bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medulloblastoma outcomes in tertiary care set-up in India using contemporary treatment protocols - A retrospective study
Authors: Hazarika Nandini , Tiwari Priya , Munshi Anusheel , Patir Rana , Vaishya Sandeep , Ahlawat Sunita , Chaudhoory Amal Roy , Goel Vineeta 
Published: April 2024

Background:
Medulloblastoma is the commonest embryonal brain tumor in children. It has shown improved outcomes with combined modality treatment. We aimed to study patient characteristics and survival outcomes of patients with this disease across two tertiary care centers in India.

Methods:
We analyzed data of patients with histological diagnosis of medulloblastoma treated from January 2010 to January 2016. Patient characteristics and follow-up data were retrieved from hospital records. Descriptive statistics were used to describe clinical and pathological characteristics. Overall survival (OS) was calculated from date of diagnosis to death due to any cause. Relapse-free survival (RFS) was calculated from date of diagnosis to occurrence of relapse or death.

Result:
Out of 26 patients treated, 24 were children and 2 were adults. Median age was 10 years (range = 0.8–22 years). Twenty (76.9%) patients were male. Fifteen (57.7%) patients were stratified as high-risk (HR), rest 11 (42.3%) were categorized as average risk (AR). Histopathology showed classical variety in majority of patients except for 4 (15%) cases, 3 with desmoplastic and 1 with anaplastic subtype. Median follow-up was 49.7 months (range= 4.2–102.5 months). Overall, eight (30.8%) patients relapsed and six (23%) deaths occurred. Five (33.3%) patients in HR category and 3 (27.3%) patients in AR group showed relapse. Median RFS and OS were not yet reached. Five-year RFS was 69.2% whereas five-year OS was 76.9%.

Conclusion:
This study highlighted patient characteristics and treatment outcomes in Indian patients. With adherence to standard treatment, high remission rates and improvement in mortality rates were achieved.
Expression of mismatch repair proteins in urothelial carcinoma of the urinary bladder
Authors: Mohamedali Rasheeda , Adhya Amit K , Mandal Swarnendu , Mitra Suvradeep 
Published: April 2024

Background:
Urothelial carcinoma of the urinary bladder (UCUB) is a frequently diagnosed malignancy. Mismatch repair (MMR), a proofreading machinery of the DNA, prevents tumorigenesis. The role of MMR deficiency in UCUB in eastern Indian population is not known.

Methods:
Immunohistochemistry panel for MLH1, PMS2, MSH2, and MSH6 (MMR proteins) was performed on the biopsy specimens of UCUB (N=100).

Results:
MMR deficiency by immunohistochemistry was demonstrated in two cases (2%). One case showed deficiency of MSH2 and MSH6 and the other case showed the deficiency of all four mismatch proteins. Both cases showed high-grade invasive urothelial carcinoma by histomorphology.

Conclusion:
The prevalence of MMR deficiency by immunohistochemistry is 2% in eastern Indian population.
A clinical study of serum human epididymis protein 4 (HE4) in the diagnosis of pancreatic cancer
Authors: Liu Weiqi , Liu Weiling , Lin Keng , Liu Yuhua , Hu He , Yang Lina 
Published: April 2024

Background:
Pancreatic cancer (PC) has poor early diagnosis rates due to its insidious onset. Since human epididymis protein 4 (HE4) is highly expressed in patients with PC, we assessed whether serum HE4 could be a marker for the detection 3 of PC.

Method:
Between May 2017 and October 2018, 127 patients with PC were recruited for the study along with 108 healthy controls who underwent health examinations. Serum HE4 concentrations were determined together with levels of carcinoembryonic antigen (CEA) and carbohydrate antigens (CA) 242 (CA242), CA19-9, CA15-3, and CA72-4 by electrochemiluminescence immunoassay (ECLIA) or chemiluminescence immunoassay (CLIA). Correlations between these biomarkers were assessed.

Results:
Serum levels of all six biomarkers were higher in patients with PC than in controls (P < 0.05). No correlation was observed between the serum levels of HE4 and the five other tumor markers, although there were strongly significant positive correlations between CA19-9 and CA15-3, and between CA242 and CA72-4. The lack of correlation indicates that HE4 has independent value in the diagnosis of PC. The combined assessment of serum HE4 levels and the other tumor markers improved the sensitivity of diagnosis. In particular, HE4 combined with CA19-9 performed significantly better than HE4 alone, or CA19-9 combined with the other markers. The HE4/CA19-9 combination resulted in 94.49% sensitivity and 99.07% specificity (95% confidence interval: 96.9–100).

Conclusion:
HE4 is a biomarker associated with PC with a high specificity, either used alone, or evaluated with other biomarkers together improving the detection of PC. This study may provide a new clinical diagnostic approach for PC detection.
Stage migration and treatment outcome in carcinoma tongue – A comparison of seventh and eighth AJCC pathological staging systems
Authors: George Rebecca , Prakasan Aparna , Anila KR , Krishna KM Jagathnath , Iype Elizabeth Mathew , Jayasree K , Ramadas Kunnambath 
Published: April 2024

Background:
The eighth edition of the American Joint Committee on Cancer (AJCC) for oral cancer has incorporated additional pathological features like depth of invasion (DOI) and extranodal extension (ENE) into T and N staging. The incorporation of these two factors will impact the staging and, hence, the treatment decisions. The aim of the study was to clinically validate the new staging system in predicting the outcome in patients treated for carcinoma oral tongue. The study also examined the correlation of pathological risk factors with survival.

Methods:
We studied 70 patients with squamous cell carcinoma of the oral tongue who underwent primary surgical treatment at a tertiary care center in the year 2012. All these patients were restaged pathologically according to the new AJCC eighth staging system. The 5-year overall survival (OS) and disease-free survival (DFS) were calculated using the Kaplan–Meier method. Akaike information criterion and concordance index were calculated between both staging systems to identify a better predictive model. Log-rank test and univariate Cox regression analysis were conducted to find out the significance of different pathological factors on outcome.

Results:
Incorporation of DOI and ENE resulted in 47.2% and 12.8% stage migration, respectively. DOI less than 5 mm was associated with a 5-year OS and DFS of 100% and 92.9%, respectively, compared to 88.7% and 85.1%, respectively, when the DOI was more than 5 mm. Presence of lymph node involvement, ENE, and perineural invasion (PNI) were associated with inferior survival. The eighth edition had lower Akaike information criterion and improved concordance index values compared with the seventh edition.

Conclusion:
The eighth edition of AJCC allows better risk stratification. Restaging of cases based on the eighth edition AJCC staging manual resulted in significant upstaging with difference in survival.
Incidence of cancers of unknown primary origin in India and their trends during 1986–2014
Authors: Labani Satyanarayana , Asthana Smita , Vohra Parul , Kailash Uma , Srivastava Abhinav 
Published: April 2024

Background:
Cancer of unknown primary (CUP) origin is cancer in which malignant cancer cells are in the body but the site of cancer where it began is unknown. Detailed incidence and time trends of these cancers, specific to various regions in India is needed. This paper aims to summarize and report the incidence of other and unknown (O&U) cancers across India in 27 population-based cancer registries (PBCRs) and to study the trends among these cancers using joinpoint regression analysis.

Methods:
Data on the incidence of CUP were obtained from the published reports on 27 PBCRs of the National Cancer Registry Programme (NCRP) of the Indian Council of Medical Research (ICMR). A joinpoint regression model was used to analyze the long-term trends of incidence related to CUP based on published data from PBCRs between 1986 and 2014. Annual Percent Change (APC) in incidence rate was estimated for various registries.

Results:
The northeast region had the highest age-adjusted rate (AAR) for both men (1.76–29.7) and women (1.99–14.68). Age-specific rate (ASR) for both men (39.8–855.7) and women (48.2–470.4) was highest in the northeast region. There is an increase in the incidence rate for all six major registries over the past decade with an exception of women in the Delhi Cancer Registry. There is a decline in incidence rate by 0.14 during 1990–2012 in the female population of the Delhi registry.

Conclusion:
The increasing incidence trends of CUP is a matter of concern for the healthcare professionals and researchers. There is a need for research and advanced and improved diagnostic tools for the improvement of the status of O&U cancers.
Does perceived social support, psychological problems, and fatigue impact quality of life of geriatric patients with cancer?
Authors: Rajagopal Revathi , Ganesan Prasanth , Veeraiah Surendran 
Published: April 2024

Background:
Health-related comorbidities often increase due to cancer among the ageing population. However, thed omains of psychological functioning of geriatric patients remain undetected especially in the Indian scenario. This study aimed to evaluate psychological problems, perceived social support, fatigue, and quality of life among geriatric patients with cancer.

Methods:
A cross sectional study was conducted in a tertiary cancer center. Geriatric patients with cancer (n = 130) having solid malignancies categorized as older patients (>65 years) and younger geriatric patients (60–65 years) were included in the study. Depression, anxiety, perceived social support, fatigue, and quality of life was assessed using the Geriatric Depression Screening Scale, Geriatric Anxiety Scale, Multidimensional Scale of Perceived Social Support, Symbolic Assessment of Fatigue Extent, and the Old People Quality of life Scale, respectively. Descriptive and inferential statistics such as cross tab analysis, correlation and regression analysis.

Results:
A majority of patients 80 (61.5%) had low perceived social support, moderate-severe depression 61 (47.7%) and mild-moderate anxiety 55 (43.1%). Half of the patients were found to have poor quality of life. Further, psychological problems were higher among older geriatric patients (p = 0.000). Very few patients had a higher impact of fatigue on their daily functioning 17 (13.3%). There was a positive correlation between perceived social support, depression, anxiety, extent of fatigue, and quality of life (r = 0.256, P = 0.003).

Conclusion:
Psychological problems are higher among older geriatric patients with cancer undergoing treatment. Clinical implications could aim at regular screening to identify specific psychological issues and provide appropriate interventions. Future research warrants the efficacy of such therapeutic interventions for better quality of life outcomes.
Dosimetric evaluation of the effect of dental restorative materials in head and neck radiotherapy
Authors: Oktay Elif A , Zerener Tamer , Dırıcan Bahar , Yıldız Selda , Sager Omer , Karaoglanoglu Serpil , Beyzadeoglu Murat 
Published: April 2024

Background:
The aim of our study is to assess the dose enhancement from scattered radiation due to dental restorative materials used for occlusal and mesio-occlusal-distal (MOD) cavity filling during simulated head and neck radiotherapy.

Methods:
We have studied the dose enhancement ratio (DER) of conventional amalgam, high-copper amalgam, and resin composite dental restorative materials at cadaver mandible teeth using 2 therapeutic photon energies of 1.25 MeV (Co-60 gamma ray) and 6 MV (Linac X-ray) for irradiation.

Results:
DER values at buccal position for Co-60 and 6 MV X-ray were 1.250 ± 0.013 and 1.151 ± 0.012, respectively. For dental cavity fillings, DER values for 6 MV X-ray were 1.065 ± 0.021, 1.100 ± 0.014, and 1.162 ± 0.016 for resin composite filling, low-copper amalgam filling, and high-copper amalgam filling, respectively. Our results revealed that DER regarding irradiation energy was minimum for 6 MV X-rays. With respect to dental restorative filling material, DER was minimum for resin composite filling. Regarding the cavity type, our results with standard deviation (SD) calculations revealed that DER was slightly but not significantly different for both Co-60 gamma ray (1.25 MeV) and 6 MV X-ray energies for both occlusal and MOD cavities.

Conclusion:
Our dosimetric results for a single beam geometry suggest that, among the three types of filling, resin composite filling is an ideal restorative filling material with minimal morbidity-inducing radiation dose enhancement that may result in increased osteoradionecrosis and secondary caries risk. There is a need for further dosimetric studies with actual clinical beam arrangements.
Radiation-induced hypothyroidism in patients of oral squamous cell carcinoma
Authors: Jain Prateek V , Das Avipsa , Manikantan Kapila , Sharan Rajeev , Mallick Indranil , Chatterjee Sanjoy , Arun Pattatheyil 
Published: April 2024

Background:
Radiation-induced hypothyroidism (RIH) is common after neck irradiation, and biochemical evaluation of thyroid function is recommended periodically for early diagnosis and treatment. This study aimed to evaluate the predictors of RIH after completion of adjuvant radiotherapy (RT) for primary oral squamous cell carcinoma (OSCC).

Methods:
This is a retrospective study involving 195 patients who received RT after surgery for OSCC between August 2011 and December 2016. Thyroid function tests were obtained every 6 months and patients were considered to be hypothyroid if thyroid-stimulating hormone level was >5 mIU/mL.

Results:
The study cohort comprised 130 men with a median age of 52 years (range 21–77 years). About 107 (54.87%) patients developed hypothyroidism, with a median of 21 months (range 2–67 months) for the development of RIH. Women [41 (63.1%) versus 66 (50.8%), p=0.035], addition of chemotherapy [36 (63.2%) versus 71 (51.4%), p= 0.019], and higher cumulative dose to the thyroid gland (median dose 4690 cGy versus 2981 cGy, P < 0.001) resulted in higher incidence of RIH on univariate analysis. On multivariate Cox regression analysis, female sex (P = 0.042), bilateral irradiation (P = 0.046), and cumulative dose to the thyroid (P = 0.001) were factors associated with increased risk of developing RIH.

Conclusion:
The addition of chemotherapy, high dose of radiation to the thyroid gland, bilateral irradiation, and female sex were at higher risk of developing RIH. However, more studies are required to identify the dose-volume constraints of the thyroid gland.
To Evaluate the Effect of Prophylactic Agents on the Surface Morphology of Different Orthodontic Wires at Different Temperatures: An In vitro Study
Authors: Kedia Ankita , Khanduri Mridul , Puri Taruna , Kashyap Varun , Bishnoi Anita , Narnoli Shubham 
Published: April 2024

Aim and Objective:
The aim and objective are to evaluate the effect of prophylactic agents on the surface morphology of different types of orthodontic wires of different dimensions at two different temperatures.

Materials and Methods:
Stainless steel (SS), NiTi, and titanium-molybdenum alloy (TMA) wires of 0.016 inch round and 0.017 inch × 0.025-inch dimensions were immersed in prophylactic agents such as 0.2% NaF, 0.2% CHx and 1.23% APF for 1.5 h at 37°C and 45°C. A one-way analysis of variance, Bonferroni test, and intraclass correlation coefficient test was performed to eliminate the bias. Scanning electron microscope was used to evaluate the surface characteristics of wire and quantitative analysis was performed using ImageJ software.

Results:
Highest corrosion can be seen on TMA wires of 0.016 inch and 0.017 inch × 0.025 inch when exposed to 1.23% APF gel at 45°C and lowest corrosion can be seen on SS wires of 0.017 inch × 0.025 inch when exposed to 0.2% NaF mouthwash at 37°C.

Conclusion:
The results suggest that sodium fluoride is the mouthwash of choice when used with all three types of orthodontic wires used for different orthodontic purposes and APF gel should not be recommended when TMA wires are used at high temperatures as it causes corrosion which can lead to increased friction.
Sports-Related Musculoskeletal Injuries in Medical Students
Authors: Champawat Vishal Singh , Santoshi John Ashutosh , Tiwari Anurag , Behera Prateek , Selvanayagam Rajkumar , Verma Virendra Kumar 
Published: April 2024

Abstract

Background:
Little attention is paid to the problem of sports-related injuries in amateur or nonathletes or recreational student athletes. We investigated the prevalence of sports-related musculoskeletal (MSK) injuries in medical students and attempted to identify the risk factors for these injuries.

Methods:
We conducted a cross-sectional questionnaire-based observational study on medical students of a tertiary care teaching hospital in central India. A total of 500 medical students were approached; the questionnaire consisted of details, such as age, gender, height, weight, predominant sport played or the sport during which they sustained an injury, estimated time spent playing every week, if they had undergone any formal training for the sport, any preexisting MSK condition, details of the injury and the treatment taken, if any, after joining medical school, and duration from getting injured to return to studies and sports. The odds ratio (OR) and logistic regression were calculated for multiple parameters. Statistical significance was set at P ≤ 0.05.

Results:
Seventy-four of the 402 students who responded reported sustaining a sports-related injury; 33 and 41 students reported injury while playing contact and noncontact sports, respectively. Of these, 58 students reported that they had received formal training in sports. Football, volleyball, cricket, and kabaddi were the sports during which most injuries occurred. The injury rate was 3.7 per 1000 playing or practice hours.

Conclusions:
Almost one-fifth of the students reported sustaining a sports-related MSK injury after joining medical school. The risk factors identified for these injuries were male gender, participation in team sports, participation in noncontact sports, and lack of adequate preparation or practice.
Silicosis-Allergic Bronchopulmonary Aspergillosis Overlap—A Rare Duet!
Authors: Neenu N , Utpat Ketaki , Desai Unnati , Samuel Magizh , Bagul Rahul , Shah Hem 
Published: April 2024

Abstract
Silicosis is a progressive pneumoconiosis caused by inhalation of crystalline silica dust commonly seen in workers of construction sites, flour mills, and mining. Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction to Aspergillus fumigatus antigens commonly encountered in patients with asthma and cystic fibrosis. We report a case of 60-year-old flour mill worker presented with clinico-radiological features of silicosis; further evaluation was found to have an overlap of ABPA in view of severe atopic symptoms. We describe a rare duet of silicosis with ABPA overlap.
Climate Change and Occupational Heat Strain Among Women Workers: A Systematic Review
Authors: Habibi Peymaneh , Heydari Ahad , Dehghan Habibollah , Moradi Amirhossein , Moradi Gholamreza 
Published: April 2024

AbstractClimate change increases heat stress exposure and occupational heat strain in tropical and subtropical regions with generally hot–humid climate conditions. The present systematic review was conducted to assess the effect of climate change on occupational heat strain among women workers. In this study, three main databases (PubMed, Scopus, and Web of Science) were searched to find relevant literature on climate change and its effects using subject headings and appropriate MeSh terms. This article has been written according to the PRISMA checklist. A total of 6,176 studies were identified for screening and 13 studies were eligible for data extraction. Scientific evidence reveals that there is an imprecise but positive relationship between climate change and occupational heat strain regarding women workers. Some complications associated with occupational heat strain among women workers include fatigue, discomfort, dehydration, reduced brain function, and loss of concentration. Climate change can lead to an increase in the occurrence of heat-related illnesses and the levels of injury risk. In addition, its adverse health effects on women workers are mentioned. This systematic study identifies key priorities for action to better characterize and understand how occupational heat strain among women workers may be associated with climate change events. Strong evidence indicates that climate change will continue to cause occupational heat strain among women workers. It is essential to implement preventive measures considering multidisciplinary strategies to reduce the adverse effects of climate change on women workers health in hot weather settings. This can limit the health risks and negative effects of climate change.
Effect of Occupational Stress on Work Behavior as Perceived by Nurses at Benue State University Teaching Hospital Makurdi
Authors: Olorunfemi Olaolorunpo , Chika Ogochukwu J. 
Published: April 2024

Abstract

Background:
Every work environment, especially in hospital settings must be conducive, friendly, and stress-free in order to promote quality care and the well-being of healthcare workers, whose job demands are increasing by the day.

Aims:
The purpose of this study was to determine the perceived effect of occupational stress on work behavior among nurses at Benue State University Teaching Hospital in Makurdi.

Methods:
From the facility’s population of nurses, a quantitative survey randomly chose 150 respondents nurses, for the purpose of gathering information and testing the hypothesis, a well- developed and validated questionnaire was employed to gather data. Using SPSS, the data were descriptively analyzed, and an inferential analysis with a significance level of 5% was performed using Pearson’s Chi-square test (0.05).

Results:
The majority of participants (56.6%) were men with a higher level of education. This study also shows the effect of occupational stress on work behavior as poor work performance 142 (94.7%), counterproductive work behavior 139 (92.7%), increases the incidence of absenteeism 112 (74.7%), high occurrence of medication error 120 (80%), Negative effect on teamwork 98 (65.3%), increases the incidence of Substance use disorders 95 (63.3), and aggressive attitude toward patients during nursing care 137 (91.3). Furthermore, there is a significant association between occupational stress and job satisfaction (x2 = 25.49, df = 8, and p < 0.001), patient safety (x2 = 51.07, df = 8, and P = 0.002), and nurses’ attitudes toward their patients (x2 = 86.67, df = 12, and P = 0.012).

Conclusion:
We discovered that workplace stress can affect how happy nurses are with their jobs and how they behave while providing nursing care. We recommend that hospital administrators implement a plan to create a stress-free working environment for nurses.