bluuebunny/crossref_metadata_2025_split huggingface dataset:
Histopathological spectrum of breast lesions at B.P Koirala Memorial Cancer Hospital
Authors: Pandey Greta , Rana Asmita , Bhatta Ranjan Raj , Upreti Suraj , Jha Nandita , Dhungana Ishan 
Published: April 2022

Background: Breast lumps are the commonest presentation in surgical outpatient clinics in females. Breast is a complex organ structure. It shows a wide range of pathologies from benign inflammatory lesions to invasive life threatening lesions. Breast cancer has become the commonest cancer in females after cervix cancer also in Nepal. Modern diagnostic facilities have helped a lot for early detection of breast lesions and treatment. The present study was conducted at a tertiary cancer center in Nepal that focused on the identification of histopathological spectrum of breast biopsies received and their relations with epidemiological variables.
Methods: This is a retrospective study of all the breast biopsies which were received, processed and analysed at Department of Pathology at B.P. Koirala Memorial Cancer Hospital from January to December 2019. The data were retrieved from the Department of Pathology. They were entered in Microsoft excel.
Results: A total 216 breast tissues specimen of true-cut biopsy and lumpectomy were examined in the year 2019. The age range was from 18-75 years. There were 37.1% benign cases and 62.9% of malignant. There were 7 male patients in this study. Most of the cases belonged to age group of 40-49 years.
Conclusion: This study shows the burden of breast cancer in Nepal. It also highlights the importance of histopathology in breast lesions not only in diagnosing the lesion but also in predicting the prognosis. Malignant lesions of breast were frequent in this study due to our center being a cancer referral hospital. This retrospective study shows that a variety of lesions are encountered in breast and histopathology helps to differentiate between various benign and malignant lesions.
Application of SPECT combined with CT and MRI in malignant tumors Clinical value in the diagnosis of bone metastasis
Authors: Li Xiao , Shi Wenda , Xu Fan , Li Qingshan , Xiao Xu 
Published: April 2022

Objective：To evaluate the value of single-photon emission computerized tomography (SPECT) combined with CT and MRI in the diagnosis of bone metastasis of malignant tumors.
Method：Eighty patients with bone metastasis from malignant tumors who admitted to Affiliated Hospital of Chengde Medical College were selected from March 2019 to June 2021. SPECT bone imaging, CT and MRI were used to analyze the regional distribution of primary tumor bone metastasis and the efficacy of three detection methods in the diagnosis of bone metastasis.
Results: A total of 464 lesions were detected by SPECT and CT in the same scanning field，with SPECT detection rate of 92. 5% ( 429 /464) and CT detection rate of 77. 8% ( 361 /464) ( P＜0. 05). In addition，143 lesions were detected by SPECT beyond the same scanning field. A total of 321 lesions were detected by SPECT and MＲI in the same scanning field，with SPECT detection rate of 95. 6% ( 307 /321) and MRI detection rate of 82. 6% ( 265 /321) ( P＜0. 05)，and other 286 lesions were detected by SPECT beyond the same scanning field. In all，259 lesions were detected by CT and MＲI scans in the wild same scanning field. The detection rate was 71. 4% ( 185 /259) for CT，and 95. 7% ( 248 /259) for MRI( P＜0. 05). The sensitivity，specificity and accuracy of SPECT imaging combined with CT and MＲI were higher than single SPECT imaging，CT and MＲI ( P＜0. 05).
Conclusion: SPECT may be the preferred screening modality for suspected bone metastases and when combined with CT and MＲI，it can clarify the regional distribution of bone metastasis from malignant tumors and improve the sensitivity，specificity and accuracy of diagnosis with high clinical significance.
Research Progress on the effect of radiotherapy on immune function of tumor patients
Authors: Li Wenxin , Yu Xiaolei , Li Qingshan , Xu Fan , Zhang Sheng Lin , Li Xiao 
Published: April 2022

With the cure rate of 21%, radiotherapy is one of the most effective methods for tumor treatment, and about 70% of solid tumors need radiotherapy.With the in-depth study of human impact by radiotherapy and immune system and tumor microenvironment, radiotherapy is no longer used as a local treatment. It is found that irradiation of tumor can activate body immunity. There exist two different views: one is that radiotherapy inhibits immunity, because it can kill tumor cells and normal cells at the same time.The other is that radiotherapy promotes immunity, causing tumor cell necrosis or apoptosis, releasing immune cytokines or promoting immune cell activation, and bystander effect. In recent years, the idea of radiotherapy promoting immunity has been more and more supported by literatures. Whether radiotherapy promotes or inhibits immunity is a research hot spot in recent years. This paper reviews the research progress of the effect of radiotherapy on immune function of tumor patients.
Use of Indocyanine green (ICG) angiography to minimize anastomotic leak in the neck after esophagectomy
Authors: Devkota Mukti , Thakur Binay , Adhikari Puroshattam , Regmi Yogesh 
Published: April 2022

Introduction: Anastomotic leak after esophagectomy for cancer of mid and lower esophagus and gastroesophageal junction (GEJ) still remains a major challenge. Poor perfusion of the gastric conduit remains the main factor for leak. Intra-operative assessment of the gastric conduit with indocyanine green (ICG) angiography helps to select a properly perfused site for anastomosis, thus minimizing the leak.
Methods: Patients undergoing surgery for cancer of esophagus and GEJ either through open or minimally approach were taken up for this study. Stomach was used for reconstruction and anastomosis was made in neck. A 0.1ml of test dose of ICG was given intra-dermally to look for any reaction. After that a dose of 5-10 milligrams was injected intravenously. Perfusion was assessed with infrared light using laparoscopic telescope. The timing of perfusion of the conduit was recorded. Well perfused segment was used for gastroesophageal anastomosis. Different parameters including leak were compared with non-ICG group.
Results: We studied 474 patients. Among these patients 67 were in ICG group and 407 were in non-ICG group. Mean age, mean weight loss and co-morbidities were similar in both groups. 72% of patients in ICG group and 50% of patient in non-ICG groups had multimodality treatment. 67% of patients in ICG group and 46% of patients in non-ICG group underwent minimally invasive surgery (p<0.001). Post-operative complications like pneumonia, recurrent laryngeal nerve palsy and surgical site infection were similar in both groups. Post-operative mortality was seen in 1.5% and 3.7% in ICG group and non-ICG group respectively (p=0.4). Overall leak in ICG group was 9% and 16.5% in non-ICG group (p=0.06). In ICG group with the perfusion time of more than 60 seconds, the leak rate was only 3.5% in comparison to 16.5% in non ICG group (p=0.009).
Conclusion: ICG angiography provides an objective assessment about the perfusion of gastric conduit during the time of anastomosis. Anastomosis at area of gastric conduit with perfusion time less than 60 seconds, minimizes leak rate in neck.
The clinicopathological profile of Renal cell carcinoma at BP Koirala Memorial Cancer Hospital
Authors: Pokhrel Gyan Prasad , Jalan Aditya , Pradhan Erena , Pokhrel Bharatmani , Gharti Binod Babu , Nepal Umesh , Lamichhane Nirmal 
Published: April 2022

Introduction: Renal cell carcinoma accounts for 3-5%of all oncological diagnoses. In this study, we aim to assess the clinicopathological profile of Renal cell carcinoma in a cancer hospital of Nepal.
Method: This is a retrospective study conducted at BP Koirala Memorial Cancer hospital Nepal. All patients with localized and locally advanced RCC who underwent radical or partial nephrectomy at our hospital between Jan 2012 to Dec 2018 were included. Normally distributed continuous variables were expressed as median, mean ± standard deviation (SD). Categorical variables were expressed as frequencies and percentages of an appropriate denominator.
Results: Among 94 patients with RCC, the median age was 55 years (53.56 ±12.83). Most of the patients were male (56.4%, n=53) and Hindu by religion (67.02%, n=63). Eighty-three percent (n=78) of patients were smokers, 58.5 % (n=55) were hypertensive and 40.4% (n= 38) had history of diabetes mellitus. The most common symptom was incidental renal mass (42.55%, n=40). Ninety-five percent (n=89) of the patients underwent radical nephrectomy and five percent (n=5) of the patients underwent partial nephrectomy. The median duration of postoperative hospital stay was 8 days. The most common histological finding was Clear cell type (86.17, n=81) followed by papillary cell type (10.63%, n= 10) followed by chromophobe type (2.12%, n=2), and duct of Bellini( 1.06%, n=1). Most of the patients had pathological T2 (41.48%, n=39) disease followed by T3 (26.59%, n=25) disease.
Conclusion: Smoker males in the fifth to sixth decade of life are at risk for developing RCC. Radical Nephrectomy is the standard of care with Clear cell carcinoma as the most common histological subtype.
Geographical Trends in Prevalence of Stomach Cancer in Nepal
Authors: Sapkota Ganga , Mallik Dipendra Kumar , Wagle Bhawna , Dhakal Sunil , Bhandari Sapana 
Published: April 2022

Background: Carcinoma stomach is a multifactorial disease accounting for second most common cancer among male and fifth most common cancer among Nepalese population. The prevalence of stomach cancer is partially influenced by geographical variation, social and cultural factors that significantly affect disease reporting and seeking medical care. In this study we have analyzed geographical trends in prevalence of stomach cancer among patients visiting BPKMCH.
Materials and Methods: A single center descriptive retrospective study to analyze the geographical trends among stomach cancer patients visiting BPKMCH from January 2013 to December 2017 was designed and patients’ information available at medical record were obtained. Analysis was completed with SPSS Statistics.
Results: During the period of 5-year total 832 cases of stomach cancer were seen at the Department of Surgical Oncology at BPKMCH. These cases comprised of 349 female and 483 males with male to female (M: F) ratio of 1.4:1. The mean age of presentation was 55 years. Maximum number of cases 57.3% (477) were from terai region of Nepal.
Conclusions: This study provides clue regarding higher cases of stomach cancer among male patients and from terai region of Nepal.
Prevalence of Breast Cancer in different geographical regions: A Retrospective Study from Central Nepal
Authors: Sapkota Ganga , Poudel Bishwa Ram , Mallik Dipendra Kumar , Wagle Bhawna , Dhakal Sunil , Bhandari Sapana 
Published: April 2022

Background: Breast cancer is the second most common malignancy among Nepalese women with prevalence of 28.5 per 100,000 population. In Nepal due to lack of uniform health resources and awareness, breast cancer cases reporting is different in three geographical regions. This study aims to look at the difference in prevalence of breast cancer in different geographical regions.
Materials and Methods: A single center descriptive retrospective study to analyze the prevalence of breast cancer in different geographical regions among patients visiting BPKMCH from January 2014 to December 2018 was designed and patients’ information available at medical record were obtained. Analysis was completed with SPSS Statistics.
Results: During the period of 5-year total 2115 cases of breast cancer were seen at the Department of Surgical Oncology at BPKMCH. These cases comprised of 2052 female and 63males. The mean age of presentation was 48 years. Maximum number of cases 65% (1376) were from terai region of Nepal.
Conclusions: This study provides clue regarding higher cases of breast cancer among individuals from terai region of Nepal.
IMPLEMENTASI KONTRAK BELAJAR DIDALAM PERKULIAHAN MENJADI PENDIDIKAN MORAL DI PERGURUAN TINGGI
Authors: Husnani Husnani , Sunarti Sunarti 
Published: April 2022

Abstract. Education is not only focused on intellectual ability alone but also must be accompanied by good moral values. Moral education is very important given to students or students as the nation's successor. Teachers and lecturers are educators who are very responsible for providing moral education to students or students, both directly and indirectly. One way that can we use as a media of moral education at higher education or campus is through the application of learning contracts or lecture contracts. Lecturers and college students make an agreement that they will run together for one semester. The implementation of this lecture contract will get maximum results if it starts with a good planning, implementation and evaluation.
The Application of Technology, Pedagogy, Content, Knowledge (TPACK) During The COVID-19 Pandemic
Authors: Lestari Ambar Sri 
Published: April 2022

This study aims to explore the application of TPACK during the Covid-19 pandemic in online learning. This research used narrative interviewing to analysis data. The participants were students and lecture who participated in online learning, with data collection interview with some lecture and student. The student’s participants in this study were willing to respond utilized Google Forms with open questions for collecting data. The research findings that students’ responses to the learning plan, learning content, learning strategies, class management, learning assessments, and supporting skills. It can be seen that student responses to the application of TPACK were based on online learning during the pandemic. The results showed three issues i.e. pedagogy knowledge, content knowledge and technical knowledge which were described in several indicators i.e. lesson plan, content material, teaching strategies, assessment, class management, and supporting skills. The mastery of TPACK itself was still not fully understood and conducted by lecturers in integrating technology-based material due to time constraints, lack of creativity in designing, and lecturers are more comfortable using conventional methods in delivering material, namely PowerPoint. This research implied that online learning changes not yet increased the lecturers’ creativity in designing teaching materials. Even though they obtained knowledge from attending workshops on teaching material design, lecturers still need assistance designing teaching materials according to the TPACK consept.
A Review of Strategies to Improve Stroke Care Services in Low and Middle-Income Countries: The Innovative Experience of LGH Stroke Programme
Authors: Ahmad Saima , Muda Ahmad Sobri , Rashid Umair , Churojana Anchalee , Mansour Ossama Yasin , Shah Husnain Haider 
Published: April 2022

This manuscript aims to outline how pre-existing resources can be used for stroke care and how public and government awareness can be raised (influencer model).
We likewise portray the achievement of the LGH stroke program as an example of advancement. In LGH, reperfusion treatment has begun in recent years and this paper portrays the one of a kind experience in Pakistan. The aim of this study is to do a comparative analysis between Pakistan, Thailand and Egypt and their approaches to stroke care management and treatment. These countries fall under similar economic standing (LMICs) but Egypt and Thailand have relatively better healthcare systems for stroke management as compared to Pakistan. Hence, this paper
looks into these differences and presents potential solutions to how stroke care management can be improved in Pakistan. Additionally, current stroke management in Pakistan is reviewed.
A Descriptive Study on Characteristics of Patients with Myocardial Infarction and Their Outcomes: A Rural Primary Healthcare Setting in Lubok Antu District, Sarawak
Authors: Ho Yik Hon , Lim Caryn Tsujean , Albart Stephenie Ann , Schee Jie Ping , Looi Irene , Fong Alan Yean Yip 
Published: April 2022

INTRODUCTION: Myocardial infarction (MI) is the leading cause of death worldwide. More studies are needed to provide insight of MI care in rural settings in Malaysia.OBJECTIVE: This study aims to define characteristics of patients who experienced MI in rural setting and their outcomes. METHODS: We conducted an observational study involving secondary data collection through review of medical records of patients who presented to rural primary healthcare facilities before being referred to regional secondary and/or tertiary centres. We explored their outcomes including inpatient and 30-day cardiac-related mortality.RESULTS: Nine patients were included. Eight (88.9%) experienced STEMI. Eight (88.9%) were male. Median age was 53 (Q1:40.5–Q3:64.5) years. Median duration from symptoms onset to presentation was 2 (1.125 – 35.250) hours. Median time from presentation to aspirin delivery was 45 (12.5 – 86.0) minutes. The median door-to-needle time was 190 (163.0 – 212.5) minutes. Five (55.6%) received medical thrombolysis in secondary hospital prior to elective percutaneous coronary intervention (PCI). Inpatient mortality was 11.1% corresponding to 30-day mortality.CONCLUSIONS: MI is potentially under-diagnosed and under-treated in resource-limited rural settings where community awareness is low complicated by logistic challenges. Better resources with better equipped healthcare facilities are essential for prompt diagnosis and interventions for MI patients.
MYSIR 2022 Virtual E-Abstract 1
Authors: Interventional Radiology Malaysian Society of 
Published: April 2022

1. ABERRATION IN VARIATION: DECEPTION BY A CTA OCCULT BLEEDING VARIANT
2. ATYPICAL MULTICENTRIC EXTRA COMPARTMENTAL AND METACHRONOUS GIANT CELL TUMOR RECURRENCE
3. A RARE CASE OF PARARENAL MALAKOPLAKIA
4. A CASE OF ERDHEIM CHESTER DISEASE WITH MULTISYSTEM INVOLVEMENT
5. EXTRAOSSEOUS EWING’S SARCOMA INVOLVING VAS DEFERENS: A CASE REPORT
MYSIR 2022 Virtual E-Abstract 3
Authors: Interventional Radiology Malaysian Society of 
Published: April 2022

1. HOW TO GET OUT OF JAIL: AN ENDOVASCULAR APPROACH TO A MAL-POSITIONED CENTRAL VENOUS DIALYSIS CATHETER FROM LEFT SUBCLAVIAN ARTERY TO LEFT VENTRICLE
2. HOW TO GET OUT OF JAIL: AN ENDOVASCULAR APPROACH TO A MAL-POSITIONED CENTRAL VENOUS DIALYSIS CATHETER FROM LEFT SUBCLAVIAN ARTERY TO LEFT VENTRICLE
3. TUNNELED ADULT PERIPHERALLY INSERTED CENTRAL CATHETER (PICC) FOR CENTRAL VENOUS ACCESS IN PEDIATRICS: A SINGLE CENTRE EXPERIENCE
4. POST TRAUMATIC FACIAL PAIN; MULTIFACTORIAL CAUSES AND ROLE OF MINIMALLY INVASIVE PAIN INTERVENTION TREATMENT OPTIONS
5. A RARE CASE OF MECKEL’S DIVERTICULUM IN ELDERLY PRESENTED WITH GASTROINTESTINAL BLEED WITH MULTIPLE INTRAABDOMINAL SMALL VESSELS PSEUDOANEYRYSM
Haemorrhage post biopsy of a bronchial carcinoid
Authors: Vadivelu Sangeta , Abdul Rahaman Jamalul Azizi , Kho Sze Shyang , Wong Soo Fen , Nasaruddin Mona Zaria 
Published: April 2022

Background: Bronchial carcinoid tumours are rare, indolent, malignant neuroendocrine tumours derived from Kulchitsky cells and are not related to smoking. As these tumours can be asymptomatic or present with nonspecific symptoms, a high index of suspicion is essential to make an early diagnosis which determines the prognosis. Surgery is curative and remains the mainstay of treatment.
Case presentation: A 41-year-old female with no background medical illness first presented with a spontaneous left sided pneumothorax requiring a chest tube insertion. High-resolution CT (HRCT) thorax detected an incidental solitary pulmonary nodule. Bronchoscopy revealed a smooth round tumour sitting at the ostium of the basal right lower lobe bronchus. Endobronchial biopsy was complicated with massive bleeding requiring emergency exploration via rigid bronchoscopy. Multiple attempts to secure haemostasis using Watanabe spigot and argon plasma coagulation failed. She was intubated with a double lumen tube to isolate the healthy left lung. An urgent CT pulmonary angiogram (CTA) was performed to look for collaterals and feasibility of embolization, but no collaterals were seen. She was then referred to the cardiothoracic surgeon for an emergency right lobectomy. Histopathological examination revealed typical carcinoid tumour. She was discharged from the hospital in a stable condition.
Discussion: Bronchial carcinoids embryologically originate from the foregut and patients rarely present with features suggestive of carcinoid syndrome and crisis. Mostly are asymptomatic resulting in late presentation and diagnosis. Majority of the typical carcinoids are centrally located and may present with obstructive symptoms and recurrent pneumonia. Bronchoscopists may face massive bleeding following endobronchial biopsy in bronchial carcinoids.
Conclusion: Massive bleeding after endobronchial biopsy can occur and therefore the bronchoscopist should have anaesthesia, interventional radiology, and cardiothoracic support to handle this complication. Using tumour markers may obviate the need for biopsy in typical bronchial carcinoids to prevent massive bleeding after endobronchial biopsy.
SUPERVISI MANAJERIAL PENGAWAS SEKOLAH UNTUK MENINGKATKAN KINERJA KEPALA SEKOLAH DALAM PENGELOLAAN SEKOLAH PADA SEKOLAH BINAAN DI KABUPATEN TANAH DATAR
Authors: Burhano Raymond 
Published: April 2022

Penelitian ini bertujuan untuk meningkatkan kinerja kepala sekolah dalam mengelola sekolah melalui Supervisi Manajerial pada SMP, binaan di Kabupaten Tanah Datar. Kajian Penelitian Tindakan Sekolah (PTS) ini dianggap relevan dalam rangka meningkatkan kinerja kepala sekolah dalam mengelola sekolah untuk meningkatkan mutu pendidikan. Penelitian ini menggunakan metode observasi dan instrumen penilaian yang berisi 40 item pengelolaan sekolah yang digunakan selama kegiatan observasi berlangsung. Hasil penilaian, kemudian dianalisis dan dijadikan sebagai bahan perencanaan tindakan pada siklus berikutnya, guna untuk menarik kesimpulan. Temuan Penelitian Tindakan Sekolah (PTS) setelah dianalisa menunjukan bahwa berdasarkan observasi awal terhadap 7 orang kepala sekolah SMP, binaan di Kabupaten Tanah Datar memperoleh nilai rata-rata 59.20%. Setelah dilaksanakan siklus 1 diperoleh nilai rata-rata 69.57%. Sedangkan pelaksanaan siklus 2 diperoleh nilai rata-rata 87%. Implikasi hasil Penelitian Tindakan Sekolah (PTS) melalui Supervisi Manajerial dapat meningkatkan kinerja kepala sekolah dalam mengelola sekolah pada SMP, binaan di Kabupaten Tanah Datar. Dengan demikian hasil Penelitian Tindakan Sekolah (PTS) ini diharapkan dapat menjadi masukan bagi kepala sekolah dalam mempersiapkan rencana program sekolah, pelaksanaan program, pengawasan dan evaluasi, kepemimpinan kepala sekolah, dan system informasi manajemen sekolah dengan baik. Bagi pengawas sekolah dan stake holder Dinas Pendidikan dan Kebudayaan Tanah Datar sebagai masukan dalam melakukan pembinaan terhadap kepala sekolah dan guru untuk meningkatkan mutu pendidikan pada setiap sekolah di Kabupaten Tanah Datar.