) with tympanic membrane (TM) perforation.

Study Design:
Retrospective study.

Setting:
Tertiary care hospital.

Methods:
A retrospective chart review of CSupOM patients younger than 18-years old and admitted for elective tympanoplasty between 2010 and 2013 was conducted. Primary cases of patients submitted to Type 1 tympanoplasty (according to Tos classification 1993) were selected and were divided into two groups: tympanoplasty with canal wall up mastoidectomy and tympanoplasty without mastoidectomy. Surgical success was defined as the presence of an intact TM with no disease recurrence after 2 years of follow-up.

Results:
From a total of 125 ears (88 pediatric patients), 59 were selected according to the inclusion criteria. The mean age of the patients was 12.5 years, with 5.1% being 7 years old or younger, 67.8% between the ages of 8 and 14 years old, and 27.1% from 15 to 18 years old. 67.8% of the patients were boys and 32.2% girls. The overall surgical success rate was 89.8%, with 88.9% in the tympanoplasty group and 90.2% in the tympanoplasty with mastoidectomy group. Audiometric improvement was observed in both groups with a mean gap closure of 14 dB ± 8.4 dB in the tympanoplasty without mastoidectomy group and 12.5 dB ± 9.5 dB in the tympanoplasty with mastoidectomy group.

Conclusion:
Type 1 tympanoplasty is an effective treatment of CSupOM in children. In these cases, performing mastoidectomy at the time of primary Type 1 tympanoplasty is not associated with improved outcomes.
Efficacy of Human Epidermal Growth Factor in the Regeneration of Tympanic Membrane Perforation
Authors: Mohite Anjana A. , Shrestha Bhagyashree , Mane Rajashri S. , Patil Balasaheb C. , Varute Vasundhara P. , Yasatwar Arpita P. 
Published: May 2024

Introduction:
Majority of tympanic membrane perforations require myringoplasty for closure. Recently, epidermal growth factor (EGF) has been shown to promote the healing of tympanic membrane perforations.

Aim:
The aim of this study was to find out a simple nonsurgical outpatient procedure to close one-quadrant tympanic membrane perforations that could reduce the hospital stay, medical cost, and morbidity in these patients.

Materials and Methods:
An interventional prospective randomized clinical study was done on 120 patients at our tertiary hospital. The allocation ratio was 3:1. Pure-tone audiometry, otomicroscopy, and otoenodoscopic recording were performed in all eligible patients who consented to take part in the study. Ninety cases received EGF gel application, whereas 30 controls received antibiotic ofloxacin application. Trichloroacetic acid chemical cautery and fibrin glue application were done in patients of both groups.

Results:
The closure rate was 97.7% in the EGF group and 70% in the ofloxacin group. The time taken for closure of perforations was 10 to 14 days in the EGF group and 3–4 weeks in the ofloxacin group. Hearing gain was observed in healed perforations of both groups.

Conclusion:
EGF application enhances the healing effect of one-quadrant nonhealing tympanic membrane perforations. It showed encouraging results and reliable safety in the regeneration of tympanic membrane.

Clinical Significance:
Apart from its use in single quadrant perforation, EGF may be considered for treating residual perforations after failed tympanoplasty.
Evaluation of the Rate of Tympanic Membrane Perforation in Otomycosis
Authors: Teharia Rajendra Kumar , Rathore Vikram Singh 
Published: May 2024

Introduction:
Otomycosis (OM) is an external ear infection of fungi and sometimes associated with tympanic membrane perforation (TMP). In this study, we analyzed and discussed the rate of TMP in otomycotic patients with no other associated pathology.

Materials and Methods:
In this prospective observational study, a total of 120 cases of OM were seen from August 2017 to April 2018 and microscopy with local cleaning was done. Fungal material was collected from all patients individually and sent for Gram staining and histopathological confirmation of fungus species and looked for TMP. Topical clotrimazole (1%) drops were given as empirical treatment with weekly microscopy and follow up to 12 weeks.

Results:
Eleven cases (9%) had tympanic perforation at the time of the first examination. In all cases with the TMPs, the causative organism was the Aspergillus species. Persistent TMP was present in 6 cases (5%). A total of three persistent TMPs required surgical intervention after 12 weeks.

Conclusion:
In OM, TMP is not infrequent and it requires careful examination especially under a microscope to identify it.
Waardenburg Syndrome
Authors: Mounji Houda , Benfdil Malika , Lakhdar Youssef , Chehbouni Mohamed , Rochdi Youssef , Nouri Hassan , Raji Abdelaziz 
Published: May 2024

Background:
Waardenburg syndrome (WS) is an autosomal dominant inherited genetic condition that manifests with sensorineural deafness and pigmentation defects of the skin, hair, and iris. This genetically and clinically heterogeneous disease accounts for 2% of the congenitally deaf population.

Objectives:
The aim of our study is to determine epidemiological and clinical characteristics of this group to improve the management, especially for the hearing impairment.

Methods:
Seven cases were diagnosed during the examination of children with suspected congenital deafness.

Results:
The age of our children ranged from 1.3 to 5 years, with a median age of 3.6 years, with female predominance; no consanguineous marriage and fetal or perinatal history have been reported; there was family history of premature greying in four cases and deafness in two cases. Two patients had WS Type 1 with a dystopia canthorum, while four cases had WS Type 2. There was one patient with Waardenburg Klein or Shah syndrome. The otoscopy was normal in all children. Evoked auditory potentials, otoacoustic emissions, and tonal audiometry were performed; they had shown a congenital, sensorineural bilateral, and profound hearing loss >100 dB in all cases. All children had received a cochlear implantation followed by speech reeducation. A genetic consultation was carried out for all our children.

Conclusion:
WS is a relatively common genetic cause of sensorineural hearing loss. Early diagnosis and improvement of hearing impairment are most important for psychological and intellectual development of the children with WS.
Preoperative and Intraoperative Evaluation of Round Window Configuration during Cochlear Implant in Children
Authors: Singh Jyoti , Prakash Jayant , Mishra Sarita Kumari , Jha Shruti , Singh Rakesh Kumar 
Published: May 2024

Context:
To establish a reliable factor for predicting the anticipated difficulty and adequacy of niche drilling without damaging the intracochlear structures during cochlear implant (CI) surgery.

Aims:
This study aimed to access the correlation of the distance from round window-to-vertical facial canal and round window to pyramid with the visibility of round window intraoperatively.

Settings and Design:
A prospective observational study of CI surgeries was conducted in the E.N.T. Department of Indira Gandhi Institute of Medical Sciences, Patna, from December 2019 to December 2021. The study included 30 children aged <5 years who presented to the E.N.T. OPD with prelingual deafness and were diagnosed with bilateral severe-to-profound hearing loss.

Subjects and Methods:
The preoperative high-resolution computed tomography images in the axial cut bone window setting at round window level were used to calculate the distance of round window-to-vertical facial canal and round window to pyramid on the RadiAnt DICOM Viewer. The intraoperative visibility was assessed through the recordings of the operation.

Statistical Analysis Used:
The data were analyzed using the MS Office 2019 Excel spreadsheet (Microsoft Corp., Redmond, WA, USA) and the program IBM SPSS 28.0.0 (SPSS Inc., Chicago, IL, USA). One-way analysis of variance was used.

Results:
A significant difference existed between round window and vertical facial canal distance measured preoperatively with the three categories of visibility of round window intraoperatively (P = 0.033), but a weak significant difference was found with the distance of round window to the pyramid with the visibility of round window (P > 0.05).

Conclusions:
Preoperative computed tomography measurement of the round window and vertical facial canal is a reliable predictor of a round window configuration that may aid in predicting the round window visibility.