bluuebunny/crossref_metadata_2025_split huggingface dataset:
A rare case of small-cell neuroendocrine tumour of the lung metastasising to the urinary bladder
Authors: Mapuranga Humphrey , Silolo Siseko , Van Wyk Abraham C. , Vlok Sucari S.C. 
Published: May 2023

A 77-year-old woman with suspected lung carcinoma had multiple bladder masses and lymphadenopathy outside the normal urinary bladder drainage area. Fine needle aspiration and immunocytochemistry of the cervical lymph node complex and transurethral biopsy of the bladder masses confirmed metastatic small-cell neuroendocrine carcinoma.Contribution: Clinical correlation, imaging findings, tumour markers and immunohistochemistry are necessary for metastatic bladder tumour work-up.
Assessment of the attitude toward medication and reasons for drug compliance among schizophrenic patients attending the tertiary care hospital
Authors: Naik D Gangadhar , Pushpalatha Sugali , Aruna D. 
Published: May 2023

Abstract

Introduction:
Medication compliance is one of the most difficult challenges in the management of schizophrenia in India. Compliance broadly means the extent to which a person’s behavior, in terms of taking medications, following diets and executing lifestyle changes, visiting for follow-up, etc., coincides with medical and health advice. The current study has tried to assess the attitudes and reasons for compliance as well as noncompliance among patients with schizophrenia, which can provide the basis for planning effective interventional strategies for the mental health professionals for improving compliance of the patient in the future.

Methodology:
A hospital-based noninterventional cross-sectional study was done on 135 schizophrenic patients attending the outpatient services in the Department of Psychiatry, Government General Hospital, Kurnool, hospital by convenient sampling method for 6 months from October 2021 to March 2022, after obtaining approval from the institutional ethical committee. Data were collected and entered in Microsoft Excel and analyzed using the Statistical Package for Social Sciences (SPSS) 16 version software.

Results:
The prevalence observed in the present study, 75 (55.56%) participants were compliant, i.e., had a positive attitude toward medication and 60 (44.44%) participants were noncompliant toward medication. Higher mean scores for the Positive and Negative Syndrome Scale score were seen in the compliant group (101.25 ± 19.27) than the noncompliant group (100.98 ± 22.51).

Conclusion:
Main reasons for drug noncompliance identified in the present study were financial difficulty, distance from the hospital, improvement or no improvement in symptoms, side effects, lack of insight into the mental illness, and lack of awareness about the need for long-term medication.
Hematological Manifestations of COVID-19 and its Correlation with Outcome – A Retrospective Study
Authors: Abraham Bobby , Gopalakrishnan Shivkumar , Kandasamy Sangeetha 
Published: May 2023

Background and Aim:
The objective was to study the hematological manifestations of disease caused by novel coronavirus 2019 (COVID-19) and evaluate the association between absolute neutrophil count (ANC), absolute lymphocyte count (ALC), neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio, total count, and outcome.

Materials and Methods:
A hospital-based retrospective study was conducted on COVID-19 adult inpatients admitted between March and August 2020. The patients were classified into three groups based on outcome as mild COVID/uneventful recovery (Group 1), severe COVID/recovered (Group 2), and death (Group 3). Their clinical profile and hematological parameters were compared using both univariate and multivariate analyses. Binary and multinomial logistic regression analyses were used to analyze the chances of survival or death with respect to the variable studied.

Results:
The median age of nonsurvivors was 62.5 years. For unit increase in age, there were 1.03 times higher chances of severe disease (P = 0.013) and 1.04 times chances of death (P = 0.028). For every 1000/μl increase of ANC, the odds of developing severe disease rose by 1.85 (P = 0.270). For every 1000/μl increase in ALC, there were 94.7% lesser chances of death (P = 0.006) and 51.1% lesser chances of severe disease (P = 0.033). The odds of developing severe disease was 1.16 times per unit rise in NLR and the OR for death was 1.27 (P = 0.053).

Conclusion:
Advanced age, presence of lymphocytopenia, increased neutrophil count, and elevated NLR were associated with severe disease and high mortality due to COVID-19. Lymphocytopenia and age were the strongest predictors of severe disease and death.
Antiproliferative and Apoptosis-Inducing Properties of Selected Medicinal Plants of Assam, India
Authors: Roy Mritunjoy Kumar , Swargiary Ananta , Verma Akalesh Kumar 
Published: May 2023

Background and Aim:
Ethnomedicine is a common practice of disease treatment among tribal communities of India. The present study investigated the antiproliferative and apoptosis-inducing activities of seven medicinal plants traditionally used by the Bodo tribe of Assam.

Materials and Methods:
The phytochemical and antioxidant activities of plants were investigated following standard protocols. Antiproliferative and apoptosis-inducing activities were evaluated in Dalton's lymphoma (DL) cells. Plant extract-treated cells were stained with acridine orange/ethidium bromide solutions to see the antiproliferative and apoptosis-inducing properties of plants.

Results:
The study showed high phenolic and flavonoid contents in all the plants. Phlogacanthus tubiflorus displayed the strongest antioxidant activity. Plant extracts showed concentration-dependent antiproliferative activity. Hydrocotyle sibthorpioides showed the strongest antiproliferative and apoptosis-inducing activities. DL cells treated with plant extracts displayed apoptotic features. Furthermore, docking study revealed 2-methyl-5-(1-adamantyl) pentan the best binding affinity with anti-apoptotic proteins.

Conclusion:
The present study revealed potential antiproliferative and apoptosis-inducing properties in H. sibthorpioides. However, further study needs to be carried out to investigate bioactive compounds responsible for their pharmacological properties.
Interferon-gamma assay and tuberculin skin test for screening of latent tuberculosis in patients with inflammatory bowel disease
Authors: Mungmunpuntipantip Rujittika , Wiwanitkit Viroj 
Published: May 2023

Background
Latent tuberculosis is an important clinical problem. This problem might be significant in some specific groups of patients. The screening for latent tuberculosis is recommended for management of those patients at risk. An important group to be screened is patients with inflammatory bowel disease.

Materials and methods
This work is a retrospective study. The summarization on the available data from published articles on the comparative study between interferon-gamma assay and tuberculin skin test for screening for latent tuberculosis in inflammatory bowel disease patients was done. The pooled detection rate was calculated for using interferon-gamma assay and tuberculin skin test in screening for latent tuberculosis in patients with inflammatory bowel disease.

Results
The pooled detection rates for using tuberculin skin test and interferon-gamma assay in screening for latent tuberculosis in patients with inflammatory bowel disease are equal to 11.67% (95% confidence interval=10.33–13.19%) and 14.64% (95% confidence interval=13.16–16.30%), respectively.

Conclusion
It can be shown that interferon-gamma assay has a better efficacy in detection of latent tuberculosis among the patients with inflammatory bowel disease.
Cost-effectiveness of active tuberculosis case finding using sputum Xpert MTB/RIF and acid-fast bacilli tests
Authors: Thatayu Wararat , Techakehakij Win 
Published: May 2023

Background
Active case finding (ACF) of tuberculosis (TB) has been recommended by the WHO for early detection of pulmonary TB. Nonetheless, there is little evidence about the cost-effectiveness of different ACF strategies.

Objective
The aim was to assess the cost-effectiveness of ACF using sputum Xpert MTB/RIF and acid-fast bacilli tests.

Materials and methods
Economic modeling was employed to assess the effectiveness and costs of three ACF strategies, based on applying Xpert MTB/RIF (‘Xpert only’), acid-fast bacilli (‘AFB only’), or both AFB and Xpert (‘AFB+Xpert’) in the screening protocols. Outcomes included TB case detection rate, lost to follow-up rate, costs, and incremental cost-effectiveness ratios of the strategies. Costs were estimated in US dollars from the societal perspective, with base year 2018.

Results
The ‘AFB only’ strategy showed a low case detection rate with higher costs, in relation to other strategies. Compared with the ‘Xpert only’ strategy, a rising rate of lost to follow-up was observed from the ‘AFB+Xpert.’ The case detection rate in the ‘Xpert only’ strategy is approximately twice the rate compared with the ‘AFB+Xpert’ strategy. The costs per TB case detected of the ‘AFB+Xpert’ and the ‘Xpert only’ strategies were $17 778.33 and $8334.47, respectively. The incremental cost-effectiveness ratio of the ‘Xpert only’ strategy was $257.28 per case detected as compared with the ‘AFB+Xpert’ strategy.

Conclusion
This study showed that the ‘AFB only’ strategy was dominated, in comparison with other strategies. It should not be recommended in the settings where application of Xpert MTB/RIF is feasible.
Surgery for middle lobe syndrome in children
Authors: Sobhy Ehab , Sarhan Dina T. , Bakry Ahmed M. , Abdelsayed Amir 
Published: May 2023

Context
Middle lobe syndrome (MLS) is a special clinical and radiographic condition that is commonly misdiagnosed in the routine pediatric clinical workup. Delay in the diagnosis may cause irreversible damage of the middle lobe with poor response to medical treatment and may indicate its surgical resection.

Aims
To evaluate the clinical presentations, diagnostic lines, and surgical management of right MLS in children.

Settings and design
This is a retrospective descriptive study that involved the records of 26 patients diagnosed as having MLS and referred for surgical resection of middle lobe in the period between March 2012 and May 2019.

Patients and methods
We reviewed the hospital data of the selected patients in a retrospective manner regarding age, sex, symptoms, duration of these symptoms and the underlying etiology, the findings of chest radiograph, computed tomography, sputum culture, and pathology used for diagnosis. Fiberoptic or rigid bronchoscopy was performed before surgery for diagnostic and/or therapeutic purposes. Standard right middle lobectomy was done in all cases, and postoperative follow-up of clinical symptom improvement and complications was done.

Statistical analysis used
Graphical representation of the numerical data is present in the form using bar charts.

Results
We studied 18 (69.2%) females and eight (30.8%) males, with a mean age of 8.09±2.9 years. Clinical findings were cough in 76.9% of patients, expectoration in 38.5%, intermittent hemoptysis in 11.5%, chest pain in 19.2%, dyspnea in 34.6%, and 30.7% presented with recurrent or prolonged fever. The mean duration of symptoms was 27.4±16.7 months. Asthma is the most frequent underlying illness (23%). Bronchiectasis of the middle lobe was the most common radiologic (50%) and pathologic finding (42.3%). Tuberculosis was the final pathology in one patient and hydatid cyst was the cause in other one. Surgical resection of the middle lobe was done without reported mortality and with only few minor complications.

Conclusion
Lobectomy of the right middle lobe is a good choice for management of children with MLS who did not respond to medical treatment with low rate of complications.
Comparison between Xpert MTB/RIF threshold cycle value and smear microscopy of bronchial lavage for diagnosis of pulmonary tuberculosis in bronchoscoped patients
Authors: Khalil Magdy M. , AbdelHalim Hesham A. , Salem Gehad Y. 
Published: May 2023

Context
GeneXpert MTB/RIF (GX) has an important role in the diagnosis and treatment of pulmonary tuberculosis (TB) and predicts the infectiousness of the patient through the threshold cycle (Ct) value.

Aims
To compare the performance of the Xpert MTB/RIF Ct-generated values with microscopy on bronchoalveolar lavage (BAL) fluid to determine the added value of GX Ct for TB diagnosis.

Settings and design
This was a prospective cohort study that was conducted in Kafr Elsheikh Chest Hospital from September 1, 2018 to December 31, 2019.

Patients and methods
The study was conducted on 111 BAL samples of highly suspected patients of MTB clinically (+\-) radiologically, who cannot give sputum or with hemoptysis. These samples were examined by direct microscopy, solid culture media, and GX, and the results were compared. An optimum Ct value was identified to determine infectious patients.

Results
Negative GX was 78 (69.3%) and the positive GX was 33 (29.7%). Culture-positive cases were 30 (27.0%). Smear result showed only seven positive cases. The correlation between smear grade and Ct value yielded a converse relation (r=−0.61). Ct cutoff value for ruling in smear-positive patients was established at 22.3 cycles (sensitivity was 90.4% and specificity of 63.2%).

Conclusions
The study confirmed that GX examination of BAL provides a good diagnostic rapid test that is superior to smear microscopy in detection of TB. Ct values demonstrate quantifying mycobacterial load and so can predict the infectiousness of the patients. Ct value less than 22.3 provides a good diagnostic test for smear-positive status.
Role of complement activation product C4d as a predictor biomarker in lung cancer diagnosis
Authors: El-Maboud Suliman Lucy A. , Moawad Amr A. , Elshahawy Heba , Abdalla Dina A. 
Published: May 2023

Background
Molecular biomarkers such as complement C4d in bronchoalveolar lavage (BAL) may interfere with lung cancer diagnosis. However, limited studies have been conducted. The authors aimed to study the role of complement C4d as a predictive marker for lung cancer diagnosis.

Participants and methods
This case–control study included 45 participants: 30 were diagnosed as patients with lung cancer, comprising 16 with non-small cell lung cancer (NSCLC) and 14 with small cell lung cancer (SCLC), and 15 apparently healthy individuals as a control group. All patients (group I) were subjected to chest radiography, chest computed tomography, and flexible bronchoscopy. Forceps biopsies and BAL were taken for histopathological and cytological examination and measurement of C4d levels. For all participants, sputum and blood samples were collected for C4d measurement.

Results
There were statistically significant higher complement C4d levels in serum (P=0.006) and sputum of patients with lung cancer versus control group (P<0.001). There was no statistically significant difference in complement C4d level between NSCLC and SCLC in the three samples (P=0.315 for BAL, 0.7 for serum, and 0.744 for sputum). Complement C4d has a high sensitivity and specificity in serum and BAL for lung cancer prediction.

Conclusion
Complement activation product C4d biomarker could be used as a predictor of lung cancer diagnosis; however, it cannot differentiate between its two major subtypes: NSCLC and NSCLC.
Safety of osimertinib in adult patients with metastatic epidermal growth factor receptor T790M mutation-positive non-small cell lung cancer
Authors: Malik Prabhat S. , Noronha Vanita , Dabkara Deepak , Maddu Vamshi K. , Rajappa Senthil , Limaye Sewanti , Batra Ullas 
Published: May 2023

Background:
A Phase IV, single-arm study was conducted to assess the safety of osimertinib in Indian patients with epidermal growth factor receptor (EGFR) T790M mutation-positive stage IV non-small cell lung cancer (NSCLC).

Methods:
Enrolled patients received 80 mg osimertinib for six cycles or until disease progression or unacceptable toxicity or withdrawal. Primary safety variables included treatment-emergent adverse events (TEAEs), serious adverse events (SAEs), and adverse events (AEs) leading to discontinuation/interruption/change (D/I/C) of drug dose, and AEs of special interest (AESIs). AEs were summarized by the percentage of patients experiencing at least one occurrence of each event.

Results:
Of the 60 enrolled patients (median age 58 [range: 34–81] years; 51.7% women) at eight sites, nine patients were discontinued prematurely due to disease progression (n = 7) and death (n = 2); median (range) duration of treatment was 126 (1–134) days. Median age of patients was 58 (34–81) years; 51.7% (n = 31) were women; 86.7% (n = 52) were nonsmokers; and most of them (98.3%) had adenocarcinoma. About 75% (n = 45) of patients experienced any of the TEAEs, with the most frequent being fatigue and creatine phosphokinase (CPK) increase (n = 6, 10% each). TEAEs in 11 (18.3%) patients were judged as study treatment related, with CPK increase being the most common (n = 4, 6.7%). TEAEs led to D/I/C of drug dose in eight (13.3%) patients, with one being study treatment related. Nine (15%) patients had AESIs of dyspnea (n = 6), chest pain (n = 2), and cardiorespiratory arrest (n = 1); two of them had a fatal outcome. One AESI (mild dyspnea) was considered study drug related. TEAEs of grade ≥3 were reported in seven (11.7%) patients, including dyspnea in two (3.3%), followed by diarrhea, mucosal inflammation, cardiorespiratory arrest, and others (n = 1, 1.7% each). None of the SAEs and fatal events were considered as study treatment related. Seven (11.7%) patients had abnormal electrocardiogram (ECG; not clinically significant) at the end of the study.

Conclusion:
Our study confirms the favorable safety profile of osimertinib without any new safety concerns in Indian patients with EGFR T790M mutation-positive stage IV NSCLC.

ClinicalTrials.gov Identifier:
NCT03853551

CTRI registration no. CTRI/2018/10/015941
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CONCORDANCE
Authors: Prabhash Kumar , Biswas Bivas , Khurana Sachin , Batra Ullas , Biswas Ghanashyam , Advani Suresh Hariram , Mohapatra Prabrajya N. , Rajappa Senthil , Sharma Ajay , Patil Shekhar , Dattatreya Palanki Satya , Roy Rakesh , Almel Sachin , Goyal Gautam , Warrier Narayanankutty 
Published: May 2023

Background:
Molecular tissue testing in non-small cell lung cancer (NSCLC) is done for the assessment of epidermal growth factor receptor (EGFR) mutation. EGFR mutation status is the basis for deciding the targeted treatment option for patients with metastatic NSCLC. The nonavailability of tissue samples and contraindications for biopsy pose a significant challenge. Hence, circulating tumor DNA (ctDNA) by liquid biopsy can be a viable alternative for NSCLC patients.

Methods:
This study was conducted at 15 sites across India. EGFR mutation testing from plasma was done as part of the study at the central laboratory by the next-generation sequencing (NGS) method, and EGFR mutation test results from tissue samples (done as part of routine practice) were recorded for all the patients.

Results:
Out of the total patients enrolled (N = 245), the majority (64.5%, n = 158) were men. The median age of patients was 58.0 (range: 26–84) years. The concordance between plasma and tissue testing was found to be 82.9% (95% confidence interval [CI]: 77.55, 87.45). The sensitivity and specificity of NGS were 68.4% (95% CI: 56.92, 78.37) and 90.1% [95% CI: 84.36, 94.21), respectively. Plasma testing detected 1.2% (n = 3) and tissue sample testing detected 2.4% (n = 6) positive status of exon 20 T790M EGFR mutation. Out of the total number of patients enrolled, 25 were tissue positive and plasma negative, while 16 were plasma positive and tissue negative.

Conclusions:
This real-world study in Indian patients suggests that plasma testing for EGFR mutation analysis is a viable diagnostic option in newly diagnosed advanced/metastatic NSCLC patients. The noninvasive plasma procedure in patients without available/evaluable tumor sample may enable more patients to receive appropriate targeted therapies by providing clinicians with valuable insights into the patient's tumor mutation status.

ClinicalTrials.gov Identifier:
NCT03562819
Personification of Stress, Depression, Anxiety, and Quality of Life, among Parents of Attention Deficit Hyperkinetic Disorder Children
Authors: Kumar Krishan , Sharma Rajni , Saini Lokesh , Shah Ruchita , Sharma Akhilesh , Mehra Aseem 
Published: May 2023

Introduction:
Attention deficit hyperkinetic disorder (ADHD) is a common pediatric condition which contributes to poor quality of life (QoL) among parents of children diagnosed with the same. These parents go through anxiety, stress, depression, and other psychological trauma; face a lot of social taboos and stigma. These entire psychosocial variables affect their day-to-day life functioning, productivity, and psychological health. Thus contribute to poor perceived QoL among these parents.

Aim:
The study's main objective is, therefore, to see the effect on an ADHD child's parent of their perceived QoL in relation to their psychological wellbeing as measured by their level of stress, anxiety, and depression.

Materials and Methodology:
A total of 30 parents of children with ADHD were selected as samples from the outpatient section of the PGIMER, Department of Psychiatry, using a purposive and convenient sampling method. Among these parents, QoL was assessed using the WHO QoL (BREF); whereas stress, depression, and anxiety levels were assessed using Depression Anxiety Stress Scale II.

Results:
Our research findings suggest the mean age of the parents to be 32 years (with the age range of 28–45), with the mean age of the child as 9 years (with the age range of 4–13). Where parents <35 years of age (86.7%); have registered better physical QoL than those over the age of 35. Nonetheless, most parents (73.3%) reported poor perception of QoL. Our research findings also showed that most parents suffer from severe depression (66.7%), stress was also perceived as high among these parents, and parents aged >35 years showed higher anxiety than compared to other age groups. The overall QoL was also found to be negatively correlated with anxiety, stress, and social relationships. The mentioned findings have been discussed further.

Conclusion:
The overall results of this study showed clearly that most of the parents had perceived serious burden and poor QoL in all areas. The research also indicates that these parents are more distressed, stressful, and depressed. Our research finding indicated that for these parents to keep their lifestyles healthy, they can make a difference by recognizing and embracing the fact that ADHD is more inevitable than the one caused by environmental and/or personal errors. Parents should share their workload, increase their need for assistance and encourage one another to take some time out of the care of the child to have a shift and enhance their QoL.