bluuebunny/crossref_metadata_2025_split huggingface dataset:
To interpret and analyze the changing patterns of histology and direct immunofluorescence findings in membranoproliferative glomerulonephritis
Authors: Nayak Pragnya P. , Pradhan Pranati , Pradhan Dilleswari , Mohapatra Nachiketa , Raman Sarojini , Sahoo Pranabandhu 
Published: July 2023

ABSTRACT

Background:
Membranoproliferative glomerulonephritis has in the recent past been regrouped into immune complex-mediated (ICM MPGN) disease (driven by the classical complement pathway) and complement-mediated (C3GN) disease (driven by the alternative complement pathway) based on pathogenetic role of alternative complement pathway and immunofluorescence deposits. The proposed regrouping lent therapeutic and prognostic support in managing the disease of MPGN.

Aims and Objectives:
The present study is undertaken to study the patterns of MPGN based on histopathological and DIF examination and sub-categorize the cases into mainly complement dominant and immune complex-mediated diseases for better prognostic and therapeutic utility.

Materials and Methods:
This is a prospective observational study carried out in a tertiary care center over a period of 2 yrs. The clinically suspected cases of MPGN were subjected to histopathologic and direct immunofluorescence examination (DIF), and the findings were interpreted in light of complement-mediated and immune complex-mediated MPGN.

Results:
Out of 620 renal biopsies, diagnosis of MPGN was confirmed both on histopathology and DIF in 36 cases accounting for 5.8% of all biopsies. Based on DIF findings, the various groups comprised 20 cases (55.6%) of immune complex deposits, 11 (30.5%) of C3 dominant picture, and 5 (13.9%) of Nil immune deposits. On analysis of the patterns on DIF, 16 cases (80%) of C3 + Ig group and 6 (54.5%) of C3GN group showed predominantly MPGN pattern. Crescentic glomerulonephritis, global glomerulosclerosis, and interstitial fibrosis were markedly observed in C3GN group.

Conclusion:
DIF is of immense prognostic and therapeutic value in managing cases of MPGN.
Burnt out testicular tumor - A case report
Authors: Surapaneni Shri Lakshmi , Nutakki Ramakoteswar R. , Gangadharan Vandana , Gara Rupa K. 
Published: July 2023

ABSTRACT
Spontaneous regression of testicular tumors known as burnt-out tumor of testis is a rare entity and is seen in about 5% of testicular germ cell tumors. It is described as a spontaneously, completely, or partially regressed testicular tumor with or without metastasis in the absence of any treatment. This entity is now included in the 2016 classification of testicular tumors. This is probably only the second case presented in India. High degree of awareness of this entity by the pathologist, clinician, and radiologist is necessary for proper management and survival of the patient.
Comparison of Clinico-pathologic features and outcomes of ANCA negative and ANCA positive pauci immune crescentic glomerulonephritis: A single centre study
Authors: Gupta Pallav , Bhargava Vinant , Malik Manish , Gupta Anurag , Bhalla Anil K. , Gupta Ashwini , Tiwari Vaibhav , Rana Devinder S. , Sapra Ramesh L. 
Published: July 2023

ABSTRACT

Introduction:
Pauci-immune crescentic glomerulonephritis (PICN) is an important cause of rapidly progressive renal failure. 10–40% of PICN cases have ANCA (antineutrophil cytoplasmic antibody) negative serology. The present study compared clinico-pathologic features, Brix’s renal risk score, Berden’s histopathological classes and differences in outcome between ANCAnegative vs ANCA positive PICN patients.

Materials and Methods:
Sixty-one patients of biopsy-proven PICN were studied. Biochemical findings and ANCA serology were recorded. Renal biopsy slides were reviewed along with direct immunofluorescence. Clinical and histological features were compared between ANCA negative and positive PICN using the Man Whitney U test and Chi-square test. Patients were compared for distribution in Berden’s histological classes and Brix’s renal risk categories. Patient and renal survival were compared using Kaplan-Meier survival analysis.

Results:
ANCA negative PICN patients were younger (44.9 ± 16.5 years vs 53.6 ± 15.1 years, P = 0.049). Nasal (0 vs 18%, P = 0.035) and pulmonary involvement (9% vs 38%, P = 0.014) were lower in ANCA negative group. Both ANCA groups had similar renal biochemical profiles, percentage normal glomeruli, 16.3 ± 18.2 vs 21.7 ± 20.4 and percentage glomeruli with crescents, 64.5 ± 28.1 vs 64.3 ± 27.1. Twenty-seven per cent of ANCA negative cases fell in the sclerotic class in Berden’s classification vs just 2.5% in ANCA positive group (p = 0.037) without significant difference in Brix’s renal risk categories (p = 0.329). Thirteen per cent of ANCA negative patients achieved complete remission on treatment compared to 33% in ANCA positive patients. Patient survival and overall probability of progressing to ESRD were similar in the two groups.

Conclusion:
ANCA negative PICN cases present at younger ages. Nasal and pulmonary involvement is uncommon in these patients. Patient survival and progression to ESRD are similar in both ANCA groups.
A comparative analysis of clinicopathological features of HPV-associated and HPV-independent cervical carcinomas based on P16 INK4a immunohistochemistry: A one-year retrospective study
Authors: Chaganti Padmavathi D. , Konkay Kaumudi , Varghese Ann M. 
Published: July 2023

ABSTRACT
The recent WHO classification of female genital tracts recommends cervical carcinomas to be further subtyped as HPV-associated and HPV-independent and accepted p16 immunoreactivity as a surrogate biomarker for HPV testing. This paper presents the clinicopathological spectrum of cervical carcinomas in correlation with p16 immunoreactivity.

Aims and Objectives:
This study aims to evaluate the immunoreactivity of p16 in cervical carcinoma, subtype them into HPV-associated and HPV-independent based on p16 immunoreactivity, and correlate them with clinicopathological features.

Design:
A hospital-based retrospective study of one-year duration was done after ethics approval. A total of 124 cases were identified, and various parameters like the presence of mitosis, lymphovascular invasion, tumor budding, tumor-infiltrating lymphocytes, the pattern of stromal invasion, and the pattern of necrosis were recorded and graded. Immunohistochemistry (IHC) with p16 marker was done in 40 cases, and immunoreactivity was correlated with clinical and histopathological parameters.

Statistical Analysis:
Multivariate analysis was done with Fisher’s exact test, and a P value of <0.05 was considered significant.

Results:
P16 was positive in 36 out of 40 cases which included 35 cases of squamous cell carcinoma (SCC) (keratinizing—14 out of 35 SCC, 11 positive out of these 14, non-keratinizing-21 out of 35 SCC, 20 positive, out of these 21), two cases of adenocarcinoma (both positive), two cases of adenosquamous carcinoma (both positive), and one case of small cell neuroendocrine carcinoma (positive). p16 negative in four cases (10%) (keratinizing type-3, non-keratinizing—1). P value was significant for HPV-independent carcinoma and keratinizing SCC morphology. The P value was not significant when p16 positivity with other parameters.

Conclusion:
HPV-associated were 90%, HPV-independent were 10%.
A case of superficial CD34 positive fibroblastic tumor: Diagnostic challenges and pitfalls
Authors: Dey Soumya , Chatterjee Uttara 
Published: July 2023

ABSTRACT
Superficial CD34 positive fibroblastic tumor (SCPFT) is a recently described soft tissue tumor of intermediate grade with predilection for subcutaneous and superficial fascial planes. Morphological diagnosis of these tumors can be challenging because of overlapping features with other benign and malignant soft tissue tumors of fibroblastic and myofibroblastic origin. A middle-aged man came with a subcutaneous mass in the left thigh. Microscopic examination showed features of an SCPFT comprised of a circumscribed spindle cell tumor with focal striking pleomorphism and bizarre hyperchromatic nuclei. Immunohistochemically (IHC), the tumor cells showed diffuse positivity for CD34 and focally for cytokeratin. Diagnosis of SCPFT on the basis of morphology alone can be challenging. A constellation of clinicoradiological profiles, IHC features, and sometimes molecular studies clinch the definitive diagnosis which can be helpful in avoiding overtreatment and chemotherapy. Here we highlight the diagnostic challenges and pitfalls in a case of SCPFT.
Acute appendicitis the first sign of appendiceal metastasis of an inoperable carcinoma of stomach—A case report and a review of literature
Authors: Lanjewar Dhaneshwar N. , Katharotiya Pooja H. , Lakhani Palak M. , Thacker Mansi M. 
Published: July 2023

ABSTRACT
Appendicitis is the most common cause of the acute abdomen and usually occurs because of the fecalith in adults and lymphoid hyperplasia in childhood. Gastric cancer metastasis to the appendix is a rare condition that might be present with symptoms of acute appendicitis. The English literature describes only thirteen cases of gastric carcinoma metastasizing to the appendix and presenting as acute appendicitis. In this report, we describe the first case of metastatic signet ring cell carcinoma of appendix presenting with clinical features of acute appendicitis.
Hepatocellular carcinoma (HCC) masquerading as hilar cholangiocarcinoma: An unusual presentation of jaundice
Authors: Mundhada Rohit O. , Chopde Amit N. , Kharat Reshma , Rane Swapnil , Goel Mahesh , Patkar Shraddha 
Published: July 2023

ABSTRACT
Jaundice usually occurs in the late stages of hepatocellular carcinoma (HCC). Obstructive jaundice is rarely seen as an initial presentation of HCC, as opposed to cholangiocarcinoma. Various causes of obstructive jaundice in these cases also known as “Icteric HCC” have been described such as tumour thrombi, compression, infiltration or tumours arising from native hepatocytes in the bile duct. We present a case of 74-year-old gentleman with “Icteric HCC” that clinically and radiologically mimicked cholangiocarcinoma for which the patient underwent left hepatectomy with Roux-en-Y hepaticojejunostomy. Histopathology revealed dilated large duct with polygonal sheets of cells of hepatoid morphology which stained diffusely positive for both glypican 3 and Hep-par 1. The epicentre was in the left hepatic duct with no discernible liver lesion and the tumour probably originated from the ectopic hepatocytes within the biliary duct The patient was disease free at 1.5 years of follow up. In conclusion, HCC should be a differential for obstructive jaundice. Patients with such “Icteric HCC” benefit from surgical resection with favourable outcomes. The prognosis in such patients is better than in patients of HCC with jaundice due to hepatic insufficiency.
Multifocal intraosseous pseudomyogenic (epithelioid sarcoma-like) hemangioendothelioma: A rare presentation of an uncommon tumor
Authors: Godkhindi Vishwapriya M. , Monappa Vidya , Mailankody Sharada , Velu Umesh , Mohammed Shuiab M. V. , Banerjee Aisharya 
Published: July 2023

ABSTRACT
Pseudomyogenic hemangioendothelioma (PHE) is an uncommon mesenchymal neoplasm of intermediate malignant potential showing endothelial differentiation. Around 20 cases of primary osseous PHE have been reported to date. A 16-year-old boy presented with complaints of pain in his right leg. Imaging revealed multifocal intramedullary and cortical-based lytic lesions involving long and small bones. Microscopic examination revealed plump, spindled cells arranged in fascicles and admixed “epithelioid” and “rhabdoid” cells sans vasoformative areas. By immunohistochemistry, the lesional cells were reactive for AE1/AE3, CD31, Erg, Fli1, and SMA, while immunonegative for CD34, myogenin, and S100. Nuclear expression of the INI1/SMARCB1 protein was retained. PHE is a rare entity, more so as a primary osseous lesion; therefore, awareness of the presence of this entity in the bone is the key to making a diagnosis. We discuss its clinicopathological features, differential diagnosis, and an attempt a short review of the literature.
A study to compare the performance of students following self-directed learning sessions conducted without online support and self-directed learning sessions conducted with the help of online support in the department of physiology
Authors: Sinha Parthasarathy , Chaudhuri Arunima , Adhya Debasis 
Published: July 2023

ABSTRACT

Background:
Medical students need to develop self-directed learning (SDL) skills to become life-long learners.

Aims:
To compare the performance of students following SDL sessions conducted in the offline mode and SDL sessions conducted with the help of online support in the department of physiology.

Methodology and Participants:
This study was conducted on 200 first-phase MBBS students (Batch 21–22) after taking Institutional Ethical Clearance and informed consent of the participants. Nerve muscle physiology was taught using the two methods of SDL. The assessment was done using multiple choice questions. Pre-test and post-test were conducted for all sessions and ten such sessions were assessed in the present study. Feedback was taken from students and facilitators. Program evaluation was done using Kirkpatrick level 1 evaluation. Pre-test and post-test scores of the same group were compared using the paired t-test and among two groups were compared using an unpaired t-test.

Results:
Students performed significantly better in SDL sessions where online support was better and the performance of female students was significantly better as compared to male counterparts (87.27 ± 7.09 vs. 84.79 ± 8.49; P<0.001**). Students were satisfied with the SDL sessions and more so with online support. Faculty members and students emphasized that online support increased bonding among students as well as bonding with the facilitators.

Conclusions:
Providing online support to medical students was found to have positive effects on learning in the present study. Female students developed better problem-solving attitudes and critical thinking abilities as compared to males and were more motivated in learning.
My five moments of hand hygiene: A cross sectional questionnaire based study on adherence and barriers among nurses in central Kerala
Authors: Madhumitha S. , George Liya Mariam , Meenakshi K. S. , Vinson Alphonsa Clara , Sebastian Shaliet Rose , Benjamin Anoop Ivan 
Published: July 2023

ABSTRACT

Background:
Hospital acquired infections have remained a concern in the field of health care as a major cause of increasing morbidity, mortality and health care costs in healthcare facilities. In the present era of emerging and re-emerging infectious diseases and multidrug resistant pathogens, there is a growing emphasis on basic measures of prevention of infections, like maintaining good hand hygiene. Although The World Health Organization (WHO) has issued guidelines on hand washing procedure with an aim to reduce the prevalence of hospital associated infections, the compliance amongst health care workers is poor.

Objective:
To study the adherence and barriers relating to non-adherence to the five moments of hand hygiene among nursing staff in Central Kerala.

Materials and Methods:
The present cross sectional study was conducted among 360 female nurses using Snowball sampling technique. The quantitative data collected was analysed using the software SPSS version 20. Chi-square test was used for comparison of proportions across groups. Logistic regression analyses were used to find out the determinants of non-adherence. The qualitative data collected was analysed using thematic analysis and classified into themes and subthemes.

Results:
Out of 338 study participants, 304 (90%) reported to be adherent to the 5 moments of Hand Hygiene. The present study found that factors associated with hand hygiene behaviour among study participants were awareness about Hand Hygiene and educational qualification.

Conclusion:
The existing level of non-adherence can be a source for outbreak of hospital acquired infections in the community and hence needs to be addressed.
Diabetes risk assessment among medical students of a medical college in Andhra Pradesh: A cross-sectional study
Authors: Ajaykumar Enibera , Anjanappa Thilak Sura , Sunanda Komera , Pranaya Y. 
Published: July 2023

ABSTRACT

Background:
A major global health concern in the 21st century is diabetes. The prevalence of diabetes in India is 8.3%, and 647,831 deaths were related to diabetes in India. Medical students tend to have a sedentary lifestyle due to academic demands, which makes them more prone to noncommunicable diseases such as diabetes. The study was conducted to assess the risk of type 2 diabetes mellitus and to determine the factors associated with the risk of diabetes among medical students at a medical college in Andhra Pradesh.

Materials and Methods:
A cross-sectional study was conducted among 277 medical students in a medical college in Andhra Pradesh. The Finnish Diabetes Risk Score scale was used to assess diabetes risk, and data were collected through online mode using Google Forms after taking informed consent. Descriptive statistics and the Chi-square test were used, and P < 0.05 was considered statistically significant.

Results:
The risk of acquiring diabetes in the next 10 years was slightly elevated in 46 (16.6%) female students, 7 (2.5%) male students, and moderate risk in 4 (1.4%) female students. There was a significant association between diabetes risk and body mass index, physical activity >30 min, eating veg/fruits daily, history of high blood glucose, and history of diabetes in the family.

Conclusion:
According to the study, one-fifth of students had a slightly elevated or moderate risk of diabetes in the next 10 years.
A study on self-medication in ophthalmic emergencies in the rural population of South India
Authors: Shetty Kiran , Vinay P. G. , Lobo Sarita R J , Vijayaraghavan Lakshmi K. 
Published: July 2023

ABSTRACT

Background:
Self-medication has been defined as the taking of drugs, herbs, or home remedies on one’s own initiative and advice from another person without consulting a medical specialist. The objective of the study was to identify the pattern of self-medication in ophthalmic emergencies in patients attending the emergency department in a peripheral rural setup in south India.

Materials and Methods:
This was a descriptive, cross–sectional, questionnaire-based observational study. The patients selected were above 18 years of age. Informed consent was taken. A questionnaire on the demographic characteristics, level of literacy, history of the ophthalmic condition for which the patient had self-medicated, type of self-medication resorted to , reasons for resorting to ocular self–medication, and the adverse effects reported were all noted in the study.

Results:
The study included 100 subjects. Fifty-three percent were male and 47% were female. Among the 100 subjects, 10% of the individuals were educated above primary school level. Thirty-five percent had only primary school level education and the remaining 55% had not been to a formal school and had no basic education. Among our respondents, the most commonly used self-medication was antibiotic drops (24%), followed by expired medication (23%). 20% used steroid drops. 15% had tried traditional eye medication (TEM). Herbal and other indigenous medications were used by 12% of the responders. 7% used oral nonsteroidal anti-inflammatory drug agents. None of the responders were aware of the adverse effects of self-medication. The most common ophthalmic emergency symptoms faced by our responders were excessive watering (37%), pain (28%), foreign body in the eye (14%), redness and discharge (12%), decreases vision (5%), and pain in the eye (4%). The common reasons given by our responders for not accessing health-care facilities were distance (living far from health-care facilities), advice from family and friends, belief if local healers, lack of finances and poverty, and lack of prioritizing health care. Following self–medication, 30% of the patients had infectious keratitis, 28% had conjunctivitis, 25% had epithelial defects, and 17% glaucoma.

Conclusion:
Irrational long-term use of drugs/traditional eye medicine or even the usage for ophthalmic emergencies can have dangerous visual outcomes. The study highlights the need of effective execution and establishment of high-quality accessible primary eye care services and health-care referral network in rural India.
A study of thyroid function in polycystic ovary syndrome
Authors: Dsouza Susan , Hegde Narasimha 
Published: July 2023

ABSTRACT

Background and Objectives:
Polycystic ovary syndrome (PCOS) is a complex endocrine disorder of multifactorial etiology. PCOS is associated with thyroid dysfunctions ranging from subclinical hypothyroidism, autoimmune thyroiditis, hyperthyroidism, and multinodular goiter. This study evaluated thyroid function in patients with PCOS.

Methods:
This comparative case-control study was done among 186 patients attending the outpatient services of a tertiary care hospital. Patients aged between 18 and 30 years were evaluated; 93 candidates with PCOS were diagnosed using the Rotterdam 2003 criteria and 93 candidates without symptoms or signs of PCOS were selected as controls. Details of symptoms and clinical examination were obtained and their serum thyroid-stimulating hormone and serum-free thyroxine were estimated. Data were statistically analyzed for differences in clinical profile and thyroid function which were compared among the groups.

Results:
The mean age of the participants was 23.65 and 24.83 years in the case and control groups, respectively. The most common features in the PCOS group were hyperandrogenism (79, 85.9%) and oligomenorrhea (66, 71.7%). The mean body mass index in the PCOS group (23.76 kg/m2) was found to be significantly higher as compared to the controls. Thirty-three (34.4%) patients with PCOS were found to have thyroid dysfunction as compared to 7 (7.5%) in the control group. Among PCOS patients, hypothyroidism was more common than subclinical hypothyroidism.

Conclusion:
The occurrence of hypothyroidism and subclinical hypothyroidism was found to be higher in patients with PCOS. Hypothyroidism was more frequent among patients in the PCOS group than in the control group.