bluuebunny/crossref_metadata_2025_split huggingface dataset:
Xanthoceraside induces cell apoptosis through downregulation of the PI3K/Akt/Bcl-2/Bax signaling pathway in cell lines of human bladder cancer
Authors: Chai Xue , Zhang Jian-Wu , Li Sheng-Hui , Cheng Qing-Shui , Qin Ming-Ming , Yang Chun-Yan , Gao Jia-Lin , Huang Hou-Bao 
Published: May 2024

Background:
Xanthoceraside is a component obtained in the husks of Xanthoceras sorbifolia Bunge. Series of researches proved that xanthoceraside had functions of anti-inflammation and anti-tumor effects. However, the mechanisms of xanthoceraside against bladder cancer are unclear. Accordingly, we proposed to investigate xanthoceraside's impacts and potential mechanisms in cells of bladder cancer.

Methods:
By using the CCK-8 assay, we measured the viability of cells. With the use of 4,6-diamidino-2-phenylindole (DAPI) staining, we examined nuclear fragmentation and chromatin condensation in the nuclei of apoptotic cells. By using flow cytometry, we measured cell apoptosis. By using Western blotting, we tested the expressions of Caspase-9, Caspase-8, Caspase-3, Bcl-xL, P53, and PI3K/Akt/Bcl-2/Bax.

Results:
The proliferation of cell lines of human bladder cancer T24 and 5637 was suppressed by xanthoceraside significantly in a time- and concentration-dependent way. When cell lines 5637 and T24 were incubated as the xanthoceraside dose increased, the rates of cell apoptosis were upregulated, which was dependent on dose. According to further analysis, xanthoceraside induced apoptosis by upregulating Bax and downregulating the expression of Bcl-xL and Bcl-2. However, xanthoceraside did not change the expression of Caspase-9, Caspase-8, and Caspase-3. Interestingly, xanthoceraside also downregulated the expression of p-PI3K and p-Akt, and upregulated P53.

Conclusions:
Xanthoceraside induces cell apoptosis through downregulation of the PI3K/Akt/Bcl-2/Bax signaling pathway in cell lines of human bladder cancer.
Immunophenotypic characterization of normal and abnormal plasma cells in bone marrow of newly diagnosed multiple myeloma patients
Authors: Awasthi Namrata Punit , Mishra Sridhar , Gupta Gaurav , Kumari Swati , Bajpayee Abhishek , Singh Pradyumn , Husain Nuzhat 
Published: May 2024

Background:
Identification of plasma cells into abnormal (APC) and normal (NPC) compartments is of utmost importance in flow cytometric (FC) analysis of multiple myeloma (MM) and related plasma cell dyscrasias for diagnosis, prognosis, and follow-up. No single phenotypic marker is sufficient to distinguish NPC from APC.

Materials and Methods:
43 newly diagnosed cases of MM and 13 controls were included in the study. Bone marrow (BM) samples from the 2nd pass were processed on the same day with antibodies against CD38, CD138, CD19, CD81, CD45, CD117, CD200, CD56, cytoKappa, and cytoLambda in a 4-color experiment with CD38 and CD138 as gating antibodies.

Results:
Mean APC% in cases was 96.5%. The expected Immunophenotype (IP) of APC which is CD19-/56+/45-/81-/117+/200+ was found in only 13/43 MM cases. In 30/43 cases, APC revealed deviation from expected IP either for single or a combination of markers. Sensitivity for APC detection was highest for CD19 (95.2%) followed by CD56 (90.4%) and CD81 (83.7%). Specificity was highest for CD19 (100%), CD56 (100%), and CD81 (100%) followed by CD117 (92.3%). Combination of markers with maximum sensitivity to detect APC (97.6%) was CD81- or CD19- and CD200+ or CD56+ (two markers); and for NPC (92.3%) was CD81+ and CD19+ and CD56- (three markers).

Conclusion:
Plasma cell IP can be highly variable with multiple minor subpopulations in both cases and normal controls. CD 19 and CD56 are highly informative markers for a 4-color experiment. Assessment of multiple markers in an 8–10 color experiment is more informative but the lack of advanced flow cytometers should not limit the use of FC in a 4-color approach. Our results emphasize that even basic equipment with limited fluorochrome can provide meaningful information if used appropriately.
Septic pulmonary embolism: Is it an underestimated diagnosis?
Authors: Kolhe Swati , Vaideeswar Pradeep 
Published: May 2024

ABSTRACT

Background:
Non-thrombotic pulmonary embolism, an uncommon entity, is defined as the embolization of tissues, microorganisms, air, or foreign material. One subset in this non-thrombotic category is septic pulmonary embolism (SPE) that refers to embolism of microorganisms with or without a thrombotic mantle into the pulmonary vasculature. This condition is often recognized on the basis of imaging with a clinical correlation. Unfortunately, data regarding the pathological features are meager. This has prompted to review such cases at autopsy.

Aims:
To study the pathological features of SPE at autopsy.

Materials and Methods:
Ten-year (2012 to 2021) autopsy records of the hospital were retrospectively reviewed. The diagnosis was based on the identification of acute necrotizing pulmonary arteritis with peri-bronchoarterial consolidation. These cases were analyzed with reference to the demographics, clinical characteristics, and pulmonary/extrapulmonary findings at autopsy.

Statistical Analysis:
Nil.

Results:
According to the inclusion criterion, 19 cases demonstrated the presence of SPE. There were 11 men and 8 women with a mean age of 32.1 years. The major source of infection included infection arising from skin and musculo-skeletal system (11 patients, 59.7%). The common clinical presentation included fever, dyspnea, chest pain, hemoptysis, and altered sensorium. The cause of death was mainly due to septicemia and/or confluent lung consolidations. A large number of bacterial colonies were seen in all; Candida species were also identified in two cases. Other lung findings included diffuse alveolar damage, fresh arterial thrombosis, infarction, arterial pseudo-aneurysms, abscess formation, and pyogenic pleuritis.

Conclusion:
Presence of an extrapulmonary infection with persistent fever, bacteremia, and pulmonary complaints should raise suspicion for this entity, particularly in resource-poor settings, to prevent grave pulmonary complications.
Online teaching of undergraduates in pathology during COVID-19 pandemic
Authors: Singh Pomilla , Swami Ravi , Kelkar Anjali , Adsul B. , Mulay Smita , Karandikar M. , Nimbargi R.C. , Mani N.S. 
Published: May 2024

Introduction:
Covid 19 pandemic has brought human life one on one with the pace of growth. The indispensable lockdown and social distancing norms have posed challenges to continue education in various fields. Distance learning via online teaching has emerged as a savior in the pandemic. In the current scenario, it is very important to keep learners in the loop and obtain feedback from students at the end of online teaching, for understanding its strength and weaknesses which will eventually assist in developing strategies to improve its quality. We intend to share our experience with the online teaching.

Materials and Methods:
The study was conducted from March 2020 to Feb 2021, which includes 8 months of online teaching classes and practicals, one online examination (mid term exam), and 1 offline examination (final professional exam). The marks obtained by the students who attended online classes (batch II) in 2020-21 session was compared with previous batch i.e 2019-20 (batch I). Also the marks obtained by batch I during online exam (mid-term exam) were compared with their marks during offline exam (final professional exam). Results: Batch II scored higher marks than batch I in theory and practical (p-value < 0.05). However, the marks of viva for both batches were equitable.

Conclusions:
We feel that the online teaching is a reasonable alternative to conventional teaching in the current scenario.
Estimation of plasma and RBC acetylcholinesterase in children
Authors: Kuvelkar Neha , DSouza Serena , Vidhyashree K. , Shankar Gowri , Bukel Maria Frances , Noronha Santosh , Kini Usha 
Published: May 2024

Background:
Increased acetylcholinesterase (AChE) activity on frozen sections of rectal mucosal biopsies accurately diagnoses Hirschsprung disease (HD). But the quest for a biomarker in blood as a screening test prompts one to look for AChE in blood and study its role in HD diagnosis.

Aim:
To develop a low-cost reliable method to estimate the AChE activity in plasma and red blood cells (RBCs) in normal children (control) and study its role in HD (test).

Materials and Methods:
Optimized method derived after modifying and standardizing known AChE assay protocols for blood were employed on 30 controls to define the AChE cut-off range, on 40 suspected HD cases to categorize them as HD/non-HD based on cut-off values and later compared with gold standard tissue AChE histochemistry of rectal mucosal biopsies.

Results:
An optimal in-house modified methods of Ellman's was found best suited to analyze plasma AChE activity, method by Wilson and Henderson was optimal for extraction and AChE estimation in RBCs. AChE levels (controls) obtained were 1.03 ± 0.31 U/mL and 5.17 ± 1.52 U/mL in plasma and RBCs, respectively while the plasma AChE was 1.35 ± 0.84 U/mL (HD) and 1.62 ± 0.85 U/mL (non-HD) while RBC AChE was 4.29 ± 3.2 U/mL (HD) and 6.48 ± 4.31 U/mL (non-HD). Sensitivity was 66.67% and 55.56%, specificity was 22.73% and 45.45%, and an accuracy rate of 42.5% and 50% for plasma and RBC, respectively.

Conclusions:
Mutually exclusive AChE activity range identified for test blood samples overlapped with the normal and hence, not considered a diagnostic tool for HD.
Audit in surgical histopathology at a tertiary healthcare center
Authors: Shinde Sweety V. , Dhanve Manisha J. 
Published: May 2024

Context:
An audit aims to verify conformance to required processes, assess their implementation, and define the targets of quality control.

Aims:
To evaluate preanalytic and analytic phases of surgical histopathology in a tertiary healthcare center.

Setting and Design:
An observational retrospective and prospective study over 3 months each of year 2013 and 2014.

Materials and Methods:
Biopsy, small resections, large organ resections, bone marrow aspirate/biopsy (BMA/BMB), and frozen section samples received in surgical histopathology were categorized as I to V, respectively. A manual audit was done for preanalytical phase (adequacy of clinical information and grossing adequacy) and analytical phase [turnaround time (TAT) and tissue section quality].

Statistical Analysis:
Qualitative data was assessed by Chi-Square test. Quantitative data was assessed using One-Way Analysis of Variance.

Results:
Among 3179 total cases, category I to V had 1558 (49%), 1099 (34.6%), 342 (10.8%), 124 (3.8%), and 56 (1.8%) cases, respectively. Category I had shortest TAT but maximum number of inadequately sent specimens and recuts. Category III had maximum cases with inadequate clinical history, grossing errors, additional sections, and longest TAT. Category IV had maximum cases with poor quality sections. Category V had maximum cases with inadequate demographic details and clinical investigations. BMB (114, 91.9%) was more useful than BMA for diagnosis. Mean TAT for fixed tissues and frozen tissues was 3.6 ± 1.8 days and 26.6 ± 11.2 min, respectively.

Conclusions:
Total 25% of annual workload was studied by an observational, manual audit. Quality indicators were achieved as per international norms despite limited resources. Remedial actions were suggested for technicians, clinicians, and pathologists to minimize errors.
Epidermal inclusion cyst embedded in benign fibrous histiocytic lesion with prominent epithelioid morphology
Authors: Sood Neelam , Juneja Binjul 
Published: May 2024

ABSTRACT
Benign fibrous histiocytoma also known as dermatofibroma is one of the common mesenchymal neoplasms. It commonly develops in young adult with female predominance and predilection for the extremities, particularly lower extremities. Implantation of epidermis in the dermis or subcutaneous tissues may lead to the formation of epidermal inclusion cyst, which is the most common type of epithelial cyst. Development of epidermal inclusion cyst within a benign fibrous histiocytoma is a rare occurrence. This is a unique case of two unrelated lesions.
Liver histopathology in scope of hematological disorders
Authors: Parikh Rashmi , Bansal Nalini , Sen Rajeev 
Published: May 2024

ABSTRACT
Liver involvement is commonly seen in various haematological disorders. They present clinically with elevation of liver enzymes and organomegaly, with or without mass lesions. However, liver involvement may be silent in many hematological disorders or there may be specific findings in liver biopsy that can lead to the diagnosis of clinically inapparent hematological disorders. Present review highlights features of hepatic manifestations in various hematological diseases with special emphasis on histopathological findings. Among RBC disorders, secondary hemochromatosis is the commonest among patients with hemolytic anemia; whereas Sickle Cell Hepatopathy is a well known complication in Sickle Cell Disease, characterised by sequestration of sickled RBCs in sinusoids. Vascular complications such as Budd Chiari syndrome and portal venopathy with portal vein thrombosis are seen in patients with myeloproliferative neoplasms. However, sometimes primary hematological disease may remain occult. Various lymphomas show characteristic pattern of hepatic involvement, most common being sinusoidal and portal infiltration. Pattern of infiltration may give clues to different types of lymphomas. Amongst all lymphomas, Diffuse large B cell lymphoma is the most common lymphoma involving liver. Disseminated intravascular coagulation is a fatal systemic condition and liver involvement by widespread fibrin thrombi, is not an exception. Assessing liver histopathology in context of hematological conditions makes better understanding of pathophysiology and progress of these diseases. It is important for hematologists and hepatologist to be aware of possible liver involvement in various hematological diseases presenting with elevated LFTs and have a logical approach to abnormal LFTs.
“Switch of E-Cadherin to N-Cadherin expression in different molecular subtypes of breast invasive duct carcinomas and its correlation with clinicopathological features”
Authors: Farrag Mayada S. , Anter Abeer H. , Farrag Nesrine S. , Ibrahiem Afaf T. 
Published: May 2024

Background:
In breast cancer, metastasis and recurrence is the main culprit in treatment failure. This study aimed to explore the role of E-cadherin/N-cadherin Switch in progression, spread and metastasis in breast invasive duct carcinoma.

Materials and Methods:
A cross-sectional study on 118 formalinfixed paraffinembedded mastectomy specimens of invasive breast duct carcinoma. Primary antibodies for E-cadherin (monoclonal, clone HECD-1; Zymed Laboratories; dilution 1:600) and N-cadherin (monoclonal, clone 3B9; Zymed Laboratories, Inc., Montrouge, France; dilution 1:200) were applied for all cases. The study revealed that E-cadherin high expression was significantly associated with advanced TNM clinical stage (P = 0.021), and nodal metastasis (P < 0.001). High expression of N-cadherin was significantly positively correlated with tumor sizes (P < 0.00), advanced clinical stage (P < 0.00), and nodal metastasis (P < 0.008). Mean OS was 39.99 months in cases with negative expression versus 41.8 months in cases with positive expression. Mean DFS in cases with positive E. cadh expression was 41.89 months was higher than mean DFS in cases with negative E. cadh expression which was 40.52 months, but it showed no statistical significance (P = 0.57).

Conclusions/Significance:
This study demonstrated that loss of E-cadherin and gain of N-cadherin promotes invasion, migration, and metastasis in invasive ductal carcinoma cells. Importantly, these findings may exploit new cancer therapies using N-cadherin antagonists.
Whisper Test – MasS Hearing Screening Programme
Authors: Taneja M.K. , Jain Megha , Taneja Vivek , Parmar Sandip M. 
Published: May 2024

Aims and Objectives:
To screen the school going mass for hearing loss and study its relationship with their academic performance and aptitude and compare it with pure tone audiometry and validate whisper test.

Material and Methods:
Procedure- Examiner stands arm distance (60cm) behind the patient. Mask the non-test ear by occluding the external auditory canal by continuously generating rubbing sound. The patient is explained to repeat the words. Test always started with consonants followed by vowels. If more than 80% were correct it was treated as passed.

Results:
In our study out of 86 students, 8 children failed in whisper test, but all passed in conversation test. In the present study performance was poor in failed students. The incidence of day dream, learning difficulty, inattentiveness was high with hearing impaired children.

Conclusion:
The whisper test is a simple effective diagnostic and mass hearing screening test which can predict an early hearing loss and if performed by a trained paramedical or social worker can differentiate in conductive, sensorineural, cochlear, and retrocochlear lesion. Since the whisper test does not require a qualified audiologist or otolaryngologist, it should be be a part of annual health check-up and national programme of prevention and control of deafness specifically hearing care in the elderly.
Evaluation of Cochlear Ototoxicity with Otoacoustic Emissions and Pure-Tone Audiogram Following Treatment for Multidrug-Resistant Tuberculosis in our Tertiary Care Center
Authors: Thamizharasan P. , Muthuchitra S. , Indu S. P. , Venkatesh Sumee 
Published: May 2024

Background and Objectives:
Hearing is a vital function and can be impaired by drugs causing ototoxicity which is inevitable in situations such as multidrug-resistant tuberculosis (MDR-TB). A longitudinal study was conducted to evaluate cochleotoxicity by otoacoustic emissions (OAEs) and pure-tone audiogram (PTA) in patients following treatment for MDR-TB.

Materials and Methods:
Sixty-five patients were included in the study after excluding cases as per criteria. Baseline pure-tone audiometry and OAEs were done. If asymptomatic, the patient followed up with PTA and distortion product OAE after 3 months and 6 months of treatment with a selected regimen for MDR-TB.

Results:
Compared to the pretreatment prevalence of 67% hearing loss, 81% of patients had hearing loss at 3 months and 97% at 6 months. OAEs were abnormal in 32% before treatment, which increased to 86% at 3 months and 97% at 6 months' follow-up.

Conclusion:
OAEs were able to pick up early the cochlear damage before it became apparent in PTA and well ahead of becoming symptomatic in patient. OAEs should be included in the pre- and post-treatment assessment of hearing with a high-frequency PTA for follow-up in MDR-TB patients or any patient on treatment which may cause ototoxicity.
High Riding Jugular Bulb
Authors: Çoban Kübra , Kansu Leyla , Ergun Tarkan , Aydin Erdinc 
Published: May 2024

Introduction:
High jugular bulb (HJB) is usually discovered incidentally; however, it may interfere with inner ear structures such as vestibular aqueduct (VA), facial nerve, and the posterior semicircular canal (PSCC).

Objective:
The aim is to investigate the incidence of HJB in benign paroxysmal positional vertigo patients with PSCC involvement (PSCC-BPPV).

Materials and Methods:
The study group included 53 consecutive, PSCC-BPPV patients, diagnosed in our clinic. Following the diagnosis, their high resolution computed temporal bone tomography were performed. The control group consisted of 90 patients, who attended to our clinic for various complaints, and to whom high resolution computed tomography of the temporal bone was conducted.

Results:
The incidence of HJB in the study group was 41.5% (n = 22). The incidence of ipsilateral HJB in this group was 28.3% (n = 15). The incidence of HJB in the control group was 11.1% (n = 10) (P < 0.001). The closest distance between HJB and PSCC canal in the control and study groups was 1.61 ± 0.74 mm and 1.17 ± 0.37 mm, respectively (P = 0.098).

Conclusion:
The HJB is significantly more frequent in PSCC-BPPV patients. Furthermore, the rate of incidence of HJB in the ipsilateral ears of these patients is significantly higher. Venous hypertension or the turbulence may cause strong pulsations, which influence the detachment of the otoconia into the PSCC.
Epidemiological Study of Unilateral Sensorineural Hearing Loss in Adults
Authors: Gupta Kartikesh , Varshney Saurabh , Tyagi Amit Kumar , Kumar Amit , Sood Rachit 
Published: May 2024

Introduction:
Unaddressed hearing loss poses great loss with an annual risk of 750 billion United States dollars. In India, the incidence of adult-onset deafness is found to be around 7.6%. Unilateral Sensorineural Hearing Loss (USNHL) has been found to affect 7.9%–13.3% of the Indian population. Since, most of the literature available is on bilateral Sensorineural Hearing Loss (SNHL), and limited work is done on USNHL. Hence, this study tends to list and analyze the clinical characteristics of patients with USNHL and is the largest Indian series related to clinical profile of USNHL.

Materials and Methods:
A prospective observational study was conducted in the Department of Otorhinolaryngology to study the clinico-epidemiological profile of 130 adult patients having USNHL. Patients were worked up using clinical, audiological, laboratory, and radiological tests, to reach a particular diagnosis.

Results:
The most common age group seen was 36–45 years (36.9%) with male preponderance. The majority of patients had an education of less than high school. About 27.7% of the patients had associated tinnitus and vertigo both. Most of the patients (30%) presented with 1–5-years duration of illness and noise as the most common associated risk factor. Forty-three percent of patients had profound hearing loss. Magnetic resonance imaging (MRI) was done in 37% of patients and was found to be diagnostic in 6.1% of cases. The most common etiology found was idiopathic progressive SNHL (43.1%).

Conclusion:
USNHL was more commonly seen in nonelderly males. Majority had profound hearing loss and presented very late. This study also mentions the possible socioeconomic correlate of the patients with their clinical profile. MRI is useful in detecting rare etiologies such as dolichoectasia, multiple sclerosis, schwannoma, and vestibulocochlear anomalies. A very diverse etiology of USNHL was seen.