bluuebunny/crossref_metadata_2025_split huggingface dataset:
A successful Ayurveda treatment of recurrence severe plaque psoriasis – A case report
Authors: Kumar Sunil , Thiyagaraj K. , Krishnan E. M. Thrijil , Maheshwari Nisha 
Published: March 2024

Abstract
Psoriasis is one of the most common dermatologic diseases characterized by erythematous, sharply demarcated papules and rounded plaques, covered by silvery micaceous scale. It is a lifelong disease with a chronic relapsing course and most patients require a long-term management. About 80%–90% of people living with psoriasis experience plaque psoriasis, the most common variant of the disease. In spite of its prevalence, recurrence is making a serious global problem. In Ayurveda, most of the chronic skin disorders are studied under a common heading Kushtha. In the present case, a 54-year-old male was diagnosed with typical symptoms of plaque psoriasis all over the body for a duration of 5 years. The patient was advised for Samshodhana (therapeutic purgation), followed by Sanshamana (disease specific internal medicine) using drugs Shuddha Gandhaka, Pancha-Nimba Churna, Panchtikta Ghrita, and Aragvadha Phala-Majja Kwatha. Psoriasis area and severity index score reduced from 65.7 to 0.9 which is a marked significant difference. There is no recurrence even after discontinuing the treatment for the last 2 years which makes it worth reporting.
Waste matters: Investigating the knowledge, awareness, and practice of electrical and electronic waste management among undergraduate medical students – A cross-sectional study
Authors: Yee Gwendolyn C. J. , Nagalingam Humhashinee , Perera Kottegodage Supipi Peumali , Hen Lim Zhong , Raman Aarthy , Nadarajah Nivedita G. S. , Htay Mila Nu Nu , Moe Soe , Soe Htoo Htoo Kyaw 
Published: March 2024

Abstract

Context:
Handling of electronic and electrical waste (E-waste) has adverse effects on the environment and human well-being. To address the environmental and health risks arising from improper e-waste disposal, it is crucial to foster responsible practices and enhance understanding of e-waste management.

Aims:
This study aimed to assess the knowledge, awareness, and practice of e-waste management and association of these factors with demographic variables among undergraduate medical students.

Settings and Design:
A cross-sectional study was conducted at a private medical university among medical students in Malaysia.

Subjects and Methods:
The selection of participants was done using purposeful sampling, and the questionnaire was distributed in the form of an online survey using Google Forms.

Statistical Analysis Used:
Chi-square test and multivariable logistic regression were calculated.

Results:
Out of the 135 medical students surveyed, 39.3% demonstrated a good knowledge and 27.4% displayed a good awareness. In terms of practice, 67.4% of respondents appropriately disposed of electronic gadgets, whereas 41.5% properly disposed of electrical appliances. Notably, no statistically significant associations were found between demographic characteristics and the knowledge, awareness, and practice in e-waste management among the participants.

Conclusions:
Our research emphasizes the insufficient knowledge, awareness, and inadequate implementation of proper practices concerning e-waste management among medical students. Fostering a supportive environment and emphasizing collaborative efforts are crucial steps that empower medical students to actively participate in and contribute to responsible electronic waste practices. This approach enables students to be proactive agents in promoting a greener and more environmentally conscious approach to electronic waste.
Efficacy of matrix rhythm therapy (MaRhyThe©) over conventional therapy on radiation induced trismus-A pilot randomised control trial
Authors: Tanna Rushil Deepak , Pattanshetty Renu B. , Ahmed Imtiaz 
Published: March 2024

Background and Objectives:
Prevalence of radiation induced trismus in head and neck cancer (HNC) is 38% to 42% globally. Radiation induced trismus depends on the dosage of the radiation therapy and the surgical procedure. Myofascial release (MFR) and Matrix rhythm therapy (MaRhyThe©) are techniques used to treat the myofascial pain and muscular restriction. The present study aimed to compare the effect of MFR and MaRhyThe© on pain, mouth opening, TMJ disability index (TDI), Gothenburg Trismuus Questionnaire (GTQ), Functional Intraoral Glasgow Scale (FIGS) and quality of life in participants with Radiation induced trismus.

Materials and Methodology:
About 30 participants in age group of 18 to 65 years diagnosed with radiation induced trismus were included in the study. All the participants were randomly allocated in 2 groups MFR group and MaRhyThe© group. Both the group received structured exercise program. Primary outcomes were Visual Analogue Scale (VAS), Vernier Caliper reading for maximum mouth opening. Secondary outcome measure viz. GTQ, TDI, FIGS and Functional Assessment of Cancer Therapy-Head and Neck (FACT-HN) all obtained values were analyzed at the end of 4th week.

Results:
The present study demonstrated significant improvement in terms of reduction in pain, improvement in maximum mouth opening and in GTQ, TMD, FIGS, and FACT-HN scores in all the participants in both group (p ≤ 0.05). However, the groups showed equal effectiveness in the treatment of radiation induced trismus.
Diagnostic accuracy of fine needle aspiration cytology of bone lesions: A study of Tertiary Care Institute
Authors: Chaudhary Ashish , Sharma Sudershan K. , Sharma Neelam , Sharma Reetika , Lal Mukand 
Published: March 2024

Aims and Objectives:
The aim is to study the spectrum and cytomorphological features of bone lesions and find out the diagnostic accuracy of Fine needle aspiration cytology (FNAC) on the same.

Materials and Methods:
The study was a cross-sectional study conducted in the Department of Pathology and Orthopedics in a tertiary institute in north India over a period of 1 year in 55 patients. All the patients were subjected to FNAC of bone lesions followed by tru-cut or open bone biopsy. Cytosmears were stained with May Grunwald Giemsa and Hematoxylin and Eosin were done on biopsy specimens. Sensitivity and specificity were calculated in percentage with a 95% confidence interval with reference to biopsy specimens.

Results:
Two peaks were observed; one between 11 and 40 years with 32 cases and another at 51 and 60 years with 12 cases. The male to female ratio was 1.4:1. In the present study, inflammatory lesions were present in 17 (31%) cases, 2 were tumor-like conditions; 10 (18%) cases of primary benign tumors, 26 (47.2%) cases were malignant. Out of these, 15 (27.2%) were primary malignant bone tumors and 11 (20%) were secondary in nature. The sensitivity, specificity, and diagnostic accuracy of the FNA of bone lesions were 55.17%, 79.04%, and 73.46%, respectively.

Conclusion:
Although there are a few limitations of FNAC such as low cellularity, small representative sample, and hemorrhagic aspirate, it can still be used as an initial diagnostic modality with proper clinical context for the management of bone lesions.
Evaluation of HLA-DR and HLA-DQ expression in gastric cancer tissues
Authors: Jafari Narjes , Khajenabi Fatemeh , Masumi Nastaran , Abediankenari Saeid , Ranjbaran Hossein 
Published: March 2024

Background and Objectives:
Despite recent advances in understanding the gastric cancer (GC) biology, the precise molecular mechanism of gastric carcinogenesis and role of deregulated immune responses in GC progression are still not well understood. In this study, mRNA levels of human leukocyte antigen (HLA)-DRA and -DQA1 were assessed in GC patients to find a potential association between expression of these HLA-II molecules and gastric carcinogenesis.

Methods:
Using quantitative real-time (qRT)-PCR, mRNA levels of HLA-DRA and -DQA1 were assessed in 20 pairs of matched GC and normal tissues.

Results:
Our results showed that overall mRNA level of HLA-DRA was decreased in the tumor samples relative to control tissues (median fold change [FC] = 0.693; P = 0.445). Overall HLA-DQA1 level was increased in the tumor samples relative to control tissues (median FC = 1.659; P = 0.5117). However, the mentioned data were not statistically significant. Meanwhile, using a ≥ 2.5 FC as the cutoff to determine upregulation or downregulation, 35% of patients showed a downregulated expression of HLA-DRA, while 10% of those showed upregulation in HLA-DRA expression. Upregulation and downregulation of HLA-DQA1 expression were detected, respectively, in 35% and 25% of samples. A strong positive correlation was determined between HLA-DRA and HLA-DQA1 levels in tumor tissues (r = 0.7298; P = 0.0003).

Conclusion:
The results reported here along with future studies can be useful to understand the interplay between immune system and GC, therefore, may be helpful to design an effective immune-based therapy.
Clinical diagnosis and management of multiple cerebral ring-enhancing lesions—study of 50 patients at a tertiary healthcare center
Authors: Patel Ankit , More Bhagirath , Rege Ishant , Ranade Deepak 
Published: March 2024

Aim of the Study:
Multiple ring-enhancing lesions are commonly experienced group of brain pathologies which we come across in day-to-day practice. Clinical symptoms in these lesions are quite non-specific, and hence, it is difficult to reach a final diagnosis. However, these lesions have a varied group of differential diagnosis and it is sometimes difficult to have an accurate diagnosis on conventional MRI. This article was written with the objective of discussing the demographical study and etiology, clinical diagnosis and management for these patients.

Materials and Methods:
It is a prospective study carried out at the Department of Neurosurgery, Dr. D Y Patil Medical College and Hospital, Pune, from September 2019 to August 2022 and included 50 patients who presented to us multiple ring-enhancing brain lesions.

Results:
In our study, 50 patients between age (1–70 years) with multiple ring-enhancing lesions were analyzed. Majority of the patients were between age group 30–39 years. Males (76%) were majority in our study than females (24%). Most common pathology was primary neoplasm (glioma) and metastasis, followed by nine patients of pyogenic abscess and tuberculosis each. Neurocysticercosis was seen in eight patients and three patients were diagnosed with CNS lymphoma. Most of our patients presented with headache (38 patients) and a subset of patients had associated seizures (28 patients). Two patients with primary neoplasm were diagnosed to have WHO grade 3 glioma and seven patients were diagnosed to have WHO grade 4 glioma. Glioblastoma multiforme presented as multifocal and multicentric lesions. Among the patients with primary neoplasm, three patients underwent stereotactic biopsy for diagnosis and the rest of seven patients underwent maximum safe resection followed by chemotherapy and radiotherapy. Ten patients were diagnosed with metastatic lesions, among them six patients underwent stereotactic biopsy for histopathological diagnosis and immunohistochemistry, and rest of the patients were managed on the basis of the primary lesion. Five patients were immune-compromised, among them two patients presented with abscess and three patients presented with primary neoplastic lesion. Thirty-six patients underwent biopsy, among them seven patients underwent frameless, seven patients underwent frame stereotactic biopsy, and the rest 22 patients underwent excision biopsy.

Conclusion:
Multiple ring-enhancing lesions of brain pose a challenge in terms of achieving an accurate diagnosis and planning further treatment. It is of utmost importance to have a diagnosis in mind based on radiological investigations, so that surgical intervention can be planned accordingly be it by invasive or minimal invasive techniques. An idea toward the diagnosis also helps in prognosticating these patients which could avoid costly whole-body scans and unnecessary surgical intervention.
Prognostic microRNAs as biomarkers for prostate cancer
Authors: Palanisamy Hema , Manoharan Jeevitha Priya , Vidyalakshmi Subramanian 
Published: March 2024

Objective:
Prostate cancer is the second largest cancer, most commonly diagnosed in men. Several studies reveal that miRNAs (microRNAs) are involved in various stages of prostate cancer. miRNAs are a family of small non-coding RNA species that have been implicated in the post-transcriptional regulation of gene expression. The present in silico study aims at identifying miRNA biomarkers that are significantly associated with the regulation of genes involved in prostate cancer.

Methods:
Dataset of miRNA and mRNA of prostate adenocarcinoma patients and controls was downloaded from The Cancer Genome Atlas (TCGA), and differential gene expression analysis was carried out. ROC and Kaplan–Meier survival analyses were performed on differentially expressed miRNAs. Pathway analysis was carried out for significant miRNAs, and protein–protein interaction of involved genes and miRNAs was examined.

Results:
A total of 185 miRNAs were differentially expressed between the patients and the control. ROC and Kaplan–Meier survival analysis showed that the two miRNAs hsa-mir-133b and hsa-mir-17-5p were found to be significantly associated with prostate cancer prognosis. HAS2 and EPHA10 gene targets of identified miRNA were also differentially expressed. A protein–protein interaction (PPI) network was constructed, and the HAS2 gene was found to be interacting with the epidermal growth factor receptor (EGFR).

Conclusion:
This study highlights the potential of hsa-mir-133b and hsa-mir-17-5p miRNAs as biomarkers for the prognosis of prostate cancer. However, further experimental studies are required to validate this finding.
Clinicopathological and prognostic significance of VEGF, PDGF-B, and HER2/neu expression in gallbladder cancer
Authors: Shukla Pooja , Mishra Kumudesh , Shukla Ratnakar , Vishwakarma Ruchira , Kumari Niraj , Krishnani Narendra , Behari Anu , Kapoor Vinay K. 
Published: March 2024

Aim:
Gallbladder cancer (GBC) is usually diagnosed in advanced stages with poor survival. The molecular mechanisms of GBC still remain unexplored. Several angiogenesis factors play a pivotal role in tumor progression. We aimed to study the expression of VEGF, PDGF-B, and human epidermal growth factor receptor 2 (HER2/neu) and its association with clinicopathological features and survival in GBC.

Materials and Methods:
VEGF, PDGF-B, and HER2/neu expression was studied by immunohistochemistry (IHC) after histological evaluation in 91 GBC cases. The relationship between these markers and clinicopathological features and survival was explained through the Cox regression model and Kaplan–Meier method.

Results:
VEGF, PDGF-B, and HER2/neu overexpressed in 45, 79, and 68% GBC cases, respectively. VEGF was significantly overexpressed in GBC without gall stones (GS) (p = 0.007) and with moderately and poorly differentiated tumors (p = 0.012). HER2/neu was significantly overexpressed in GBC with GS (p = 0.022). Median overall survival (OS) was 39 months (95% CI: 23–55). In univariate analysis, histological type (adenocarcinoma and papillary) vs. others (signet ring/mucinous/adenosquamous) (p = 0.004), depth of tumor infiltration (p = 0.017), distant metastasis (p = 0.012), and adjuvant therapies (chemotherapy/radiotherapy) (p = 0.083) were associated with poor prognosis. Multivariate survival analysis showed histological type (p = 0.004) and distant metastasis (p = 0.032) to be independent prognostic factors for OS. Histological type (p = 0.002), distant metastasis (p = 0.003), and depth of tumor infiltration (T3-T4) (p = 0.012) showed poor median survival. Poor survival was seen in VEGF and HER2/neu positive cases.

Conclusion:
Overexpression of VEGF, PDGF-B, and HER2/neu might be possible prognostic biomarkers in GBC. Poor survival of VEGF and HER2/neu positive cases indicates the possibilities of using their blockers as therapeutic agents.
The association between calreticulin and glucagon-like peptide-1 expressions with prognostic factors in high-grade gliomas
Authors: Baran Oguz , Akgun Mehmet Yigit , Kayhan Ahmet , Evran Sevket , Ozbek Arif , Akyoldas Goktug , Samanci Mustafa Yavuz , Demirel Nail , Sonmez Derya , Serin Huriye , Kocak Ayhan , Kemerdere Rahsan , Tanriverdi Taner 
Published: March 2024

Objective:
The aim of this study is to present the expressions of Calreticulin (CALR) and Glucagon-like peptide-1 (GLP-1) in high-grade gliomas and to further show the relation between the levels of these molecules and Ki-67 index, presence of Isocitrate dehydrogenase (IDH)-1 mutation, and tumor grade.

Patients and Methods:
A total of 43 patients who underwent surgical resection due to high-grade gliomas (HGG) (grades III and IV) were included. The control group comprised 27 people who showed no gross pathology in the brain during the autopsy procedures. Adequately sized tumor samples were removed from each patient during surgery, and cerebral tissues were removed from the control subjects during the autopsy procedures. Each sample was stored at −80°C as rapidly as possible until the enzyme assay.

Results:
Patients with high-grade gliomas showed significantly higher levels of CALR and significantly lower levels of GLP-1 when compared to control subjects (P = 0.001). CALR levels were significantly higher, GLP-1 levels were significantly lower in grade IV gliomas than those in grade III gliomas (P = 0.001). Gliomas with negative IDH-1 mutations had significantly higher CALR expressions and gliomas with positive IDH-1 mutations showed significantly higher GLP-1 expressions (P = 0.01). A positive correlation between Ki-67 and CALR and a negative correlation between Ki-67 and GLP-1 expressions were observed in grade IV gliomas (P = 0.001).

Conclusions:
Our results showed that higher CALR and lower GLP-1 expressions are found in HGGs compared to normal cerebral tissues.
Recurrent mucinous cystic neoplasm of the mesentery in a young nullipara mimicking as ovarian carcinoma
Authors: Jaiswal Riddhi , Dubey Deval B. , Singh Richa , Mishra Ashutosh 
Published: March 2024

Inroduction:
Mucinous cystic neoplasms are rare tumors. They may originate from either ovaries, pancreas, or other intra-abdominal sites, but rarely from the mesentery.

Case History:
A 22-year-old nulliparaous woman, who had undergone laparascopic bilateral cystectomy for recurrent ovarian mass, presented with pain in abdomen, backache, and menstrual irregularities. Provisionally diagnosed as ovarian carcinoma, she underwent bilateral salpingo-oophorectomy and sigmoid colectomy. However, the histopathological examination revealed mucinous cystic neoplasm of the mesentery.

Discussion:
Thus, complete resection of the cysts with meticulous gross and histopathological examination remains the gold standard to differentiate mucinous cystic neoplasm (MCN) of the mesentery from its mimics, especially malignant counterparts, enabling clinicians to adequately manage such patients. Here, we present a case of recurrent MCN of mesentery (mesocolon), mimicking as ovarian carcinoma confirmed on histopathological examination, in a young adult.
Postgraduate teaching–learning pattern for radiation oncology students in India – A survey-based analysis
Authors: Janaki Manur G. , Arul Ponni TR 
Published: March 2024

Context:
Teaching and training in Radiation Oncology is only at postgraduate level with 8–10 hours of theory sessions during undergraduate course. Uniform training during the post-graduation course across the country is a major challenge as many new concepts are introduced.

Aim:
This study is an effort to look into various aspects of training in terms of teaching–learning and assessment. In addition, we aim to look into innovative methods that can be implemented across the country.

Settings and Design:
This is a survey-based analysis.

Methods and Materials:
Postgraduate teaching institutes in Radiation Oncology were obtained from the National Medical Council and National Board of Examination websites. A questionnaire was created with Google form and sent to the heads of departments across the country. The data were entered on a spreadsheet and the responses were analyzed using Microsoft Excel sheet.

Results:
Thirty-five out of 87 institutes responded out of which 40% were government institutes. Twenty-six (74%) offered MD seats with 14 (40%) having less than five teachers and 13 (37.14%) with 5–10 teachers. With uniform teaching learning method across the country, there was wide variation in formative assessment patterns. There was consensus regarding inadequate exposure in research methodology and statistics.

Conclusion:
There is uniformity in teaching learning methods with differing patterns of formative assessment. Innovative methods focusing on affective and skill domains with competency-based medical education will help in bringing out a competent radiation oncologist.
Low-grade malt lymphoma of the nasopharynx in young adults: Successful treatment of a rare diagnosis at a rare site by radiotherapy
Authors: Singh Sankalp , Bhatnagar Sharad , Bisht Niharika , Kapoor Amul , Mishra Prabha Shankar , Lohia Nishant 
Published: March 2024

Introduction:
Mucosa Associated Lymphoid Tissue (MALT) lymphoma is the third most common subgroup of Non-Hodgkin’s lymphoma and is the most common type of primary extranodal lymphoma. They are rarely found in the nasopharyngeal region and their mean age at presentation is the sixth decade of life.

Materials and Methods:
We present the clinical, pathological, treatment and 5-year follow-up data of 5 cases of nasopharyngeal MALT lymphoma treated with definitive radiotherapy at our hospital, between 2009 and 2011.

Results:
The average age of diagnosis was 27 years which is more than a decade earlier than what has been reported previously. Clinical symptoms included nasal obstruction, tinnitus and hearing loss. All five patients had locoregional disease. They were treated by definitive radiotherapy to a dose between 30 to 40 Gy. At 5 years of follow-up, 4 patients were in complete remission while one had disease relapse.

Conclusion:
The younger age of presentation compared to older reports in this rare subsite was an interesting finding in our study. The authors speculate that rising levels of particulate air pollution may have played a part in the etiology in this younger population. Our series shows that despite the younger age, the disease displays an indolent course and responds well to radiotherapy alone as the primary treatment. Recurrence or disseminated disease is also highly treatable with systemic chemotherapy.