bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analyzing Tumor Budding Scores in Invasive Breast Carcinoma: A Tertiary Care Center Study in South India
Authors: Vasudevan Sudha , Kannan Kavitha , Raghavan ATM Venkat , Sulochana Sonti 
Published: April 2024

ABSTRACT

Introduction and Aim:
Tumor budding is a distinctive phenomenon which involves the presence of small clusters or individual cancer cells at the invasive front of tumors. Tumor budding has garnered attention due to its potential implications for prognosis, treatment strategies, and our understanding of cancer progression. Our aim is to study the distribution of tumor buds and its scoring in patients with infiltrating breast carcinoma and to associate with other histopathological parameters like the size of the tumor, its grade, lymphovascular invasion, and lymph node metastasis.

Materials and Methods:
This was a study analyzing the data of 70 resected specimens of primary breast carcinomas and providing a descriptive overview. Tumor budding was recognized, counted, and graded in hematoxylin and eosin slides. The cases were classified as low (0–4), intermediate (5–9), and high (≥10 buds) based on the count of tumor buds. Tumor budding has significant correlation with tumor grade and tumor size.

Results:
Of the 70 cases, 60 cases (85.71%) were diagnosed as invasive ductal carcinoma NOS. The majority [38 (54.28%)] of the cases showed an intermediate tumor budding score of 5–9/10 HPF.

Conclusion:
Evaluation of tumor budding allows pathologists and oncologists to gather valuable information about the tumor’s biological aggressiveness and potential for metastasis. It also helps in better risk stratification of patients, enabling a more personalized and tailored approach to treatment planning. In conclusion, assessing tumor budding in breast carcinoma holds significant clinical importance in the management and prognosis of this disease.
Comparative Evaluation of Preoperative Paracetamol and a Combination of Paracetamol with Nebulized or Intravenous Dexamethasone for Prevention of Postoperative Sore Throat
Authors: Rathore Sandeep Singh , Prakash Smita , Mullick Parul , Garg Bhawna 
Published: April 2024

ABSTRACT

Background and Aims:
Postoperative sore throat (POST) is a common complication following general anesthesia with tracheal intubation that increases patient morbidity. We evaluated the effect of preoperative administration of IV paracetamol and a combination of paracetamol with nebulized or IV dexamethasone on the incidence of POST (primary objective), hoarseness of voice and cough (secondary objectives) in adult patients.

Methods:
In a randomized, double-blind study in a tertiary care hospital, 150 patients undergoing laparoscopic cholecystectomy under general anesthesia with tracheal intubation were divided into three groups (n = 50): Group P received IV paracetamol 1 g infusion; Group I received IV dexamethasone 8 mg and IV paracetamol 1 g infusion; and Group N received nebulized dexamethasone 8 mg and IV Paracetamol 1 g infusion. The incidence and severity of POST, hoarseness and cough were assessed at various time-points for 24 hours after surgery.

Results:
The overall incidence of POST was 72%, 18%, and 24% in groups P, I, and N, respectively; P < .0001. The severity of POST was significantly less in groups I and N compared with group P; both P < .0001. The incidence of postoperative hoarseness was comparable between the three groups; P = 0.216. The incidence and severity of postoperative cough were significantly higher in group P compared with group I; P = 0.016. Statistical calculations were done using SPSS 21 version program for Windows.

Conclusions:
Prophylactic administration of both nebulized and IV dexamethasone 8 mg in combination with IV paracetamol was effective in decreasing the incidence and severity of POST in adult patients undergoing laparoscopic cholecystectomy under general anesthesia with tracheal intubation.
Microbiological Analysis of Semen Samples in Male Partners of Couples Attending a Fertility Clinic in a Tertiary Care Hospital, Jaipur
Authors: Kataria Shaveta , Rajni Ekadashi , Priyanka  , Kumar Mohit , Ali Afreen 
Published: April 2024

ABSTRACT

Background:
The natural capability to produce offspring is termed as fertility. As the growing world is flourishing with modern means and advances in technology, there is a sharp fall in the birth rate all over. Many developing countries including India are now struggling with this issue. Bacterial infection of the male genitourinary tract is one of the key factors responsible for male infertility. These pathogenic bacteria induce an alteration in semen parameters, such as sperm count, morphology, and motility which are predictors of male fertility potential.

Material and Methods:
This is a retrospective descriptive observational study and includes culture reports of 388 semen samples of adult men attending the infertility clinics over a 3-year study period. Sample inoculation was done on culture media plates and incubated for 18–24 h at 37°C. Culture identification and antibiotic susceptibility testing were done using VITEK 2-automated system.

Result:
Eighty-one samples showed growth of single isolate and were further processed. The majority of the patients were 26–30 years of age, followed by 31–35 years. Gram-positive isolates outnumbered the gram-negative isolates (58% vs. 42.0%). The antimicrobial susceptibility pattern of gram-negative isolates showed maximum resistance against third-generation cephalosporins (70.6%), followed by cotrimoxazole (54.5%) and flouroquinolones (50.0%). Amongst gram-positive isolates, high degree of resistance was observed against tetracycline (89.4%) and fluoroquinolones (72.3%).

Conclusion:
Urogenital infections in males have been found to be associated with a reduction in fertility. Though these patients may be completely asymptomatic, these infections are known to reduce the sperm counts and motility. Proper bacteriological profiling of these patients is thus an important part of diagnostic workup.
Prevalence and Predictors of COVID-19 Breakthrough Infections Among Vaccinated Health Care Providers and Medical Students at All India Institute of Medical Sciences Nagpur, Central India
Authors: Kodankandath Jess S. , Tiwari Priti Nandkishor , Kushwaha Arvind Singh , Tayade Hitesh Chandrakant 
Published: April 2024

ABSTRACT

Context:
As per the national policy, two doses of COVID-19 vaccine at least four weeks apart were available for administration to all HCW’s since January 2021. A small proportion of individuals will contract COVID-19 despite complete vaccination. Healthcare workers (Health Care Providers) represent a very high-risk group for contracting COVID-19 infection.

Aim:
To determine the breakthrough infection rate of COVID-19 among vaccinated healthcare providers and students.

Methodology:
The present cross-sectional study was conducted at All India Institute of Medical Sciences, Nagpur from August to December 2022. The sample size of 308 was achieved through proportionate stratified sampling among different cadres of employees working at the institute.

Statistical Analysis:
Chi-square test was used for significance. Fischer’s Exact test was used wherever necessary. A P value < 0.05 was considered statistically significant. Strength of the association was estimated using odds ratio.

Results:
The mean (SD) age of participants in our study was 29.26 (±8.64) years. Prevalence of COVID breakthrough infection was found to be 28.25% [95% CI: 23–33]. It was found that those participants having one or more co-morbidities and are directly involved in COVID patient care were likely to suffer more from COVID-19 breakthrough infection.

Conclusion:
Predictors of COVID-19 breakthrough infection found to be a presence of one or more co-morbidities, direct involvement with COVID-19 patients and not observing respiratory hygiene. There is increased risk among participants with comorbidities and involving directly in patient care. Therefore, it is recommended that vaccine policy needs to focus on high-risk group.
Hematological Alterations and their Prognostic Significance in Critically ill Children Admitted to the PICU
Authors: Agarwal Anuradha , Misra Sarbani , Mukherjee Dikpati , Bhattacharyya Basundhara , Basu Suprit , Sarkar Sumantra , Datta Supratim 
Published: April 2024

ABSTRACT

Objective:
Hematological parameters such as complete blood count, including red cell distribution width and prothrombin time, activated partial thromboplastin time, and international normalized ratio (INR) are the earliest markers of critical illness. This study was undertaken to evaluate their significance in prognosticating critically ill children admitted to the pediatric intensive care unit (PICU).

Methodology:
This was a cross-sectional and observational study on 125 critically ill children aged 1 month to 12 years and admitted to the PICU of a tertiary care hospital, conducted from February 2019 to July 2020. Hematological alterations along with clinical profile, Pediatric Risk of Mortality III (PRISM III), and Pediatric Sequential Organ Failure Assessment (pSOFA) scores were analyzed, and prognosis was defined by invasive ventilation requirement, duration of PICU stay, and death.

Result:
Among the 125 critically ill children, 35.2% were infants. The most common cause of PICU admission was infections (29.6%) followed by the central nervous system (20.8%) and respiratory system (20.8%). Around one-third of the patients required invasive ventilation and about half of the patients required inotropic support in our cohort. Sixty-four percent of critically ill children were found to be anemic at the time of PICU admission. Approximately 50% had leukocytosis and only 6% presented with leukopenia. Thrombocytopenia was present in 24.8%, and 20.8% had thrombocytosis on admission. Fourteen point four percent had deranged INR values.

Conclusion:
Critically ill children with low hemoglobin (Hb) levels, low white blood cell (WBC) count, high red cell distribution width (RDW) values, and deranged INR required invasive ventilation during PICU stay. Both leukocytosis and leukopenia along with low Hb were associated with prolonged PICU stay and death. No such association was found with either thrombocytopenia or thrombocytosis.
Association between Presepsin and SARS-CoV-2: A Case–Control Study
Authors: AL-Khikani Falah Hasan Obayes , Alkhafaji Zaytoon Abdulridha 
Published: April 2024

ABSTRACT

Background:
Presepsin (PSN) is a soluble CD14 subtype that has lately been presented as a novel biomarker in patients with sepsis. The aim of the current study was to detect the relation of PSN to COVID-19 as well as its relation to other biomarkers.

Materials and Methods:
A total of 125 severe/critical COVID-19 patients were involved in this work as well as 60 persons enrolled as a control group. Between February 2022 and July 2022, these patients were admitted to Marjan Medical City and Al-Sadiq hospital. Patients were determined as severe cases according to the guidelines released by National Health World depending on SpO2 percentage. The inflammatory cytokine (PSN) was detected by the ELISA technique.

Results:
PSN revealed statistically significant differences between patients 261 pg/ml (244–324) and control groups 193 pg/ml (172–218) (P < 0.0001). Correlations between PSN and lymphocytes (LYM), as well as platelets (PLT), were nonsignificant (P > 0.05), while significant negative correlation was found between PSN and both white blood cell (WBC) (r = −0.21, P = 0.01) and granulocytes (GRA) (r = −0.25, P = 0.004). No significant differences between males 273.55 pg/ml and females 284.90 pg/ml regarding presepsin titer mean were detected (P = 0.67).

Conclusion:
This work adds to the mounting evidence that pro-inflammatory cytokines directly influence COVID-19 progression. The management of a cytokine storm that affects COVID-19 patients and is mostly brought on by pro-inflammatory cytokines may depend on the early detection and treatment of PSN.
A Study of Clinico-Radiological Profile and Outcomes of Cerebral Venous Thrombosis
Authors: Suman G R , Kulkarni Sriharsha , Ismail  , Moota Sai S. , Bhagavath Aravind 
Published: April 2024

ABSTRACT

Background:
Cerebral venous thrombosis (CVT) includes highly variable clinical presentations ranging from headache to coma. It often affects young to middle-aged patients. Early diagnosis and treatment improve outcomes. Outcome determinant factors are the extent of the disease, jugular occlusion, spread to deep or cortical veins, level of sensorium at onset, background factors, and presence of raised intracranial pressure.

Objectives:
This study aims to study the clinical profile, radiological features, and outcomes of CVT.

Materials and Methods:
Fifty-seven patients admitted to SSIMS&RC, Davangere, clinically suspected of CVT, were subjected to neuroimaging techniques, patients with a confirmed diagnosis of CVT (radiologically) were recruited by simple random sampling, and data collected was analyzed by correlational studies. Follow-up was done until 6 months.

Results:
Of the 57 patients, 30 (53%) were females and 27 (47%) were males, with a maximum incidence of 84% in the age group 18–40 years. The most common symptoms were headache (86%), seizures (65%), focal deficits (58%), and altered sensorium (52.6%). Radiologically, the most common sinus involved was the superior sagittal sinus 72%. In total, out of 57 patients, 6 patients died during hospitalization. Out of the surviving patients, 39 patients (70%) had a complete recovery. Poor prognostic factors were stupor and coma on admission and evidence of hemorrhagic infarction in the primary computed tomography (CT) scan.

Conclusion:
Compared to the previous studies, the prevalence of CVT was higher in women. Clinical manifestations, prognostic factors, “commonly involved sinuses,” and “image findings of this study” were similar to those of other studies. The overall prognosis was good, but a small percentage of patients died.
Evaluation of Nonculprit Coronary Artery Lesions in Patients with Acute ST-Segment Elevation Myocardial Infarction
Authors: Hegazy Mustafa A. , Mansour Kamal S. , Alzyat Ahmed M. , Hegazy Abdelmonem A. , Mohammad Mohammad A. 
Published: April 2024

ABSTRACT

Background:
Multivessel coronary artery disease is a common finding during the primary percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction (STEMI). It might be a cause for recurrent attacks. This study aimed to evaluate nonculprit lesions (NCLs) encountered in the three major epicardial coronary arteries.

Methods:
Patients with STEMI who underwent PPCI and matched the study inclusion criteria were enrolled. They were evaluated clinically, biomedically, and coronary angiographically. The coronary angiography analysis was examined by four cardiologists using the Quantitative Coronary Artery Analysis software. The data was analyzed statistically.

Results:
Of the 154 patients included in the study, 130 (84.4%) were males and 24 (15.6%) were females, with a mean age of 52.92 ± 13.14 years. Five hundred seventy-four NCLs were found in 132 (85.7%) patients. Nonobstructive lesions with stenosis less than 70% of vessel diameter were more frequent than obstructive lesions. The left circumflex coronary artery (LCX) was the first one of the three major arteries to be affected by obstructive NCLs. The obstructive NCLs were 128 in number; found in 78 (50.4%) patients; 65 (50.8%) of them were in LCX; 32 (25%) were in left anterior descending (25%); and 31 (24.2%) were in right coronary artery.

Conclusions:
NCLs are common among STEMI patients. LCX obstructive NCLs are comparable to those in the other two major epicardial coronary arteries, with respect to frequency and severity of luminal stenosis.
Assessment of the Pattern of Substance Use and Quality of Sleep in Drug Naïve Patients: Depression vs. Mania, a Comparative Study
Authors: Kaur Amaneet , Bathla Manish , Singh Angad H. , Sibia Ishrat 
Published: April 2024

ABSTRACT

Background:
Literature reveals that both substance use and sleep are interlinked, and even various aspects of substance use are relevant to sleep. Sleep disturbances are among the most common and consistent symptoms in patients with acute episodes of mood disorders. These psychiatric illnesses commonly co-occur with substance use disorders (SUDs), and the combination has adverse clinical consequences.

Aim:
To compare the pattern of substance use and quality of sleep in patients with depression and mania.

Materials and Methods:
A total of 150 patients (75 in each group) of either sex in the age group of 18-65 years visiting the psychiatry department who gave written informed consent were diagnosed using International Classification of Diseases-10 (ICD-10) for either mania or depression including recurrent depressive disorder and bipolar affective disorder. The patients in each group were evaluated using WHO ASSIST version 3 for substance pattern and PSQI for quality of sleep.

Results:
The most common substance used was tobacco followed by alcohol in both groups with a significant P value of 0.01. When comparing WHO ASSIST grades, 62.7% of depression had low grades whereas 48% of patients with mania had a moderate grade, with a P value of 0.002 which is significant. There was a significant difference in the individual component of PSQI between the two groups and patients in mania had a higher score.

Conclusion:
There was a significant association between the pattern of substance use and mood disorder. In the study subjects, all the patients in both groups had poor sleep quality. Further substance use and quality of sleep are interrelated with both mood disorders.
Predictive Ability of Different Scoring Models in Severe Alcoholic Hepatitis
Authors: Siddharda Bikkina Venkat , Gupta Monica , Singh Ram , Lehl Sarabmeet Singh 
Published: April 2024

ABSTRACT

Introduction:
Alcoholic hepatitis is a major health problem which carries a high mortality despite treatment. Predicting severity of disease is of utmost importance to avoid overzealous and unnecessary treatment with steroids in each and every case. Maddrey’s discriminant function (DF) may not always be reliable in predicting such prognosis.

Aim of the Study:
To observe the predictive ability of Glasgow alcoholic hepatitis score (GAHS), age, bilirubin, international normalized ratio (INR) and creatinine (ABIC) score, model for end stage liver disease (MELD) score, and Lille’s score in determining the prognosis in severe alcoholic hepatitis.

Materials and Methods:
Patients of severe alcoholic hepatitis were enrolled in this study as per inclusion and exclusion criteria and a DF score of >32. Once the decision to initiate corticosteroids was made, DF scores, MELD scores, GAHS scores, and ABIC scores were calculated on the day on initiation of therapy. On day 7, patients were re-assessed and Lille score was calculated in addition. Follow-up was obtained on repeat out-patient visit or telephonically after every 2 weeks till 90 days or till mortality, whichever occurred first.

Statistical Analysis:
The scores were compared among the survival and mortality groups to see association between mortality and severity of scores using Chi-square test of significance. Cut-offs providing a composite of best sensitivity, specificity, negative predictive value, and positive predictive value were derived on the basis of data of our study. P value of ≤ 0.05 was taken as a cut-off for significance.

Results:
Our study comprised 30 patients with severe alcoholic hepatitis. At the end of 90-day follow-up, 23 patients survived with 7 (23%) mortalities because of liver failure and sepsis. On day 7, barring the ABIC score (0.713), the areas under curve of all scores were above 0.8 and were hence of comparable efficacy. Lille score performed the best at assessing treatment response but had the limitation of not being applicable at day 1.

Conclusion:
Severe alcoholic hepatitis carries a bad prognosis. Cut-offs of DF and MELD need to be raised, whereas they need to be lowered in the case of GAHS, ABIC, and Lille score to improve the predictive value of score. Steroid-treated patients should be evaluated preferably with Lille score for a better prediction of survival.
Conventional Pterygium Excision with Conjunctival–Limbal Autograft Compared with Supra-Tenon Excision of Pterygium Along with Small Limbal Autograft
Authors: Surana Nivea R. , Sambarey Prajakta P. , Pawar Smita 
Published: April 2024

ABSTRACT

Context:
New pterygium surgery methods have been developed over the years because recurrence is high (30–70%) after simple excision.

Aims:
To compare the surgical time, ocular discomfort score, and recurrence rate in conventional pterygium surgery, where excision of pterygium and Tenon’s capsule is performed and the area is covered using conjunctival–limbal autograft (CLAU) with supra-Tenon excision of pterygium (STEP) along with small limbal autograft in patients with primary pterygium.

Settings and Design:
A Prospective comparative study was conducted at a rural medical college–hospital from November 1, 2017, to October 31, 2019, among 110 participants after ethical approval from Institutional Ethics Committee.

Materials and Methods:
All participants had primary pterygium of grades I and II depending on corneal encroachment and Tan’s stages T1 and T2 morphologically. Fifty-five underwent conventional surgery with CLAU (group A), and STEP with small limbal autograft (group B) was performed in the remaining fifty-five. The follow-up period was one year. The ocular problem, comfort of subject, recurrence, or other complications were documented, and statistical analysis was carried out with Statistical Package for the Social Sciences (SPSS) software version 21.

Results:
The mean surgical time was significantly less in group B (38.79 vs. 42.04 minutes) (Z = 11.38, P = 0.001 with confidence interval 10.81–13.38) and ocular discomfort score (ODS) was lower in group B as compared with group A (P < 0.05). Group B had two eyes with recurrence, though not statistically significant (P = 0.49).

Conclusion:
STEP with small limbal autograft is worth consideration for primary pterygium management.
The Influence of Price Perception, Sales Promotion, and Consumer Confidence on Pinkyshop Online Purchase Decisions at Shopee Market Place
Authors: Suhendi Intan Filiana , Elwisam Elwisam , Digdowiseiso Kumba 
Published: April 2024

This study aims to analyze the influence of price perception, sales promotion, and consumer confidence on pinkyshop online purchase decisions in the shoppe marketplace. The results of the study using primary data in the form of questionnaires to 115 Pinkyshop consumer respondents showed that there was a positive and significant influence between sales promotion and consumer confidence in purchasing decisions for Pinkyshop products. And there is a non-positive and insignificant influence on the price perception variable on purchasing decisions that means if prices rise then purchasing decisions will decrease, otherwise if prices fall then purchasing decisions will increase. Even so, the prices provided at pinkyshop in the shoppe marketplace are in accordance with the quality of the product and the price is almost similar to competitors. While sales promotions carried out to provide product information to consumers can improve purchasing decisions. Consumer confidence contributes the most than price perception and sales promotion. This shows that according to consumers, trust is caused by security, the information conveyed is accurate and there are various kinds of products in it. From this study found that of the many factors that can influence the occurrence of transactions through ecommerce, the trust factor is the key factor. Only customers who have trust will dare to make transactions through internet media, thus making consumers more confident to decide to shop at pinkyshop.