bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of Hematological and Inflammatory Markers in Early Diagnosis and Severity of COVID-19 Disease
Authors: Awasthi Seema , Mittal Ankita , Singh Vivek , Kumar Ashutosh , Ahmad Faiyaz , Sharma Nilisha 
Published: March 2024

Background:
COVID-19 virus, causing severe acute respiratory illness (SARS-CoV-2), was declared as a pandemic by the WHO in March 2020, after its first outbreak in China at the end of 2019. The major purpose is to establish the role of a hematological and inflammatory markers in early diagnosis of COVID-19 illness and its relationship with the disease severity.

Materials and Methods:
The study was performed in a tertiary care center from April to September 2020. The study included 150 hospitalized COVID-19 Reverse transcription-polymerase chain reaction positive patients. According to ICMR standards, research patients were grouped into mild, moderate, and severe categories depending on clinical evaluation. Different laboratory parameters complete blood counts, prothrombin time (PT), activated partial thromboplastin time (APTT), d-dimer, serum ferritin, C-reactive protein (CRP), and mean results are compared among the patient in three disease severity groups.

Results:
In the studied population, there were 106 (70.7%) males and 44 (29.3%) females. The average age of the research participants was 48.40 ± 11.50 (21–75 years), with majority of patients being old (>60 years). Hematological markers such as total leukocyte count, Neutrophil-to-lymphocyte ratio (NLR), and platelet lymphocyte ratio (PLR) and the levels of PT, APTT, and D-dimer, as well as ferritin and CRP, all were considerably high with different groups of disease severity (P = 0.001).

Conclusion:
The study concluded that patients of severe disease category have significantly higher levels of leukocytosis, neutrophilia, elevated NLR, PLR, PT, APTT, D-dimer, serum ferritin, and CRP. Hematological and coagulation symptoms are associated with COVID-19 illness, and these indicators might be employed as a prognosticator for prediction of early disease severity.
Comparison of the Locoregional Outcome, Toxicities, and Compliance between Hypofractionated and Conventional Chemoradiotherapy for Head-and-Neck Cancers
Authors: Sharma Jyoti , Loyal Anushree , Dhal Shikha , Goyal Sumit , Kapoor Tapan , Rajendra Ishitaa , Singh D. P. 
Published: March 2024

Introduction:
Head-and-neck cancer (HNC) treatments are elusive, and the hunt for an appropriate radiation strategy continues. Hypofractionation has the potential to provide several advantages, including a shorter overall duration that reduces rapid repopulation, dosage escalation with a higher biologically effective dose, and patient convenience. Hypofractionation is also beneficial in minimizing the danger of catching an infectious agent by reducing the number of hospital visits during the height of the COVID-19 epidemic.

Materials and Methods:
Between January 2020 and August 2021, 120 patients with squamous cell carcinoma of the head-and-neck subsites were randomly allocated to either the hypofractionated arm A (n = 60) or the standard fractionation arm B (n = 60) with concomitant treatment.

Results:
Locoregional tumor response, acute and late toxicity, and compliance were the study's endpoints. The normal tissue toxicities of each patient undergoing radiation were monitored weekly. Clinical and radiographic evaluations of locoregional control were conducted.

Conclusion:
Hypofractionation effectively overcomes tumor repopulation in rapidly growing tumors such as HNC, and we conclude in our study that the hypofractionated chemoradiation schedule appears to be more efficacious, with relatively superior locoregional control when compared to conventional chemoradiation with comparable normal tissue toxicities and compliance.
Ki-67 Expression in Oral Potential Malignant and Malignant Lesions and Correlation of Mitotic Index with MIB-1 Labeling Index
Authors: Mittal Ankita , Awasthi Seema , Chauhan Rashmi , Ahmad Faiyaz , Kumar Ashutosh , Mitra Nishant 
Published: March 2024

Introduction:
Oral cancers are the most serious health issues in underdeveloped countries such as India and considered as the main cause of death. Among them, oral squamous cell carcinoma is the most common type (90%) of all malignancies. Various oral potential malignant lesions (OPMLs) can transform into malignancies. This study was conducted to determine the significance of Ki-67 expression in oral potential malignant and malignant lesions (MLs) as well as correlation of mitotic index (MI) with MIB-1 labeling index (LI) in these lesions.

Materials and Methods:
The study was performed on 60 cases in a tertiary care center over a period of 2 years. Ki-67 expression, MI and MIB-1 LI were calculated and correlated.

Results:
In the studied population, there were 49 (81.7%) males and 11 (18.3%) females. The mean age was 46.60 ± 9.94 (23–68 years), with majority of patients in 41–60 years of age group (46/60 cases). Anterior 2/3rd tongue is the most affected site, presented ulcer as the most common lesion. Smoking, tobacco, and betel nutchewing addiction were presented in 72% of the patients. Among 60 cases, 45 (75%) were OPMLs, while 15 (25%) cases were MLs. MI increases in OPMLs and MLs and comparison was significant (P < 0.01). MIB-1 LI was significant (P < 0.01) on comparison to dysplasia III and MLs. A positive correlation (0.01) was established between MI and MIB-1 LI of OPMLs and MLs.

Conclusion:
Ki-67 expression was found correlated with the progression of disease from OPMLs to MLs. Therefore, it is considered a proliferative marker that corresponds with disease progression. Both proliferative indices (MI and MIB-1 LI) are positively correlated.
Estimation of plasma soluble interleukin-2 receptor alpha chain level in adults with acute myeloid leukemia
Authors: Abd-Alabass Yusur Zaher , Mohammed Najlaa Bader 
Published: March 2024

Abstract:BACKGROUND:Acute myeloid leukemia (AML) is a clonal malignant condition of immature hematopoietic cells, characterized by clonal proliferation of abnormal cells (blasts) in the marrow leading to impairment of the normal blood cell production giving rise to failure of the bone marrow. Soluble interleukin-2 (IL-2) receptor alpha chain is a protein that is involved in the assembly of the high-affinity IL-2 receptor, and it has a critical role in controlling immune system homeostasis. The overexpression of sIL-2RA was investigated in many hematopoietic malignancies, and it was correlated with poor outcome.OJECTIVES:The aim of this study was to assess the sIL-2RA level as a prognostic factor and assess its impact on survival and if it can be used as a targeted treatment for a better outcome.MATERIALS AND METHODS:Sixty newly diagnosed adults with AML before starting therapy were included in the study, and they were followed up for 6 months to document survival status. Thirty healthy adults were taken as a control group. Using an enzyme-linked immunosorbent assay, the plasma sIL-2RA level was measured. Statistical analysis was done using Microsoft Excel 2019 and version 26 SPSS statistical software.P<0.05 was considered statistically significant.RESULTS:A considerable difference in the plasma sIL-2RA level between AML patients and controls also was more elevated in patients who died after 6-month follow-up. According to the blast percentage, total white blood cell count, and M0-M2 subgroups, the sIL-2RA level correlated positively. Irrelevant association was found regarding the patients’ age, the count of platelet, and the hemoglobin.CONCLUSIONS:Plasma sIL-2RA level is higher in AML patients than the control group at the time of diagnosis. Patients with a high level of plasma sIL-2RA have an inferior (overall survival) and poor outcome. SIL-2RA level is higher in M0-M2 subgroups than other subtypes. There is a significant association between sIL-2RA level and the absolute count of leukemic blasts.
A comparison of the shear bond strength of orthodontic brackets bonded after enamel conditioning with sodium hypochlorite and papain gel
Authors: Fathima Ferin , Shantaraj Ravi , Pradeep Subbaiah , Rajashekar Dhakshaini Mysore , Kumar I. Girish 
Published: March 2024

Objectives:
The objective of this research was to evaluate the effect of conditioning the enamel surface with 10% papain gel and 5.25% sodium hypochlorite (NaOCl) on the shear bond strength (SBS) of orthodontic brackets and correlate it with the conventional bonding mechanism utilizing a universal testing machine.

Materials and Methods:
Ninety extracted human premolars divided into three groups: In Group 1, treatment with 5.25% NaOCl for 60 s on enamel surface followed by etchant and primer application. In Group 2, treatment with 10% Papain gel for 40 s followed by etching and primer application. In Group 3, etching was followed by primer application. A universal testing machine was used to record the SBS of the orthodontic brackets.

Results:
About 5.25% NaOCl (15.10 ± 2.66) and 10% papain gel (15.66 ± 2.83) treatment on enamel before acid etching when compared to the control group (12.82 ± 2.03) increased the SBS with a statistically significant difference between them (P = 0.002, P < 0.001). The experimental groups, NaOCl (15.10 ± 2.66) and papain gel (15.66 ± 2.83) group, were comparable but did not show any statistically significant difference between them (P = 0.665).

Conclusion:
SBS of orthodontic brackets can be significantly increased if the enamel is deproteinized with 5.25% NaOCl and 10% papain gel before acid etching with 37% phosphoric acid compared to the conventional bonding technique. Deproteinizing enamel can be considered a cost-effective ally to increase orthodontic brackets' bond strength and thereby reduce the duration of orthodontic treatment.
Glycated hemoglobin as surrogate indicator of dyslipidemias and impending complications in type 2 diabetes patients
Authors: Kumar Sumit , Agarwal Vijender Kumar 
Published: March 2024

ABSTRACT

Introduction:
Prevention of long-term complex metabolic complications of type 2 diabetes mellitus (T2DM) can be achieved by good glycemic control. Different studies have highlighted several biomarkers and their connection with T2D risk and glycated hemoglobin (HbA1c) level is now universally accepted as the most reliable indicator of long-term glycemic control. However, few of them have explored the interconnection of these biomarkers as well as the prospective alterations in the diabetes biomarker correlation between diabetes, blood biochemical markers, age, and body mass index (BMI). Diabetes and dyslipidemia commonly coexist and dyslipidemia is a major risk factor for cardiovascular, neurological, and eye complications but there is a lack of evidence on the pattern of dyslipidemia and whether Hb1Ac level is related with serum lipid profile in T2DM patients.

Aim:
To determine a multi-level approach to establish a relationship between mean Hb1Ac level in the study and correlate its association with the serum lipid profile, age, BMI, and neurological complications in T2DM patients.

Materials and Methods:
A total of 105 T2DM patients with a mean age of 54.1 ± 10.08 years were included in this cross-sectional study. The whole blood and sera were analyzed for fasting blood sugar, HbA1c, total cholesterol, triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), low-DL-C (LDL-C), and very LDL-C (VLDL-C). Neurological assessment done by simple screening methods including the 10 g monofilament and the 128-Hz tuning fork test for the detection of early neuropathies. The correlation of HbA1c with the lipid ratios and individual lipid indexes was done by Pearson correlation test (r) using SPSS version 28.0 software.

Results:
Mean Hb1Ac level was 7.36 ± 1.78 which was abnormal in 61.9% of the total enrolled diabetic patients. Mixed dyslipidemias were common with abnormal TG, LDL and VLDL values followed by abnormal HDL-C values in 83.8% of the total enrolled diabetic patients. The Hb1Ac levels showed significant positive correlation with serum cholesterol, TG, LDL and VLDL levels but showed statistically significant negative correlation with serum HDL levels in the study. Duration of diabetes and Hb1Ac values also showed positive correlation with ophthalmological and neurological complications at presentation in the study.

Conclusion:
Apart from a reliable indicator of long-term glycemic control, HbA1c can also be used as a predictor of dyslipidemia and early diagnosis of dyslipidemia can prevent cardiovascular neurological and eye complications in T2D patients.
A clinicopathological study of lupus nephritis based on the international society of nephrology-renal pathology society 2018 classification system
Authors: Charaya Payal , Solanki Ranjana , Hemrajani Deepika , Agnani Bhawna 
Published: March 2024

ABSTRACT

Background:
Lupus nephritis is one of the most frequent and severe manifestations of systemic lupus erythematosus. The histological class of lupus nephritis, the degree of activity, and chronicity are major determinants of treatment and prognosis. Revised ISN/RPS classification 2018 is designed to improve problematic definitions that form the basis of lupus nephritis classification by using an evidence-based approach by refining definitions for lesions and thereby increasing the interobserver agreement between nephropathologists.

Objective:
To evaluate the clinical and histopathological profile of lupus nephritis as per Revised ISN/RPS guidelines 2018.

Materials and Methods:
Sixty-one patients with the clinical diagnosis of lupus nephritis who underwent renal biopsy were studied. Light microscopy and immunofluorescence study performed. Parametric tests such as the unpaired T-test and Pierson correlation test were used for the analysis of linear variables.

Results:
Out of 61, 49 patients were designated class as per revised International Society of Nephrology-Renal Pathology society guidelines and 12 biopsies were found suboptimal for class evaluation. There was a female preponderance (54/61) with most patients within the first two decades. Class IV was found to be the most common class. Most patients presented with generalized swelling/edema and fever. Anemia and proteinuria showed a significant correlation (p < 0.05) with class.

Conclusion:
The key to improving renal outcomes is early detection of the lesion by proper assessment of renal biopsy. It also aids in the formulation of a treatment plan according to class. However, clinical parameters can be used while following up with the patients for disease activity.
Perception and reflections of second year medical students on attitude, ethics, and communication skills module on patient autonomy and decision making in a tertiary care teaching hospital
Authors: Kamath Latha , Chakraborty Ananya , Asanaliyar Meharban 
Published: March 2024

ABSTRACT

Background:
Attitude, ethics, and communication (AETCOM) module is a new inclusion in the current medical curriculum. It is designed to improve the competence levels of undergraduate medical students with regard to their communication skills, demonstration of empathy, and resolution of ethical dilemmas. This study aims to assess the student’s perspective and reflections on the AETCOM module conducted by the pharmacology department.

Methods:
This was a cross-sectional observational study conducted for1 month involving 2nd year medical students of Vydehi Institute of Medical Sciences and Research Centre. An internally validated questionnaire was used to assess student’s perspective on the AETCOM module. Student’s reflections were obtained from their logbook entry. The data obtained were analyzed in Microsoft Excel.

Results:
The mean score for overall benefit of the AETCOM module for all participants (n = 163) was 4.1 out of 5. In our study, 85.3% of students agreed that the AETCOM module helped them to understand about sociocultural, ethical, and medico-legal aspects related to case scenarios. About 89.6% of students found panel discussion to be effective tool to understand case scenarios better. About 88.3% of students agreed that the inclusion of module in the curriculum was good. The mean score for reflections for students was 6.2 on 10.

Conclusions:
Our analysis of student’s perspective and reflection about the AETCOM module showed that students understood about patient autonomy and decision-making better when case scenarios, role-play and panel discussion were used to teach them the module. Inclusion of the module into the regular curriculum increases the student’s participation and awareness regarding different clinical scenarios and equips them in a better way for future clinical practice.
Assessment of depression and suicidal risk in patients with psoriasis
Authors: Dey Pranjal , Zaman Rezib Uz , Nath Jyoti 
Published: March 2024

Background:
Psoriasis is one of the common psychosomatic illnesses which have impairment of physical, psychological, social functioning of an individual. This impairment may lead to psychiatric morbidities such as anxiety disorders and depressive disorder which increase the suicidal risk in these patients. The present hospital-based comparative study was carried out to evaluate the depression and suicidal risk in patients with psoriasis and to compare them with healthy control.

Methods:
This was a hospital-based cross-sectional study. Fifty patients with psoriasis were enrolled for the study after their informed consent with purposive sampling method from the department of dermatology in a tertiary care hospital in the northeastern part of India and compared them with those of the control group. The severity of psoriasis was assessed using the Psoriasis Area and Severity Index scale. The same patients were evaluated by the International Classification of Mental and Behavioral Disorders tenth revision research criteria along with the Hamilton Rating Scale for Depression and suicidal risk assessment form to diagnose and grade depression and assess for suicidal risk. Data were analyzed in SPSS version 16.0.

Results:
The incidence of depression was significantly higher in the psoriasis patient group (44%) in comparison to the control group. Among them, 50% of the depressed patients had mild depression and 31.9% of the patients had very severe depression with death wish with suicidal ideation. Furthermore, 4.6% of the depressed patients have a high risk of suicide.

Conclusions:
These findings indicate the need of early recognition of depression and suicidal risk among these patients and their early intervention will improve the primary disease process and will prevent a devastating outcome like suicide.
Elevated circulating levels of matrix metalloproteinase-9 and its association with cardiovascular risk in young smokers
Authors: Nath Dinesh , Shivasekar Meera , Vinodhini V. M. 
Published: March 2024

Background:
Smoking causes cardiovascular risk which may alter the stability between the production and degradation of the extracellular matrix. Matrix metalloproteinase-9 (MMP-9) is a zinc-containing endopeptidase that degrades extracellular matrix and plays a vital role in tissue remodeling. As a result, elevated serum MMP-9 levels produced by smoking, particularly in younger age, raise the risk of future coronary heart disease (CHD).

Aim and Objective:
Our aim is to find out the possible relationship between circulating MMP-9 and the risk of cardiovascular disease in young smokers.

Materials and Methods:
The study contains three groups. Group 1 includes 60 young active smokers with diabetic CHD, Group 2 includes 60 young active smokers with CHD, and Group 3 includes 60 healthy controls as nonsmokers who were attending SRM Medical College Hospital in Tamil Nadu for cardiology and medicine OP. Enzyme-linked immune sorbent assay was used to measure serum MMP-9, high-sensitivity C-reactive protein (hsCRP), and apolipoprotein E (APO-E) levels, and enzymatic techniques were employed to quantify lipid levels.

Results:
When compared to the controls, the mean serum MMP-9, hsCRP, and APO-E levels were significantly higher in both the groups. The study also shows a significant positive association between MMP-9 with hsCRP, APO-E, smoking burden, and smoking intensity.

Conclusion:
The study concludes that increased MMP-9 levels, particularly in inflammatory conditions caused by smoking, are associated with an increased risk of future cardiovascular disease.
Myotonic Dystrophy Type 1 (DM1): Clinical Characteristics and Disease Progression in a Large Cohort
Authors: Chawla Tanushree , Reddy Nishanth , Jankar Rahul , Vengalil Seena , Polavarapu Kiran , Arunachal Gautham , Preethish-Kumar Veeramani , Nashi Saraswati , Bardhan Mainak , Rajeshwaran Jamuna , Afsar Mohammad , Warrier Manjusha , Thomas Priya T , Thennarasu Kandavel , Nalini Atchayaram 
Published: March 2024

Background:
DM1 is a multisystem disorder caused by expansion of a CTG triplet repeat in the 3’ non-coding region of DMPK. Neuropsychological consequences and sleep abnormalities are important associations in DM1.

Objective:
To describe the clinical phenotype, disease progression and characterize the sleep alterations and cognitive abnormalities in a sub-set of patients.

Materials and Methods:
A retrospective study on 120 genetically confirmed DM1 cases. Findings in neuropsychological assessment and multiple sleep questionnaires were compared with 14 age and sex matched healthy individuals. All 120 patients were contacted through letters/telephonic consultation/hospital visits to record their latest physical and functional disabilities.

Results:
The mean age at symptom onset was 23.1 ± 11.4 years, M: F = 3.8:1, mean duration of illness = 14.3 ± 9.5 years. Clinically 54.2% had adult onset form, juvenile = 27.5%, infantile = 10.8%, late adult onset = 7.5%. Paternal transmission occurred more frequently. The predominant initial symptoms were myotonia (37.5%), hand weakness (21.7%), lower limb weakness (23.3%) and bulbar (10%). Twenty patients completed sleep questionnaires (SQ). Abnormal scores were noted in Epworth sleepiness scale (55%); Pittsburgh sleep quality index (45%); Berlin SQ (30%); Rapid eye movement sleep Behaviour Disorder SQ (15%); Restless leg syndrome rating scale (10%). Neuropsychological assessment of 20 patients revealed frontal executive dysfunction, attention impairment and visuospatial dysfunction. Frontal lobe was most affected (72%) followed by parietal (16%) and temporal lobe (12%).

Conclusions:
The current study provides a comprehensive account of the clinical characteristics in Indian patients with DM1. Hypersomnolence was most commonly seen. Excessive daytime sleepiness and Sleep disordered breathing were the most common sleep related abnormality. Cognitive impairment comprised predominantly of frontal lobe dysfunction.