bluuebunny/crossref_metadata_2025 huggingface dataset:
Determinants of Stunting Prevention among Mothers with Children Aged 6–24 Months
Authors: Yunitasari Esti , Pradanie Retnayu , Arifin Hidayat , Fajrianti Dita , Lee Bih-O
Published: June 2021

AIM: The purpose of this study was to analyze the determinants of stunting prevention in relation to mothers with children aged 6–24 months in Madura Indonesia.

METHODS: The design of this study was cross-sectional. The number of samples totaled 109 respondents using a purposive sampling technique. The independent variables were knowledge, attitudes, income, cultural values, and parenting. The dependent variable was stunting prevention. The data were collected using a questionnaire and then analyzed using the Chi-square test with a significance level of α _< 0.05.

RESULTS: The factors associated with stunting prevention were knowledge (p = 0.007), attitude (p = 0.034), income (p = 0.006), cultural values (p = 0.016), and parenting patterns (p = 0.000).

CONCLUSIONS: Knowledge, attitude, income, cultural values, and parenting influenced the parent’s strategy when it came to prevent stunting in their children. Stunting prevention programs should focus on improving parental behavior by modifying these factors.
Pro-and Anti-vaccination among Mothers in Deciding Children’s Immunization: A Qualitative Study
Authors: Izzati Aisyah Nur , Indarwati Retno , Makhfudli Makhfudli , Utomo Budi , Has Eka Mishbahatul M. , Arief Yuni Sufyanti , Arifin Hidayat
Published: June 2021

BACKGROUND: Society participation in the mandatory basic immunization program has declined in the last 2 years in Indonesia. One of the causes is the widespread of anti-vaccine issue, which has recently been debated on social media. This study aimed to explore the perspectives, backgrounds, experiences, and aspects that underlie the mother’s confidence in anti-vaccine and pro-vaccine groups who join the Facebook social media forum.

METHODS: A phenomenology qualitative design was undertaken. The data were collected from June to August 2020. We conducted in-depth structured interviews with 5 anti-vaccine participants and 5 pro-vaccine participants. We obtained saturation data with ten participants. The data managed by NVIVO 12 software and analyzed using the thematic analysis method.

RESULTS: We obtained 4 themes, including social media values, perceptions of immunization, immunization barriers, and knowledge about immunization. Anti-vaccine parents were firm not to immunize their children even though they knew the purpose of immunization and were perceived that there were no barriers to taking immunization. Pro-vaccine parents were determined to take basic immunization despite experiencing various barriers.

CONCLUSION: This study showed that social media, perceptions, knowledge, and barrier about immunization affect mothers in considering the decision to give immunization to their children. Nurses and other healthcare workers should be provided positive communication and mutual trust between parents and health services are required to develop parental vaccine confidence so that basic immunization coverage can increase.
Comparison of the Unilateral and the Bilateral Pedicle Screw Fixation without Using an Interbody Cage: Randomized Clinical Trial
Authors: Lychagin Alexey , Cherepanov Vadim , Lipina Marina , Vyazankin Ivan
Published: June 2021

BACKGROUND: Lumbar spine instability is one of the main causes of low back pain and has become more prevalent in recent years. Bilateral pedicle screw fixation is used to perform posterior lumbar stabilization, which is complemented by the installation of an interbody cage.

AIM: The aim of the study was evaluating of the results of unilateral and bilateral pedicle screw fixation without using of an interbody cage.

METHODS: A prospective randomized study of 96 patients was carried out. Forty-seven patients were assigned to the group of the unilateral pedicle screw fixation versus 49 patients were moved to the group of the bilateral pedicle screw fixation of the lumbar spine. Of the 96 patients, 80 patients eventually were included in the study. However, seven patients in the first group and nine patients were lost to follow-up. Surgery timing, blood loss volume, clinical outcomes (scores on the Oswestry disability index [ODI], EQ-5D and visual analogue scale [VAS]) were evaluated in 6–12 months after surgical treatment. All the patients included in this study underwent functional and control computed tomography in 12 months after surgery.

RESULTS: Both groups showed a significant improvement in VAS, EQ-5D, and ODI in 1 year after surgical treatment. The two groups significantly differed in the surgery timing (unilateral – 90.2 min; and bilateral – 129.4 min) and blood loss volume (unilateral – 152.7 ml; and bilateral – 230.1 ml), p < 0.05.

CONCLUSIONS: Unilateral and bilateral pedicle screw fixation showed similar clinical results, while results in both types of fixation differed in slight manner. However, the duration of surgical treatment and intraoperative blood loss volume proved to be lower for the unilateral fixation group, which indicates that the use of the unilateral fixation can be the choice of performing posterior stabilization at a single-level instability of the spine without using an interbody cage.
Implementation of Behavioral Therapy (Economic Token) on the Ability of People with Mental Disorders in Fulfilling Self-Cleaning (Personal Hygiene) in Medan Sunggal Subdistrict
Authors: Nasution Mahnum Lailan , Daulay Wardiyah , Wahyuni Sri Eka
Published: June 2021

BACKGROUND: Some common problems experienced by all people with mental disorders (ODGJ) are impaired personal hygiene activities including bathing, dressing up, eating, and toileting. Psychiatric nurses must, therefore, possess the ability and knowledge on how to meet the personal hygiene requirements for these patients by providing caregiving with behavioral therapy (economic tokens), through behavior modification, using positive reinforcement.

AIM: This study aimed to apply behavioral therapy (economic tokens) to the ability of ODGJ in the fulfillment of personal hygiene within Medan Sunggal subdistrict.

MATERIALS AND METHODS: The research type used was quasi-experiment with the one-group pre-test-post-test approach, while the procedure was performed by providing nursing actions in the form of behavioral therapy (economic tokens). This study involved a total of 31 respondents with mental disorders ODGJ, obtained through total sampling in the unified Medan Sunggal subdistrict.

RESULTS: The use of behavioral therapy (economic tokens) was found to improve the ability of ODGJ to carry out personal hygiene, with a mean difference of 1.19 (from 1.87 to 3.06).

CONCLUSIONS: Psychiatric nurses, therefore, ought to motivate and help accompany families to monitor the personal hygiene fulfillment ability of family members with mental disorders.
Correlation between Beck Depression Inventory and World Health Organization Quality of Life-BREF Scores in Stage III of Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome Patients at Central Public Hospital of Pusyansus RSUP Haji Adam Malik Medan
Authors: Yulia Erlina , Amin Mustafa M. , Loebis Bahagia , Nasution Nazli M.
Published: June 2021

Background: Depression is the psychiatric complication that mostly associated with HIV disease. For people in HIV positive infection stage, unstable and declining physical conditions followed by the appearance of physical symptoms and intense social pressure from the environment can be a source of stress that results in depression. After entering the stage of AIDS, depression is more susceptible to experience because of worsening health conditions. Furthermore, patients also often feel that their life will be not long so that everything that happen in his or her life will be in vain which will have an impact on their quality of life.
Objective: To determine the correlation between Beck Depression Inventory (BDI) II and World Health Organization Quality of Life (WHOQOL-BREF) scores in stage III of HIV / AIDS patients at Pusyansus RSUP Haji Adam Malik Medan.
Methods:This study is a cross-sectional study using a correlative analytic design, which was conducted at the Pusyansus Haji Adam Malik Hospital Medan, North Sumatra from May 2019 to November 2019. The research subjects were 65 people diagnosed with HIV / AIDS stage III. The degree of depression was measured based on the Beck Depression Inventory (BDI) II and the quality of life was measured based on the World Health Organization Quality of Life (WHOQOL-BREF).
Conclusion: There is a significant correlation between Beck Depression Inventory (BDI) II score and World Health Organization Quality of Life (WHOQOL-BREF) score in HIV / AIDS patients stage III at the RSUP Haji Adam Malik Medan Hospital.
Association of Polymorphism −174G/C Interleukin-6 (IL-6) and Schizophrenia in Bataknese Population
Authors: Saragih Munawir , Amin Mustafa Mahmud , Effendy Elmeida
Published: June 2021

BACKGROUND: Schizophrenia is a mental disorder characterized by positive symptoms, negative, and cognitive deficits. Polymorphism of −174G/C interleukin-6 position of the promoter has been described as one of polymorphism that believes have association with schizophrenia and Batak people have a philosophy of life, principles, and at the same time as a structure and system in society called Dalihan na Tolu. This Dalihan na Tolu has a role in the Batak customary marriage laws that cannot be separated during a customary marriage ceremony according to the traditions of the Batak people. This system causes most Batak people to marry each other so that the purity of the population is maintained and can be applied according to Hardy-Weinberg Equilibrium.

AIM: Hence, we looked for association in the polymorphism of −174G/C interleukin-6 between people with schizophrenia of the Bataknese population and healthy controls.

METHODS: We conducted a cross-sectional study that included 75 people with schizophrenia in the Bataknese population and 75 healthy controls with the same ethnic group. The alleles and genotypes polymorphisms were compared between people with schizophrenia in the Bataknese population and healthy controls and were tested statistically using Chi-square.

RESULTS: Frequency of appearance of allele and genotype of −174G/C polymorphism found that there were significant differences in both alleles and genotypes between groups of people with schizophrenia and healthy control groups (p < 0.001) and −174G/C polymorphisms were risk factors for schizophrenia statistically in the Bataknese population (Odds Ratio >1).

CONCLUSIONS: We report an association of −174G/C polymorphism and schizophrenia in Bataknese population and polymorphism of −174G/C may be one of the risk factors for schizophrenia in the Bataknese population.
Un photographe dans la ville. Entretien avec Julien Hazemann
Authors: Choplin Armelle
Published: June 2021

Julien Hazemann est photographe documentaire. À travers son regard d’artiste, il développe une réflexion décalée sur l’urbain, très complémentaire à la démarche scientifique du géographe. De Chongqing à Dehli en passant par Dakar, Julien Hazemann a pour projet de photographier « La fabrication de la ville au xxi e  ». Cet entretien lui donne l’occasion d’expliquer sa démarche qui lui permet d’explorer cette dynamique contemporaine d’urbanisation massive et mondiale.
La fabrique d’une revue non académique : Tous urbains
Authors: Ghorra-Gobin Cynthia
Published: June 2021

Ce texte présente les raisons d’être et la fabrique d’une revue non-académique ayant opté dès sa création en 2013 pour une approche généraliste des idées et enjeux urbains en France et dans le monde. Sa ligne éditoriale dessinée par une équipe de douze chercheurs et professionnels s’inscrit dans un contexte d’urbanisation et de mondialisation. Son objectif est de s’interroger sur la démocratie urbaine et sociale et de contribuer à la réinvention d’un univers capable de « faire monde ». Son originalité est caractérisée par des éditos qui représentent la moitié de chaque numéro et qui mettent en lumière la pluralité des acteurs qui contribuent à la fabrique de la ville.
Quel amont et quel aval pour le roman de Jordane ?
Authors: Puech Jean-Benoît
Published: June 2021

Je dois décrire mes livres organisés en un ensemble intitulé le « cycle Jordane ». Pour ce faire, il faut d’abord présenter le genre dans lequel ils s’inscrivent : la « supposition d’auteur », invention d’un écrivain et de son œuvre. Puis proposer la définition de quatre types de discours, par rapport au « contrat de communication » : l’Histoire, la fiction, la fabulation, le mensonge. Je peux dire alors auquel de ces types de discours le « cycle Jordane » appartient, ou s’il en recoupe plusieurs, et quels sont ses enjeux psychologiques, institutionnels, esthétiques.
Fictions du storytelling
Authors: Wagner Frank
Published: June 2021

Par un juste retour des choses, sont parus au cours de ces dernières années plusieurs romans qui opèrent une fictionnalisation du storytelling, en démontant ainsi les rouages autant qu’en dévoilant les fonctions. Tel est exemplairement le cas de la trilogie des Falsificateurs d’Antoine Bello, comme, à un degré moindre et selon des modalités plus obliques, de La Montagne de Minuit de Jean-Marie Blas de Roblès. À la lumière d’une réflexion sur les notions de récit, de faux, de vrai, d’affabulation, de fiction, de mystification et de supercherie, on se propose donc d’examiner de plus près ces exemples, plus ambigus qu’il n’y paraît de prime abord, dans l’espoir de cerner les jeux et les enjeux de telles mises en intrigue du storytelling , tant à l’intérieur qu’à la périphérie et à l’extérieur de la diégèse des œuvres en cause.
Entre imposture biographique et posture romanesque : l’autofiction chez Chloé Delaume
Authors: Lafontaine Marie-Pier
Published: June 2021

Cet article réfléchit, grâce à une analyse du traitement narratif des traumas biographiques, à la place et à la fonction de l’imposture dans les œuvres d’autofiction de Chloé Delaume. Plus précisément, il s’agit d’interroger le pacte de lecture singulier qu’instaure un projet littéraire où la fictionnalisation de l’auteure – « Je m’appelle Chloé Delaume. Je suis un personnage de fiction » – tient lieu de posture énonciatrice, voire de condition à l’écriture.
Du sexe au texte, l’imposture de genre
Authors: Larrieu Gérald
Published: June 2021

À la lecture de El Beso de la mujer araña ( Le Baiser de la femme araignée ), publié en 1976 par l’auteur argentin Manuel Puig, le lecteur se rend très vite compte que les récits sont biaisés mais par qui ? et comment ? Le dupe est-il celui que l’on croit ? le personnage ? oui, mais lequel ? le narrateur ? inexistant ? l’auteur, qui avance travesti ? pour quoi ? Le lecteur entre dans ce bal des imposteurs en essayant de ne pas se prendre les pieds dans des entrelacs narratifs savamment tramés dont l’enjeu est juste une question de survie.
Nation et Europe : la difficile synthèse de la diplomatie française
Authors: Vimont Pierre
Published: June 2021

L’Europe découvre qu’elle doit affirmer sa souveraineté et donc avoir une diplomatie moins irénique. La France reste méfiante vis-à-vis des initiatives européennes en matière de politique étrangère. Or, il est urgent que Paris démontre sa confiance par des gestes politiques plus européens.
France-Europe : un projet toujours contrarié ?
Authors: Gnesotto Nicole
Published: June 2021

La relation entre la France et l’Europe a été depuis les débuts de la V e  République complexe et ambivalente. La revendication d’une Europe puissance a été perçue comme une remise en cause de l’Otan. La crise de la Covid-19 a obligé les Européens à repenser leur souveraineté dont une approche plus globale est indispensable.
Y a-t-il une « grande stratégie » française ?
Authors: Tertrais Bruno
Published: June 2021

La France a-t-elle encore une « grande stratégie » ? Est-elle encore un acteur reconnu et crédible sur la scène internationale ou n’est-elle plus qu’une puissance largement déclassée, au grand dépit de ses dirigeants ? Autant d’interrogations essentielles aujourd’hui pour mieux affronter les défis de demain.
Les élections allemandes : une longue période turbulente pour la France et l’Europe
Authors: Major Claudia
Published: June 2021

Les élections allemandes de septembre vont longuement figer la politique étrangère de Berlin et ses choix en termes de défense. La mise sur pied vraisemblable d’une coalition va peser sur les projets à conduire alors même que l’Europe a besoin d’un engagement fondé de la part de la première puissance économique de l’Union.
Les enjeux industriels de la défense française : le prisme du nucléaire
Authors: Collet-Billon Laurent
Published: June 2021

Les enjeux industriels contribuent directement à la défense et nécessitent plus que jamais une volonté politique forte conduite par l’État. Cela signifie une vision s’inscrivant dans la durée pour préparer l’avenir. Cela signifie aussi un État stratège et une vraie ambition européenne.
Sahel : la France dans une guerre multiforme
Authors: Ndiaye Ousmane
Published: June 2021

Le Sahel est confronté à une guerre multiforme où s’entrechoquent conflits intercommunautaires et lutte contre le djihadisme. La France est engagée dans cette complexité avec une divergence stratégique croissante entre Paris et ses partenaires sahéliens. Il est nécessaire de revoir la stratégie française dans cette région.
Le réveil du « Béarn » et la préparation des défis de demain
Authors: Martial Pierre-Yves
Published: June 2021

Un deuxième escadron opérationnel mettant en œuvre l’A400M, le « Béarn », va reprendre du service. Cela traduit la montée en puissance de l’appareil dont les capacités opérationnelles ne cessent de se développer. Les équipages d’A400M sont ainsi pleinement engagés en opération, bénéficiant d’un appareil remarquable.
La Cour de justice de l’UE menace de remettre en cause l’organisation des armées européennes
Authors: d’Aboville Benoît , Spitzer Jean-Pierre
Published: June 2021

La directive sur le temps de travail en cours d’examen par la Cour de justice de l’UE est un contresens et une aberration sur le plan militaire. Hors de propos sur le plan opérationnel, un tel texte ne pourrait qu’affaiblir nos armées, mais aussi la légitimité de la Cour dans un champ où elle n’est pas compétente.
La question écologique dans les armées : le contre-exemple historique de Camp Century
Authors: Noël Sébastien
Published: June 2021

Les implantations militaires sont de plus en plus contraintes par les questions environnementales, obligeant à s’adapter à de nouvelles exigences. L’histoire du Camp Century, une installation américaine construite au Groenland, est un exemple malheureux de la non prise en compte de l’environnement.
Le conseil médical au commandement
Authors: Loarer Gwion , Luft Antoine , Angot Emmanuel
Published: June 2021

Le conseil médical au commandement est une activité essentielle, mais méconnue du Service de santé des Armées. Reposant sur une relation de confiance entre médecin et commandement, il s’appuie sur l’expérience, le compagnonnage et une connaissance mutuelle qu’il convient de consolider pour gagner en efficacité.
Comment définir l’autonomie stratégique européenne ?
Authors: Favin Lévêque Jacques
Published: June 2021

L’Union européenne a constaté sa totale dépendance à la mondialisation sur le plan économique et sa très faible autonomie stratégique, l’Otan l’assurant sur le plan de la sécurité. Il est donc urgent et nécessaire de redéfinir ce que signifierait cette autonomie et donc de proposer ainsi un objectif politique.
« Prendre garde ». Les acteurs de la surveillance politique sous le règne d’Henri IV (vers 1598-1610)
Authors: Micallef Fabrice
Published: June 2021

Au lendemain des guerres de Religion, de nombreux opposants à Henri IV choisissent l’exil. Protégés par l’Espagne et la Savoie, ils complotent contre le Bourbon et gardent des complicités en France. Cet article étudie les dispositifs de surveillance mis en place par la monarchie française pour faire face à ce défi sécuritaire. Si le personnel diplomatique est fortement impliqué dans la surveillance des exilés, la mobilité transnationale des comploteurs implique également de mettre à contribution le personnel judiciaire et administratif des provinces frontalières. Les partages d’informations entre différentes ambassades ou entre diplomates et officiers provinciaux donnent à ce système de surveillance une dimension transnationale et polycentrique, même si le gouvernement royal joue un important rôle de redistribution des informations. À un niveau inférieur, un rôle essentiel est joué par une foule d’acteurs de première main de la surveillance : exilés retournés, espions infiltrés, dénonciateurs plus ou moins désintéressés. Les suspects eux-mêmes tentent par diverses manières d’infléchir la surveillance dont ils font l’objet. Ainsi, ce système, marqué par ses incertitudes et ses fragilités, ne donne pas tant à voir le fonctionnement d’un appareil d’État que les interactions permanentes entre des agents d’État et de multiples forces sociales.
« Captations d’héritages » : les enjeux juridiques et judiciaires d’un combat anticlérical (France, 1880-1905)
Authors: Anrich Inès
Published: June 2021

Pendant l’âge d’or de la « République anticléricale » (1880-1905), le clergé français est régulièrement accusé de captation d’héritage, un motif qui n’a pas été étudié par l’historiographie de l’anticléricalisme, pourtant foisonnante. Ce terme désigne les manœuvres déployées par les clercs pour faire main basse sur la fortune de certains catholiques, tout particulièrement les malades et les vieillards. Il constitue le moyen d’une attaque en règle contre la générosité pieuse. Bien qu’utilisées dans la presse pour désigner des procès intentés par des héritiers, à des membres du clergé ayant reçu un don ou legs, de la part de leur parent défunt, les captations d’héritages ne correspondent pas vraiment à une catégorie juridique. Elles n’ont dans le Code civil qu’une acception restreinte, tandis que de nombreuses dispositions dérogatoires encadrent et limitent la générosité pieuse. Trois affaires passées devant les tribunaux civils entre 1880 et 1905 montrent que si les héritiers s’estimant lésés s’efforcent de prouver qu’il y a bien eu captation d’héritage, les juges écartent ce motif. Ils décident d’annuler les donations litigieuses en appliquant le régime d’exception juridique qui encadre les dons et legs au clergé. Cela n’empêche la presse de désigner ces affaires comme des captations d’héritages, en leur appliquant une grille de lecture anticléricale et fictionnalisante. Ce motif imprègne ainsi l’imaginaire social, au point d’influencer le comportement des héritiers qui attaquent en justice certains membres du clergé, et, dans un cas, celui des magistrats chargés de rédiger le jugement, alors pétri par l’imaginaire anticlérical.
« La rigueur des règlements » contre « le levier de la faveur » : la professionnalisation des consuls de France face au clientélisme (1815‑1852)
Authors: Massé Alexandre
Published: June 2021

Au cours du premier xix e  siècle, la professionnalisation des consuls de France se poursuit. Nommés par le roi et rétribués par l’État, ils suivent désormais une véritable carrière caractérisée par des mutations fréquentes, souvent dans des espaces géographiques et culturels hétérogènes. Le ministère des Affaires étrangères exige d’eux des compétences généralistes. Des ordonnances fixent les règles de fonctionnement de la carrière, qui se ferme entre 1833 et 1845, le passage par le statut d’élève vice-consul devenant obligatoire. La professionnalisation ne met pas un terme à la pratique de la faveur. À partir des recommandations contenues dans les dossiers personnels des consuls, cet article étudie aussi les liens entre les consuls et leurs soutiens, l’objectif des recommandations et leur prise en compte par le ministère. Il en ressort que la mobilisation par les consuls de leur capital social est utile pour leur carrière, mais que leurs compétences constituent l’élément déterminant de leur réussite professionnelle, ce qui fait du ministère un espace relativement méritocratique.
Distribution of Kell antigens K, k, Kpa, and Kpb among blood donors in Jeddah city of Western Saudi Arabia
Authors: Felimban Raed I. , Sumeda Samaha M.
Published: June 2021

CONTEXT:

Kell blood group system is considered as the third clinically significant blood group in blood transfusion due to the highly immunogenetic of their antigens. No data are available regarding the frequencies of the Kell blood group antigens in Jeddah city. Knowledge of the antigen and phenotype frequencies is crucial to assess the risk of alloimmunization and to guide the probability of finding antigen-negative donor blood, which can be useful when blood transfusion is required for a patient who has multiple red cell alloantibodies.

AIMS:

The aim of this study was to determine the distribution of Kell blood group: K, k, Kpa, and Kpb antigens and phenotypes among blood donors in Jeddah city, western Saudi Arabia, to improve the transfusion services in the area.

SUBJECTS AND METHODS:

Seven hundred and fifty-eight blood samples from blood donors were used in the study. The samples were collected from different national blood bank centers in Jeddah city hospitals. Kell antigens were typed through gel card method using commercial antisera.

STATISTICAL ANALYSIS USED:

The gathered data were analyzed using the SPSS program. Frequency and crosstab tests were completed to achieve the objectives of the current study.

RESULTS:

The most frequent Kell phenotype in this study was Kp(a−b+), followed by K−k+, K+k+, and then Kp(a+b+), and the less frequent was K+k−. K−k− and Kp(a+b−) phenotypes were not observed in studied donors.

CONCLUSIONS:

This study is the first report to determine the frequency of Kell antigens and phenotypes among blood donors in Jeddah city. These results appear to be useful in providing better care for patients by implementing tests that should become a routine in blood banks. The Kell system is very important in transfusion medicine practice.
Therapeutic plasma exchange an emerging treatment modality
Authors: Solanki Archana , Singh Ashutosh , Chauhan Abhishek , Agarwal Devisha , Himanshu D. , Chandra Tulika
Published: June 2021

BACKGROUND AND AIMS:

Therapeutic plasma exchange (TPE) is increasingly used throughout the medical field. We aimed to analyze the various aspects of TPE practices at our hospital in terms of clinical indications, technical feasibility, safety, outcome as well as complications associated with the procedures.

MATERIALS AND METHODS:

The data included demographic profiles, clinical parameters, and technical characteristics of each TPE procedure. All the information was noted in data spread sheet (Microsoft Excel 2013) for further analysis.

RESULTS:

This is a 3-year retrospective study of total 266 TPE procedures carried out on 92 patients with different clinical conditions. Out of them, 55 (59.8%) were male and 37 (40.2%) were female patients. There were six major categories such as (1) neurological, (2) hematological, (3) gastrological, (4) renal, (5) rheumatic, and (6) others. The TPE treatment was highest in neurology group (60.2%), followed by gastrology group (24.4%). Most of the procedures (82.6%) were according to the American society of apheresis 2016 I or II categories (76/92 patients).

CONCLUSION:

TPE is beneficial and used as primary or secondary adjunctive therapy for a wide spectrum of various diseases and syndromes. TPE is considered as safe, cost-effective, and life-saving treatment modality in various diseases.
Red cell antibodies resulting in false-positive complement-dependent cytotoxicity cross-match
Authors: Sawant Rajesh B. , Sheth Sharad , Mehta Pooja , Naker Deepali
Published: June 2021

A false-positive complement-dependent cytotoxicity cross-match (CDC XM) has a negative impact in donor selection process obliterating healthy, donor compatible population. A 47-year-old male with chronic kidney disease was planned for ABO-compatible renal transplantation from his sister. CDC and donor-specific antibody (DSA) lysate XM were negative 10 days before transplant. The pretransplant CDC XM showed 40% positivity. DSA lysate XM and HLA antibody screen were negative. Patient's Indirect antiglobulin test (IAT) was positive and anti-M antibody (IgG + IgM) was identified. Therapeutic plasma exchange, intravenous immunoglobulin, and rituximab were used for desensitization. Decrease in positivity of CDC XM and anti-M titer was seen. The transplant was performed successfully. Red cell alloantibody should be considered in differential diagnosis of a positive CDC XM. The utility of DSA lysate XM as a pretransplant monitoring tool is immense in such situations. Institutional policies regarding plan of action in the event of positive CDC XM and negative DSA lysate XM and vice versa should be formed.
“Auto-anti-A1” in a healthy young blood donor
Authors: Das Sudipta Sekhar , Biswas Rathindra Nath , Safi Mahammad
Published: June 2021

”Auto-anti-A1” has been sparsely discussed in the literature. Only few workers in the past depicted such antibody in transfused and nontransfused patients. The current case is probably the first example of auto-anti-A1 in a healthy young blood donor who was typed as ABO Group “A1B.” The cold reacting autoantibody in the donor was serologically characterized in details and was found to be nonhemolytic. ABO discrepancy was resolved and the donor was finally typed as “A1B Negative.” Therefore, we concluded that auto-anti-A1 may be a rare cause of ABO discrepancy and its resolution is essential to confirm blood group and subsequent blood transfusion management.
Evaluation of efficacy of Valsalva for attenuating needle puncture pain in first time nonremunerated voluntary plateletpheresis donors
Authors: Srivastava Anubha , Kumar Sanjay , Agarwal Anil , Khetan Dheeraj , Katharia Rahul , Mishra Prabhaker , Khati Shikha , Gautam Sujeet , Sandeep Khuba
Published: June 2021

BACKGROUND:

Plateletpheresis is generally safe but may have adverse reactions. Adverse reactions can negatively influence donor recruitment and retention. Valsalva is a proven method of attenuating pain caused by venipuncture.

AIMS:

The aim was to evaluate the efficacy of the Valsalva maneuver on the attenuation of needle pain and donor anxiety.

SETTINGS AND DESIGN:

This prospective randomized controlled trial was conducted between November 2015 and April 2016 at the Department of Transfusion Medicine.

SUBJECTS AND METHODS:

One-hundred and sixty consecutive donors were grouped into control group (C) and Valsalva group (V) each of sample size 80. The Valsalva group performed a Valsalva maneuver and control did nothing before the venipuncture. Anxiety and pain were scored using a 10 cm visual analog scale (VAS). Severity was graded as VAS = 0 defines no pain and anxiety, VAS = 1–3 as mild pain and anxiety, VAS = 4–6 as moderate pain and anxiety, VAS = 7–9 as severe pain and anxiety, whereas VAS = 10 denotes extreme pain and anxiety.

STATISTICAL ANALYSIS:

Statistical Package for Social Sciences, version 23 was used for analysis. Independent samples t-test/Mann–Whitney U-test was used to compare between treatment and control group, whereas the Wilcoxon signed-rank test was used to test the difference between pre- and postobservations.

RESULTS:

In the Valsalva group, post-Valsalva anxiety levels were significantly reduced to (1 [0–2]) from their pre-Valsalva values of (2 [0–3]); (P < 0.001). Pain was significantly lower (2[1-2]) in Valsalva group compared to control (4[2–5]); (P < 0.001).

CONCLUSIONS:

Valsalva reduced both severity of venipuncture pain and anxiety. Valsalva can be performed by donors as it is an easy, painless, and nonpharmacological method of pain and anxiety attenuation.
A comparative study of knowledge, attitude, and practices about organ donation among blood donors and nonblood donors
Authors: Basavarajegowda Abhishekh , Arjunan Charumathy , Nalini Y. C. , Parameshwaran Sreejith , Kannan Sujitha
Published: June 2021

INTRODUCTION:

Shortage of organs by donation is a national problem which needs a multipronged approach for its strengthening. Educating the people and increasing the awareness of the need for donation would be of the foremost priority. Identifying the target population who are more likely to respond would be very important to reap the maximum results. There is speculation that blood donors would be more amenable and likely to accept the idea and thought of organ donation. This study is being designed to study the same.

METHODOLOGY:

This was a cross-sectional comparative questionnaire-based study among two groups: blood donors and nonblood donors. Donors were defined as aged above 18 years and have made at least one whole blood/apheresis donation. Nondonors were the ones who were aged above 18 years and have not donated whole blood/apheresis blood products in the past. All the responses were entered in the Microsoft Excel sheets, and statistical analysis was carried out using Statistical Package for Social Sciences.

RESULTS:

A total of 829 participated in the study. Among the 829 participants, 416 were donors, and 413 were nondonors. There was no difference in knowledge regarding organ donation among the groups except for perceived risks of organ donation among nondonors. Concerning attitudes, they were more favorable among blood donors, and it was statistically significant at a P < 0.05.

CONCLUSION:

There was no difference with respect to knowledge between donors and nondonors. However, donors had a more favorable attitude toward organ donation. Factors like concerns about misuse of donated organs, lack of clarity on their religion's policy toward organ donation, and potential for harm for the organ donor seem to account for the unfavorable attitude of nondonors toward organ donation.
Evaluation of Retinal Microvascular Changes in Patients with Prediabetes
Authors: Lİ Rudvan AL , Can ME , Efe FK , Keskin M , Beyan E
Published: June 2021

Aim:

Diabetic retinopathy is a chronic progressive complication with neuronal cell and retinal microvascular involvement and is closely associated with blood sugar and blood pressure levels. Studies have shown that retinal neural dysfunction takes place before the microvascular changes in patients with Type 2 diabetes mellitus. The aim of this study is to compare the retinal microvascular changes of patients who are at the prediabetes stage and healthy volunteers.

Method:

Our study included 41 patients with prediabetes who were referred to the internal medicine outpatient clinic and 47 healthy volunteers. All patients underwent ophthalmologic examinations, including best visual acuity, intraocular pressure measurement, slit-lamp examination, and dilated fundus examination. Refractive error measurements were performed with the same automatic refractor-keratometer device. Typically, 3 × 3 mm macular images centered on foveola were obtained by using XR Avanti Optical Coherence Tomography Angiography with AngioVue (RTVue XR AVANTI, Optovue, Fremont, CA, USA) device. In the statistical analysis of the measurements, it was examined by Kolmogorov Smirnov test. Conditions expressed as IFG or IGT are considered as prediabetes; IFG is defined as fasting blood sugar to be between 100 and 125 mg/dL, while IGT is the condition in which the second hour value of the oral glucose tolerance test is 140–199 mg/dL.

Results:

There was no statistically significant difference between the control and pre-DM groups in terms of mean age. The distribution of males and females between groups was statistically similar (P = 0.087). In the pre-DM group, 24 (58.6%) patients had IFG, 16 (39.0%) had IFG + IGT, and 1 (2.4%) had IGT. There were no statistically significant differences between the groups for the nonflow area (NFA) and the foveal avascular zone (FAZ) area (P > 0.05). The mean values of superficial and deep capillary plexus (DCP) density were not statistically significant differences between the groups. No statistically significant difference was found between the control group and pre-DM group in terms of the mean measurements of clinical ocular findings (P > 0.05). Retinal thicknesses were also not statistically significant differences between the groups (P > 0.05).

Conclusion:

All of the retinal measurements of both patients with prediabetes and healthy volunteers are similar. We did not find any difference between prediabetes and control groups. The ophthalmologic examinations which contain best-visual acuity, intraocular pressure measurement, slit-lamp examination, and dilated fundus examination are similar.
Macula Hole as a Sequelae of Presumed Ocular Toxoplasmosis, an Incidental Finding in a Female Nigerian
Authors: Babalola YO
Published: June 2021

A 39-year-old Nigerian woman presented to the eye clinic for a new pair of spectacles on account of a two-week history of headaches and bilateral eye ache. She was a known spectacle wearer for the past nine years. The presenting visual acuity was 6/6 and 6/36, respectively, in the right and left eye. Anterior segment examination was essentially normal bilaterally. Posterior segment examination with binocular indirect ophthalmoscopy of the right eye revealed a punched out hyperpigmented, chorioretinal scar in the periphery at 6 o'clock and in the left eye, a large macula hole adjacent to a hyperpigmented chorioretinal scar along the inferotemporal arcade was present. Active inflammation was absent in both eyes. Optical coherence tomography confirmed a left, grade-4 full-thickness macula hole.
Synchronous Thyroid Cancer on the Edge
Authors: Ayan A , Basaran Y , Kirnap NG , Çınar A
Published: June 2021

Aims:

The objective of this study was to discuss the outcomes of the oncology patients whose PET/CT scans show incidental focal thyroid 18F-FDG uptake.

Methods:

This retrospective analysis examined 2575 18F-FDG PET/CT scans from 1803 patients with no known thyroid cancer history. The survival rates were analyzed for patients with and without cytopathological evaluation.

Results:

Increased metabolic activity of the thyroid was detected in 96 patients. Of those, 72 were diagnosed with a focal uptake of 18F-FDG and 24 subjects had a diffuse uptake. All 72 patients with a focal uptake were referred for ultrasound (US) and fine-needle aspiration cytology (FNAC). Of those patients, 44 were admitted for US and 16 underwent FNAC. The mean SUVmax was 16.0 ± 7.97 for patients with malignant lesions and 3.24 ± 0.88 for patients with benign lesions (p = 0.023). The mortality rate was higher in the patients who were not evaluated with FNAC.

Conclusion:

Patients with incidental focally increased thyroid 18F-FDG accumulation on PET/CT are known to have a high risk of malignancy. These patients require additional diagnostic procedures to distinguish the underlying pathology. However, the clinical condition of these patients will be the primary concern when performing these procedures.
Effect of Prosthetic Framework Material, Cantilever Length and Opposing Arch on Peri-Implant Strain in an All-on-Four Implant Prostheses
Authors: Shetty R , Singh I , Sumayli HA , Jafer MA , Abdul Feroz SM , Bhandi S , Raj AT , Patil S , Ferrari M
Published: June 2021

Aim:

To evaluate the effect of prosthetic framework material and cantilever length on peri-implant strain in mandibular all-on-four implant-supported prostheses with different types of arch antagonist forces.

Materials and Methods:

Models simulating a completely edentulous mandibular arch fabricated in heat-cured acrylic resin were used. On the acrylic models, four implants were placed at regions 34, 32, 42, and 44 simulating all-on-four implant placements. Implant-supported screw-retained fixed prosthesis frameworks were fabricated using three different materials (cobalt-chromium, zirconia, and polyetheretherketone) and with three different cantilever lengths (zero mm, 15 mm, and 25 mm). Strain gauges were attached on the model at the buccal and lingual positions of each implant. Forces simulating opposing natural dentition, conventional complete denture, and the parafunctional habit were applied to the models. The peri-implant strain in each strain gauge was recorded.

Results:

Least peri-implant strains (67 microstrains) were observed when forces simulating conventional complete dentures were applied on the models and the highest peri-implant strains (9091 microstrains) were observed when forces simulating parafunctional habit were applied. One-way ANOVA test followed by Tukey's post hoc analysis was performed to compare the mean deformation scores between different materials at 50 N load. The level of significance [P-value] was set at P < 0.05. Tests showed significant differences between zero mm and the other types in all the different materials, and also between 1.5 x AP and 2.5 x AP for Zirconia and Peek material at P = 0.02 & P = .008, respectively. The results showed that the type of framework material, cantilever length, and occlusal forces from the opposing arch influence the peri-implant strain in the bone in all-on-four implant-supported prostheses.

Conclusion:

Rehabilitation of a single, completely edentulous arch with implant-supported prostheses should consider the situation of the opposing arch. The choice of framework material, as well as the cantilever length, should be altered based on the forces from the opposing arch.
What is the Impact of Thyroidectomy on Autoimmune Features Associated with Hashimoto's Thyroiditis?—Institutional Experience
Authors: Panchangam RB , Kota SK , Mayilvaganan S , Kuravi BG
Published: June 2021

Background:

Hashimoto's thyroiditis (HT) is one of the commonest endocrine disorders, globally. Often, HT presents a protean range of associated autoimmune features (AAI) such as vitiligo, rheumatoid arthritis, pernicious anemia, skin allergy/atopy, thrombocytopenia, Addison's disease, type 1 diabetes, celiac disease, eosinophilia, etc., The usual treatment of HT is symptomatic with no curative option. In this context, we report our experience on the impact of surgical thyroidectomy on remission of AAI in HT.

Aims:

To report our experience on the impact of surgical thyroidectomy on remission of AAI in patients with HT.

Material and Methods:

This is a retrospective study conducted in the Endocrine Surgery department of a tertiary care hospital. A total of 61 patients with HT and various AAI combinations were included in this study. All the clinicoinvestigative and operative data were systematically analyzed. The most frequent indication for surgery was nodular goiter followed by associated malignancy, persistent goiter, and painful thyroiditis. Others were cosmetic/pressure symptoms and not AAI per se. The mean follow-up after surgery was 55.6 ± 11.8 months.

Results:

The gender ratio was 5.8:1 in favor of women and the mean age was 41.5 ± 5.4 years. The mean preoperative and postoperative serum anti-thyroperoxidase antibody (Anti-TPO Ab) levels were 339 ± 98.2 and 58.75 ± 25 IU/L at the last follow-up visit. A total of 60% AAI manifestations had resolution or significant alleviation. The major improvements in AAI were skin allergy, eosinophilia, rheumatoid arthritis, vitiligo, thrombocytopenia, celiac disease symptomatic episodes; but, type 1 diabetes and Addison's disease showed static response.

Conclusions:

Surgical total thyroidectomy and anti-TPO Ab-related autoimmunity appear to play a beneficial role and definitive role in the remission of AAI in HT.
Serum Total Adiponectin in Healthy Pre-Pubertal Nigerian School Children
Authors: Nri-Ezedi CA , Ulasi T , Chukwuka J , Okpara H , Ofiaeli O , Nwaneli E , Ulasi A
Published: June 2021

Background:

Adiponectin is an excellent insulin sensitizer. It also possesses anti-inflammatory and anti-atherogenic properties that play a crucial role in the pathogenesis of cardio-metabolic disorders. Evaluating adiponectin distribution in children and factors that modulate its blood level is critical for advancing knowledge in its future role in managing associated non-communicable diseases.

Aim:

To investigate the adiponectin profile in apparently healthy pre-pubertal Nigerian school children.

Methods:

This is a cross-sectional study comprising 125 randomly recruited pupils from eight primary schools in Nnewi located in Anambra State, Nigeria. Anthropometric values were taken and venous blood samples assayed for adiponectin using Enzyme-linked immunosorbent assay (ELISA) kits. Analysis of data was done with SPSS software version 22 and R programming software. The level of significance set at P < 0.05.

Results:

We enrolled a total number of 125 children, which comprised of 68 (54.4%) males and 57 (45.6%) females with a male to female ratio of 1.2:1. The mean age of all the subjects was 7.7 ± 2.0 years. The mean serum adiponectin level of all the participants was 4.67 ± 2.2 ng/mL with a range of 1.9 ng/mL to 10.0 ng/mL. Adiponectin was slightly higher in females than males (4.93 ± 2.4 ng/mL vs 4.45 ± 2.0 ng/mL, respectively; P = 0.223). In males, an inverse relationship was observed between adiponectin and increasing age, whereas in females, a positive correlation was noted (P = 0.637 vs P = 0.639, respectively). The body mass index (BMI) correlated negatively with adiponectin in all the subjects and across both the genders, but these were not statistically significant.

Conclusion:

Adiponectin varies with sex, age and BMI in pre-pubertal Nigerian children with normal BMI. Further local studies are needed to elucidate its role in the management of associated disease states.
The Effects of Blood Glucose Regulation and Treatment Regime on Mean Platelet Volume in Type 2 Diabetic Patients
Authors: Alay M , Atmaca M , Ucler R , Aslan M , Seven İ , Dirik Y , Sönmez MG
Published: June 2021

Background:

Mean platelet volume (MPV) is associated with cardiovascular morbidity and mortality in type 2 diabetic patients. However, the effects of blood glucose regulation and treatment regime on MPV has not been adequately studied in type 2 diabetic patients. Aims: We studied the effects of blood glucose regulation and treatment regimen on mean platelet volume in Type 2 diabetic patients.

Subjects and Methods:

A total of 232 diabetic patients who were admitted to the hospital in short intervals of 3 months in the last 2 years were included in the study. When the second admission HbA1c was greater than the first admission HbA1c, they were classified as being in the deteriorated blood glucose regulation group, otherwise they were classified in the improved blood glucose regulation group. Also, the deteriorated and improved blood glucose regulation groups were classified based on therapy modalities as the sulfonylurea + metformin group and the insulin + metformin group. Paired t-test was used for comparison of the groups.

Results:

Of the 232 patients, 98 (42.2%) were male and 134 (57.8%) were female. There were 126 (55.2%) patients using sulfonylurea + metformin, while 106 (44.8%) patients were using insulin + metformin. MPV levels were significantly increased in patients with deteriorating glucose regulation (p = 0.003). This increase in MPV was only seen in the oral hypoglycemic treatment group (p = 0.003).

Conclusions:

Our results suggested a close relationship between poor glycemic control and increased platelet activity in type 2 diabetic patients with oral antidiabetic therapy when compared to the insulin and metformin therapy modality.