bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of serum lactate dehydrogenase as early diagnostic biomarker in pregnancy with preeclampsia and eclampsia
Authors: Lavanya B  , Ullagaddi Rashmi , Pavani M  , Rao K Srinivas 
Published: February 2022

Pregnancy is a physiological state associated with many alterations in biochemical, physiological, hematological & immunological processes. Preeclampsia and eclampsia complicate 6-8% of all pregnancies and lead to various maternal and fetal complications. The aim of the present study was to evaluate serum LDH levels in the normal pregnant women and pregnant women with preeclampsia and eclampsia in ante-partum period and to study the correlation of maternal and perinatal outcomes with serum LDH levels.This prospective study was conducted among ANC mothers from 18-35 years with term singleton pregnancy attending OBG OPD and labour room at Navodaya Medical College Hospital & Research Centre, Raichur. After taking informed consent & detailed clinical examination, relevant laboratory investigations were performed. The serum LDH estimated using fully automated ERBA biochemical analyser.In the present study, a total of 200 pregnant women were included, out of which 100 were normal pregnant women which served as control group; remaining 34 (17%) cases were included in pregnancy with eclampsia and 66 (33%) were pregnancy with pre-eclampsia. In 29 cases of study group with Serum LDH in the range of 600-800 IU/L, 08 (27.6%) had severe pre-eclampsia and 18 (62.0%) had eclampsia. Of 34 eclampsia cases, 18(52.9%) had Serum LDH range 600-800IU/L and 14 (41.2%) had serum LDH &#62;800IU/L. The mean Serum LDH in study group was 570.5 IU/L and in control group was 201.5 IU/L. The patients had maternal complications like abruption, PPH, DIC, eclampsia with LDH&#62;600. Neonatal complications like IUGR, fetal distress, neonatal death, LBW, premature birth, IUD were increased with raised LDH. Serum LDH is the earliest marker in blood during hypoxia and oxidative stress. It is raised in cases of pre-eclampsia and eclampsia. Detection of high-risk patients with increased levels of LDH mandates close monitoring, prompt and correct management to decrease both maternal and foetal morbidity and mortality. Estimation of serum Lactate Dehydrogenase can be used as a prognostic marker for preeclampsia and eclampsia.
A case series on abnormal placenta accreta spectrum in a rural tertiary care centre
Authors: Jahnavi C , Gomathy E  
Published: February 2022

Placenta accreta spectrum (PAS) is a potentially life-threatening obstetric condition that requires a multidisciplinary approach to management. The main complication of PAS is due to it’s massive obstetric haemorrhage which leads to maternal morbidity and mortality. The incidence of placenta accreta spectrum increases day by day due to an alarming increase in caesarean section rates. Depending on the range of invasiveness, The Placenta accreta spectrum is classified as placenta accreta, placenta increta and placenta percreta. The etiology of placenta accreta spectrum is that a defect of the endometrial–myometrial interface leading to failure of normal decidualization in the area of a uterine scar, which allows abnormally deep placental anchoring villi and trophoblast infiltration. In recent times, prenatal ultrasound scanning with gray scale imaging and color Doppler imaging seems to be an excellent tool for screening of PAS.We report here a series of 5 cases of Placenta Accreta who reported to hospital as Bleeding P/v or USG scan report showing Abnormal Placental invasion or Placental Position. Patients reported were posted for Emergency LSCS under definitive indications but underwent Peripartum hysterectomy. The Ultrasound findings were subsequently confirmed at surgery and proven on histopathological examination. Peripartum hysterectomy remains the life saving procedure over conservative methods for PPH secondary to Abnormal Placental invasion.
Topographical distribution and histological characterization of stromal fibrosis in invasive breast carcinoma
Authors: Sharma Sushil Kumar , Khurana Nita 
Published: February 2022

Carcinoma breast is associated with various changes in organ and at the tissue level. The desmoplastic response in a tumor due to tumor hypoxia may result in dense or sparse, homogenous or focally hetrogenous fibrosis of the breast tissue. Peritumoral and stromal fibrosis has been assessed as an marker of intratumoral hypoxia and is being studied as histological surrogate prognostic parameter in breast cancer. We studied the topographical distribution and histological characterization of fibrosis and correlated it with various other histopathological parameters. 50 patients of carcinoma breast presenting to our institute were included in the study. We obtained a statistically significant correlation of presence of fibrosis with presence of lymphovascular invasion (p value =0.043), while we could not obtain any significant difference with age, menopause, tumor size, tumor grade, pathological stage, lymph node involvement, presence of necrosis, adipocytic invasion, duration of tumor, laterality, presence of inflammatory infiltrate and with ER, PR, HER2Neu status. This is a limited study in a small number of patients focussing on various stromal changes in breast cancer. This study has further characterized the heterogeneous nature of fibrosis in breast carcinoma using special staining which may facilitate the physician in making patient diagnosis, prognostication and outcome.
Clinicopathological study of epithelial neoplasms of ovary with special reference to the expression of P53 and Her2/neu in epithelial carcinoma
Authors: Sen Sarmila , Chatterjee Amrita 
Published: February 2022

Ovarian cancer represents 30% of all cancers of female genital tract. An accurate histopathological diagnosis of ovarian tumours is essential for their management and the outcome of therapy.Clinicopathological study of ovarian epithelial neoplasms and to study the expression of p53 and Her2/neu in epithelial carcinoma of ovary and their association with the histological grade. An observational descriptive type of study in a tertiary care hospital in Eastern India. 72 cases diagnosed as ovarian epithelial neoplasms in the department of Pathology, CNMC&H Kolkata during the study period of January, 2019 to December, 2020 were studied. Specimens were processed routinely. Immunohistochemistry was done following standard protocol.Statistical analysis was done using SPSS (version 21.0, Chicago inc., Chicago, Illinois, USA) software. 57 cases were benign followed by 14 malignant and 1 borderline case. Majority of the tumours were serous type (71.4%) followed by mucinous (27.2%) and seromucinous (1.4%). P53 expression was noted in 50% of the epithelial ovarian carcinoma and 85.7% of the high grade serous carcinoma. Her2/neu expression was noted in 21.4% of epithelial ovarian carcinoma cases. p53 expression was more in serous carcinoma and the expression of p53 was associated with higher grade of serous carcinoma. Her2/neu expression was more in serous carcinoma. There was no significant association between Her2/neu expression and histological grade and a larger population based study is needed for further evaluation.
Clinicopathological correlation of p53 expression in benign prostatic hyperplasia and prostate adenocarcinoma
Authors: Karia Kunjal Mukesh , Mallya Mrinal Kishor 
Published: February 2022

Prostate adenocarcinoma is the 6 most common carcinoma in men worldwide. It is usually a cancer of the elderly age group. Benign prostatic hyperplasia is a common cause of urinary incontinence and urine flow symptoms, usually seen in the middle along with elderly age group. In this study we have evaluated the expression of p53 immunohistochemistry (IHC) in prostate adenocarcinoma with benign prostatic hyperplasia along with its diagnostic, treatment and prognostic implications.: 1. Assessment of clinical and biochemical parameters in patients with benign prostatic hyperplasia (BPH) and prostate adenocarcinoma. 2. To assess p53(IHC) expression in benign prostatic hyperplasia and prostate adenocarcinoma : The study population comprised of a subset of patients who came to Ramaiah hospital, Bangalore from May 2018 till June 2019, for treatment regarding prostate related symptoms. The clinicodemographic data was collected and prostate biopsies were taken for which histopathological assessment was done. A total of 60 cases comprising of 30 cases of BPH and 30 cases of prostatic adenocarcinoma was subjected to p53 immunohistochemistry. The results were tabulated and statistically analyzed for significance.The present prospective study was conducted on 60 patients with 30 cases (50%) of BPH and 30 cases (50%) of prostatic adenocarcinoma. Based on the tumor differentiation there was 1 case (3.3%) of well differentiated carcinoma, 18 cases(60%) of moderately differentiated carcinoma and 11cases (36.6%) of poorly differentiated carcinomas. We observed an inverse relationship between p53 expression and histological grade. All poorly differentiated carcinoma had higher p53(&#62;50% expression). There was statistically significant difference in expression of p53 between cases of BPH and carcinoma prostate, indicated by P value of &#60;0.05. Among prostate carcinomas p53 had higher expression on those cases with Gleason score 9 and 10.: P53 expression directly correlates with Gleason score, while inversely correlating with tumor differentiation of prostate carcinoma cases. The expression of p53 is low in BPH as compared to that of prostate cancers. Hence it can be used as a good diagnostic and prognostic marker in prostate carcinoma.
Brachial plexus injury following blunt trauma; an anatomical variation in electrodiagnostic findings
Authors: Abdolrazaghi Hosseinali , Haghshomar Maryam , Azadvari Mohaddeseh 
Published: February 2022

Damage to the brachial plexus branches is one of the most important events during traumatic events, which may cause various disabilities. Electrodiagnostic testing is the preferred method to evaluate the extent of damage to the brachial plexus following trauma. The case presented in this paper, is a 26-year-old man who had near normal function of pronator teres and flexor carpi radialis muscles on electrodiagnostic testing following a right upper limb severe blunt injury at the level of his arm. After surgical investigation, we found a rare variation in the proximal part of the median nerve. In this case, branches to the pronator teres muscle and flexor carpi radialis had emerged from the proximal section of the median nerve in the arm region. This new variation holds important clinical implications especially in trauma patients presenting with weakness in forearm flexion.
Artritis tuberculosa del tobillo. Reporte de caso
Authors: Bouchentouf Rachid 
Published: February 2022

Introducción: la tuberculosis del astrágalo no es una patología frecuente, por esta razón se retarda su diagnóstico y tratamiento oportunos, necesarios para evitar la destrucción de las articulaciones y la deformidad esquelética.
Caso clínico: paciente masculino de 45 años de edad presenta traumatismo del tobillo derecho de 5 años de evolución, antecedentes familiares de tuberculosis pulmonar; acude a emergencia por presentar en el tobillo derecho tumefacción dolorosa y fístula cutánea, además de fiebre, sudoración y malestar general. La radiografía y la Tomografía Axial Computarizada (TAC) del pie muestran una lesión osteolítica del astrágalo derecho. Es tratado con antibióticos para estafilococo sin mejorar la sintomatología. Se puncionó la herida, tomando muestras con resultado negativo en tinción Ziehl-Neelsen, cultivos de aerobios, anaerobios y citología. Se decide el abordaje quirúrgico de la lesión con drenaje. El estudio histopatólogico reveló la presencia de granulomas necrosantes. Se evidencia mejora clínica y de seguimiento radiológico 9 meses luego de tratamiento para tuberculosis.
Conclusión: el presente caso nos muestra que en una lesión crónica inflamatoria de tobillo debe descartarse el diagnóstico de tuberculosis sobre todo en pacientes originarios de regiones endémicas de tuberculosis.
La virtualidad, un reto para la educación, ¡ahora!
Authors: Castro Calle Fernando Eugenio , Medina Rodríguez María Elizabeth , Sacoto Molina Adrian Marcelo 
Published: February 2022

Con la irrupción de las tecnologías el mundo ha cambiado, de la misma forma la educación se ha transformado, tal vez no al mismo ritmo de este mundo globalizado. La virtualidad conlleva una serie de retos pedagógicos que no se están viendo plasmados en la práctica educativa.
El presente ensayo busca reflexionar sobre el papel de la virtualidad en la educación, particularmente en la educación médica y el reto que esto implica a sus protagonistas en una modalidad que ha cobrado trascendencia con la pandemia del coronavirus.
Es indispensable repensar las formas de enseñanza - aprendizaje, reconocer las potencialidades de las herramientas tecnológicas y al mismo tiempo sus limitaciones; además, debemos reflexionar sobre la necesidad evidente de la presencialidad para el desarrollo de habilidades de los futuros médicos. La pandemia generada por SARS CoV-2 (COVID-19) reveló muchas debilidades en el sistema educativo universitario; es necesario meditar la forma de reorganizar los aprendizajes y reconocer los errores, lo que permitirá a cada uno de los protagonistas del quehacer educativo junto con prácticas creativas mejorar la formación médica.
Al emplear los entornos virtuales para el aprendizaje nos enfrentamos a cuatro elementos: la formación docente, el compromiso de los estudiantes, un modelo pedagógico muy bien enfocado y los medios o recursos como las plataformas, la conectividad y el contexto que pueda ofrecer la institución educativa, todo esto sin descuidar aquellos componentes formativos que fundamentalmente requieren de la presencialidad.
Physicians’ perceptions on decision-making about withholding/withdrawing life-sustaining treatments in paediatric patients: A systematic review of qualitative evidence
Authors: Zhong Yajing , Cavolo Alice , Labarque Veerle , Gastmans Chris 
Published: February 2022

Abstract
Background: With paediatric patients, deciding whether to withhold/withdraw life-sustaining treatments (LST) at the end of life is difficult and ethically sensitive. Little is understood about how and why physicians decide on withholding/withdrawing LST at the end of life in paediatric patients. In this study, we aimed to synthesise results from the literature on physicians’ perceptions about decision-making when dealing with withholding/withdrawing life-sustaining treatments in paediatric patients.Methods: We conducted a systematic review of empirical qualitative studies. Five electronic databases (Pubmed, Cinahl®, Embase®, Scopus®, Web of Science™️) were exhaustively searched in order to identify articles published in English from inception through March 17, 2021. Analysis and synthesis were guided by the Qualitative Analysis Guide of Leuven.Results: Thirty publications met our criteria and were included for analysis. Overall, we found that physicians agreed to involve parents, and to a lesser extent, children in the decision-making process about withholding/withdrawing LST. Our analysis to identify conceptual schemes revealed that physicians divided their decision-making into three stages: (1) early preparation via advance care planning, (2) information giving and receiving, and (3) arriving at the final decision. Physicians considered advocating for the best interests of the child and of the parents as their major focus. We also identified moderating factors of decision-making, such as facilitators and barriers, specifically those related to physicians and parents that influenced physicians’ decision-making.Conclusions: By focusing on stakeholders, structure of the decision-making process, ethical values, and influencing factors, our analysis showed that physicians generally agreed to share the decision-making with parents and the child, especially for adolescents. Approaches for evaluating young children’s capacity for making EOL decisions are still unclear and need to be explored further. Further research is required to better understand how to minimise the negative impact of barriers on the decision-making process (e.g., difficult involvement of children, lack of paediatric palliative care expertise, conflict with parents).
Students’ Perspective And Experience Of The Skills Course And Learning Management System In A Reformed System-Based Curriculum
Authors: Khan Shakir , Alshara Mohammed Ali 
Published: February 2022

Abstract
Background: The reformation of medical education system and getting up-to-date with novel technologies to understand the learning concepts is a biggest challenge.Objectives: The aim of this study was to explore the Saudi students’ perspective and experience of learning skills (LS) course and learning management system included in their medical curriculum. Materials and methods: Courses can be improved significantly if students provide meaningful feedback. The course evaluation survey is the most widespread indirect method of assessing courses. Imam Mohammad Ibn Saud Islamic University (IMSIU) introduced dynamic Blackboard (Bb) in LS course nearly 7-8 years in the first semester of the first year medical curriculum. The College of Medicine, IMSIU, Riyadh, Saudi Arabia. A total of 306 students who had successfully completed their preparatory year from the academic year 2019-2020 were enrolled. Results: Out of 306 participants, 241 (53.9% males and 46% females) responded and agreed that the LS course has improved their learning process. The LS course has enhanced students’ overall communication (65.6% males and 66.9% females) and time management (75.4% males and 64.9% females) skills. The LS course helped in students’ understanding of problem and team -based learning methods (72.3% males and 61.3% females), and also assisted in learning of other learning techniques (67.7% males and 64.9 females). Likewise, ~72.2% students agreed that the LS course aided in managing of psychological conditions of stress and anxiety. Most of the students (78.5% males and 74.8% females) revealed that the training of the LS course has tremendously improved their knowledge (p=0.04).Conclusions: The majority the students were convinced about the utility of the LS course. The present study warrants the practice of Bb as a new educational instructional learning technique. This is the very first report exploring the Saudi students’ experience and opinion about the effects of the LS course and learning management system on their academic achievements, coping techniques and career advancements since its implementation in IMSIU’s medical curriculum.
CXCR4 and RAC2 as Biomarkers of Periodontitis and Their Potential Influence on Macrophage Infiltration
Authors: Tian Xiufen , Zheng Juan , Wang Jing , Song Da , Luo Yuanyuan , Wang Dawei , Chen Yunzhen 
Published: February 2022

Abstract
Objective Chronic periodontitis is an incurable infectious disease characterized by complex inflammatory immune response. This study aimed was to screen and identify effective biomarkers correlated with macrophage in chronic periodontitis. Materials and methods Periodontitis datasets obtained from the gene expression omnibus (GEO) were analyzed to identify differentially expressed genes (DEGs). Functional enrichment analysis of DEGs by GO and KEGG revealed multiple biological processes and signaling pathways related to immune response. Further analysis was performed on two immune-related gene databases, ImmPort and innateDB, to identify DEGs related to immune cells infiltration in chronic periodontitis. Subsequently, Protein-protein interaction (PPI) network were established to reveal hub genes with MCC algorithm using CytoHubba tool. Enrichment analysis in DisGeNet showed that immune-related DEGs were enriched in periodontitis. Next, CIBERSORTx tool was analyzed to investigate immune cells infiltration in GSE10334 dataset. Results The results demonstrated differential macrophage infiltration in periodontitis. Notably, RAC2 and CXCR4 were identified as biomarkers correlated with M2 macrophages in chronic periodontitis. Finally, receiver operating curve (ROC) was plotted to determine the diagnostic value of identified hub genes which was then validated using relevant datasets of macrophages. Conclusion RAC2 and CXCR4 are potential biomarker of chronic periodontitis correlated with M2 macrophages infiltration. Further experiments are needed to more deeply explore the roles of CXCR4 and RAC2 in the molecular mechanism of M2 macrophages in periodontitis microenvironment.
Antimicrobial Resistance Among GLASS Pathogens In Morocco: An Epidemiological Scoping Review
Authors: Nejjari Chakib , Achhab Youness El , Benaouda Amina , Abdelfattah Chakib 
Published: February 2022

Abstract
Background: Monitoring of antimicrobial resistance (AMR) is of great importance due to the frequency of strains becoming increasingly resistant to antibiotics. This review, using a public health focused approach, aimed to understand and describe the current status of AMR in Morocco in relation to WHO priority pathogens and treatment guidelines.Methods: PubMed, ScienceDirect and Google Scholar Databases and grey literature were searched published articles on antimicrobial drug resistance data for GLASS priority pathogens isolated from Morocco between January 2011 and December 2021. Articles were screened using strict inclusion/exclusion criteria. AMR data was extracted with medians and IQR of resistance rates.Results: Forty-nine articles were included in the final analysis. The most reported bacterium was Escherichia coli with median resistance rates of 90.9%, 64.0%, 56.0%, 47.8%, 34.4%, 34.0%, and 23.0% for amoxicillin, amoxicillin-clavulanic acid, co-trimoxazole, nalidixic acid, ceftriaxone, fluoroquinolones, and gentamicin, respectively. Colistin had the lowest median resistance with 0.1% (range 0.0-11.9).Conclusions: Whilst resistance rates are high for most of GLASS pathogens, there were deficient data to draw vigorous conclusions about the current status AMR in Morocco. The recently join to the GLASS system surveillance will begin to address this data gap.
Understanding coalescence of phase separated droplets and verification via growing a single suspended crystal
Authors: Wu Zi-Qing , Liu Yong-Ming , Cheng Qing-Di , Li Chen-Yuan , Chen Liang-Liang , Liu Ya-Li , Ge Wan-Yi , Falke Sven , Brognaro Hevila , Chen Jing-Jie , Zhao Feng-Zhu , Zhou Huan , Zhang Chen-Yan , Deng Xu-Dong , Ye Ya-Jing , Lin Wen-Juan , Guo Wei-Hong , Shang Peng , He Jian-Hua , Betzel Christian , Yin Da-Chuan 
Published: February 2022

Abstract
Liquid-liquid phase separation (LLPS) is a ubiquitous process found in a variety of fields. It is of particular importance in biological sciences since it plays essential and vital roles in a number of physiological and pathological processes in biological systems. After LLPS, the dense droplets can grow in size via incorporating solutes from surrounding environment and in some cases coalescing with other droplets. Interestingly, the size of the dense droplets seems to have an upper limit but the mechanism remains to be explored. Since the droplet size can be essential for biological functioning, it is important to understand the size evolution of the phase separated droplets. Here we propose a physical mechanism with consideration of impurities on the surface of the dense liquid droplets. The theoretical predictions can be used to explain the observations on the size evolution. Based on the coalescence mechanism, we succeeded for the first time performing a challenging task, i.e., growing a single suspended protein crystal via merging phase-separated droplets in a fully non-contact manner. The mechanism observed may be considered as a basic model for researches in much broader fields involving phase separation, such as in biology, materials science, physics, chemistry, and meteorology.