bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Dysfunctional Descending Pain Modulation System in Chronic Nonspecific Low Back Pain
Authors: Hazra Sandipan , Handa Gita , Nayak Prasunpriya , Sahu Samantak , Sarkar Kaushik , Venkataraman Srikumar 
Published: September 2022

Abstract
Pain, a physiological protective mechanism, turns into a complex dynamic neural response when it becomes chronic. The role of neuroplastic brain changes is more evident than the peripheral factors in the maintenance, modulation and amplification of chronic low back pain (cLBP). In this background, we summarise the brain changes in cLBP in a coordinate-based activation likelihood estimation (ALE) meta-analysis of previous functional magnetic resonance imaging (fMRI) studies. Databases ('PubMed', 'Scopus' and 'Sleuth') were searched till May 2022 and the activity pattern was noted under the 'without stimulation' and 'with stimulation' groups. A total of 312 studies were selected after removing duplicates. Seventeen (553 cLBP patients, 192 activation foci) studies were fulfilled the eligibility criteria and included in the 'without stimulation' group. Twelve statistically significant clusters are localized in the prefrontal cortex, primary somatosensory cortex, primary motor cortex, parietal cortex, anterior cingulate cortex, caudate, putamen, globus pallidus amygdala, occipital lobe, temporal lobe and associated white matter in this group. Ten studies (353 cLBP patients, 125 activation foci) were selected in the' with stimulation' groups. In this group, seven statistically significant clusters were found in the frontal cortex, orbitofrontal cortex, premotor cortex, parietal cortex, claustrum and insula. These statistically significant clusters indicate a probable imbalance in GABAergic modulation of brain circuits and dysfunction in the descending pain modulation system. This disparity in the pain neuro-matrix is the source of spontaneous and persisting pain in cLBP.
Reverse Foster Kennedy Syndrome Caused by an Intra-axial Tumor
Authors: Ramdasi Raghvendra , Thorve Smita , Vekariya Mayank , Karnavat Chandresh 
Published: September 2022

Abstract
We present a case of a 23-year-old male complaining of painless loss of vision in right eye for 1 year and rapidly progressing vision loss in left eye with bilateral lateral rectus palsy. His fundoscopy revealed optic atrophy on the right side and papilledema on the left. Magnetic resonance imaging (MRI) showed intra-axial contrast-enhancing left frontal tumor. We discuss this first case of reverse Foster–Kennedy syndrome in the English literature with emphasis on the clinico-radiological and clinico-histopathological correlation.
Postoperative Salvage Decompressive Craniotomy
Authors: Krishnan Prasad , Ghosh Nabanita 
Published: September 2022

Abstract
Salvage decompressive craniotomies performed following complications after initial planned craniotomies may be inadequate if they are only restricted to removal of the small previously replaced bone flap with some additional nibbling of bone from the surrounding craniotomy margins by retracting the skin. To achieve the aim of adequately decreasing intracranial pressure without affecting wound healing, fresh incisions need to be placed to expand the craniotomy adequately while not compromising vascularity of the scalp. The rationale and safety of the simple posteriorly placed release incision to expand frontotemporal flaps is described.
Epidural Fluid Collections After Cranioplasty
Authors: Raju Dimble , Bhosle Rajesh , Krishnan Prasad 
Published: September 2022

Abstract

Background:
Common complications following cranioplasty (CP) include infections, seizures, bone flap resorption, and intra-cranial hemorrhages. Epidural fluid collections (EFCs), often seen in the immediate post-operative scan as hypo-dense accumulations below the bone flap, have been very infrequently discussed in the literature as in the majority of the cases, they are small, get resorbed spontaneously, and usually do not cause neurological deficits.

Objective:
To document our experience with EFCs that needed re-operation and analyze their clinical and radiological findings.

Materials and Methods:
We describe a series of six cases of symptomatic EFCs following CP that necessitated re-operation in a series of 89 cases over 7 years.

Conclusions:
EFCs following CP have a different pathogenetic mechanism compared to post-operative epidural hemorrhages. Meticulous surgical techniques can reduce their incidence. Symptomatic EFCs can be evacuated by either re-opening the flap or placing burr holes in the replaced bone. EFCs may become symptomatic even a few days after CP.
A Retrospective Cytogenetic Abnormality in Pediatric Acute Lymphoblastic Leukemia
Authors: Ghaffari Kazem , Kouhfar Athena , Ghasemi Ali , Gholami Milad , Arjmand Ali , Falahati Vahid 
Published: September 2022

Background:
Acute lymphoid leukemia (ALL) is the largest subset of hematologic malignancies, accounting for approximately 70%–80% of childhood leukemia, and is most common at age 4 years. The aim of this study was to define the frequency of chromosomal abnormalities in pediatric ALL.

Materials and Methods:
In this 11-year retrospective study, we investigated 99 patients which referred to our department due to ALL from 2010 to 2020. The age group of the patients ranged from 6 months to 14 years with a mean of 6.71 ± 4.09 years. Clinical and diagnostic findings were extracted from patients’ medical records.

Results:
We showed cytogenetic abnormalities of 99 pediatric ALL patients, including 78 pre-B-ALL, 9 common B-ALL, and 12 T-ALL cases. The 5-year overall survival rate (OSR) and event-free survival (EFS) of all cytogenetic abnormalities (n = 99) were 48% and 43%, respectively. There was a significant relationship between the two cytogenetic abnormalities, hypodiploidy and t(9;22), with death (P < 0.05). On comparing the subjects with normal cytogenetics to the other cytogenetic abnormalities, EFS was significantly low for hypodiploidy (P = 0.0163, hazard ratio = 0.5308) and t(9;22) (P = 0.0131, hazard ratio = 0.4908), while other cytogenetic abnormalities did not have a statistically significant difference in EFS.

Conclusions:
Our results emphasized the importance of the cytogenetic findings in evaluating the survival outcomes, which allows identifying a variety of OSR and EFS, because some of the cytogenetic abnormalities may interfere with the death and prognosis.
Preliminary report on value of Wallis interspinous device for back pain following microdiscectomy
Authors: Hsieh Cheng-Ta , Chen Yu-Hao , Huang Kuo-Chang , Ko Pi-Chan , Sun Jui-Ming 
Published: September 2022

Abstract

Background:
Postoperative back pain is a common complaint following microdiscectomy. The Wallis implant, an interspinous process device, is effective against mechanical low back pain due to spinal instability following discectomy. The present study aims to evaluate the value of the Wallis implant with microdiscectomy compared with microdiscectomy alone.

Materials and Methods:
Twenty patients were enrolled between June 2016 and August 2019. All patients received complete radiography and completed a questionnaire before and 1, 3, 6, and 12 months after surgery. Clinical outcomes were evaluated using the visual analogue scale (VAS) for back pain and Oswestry Disability Index (ODI). Radiologic outcomes were posterior disc height, foraminal height, foraminal area, segmental angle, and range of motion in flexion and extension views.

Results:
The Wallis group contained six male and three female patients (mean age 45.7 ± 13.3 years, range 20–61 years), and the control group comprised three male and eight female patients (mean age 47.6 ± 7.5 years, range 34–58 years). All patients had clinical improvements in VAS score and ODI after microdiscectomy alone or with the placement of the Wallis implant. The Wallis group had more favorable mean VAS score and ODI at the 1-, 3-, 6-, and 12-month follow-ups compared with the control group. However, the mean VAS score of the Wallis group was significantly lower than that of the control group only at postoperative month 6 (P = 0.012), whereas the mean ODI in the Wallis group was significantly better than that of the control group only at postoperative months 1 (P = 0.036) and 12 (P = 0.042). Although greater posterior disc height, foraminal height, and foraminal area were observed in the Wallis group, especially in the extension view, the difference in comparison with the control group was not significant.

Conclusion:
Our limited results indicate that the Wallis implant may reduce postoperative low back pain (VAS score) and improve quality of life (ODI) following microdiscectomy. However, the difference between microdiscectomy alone and microdiscectomy with the Wallis implant was not consistently significant throughout the 12 months of follow-up, regardless of the maintenance of radiologic outcomes.
Dynamics of the Neural Network Accuracy in the Context of Modernization of the Algorithms of Skin Pathology Recognition
Authors: Sokolov Kirill , Shpudeiko Viktor 
Published: September 2022

Background:
The lack of objective methodologies and open datasets for the evaluation of the algorithms complicates the objective evaluation by specialists and hinders the widespread use of this technology in health care. The purpose of this study was to estimate the accuracy of Skinive's algorithm 2020 version, then, after an algorithm improvement in 2020–2021, to show a statistically significant decrease in neural network errors in the risk assessment of skin pathologies in 2021.

Methods:
The Skinive neural network uses a machine-learning algorithm to calculate the risk rating of skin pathologies. For this study, we used Skinive's algorithm 2020 and 2021 versions trained on 64,000 and 115,000 images, respectively. Three validation datasets were used to assess the sensitivity of the algorithm: precancer + cancer, viral skin pathology, acne, containing 285 images in each set. The specificity has been calculated on a separate validation set containing 6,000 benign neoplasm cases.

Results:
The sensitivity of the Skinive neural network in detecting malignant neoplasms was 89.1% and 95.4% in 2020 and 2021, respectively. The specificity of Skinive's neural network in determining benign neoplasms was 95.3% in 2020 and 97.9% in 2021. For all skin neoplasms, in 2020, the sensitivity was 95.3%, and specificity was 93.5%; in 2021, these were 97.9% and 97.1%, respectively.

Conclusions:
The results of sensitivity and specificity of the Skinive neural network indicate that the algorithm is highly accurate in detecting various neoplasms and skin diseases. After improving the algorithm, we showed a statistically significant decrease in the number of neural network errors in determining the risks of skin pathologies.
Acquired Fibrokeratoma
Authors: Palaniappan Vijayasankar , Sadhasivamohan Anusuya , Sankarapandian Jeyalakshmi , Karthikeyan Kaliaperumal 
Published: September 2022

Background:
Acquired fibrokeratoma (AFK) is an uncommon, sporadic, benign, acquired, slow-growing dermo-epidermal tumour.

Aims and Objectives:
The purpose of this study was to summarize the demographic, clinical characteristics and treatment outcomes of patients with AFK in a tertiary care centre in South India.

Methods:
We evaluated the records of 26 patients with AFK who were diagnosed and treated in our centre between January 2017 and December 2021. The retrospective data related to age, sex, occupation, consistency, duration of lesions, history of trauma, anatomical site, morphological appearance, histopathological type, treatment provided and recurrence were taken into account and analysed.

Results:
Of the 26 patients, there were 21 males and 5 females. Fingers (n = 23) were the most common site involved, followed by toes (n = 2) and palm (n = 1). A total of 18 patients had finger-like projected lesions and eight patients had dome-shaped lesions. In histopathology, Type I AFK type was observed in 16 cases and Type II in 10 cases.

Conclusion:
We believe that our study would contribute by providing the clinical, histopathology and treatment outcomes of this uncommon dermo-epidermal tumour. The frequency of this condition is often underestimated as it is misdiagnosed for many other dermatological conditions.
An Analysis of Interns’ Feedback after Dermatology Posting
Authors: Ganguly Satyaki , Jaykar Kranti Chandan , Chhabra Namrata , Prabha Neel 
Published: September 2022

Background:
Dermatology knowledge among fresh medical graduates is poor in India as undergraduate medical curriculum and Internship training lack adequate focus on this subject. This contributes to the inappropriate management of Dermatology patients by the medical graduates.

Objective:
To analyse the expectations, motivations and experience of interns during their dermatology posting.

Materials and Methods:
This was a retrospective record review of questionnaire-based anonymous validated feedback forms submitted by interns posted in a dermatology department of a tertiary care institute. The feedback form contained nine multiple choice questions some of which allowed multiple responses.

Results:
A total of 63 completed forms were analysed. The common expectations before the posting were, to learn the management of basic dermatological problems (98.4%), to take an informed decision regarding post-graduation in dermatology (53.9%) and hope that the posting will be useful for the postgraduate entrance test (50.7%). After the posting, 69.87% of them felt that their expectations were fulfilled. After the posting, 84.1% of the interns felt that they would have liked to study dermatology as a separate undergraduate subject with a summative assessment at the end.

Limitations:
The sample size was less and the feedback form contained limited questions.

Conclusion:
The majority of the interns were satisfied after dermatology posting. Increased exposure of interns to dermatology inpatients and side laboratory procedures will further enrich their clinical experience. The inclusion of dermatology as a separate subject with examination in the undergraduate curriculum was a felt need.
Desloratadine Efficacy in Relation to GSTM1 and GSTT1 Polymorphic Genes in Chronic Spontaneous Urticaria
Authors: Maouia Amal , Leban Nadia , Youssef Monia , Helal Ahmed Noureddine , Kassab Asma 
Published: September 2022

Background:
The etiopathogeny of chronic spontaneous urticaria (CSU) is not well defined. Allelism in glutathione S-transferase GSTM1 and GSTT1 has been suggested as a risk factor. Desloratadine is the first-line treatment for this disease.

Objective:
This study aimed to investigate the efficacy of a first-line treatment: desloratadine 5 mg/day on antioxidant status and clinical assessment in Tunisian patients with CSU and to identify possible associations between GSTT1 and GSTM1 genotypes and susceptibility to CSU.

Methods:
Sixty patients with CSU and 60 age- and gender-matched healthy controls were included in the study. We calculated the urticaria activity score (UAS) and assessed the antioxidant parameters (total antioxidant status [TAS], glutathione S-transferase [GST], SOD, CAT, GPx]). Multiplex PCR was performed to find the relationship between GSTM1 and GSTT1 polymorphisms with CSU susceptibility.

Results:
At baseline, GST, GPx, CAT, SOD activities, and TAS were significantly lower in CSU patients compared to healthy controls (P < 0.05). After treatment, GST, GPx, CAT, SOD activities and TAS were significantly increased in patients compared to those before treatment (P < 0.001). We observed a significant association in null alleles of GSTM1. Before treatment, GST activity was significantly lower in patients having GSTM1+ genotype than those having GSTM1- genotype (P = 0.001). After treatment, TAS and antioxidant enzymes GST, GPx, SOD, and CAT were significantly elevated in patients having GSTM1- genotype than those having GSTM1+ genotype (P < 0.05).

Conclusion:
These results suggest the impact of GSTM1 and GSTT1 on CSU susceptibility and desloratadine efficacy in Tunisian patients.
Skin Damage and Quality of Life among Healthcare Workers Providing Care during the COVID-19 Pandemic
Authors: Christopher Paulus M. , Roren Regina S. , Tania Clarissa , Jayadi Nana N. , Cucunawangsih Cucunawangsih 
Published: September 2022

Background:
Since the occurrence of the coronavirus disease-2019 pandemic, healthcare workers (HCWs) have been strictly adhering to infection control practices within healthcare facilities. However, regular use of personal protective equipment (PPE) and hand hygiene have led to increased prevalence of skin damage, subsequently impacting the quality of life (QoL).

Objective:
To analyse the connection between skin damage and the QoL among HCWs in a multicenter setting in Indonesia.

Methods:
A cross-sectional survey was conducted among HCWs working in hospitals in Banten Province, Indonesia. The data was obtained using a reliable self-reported questionnaire (Cronbach α 0.765) and a validated Indonesian version of the Dermatology Life Quality Index.

Results:
A total of 113 respondents (56.5%) who experienced at least one self-perceived PPE-related skin damage and had worn PPE of any level within the last 7 days were analysed. The mean age ± SD of respondents was 26.09 ± 6.22 years old, while the mean DLQI score ± SD was 5.46 ± 4.88, with a median of 4.0 (range, 0-24). The regression model showed that the level of PPE used (P < 0.05) to be a significant risk factor.

Conclusions:
Skin damage due to PPE affects HCWs physically and emotionally. It is crucial to recognise its impact on life and reinforce awareness, prevention, and treatment of skin damage. Dermatologist referral and intervention should be considered for optimum management.
Comparative Evaluation of Efficacy of Therapeutic Ultrasound and Phonophoresis in Myofascial Pain Dysfunction Syndrome
Authors: Mahendra Raj Rajamohan Radhamani , Saravanan Thalaimalai , Preethi Paramasivam , Ezhilarasi Ilamurugan 
Published: September 2022

Introduction:
Myofascial pain dysfunction syndrome (MPDS) is a common presenting condition in the dental office. No specific therapy has proven its superiority over the other in managing myofascial pain dysfunction syndrome. Since phonophoresis was beneficial for other musculoskeletal medical conditions, the same strategy was adopted to prove its efficacy in MPDS.

Aim and Objective:
The aim of the study is to compare and evaluate the effectiveness of therapeutic ultrasound (ThUS) and diclofenac and thiocolchicoside gel phonophoresis in MPDS.

Materials and Methods:
Thirty patients with MPDS were randomly assigned into two groups. Group 1 (n = 15), therapeutic ultrasound was applied with ultrasound gel without any therapeutic ingredient for 10 min and five sessions. Group 2 (n = 15), ultrasound was applied with ultrasound gel with diclofenac and thiocolchicoside gel for 10 minutes and five sessions. Pain and mouth opening was taken as evaluation parameters.

Result:
A comparison of results obtained from the two groups before and after treatment at the end of each session shows significant improvement in both the parameters. However, in Group 2 more improvement in all outcome variables can be seen compared with group 1.

Conclusion:
Phonophoresis with diclofenac and thiocolchicoside (analgesic and muscle relaxant) proved to be an excellent treatment in MPDS. They proved more effective than therapeutic ultrasound in controlling pain and improving mouth opening.
Evaluation of Orofacial Symptoms and Oral Health-Related Quality of Life Among COVID-19 Patients Attending a Tertiary Hospital in Thiruvananthapuram
Authors: Mini M. M. , Tinky B. C. , Fathima S. C. R. , Aswathi K. , Ramachandran Sunu , Girija K. L. , Ramesh S. 
Published: September 2022

Background:
Researchers have been perplexed by the diverse clinical symptoms of COVID-19 spikes, and its oral symptoms are not frequently documented.

Objectives:
To estimate the prevalence of orofacial symptoms associated with confirmed COVID-19 cases and to assess the oral health–related quality of life among these patients.

Methods:
After audio consent, a pre-tested structured questionnaire was used to gather data from COVID-19-confirmed patients, and cases from a tertiary dental care facility in Thiruvananthapuram were also included.

Results:
Out of 200 participants, 86 (43%) were females, and 114 (57%) were males. The mean age was 40 years, ranging from 10 to 75 years. It was found that loss of taste (111, 56%), dry mouth (54, 27%), oral ulceration (18, 9%), white discoloration (12, 6%), burning sensation (9, 4.5%), red discoloration (7, 3.5%), tooth mobility (4, 2%), osteomyelitis (3, 2%), mucormycosis (4, 2%) and gingival bleeding (1, 0.5%) were the orofacial symptoms present in the participants.

Conclusion:
The prevalence of orofacial symptoms was 68% in COVID-19 patients, with loss of taste, dry mouth, and oral ulcerations as predominant symptoms. The mean oral health impact profile (OHIP) value of the COVID patients who showed oral manifestations was 17.44, whereas for those who did not show oral manifestations, it was only 7.46.
Significance of Mandibular Canal Position and its Foramina in Cone Beam Computed Tomography Images of Mandible for Analysing Sexual Dimorphism- A Retrospective Study
Authors: Shil Malabika , Sailaja Sambhana , Lavanya Reddy , Ravali T. , Fathima P. Raziya , Aparna T. Yamini 
Published: September 2022

Background:
Determination of gender from unidentified skeletal residue remains an arduous task in a forensic setting and for medico-legal assessment. The use of mandible in the field of human identification is less explored. Therefore, this study was done to analyze sexual dimorphism by identifying the relative location of mandibular canal and the mandibular and mental foramina using cone beam computed tomography images in a sample of south Indian inhabitants.

Materials and Methods:
This study was done on one hundred twenty cone beam computed tomography images (sixty males and sixty females) with an age range of twenty to sixty years. In these images, eight measurements were performed: six measurements in the coronal view and two measurements in the axial view. The variables between the sexes were compared using a student's t-test with level of significance of < 0.05.

Results:
All the eight variables were significant in predicting gender (P < 0.05). The mean values of all the measurements were higher in males except for one measurement which was higher in females. A logistic formula was obtained with all the variables to predict gender.

Conclusion:
The mandibular canal and the foramina showed significant differences among males and females of the study population. Therefore, the location of the mandibular canal and mental foramina can be used for gender determination in the study population.