bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Epidemiological Analysis and Evaluation of 45 Patients between 2006-2021: A Descriptive Study of Rare Tumor
Authors: Demirdover Cenk , Geyik Alper , Vayvada Haluk , Menderes Adnan , Geyik Selin G. 
Published: December 2023

Abstract

Background:
Rare tumors which are derived from the skin and soft tissue include a wide variety of types, but the knowledge and awareness of these tumors are limited. Besides, the number of specialists with specific training and experience in these tumors is very few. They are frequently associated with problems in the diagnosis and treatment.

Purpose:
In this study, we shared our experience and compared the outcome with the literature.

Methods:
Depending on clinicopathological evidence, 45 patients who were treated in our clinic between 2006 and 2021 were included in this descriptive study. Histopathological, etiological, and epidemiological results were analyzed. Tumors are classified as one of two types – either benign (noncancerous) or malignant (cancerous). Malignant tumors are also divided into carcinoma and sarcoma. Radiologic imaging methods and incisional/excisional biopsy were used for the diagnosis and staging. Chemotherapy/radiotherapy was planned after surgical treatment according to the diagnosis.

Results:
Of 45 cases, 40 (81.25%) were malignant and 5 (18.75%) were benign. The ages of the patients ranged from 10 to 94 years, and the mean age was 54.05 ± 20.1. The male/female ratio was 4.5/1. All patients were from the Aegean region of Turkey. The classification of the malignant tumors was carcinoma and sarcoma. The most common type of sarcomas was leiomyosarcoma and synovial sarcoma.

Conclusion:
When we consider the growing interest and knowledge in rare tumors, these case series are beneficial for epidemiological and surgical assessments.
Anorectal Syphilis Presenting at Crohn’s Disease: A Case Report
Authors: Myers Hannah E. , Pennycook Kevin , Buckley Christopher 
Published: December 2023

Abstract
This article reports on a case of anorectal syphilis in a 54-year-old man with a history of Crohn’s disease. The patient began experiencing a new onset perianal rash approximately when his medication regimen for Crohn’s disease was switched from sulfasalazine to mesalamine. There was no reported history of new sexual partners or sexually transmitted infection exposures. Chief differential at this time included Cutaneous Crohn’s disease, Lichen Planus, Extramammary Paget’s Disease, and Porokeratosis Ptychotropica; however, shave biopsy results revealed unexpected syphilis. There is only one other reported case of syphilis presenting as Crohn’s disease, but the incidence of syphilis has been rapidly increasing within the last decade. A high index of clinical suspicion is needed to properly diagnose syphilis, even with a lack of sexual history, for new onset genital lesions.
Delayed Presentation of Cutaneous Endometriosis at the Cesarean Section Scar: A Case Report
Authors: Mitwalli Hadeel , Alfurayh Nuha , Alsharif Sahar 
Published: December 2023

Abstract
Cutaneous endometriosis is a rare skin disease presents with variable symptoms and morphologies. A high degree of suspicion followed by a histopathological examination is required to establish the diagnosis of cutaneous endometriosis. It usually appears shortly following a gynecological procedure. We herein report a delayed presentation of cutaneous endometriosis at a cesarian section scar of a 45-year-old female that started to appear four years following the surgery and continued to grow for seven years prior to her presentation. MRI findings were consistent with cutaneous endometriosis and the histopathological examination result confirmed the diagnosis. We reported this case to increase the dermatologists’ awareness on this rare cutaneous disease.
Sleep Disturbances and Female Gender Predict a Poor Quality of Life in Iraqi Contact Dermatitis Patients: A Cross-sectional Study
Authors: Al-Imam Ahmed , Al-Baghdadi Mohammed H. , Abdullah Sama T. , Al-Jawhar Sama H. , Michalak Michal 
Published: December 2023

Abstract

Background:
Contact dermatitis is a form of eczema triggered by an allergen or an irritant substance. Its impact on the quality of life (QoL) is unknown among Iraqi patients.

Purpose:
We aim to survey the QoL among Iraqi contact dermatitis patients and infer the risk factors influencing it.

Methods:
The current study is cross-sectional among patients admitted to Baghdad Medical City. We used the dermatology life quality index to assess the QoL and collected parameters related to socio-demographics and other eczema-related factors.

Results:
A hundred patients (males = 43%; females = 57%) were in the third decade of life (total = 34 ± 0.97; males = 33 ± 1.5; females = 34 ± 1.3). The multivariable logistic regression had good statistical accuracy and satisfied the Hosmer–Lemeshow goodness-of-fit test (Nagelkerke’s R
2 = 0.13, statistical accuracy = 67%, P = 0.47). Three factors associated with an impaired QoL, including sleep disturbances (odds ratio [OR] =4.8, 95% confidence interval [CI] [1.3, 18], P = 0.021), female gender (OR = 2.6, 95% CI [1.1, 6.4], P = 0.036), and family size (≤4 members) (OR = 3.2, 95% CI [0.99, 10], P = 0.053). Females with contact dermatitis who experience sleep disturbances and live in small households are more likely to suffer from severely impaired QoL.

Conclusion:
The QoL among Iraqi contact dermatitis patients is influenced by sleep disturbances, female gender, and family size.
Evaluation of the Adverse Dermatological Effects Due to Frequent Handwashing Accompanying the COVID-19 Pandemic: A Cross-sectional Study
Authors: Alshammarie Fawwaz F. , Aloufi Asma A. , Alshammari Laila M. , Alanazi Wael S. 
Published: December 2023

Abstract

Background:
Washing hands regularly is among the key suggestions the World Health Organization (WHO) made for the general public. However, intensive handwashing can cause hand dermatitis and is associated with illnesses such as methicillin-resistant Staphylococcus aureus infection.

Purpose:
The purpose of this study was to assess the prevalence and consequences of handwashing during the COVID-19 pandemic.

Methods:
This descriptive cross-sectional study was carried out in a convenience sample of 5000 participants in Saudi Arabia and captured participant handwashing practices, glove use, and potential dermatological side effects from regular handwashing. Data were obtained using a pretested questionnaire and then analyzed using the Statistical Package for the Social Sciences (SPSS), version 24.

Results:
The majority of participants (80%) repeatedly washed their hands with sanitizers and disinfectants. Only 31% used moisturizing soap, and 19% used warm water. A quarter of participants washed their hands for 20–30 s, and roughly 26% washed their hands 1–5 times every day. Moreover, 27% of participants experienced contact dermatitis on their skin because of the use of gloves and sterilizers.

Conclusion:
The repeated use of alcohol-based sanitizers in handwashing is associated with a high risk of eczema in about 27%. Decreasing the number of times they wash their hands and the use of detergents while using more emollients and nonpowdered gloves, may be helpful for avoiding hand dermatitis.
Successful Surgical Management of Periapical Cyst with Accidentally Extruded MTA through Open Apex - A Case Report with One Year Follow up
Authors: Anirudhan Subha , Shoba G. Joy , Ravichandran Kavimalar , Koshy Minu 
Published: December 2023

ABSTRACT

An immature tooth with a blunderbuss canal presents a challenge in achieving a hermetic seal. Closure of the wide-open apex with materials such as mineral trioxide aggregate (MTA), biodentine, and endosequence root repair material is required to achieve success. Despite following proper methods, the extrusion of filling material into the periapical region is unavoidable. In this case report, due to a lack of apical stop, MTA was extruded unintentionally. Endodontic surgery was performed to remove the extruded MTA and curettage of the apical lesion was done to remove the cystic lining. Follow-up after regular intervals of 1, 3, 6 months, and 1 year showed resolution of periapical radiolucency with radiopaque corticated borders surrounding the radiolucency. This case report describes the successful surgical management of accidentally extruded MTA through large wide-open apex.

CLINICAL RELEVANCE TO INTERDISCIPLINARY DENTISTRY
Surgical planning involved flap design in collaboration with periodontist for preservation of the interdental papilla.
Mucinous Adenocarcinoma of the Lung Diagnosed by Radial Endobronchial Ultrasound-guided Bronchoscopic Cryobiopsy and Presenting as Interstitial Lung Disease in a Patient with Systemic Sclerosis
Authors: Lin Yan-Ting , Lin Chiung-Hung , Wang Shao-Chung , Huang Yun-Ju , Wu Ren-Chin , Lee Chung-Shu , Chang Chih-Hao 
Published: December 2023

Abstract
We report a patient with systemic sclerosis who was diagnosed with advanced-stage mucinous adenocarcinoma of the lungs. The clinical presentation, imaging findings, pathological results, and molecular diagnoses are presented. A 64-year-old woman with systemic sclerosis was administered prednisolone and hydroxychloroquine sulfate to control her disease. High-resolution computed tomography (HRCT) revealed an interstitial pattern in both lungs during annual imaging. Connective tissue disease-associated interstitial lung disease (CTD-ILD) was diagnosed using blood tests, pulmonary function tests, and imaging findings. One year later, the patient underwent follow-up chest HRCT, which showed progressive lung disease. The patient underwent endobronchial ultrasound (EBUS)-guided transbronchial lung cryobiopsy and computed tomography-guided biopsy for a pathological diagnosis. The pathology reports of bilateral lungs disclosed mucinous adenocarcinoma. After tumor staging and mutation testing, the patient received chemotherapy with pemetrexed and cisplatin. The bilateral lung lesions subsided after four cycles of first-line chemotherapy. Patients with CTD and lung involvement may be diagnosed with CTD-ILD. Although histopathological results are not mandatory for ILD diagnosis, EBUS-guided transbronchial lung biopsy or lung cryobiopsy should be considered when ILD has atypical or unexplained features.
Paracetamol induced facial puffiness: An uncommon case report
Authors: Siddhu Charis Kaur , Joseph Girish , Bhatti Neena , Badyal Dinesh 
Published: December 2023

Abstract:
Paracetamol is one of the most commonly used antipyretic medications. paracetamol is a nonopioid synthetic, centrally acting analgesic and antipyretic drug with poor anti-inflammatory action. The World Health Organization (WHO) has approved the use of paracetamol in patients of almost all ages. The adult dose ranges from 1000 mg to 4000 mg/day. However, most people are unaware of the potential issues that can occur with paracetamol consumption. The adverse events (AEs) include edema of the eye and orbital region, edema of the rest of the head and neck, and edema of the respiratory system. Swelling of the throat, tongue, or face and reports of edema with an unspecified location is the less frequent AEs. This case involves a 21-year-old patient who had taken paracetamol 500 mg once a day for fever, following which he noticed generalized facial puffiness with swelling of the eyes and lips. It has been reported that more than 25% of all serious AE reported with paracetamol were hypersensitivity reactions. However, in this patient, hypersensitivity was ruled out by performing immunoglobulin E hypersensitivity testing.
Low-dose aspirin-induced upper gastrointestinal bleed and ulceration
Authors: Parikh Vrunda T. , Shah Meet K. , Gupta Sapna D. , Malhotra Supriya D. 
Published: December 2023

Abstract:
We present the case of a 58-year-old male patient who developed upper gastrointestinal bleeding (UGIB) after taking dual antiplatelet therapy (DAPT). He also tested positive for Helicobacter pylori (H. pylori) infection. He was on low-dose aspirin (LDA), i.e. 75 mg, as a part of DAPT. In clinical practice, UGIB is a common medical condition that is encountered; its three most frequent causes are peptic ulcer disease (PUD), esophagogastric varices, and erosive esophagitis. H. pylori and aspirin and/or nonsteroidal anti-inflammatory medicine are the two most common causes of PUD. In our case, the patient is a known case of hypertension, diabetes mellitus, and ischemic heart disease. He was diagnosed with multiple gastric ulcers on an upper gastrointestinal endoscopy. He was started on triple therapy for H. pylori and shifted to single antiplatelet therapy from DAPT. In our case, we discuss the factors that could have aggravated the development of multiple gastric ulcers on LDA treatment.
Correlation of the severity of mucormycosis with levels of inflammatory markers in COVID-19 patients
Authors: Kruthika S. , Inchara N. , Madala Poojitha 
Published: December 2023

Purpose:
The purpose of the study is to explore the clinical spectrum of rhino-orbital cerebral mucormycosis (ROCM) and to correlate its severity with the levels of inflammatory markers of COVID-19 patients.

Materials and Methods:
It is an observational analytical study. Clinical and laboratory data of the patients with mucormycosis admitted in COVID-19 wards in a notified nodal tertiary care center were collected and stratified clinically according to the severity of ROCM. Serum ferritin, serum lactate dehydrogenase (LDH), D-dimer, total count, neutrophils, and lymphocyte count were considered primary outcome variables. The severity of the ROCM (Stage II, Stage III, and Stage IV mucormycosis) was considered the primary explanatory variable.

Results:
Forty-five participants were included, of which 38 (84%) were male and 7 (16%) were female. The mean age was 48.71 ± 10.71 years, which ranged from 29 to 75 years. In people with the severity of the ROCM, 26 (58%) were in Stage II, 15 (33%) were in Stage III, and 4 (9%) were in Stage IV. The mean serum ferritin, mean serum LDH, and D-dimer across the severity of ROCM were statistically significant. The median total count, mean neutrophils, and mean lymphocytes across the severity of ROCM were not statistically significant.

Conclusion:
The study shows that raised serum ferritin, LDH, and D-dimer levels at admission significantly predict disease severity in COVID-19 patients with mucormycosis. Mucormycosis and its severity are associated with higher inflammatory markers levels than the mild disease in COVID-19 patients. Tracking these markers may allow early identification or even prediction of disease progression.
Susac syndrome – A Portuguese experience
Authors: Portela Mariana , Nogueira Vanda , Liverani Marco , Figueira Luís , Jesus Jeniffer , Lorga Tiago , Baptista Margarida , Guedes Marta 
Published: December 2023

Introduction:
Susac syndrome (SS) is characterized by microvascular occlusions in the brain, retina, and inner ear. Despite significant advances in understanding this disorder, it remains an under- and misdiagnosed entity in the clinical setting.

Methods:
This study was retrospective review of clinical records.

Results:
We present the cases of three young adults complaining of visual loss, hearing impairment, and headache. In all patients, the fundoscopy and fluorescein angiography revealed nonperfused arteriolar segments and multifocal arterial vasculitis. The brain magnetic resonance imaging demonstrated characteristic white matter brain lesions and the audiometry revealed low-frequency hearing loss. The diagnosis of SS was therefore established. We present and discuss the different treatment regimens applied and the course and outcomes of each case.

Conclusion:
SS is a rare and complex disease with possibly severe consequences that must be promptly diagnosed and treated. However, as no prospective or randomized controlled trials exist, empirical treatment strategies are still the norm, mainly based on the case reports and series.
Ophdthalmological profile in the elderly aged 80 years or more in the city of Maués – Amazonas
Authors: Osório Chaves Cláudia Maria , Cypel Marcela Colussi , Belfort Jr Rubens 
Published: December 2023

Objective:
The objective of this study was to determine the frequency and main causes of visual impairment and blindness in the elderly aged 80 years or more, predominantly living in the urban area of the municipality of Maués – Amazon/Brazil.

Methods:
This was a cross-sectional study of a population of 360 elderly people aged 80 years or more, predominantly living in the urban area of the City of Maués-AM, who were invited to a complete eye examination along with a questionnaire to describe nutritional habits and frequency consumption of guarana. Uncorrected visual acuity, presented visual acuity, and best-corrected visual acuity of each eye were obtained. If necessary, prescription for glasses, surgery, or other types of treatment was provided free of charge.

Results:
A total of 360 individuals aged between 80 and 108 years (mean: 86.02 ± 5.57 years) were submitted to an ophthalmological evaluation. Of these, 182 (50.5%) were male and 178 (49.5%) female. Of the total number of eyes examined, the causes of visual impairment and blindness were cataract (51.8%), refractive errors (12.2%), age-related macular degeneration (9.1%), other nerve atrophies (3.9%), posterior capsule opacity (3.6%), glaucoma (3.5%), corneal changes (3.3%), absent globe/phthisis (3.1%), other retinal changes (1.1%), diabetic retinopathy (1.0%), pterygium (0.6%), amblyopia (0.4%), and other causes (1.8%). According to the Nutritional Screening Initiative Nutritional Dysfunction Questionnaire, 45.0% of the participants had low risk of nutritional dysfunction, 51.7% moderate risk, and 3.3% high risk.

Conclusions:
A high frequency of blindness (43.6%) was detected in this sample of very elderly people living in urban areas in the city of Maués. The main causes of blind eyes would be preventable with provision for cataract surgery followed by postoperative actions and prescription of glasses. Half of the elderly (50.0%) reported frequent consumption of guarana, at least once a week, but this did not prove to protect against visual impairment and blindness. These results reflect this population's limited access to eye care services, reinforcing the need for sustainable actions to improve eye health in remote areas of Brazil.
Artificial intelligence at the pen’s edge: Exploring the ethical quagmires in using artificial intelligence models like ChatGPT for assisted writing in biomedical research
Authors: Sharma Hunny , Ruikar Manisha 
Published: December 2023

Abstract
Chat generative pretrained transformer (ChatGPT) is a conversational language model powered by artificial intelligence (AI). It is a sophisticated language model that employs deep learning methods to generate human-like text outputs to inputs in the natural language. This narrative review aims to shed light on ethical concerns about using AI models like ChatGPT in writing assistance in the health care and medical domains. Currently, all the AI models like ChatGPT are in the infancy stage; there is a risk of inaccuracy of the generated content, lack of contextual understanding, dynamic knowledge gaps, limited discernment, lack of responsibility and accountability, issues of privacy, data security, transparency, and bias, lack of nuance, and originality. Other issues such as authorship, unintentional plagiarism, falsified and fabricated content, and the threat of being red-flagged as AI-generated content highlight the need for regulatory compliance, transparency, and disclosure. If the legitimate issues are proactively considered and addressed, the potential applications of AI models as writing assistance could be rewarding.
Evaluation of factors that act as barriers in conducting academic trials – An investigator’s perception
Authors: Gajbhiye Snehalata Vijayanand , Dakhale Ganesh Natthuji , Chindhalore Chaitali Ashish , Gupta Ashish Vijay , Selvi E Tamil 
Published: December 2023

Abstract

Background:
Academic trials are essential in investigating health research questions relevant to the society. Only a few leading research institutions in India have been engaged in academic trials. Thus, there is a need to understand what factors dampen the spirit of the academician in conducting academic clinical trials.

Aims and Objectives:
The aim of the study is to evaluate the investigator’s perception of obstacles to carrying out academic trials and to identify factors that will motivate investigators in conducting academic trials

Materials and Methods:
We conducted a prospective observational study in a tertiary care hospital for 6 months. Faculty members working in academic institutes were selected. A structured questionnaire was designed for the study and administered using google forms. Responses were taken on a Likert scale. Validity and reliability assessments were carried out. Mann-Whitney test was applied to assess differences between demographic groups. P <0.05 was considered significant.

Results:
Most of the participants rated applying for research grants (76%), obtaining funding for the study and making arrangements for compensation for trial-related events (75%) as extremely challenging. We found that the degree of challenge is significantly lower in the faculty members who conducted clinical trials in the past as against those who did not (P = 0.00069). We also found that the degree of challenge is significantly higher in the faculty members with <10 years of experience than those with >10 years of experience (P = 0.00001).

Conclusion:
Thus, to conclude the challenges faced by investigators were at multiple levels, most common being applying for research grants and making arrangements for the funds for payment towards participation or study-related injury. Faculty members with exposure to conducting clinical trials and with experience of more than 10 years had perceived a reduced degree of challenges.
Surgical rescue strategies and techniques for gastrointestinal fistulas
Authors: Ren Jianan , Teng Yitian 
Published: December 2023

Abstract
A gastrointestinal fistula is a severe medical condition that may lead to sepsis or septic shock. It requires immediate response and valid treatment to prevent subsequent deterioration. Surgical rescues are effective measures to cope with aforementioned situations, but there remain challenges in successful implementation. Institutional factors, including constrained hospital volume, technological gap, and limited competence of surgeons and nurses, could lead to surgical failure to rescue (FTR), while high-risk patient characteristics such as aging, diabetes mellitus, and chronic organ dysfunction have a bearing on the outcome as well. Surgical rescue strategies encompass damage control surgery and resuscitation. Based on disease severity, sequential damage control measures involving vessel catheter removal, abdominal drainage tube replacement, trocar-assisted percutaneous abscess drainage, laparoscopic drainage, and open abdomen therapy should be applied accordingly.