bluuebunny/crossref_metadata_2025_split huggingface dataset:
Occurrence of Retrorenal Colon in the Indian Population – A Significant Finding from Urological Perspective
Authors: Jain Tanya , Rastogi Rajul , Aggarwal Amit , Khajuria Lakshay , Pratap Vijai 
Published: December 2023

Introduction:
Ascending and descending coli normally are located anterolateral to kidneys. Retrorenal position of the colon has a reported prevalence of 10%–20% in the general population. Its occurrence is of significant while performing percutaneous nephrolithotomy (PNL) which is a routine management procedure for patients showing clinical disease associated with renal calculus. PNL in patients with retrorenal colon can lead to colonic perforation which is associated with significant morbidity and mortality related to septicemia, peritonitis, formation of abscess, and nephro-colic and/or colo-cutaneous fistulae. Hence, the preoperative information about the presence of retrorenal colon is essential for the prevention of surgical complications.

Materials and Methods:
Our retrospective study included patients who underwent computed tomography (CT)/magnetic resonance (MR) abdomen in our department of radiodiagnosis. All the scans were evaluated for the presence of retrorenal colon. The persistence of retrorenal colon was also observed with change in posture among those with prone scans.

Results:
The retrorenal colon was present in 130 out of 669 patients included in the study, with an occurrence rate of nearly 20%. Alteration in the position of retrorenal colon was noted with prone position in approximately 79%.

Conclusion:
The occurrence of retrorenal colon is high in the Indian population being approximately 20% without change with prone position in one-fifth. Thus, to reduce the risk of complication related to colonic perforation during PNL, all patients must be subjected to CT/MR abdomen to detect retrorenal colon followed by scan in the prone position, if retrorenal colon is present, to evaluate the alterations in colonic position with prone posture.
A Comparative Study Between 0.125% Bupivacaine and 0.2% Ropivacaine in Ultrasound-Guided Supraclavicular Brachial Plexus Block Using a Perineural Catheter for Postoperative Analgesia in Upper Limb Surgeries
Authors: Ahmed Syed Arafath , Desingh Dilip Chandar , Kuppusamy Suresh Kumar , Lazarus Suneeth P. 
Published: December 2023

Introduction:
Regional anesthesia offers the anesthesiologist, the surgeon, as well as the patient with better advantages over general anesthesia such as being conscious throughout the surgery, avoiding multiple drugs, better hemodynamic stability, excellent postoperative analgesia, and faster per oral consumption after surgery. Compared with the axillary approach, brachial plexus block at the level of clavicle can anesthetize all four distal upper extremity nerve territories without the requirement for a separate block of the musculocutaneous nerve. The aim of the study was to assess the duration of postoperative analgesia using visual analog scale and onset of motor blockade in two groups – bupivacaine group and ropivacaine group.

Materials and Methods:
A single-blinded, randomized, prospective experimental study was conducted in the Department of Anesthesiology, Sri Manakula Vinayagar Medical College and Hospital a Tertiary Care Teaching Hospital in South India from November 2019 to May 2021. Sixty patients undergoing upper limb surgeries were randomized into two groups – bupivacaine and ropivacaine. All patients were administered 25 mL of 0.5% bupivacaine as the standard intraoperative drug and at the end of 3 h study drug was administered accordingly. We assessed onset of sensory and motor blockade, duration of block, hemodynamic parameters, and duration for first rescue analgesia. The duration of postoperative analgesia was the primary outcome, and onset of motor blockade and time of first rescue analgesia required were the secondary outcomes. The statistical significance between the groups was analyzed using the Chi-square test for categorical variables, and ANOVA test for continuous variables a P < 0.05 was considered statistically significant.

Results:
We observed that 0.125% bupivacaine group had prolonged duration of action (25 h) than 0.2% ropivacaine group (16.9 h) with P < 0.001. The onset of motor block of both drugs was found to be similar in both groups, but it was not found to be statistically significant (P = 0.786).

Conclusion:
0.125% bupivacaine provides longer duration for postoperative analgesia given through perineural catheter than 0.2% ropivacaine in ultrasound-guided supraclavicular blocks for upper limb surgeries.
Role of Morphology and Immunohistochemistry in the Diagnosis of Incidental Cancers in Gallstone Disease
Authors: Saxena Mohiny , Bohara Sangita , Gupta Vivek , Goel Vijay Kumar 
Published: December 2023

Introduction:The majority of gallbladder adenocarcinomas have been known to develop from dysplasia or carcinoma in situ, without pre-existing adenomas, hence observation of these non-neoplastic or preneoplastic lesions is important as it may underlie an occult malignancy. To study the role of morphology and immunohistochemistry in the diagnosis of incidental cancers in cases of gall stone disease by adopting a universal histopathological screening policy for all the gallstone disease cases operated at our tertiary care center.Material and Methods:The present study was designed as an observational cross sectional study completed over a time period of 14 months. A total of 176 cases were included in the study including all the patients of gall stone disease in the adult age group. All the indeterminate and frankly malignant cases were subjected to immunohistochemistry with a panel of antibody markers including p53, CEA and Ki-67 using Streptavidin Biotin immunoperoxidase method Fisher-exact test was used to compare the data taking‘p’ value less than 0.05 as statistically significant.Results:Mean age of patients was 40.55±13.25 years. Majority of patients (n=141; 80.1%) were females. The final diagnosis revealed a dominance of non-neoplastic inflammatory (n=168; 95.5%) pathology. There were 8 (4.5%) of malignancy, of these 7 were adenocarcinoma and 1 was adenosquamous carcinoma. Atypia was seen in 5 (2.8%) cases and 3 (1.7%) cases were of dysplasia. Histopathology detected carcinoma in 7 (4%) cases whereas addition of immunohistochemistry helped to find out one more unidentified case, thus the diagnostic yield increased to 8 (4.5%) cases. Out of three dysplasia cases, one (33.3%) was found positive on immunohistochemistry, which was later confirmed to be malignant. None of the cases of atypia were positive on p53, Ki-67 and CEA immunohistochemistry. On comparison between the three groups, the results were statistically significant (p=0.00062).Conclusion:Immunohistochemistry has a useful role in detection of incidental gallbladder carcinoma when morphology is limited by indeterminate results. A panel of immunohistochemical markers including p53, Ki-67 and CEA may prove very useful to pick up cases of malignancy in such cases of diagnostic dilemma.
Histopathology of Endoscopic Biopsies of Gastrointestinal Tract Lesions with Clinical Correlation
Authors: Rastogi Gaurav , Chawhan Sanjay Madhukar. 
Published: December 2023

Introduction:
Because of limited anatomical space and certain unusual clinicopathological features, gastrointestinal tract lesions causes problem in their diagnosis, prognosis, and management. The primary objective of the study is to know the utility of endoscopic biopsy in diagnosing gastrointestinal lesions, and the secondary objective is to correlate the histopathological findings with the clinical symptoms and endoscopic appearance of the lesions.

Materials and Methods:
The present study is a simple retrospective observational study. Upper and lower gastrointestinal lesions in the form of ulcer, polyp, and growth were biopsied by biopsy forceps using flexible fiberoptic endoscopes. Only adequate biopsies were included in the study. The exact site of the biopsy with clinical data was provided by the endoscopist. Routine histopathological examination was done on the specimens submitted in 10% formalin. The use of special stains was done wherever needed.

Results:
A total of 100 cases were categorized as nonneoplastic and neoplastic. Friedman and Osborn classification was used for nonneoplastic lesions. The maximum number of cases was seen in 5th–6th decade with male predominance with equal distribution of cases as far as anatomical site is concerned.

Conclusion:
Targeted biopsies are possible with definitive diagnosis in 90% of cases with safe use of endoscopy. 17% of cases diagnosed on endoscopy were confirmed on histopathology. In 73% of cases, histopathology was essential for further subtyping. Histopathology was mandatory in 8% of the cases. Recommended combined use of endoscopy and histopathology can offer a definitive diagnosis in 98% of cases.
A narrative review of potential neural repair poststroke: Decoction of Chinese angelica and peony in regulating microglia polarization through the neurosteroid pathway
Authors: Qin Linhui , Kamash Peter , Yang Yong , Ding Yuchuan , Ren Changhong 
Published: December 2023

Abstract:
Ischemic stroke is a major global health crisis, characterized by high morbidity and mortality rates. Although there have been significant advancements in treating the acute phase of this condition, there remains a pressing need for effective treatments that can facilitate the recovery of neurological functions. Danggui-Shaoyao-San (DSS), also known as the Decoction of Chinese Angelica and Peony, is a traditional Chinese herbal formula. It has demonstrated promising results in the regulation of microglial polarization and modulation of neurosteroid receptor expression, which may make it a potent strategy for promoting the recovery of neurological functions. Microglia, which plays a crucial role in neuroplasticity and functional reconstruction poststroke, is regulated by neurosteroids. This review posits that DSS could facilitate the recovery of neuronal function poststroke by influencing microglial polarization through the neurosteroid receptor pathway. We will further discuss the potential mechanisms by which DSS could enhance neural function in stroke, including the regulation of microglial activation, neurosteroid regulation, and other potential mechanisms.
Association of Central serous chorioretinopathy with type of personality, anxiety and depression
Authors: Mukherji Sushmita , Karmakar Soumen , Dasgupta Sibaji 
Published: December 2023

Purpose:
Central serous chorioretinopathy (CSCR) a relatively common cause of visual impairment, which is characterized by subretinal fluid accumulation in the macula and is more common in middle-aged males. Various risk factors have been reported in literature, among which substantial role of psychological factors is cited. Our aim was to look for the prevalence and association of the psychiatric factors in CSCR patients and to compare them with other non-chorioretinal ocular pathologies.

Methods:
A cross-sectional correlational study was undertaken involving 91 CSCR patients, along with 91 patients with other non-chorioretinal diseases. Their risk factors, clinical history, ocular examination, and psychiatric assessments were done using standardized tools, and the groups were compared in terms of scoring of Framingham Type A scale (FTAS), Hamilton Anxiety Rating Scale (HAM-A), and Hamilton Depression Rating Scale (HDRS).

Results:
CSCR patients had a male:female ratio of 8:1. Chronic, bilateral, and recurrent diseases were found in 15%, 20%, and 23% cases, respectively. Anxiety disorder had a prevalence of 40%, followed by major depression with a prevalence of 24%, and these were significantly higher than non-chorioretinal disease patients (odds ratios 14.18 and 5.30, respectively). Also, these psychiatric disorders were significantly associated with an overall lower visual acuity and greater central macular thickness due to subretinal fluid accumulation.

Conclusion:
Psychiatric comorbidities like Type A personality trait and depression and anxiety disorders were significantly more prevalent in CSCR patients, compared to non-chorioretinal pathologies. Focus on psychological health would certainly benefit these patients in terms of better management of not only CSCR, but their psychiatric morbidity as well.
Gender- and age-related differences in foveal pit morphology
Authors: Liu Yen-Ting , Ma I-Hsin , Hsieh Yi-Ting 
Published: December 2023

Aims:
To measure the foveal pit morphology parameters and evaluate their correlations with age and sex.

Settings and Design:
A retrospective cross-sectional matched comparison study in a tertiary center.

Methods and Materials:
Forty men and 40 age-matched women who had normal macular structures and foveal contours were enrolled. Foveal pit parameters including top width, base width, nasal width, temporal width, minimal thickness, nasal thickness, temporal thickness, nasal height, temporal height, nasal slope, and temporal slope were measured on horizontal B-scan macular optical coherence tomography and compared between men and women.

Statistical Analysis Used:
Paired t-tests and Pearson's correlation analysis.

Results:
The average patient age was 51.4 ± 17.5 (21–84) years. Women had a wider base width (313.1 ± 68.0 μm vs 266.8 ± 70.9 μm, P = 0.006), wider temporal width (1043.1 ± 245.6 μm vs 968.9 ± 261.0 μm, P = 0.006), thinner nasal thickness (345.6 ± 36.2 μm vs 359.7 ± 35.8 μm, P = 0.048), and flatter temporal slope (11.60 ± 2.52° vs 12.98 ± 2.68°, P = 0.016) than men. With age, the base width (r = 0.35, P = 0.025) and temporal width (r = 0.54, P = 0.0003) tended to be wider and the temporal slope was flatter (r = -0.45, P = 0.003) in women but not men. The minimal thickness tended to be thinner in the elderly group (r = 0.038, P = 0.015).

Conclusions:
Women had a significantly wider base width, wider temporal width, thinner nasal thickness, and flatter temporal slope of the foveal pit than age-matched men. The base width and temporal width were wider and the temporal slope was flatter with age in women but not men.
Proximal nailfold videocapillaroscopy findings of patients with idiopathic macular telangiectasia type 2
Authors: Gedik Birumut , Erol Muhammet K , Bulut Mehmet , Dogan Berna , Bozdogan Yigit C , Ekinci Rojbin , Ayan Ayse 
Published: December 2023

Purpose:
Idiopathic macular telangiectasia type 2 (IMT) is a neurodegenerative disease characterized by bilateral, idiopathic, and perifoveal retinal telangiectatic vessel formations. We aimed to compare proximal nailfold videocapillaroscopy (NV) findings between patients with IMT and healthy individuals and evaluate the optical coherence tomography angiography (OCTA) parameters of the patients with IMT according to their NV findings.

Methods:
The study included 43 patients with IMT and 92 healthy controls of similar age and gender without any additional diseases. The OCTA and NV findings of the patients and controls were examined.

Results:
The mean age was 59.76 ± 5.73 years in the IMT group and 58.23 ± 4.96 years in the control group. Of the 43 patients with IMT, 19 were found to have increased capillary tortuosity, six had microhemorrhage, and 18 had bizarre capillaries (P < 0.001). In the IMT group, the total vascular density value of the superficial capillary plexus was higher among the patients with capillary microhemorrhage (P = 0.001), and the subfoveal choroidal thickness was lower among those with increased capillary tortuosity and bizarre capillaries (P = 0.04 and P = 0.07, respectively).

Conclusion:
This is the first study in which the NV findings of patients with IMT were compared with those of a control group. We found higher rates of increased capillary tortuosity, microhemorrhage, and bizarre capillaries in the IMT group compared to the controls. We consider that this situation is caused by microvascular damage. We also think that IMT is a systemic disease that affects both proximal nailfold capillaries and eye vessels.
Patient adherence to therapy after switch to aflibercept from bevacizumab or ranibizumab for treatment-refractory neovascular age-related macular degeneration
Authors: Archambault Simon D , Nichols Megan M , McCullum James C , Zhang Yubo , Steinberger Elise E , Ramsey David J 
Published: December 2023

Purpose:
Clinical trials have demonstrated that switching patients from intravitreal bevacizumab (IVB) or ranibizumab (IVR) to aflibercept (IVA) for treatment-refractory neovascular age-related macular degeneration (nAMD) can decrease the injection frequency. This study evaluated whether there was a difference in the rate of injections or nonadherent events after switching therapies.

Methods:
The study comprised a retrospective, cross-sectional analysis of patients treated for nAMD from 2010 to 2018 who received ≥3 intravitreal injections of IVB/IVR prior to switching to IVA because of treatment-refractory nAMD. The treatment index, outcomes, and adherence to treatment were compared between both treatment regimens.

Results:
Sixty-two patients (67 eyes) met inclusion criteria. There was no change in the treatment index (0.65 versus 0.66, P = 0.650) or the number of nonadherent events (33 versus 36, P = 0.760) after the switch from IVB/IVR to IVA. Central macular thickness (CMT) increased 7.7%±13.8% in eyes that had a nonadherent event (283±69 µm to 304±75 µm after resuming care, P = 0.039). There was no short-term impact on visual acuity (VA) for this subset of eyes (0.387±0.202 LogMAR versus 0.365±0.156 LogMAR, P = 0.636). Patients who had nonadherent events ended the study with similar VA compared with patients who had no treatment lapses (0.370±0.616 LogMAR versus 0.337±0.638 LogMAR, P = 0.843).

Conclusion:
Switching from IVB/ IVR to IVA for treatment-refractory nAMD in a real-world setting does not reduce the treatment index or increase adherence to treatment. Although there were short-term anatomical effects resulting from missed treatments, VA remained stable.
Evaluation of retinal and peripapillary vessel density and subfoveal choroidal thickness changes in patients undergoing cardiopulmonary bypass: An OCTA study
Authors: Şimdivar Göksu Hande Naz , İncekalan Tuğba Kurumoğlu , Gündüz Akif 
Published: December 2023

Purpose:
We aimed to investigate hemodynamic changes in the retina, peripapillary area, and choroid in patients undergoing coronary artery bypass grafting (CABG).

Methods:
This prospective case series included 35 eyes of 35 patients. Vessel density (VD) of superficial capillary plexus, deep capillary plexus, radial peripapillary capillary, foveal avascular zone area, and subfoveal choroidal thickness changes were evaluated using optical coherence tomography angiography (OCTA) 1 day before and 2 weeks after surgery. The correlation of these parameters with aortic cross-clamp (ACC) duration and cardiopulmonary bypass (CPB) duration was evaluated.

Results:
There were no differences in the OCTA measurements of the patients after CABG compared to before surgery (P > 0.05). Inside-disc VD showed a negative correlation with both ACC (P = 0.036) and CPB duration (P = 0.048); peripapillary inferior hernia showed a negative correlation with both ACC (P = 0.042) and CPB duration (P = 0.027). Another negative correlation was observed between mean peripapillary VD and CPB duration (P = 0.039).

Conclusion:
The CPB procedure had no permanent effect on retinal choroid and optic disc blood flow postoperatively. Prolonged ACC and CPB times seem to be important in terms of optic nerve blood flow. Clinicians should be alert for postoperative ocular complications after long surgeries.
A double-blinded study for quantifiable assessment of the diagnostic accuracy of AI tool “ADVEN-i” in identifying diseased fundus images including diabetic retinopathy on a retrospective data
Authors: Acharyya Mausumi , Moharana Bruttendu , Jain Sahil , Tandon Manjari 
Published: December 2023

Purpose:
To quantifiably assess the diagnostic accuracy of Adven-I, a proprietary artificial intelligence (AI)-driven diagnostic system that automatically detects diseases from fundus images. The purpose is to quantify the performance of Adven-i in differentiating a nonreferable (within normal limits) image from a referable (diseased fundus) image and further segregating diabetic retinopathy (DR) from the rest of the abnormalities (non-DR) encompassing the wide spectrum of abnormal pathologies. The assessment is carried out in comparison to manual reading as the reference gold standard. Adven-i is the only AI system classifying retinal abnormalities into DR and non-DR classes separately, apart from predicting nonreferable fundus, while most existing systems classify fundus images into referable and nonreferable DR.

Methods:
The double-blinded study was conducted on retrospective data collected over the course of a year in the ophthalmology outpatient department (OPD) at a top Tier II eyecare hospital in Chandigarh, India. Three vitreoretina specialists who were blinded to one another read the images. The ground-truth was generated on the basis of majority agreement among the readers. An arbitrator's decision was regarded final if all three readers disagreed.

Results:
2261 fundus images were analyzed by Adven-i. The sensitivity and specificity of Adven-i in diagnosing images with abnormalities were 95.12% and 85.77%, respectively, and for segregating DR from rest of the retinal abnormalities were 91.87% and 85.12%, respectively.

Conclusions and Relevance:
Adven-i shows definite promise in automated screening for early diagnosis of referable fundus images including DR. Adven-i can be adopted to scale for mass screening in resource-limited settings.
Quantitative measurement of retinal nerve fiber layer thickness and its correlation with optical coherence tomography angiography vascular biomarker changes in preclinical diabetic retinopathy
Authors: Verma Shweta , Singh Vinod Kumar , Rana Jagriti , Kumar Santosh , Singh Kamaljeet , Srivastava Ratnapriya 
Published: December 2023

Purpose:
The present study was done to assess the use of optical coherence tomography angiography (OCTA) in detecting earlier stages of diabetic retinopathy and for the early management and effective blood glucose control in preclinical diabetic patients for preventing retinal nerve fiber layer (RNFL) thinning.

Methods:
A tertiary care center–based prospective observational study was conducted from the year 2021 to 2022 in the Department of Ophthalmology. The study included 50 cases and 50 controls. The parameters analyzed by using OCTA (Topcon 3D OCT-1 Maestro2) were RNFL thickness and peripapillary vessel density.

Results:
We found that the RNFL thickness in the temporal and superior disc in patients with preclinical diabetic retinopathy was significantly (0.041 and 0.044, respectively) decreased. The duration of diabetes and glycated hemoglobin (HbA1c) were the risk factors for peripapillary vessel density reduction in patients with preclinical diabetic retinopathy (P < 0.001).

Conclusion:
RNFL thinning is an early sign of retinal neurodegeneration and is associated with peripapillary vessel density reduction. Early management and effective blood glucose control in diabetes patients may be beneficial for preventing RNFL thinning in superior and temporal disc.