bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Lockdown on Air Quality in the Most Polluted Cities of India
Authors: George Noel , Prasad Jang Bahadur , Varghese Elizabeth , Rajesh Richu , Kumar Aravind 
Published: January 2024

Background:
COVID-19 has become a global pandemic, prompting lockdowns in practically every country. To prevent the spread of the disease, India has enforced a rigorous nationwide lockdown that commenced in March 2020. The lockdown imposed amid the pandemic ensured that most commercial activities and vehicle transportation ceased, resulting in a significant reduction in air pollution levels.

Material and Methods:
The value of air pollutants PM10, PM2.5, NO2, and SO2 from January to May 2020 was obtained from the Indian Central Pollution Control Board. Before lockdown and during lockdown, relative fluctuations in ambient concentrations of four air contaminants were investigated. The Box–Jenkins approach was used to estimate future air pollution data points using time series data analysis.

Results:
The PM10 level reduced by 61%, 30%, 68%, 37%, and 43% in the selected cities, respectively. Comparison of other pollutant concentrations before and after the lockdown also found a reduction in ambient pollutant concentrations, resulting in improved air quality. Inference of predicted model values to observed values revealed a significant increase in the concentrations of all pollutants. The percentage increases in AQImean from predicted to observed values were 206% in Ghaziabad, 148% in Delhi, 59% in Hyderabad, and 160% in Cochin.

Conclusion:
The strict lockdown has resulted in a significant drop in air pollutant levels. Upgrading present technologies could help keep pollution to a minimum of 37% under control. The findings would prompt the government to consider how to strictly reduce vehicle and industrial pollution to improve air quality and maintain improved public health.
Surgery for supplementary motor area gliomas—Controversies and rationale for surgical approach: A perspective
Authors: Pasricha Paurush , Raheja Lakshay , Moiyadi Aliasgar 
Published: January 2024

Abstract
Supplementary motor area (SMA) has a role in planning and coordinating motor movements as well as in speech (dominant SMA). SMA gliomas are complex tumors to operate on and sufficient knowledge regarding connection fibers is needed to plan and prevent complications, the most important being SMA syndrome. Development of SMA syndrome causes significant morbidity and although SMA syndrome is transient and the majority of symptoms are relieved over time some symptoms persist that may lead to loss of quality of life in these patients. A thorough review of the literature was done to expand on the white matter tracts connecting SMA to other eloquent regions, SMA syndrome, best surgical practices for SMA gliomas (addressing the dilemma of awake vs. asleep craniotomy), and intraoperative monitoring techniques being used currently. An attempt has been made to address the debate regarding outcomes and controversies in the treatment of SMA region gliomas and we have also presented our experience through three case illustrations, which include two cases of SMA gliomas operated under asleep monitoring and one case operated under awake monitoring.
Plasmocitoma/multiple myeloma with severe cord compression: Case reports
Authors: Sincari Marcel , Cabrita Francisco , Pina Gabriel , Nunes André Fernando 
Published: January 2024

Abstract

Introduction:
Multiple myeloma (MM) is generally located in the bone marrow (BM) and is associated with a wide spectrum of clinical, laboratory, and radiological findings.[1] Conversely, solitary plasmacytoma (SP) is characterized by a single mass of clonal plasma cells, with no or minimal BM plasmacytosis and with no other symptoms than those derived from the primary lesion.[2] The cases with spine involvement and spine cord suffering from compression always were very complicated and challenging.

Materials and Methods:
We describe two cases of SP and MM with severe spine cord compression treated surgically with an indication to address the compression and stabilization of the affected segments with subsequent treatment in hematology and oncology.

Results:
In both cases, the surgery was a success, the patient with SP survived 3 years and 1 month, and the patient with MM survived 1 year and 3 months.

Conclusion:
The outcomes of surgical interventions for these patients with spine cord compression and spinal instability due to MM and plasmacytoma of the spine were improved with neurological function following surgery and no instrumentation failure.
Giant convexity enchondroma mimicking a meningioma: A case report and literature review
Authors: Patil Monali M , Patil Sagar M , Balasubramaniam Srikant , Nadkarni Trimurti D 
Published: January 2024

Abstract
Most intracranial enchondromas are located in the skull base. Intracranial enchondromas over convexity are very rare benign extra-axial tumors that tend to present with protracted symptomatology and as large dural-based space-occupying lesions. We report a large convexity enchondroma in a 23-year-old male who presented with 3 years of recurrent seizures. Surgical gross total removal resulted in a good outcome. This case report emphasizes the unusual location of enchondroma in the form of an extra-axial space-occupying lesion in the parietooccipital lobe and further adds to the literature on this pathological entity. Our objective is to report this rare case and review the pertinent literature, especially concerning presentation, pathology, and management.
Factors Associated with Therapeutic Outcomes in the Treatment of Nontraumatic Acute Upper Limb Ischemia at a Tertiary Care Center in South India: A Prospective Analysis
Authors: Sreevathsa K S P , Vairagar Siddhant Rajendra , Ramshankar S P , Munuswamy Hemachandren , Malladi Varsha , Sunil Julia 
Published: January 2024

Abstract

Background:
The outcomes of acute upper extremity ischemia (AUEI) demonstrated lower rates of limb loss (0%–3.1%) and mortality (~6%) compared to acute lower extremity ischemia. However, AUEI still is a challenge for a vascular surgeon as delays in diagnosis and treatment are likely to result in severe functional disability, even in the absence of overt tissue loss.

Objectives:
The objectives of this study are to determine the association of factors affecting the clinical outcomes of acute upper limb ischemia treatment.

Methodology:
A single-center prospective observational study was done between July 2021 and July 2023 on patients with AUEI who came to our emergency medicine department at a tertiary care center in South India. The demography, risk factors, duration of ischemia, time from onset of complaints, and primary intervention chosen were recorded. Functional improvement on subsequent follow-up intervals was analyzed to describe the surgical outcome.

Results:
Of 53 patients with AUEI, 31 (58.5%) had atrial fibrillation. In 81.1% of patients, thrombosis was the primary cause of acute limb ischemia. Most patients belonged to the 2A Rutherford classification (47.2%), followed by 2B (26.4%). Regardless of the severity of ischemia, the patients (n = 10) who arrived after 36 h had a higher rate of amputation (5; 50%). Lower levels of preoperative serum lactate dehydrogenase and serum glutamic-oxaloacetic transaminase were associated with better postoperative outcomes (P = 0.007) and lesser amputation rates (P = 0.017). Lower grades of ischemia, prompt intervention, and early consultation were all linked to better postoperative functional outcomes (P = 0.026).

Conclusion:
At our facility, AUEI due to cardiac or noncardiac emboli, thrombosis, or both was a significant cause of inhospital morbidity. An important risk factor for worse outcomes was hypertension. The availability of appropriate interventional care, and the timing of presentation after the onset of symptoms are thus significant modifiable factors in lowering the rates of amputation.
Approach to the Management of Vascular Malformations of Head and Neck and Its Challenges: An Institutional Experience
Authors: Senthilnathan K , Duraichi B Vella , Sritharan Narayanan , Jayachander K , Kumar P Ilaya , Kumar S Prathap , Babu R Ranjith , Ramya M 
Published: January 2024

Abstract

Background:
Vascular malformations (VMs) in the region of the head and neck are a complex group of lesions that present with serious challenges in diagnosis and management. We sought to study the efficacy and safety of a therapeutic algorithm emphasizing multimodal management in the treatment of head and neck VMs.

Methodology:
A retrospective study was conducted reviewing all the patient information from the database who were treated for VM of the head and neck at the institution. Patients who presented during the period between January 2012 and December 2022 were included in the study. Conservative care, sclerotherapy, embolization, surgical excision, or a combination of these techniques were among the management options based on the clinical profile of the patient as well as the characteristics of the lesion.

Results:
91 VMs in the region of the head and neck included 45 (49%) males and 46 (51%) females, with an age range of between 4 years and 71 years (mean 23.9 ± 14.06 years). There were 53 low-flow vascular malformations (LFVMs), of which 6 (11.9%) were managed conservatively, 26 (49.05%) were treated with sclerotherapy, 20 (37.7%) underwent excision, and 1 (1.8%) was treated with combination therapy. Of the 38 high-flow vascular malformations (HFVMs), 12 (31.5%) were treated with arterial embolization, 13 (34.2%) were primarily resected, 2 (5.2%) with excision and reconstruction, 5 (13.1%) underwent embolization and excision, and 1 (2.6%) underwent emergency external carotid artery ligation. In the LFVM group, response to sclerotherapy led to improvements in 24 (92%) patients, while surgical resection led to improvements in 20 (100%) individuals. In the HFVM group, embolization therapy improved 9 (75%), combination therapy improved 5 (100%), and surgical resection improved 15 (100%) of the patients.

Conclusions:
In our experience, the implementation of a multimodal management algorithm has had favorable outcomes with an acceptable complication rate in head and neck VMs.
Evaluation of Serum Cysteine-rich Angiogenic Inducer 61 for Peripheral Arterial Disease in Patients with Type 2 Diabetes Mellitus
Authors: Rahman Nabila , Khan Siraj Ahmed , Mahapatra Sandeep , Bhaskar M. Vijaya , Baba K. S. S. Sai , Noorjahan M. , Sreedevi N. 
Published: January 2024

Abstract

Background:
Peripheral artery disease (PAD) is a common manifestation of atherosclerotic disease, which is related to considerable disability and mortality. Currently, approximately 202 million people worldwide are suffering from lower extremity arterial disease, giving rise to a major public health problem and a heavy economic burden. Type 2 diabetes mellitus (T2DM) is one of the major risk factors for atherosclerosis, and the prevalence of PAD increases with the prevalence of T2DM.

Materials and Methods:
A cross-sectional case–control study comprising 100 cases and 40 age- and sex-matched healthy controls was done. The cases were divided into three groups: Group 1 (T2DM with PAD) – 40, Group 2 (T2DM without PAD) – 40, and Group 3 (PAD without T2DM) – 20. The serum cysteine-rich angiogenic inducer 61 (CYR61) levels were assessed using the sandwich enzyme-linked immunosorbent assay. Statistical analysis was done using MedCalc version 20.114. P <0.005 is taken as statistically significant.

Results:
The mean concentrations of CYR61 in Group 1, Group 2, and Group 3 were 3680 pg/ml, 3059 pg/ml, and 2866 pg/ml, respectively, whereas, in controls, it was 2318 pg/ml. The serum CYR61 levels were significantly higher in cases compared to controls (P < 0.0001). CYR61 concentrations are significantly higher in Group 1 compared to the other two groups – Group 2 and Group 3. CYR61 levels showed a statistically significant difference between Stage 2 and Stage 4 of PAD in Group 1. Receiver operating characteristic analysis has shown area under curve (0.946) for CYR61 higher than ankle-brachial index (0.750).

Conclusions:
CYR61 proved to be a better marker for diagnosing PAD in patients with T2DM.
Emergency Endovascular Management of Gluteal Artery Pseudoaneurysm
Authors: Yadamreddy Rohit Kumar , Lakshmidharan M , Raju Radhakrishnan , Ayyappan M K 
Published: January 2024

Abstract

Introduction:
Gluteal artery pseudoaneurysms are rare, yet the most common in cases involving the superior gluteal artery. Pseudoaneurysms of the inferior gluteal artery are uncommon and are often related to blunt or penetrating trauma, infections and fractures of the pelvis.

Presentation of Case:
The authors describe a case of pseudoaneurysm which was presented to the emergency department. A thorough workup revealed a history of pelvic fracture that could constitute a probable cause of the pseudoaneurysm, which was treated with selective embolization of the artery during angiography.

Discussion:
The most common manifestation pseudoaneurysm of inferior gluteal artery is the presence of a painful mass in the buttock. However, both diagnosis and therapy are facilitated by catheter angiography.

Conclusion:
Although pseudoaneurysms are rare, pseudoaneurysms of the inferior gluteal artery require a high index of suspicion and careful physical examination by the physician in order to avoid misdiagnosis. In addition, the treatment performed using the endovascular technique is less invasive than the conventional technique, giving the patient better recovery.
Splenic Artery Pseudoaneurysm Rupture in Pseudocyst of Pancreas Successfully Managed with Coiling: A Rare Case Report
Authors: Batra Nitish , Phate Neha , Soni Raj Jaydeep , Kumar Sunil , Acharya Sourya , Banode Pankaj 
Published: January 2024

Abstract
Splenic artery pseudoaneurysm is a rare condition with approximately 1% prevalence. Potential risks of splenic artery aneurysms (SAAs) include rupture and life-threatening hemorrhage, which can occur in about 10% of cases. The ratio of splenic artery pseudoaneurysms in female-to-male is 4:1. It is significantly higher in patients older than 60 years and patients with portal hypertension. Such patients are usually asymptomatic, but 20% of them present with complaints such as abdominal pain and chest pain and most are usually diagnosed incidentally. In this case report, we have highlighted a 40-year-old patient who presented with pain abdomen and shock, which, after a thorough workup, came out to be a case of pseudocyst of the pancreas with rupture of SAA as well as eventration into the mediastinum through hiatus hernia. The patient was successfully managed with splenic artery coiling.
Comparison of the Long-term Results of Bypass Surgery versus Below-the-knee Angioplasty in Infrapopliteal Lesions that Results in Ulcer or Toe Gangrene
Authors: Motamedi Mohammad Reza Kalantar , Tadayon Niki , Sabet Babak , Abdolalian Younes 
Published: January 2024

Abstract

Background and Aim:
The optimal revascularization strategy for patients with severe leg ischemia remains uncertain. The purpose of this study was to compare outcomes of bypass surgery and angioplasty in isolated below-the-knee lesions.

Methods:
Patients with ulcers or toe gangrenes, undergone below-the-knee bypass surgery or angioplasty from January 2015 to December 2017, were included in the study. Amputation-free survival (AFS) and overall survival (OS) were assessed using the Kaplan–Meier and Cox regression tests.

Results:
Eighty-eight patients were included in this study, of which 43 underwent bypass surgery and 45 underwent endovascular interventions. The mean age in the bypass group was 73.1 (±7.1) years and 73.9 (±7.2) years in the angioplasty group. There were no significant differences in sex, diabetes, hypertension, history of smoking, history of stroke, and renal insufficiency between the two groups. AFS was 43.4 (±8.5) months in the bypass group and 39.8 (±8.9) months in the angioplasty group which was significantly better in the bypass group (P = 0.05). OS was 49.6 (±10.6) months in the bypass group and 46.2 (±11.7) months in the angioplasty group but did not differ statistically significant (P = 0.32).

Conclusion:
AFS was significantly higher in the bypass group. Thus, bypass surgery seems preferable to angioplasty for all patients with severe leg ischemia except those with multiple comorbidities and those whose vein is not adequate for bypass.
Correlation of behavioral and psychological symptoms of dementia with patients’ sociodemographic & clinical details and caregivers’ distress
Authors: Deo Vinay Kumar , Singh Krishna Kumar , Sinha Niska , Kumar Abhay , Kumar Santosh 
Published: January 2024

Background:
Behavioral and psychological symptoms of dementia (BPSD) influence dementia care significantly. BPSD can be affected by factors related to the patient’s illness and socio-cultural background.

Aim:
This study aimed to find a relationship between BPSD with patients’ socio-demographic and clinical profiles and their caregivers’ distress in a tertiary care center.

Materials and Methods:
In this hospital-based cross-sectional study, the purposive sampling technique was used to select 100 dementia patients. A comprehensive record of socio-demographic and clinical details was made on a self-prepared semi-structured data sheet. The Neuropsychiatric Inventory Questionnaire was the principal tool to find the BPSD and related caregivers’ distress.

Results:
The sample comprised predominantly Hindu (91%) male patients (66%) with Alzheimer’s dementia (76%) coming from rural backgrounds (74%) and joint familial systems (96%), with a mean age of 71.77 ± 7.41 years. Patients’ main caregivers were their children/children-in-law (65%). The severity of an overall BPSD and its variable individual domains were directly related to the duration of dementia, patients’ age, their cognitive decline, and related decline in activities of living, as well as their caregivers’ distress. In comparison to Alzheimer’s disease patients, those with other dementia types had more impairment in cognitive functions and activities of daily living and they had a higher number and severity of BPSD.

Conclusion:
The advancing age, increased duration of dementia, and decline in cognition and related activities of daily living of the patients, as well as their caregivers’ distress, are important correlates of BPSD. The findings are essential for the better management of dementia patients.
Inflammatory myofibroblastic disease of right petrous apex: A rare case with review of literature
Authors: Mahadev Doddala Sankara , Praveen N. V. S , Suryadevara Aparna , Naga Kishore M. G 
Published: January 2024

ABSTRACT
Inflammatory myofibroblastic tumor (IMFT) is a rare tumor of unknown etiology. It can involve any part of the body. The IMFT involving the base of skull is rare with only 36 cases reported in the literature. We report a rare case of IMFT of temporal bone with review of literature. A 42 year old male presented with complaints of headache and double vision and MRI brain showed lesion in the right petrous apex region suggestive of a neurogenic mass. He had excision of lesion and histopathology was suggestive of IMFT with IgG4 and ALK positive. He had complete clinical response but a month later he presented with right eyelid ptosis and decreased rotation of eye medially with recurrent lesion on MRI. Patient received radiation by SRT technique and then started on Ceretinib with partial response. The IMFT is rare tumor of unknown etiology and tumors of temporal bone are more aggressive. It is benign but locally invasive tumor. Treatment of IMFT is controversial. Extensive surgery with complete excision has about 80% response rates and with intracranial extension, adjuvant radiation is need. In head and neck IMFT response rates are lower (30 to 40%). Monoclonal antibodies and steroids are used in IMFT at recurrence. In advanced or metastatic ALK positive tumors, Crizotinib is used with a response rate of 50%. Radiotherapy (25 to 30 Gy) induces remission and helps to taper the steroids. Temporal bone IMFT is a rare tumor with multimodality approach and variable response to treatment.
Origin and survival outcomes of Pseudomyxoma peritonei—A retrospective study
Authors: Nayanar Sangeetha K. , Markose Anu Jose , Avaronnan Manuprasad , Dharmarajan Adarsh 
Published: January 2024

ABSTRACT

Background:
Pseudomyxoma peritonei (PMP) is an unusual clinical condition typically presenting with widespread mucinous neoplastic lesions within the peritoneum resulting in gelatin material-rich ascites. It was first described by Werth in 1884. Ever since, its clinical presentation, definition, site of origin, and prognosis have been a subject of debate. However, many histopathologic, immunohistochemical, and genetic studies have attempted to locate the primary lesion in the appendix in both genders.

Objectives:
To analyze the histological origin and survival outcomes of pseudomyxoma peritonei in patients treated at a regional cancer center.

Materials and Methods:
Fifteen cases of PMP were diagnosed during the five-year study period. The demographic and clinicopathological details were retrieved; the slides were reviewed and histological parameters reassessed. Descriptive statistics were used to express proportions. Continuous variables were recorded as mean (SD) or median (IQR). Kaplan–Meier (KM) curve was used to estimate overall survival.

Results:
Mean age for PMP was found to be 47.5 years for low grade Mucinous Carcinoma Peritonei (MCP), 54.2 years for high grade MCP, and 58 years for high grade MCP with signet ring cells. Most common overall presentation was abdominal distension in 53.3% (8/15) of cases, followed by acute appendicitis in 20% (3/15) cases. PMP was detected synchronous with the primary tumor in 9/15 cases (60%). Primary lesion in the appendix was grossly identified in 7/15 cases, while it was not explored in the remaining eight cases. Yet, by combined clinical, radiological, histopathological, and immunohistochemical analysis, we identified that most of the cases (14/15) had an appendiceal origin (93.3%). The overall survival for 12 months was 50% and for 18 months was 37%.

Conclusion:
The surgeon and radiologist may well bear in mind the most common possibility of an appendiceal origin for PMP and resect the appendix, irrespective of the presence of a grossly or radiologically detectable lesions. We emphasize that immunohistochemistry helped to detect the site of origin even when the primary was occult.