bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Modified Technique to Harvest Integrated Zygomatic Arch-Temporal Bone Flap
Authors: Tianzhi Zhao , Yingwu Shi , Zijian Yang , Yingxi Wu , Yafei Xue , Yunze Zhang , Bao Wang , Yan Hu , Feng Xue , Shunnan Ge , Shiming He , Yan Qu 
Published: February 2024

Background:
In skull base surgery, zygomaticectomy is an effective method to increase surgical exposure and reduce brain retraction. However, the traditional zygomaticectomy methods are complicated and more invasive.

Objective:
To improve the procedure of zygomaticectomy, we introduced a modified technique to harvest integrated zygomatic arch-temporal bone flap.

Subjects and Methods:
A modified technique to section the zygomatic arch integrated with the temporal bone flap was described in the present work. This technique was applied in eight skull base lesion patients. The improved surgical angle was measured using Osirix software.

Results:
The surgical exposure is satisfied and no temporal lobe contusion or severe complications occurred in the patients. An increased surgical angle was obtained by zygomatic arch removing, with a mean value of 13.31°.

Conclusions:
This integrated zygomatic arch-temporal bone flap technique achieved increased exposure, decreased temporal lobe retraction, and minimal bone loss, leading to better cosmetics and functional reconstructions.
Neglected Case of Primary Intraorbital Hydatid Cyst
Authors: Kumar Manoj , Harsh Viraat , Prakash Anand , Sahay Chandra B , Kumar Anil 
Published: February 2024

Background:
Hydatid cyst is a parasitic infection caused by Echinococcus granulosus and human is an accidental host. Liver and lungs are the most widely recognized organ of association but relatively low in other organs. Orbital involvement of the hydatid cyst is rare.

Case Description:
The case was a 47-year-old lady presented in the late stage of disease when corneal ulcer had developed and with complete vision loss along with headache, proptosis, and pain in the left eye. Cystic lesion in the retro-orbital region of the left eye was revealed by Computed tomography scan and magnetic resonance imaging. The patient underwent surgery. Hundreds of daughter cysts were seen intraoperatively and cyst wall sent for histopathological examination to confirm the diagnosis. The patient was further treated with albendazole for 3 months.

Conclusion:
Although hydatid cyst is uncommon, it ought to be considered in the differential diagnosis of cystic lesion of orbital locale, more so in the endemic territories.
Primary Headache in Behçet's and Neuro-Behçet's Disease
Authors: Beton Ozlem Ergin , Yucesan Canan 
Published: February 2024

Background:
Behçet's disease (BD) is a multisystem vasculitis, which can involve the central nervous system, the gastrointestinal tract, the blood vessels, the joints, and the lungs. Neurological involvement is about 5%, but the headache is common in these patients.

Objective:
This study aimed to investigate whether differences exist in the onset and types of primary headaches between patients with BD without neurological involvement (BWoNI) and patients with neurological involvement, that is, neuro-Behçet's disease (NBD).

Materials and Methods:
A total of 136 consecutive BD patients (98 BWoNI and 38 NBD) were evaluated and compared.

Results:
Primary headaches beginning before and after the onset of BD were found in 27.6 and 48.1% of BWoNI patients, respectively, and in 10.5 and 34.2% of NBD patients, respectively. The start of primary headaches was more frequent after then before the onset of BD in each group and overall. The primary headache types were similar in both BWoNI and NBD patients.

Conclusions:
The primary headache starts more frequently after then before the onset of BD, and characteristics of primary headaches were similar in both BWoNI and NBD patients.
An Uncommon, Extensive Involvement of Hydatid Cyst—Cervical Spine to Brachial Plexus
Authors: Bishnoi Ishu , Sachdeva Deepashu , Mujal Bhagya , Sorout Sunil , Arora Ruhani , Singh Pradhaman 
Published: February 2024

Introduction:
Hydatid cyst usually involves liver and lung. But it has been reported in uncommon locations like the spine and brain. There are few reports of cervical spine to brachial plexus. This report is about such extensively involved hydatid cyst management.

Case Report:
A 32-year-old male had complaints of neck pain, left-hand weakness, and atrophy. MRI of cervical spine and thorax revealed a multicystic lesion involving the cervical spine, vertebrae, brachial plexus, and lung apex. The lesion was removed in two stages.

Discussion:
Due to scarcity of literature, dense adhesions with dura and surroundings, risk of rupture, anaphylactic shock, and its management require proper planning. Excision of cervical, followed by plexus lesion, might help. Long-term use of albendazole prevents recurrence as suggested by other reports.

Conclusion:
Extensive spinal hydatid cyst is exceptionally challenging. These behave like malignant lesions. To get the best results, surgical planning is as essential as medical management.
Human to Humanoid
Authors: Singh Daljit , Wadhwa Rachna , Daljit Tanshi 
Published: February 2024

Background:
Neuroethics is a subsection of ethics which allows us to express our concerns with advances in neurotechnology, threat to human race, our freedom of expression, autonomy, and justice.

Objectives:
Aim of the review is to familiarize readers about the concept of neuroethics and alarming threats with newer neurotechnology and to sensitize them about our responsibilities as neuroscientists.

Materials and Methods:
Systematic literature search was conducted from 2010 to 2021 in PubMed to look at previously published review articles related to neuroethics. Relevant filters were added addressing autonomy and consent. Of the 426 articles, only 12 addressed the issue of autonomy and neuroethics and two on consent and neuroethics.

Results and Conclusions:
International literature has expressed limited concern on the scope of neuroethics. Newer threats are getting added on with advancing technology, and as neuroscientists, we all need to understand and educate neuroscientists about our social responsibilities in curtailing an out-of-reach situation for the mankind.
Thirteen-and-a-half Syndrome Secondary to the Brainstem Cavernoma
Authors: Gosal Jaskaran Singh , Khatri Deepak , Das Kuntal Kanti , Gajbhiye Sanjog , Mehrotra Anant , Jaiswal Awadhesh Kumar , Behari Sanjay 
Published: February 2024

Background:
“Thirteen-and-a-half” is a newly described clinical syndrome characterized by the combination of the one-and-a-half syndrome with fifth and seventh cranial nerve nuclei involvement (11/2 + 5 + 7 = 131/2). To the authors' knowledge, this is the first report of the thirteen-and-a-half syndrome secondary to pontine cavernoma and, overall, only the second reported case of this syndrome in the literature till date.

Case Report:
A 20-year-old man presented with the clinical features suggestive of the thirteen-and-a-half syndrome, explained radiologically by pontine cavernoma. We operated him using a suboccipital transvermian approach and he is doing well at 2.5 years follow-up. Interestingly, his one-and-a-half syndrome has partially improved to left horizontal gaze palsy.

Conclusion:
The clinical appreciation of the thirteen-and-a-half syndrome precisely localizes the lesion to ipsilateral dorsal pontine tegmentum. Neurosurgeons must be aware of the newly described “one-and-a-half- plus” syndromes as they help in a better understanding of pathoanatomy caused by different disease processes in the brainstem.
Comparison between Oblique Lumbar Interbody Fusion (OLIF) and Minimally Invasive Transforaminal Lumbar Interbody Fusion (MISTLIF) for Lumbar Spondylolisthesis
Authors: Chandra Vemula V R , Prasad Bodapati C M , Hanu Tammireddy G , Kale Pavan G 
Published: February 2024

Background:
Lumbar interbody fusion has gained popularity for the treatment of spondylolisthesis in recent years. Both procedures have their own advantages and disadvantages.

Objective:
The aim of this study was to compare the clinical and radiological outcomes of MIS TLIF and OLIF in terms of visual analog score, Oswestry Disability Index, Intraoperative blood loss, and various other parameters.

Material and Methods:
This is a retrospective matched-pair comparative analysis between two groups who underwent Single level either OLIF or MISTLIF for spondylolisthesis operated from January 2017 to January 2020 at a Single institute by a Single surgeon.

Results:
Statistically there is no difference in various preoperative parameters between the two groups. The intraoperative blood loss is 112.5 mL in OLIF, and 144.6 mL is MISTLIF. The duration of surgery in OLIF is 4.41 h and 3.16 h in MISTLIF. The mean duration of the requirement of postoperative analgesia is 3 months after OLIF and 5 months after MISTLIF. The time taken for returning to regular activities is less in OLIF than MISTLIF.

Conclusions:
Although both OLIF and MISTLIF have almost equivalent outcomes, OLIF is better than MISTLIF in having lesser intraoperative blood loss and achieving better lordotic correction.
Short term evaluation of right ventricular longitudinal strain in children post balloon pulmonary valvuloplasty
Authors: Wagdy Reham , El-Gandour Mamdouh , Mohsen Aly A. 
Published: February 2024

Background
Children with isolated severe valvular pulmonary stenosis (sPS) are considered under chronic right ventricle (RV) pressure overload. Little is known about the needed duration for reverse remolding in pediatrics.

Objective
The study aimed to compare RV function and longitudinal strain in children before and 3 months after balloon pulmonary valvuloplasty (BPV).

Patients and methods
Thirty-seven children with sPS indicated for BPV were recruited. All patients underwent RV evaluation by Tissue Doppler (TDI) and speckle-tracking echocardiography. RV free-wall longitudinal strain (RV-FW), global RV strain (RV-4C), and global LV strain (GLS-LV) were studied one day before the procedure, 3 months postintervention, and compared with 37 healthy children enrolled as controls. Patient demographic and hemodynamic data during cardiac catheterization was collected.

Results
Successful BPV of 37 cases (mean age 3.2±4.9 years) showed a significant reduction in transpulmonary gradient from 89.2±23.9 mmHg to 16.1±8.4 mm Hg immediately postprocedure. The RV-FW and RV-4C of patients with sPS and GLS-LV were significantly lower than the control group (P=0.001), respectively. A significant rise of RV-FW and RV-4C occurred 3-month postintervention (−17.5±3.8 vs. 27.4±4.4) and (−15.3±3.8 vs. −23.9±3.9, P=0.001), respectively, and became insignificantly different from the control group. GLS-LV is positively correlated to RV-FW (r=0.342, P=0.038). Cases aged less than 1 year showed a significant rise of RV strains 24 h postprocedure.

Conclusion
Improvement of RV longitudinal strains of children is highly possible within 3 months of successful BPV up to normalization especially for infants below the age of one year.
Screening of iron deficiency anemia in children with chronic functional constipation
Authors: Metwally Rasha H. 
Published: February 2024

Background
Iron deficiency anemia (IDA) is one of the most common nutritional deficiencies worldwide. Constipation is one of the most common gastrointestinal disorders in childhood.

Aim
To screen for IDA or iron deficiency (ID) among children with chronic functional constipation (CFC).

Patients and methods
It was a prospective study. Two groups of children in the age range of 1–15 years were collected for 6 months from June 2022 to December 2022 at Alexandria University gastroenterology clinic. Children who fulfilled Rome IV criteria of CFC were assigned to CFC group. Children who did not have constipation were considered as the control group. Complete blood count, serum iron, total iron binding capacity, and serum ferritin were done for both groups. Data were fed to the computer and analyzed using IBM SPSS software package version 20.0. Quantitative data were described using range (minimum and maximum), mean, standard deviation, and median.

Results
Hemoglobin levels, serum ferritin and serum iron were significantly lower in the CFC group when matched with the control group. ID and IDA were significantly higher in the CFC group. The longer days of constipation were correlated with significantly lower hemoglobin, serum iron, and serum ferritin.

Conclusion
CFC causes mild IDA or ID. The longer the days of CF, the lower values of hemoglobin, iron and ferritin are present. ID and IDA are more common in the CFC group.
Study of coagulase-negative staphylococci in hospital-acquired neonatal sepsis
Authors: Eldegwi Marwa , Abu-Elmagd Nehal El-Sayed , Darwish Ahmad , Ghaleb Sara , El-Shabrawy Walaa O. , El-Sayed Eman 
Published: February 2024

Background
Coagulase-negative staphylococci (CoNS) has become increasingly prevalent as the leading cause of late-onset bacteremia in neonatal ICUs. Diagnosing CoNS septicemia poses challenges because this bacterium commonly resides on the skin, leading to potential contamination of blood culture samples. Therefore, this study aimed to identify the bacterial causes of sepsis in neonates who exhibit clinical signs of the condition, also to assess the methicillin susceptibility of CoNS through both phenotypic and molecular methodologies.

Materials and methods
This study was carried out at Mansoura University Children Hospital. Blood samples were obtained and directly cultured using the BACT/ALERT system. All isolates were identified using BD Phoenix system. CoNS isolates were subjected to a disk diffusion susceptibility test with cefoxitin 30 µg, serving as an initial screening test to identify methicillin resistance. Automated antibiotic susceptibility was done using BD Phoenix system followed by PCR testing to detect the presence of the mecA gene in resistant CoNS isolates.

Results
Among all the isolated micro-organisms, Klebsiella pneumoniae and CoNS were found to be significantly higher in early-onset sepsis and late-onset sepsis, respectively. Staphylococcus epidermidis constituted 30% of the isolates, with Staphylococcus haemolyticus and Staphylococcus hominis each accounting for 20%, while other Staphylococcus species made up the remaining 20%. Among the identified CoNS, 47.4% tested positive for the mecA gene. The presence of the mecA gene was significantly associated with a higher incidence of late-onset sepsis (P=0.033).

Conclusion
CoNS are the predominant culprits behind late-onset sepsis in hospitalized newborns. Notably, the presence of the mecA gene was significantly linked to a higher occurrence of late-onset sepsis. Our study has uncovered a concerning surge in antibiotic resistance genes within our community. This underscores the urgency of implementing an active antibiotic surveillance program and exploring alternative therapeutic strategies to effectively combat neonatal sepsis.
A Hospital-based Study to Assess Various Laboratory Parameters for Prediction of Severity of COVID-19 Disease at the Time of Admission at a Teaching Tertiary Hospital
Authors: Patel Ruchik , Patel Swati , Chaudhary Aditya , Patel Rahi , Bodalia Aaryaman 
Published: February 2024

Abstract

Background:
The main aim of this study was to determine the association between various laboratory parameter values at the time of admission with the severity classification of COVID-19 infection. Secondarily, this study also determined the cutoff value of associated laboratory parameters with the severity of infection at the time of admission. This study evaluated the association of laboratory parameters and other factors with the severity of COVID-19 infection (mild, moderate, and severe).

Methodology:
This study analyzed 170 adult patients with symptomatic COVID-19 infection hospitalized between July 2020 and December 2020 at a teaching tertiary care center in South Gujarat. All the patients selected in the study had a positive polymerase chain reaction test result of SARS-CoV-2. Laboratory parameters and clinical details of patients were recorded.

Results:
A total of 170 COVID-19-infected hospitalized patients were analyzed. The serum ferritin levels were 1.12 times higher in severe patients compared to mild category patients and 1.006 times higher in severe patients compared to moderate category patients, as determined using multinomial logistic regression. The requirement of invasive positive pressure ventilation (IPPV), BIPAP, and nonrebreathing mask at admission was substantially linked with patients in the severe and moderate categories (P < 0.0001). Compared to the mild category, the need for IPPV was 534.9 (95% confidence interval [CI]: [21.93–13022.20]) times greater in the severe category, and 50.41 (95% CI: [3.034–837.55]) times higher in the severe individuals. In addition, this study also evaluated the cutoff value for serum ferritin was identified at ≤276.35 ng/mL for mild, 276.35–473.5 ng/mL for moderate, and ≥473.5 as severe COVID-19 infection at the time of admission.

Conclusion:
Early ferritin estimation could be used to assess the severity and categorization of COVID-19 infection at the time of admission itself and can be of immense benefit in the treatment of the disease.
Occupationally Acquired Hepatitis C Virus Infection in Health-Care Workers: A Case Report and Review of Literature
Authors: Rupali Priscilla , Alexander Hanna , Abraham Priya , Eapen C. E. 
Published: February 2024

Abstract
The incidence of occupational health exposures to the risk of blood-borne pathogens is common yet underreported in health-care workers in India. These occur despite necessary precautions and training in often trying real-world circumstances. Indian health community reports very few occupational exposures and national guidelines with regard to postexposure monitoring or detection of acute hepatitis C virus infection are not available. We describe a case where acute hepatitis C infection was detected early due to intensive monitoring postneedlestick injury where prompt initiation of direct-acting antivirals led to a rapid response with no seroconversion.
Jejunal calcifying fibrous tumor: A jigsaw puzzle with a pool of diagnostic dilemma
Authors: Raj Akshi , Singh Madhuri , Buch Archana C. , Gurwale Sushama 
Published: February 2024

ABSTRACT
Calcifying fibrous tumor (CFT) is a very rare benign fibroblastic tumor featuring a wide anatomical distribution and mimicking various spindle cell tumors. CFT has been documented in soft tissues, gastrointestinal tract (GIT), neck, adrenal glands, and pleura. Within the GIT, it is reported in the stomach, small bowel, large intestine, stomach, esophagus, and appendix. The occurrence of CFTs in the gastrointestinal tract presents a diagnostic dilemma, firstly due to the rarity of the lesion and secondly, due to the occurrence of a variety of other stromal lesions in the gastrointestinal tract with histological features that overlap with CFT. In the jejunum, it is extremely rare. We present one such rare case of jejunal CFT at an unusual age, complicated by jejuno-jejunal intussusception resulting in acute intestinal obstruction.
Hepatic and perihepatic PEComas: A study describing a series of five rare cases
Authors: Vijayanirmala P , Yadav Rajni , Goyal Surbhi , Barwad Adarsh , Bhowmik Subham , Malik Rohan , Pal Sujoy , Sharma Raju , Sakhuja Puja , Das Prasenjit 
Published: February 2024

ABSTRACT

Background:
Perivascular epithelioid cell tumors (PEComas) encompass a group of rare mesenchymal neoplasms, with dual melanocytic and muscular differentiation. Hepatic PEComas are rare and difficult to diagnose, and their behavior is still unclear.

Materials and Methods:
Herein, we report a total of five cases of hepatic and perihepatic PEComas over a period of the last 5 years from our and collaborating center’s archive. A detailed histological evaluation was done. A comprehensive panel of immunohistochemical stains was used and fluorescence in-situ hybridization analysis was performed for the TFE3 gene using break-apart probes.

Result:
All these patients were women, with an average age of presentation of 44 years. The lesions were in the right hepatic lobe: three cases, the left hepatic lobe: one case, and gastrohepatic ligament: one case. The preoperative clinicoradiological diagnoses were hepatocellular carcinoma (HCC), focal nodular hyperplasia, hemangioma, metastasis, and gastrointestinal stromal tumor, respectively. Surgical excision was performed in four cases with no further adjuvant therapy. Histopathological examination and subsequent immunophenotyping revealed a diagnosis of PEComa. Fluorescence in-situ hybridization analysis was performed for TFE3 gene rearrangement in four cases.

Conclusions:
This series highlights the fact that accurate histological diagnosis of hepatic or perihepatic PEComas is important to prevent unnecessary aggressive treatment, unlike primary hepatocellular carcinomas or hepatoid/epithelioid metastatic tumors.
Syringoid eccrine carcinoma of the nipple in a male patient with lymph node metastasis: A case report
Authors: Sable Mukund , Sahoo Nibedita , Panigrahi Chinamyee , Mishra Pritinanda , Kumar Pradeep 
Published: February 2024

ABSTRACT
Syringoid eccrine carcinoma of nipple is an extremely rare neoplasm of adnexal origin with variable clinical appearance and diverse histologic findings. Syringoid eccrine carcinoma (SEC) is often a diagnostic dilemma due to its morphology and presentation. Usually, these malignancies arise as non-ulcerated nodules or plaques in the head & neck region including the trunk. They are locally aggressive and have an infiltrative growth pattern with a propensity for metastasis. SEC is characterized by syringoma-like tadpole morphology with ductular differentiation and predominant desmoplasia. Immunostaining in SEC is variable and this variability is believed to arise from the tumor’s ability to differentiate along multiple routes including sweat secretory and or ductal differentiation. Here we present a rare case of SEC/ syringomatous carcinoma of nipple in a 51-year-old male breast with associated axillary lymph node metastasis. As per English literature, this is the second case of SEC in nipple of male patient.