bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 75
Authors: Behera Kishore Kumar , Sahoo Biswajit 
Published: February 2023

Background: Thyroid-associated ophthalmopathy (TAO) is an array of symptoms caused by an autoimmune process involving the orbital tissue. Most TAO is reported in hyperthyroid Grave’s disease and in euthyroid and hypothyroid Graves’ patients with positive thyroid receptor antibodies. But TAO is rarely reported in Hashimoto’s thyroiditis (HT) and is a poorly understood entity. Here we report a unilateral TAO in a patient withhypothyroidHTwith negative TSH-R antibodyand high TPO antibody. Hewas treated with pulse methyl-prednisolone, levothyroxine, and artificial teardrops.

Case Report: A 43-year-old non-smoker, non-alcoholic male with a complaint of fatigue and lethargy with mild swelling of both legs. On evaluation, his TSH was 180 miu/ml in 2016, and levothyroxine 50 mcg was initiated, then gradually increased throughout three months to 150 mcg daily. He became euthyroid. In January 2021, he noticed pain and protrusion in the right eye, so he consulted an ophthalmologist. On investigation, his TSH was 70 miu/ml; on asking, he agreed that he was not consistently on thyroid hormone replacement. So, he restarted 100 mcg of LT4. In March 2021, he noticed further aggravation of eye symptoms despite taking LT4 replacement with TSH of 8 miu/l, so he consulted endocrinology. Details of hormonal test in table-1.
General physical and systemic examination was unremarkable. The degree of exophthalmos on the Hertelexophthalmometers was 18 mm for the left eye and 25 mm for the right eye. Intraocular pressure was normal in both eyes. The CAS SCORE was 4 in March 2021, then improved over six months to 2. Magnetic resonance imaging of orbits revealed unilateral right eye proptosis with a mild increase in bulk of inferior rectus (IR) (maximum thickness 6.5 mm) with sparing of the anterior part of tendons.

Treatment and follow-up: He hadbeen given pulse methyl-prednisolone 500 mg weekly for five weeks and advised to continue LT 150 mcg once daily. At the discharge, he was euthyroid biochemically, and there was an improvement in eye symptoms. He had followed up on Aug 20th; his CAS was 2 with stable eye disease and was euthyroid on LT150 mcg. CT orbit showed enlargement of IR and MR.

Discussion: Pathogenesis of TAO in Hashimoto thyroiditis is poorly understood. We have reported TAO in a patient with hypothyroidism and negative TRAb with a high anti-TPO antibody. HEwas managed with LT, and pulse methylprednisolone on March 2021, and subsequent follow-up showed stable unilateral eye disease.

Conclusion: Thyroid-associated ophthalmopathyisrarebut can sometimes occur in Hashimoto’s thyroiditis. Awareness of this atypical form is essential for appropriate treatment because prompt recognition and management can prevent corneal involvement and blindness due to optic nerve compression.
Red Cell Distribution Width and the Severity of Acute Exacerbration of Chronic Obstructive Pulmonary Disease - A Hospital Based Case Control Study
Authors: Tundwal Vijay Kumar , Gaur Ravi , Ritumbhara  , Kumar Harish , Singh Saranshi , Tundwal Divyanshi 
Published: February 2023

Abstract

Background and Objective:
Acute exacerbation of chronic obstructive pulmonary disease (COPD) is one of the most common diseases in patients with having frequent hospitalization. The aim of this study is to find whether there is any relationship between red cell distribution width (RDW) with mortality in acute exacerbation of COPD.

Materials and Methods:
The hospital-based case–control study is conducted on hospitalized 50 patients with the diagnosis of acute exacerbation of COPD and 50 patients with stable period of COPD.

Results:
This was a hospital-based case–control study in the age group of above 30 years in hospitalized 50 patients with a primary and definite diagnosis of acute exacerbation of COPD and 50 participants in stable period of COPD conducted among admitted in the department of medicine. Maximum patients in both groups were found in the >60 years age group. The mean age in acute exacerbations of COPD group was 64.62 ± 8.24 years and in stable COPD were 63.22 ± 9.18 years. Both groups were comparable. Maximum patients in both groups were male. The mean RDW significantly higher in acute exacerbation of COPD (17.60% ±5.70%) as compared to stable COPD patients (13.80% ±3.33%). The difference in both groups was found statistically significant. The mean corpuscular volume was significantly lower in acute exacerbation of COPD (82.04 ± 1.49) as compared to stable COPD patients (86.50 ± 1.87). The difference in both groups was found statistically significant. RDW was significantly higher in those patients who were died (19.50% ±0.70%) as compared to survived patients (17.52% ±5.61%). The difference in both groups was found to be statistically significant. 4.00% hospital mortality in acute exacerbation of COPD group compared with stable COPD patients.

Conclusion:
We have concluded that the mean RDW on the day of presenting the illness was significantly higher in acute exacerbation of COPD as compared to stable COPD. Those patients who had a high RDW during admission were associated with poor prognoses.
Awareness of Periconceptional Folic Acid in Parents of Children Affected by Spina Bifida – A Pilot Study
Authors: Vashisht Rohan Giridhar , Dasaratha Vinupriya , Santahanakrishna Ramesh 
Published: February 2023

Background:
Spina bifida is a congenital malformation involving an open vertebral column resulting from failure in neural tube closure. It is among the most frequently occurring birth defects, observed in 1-3 cases per 1,000 live births worldwide. Conventionally requiring surgical repair, it can cause severe neurologic and musculoskeletal complications. However, consumption of prophylactic folic acid in mothers, at least 3 months before to 12 weeks after conception (periconceptional) has been shown to reduce the incidence of spina bifida by approximately 75%. This makes ascertaining parental understanding of such benefits critical. Therefore, this study provides baseline information on the awareness of periconceptional folic acid among parents whose children previously underwent surgical repair of spina bifida defects.

Materials and Methods:
The study subjects constituted 80 parents whose biological children had undergone surgical repair of spina bifida defects from 2014 to 2021 at a large paediatric tertiary care centre in South India. Upon providing informed consent, the subjects answered a cross-sectional telephonic survey containing 21 questions aimed at exposing their understanding of folic acid and its association with spina bifida.

Results:
None of the mothers had consumed folic acid before conception. However, 75% of them had consumed it as prescribed by their obstetrician during the first trimester of pregnancy. Finally, only 35% of them were aware of its role in preventing spina bifida.

Conclusion:
The awareness of periconceptional folic acid and its preventive role in spina bifida was low amongst parents whose children were once treated for same congenital abnormality.
The Outcomes of Modified Millard Technique Versus Tennison-Randall Technique in Unilateral Cleft Lip Repair
Authors: Abdullateef Khaled Salah , Nagaty Mohamed A. M. , Fathy Mohamed , Elmenawi Khaled Abdelmoneim , Aboalazayem Abeer , Abouelfadl Mohamed H. 
Published: February 2023

Purpose:
This study aimed to use anthropometric measurements taken pre- and post-operation to evaluate quantitative assessment of modified Millard technique compared with Tennison-Randall technique in unilateral cleft lip (UCL) repair.

Patients and Methods:
Prospective randomised controlled study recruited infants scheduled for UCL repair. Infants aged 2–6 months, either complete or incomplete deformity. A total of 68 patients were randomised in 1:1 ratio to undergo either modified Millard technique (Group I) or Tennison-Randall technique (Group II).

Results:
Group I had significantly longer operative time than Group II (85.7 ± 7.4 vs. 68.7 ± 8.8 min, respectively; P < 0.001). Group I has less post-operative wound infection, wound dehiscence and wound scarring than Group II, but Group II has less post-operative lip notch. In Group I, greater increases in post-operative horizontal lip length and vertical lip height were observed, compared to Group II, without statistically significant difference. Group I showed a greater reduction in nasal width and total nasal width than Group II, without statistically significance. Group II had a greater increase in philtral height. However, only post-operative Cupid’s-bow width was significantly different between two groups (P = 0.041).

Conclusion:
Overall results demonstrate no significant differences between modified Millard technique and Tennison-Randall technique.
Effects of Tai Chi and Qigong on fatigue and quality of life in patients with breast cancer: A narrative review of systematic reviews and meta-analyses
Authors: Gholamalishahi Shima , Okechukwu Chidiebere Emmanuel , La Torre Giuseppe , Mannocci Alice 
Published: February 2023

ABSTRACT
Tai Chi is a slow-moving exercise that incorporates deep and steady breathing. Qigong is a self-guided workout that involves breathing exercises and meditation. Tai Chi, as it is practiced today, incorporates Qigong. The objective of this review was to evaluate the efficacy of Tai Chi and Qigong in improving the quality of life and reducing fatigue among patients with breast cancer. Three electronic medical databases (PubMed, Scopus, and Web of Science) were searched from their inception up to July 2021. Nine systematic reviews and meta-analyses were included in this narrative review. Quality assessment was independently conducted by the first two authors (SG and CEO) using a measurement tool to assess systematic reviews. Three systematic reviews and meta-analyses reported the effects of Tai Chi and Qigong on cancer-related fatigue and four reported their effects on the quality of life of patients with breast cancer. Tai Chi and Qigong are beneficial, safe, low-impact, and low-intensity therapeutic exercises for patients with breast cancer that can improve their quality of life and psychological health and can be utilized as adjunctive therapies for the management of fatigue, if appropriately recommended. The evidence that Tai Chi and Qigong reduce fatigue and improve health-related quality of life among patients with breast cancer is moderate.
Bendamustine in the third line or beyond in metastatic, recurrent, or relapsed head-and-neck cancers: A retrospective observational study
Authors: Patil Vijay , Adak Supriya , Noronha Vanita , Menon Nandini , Singh Gunjesh Kumar , Prabhash Kumar 
Published: February 2023

ABSTRACT

Background:
Head-and-neck squamous cell carcinoma (HNSCC) is one of the most aggressive malignant tumors and is commonly diagnosed at an advanced stage. In the palliative setting, there are very limited options available for patients unfit to receive immunotherapy. Bendamustine has shown promising results in solid tumors, both alone and in combination with other treatment modalities.

Objectives:
We aimed to explore the role of bendamustine as palliative chemotherapy in patients with metastatic, recurrent, or relapsed HNSCC.

Materials and Methods:
We included patients with advanced HNSCC that was refractory to multiple lines of palliative intent therapy, and who were treated with bendamustine between October 2020 and January 2021 in the Department of Medical Oncology at the Tata Memorial Hospital, Mumbai, India. We evaluated the efficacy and safety parameters of the drug.

Results:
The study cohort included a total of 25 patients with a median age of 47 (range, 29-58) years; 21 (84%) were men. The primary tumor sites were buccal mucosa and oral tongue in 12 (48%) and 6 (24%) patients, respectively. The patients had received a median of 2 (range, 2-5) prior lines of treatment including platinum-taxane combination in 19 (76%), oral metronomic chemotherapy in 8 (32%), and immunotherapy in 4 (16%). Bendamustine resulted in a median progression-free survival of 1.3 months (95% CI, 0.9-2.0) and a median overall survival of 2.2 months (95% CI, 1.6-3.6). The common toxicities reported were constipation (7, 28%), neuropathy (5, 20%), and fatigue in 4 (16%) patients.

Conclusion:
Bendamustine is a promising and well-tolerated alternative drug for patients with metastatic, recurrent, or relapsed refractory HNSCC.
Paclitaxel with Mycidac-C in the second line and beyond in advanced head-and-neck cancer: A retrospective analysis from a tertiary cancer center
Authors: Sarma Rup J. , Patil Vijay M. , Shetty Alok , Menon Nandini , Noronha Vanita , Prabhash Kumar 
Published: February 2023

ABSTRACT

Background:
Head-and-neck squamous cell cancers (HNSCC) are common in India. Recurrent and metastatic HNSCC carry a poor prognosis. The chemotherapy options are limited, and the median survival is measured in months. The addition of targeted antibodies and immunotherapy improves overall survival (OS). In resource-limited settings, chemotherapy remains the only option in advanced HNSCC.

Objectives:
We aimed to assess the efficacy and safety of the combination of paclitaxel and Mycidac-C (heat-killed Mycobacterium w) in the palliative setting for advanced HNSCC.

Materials and Methods:
This was a retrospective study conducted in the Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India in patients with relapsed/refractory or metastatic HNSCC who received the combination of paclitaxel and Mycidac-C between August 2019 and May 2020. Patients were treated until progression or unacceptable toxicity. The study was approved by the Institutional Ethics Committee, and the requirement for written informed consent was waived.

Results:
We included 28 patients in the study. Most of the patients (22, 78.6%) had oral cavity cancers and had platinum-refractory disease (25 patients, 96.4%). The median age was 51 years (range, 31-70), 26 (92.9%) patients were male, and 25 (89.3%) had a performance status of 0-1. At least two lines of previous therapies had been administered to 23 (82.1%) patients. The median duration of follow-up was 3.4 months (range, 0.2-18.1). The median numbers of cycles of paclitaxel and Mycidac-C administered were 3 (range, 1-6) and 2.5 (range, 1-6), respectively. The median progression-free survival (PFS) and OS were 2.9 months (95% confidence interval [CI], 2.36-3.48) and 4.9 months (95% CI, 3.78-5.99), respectively. The most common adverse effects were anemia in 26 (93.9%) patients and increased alanine aminotransferase and aspartate aminotransferase levels in five (17.9%) and four (14.3%) patients, respectively. Four (14.3%) patients developed neutropenia, two (7.1%) developed diarrhea, and two (7.1%) developed peripheral neuropathy.

Conclusion:
In resource-limited settings, the combination of paclitaxel and Mycidac-C can be considered a therapeutic option for patients with advanced relapsed/metastatic HNSCC.
Do you have a standard way of interpreting the standard deviation? A narrative review
Authors: Darling H. S. 
Published: February 2023

ABSTRACT
Data presented in a paper have the limitation of summarizing the individual findings into statistical inferences. The standard deviation allows the reader to understand the spread of the data or the measurement of variation in a dataset that follows a normal distribution. The correct calculation and presentation of data along with measures of central tendency allow the comparison of data in systematic reviews and meta-analyses. A medical literature database search was performed in PubMed, Embase, and Cochrane using the keywords, “standard deviation”, “biostatistics”, and “clinical studies,” followed by abstract screening, and full paper evaluation to gather the desired information. This review highlights the importance of the standard deviation, its uses, interpretation, and fallacies.
Fam-trastuzumab deruxtecan-nxki (Enhertu®): A narrative drug review
Authors: Varghese Ryan , Soman Niraja , Karsiya Jainam , Bafna Nimesh , Nag Shona 
Published: February 2023

ABSTRACT
Human epidermal growth factor receptor 2 (HER2) is a subset of the epidermal growth factor receptor family that expresses tyrosine kinase activity. Dimerization of the receptor initiates various cellular signaling pathways, ultimately leading to the proliferation and division of cancer cells. The HER2 receptors are expressed in a multitude of cancers, such as metastatic breast cancer, gastric cancer, gastroesophageal adenocarcinoma, and non-small-cell lung cancer. Owing to its expression in several cancers, precision medicine products such as antibodies can be conjugated with conventional drugs to form antibody-drug conjugates (ADCs). These ADCs, like fam-trastuzumab deruxtecan-nxki, could be employed against these cancers, especially when previous lines of therapy have failed. This drug review aims to explore the pharmacodynamics, pharmacokinetics, clinical indications, contraindications, dosing regimen, dose modifications, adverse drug events, and the storage and administration of fam-trastuzumab deruxtecan-nxki. We screened all previous trials and tabulated the results to provide a bird’s eye view of the clinical outcomes. This review was prepared after an exhaustive literature search in PubMed, ScienceDirect, Google Scholar, Dimensions, and EBSCO Host, as well as by searching the websites of the United States Food and Drug Administration (US FDA), drug manuals, and conference presentations, using terms such as “fam-trastuzumab deruxtecan-nxki”, “Enhertu” and “HER2”. Of a total of 755 publications, 29 were found pertinent, and after rigorous scrutiny, 13 were included for curating this drug review. Supporting data were obtained from various abstracts and conference proceedings.
COVID-19-associated pathological changes in placentae of third-trimester pregnant women
Authors: Abdelwahab Mai M. , Tash Rehab M.E. , Shazly Sherin A. , Elbasateeny Samah S. 
Published: February 2023

Background and aim
Recently, many instances of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [coronavirus disease 2019 (COVID-19)] placental invasion in late pregnancy have been reported, and this is still not completely clear. Controversy data are sequentially published, so more studies are needed to investigate placental pathology as it gives vital information on placental changes, mechanisms of maternal–fetal infection transmission, and viral effects on the placenta as inflammatory or vascular changes. We aimed to find out the placental pathological changes in term placentae and to detect SARS-CoV-2 RNA in specimens fixed in formalin and embedded in paraffin.

Patients and methods
A total of 30 placentae were obtained from COVID-19-infected pregnant women. They were examined for pathological changes by histopathology; immunohistochemistry for CD3, CD20, CD15, CD68, angiotensin-converting enzyme 2, cytokeratin, and PDL-1; and reverse transcription-PCR to recognize viral RNA.

Results
According to the COVID-19 status at the delivery time, four groups were identified. Group 1 (12 patients with COVID-19 at the delivery time) showed chronic villitis and placental maternal and fetal malperfusion. Group 2 (seven cases that turned negative by PCR of the nasopharyngeal swab prior to delivery by 5–8 days) showed maternal malperfusion but no villitis. Both groups were SARS-CoV-2 RNA positive by PCR of the nasopharyngeal swab. Group 3 (five cases that turned negative 1 day before delivery) showed maternal–fetal malperfusion and mild chronic subchorionitis and deciduitis. Only three had SARS-CoV RNA. Group 4 (six cases with a persistent negative swab for 20 days before delivery) showed focal villitis (much less than other groups) and maternal malperfusion. Only two had SARS-CoV-2 RNA. Immunophenotyping of cases in the four groups detected mixed inflammatory infiltrate with variable diffuse angiotensin-converting enzyme 2 immunostaining of villus and extravillous trophoblasts. Cytokeratin staining detected thinning and discontinuity of syncytiotrophoblast and strong PD-L1 expression was seen in villitis areas.

Conclusion
SARS-CoV-2-positive women exhibited a diverse range of results; thus, pregnant women should not be considered a homogeneous group as outcomes are dependent on a multitude of interdependent circumstances.
Aldehyde dehydrogenase 1 expression in invasive breast carcinoma and its correlation with other clinicopathological parameters
Authors: Farrag Mayada S. , Elmetwally Mohamed , Farrag Nesrine S. , Ibrahiem Afaf T 
Published: February 2023

Background
Breast cancer is the main reason for mortality due to cancer among women worldwide. Activity of aldehyde dehydrogenase 1 (ALDH1) is known worldwide as a signature of breast malignancy stem cells. In this research, we tried to discover the variable expression of ALDH1 in diverse molecular categories of invasive breast duct carcinoma and its relation to other clinical and pathological parameters and to patient outcomes.

Study design
This is a retrospective study carried out on 118 samples of invasive breast duct carcinoma retrieved from the archives of Pathology Laboratory Department of Oncology Center, Mansoura University, Egypt.

Patients and methods
Immunostaining for ALDH1was done in addition to ER, PR, Her2, Ki67, EGFR, and CK5/6.

Results
We found that ALDH1 overexpression was found in 89% of cases. ALDH1 overexpression was considerably related to increased TNM staging (P=0.001). Moreover, disease-free survival was lesser in patients with ALDH1 overexpression than in patients with low ALDH1 expression.

Conclusions
Elevated ALDH1 expression is associated with aggressive traits as well as advanced TNM stage of breast cancer. Importantly, these discoveries may pave the way for novel cancer therapeutics based on ALDH1 inhibitors or antibodies.
Effects of ketamine or dexmedetomidine on postoperative cognitive dysfunction after cataract surgery: A randomized controlled trial
Authors: Oriby Mohamed E , Elrashidy Ayman A , Elsharkawy Ahmed , Ahmed Sameh A 
Published: February 2023

ABSTRACT

Background and Aims:
Ketamine and dexmedet omidine have neuroprotective effects that may reduce the occurrence of postoperative cognitive dysfunction (POCD) when they are used by intravenous infusion in geriatric patients scheduled for cataract extraction.

Methods:
Ninety patients aged 65-85 years old, ASA physical status II and III, and scheduled for cataract extraction under peribulbar block were randomly distributed equally among three groups: control group, in which patients received normal saline; ketamine group, in which patients received 0.3 mg/kg/h of ketamine; and dexmedetomidine group, in which patients received 0.5 µg/kg/h of dexmedetomidine. Medications were administrated by intravenous infusion and started 10 min before the surgery and continued throughout the duration of surgery. The analysed parameters included the incidence of POCD (primary outcome) through composite score of neuropsychological testing at one week and 3 months after surgery, postoperative pain score, postoperative sedation score, changes in haemodynamic parameters, changes in intraocular pressure, and incidence of complications.

Results:
In comparison with control group, ketamine and dexmedetomidine groups exhibited a significant decline in number of patients who developed POCD (P < 0.0001), a decrease in the postoperative pain score 4 h after surgery (P = 0.038), and an increase in the postoperative Ramsay sedation Score (P = 0.0002, 0.0003, and 0.011), without significant changes in the vital parameters, intraocular tension, or incidence of complications. Ketamine and dexmedetomidine groups were comparable.

Conclusion:
Intravenous administration of ketamine or dexmedetomidine in elderly patients undergoing cataract surgery under peribulbar anesthesia significantly decreases the incidence of POCD.