bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Zoledronic Acid in Hepatic Osteodystrophy: A Double-Blinded Placebo-Controlled Trial
Authors: Raj Henith , Kamalanathan Sadishkumar , Sahoo Jayaprakash , Mohan Pazhanivel , Nagarajan Krishnan , Reddy Sagili V. B. , Durgia Harsh , Palui Rajan 
Published: January 2024

Abstract

Purpose:
Literature on the treatment of pre-transplant hepatic osteodystrophy (HOD) is limited. The general treatment measures and their timing are currently adopted from the literature on postmenopausal osteoporosis. Therefore, we conducted this randomized study to investigate the effect of zoledronic acid (ZA) on HOD.

Methods:
We randomized 36 male patients with cirrhosis (Child–Pugh class A and B) into 19 to the ZA arm and 17 to the placebo arm, respectively. Patients in the ZA arm received a single infusion of 4 mg ZA dissolved in 100 mL of normal saline at baseline, while patients in the placebo arm received a similar infusion of normal saline at baseline. The primary outcome of the study was the change in lumbar spine bone mineral density (LS-BMD) at 12 months.

Results:
Of 36 patients, 28 completed the study (15 in the ZA arm and 13 in the placebo arm). The mean increase in LS-BMD (g/cm2) in the ZA and placebo arms was 5.11% (3.50) and 0.72% (4.63) [P = 0.008], respectively. The trabecular bone score (TBS) did not improve significantly in either arm. The incidence of vertebral fractures (VFs) was similar in both arms. There was a significant decrease in plasma beta-C-terminal telopeptide (β-CTX) levels in the ZA arm compared to the placebo arm, while the change in plasma levels of procollagen 1 intact N-terminal propeptide (P1NP) was similar in both arms. Six patients (31.6%) in the ZA arm experienced adverse reactions such as fever and myalgia.

Conclusion:
ZA improved LS-BMD in male patients with HOD by decreasing bone resorption. However, it may not improve trabecular microarchitecture or prevent morphometric VFs in this population.
Incidence of Prostate Cancer in Transgender Women Undergoing Androgen Deprivation Therapy: A Review
Authors: Tyagi Saurabh , Tyagi Surbhi 
Published: January 2024

Abstract
Transwomen frequently undergo androgen deprivation therapy (ADT) incorporated with oestrogen, but they are still prone to the occurrence of prostatic cancer since the prostate remains intact. The probability of this clinical condition reduces as compared with the general male population. This study aimed to study the occurrence of prostatic malignancy under hormonal therapy such as ADT in transwomen. An extensive literature search was performed using online searches on transgender health, centring on the incidence, diagnosis, treatment and management of prostate cancer in transgender women. Original articles from 1975 to 2022 were searched using PubMed, Scopus, EMBASE, DOAJ and Cochrane databases. Physical, mental and communal deliberation of health development is the major constituent of trans-health. It exhibits a fivefold reduction in prostatic malignancies in transwomen undergoing hormonal therapy contrasted with the extensive male community of indistinguishable age.
Primary sclerosing encapsulating peritonitis
Authors: Mishra Swati , Chaudhary Kuldeep , Tyagi Swati , Mishra Pratibha , Misra Vatsala 
Published: January 2024

ABSTRACT
Sclerosing encapsulating peritonitis also known as cocoon abdomen is a rare chronic inflammatory condition of the peritoneum in which the bowel loops are encircled by a membrane (cocoon formation) within the peritoneal cavity leading to intestinal obstruction. It can be primary (idiopathic) or secondary (chemotherapy, beta-blockers, peritoneal dialysis, shunts, tuberculosis, systemic lupus erythematosus, etc.). The symptomatology report includes recurrent episodes of abdominal pain and vomiting. We present here a case of a 32-year-old male who presented with complaints of being unable to pass stools, vomiting (3–4 times), and abdomen pain for 4 days. This case is considered worth mentioning due to its rarity, lack of identification of secondary causes, and diminutive mention of histopathological aspect.
Systemic xanthogranuloma involving bone marrow and skin in a case of B-Lymphoblastic Leukemia
Authors: Mundada Manasi C. , Ahmed Faiq , Kodandapani Suseela , Patil Veerendra 
Published: January 2024

ABSTRACT
Juvenile xanthogranuloma is a benign self-limiting lesion commonly described in infants and young children. It most commonly involves the skin presenting as single or multiple yellowish-brown papules. Clinical scenario with the classic histomorphology showing histiocytic aggregates in the dermis with xanthomatous cytoplasm, toutan type giant cells, immunohistochemistry with positive CD68, CD163, factor XIIIa and negative CD1a and S-100 help in diagnosis. However, diagnosis becomes challenging with predominant systemic bone marrow involvement in post-B-lymphoblastic leukemia settings.
Primary extranodal NK/T cell lymphoma of stomach: A case report and review of literature
Authors: Mane Prashant , Ramteke Prashant , Singh Anand , Gogia Ajay , Mallick Saumyaranjan 
Published: January 2024

ABSTRACT
Extranodal Natural killer/T (NK/T) cell lymphoma nasal type is an aggressive non-Hodgkin lymphoma and has a constant association with Epstein-Barr virus (EBV) infection. Approximately more than 75% cases are located in upper aero-digestive tract, of which stomach is a very rare site. Very few cases of gastric extranodal NK/T cell lymphoma have been reported in the literature. A 22-year-old male patient presented with complaints of abdominal pain and hematemesis. Endoscopy showed a large ulcer in the stomach. Partial gastrectomy done and histopathology showed transmural infiltration by intermediate size atypical lymphoid cells which are immunopositive for CD3, CD56, TIA, EBV-encoded RNA (EBER) and negative for CD4, CD8, CD20. A diagnosis of extranodal NK/T cell lymphoma nasal type was made.
Case of angioimmunoblastic T-cell lymphoma presenting as peripheral and bone marrow plasmacytosis: A diagnostic conundrum
Authors: Gupta Deepika , Jaine Nagarjun S. , Bairwa Sandeep K. , Thirunavukkarasu Balamurugan , Vishwajeet Vikarn , Purohit Abhishek H. L. 
Published: January 2024

ABSTRACT
Angioimmunoblastic T-cell lymphoma (AITL), a subtype of peripheral T-cell lymphoma (PTCL), is associated with unique clinical, morphological, and immunohistochemical features. The peripheral circulation might show presence of an occasional reactive plasma cell but significant plasmacytosis masquerading as plasma cell leukemia is rare. We report a case of AITL in a 42-year-old male, who presented with two-month history of generalized lymphadenopathy. On investigations, he had hypergammaglobulinemia and plasmacytosis in the peripheral blood and bone marrow masquerading as plasma cell leukemia. Immunohistochemistry and serum protein electrophoresis revealed polyclonal nature of plasma cells. Diagnosis of AITL was made on cervical lymph node biopsy. This case highlights the diagnostic challenge faced due to heterogeneity in the clinical presentation and pathological findings and to alert the clinician so that timely accurate diagnosis can be made to initiate the treatment.
Expression of CD68+ Tumor associated macrophages in relation to β-catenin in carcinoma stomach
Authors: Sharma Nikhil , Panigrahi Ranjita , Pradhan Prita , Parida Sabyasachi , Sahoo Saroj R. 
Published: January 2024

ABSTRACT

Background:
With no unified system for tumor associated macrophages (TAMs) density assessment, limited information is available on their relationship with β-catenin expression.

Aim:
To evaluate the density of CD68+ TAMs in gastric adenocarcinoma samples by immunohistochemistry and correlate it with grade, stage, invasion, and beta-catenin.

Designs and Settings:
Formalin fixed paraffin embedded (FFPE) blocks from gastrectomy specimens of proven gastric adenocarcinoma were prospectively and retrospectively were studied over a period of two years.

Materials and Methods:
Immunohistochemistry with CD68 and β-catenin was performed. TAM density was qualitatively compared in “tumor” versus “stroma” and “tumor” versus “non-tumor” regions. Quantitative CD68+ TAM density was assessed using different methods and compared. Cases were classified as high and low TAM based on the median value and correlated with histologic type, location, grade, stage and β-catenin expression pattern.

Statistical Analysis:
Spearman’s rank correlation test was used to compare the different methods of TAM density evaluation. The categorical variables were studied using Pearson’s Chi-square or Fisher’s exact test. CD68+ TAM density and β-catenin expression were correlated by analysis of variance. A P value ≤ 0.05 was taken as statistically significant.

Results:
The CD68+ TAMs in the “tumor” versus “non-tumor” area (p = 0.34) and “tumor” versus “stroma distribution” (p = 0.81) did not show any statistical significance. All methods of TAM density were found to be comparable. High TAM group is significantly associated with lymphovascular invasion, tumor depth, lymph node metastasis, and abnormal β-catenin expression.

Conclusion:
TAMs density plays an important role in the tumor stage. Macrophages may possibly induce gastric cancer invasiveness by activating β-catenin pathway.
Papillary urothelial neoplasm of low malignant potential with osseous metaplasia in a 19-year-old chronic smoker: A case report with review of literature
Authors: Gupta Rakesh K. , Wasnik Poonam , Sharma Amit R. 
Published: January 2024

ABSTRACT
Urothelial tumors characteristically occur in elderly persons, more commonly in males with typical complaints of hematuria. Although few studies attempted to describe clinic-pathological features of urothelial malignancies in young patients, due to heterogeneity in the inclusion of age groups under “young patients” no reliable conclusions can be derived. Herein, we are describing an interesting case of papillary urothelial neoplasm of low malignant potential with osseous metaplasia in a 19-year-old chronic smoker young patient presented with chief complaints of abdominal pain with a review of the literature.
Resin related enterocolitis: An underreported co-occurrence
Authors: Mishra Sonali , Yadav Gajendra K. , Gupta Rohit , Kumar Arvind 
Published: January 2024

ABSTRACT
Medication resins are often encountered in gastrointestinal biopsy specimens of patients being treated for renal compromise. As important as they are for the electrolyte equilibrium of the patients, they often come with a cost of fatal but reversible damage to the gastrointestinal tract. This often manifests as inflammatory bowel disease in the affected individuals. This misleading manifestation coupled with the lack of patient history further masks resin-related colitis from a pathologist’s eyes. Through this report, we convey how meticulous history-taking, representative endoscopic sampling, and recognition under the microscope are vital for timely reporting in conditions like this.
Plasmacytoid urothelial carcinoma with duodenal metastasis—A rare tumor with unusual site of metastasis with grim outcome
Authors: Chenniappan Aparna , Stephen Norton S. , Srinivas Bheemanathi H. , Sreenivasan Sreerag K. , Govindarajalou Ramkumar 
Published: January 2024

ABSTRACT
Plasmacytoid urothelial carcinoma (PUC) is a newly recognized rare variant of urothelial carcinoma, which is now being increasingly diagnosed prospectively as well as by retrospective analysis of cases with a poor prognosis. Morphologically, these tumors simulate plasma cell neoplasms and pose a diagnostic challenge. Identifying this variant is essential in two aspects: therapy and prognosis. Here, we present a case who underwent multiple transurethral resection of bladder tumor (TURBT) procedures, each with a diagnosis of urothelial carcinoma, the plasmacytoid type which was confirmed on radical cystectomy, and after 1 year, the patient presented with duodenal metastasis. We discuss the morphological aspects of differentiating this tumor from variants of urothelial carcinoma and other tumors with a plasmacytoid appearance. Despite the recognition and aggressive treatment, the patient expires within 2 years of the first diagnosis of bladder carcinoma.
Extra-ocular sebaceous carcinoma - A rare case report
Authors: Sindhura Manda , Santosh Tummidi , Kumar Jarang Rajesh , Shankaralingappa Arundhathi , Pannerselvam Naresh Kumar , Balakrishna Pavithra 
Published: January 2024

ABSTRACT
Sebaceous gland carcinoma is a rare and aggressive skin cancer derived from the sebaceous glands. Sebaceous carcinomas are divided into those occurring in ocular (75%) and extra-ocular locations. A 45-year-old female patient presented with rapidly growing swelling over the upper back region. It was provisionally diagnosed as an infected sebaceous cyst, and an excision biopsy was received in the pathology department. Histopathology was reported as sebaceous carcinoma, Grade II, Stage P T3 Nx. Immunohistochemistry was positive for epithelial membrane antigen. Sebaceous carcinoma accounts for 0.2–4.6% of all malignant cutaneous neoplasms, and the estimated rate of occurrence is only 1–2 per 1 million individuals per year. These tumors frequently present with a painless sub-cutaneous nodule, but they can also present as pedunculated lesions, irregular mass, or diffuse thickening of the skin. Hence, they are misinterpreted as other benign tumors or inflammatory conditions, thereby leading to delay in diagnosis, inappropriate treatment, increased morbidity, and mortality.
Single monoclonal spike characterized as double monoclonal gammopathy in a patient with multiple myeloma: A rare finding
Authors: Saijpaul Rajni , Khurana Vatsala , Verma Rashmi , Kaushik Smita 
Published: January 2024

ABSTRACT
Multiple myeloma (MM) is associated with the secretion of a unique monoclonal protein (M-protein) due to overproduction of immunoglobulin (Ig) by a clone of abnormally proliferating plasma cells. However, in 4% of the cases more than one M-protein can be found. This category of gammopathies is called “double monoclonal gammopathies.” Here, we present a rare case of MM with double monoclonal gammopathy, where the presence of both M-proteins was observed in the single sharp peak on capillary zone electrophoresis (CZE). Further the interference of Hook effect is also discussed. Double monoclonal gammopathies need to be identified to increase diagnostic accuracy and reliability, and to get a better understanding of the disease pathogenesis and progression.
Orbital spindle cell hemangioma with acute presentation
Authors: Anand Aishwarya , Shanmugam Sridhar , Veluswamy Anand 
Published: January 2024

ABSTRACT
We report an unusual presentation of an orbital spindle cell hemangioma in a 40-year-old male, who noted sudden redness and swelling of the left eye on waking up. On examination, the patient was found to have edema of upper eyelid edema, periorbital ecchymosis, and subconjunctival hemorrhage in the left eye at presentation. On treatment with topical medications, patient had transient symptomatic relief; however, he later developed blurring of vision. When seen 10 days later, the patient’s left eye showed axial proptosis. Radiological investigations revealed an intraconal soft tissue mass in the left medial rectus. Emergency orbital decompression with mass excision was done; histopathological examination of the excised mass revealed spindle cell hemangioma. Postsurgery patient had complete restoration of vision. To our knowledge, an acute presentation of an orbital hemangioma with subconjunctival hemorrhage and periorbital ecchymosis, visual loss doesn’t occur commonly; hence, such presentations have to be reviewed with care.
Physicians’ attitudes and confidence to dementia care: A cross-sectional study at primary healthcare facilities in the Eastern Province, Saudi Arabia
Authors: Al-Awad Feras A. , Al-Zahrani Mohammed A. , Bawazeer Abdullah O. , Al-Qahtani Faisal S. , Al-Jabari Sulaiman A. , Jayaseeli Nithya J. , Alabdulkader Assim M. , Al-Harkan Khalid S. , Al-Shammari Malak O. , Mohammedin Ahmed S. , Rohaiem Shaimaa N. , Al-Muslim Nora I. , Al-Shurem Mohammed A. , Albakr Dalal M. 
Published: January 2024

Abstract:

BACKGROUND:
Primary care physicians play an essential role in the health of older adults, as they are frequently the first point of contact. Their positive attitude and knowledge influence the quality of care provided to patients with dementia and their caregivers. This study examined the attitudes of primary care physicians towards dementia care and their confidence in their own dementia-care skills.

MATERIALS AND METHODS:
This cross-sectional study was conducted among 316 primary care physicians working in Eastern Province of Saudi Arabia. Data was collected using a structured questionnaire that included questions related to demographic characteristics, number of dementia patients encountered, Dementia Care Attitude Scale (DCAS) to assess attitudes towards dementia, and Confidence in Dementia Care Skills (CDCS) Scale to measure confidence. Data were analyzed using SPSS version 29; mean and standard deviation (SD) were computed for continuous and categorical variables were described using frequencies and percentages. Mann Whitney U test and Kruskal Wallis test were used to compare attitude and confidence scores by categorical variables.

RESULTS:
The mean DCAS score was 36.4 ± 5.41 out of 50. On a scale ranging from 15 to 75, the mean CDCS was 51.89 ± 10.20. A statistically significant (P < 0.05) relation was found between confidence and professional rank, knowing close relatives with dementia, and number of dementia and elderly patients treated. Overall, 78.9% of physicians lacked confidence to prescribe memory medications; 32% felt that dementia management was generally more frustrating than rewarding.

CONCLUSION:
Primary care physicians had a positive attitude toward caring for patients with dementia. However, they lacked confidence in their dementia care skills in several areas. The confidence in their diagnostic skills was higher than their management skills. Most challenging skills were recognizing and managing behavioral symptoms of dementia. Need to develop educational and training interventions that target healthcare providers to help improving dementia care in primary care settings.
Analyzing Cardiovascular Response in Neonates with Perinatal Asphyxia by Combining Echocardiographic, Electrocardiographic, and Biochemical Parameters: Collaborating Bench and Bedside in Low- and Middle-income Country Setups
Authors: Tomar Munesh , Goel Tanvi , Chaudhuri Maitri , Rastogi Anuj , Agarwal Vikas , Saxena Vineet 
Published: January 2024

Abstract

Background:
Perinatal asphyxia (PA) is a neonatal emergency causing multi-organ dysfunction, and neurological insult called hypoxic-ischemic encephalopathy (HIE). The traditional focus is on neuroprotection. However, the immature cardiovascular system simultaneously undergoes tremendous hypoxic-ischemic insult especially during the secondary phase of HIE. The hemodynamic consequences, comprehensive cardiac assessment, and care are often overlooked in bedside practice.

Objective:
The objective is to quantitatively document myocardial dysfunction in neonates with PA using electrocardiography (ECG), echocardiography, and cardiac enzymes (creatinine kinase-MB [CK-MB], B-type natriuretic peptide [BNP], and troponin I).

Design and Methods:
This was a single center, case–control prospective study. Sixty-four neonates with PA were enrolled. Myocardial function was assessed by clinical, ECG, echocardiography, and biomarkers assay. The same number of healthy neonates was taken as control.

Results:
15 (23.4%) had mild, 28 (43.7%) moderate, and 21 (32.8%) severe HIE in the case arm. Abnormal ECG was observed in 42 (65.6%), of which 20 (47.6%) had Grade I, 13 (30.9%) Grade II, 8 (19.04%) Grade III, and 1 (2.38%) had Grade IV changes. Serum levels of CK-MB, BNP and Troponin I were raised in 29 (45.3%), 30 (46.8%) and 10 (15.6%) neonates, respectively. Echocardiographic parameters such as ductal shunting pattern, mitral and tricuspid regurgitation, pulmonary hypertension, and systolic and diastolic ventricular function were significantly abnormal in cases versus controls as demonstrated by P value.

Conclusion:
Abnormal ECG, echocardiography, and cardiac enzymes in PA are markers and prognosticators of cardiac injury affecting overall outcomes in neonates with PA. Early detection can help in better management and survival of these neonates.
Transoral endoscopic thyroidectomy vestibular approach versus conventional open thyroidectomy for the treatment of benign thyroid tumours: A prospective cohort study
Authors: Ngo Quy Xuan , Ngo Duy Quoc , Le Duong The , Nguyen Duc Dinh , Tran Toan Duc , Le Quang Van 
Published: January 2024

Abstract

Introduction:
Thyroid tumours are a common condition and open surgery is a conventional method for treating benign thyroid tumours when surgery is indicated. In this study, we evaluate the outcomes of benign thyroid tumour treatment using transoral endoscopic thyroidectomy via vestibular approach (TOETVA) and compare the results with those of conventional open thyroidectomy (COT).

Patients and Methods:
We conducted a prospective cohort study between 100 patients who underwent TOETVA and 100 who underwent COT surgery for benign diseases from June 2018 to December 2021 in our hospital. Outcomes between the two groups, including post-operative complications, operative time and length of stay, were compared.

Results:
The surgical time in the TOETVA group was significantly longer than in the COT group. The operative time of lobectomy in the TOETVA and COT groups was 77.5 ± 13.3 and 51.5 ± 4.2 min, respectively, with a P < 0.001. The operative time of total thyroidectomy in the TOETVA and COT groups was 108.1 ± 7.0 and 65.0 ± 4.1 min, respectively, with a P < 0.001. There was no difference in post-operative length of stay between the two groups. In TOETVA group, there were no patients who converted to open surgery. Amongst all 200 patients in the study, there were no cases of post-operative bleeding. The transient hypoparathyroidism rate after surgery in the TOETVA and COT groups was 3% and 2%, respectively, with no statistically significant difference (P = 0.651). Similarly, the transient recurrent laryngeal nerve injury rate showed no difference between the two groups, with rates of 5% and 4% in the TOETVA and COT groups, respectively (P = 0.733). There were no cases of post-operative infection in either group in our study. At 3 months postoperatively, the cosmetic satisfaction were significantly higher in the endoscopic groups than in the conventional group (P < 0.001).

Conclusions:
TOETVA is a safe and effective method, with a low complication rate and optimal aesthetic results compared to traditional surgery to treat benign thyroid tumours.
Application of percutaneous biliary drainage in the treatment of post-operative bile leakage after liver rupture: A case report
Authors: Chen Jinlong , Wang Zhikuan , Zhang Lixin , Chen Xi , Liu Yuanyuan , Chen Hong , Tong Xiaoqiang , Dong Yanchao 
Published: January 2024

Abstract
Post-operative bile leakage (POBL) is a serious complication following hepatobiliary surgery, with potentially life-threatening consequences if left untreated. This article presents a successful case of POBL management without surgical intervention. A 31-year-old male, diagnosed with bile leakage before hospitalisation, underwent percutaneous biliary drainage (PTBD) to address bilomas. Follow-up after 3 months indicated biloma atrophy and POBL healing but revealed bile duct stenosis. The patient received a larger biliary drainage tube, and after 1 month, the biloma and tube were removed. A 1-year follow-up confirmed the patient’s excellent health. This case underscores the safety and efficacy of PTBD for managing POBL, offering a non-invasive alternative for patients with this complication. PTBD presents a viable treatment option for POBL cases, minimising the need for surgical interventions and their associated risks.