bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary cutaneous large B cell lymphoma masquerading as lupus vulgaris
Authors: Gupta Pooja , Shruti Sharma , Siraj Fouzia , Bhargava Aradhana , Khullar Geeti 
Published: September 2023

ABSTRACT
Primary cutaneous large B cell lymphoma, leg type is a rare and aggressive variant of cutaneous B cell lymphoma. It predominantly affects elderly women, with the lower limb being the most common site of presentation. The overall prognosis is poor, compared to other cutaneous B cell lymphomas. A 47-year-old man presented with a progressively enlarging nodule over the medial aspect of the left foot since 2 months. Clinical examination revealed a nodular plaque-like lesion with central ulceration that measured 7 × 7 cm, firm in consistency, and with ill-defined margins. The initial clinical diagnosis was lupus vulgaris. An incision biopsy was done, which on histopathology and immunohistochemistry revealed a rare diagnosis of primary cutaneous B cell lymphoma, leg type. The patient was started on chemotherapy; however, he succumbed to his illness about 1 year after the initial presentation. It is a rare type of cutaneous lymphoma, which may masquerade infectious disorders such as lupus vulgaris. A detailed histopathological and immunohistochemical analysis is essential for its correct diagnosis and management. Only a handful of cases of this rare condition are reported to date. This case has been reported in view of its rarity and unusual clinical presentation.
A systematic review of Pilomatrix carcinoma arising from the previous scar site of Pilomatrixoma
Authors: Panda Sangram K. , Sahoo Pradyumna K. , Agarwala Sunil K. , Houghton T Tim , Sankar K Vikas , Mohanty Pranita 
Published: September 2023

ABSTRACT
Pilomatrix carcinoma is a rare tumor arising from the hair follicle matrix cells most commonly seen in the head and neck region. Also known as “calcified epithelial carcinoma of Melherbe,” it was first reported in 1980 by Lopansri and Mihm. Since then till date to the best of our knowledge only around 125 cases were reported in literature, of which only 11 cases were reported to arise from histologically proven areas of previous pilomatrixoma which is the benign variant. One such case is being reported here along with the review of literature. A 50-year-old man presented with a swelling in the nape of his neck since 6 months, which was gradually increasing in size. He had a history of similar swelling at the same site 18 months back for which he underwent a surgery at a center outside. Final histopathology report was suggestive of pilomatrixoma with negative margin. Wide local excision of the tumor with 3 cm margin, placement of surgical clips followed by a primary closure was done. The final histopathology report is suggestive of pilomatrix carcinoma. The patient has no recurrence in 6 months follow-up. The differential diagnosis of pilomatrix carcinoma should be considered in cases of recurrent skin tumors. Wide local excision is the preferred treatment. Re-excision should be done in margin positive cases and cases where simple excision was done due to improper preoperative diagnosis. Due to the rarity of the disease, adjuvant treatment is not properly defined.
Spindle cell carcinoma in the trail of radiotherapy for oral squamous cell carcinoma: A quest for rationale
Authors: Rajalekshmi M. P. , Thankappan Prasanth , Joseph T. Isaac , Girish K. L. 
Published: September 2023

ABSTRACT
Spindle cell carcinoma (SpCC) is a rare variant of oral squamous cell carcinoma (SCC) with unique clinicopathological characteristics, a high recurrence rate, and metastatic potential. It will be truly devastating when it occurs as a second wave in a cancer survivor. Despite the multidisciplinary approach in the management of oral SCC, the incidence of second malignancies or multiple carcinomas has been constantly reporting in the literature. Although radiotherapy has saved the lives of countless cancer patients, its several serious late effects are well-documented in the literature, making it a double-edged sword. Radiation epidemiology studies revealed an increased risk of developing radiogenic second cancers after 5 or more years. The purpose of this article is to document a case of SpCC arising in a patient after a span of 5 years who was previously diagnosed and treated with radiotherapy for well-differentiated SCC.
Neoadjuvant chemotherapy for locally advanced head and neck squamous cell carcinoma – Is it still relevant? A practice pattern survey among oncologists of India
Authors: Bandyopadhyay Anis , Goswami Uddiptya , Ghosh Poulomi , Das Priyanka , Mandal Srikrishna 
Published: September 2023

ABSTRACT

Objectives:
Concurrent chemotherapy is the recommended treatment for locally advanced head and neck (H&N) squamous cell carcinoma, and neoadjuvant chemotherapy (NACT) is debated with a few special indications. NACT for advanced head and neck cancer has been studied in clinical trials for more than 2 decades without clear demonstration of the benefit for loco regional tumor control or overall patient survival. Its benefit remains controversial in the absence of clear evidence to define its role. However, there is widespread use of NACT among oncologists. We conducted an online survey to find out the frequency, pattern, prevalence, and aims for use of NACT in locally advanced head and neck cancers among radiation, medical, and surgical oncologists.

Materials and Methods:
Oncologists across India who expressed interest to participate in our survey were asked to complete a short online questionnaire designed to identify the current practice pattern of NACT in head and neck cancer. A mobile app-based questionnaire was sent to 200 oncologists across the country to assess the pattern of NACT use and to solicit their most frequent therapy approach for patients with locoregionally advanced head and neck cancer.

Results:
One hundred and fifty (150) oncologists completed and returned the survey (75%), and 130 were finalized (94 radiation oncologists, 19 medical oncologists, and 17 surgical oncologists). The single most common treatment approach reported for patients with locoregionally advanced H&N cancer was that of sequential chemoradiation (61%), specifically NACT with the TPF regimen (78.5%), followed by radiation therapy. The primary objectives cited by respondents for the use of NACT included the desire to buy time for definitive treatment (20%) and to achieve R0 resection (19.2%). Use of NACT in most patients was more preferred by medical oncologists (21.1%) and radiation oncologists (19.1%) than surgical oncologists (11.8%). Thus, there is not much difference in perception in practice of NACT in radiation, medical, and surgical oncologists. A minimum of two cycles of NACT was preferred by more than half of the doctors (55.4%) with 59.6% radiation oncologists using it before further assessment.

Conclusion:
Although level I evidence for inferior outcomes with NACT as compared to concurrent chemoradiation therapy is there, the use of NACT is quite common among various oncologists in the country because of reasons such as buying time for definitive treatment, achieving R0 resection, better outcome and survival, partial response, better tolerability, better distant control, LN size regression, down-staging of primary tumor, selection of chemosensitive patients, reducing the volume of the radiation field, and better tolerability of subsequent Chemoradiation (CTRT) intensity of subsequent chemoradiation therapy.
Smoking cessation through nicotine replacement therapy for patients visiting the Dental College, Pune – A quasi-experimental study
Authors: Mukadam Ajinkya , Shetiya Sahana H. 
Published: September 2023

ABSTRACT

Background and Aim:
Smoking leads to a very unhealthy lifestyle and has many deleterious effects on the body and surroundings. Studies have indicated that aiding contemplating smokers using behavior counseling and nicotine replacement therapy has shown positive results for abstaining from the habit. We aimed to assess and carry out smoking cessation for smokers using behavioral counseling, motivational interviewing, and nicotine replacement therapy (NRT) and assess their carbon monoxide (CO) cutoff level, Fagerstrom nicotine dependence test (FTND) scoring, and transtheoretical model (TTM) of change at baseline and 6 months, along with abstinence from the habit.

Materials and Methods:
CO cutoff, FTND scoring, and TTM of change were assessed at baseline and 6 months for smokers. Behavioral counseling with motivational interviewing was provided to the participants on the day of recruitment, and baseline data were recorded. All smokers included in the study were in the precontemplation and contemplation stages to quit smoking. Based on the frequency of smoking, NRT was prescribed to them in the form of a patch (21, 14, or 7 mg), only gums (2 mg), or a combination of both. Counseling was provided telephonically every month for 6 months. Urine cotinine assessment was carried out to verify the self-reported smoking status of the participants at the sixth month.

Results:
The CO cutoff, FTND scoring, and TTM of change showed statistically significant difference from baseline to the sixth month. Also, 20% (confidence interval [CI] 0.10–0.33) of participants who abstained from the habit were in the action and maintenance stages of change. Among 20% of participants, 16% (CI 0.10–0.36) of participants self-reported quitting within 6 months using combination therapy. Two percent (CI 0.00–0.40) each abstained by using nicotine gums and combination therapy of patch and gums, which was validated through urine cotinine.

Conclusion:
The cotinine test provided negative results, confirming the self-reported abstinence of 20% of participants, who were mostly male students and professionals in the age group of 20–40 years and those who used NRT. Nicotine patches provided the highest point prevalence of abstinence compared to gums and combination therapy.
Can combined non-invasive methods improve diagnosis of lung cancer?
Authors: Mohapatra Madhusmita Mohanty , Rajaram Manju , Gochhait Debasis , Kumar Saka Vinod , Chakkalakkoombil Sunitha Vellathussery 
Published: September 2023

ABSTRACT

Background:
Lung cancer is the most common malignancy in both gender. Early diagnosis is needed to reduce morbidity and mortality. There is a debate about the most accurate investigating modality for the diagnosis of lung cancer.

Methods:
It is a retrospective cohort analysis to determine whether an approach of combined contrast-enhanced computed tomography (CECT) thorax with bronchoscopy method has higher sensitivity and specificity than combined CECT thorax with sputum cytology method. Records of patients with lung cancer who had visited the hospital within the last 6 months were retrospectively analyzed for their diagnostic modality. SPSS version 19 software was used for statistical analysis of the data. CECT scan thorax, bronchoscopy, and sputum cytology for lung cancer patients were analyzed. The CECT thorax plus bronchoscopy method was compared with the CECT thorax plus sputum cytology method. Their sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in diagnosing lung cancer were analyzed.

Results:
Sixty-two patients were considered, including 62.9% males with a mean age of 55.5 years. In patients diagnosed with lung cancer, CECT thorax combined with bronchoscopy method was found to have a sensitivity of 96.67% than CECT thorax combined with sputum cytology method with a sensitivity of 90% and the difference in sensitivity between all individual approaches as well as the combined method was statistically significant with a P = 0.00001 and Chi-square value of 86.5909 owing to the low sensitivity of sputum cytology. CECT thorax combined with sputum cytology approach had a better specificity than CECT thorax combined with bronchoscopy.

Conclusion:
Combined CECT thorax with sputum cytology method has a better specificity in diagnosing lung cancer than combined CECT thorax with bronchoscopy method.
Computer-aided Diagnosis of Polyp Classification Using Scale Invariant Features and Extreme Gradient Boosting
Authors: Don S. 
Published: September 2023

Aims:
Analysis of colonoscopy images is an important diagnostic procedure in the identification of colorectal cancer. It has been observed that owing to advancements in technology, numerous machine-learning models now excel in the analysis of colorectal polyps classification. This work focused on developing a framework that can classify polyps using images during colonoscopy.

Materials and Methods:
First, the images were corrected by removing their spectral reflection. Second, feature pools were obtained by applying Radon transform (θ=45, 90, 135, and 180). From the Radon transform, fractal dimension was calculated as a feature vector combined with Zernike moment obtained from the Zernike features. Finally, Extreme Gradient Boosting (XGBoost) algorithm was applied for the classification and to compare it with state-of-the-art methods.

Results:
The experimental results obtained with the proposed framework have been reported, cross-validated, and discussed. The proposed method gives a classification accuracy of 93% for light XGBoost and 92% for XGBoost.

Conclusion:
This study shows that by applying scale invariant features over a small dataset, XGBoost outperforms state-of-the-art methods when it comes to polyp classification.
Development of Prediction Model for Mean Parotid Dose of HNC Undergoing Radiotherapy - A Single Institutional Study
Authors: Bera Soumen , Choudhury Dipika , Roy Sanjoy , Mukhopadhyay Partha , Sarkar Sandip 
Published: September 2023

Aim:
The aim of the study was to develop a simple prediction model based on previous treatment plans for head-and-neck cancer (HNC).

Materials and Methods:
This study was conducted on 95 patients who underwent volumetric-modulated arc therapy (VMAT) with curative intent for HNC at our institute between January 2016 and December 2022 with intact bilateral parotid glands. Two simple prediction models were used: one linear regression model and one exponential model. Both models use fractional overlapping parotid volume with planning target volume (PTV) as a predictor of mean parotid dose. The fractional overlapping volume was calculated as the difference between the volume of the parotid gland minus the volume of the parotid gland outside the PTV plus a 2 mm margin, divided by the volume of the parotid gland. Statistical calculations were done using data analysis tools and Solver in Microsoft Excel (Microsoft Office 2013, Redmond, WA, USA). To enhance the accuracy of the results, outliers were excluded with residuals >2 standard deviations below and above the residuals. R
2 and root-mean-square error were calculated for both models to evaluate the quality of the predictions. The normality of both models’ residuals was validated using the Shapiro–Wilk test.

Results:
Both linear and exponential prediction models exhibited strong correlation statistics, with r
2 = 0.85 and 0.82, respectively. The authors found a fractional overlap of 16.4% and 18.9% in linear and exponential models that predict parotid mean dose 26 Gy. The implementation was carried out on a cohort of 12 prospective patients, demonstrating a remarkable improvement in minimizing the dose to the parotid glands.

Conclusion:
In this single-institutional study, the authors successfully developed a prediction model for mean parotid dose in HNC patients undergoing radiotherapy. The model showed promising accuracy and has the potential to assist planners in optimizing treatment plans and minimizing radiation-related toxicity. It is possible to avoid under sparing the organs at risks in some cases and wasting time or effort on physically impossible goals in others using this prediction model. As a result, planning resources can be used much more efficiently. Future studies should focus on validating the model’s performance using external datasets and exploring its integration into clinical practice.
Effects of pneumoperitoneum and Trendelenburg position on intracranial pressure and cerebral blood flow assessed using transcranial doppler: A prospective observational study
Authors: Joseph Anu , Theerth Kaushic A. , Karipparambath Vinodan , Palliyil Aruna 
Published: September 2023

Abstract

Background and Aims:
Laparoscopic lower abdominal surgeries involve carbon dioxide (CO2) insufflation and Trendelenburg position. The raised intra-abdominal pressure can increase intracranial pressure (ICP) and alter cerebral blood flow. This study was conducted to determine the effect of pneumoperitoneum and Trendelenburg position on ICP and cerebral perfusion pressure (CPP) measured using transcranial Doppler (TCD)

Material and Methods:
A prospective observational study was conducted in 43 patients of either sex, aged between 18 and 60 years with American Society of Anesthesiologists physical status I and II, undergoing elective laparoscopic surgery in Trendelenburg position. After standard anesthesia induction, pneumoperitoneum was created to facilitate surgery, maintaining an intra-abdominal pressure of 10–15 mmHg and Trendelenburg position of 25°–30°. End-tidal carbon dioxide (EtCO2) was maintained between 30 and 35 mmHg. The ICP was assessed non-invasively using TCD-based diastolic flow velocities (FVd) and pulsatility index (PI) of middle cerebral artery. Data was represented as mean ± standard deviation and compared using paired t test. A P value of < 0.05 was considered significant.

Results:
Mean ICPPI at baseline was 14.02 ± 0.89 mmHg which increased to 14.54 ± 1.21 mmHg at pneumoperitoneum and Trendelenburg position (P = 0.005). Mean ICPFVd at baseline was 6.25 ± 2.47 mmHg which increased to 8.64 ± 3.79 mmHg at pneumoperitoneum and Trendelenburg position (P < 0.001). There was no statistically significant change in the CPP or mean arterial pressure values intraoperatively.

Conclusions:
Laparoscopic procedures with CO2 pneumoperitoneum in Trendelenburg position increase ICP as measured using TCD ultrasonography. The CPP was not significantly altered when EtCO2 was maintained in the range of 30–35 mmHg.
Management of Tolosa-Hunt syndrome with Ayurveda therapeutic measures and interventions
Authors: Parameswaran Sreekala N. , Kumar Aravind , Sukumaran Krishnendu , Varma Kavya R. 
Published: September 2023

BACKGROUND:
Tolosa-Hunt syndrome (THS) is a rare disorder characterized by episodic periorbital pain associated with paralysis of either one or more of the III, IV, or VI cranial nerves. It is usually self-resolving, but relapse may be seen. In Ayurveda, a clinical condition “Vatahata Vartma” is narrated, resembling THS. Based on the resemblance, a diagnosed case of THS was treated by Ayurveda measures and treatment described for the management of Vatahata Vartma.

MATERIALS AND METHODS:
A 50-year-old man, who was previously diagnosed and underwent treatment for THS, presented with complaints of increased drooping and swelling at his left upper eyelid along with strenuous eyeball movements since February 2021. Drooping of the eyelids was measured by the amount of ptosis, margin-reflex distance, and the function of the levator palpebrae superioris. The patient was treated with Ayurveda oral medicines (herbal decoctions, herbal clarified butter, herbal powders, and herbal tablets), biopurification (therapeutic purgation and retention of medicine in the buccal cavity), and external Ayurveda ocular therapy (ocular irrigation, bolus sudation, eye drops, herbal paste over the eyelids, retention of herbal clarified butter over the eyes, collyrium, paste over the head, and irrigation over the head). The total duration of therapy was 11 months.

RESULTS:
Swelling and ptosis of the left upper eyelid were reduced, and the patient could do the normal movement of the left upper eyelid.

CONCLUSION:
THS can be treated with Ayurveda measures and interventions narrated in Ayurveda under Vatahata Vartma. A clinical study on large sample size is required to validate the result obtained in the present case study.
Efficacy and safety of Ayush AGT gel-based cream in superficial external wounds
Authors: Rai Amit K. , Khanduri Shruti , Goel Sumeet , Thugutla Maheshwar , Panigrahi Hemanta K. , Sai Prasad Avvaru J. , Avhad Anil , Singhal Richa , Rana Rakesh , Chandrasekhararao Bhogavalli , Srikanth Narayanam 
Published: September 2023

BACKGROUND:
Traditional medicine has been extensively used to manage skin wounds since ancient times. Central Council for Research in Ayurvedic Sciences has developed a coded herbal formulation, Ayush AGT gel-based cream, through a systematic drug development process for managing superficial skin wounds.

OBJECTIVE:
This clinical study is designed to determine the clinical efficacy and safety of Ayush AGT gel-based cream in healing superficial external wounds.

MATERIALS AND METHODS:
This open-label, multicenter, prospective, interventional single-arm trial is being conducted at three peripheral institutes of the Central Council for Research in Ayurvedic Sciences, Ministry of Ayush, Government of India viz. Central Ayurveda Research Institute, New Delhi, and Regional Ayurveda Research Institutes at Ahmedabad and Vijayawada, India. A total of 30 participants will be enrolled in the study from each of the three study sites. Patients of any sex aged 18–60 years with superficial external wounds requiring dressing and solitary wounds not less than 2.5 cm in diameter will be considered for enrollment in the study. The enrolled participants will be managed by the topical application of Ayush AGT gel-based cream on the wound bed once daily, followed by bandaging with the sterile material for four weeks. The outcome measures are time to complete re-epithelialization of the wound, incidence of wound infection, pain during the change of dressing (assessed through visual analog scale), incidence of blistering, and adverse events.

DISCUSSION:
Ayurveda interventions have been found effective in wound healing in routine clinical practice as well as in published experimental and clinical studies. Ethno-medicine practices also utilize different medicinal plants to manage skin wounds. Several patents on herbal interventions for wound healing have also been granted. However, clinical research to explore the standard wound management for superficial external wounds is not common. So, it is expected that the outcomes of this study will provide a significant lead in the search for safe and effective management options for skin wounds.