bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interaction between peritumoral reactivity and histomorphological pattern of lymph node reactivity in oral squamous cell carcinoma
Authors: Bhatta Archana , Rath Rachna , Das Surya Narayan , Mishra Sudha Smruti , Sethi Debashis 
Published: January 2023

Background:
The invasive tumor front (ITF) of oral squamous cell carcinoma (OSCC) and the reactive changes in regional lymph nodes (RLNs) are believed to carry integral prognostic information about the tumor's invasive capacity and insight into host immune response, respectively.

Aim:
This study aims to evaluate the reactivity patterns of RLNs in relation to the tumor stage, grade and various histopathological parameters at the ITF of primary tumor, in an attempt to elucidate the nature of host-immune response to tumor.

Materials and Methods:
Pattern of invasion (POI) using Bryne's criteria, peritumoral inflammation, and status of connective tissue (CT) stroma of 50 OSCC cases, that underwent selective neck dissection were assessed at the ITF. Immunoreactivity patterns in corresponding 450 RLNs were assessed as proposed by Tsakraklides and Ioachim. Further, 97 metastatic lymph nodes (LNs) were evaluated for degree and pattern of tumor invasion. The datasets were subjected to the Chi-square analysis.

Results:
There was statistically significant association (P = 0.001) of Type III and Type IV POI as well as mild peritumoral inflammation (P = 0.024) with the advanced stages of OSCC as compared to early stages. Significant association was observed between LN reactivity pattern and tumor stage (P = 0.05), with metastatic nodes exhibiting germinal center predominance (97.9%) and lymphocyte predominance (69.1%) largely observed in nonmetastatic nodes. Majority of metastatic nodes showed Grade 3 invasion (54.7%) in the form of large islands (57.7%), whereas two (2.1%) nodes were totally effaced by tumor metastasis. Statistical significance was observed between CT stroma at ITF and degree of tumor invasion in metastatic LN (P = 0.001). POI also showed significant correlation with peritumoral inflammation (P = 0.002), CT stroma (P = 0.02), and LN reactivity pattern (P = 0.03).

Conclusion:
This study supports the presence of a strong immunological host-tumor relationship.
Fine needle aspiration cytology of primary thyroid non-hodgkins lymphoma
Authors: Singh Meeta , Nain Gunjan , Jain Shyama , Singh Sarika , Malhotra Vikas 
Published: January 2023

Presentation:
Twelve cases of Primary Thyroid Non-Hodgkin's Lymphoma (PT-NHL) were retrieved from the records suspected or diagnosed as NHL on fine needle aspiration cytology (FNAC) over a period of nine years from 2010-2018. During this period 5236 patients underwent thyroid FNAC;of these 685 cases were diagnosed under Bethesda Caregory V and VI. Thyroid NHL constituted 0.23 % of all thyroid FNA (12/5236 cases)and 1.7% (12/685) of all thyroid malignancies. Patients ranged in age from 40–61 years with Female:Male 7:5. All patients presented with thyroid enlargement (5-14 cms), and were of two months to five years duration. Patients had history of tobacco intake (smoking/chewing)in nine cases (75%). Thyroid function tests showed hypothyroidism in four (33%), positive antithyroid antibodies in three (25%) and; two cases(16.7%) were known cases of Hashimotos thyroiditis with follow up

Cytological Findings:
Eight cases (66.7%) had monomorphic large cell morphology, other four had mostly intermediate cell types (33.3%). A panel of immunocyto/ histochemistry (ICC/ IHC) showed CD 19 and CD 20 positivity in all cases;sixof these could be correlated on Flow cytometry (FC) with expression of FMC7, CD20, CD19 with kappa light chain restriction (5) and Lambda (1). FC findings corroborated completely with IHC on biopsy sections. The final diagnosis were Diffuse large B cell Lymphoma (DLBCL, 8) and MALT- Lymphoma(4). The follow up was available in DLBCL (4) and MALT- Lymphoma (1). CHOP therapy were given in all patients followed by radiotherapy in DLBCL; one patient of DLBCL died following pulmonary complications, rest are well and alive on follow-up.

Discussion:
PT-NHL is rare in India. DLBCL is the commonest histological type reported. In the present study, tobacco exposure has shown strong association. Combined FNAC-FC provide definitive diagnosis and thus can replace histopathology reducing turn around time.

Conclusion:
FNAC –FC provides a definitive diagnosis and thus can reduce turnaround time.
Incidence of xerostomia in locally advanced head-and-neck cancers in elderly patients treated with intensity-modulated radiotherapy
Authors: Jain Neeraj , Jain Sakshi , Kaur Amandeep , Sachdeva Kanchan , Sharma Ramita , Sudan Meena , Rakesh Abhimanyu , Abrol Deepak 
Published: January 2023

Introduction:
Dysphagia and xerostomia are the main sequelae of radiotherapy for head and neck cancer (HNC) and the main factors in reducing the longterm patient quality of life. Intensitymodulated radiotherapy (IMRT) uses advanced technology to focus the high radiation doses on the targets and avoid irradiation of noninvolved tissues.

Material and Methods:
During 2016–2017, 44 patients of locally advanced HNCs were treated with a curative intent with IMRT. They were in the age range of 65–75 years. The median age was 69 years. Thirtyfive patients were male and nine patients were female. Histopathologically, all had squamous cell carcinoma. Stage wise all were T3N2 or more. No concurrent chemotherapy was given. The Eastern Clinical Oncology Group criteria were used for grading the toxicities. Patients were assessed after 4 weeks of completion of treatment.

Results and Conclusion:
The incidence of mucositis was of Grade 1–2 in 37 patients. Moreover, patients experienced severe mucositis. Six patients had treatment interruptions due to mucositis. Xerostomia was Grade 1–2 in 42 patients and Grade 3 in 2 patients. Dysphagia was Grade 1–2 only. No hematological toxicity was seen. Patients having dysphagia during the treatment were given nasogastric feed. Response wise 14 patients achieved complete response, 28 patients had partial response, and 2 had stable disease. There was no treatmentrelated mortality.
Molecular profiling of oral squamous cell carcinoma associated with oral submucous fibrosis
Authors: Choudhari Sheetal , Masne Sneha , Bhandare Prachi , Dhumal Snehal 
Published: January 2023

Context:
Areca nut, a causative factor for oral submucous fibrosis (OSMF), is identified as a Group 1 human carcinogen. Oral squamous cell carcinoma (OSCC) associated with OSMF is now one of the most common malignancies in South and Southeast Asian countries.

Aim:
The present study was aimed to have clarity whether OSCC associated with OSMF is a pathologically different disease having different prognosis.

Settings and Design:
The difference between OSCC associated with OSMF and OSCC not associated with OSMF was studied in relation to expression of molecular markers, Ki-67, a proliferative and prognostic marker for OSCC and matrixmetalloproteinase-9 (MMP-9), and alpha smooth muscle actin (α-SMA), markers for invasiveness.

Subjects and Methods:
Expression was analyzed immunohistochemically using paraffin-embedded tissues from ten normal oral mucosa (Group I), thirty OSCC associated with OSMF (Group II), and thirty OSCC not associated with OSMF (Group III).

Results:
Group II showed OSCC occurring at younger age with more cases of well-differentiated OSCC. It also showed lower expression of Ki-67, MMP-9, and α-SMA as compared to Group III, and the difference was statistically significant. In addition, statistically significant low expression of markers was found in well and moderate grades of Group II as compared to those of Group III.

Conclusion:
OSCC associated with OSMF may have better prognosis and survival rate as it is found to occur at younger age with better grade of tumor differentiation and less expression of molecular markers Ki-67, MMP-9 and α-SMA. Thus, OSCC associated with OSMF can be considered a different disease pathologically and biologically. In-depth analysis of this molecular profiling can help to establish diagnostic, prognostic and therapeutic modalities for this unique malignancy.
An audit of Grade III or more skin reactions in consecutively assessed patients at a modern radiation oncology center
Authors: Pandey Vikas Kumar , Munshi Anusheel , Mohanti Bidhu Kalyan , Bansal Kanika , Rastogi Khushboo , Ganesh Tharmarnadar , Chauhan Rohit Singh , Chaudhari Bhavini , Pandey Pramod 
Published: January 2023

Purpose:
Radiation dermatitis is most common and debilitating side effects of radiotherapy leading to treatment interruption, thereby compromising the local control, and effecting quality of life. With the invent of modern imaging and recent advances in megavoltage radiotherapy, radiation-related side effects have reduced. In this audit, we report the risk factors associated with Grade III dermatitis in modern centers.

Materials and Methods:
We analyzed 172 patients treated with volume modulated arc therapy (VMAT) and static field intensity-modulated radiotherapy (SFIMRT) at our center. All head and neck, breast, gynecological, GU malignancies, and sarcoma patients treated with a dose of >45 Gy from April 2018 to December 2019 were included in the study. On couch, treatment verification was done with cone-beam computer tomography (CBCT). Slice-by-slice verification of planning target volume (PTV) with CBCT was done in the first three fractions and weekly thereafter. Skin evaluation was done using CTCAE v. 5. Statistical analysis was done using SPSS v. 22.

Results:
Of the 172 patients treated with VMAT and SFIMRT, 15 patients (8.7%) had Grade III dermatitis. Grade III dermatitis was mostly seen in breast cancer followed by head-and-neck patients. More reactions were observed in patients with advanced stage disease. Treatment verification is important at the later course of treatment, especially in head-and-neck cases where the treatment volume is large and PTV may extend outside skin. Contributing factors of radiation dermatitis at modern radiotherapy center are gene mutation, use of concurrent chemoradiotherapy, and bolus.

Conclusion:
We hereby conclude that PTV mismatch in weekly treatment verification, genetic mutations, concurrent chemo-radiotherapy, use of thermoplastic mask, and bolus are the contributing factors for Grade III dermatitis in modern radiotherapy centers.
Detection of differential expression of miRNAs in computerized tomography-guided lung biopsy
Authors: Singh Anjana , Kant Ravi , Nandi Soumyadeep , Husain Nuzhat , Naithani Manisha , Mirza Anissa Atif , Saluja Tajindra Singh , Srivastava Kamini , Prakash Ved , Singh Satyendra Kumar 
Published: January 2023

Aims:
Nonsmall-cell lung carcinoma comprises 85% of lung malignancies and is usually associated with a poor prognosis due to diagnosis at advanced stages. Molecular diagnosis of computerized tomography (CT)-guided biopsy has the potential to identify subtypes of lung carcinoma like adenocarcinoma (AC) and squamous cell carcinoma (SCC) along with its molecular stratification. This approach will help predict the genetic signature of lung cancer in individual patients.

Subjects and Methods:
Histopathologically proved a CT-guided biopsy sample of lung cancer cases was used to screen for the expression of microRNA (miRNA) earlier quantitated in blood plasma. Primers against hsa-miR2114, hsa-miR2115, hsa-miR2116, hsa-miR2117, hsa-miR449c, and hsa-miR548q with control RNU6 were used to screen 30 AC, 30 SCC, 5 nonspecific granulomatous inflammation, and 8 control samples. Reverse transcription polymerase chain reaction (RT-PCR) data revealed expression of hsa-miR2114 and hsa-miR548q in AC as well as SCC.

Results:
RT-PCR data revealed that the expression of hsa-miR2116 and hsa-miR449c was found upregulated in AC while hsa-miR2117 was expressed in SCC cases. Bioinformatic analysis revealed that genes, where these miRNAs are located, were also upregulated while targets of these miRNAs were downregulated.

Conclusions:
miRNAs expression pattern in the CT-guided biopsy samples can be used as a potential tool to differentially diagnose lung cancer subtypes. The expression pattern of miRNAs matches very well in blood plasma and tissue samples, albeit levels were very low in the earlier case than later. This approach can also be used for screening mutations and other molecular markers in a personalized manner for the management of lung cancer patients.
Clinical response of carboplatin-based chemotherapy and its association to genetic polymorphism in lung cancer patients from North India – A clinical pharmacogenomics study
Authors: Tiwari Sonia , Vijayaraghavalu Sivakumar , Siddiqui Maqsood A. , Al-Khedhairy Abdulaziz A. , Kumar Munish 
Published: January 2023

Purpose:
Lung cancer mostly diagnosed at advanced inoperable stages; thereby, the chemo-, radiation-, targeted or immune-therapy alone or in combination remains the treatment of choice. In chemotherapy, platinum-based compounds such as cisplatin and carboplatin and third-generation drugs such as docetaxel, paclitaxel, gemcitabine, and vinorelbine are widely used. The beneficial therapeutic outcome of the chemotherapy alone or in combination with radiation (chemoradiation) and/or development of drug resistance depends on the inter-individual genetic differences. Hence, this study was carried out to find gene biomarker that could be useful in the diagnosis of the disease and to predict the outcome of chemo/chemoradiation therapy in ethnic North Indian population.

Materials and Methods:
In this clinical study, lung cancer (n = 52) patients from North Indian population were recruited. All the patients were treated with carboplatin target area under curve-5 in combination with third-generation drugs (gemcitabine 1.2 mg/m2; paclitaxel 175 mg/m2; and etopside 100 mg/m2) and radiation therapy. The genomic DNA was isolated from the blood sample and performed polymerase chain reaction (PCR) and PCR-restriction fragment length polymorphism.

Results:
We found hazard ratio to be significantly higher for XPDLys751Gln (hazard ratio [HR] =2.11, 95% confidence interval [CI]: 0.98–4.53, P = 0.056) and IL1 β511C/T (HR = 9.9, 95% CI: 2.55–38.40, P = 0.001). GSTT1 null (HR = 0.39, 95%CI: 0.18-0.84, P = 0.017) genotype has better response to chemotherapy. Generalized multidimensional reduction model suggested that IL1RN (cross-validation consistency [CVC] =10/10, P = 0.054) and XRCC1399Gln, GSTM1 (CVC = 10/10, P = 0.001) as best predicted model in lung cancer patients to the treatment response.

Conclusion:
Genetic polymorphisms and single nucleotide polymorphisms in DNA repair gene (XRCC1, XPD) and drug-metabolizing gene (GSTM1 and GSTT1) could serve as genetic biomarkers in lung cancer patients treated with the above indicated chemotherapy. Based on genotype and chemotherapy treatments, the toxicity effects can be minimized, this will help in the development of personalized medicine in future with better efficacy.
Modified neoadjuvant clinicopathological risk stratification as a prognostic score in early and locally advanced triple-negative breast cancer
Authors: Dubashi Biswajit , Matta Kirankumar , Kayal Smita , Thumathy Divya Bala , Nisha Yadav , Dharanipragada Kadambari , Gunaseelan Karunanithi , ch Toi Pampa , Ganesan Prasanth 
Published: January 2023

Background:
Triple-negative subtype is an aggressive breast cancer with inferior survival. Pathological complete remission (pCR) is a good surrogate endpoint for survival among patients receiving neoadjuvant chemotherapy (NACT). We attempted to validate the clinical pathological score (CPS) with a modified risk grouping among Triple-negative breast cancer (TNBC) patients receiving NACT at our center.

Methodology:
Data of patients with TNBC who underwent NACT between January 2014 to July 2017 were retrospectively analyzed. The composite CPS score included cTN stage and y pTN stage and ranged from 0 to 4. This was calculated using an available online software developed by MD Anderson Center. The score obtained from the calculator was used to develop a risk grouping into low risk (0, 1) and high risk (2, 3, 4). Invasive disease-free survival (iDFS) and locoregional recurrence-free survival (LRFS) were calculated using the Kaplan–Meier method.

Results:
Seventy-eight patients with TNBC (median age: 45 [24-75]) had received NACT (anthracyclines and taxanes). Early and locally advanced breast cancer constituted 17 (21.8%) and 61 (78.2%), respectively, and 22 (28.2%) achieved pCR. After a median follow-up of 25 months (5–62), 3-year iDFS and OS were 59% and 81%, respectively, for the entire population. The 3-year iDFS in low-risk (n = 18) and high-risk (n = 60) patients was 85% and 51%, respectively (P = 0.03). The 3-year LRFS in low risk and high risk was 93% versus 58% (P = 0.03). The 3-year OS in the low and high risk was 93% and 77%, respectively (P = 0.24, NS).

Conclusion:
Our study supports the use of the modified neoadjuvant clinicopathological score as a prognostic marker in patients with nonmetastatic triple-negative breast cancer. This needs to be validated in a larger subset of patients.
Prevalence of Osteoporosis and Associated Risk Factors among Postmenopausal Women
Authors: Imran Mohammad , Singh Abhishek , Bhardwaj Anu , Agrawal Deepika 
Published: January 2023

Context:
Prevalence statistics of postmenopausal osteoporosis and knowledge regarding its independent predictors are lacking, especially in India, where every third woman and every eighth man is suffering from it.

Aim:
This study aims to investigate the prevalence of osteoporosis and associated risk factors among postmenopausal women.

Study Settings and Design:
This was a hospital-based prospective cross-sectional study.

Methods:
This study was carried out among postmenopausal women, who attended orthopaedics outpatient department from August 2020 to July 2021 and 587 women ranging in age between 50 and 80 years who had confirmed menopause were enrolled for the study. Finally, 539 women were recommended for bone mineral density testing, using dual energy X-ray absorptiometry.

Statistical Analysis:
To analyze the differences between the groups, a Chi-square and Student’s t-test were used for the categorical and continuous variables, respectively. P < 0.05 was considered to show significant associations.

Results:
In our study, 54.7% of subjects belonged to <60 years of age group. Half of the subjects (51.9%) were illiterate. 37.7% of subjects were having 6 or more children. 14.5% of subjects were currently smoking or chewing tobacco. Age of menopause among 38.0% of subjects was after 50 years of age and duration of menopause at the time of enrolment in the study was more than 10 years in 48.8% of subjects. The prevalence of osteoporosis increased with the increase in the parity and increased number of abortions. Subjects with family history of symptoms related to osteoporosis, and fragility fracture; and self-history of fragility fracture had higher prevalence of osteoporosis (P < 0.05).

Conclusion:
In our study, the overall prevalence of osteoporotic fractures among postmenopausal females was 82.2% (osteoporosis: 37.5% and osteopenia: 44.7%). The findings of current study and previous studies clearly indicate the urgent need of collective efforts towards the growing problem of osteoporosis in postmenopausal women.
Evaluating Clinical Features in Intracavitary Uterine Pathologies among Vietnamese Women Presenting with Peri-and Postmenopausal Bleeding
Authors: Nguyen Phuc Nhon , Nguyen Van Tuan 
Published: January 2023

Background:
Intracavitary uterine pathologies (IUPs) may be resulting in vaginal bleeding in perimenopausal and postmenopausal women. Especially, malignant disease needed to be investigated due to its adverse impact on the quality of mid-life women as well as the burden of health-care costs in low- and middle-income countries such as Vietnam.

Objective:
Thereby, through this study, we aimed to assess the major clinical features of IUPs in women with perimenopausal and postmenopausal bleeding women.

Materials and Methods:
This was a cross-sectional observational study at Hue University Hospital and Hue Central Hospital from June 2016 to June 2019. The study enrolled 150 women above 40 years old involving with intrauterine bleeding.

Results:
The mean age of the study population was 51.51 ± 7.65. The most common symptom in perimenopausal women was menorrhagia, up to 62.2% of cases. In addition to intrauterine bleeding, there were 54.7% of cases had at least one other functional symptom, they were pale skin (35.9%), and lower abdominal pain (31.3). Endometrial hyperplasia (EH) was the most common pathology in both groups with perimenopausal and postmenopausal bleeding (PMB), respectively, 66.7% and 51.7%. In PMB group, endometrial cancer (EC) occupied approximately 38.3% following EH. Our study revealed age, menstrual characteristics, and diabetes in relation to malignant disease. Other factors seemed to be less associated with EC.

Conclusions:
Menorrhagia was the most common type of abnormal uterine bleeding in perimenopausal women. Besides vaginal bleeding, others symptoms such as pale skin, pelvic pain, and fatigue were also common. Length day and blood loss before hospitalization in perimenopausal women were greater significantly than that in postmenopausal women. Age, menstrual characteristics, and diabetes increased the risk of EC in women with PMB.
Depression among Peri- and Post-Menopausal Women during COVID-19 Pandemic in Chandigarh, North India
Authors: Khatak Sukriti , Gupta Madhu , Grover Sandeep , Aggarwal Neelam 
Published: January 2023

Background:
Peri- and post-menopausal women are vulnerable to suffer from mental health problems including depression, anxiety, and stress, which might have increased during the COVID-19 pandemic.

Objective:
To estimate the prevalence of depression and associated factors among peri- and post-menopausal women during the COVID-19 pandemic in Chandigarh.

Materials and Methods:
A community-based cross-sectional study was conducted among 200 urban peri- and post-menopausal women of age 40–60 years in Chandigarh, from May to June 2021. Patient Health Questionnaire-9, Generalized Anxiety Disorder 7, and EuroQol-5D validated tools were used to screen depression, anxiety, and quality of life (QOL). Fear of COVID-19 scale was developed as part of this study was used to assess the fear related to COVID-19 infection. Data analysis was done using the Statistical Package for the Social Sciences (SPSS) software version 26.0. Binary multivariate logistic regression model was used to identify the predictors.

Results:
The prevalence of depression was 39% and anxiety 29.5% among peri-and post-menopausal women. The fear of COVID-19 infection (adjusted odds ratio [aOR] 8.43, confidence interval [CI]: 1.99–35.64; aOR 10.54, CI: 2.76–40.24) and sleeplessness (aOR 13.29, CI: 3.22–54.82) were the significant (P < 0.005) predictors of depression and anxiety, respectively. Fearful peri- and post-menopausal women (aOR 5.94, CI: 2.68–13.13) and widow status (aOR 7.08, CI: 1.10–45.28) were the significant (P < 0.005) predictors of poor QOL.

Conclusions:
The prevalence of depression was high among peri- and post-menopausal women during the COVID-19 pandemic. Fear of getting COVID-19 infection was significantly associated with depression, anxiety, and poor QOL.