bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of C-Reactive Protein in COVID-19 Pneumonia as “A Jack of all Trades is a Master of None!”
Authors: Patil Shital , Khule Shubhangi , Patil Deepak , Toshniwal Sham
Published: February 2023

Introduction:

Robust data of C-reactive protein (CRP) are available in bacterial infection, and it can be utilized in this coronavirus disease 2019 (COVID-19) pneumonia pandemic for initial assessment and planning of treatment in indoor setting in association with high-resolution computed tomography (HRCT) severity.

Methods:

A prospective, observational, 12-week follow-up study included 2000 COVID-19 cases confirmed with reverse transcription–polymerase chain reaction (RT-PCR). All cases were assessed with lung involvement documented and categorized on HRCT thorax, oxygen saturation, CRP at entry point, and follow-up. Protocolised recordings of age, gender, comorbidity, and bilevel-positive airway pressure (BIPAP)/non-invasive ventilation (NIV) use were done. Final radiological outcome as with or without lung fibrosis as per follow-up computed tomography in accordance to entry point severity were analysed. Clinical and final outcomes were recorded as per requirement of interventions in indoor units. Statistical analysis was done by Chi-square test.

Results:

HRCT severity score at entry point has a significant correlation with CRP titer (P < 0.00001). CRP titer has a significant association with duration of illness (P < 0.00001). Comorbidities have a significant association with CRP titer (P < 0.00001). CRP titer has a significant association with oxygen saturation (P < 0.00001). BIPAP/NIV requirement during hospitalization has a significant association with CRP titer (P < 0.00001). Timing of BIPAP/NIV requirement has a significant association with CRP titer (P < 0.00001). Follow-up CRP titer during hospitalization as compared to entry point (initial) normal and abnormal CRP has a significant association in post-COVID lung fibrosis (P < 0.00001).

Conclusions:

CRP has documented a very crucial role in COVID-19 pneumonia in predicting severity of illness at entry point and progression of illness during course of hospitalization. Role of CRP as “a jack of all trades is a master of none” in COVID-19 pneumonia is a real misnomer due to its major impact on guiding step-up and step-down interventions in critical care units. CRP is considered a 'game changer' inflammatory molecule during the entire course of COVID-19 assessment. Role of CRP as an inflammatory marker “oftentimes better than a master of one” in comparison to other available markers interleukin-6, ferritin, and lactate dehydrogenase due to easy availability and cost-effectiveness.
Newborn care in Northern India: A study of regional and seasonal peculiarities for desired professionalism and definitive practices
Authors: Jain Sunil , Samrina Jaskar , Samanta Indranil
Published: February 2023

ABSTRACT

Introduction:

Improvements in newborn health with study of present status, progressive perfection of practices, and data diligence for future is desirable.

Methods:

Study of mortality and morbidity patterns. Analyze findings for focus areas and for favourable advancements in practices. Corroborate with existing evidence and practice protocols.

Setting:

Tertiary care referral hospital.

Protocols:

Preterm babies given special attention. This includes, in addition to the WHO 10 main recommendations, meticulous monitoring and health education for care. Neonatal jaundice evaluation on the basis of risk factors and clinical monitoring.

Results:

A total of 1749 live, born babies (2018–2020) were studied. The neonatal mortality rate in the study was 6.29. Preterm births were 102 (5.83%), with mortality of 7.84%, that is, 8 out of 102 preterm babies, and overall 4.57 premature deaths per 1000 live births. Prematurity was the commonest cause of mortality, responsible for 8 out of 11 deaths (72.73%). Birth asphyxia incidence was 5.26% (92 babies) with a case fatality ratio of 4.35%. Newborns with severe birth asphyxia were 7, and of these 4 (all premature) had fatal outcome. The low birthweight (LBW) incidence was 13.32% with the majority (79.83%) in the 2000–2499 g range. Preventive practices for hypothermia were 100% successful. An unusual rise in incidence and severity of hyperbilirubinemia during December 2018 to February 2019 when winter was severe was noted.

Conclusion:

Mortality reduction requires focusing on prematurity. Meticulous monitoring and health education for them improves results. The unusual rise in incidence and severity of hyperbilirubinemia in severe winter points towards the need for vigilance. We need to be forewarned and forearmed for frequent extreme weather events.
Prevalence of disrespect and abuse during childbirth and its related factors in women hospitalized in the postpartum ward
Authors: Hosseini Tabar Jila , Shahoie Roonak , Zaheri Farzaneh , Mansori Kamyar , Hashemi Nasab Leila
Published: February 2023

ABSTRACT

Background:

Disrespect and abuse during health care is an emerging concept without a common and agreed definition that has not been sufficiently studied in Iran. Therefore, this study was conducted to determine the prevalence of disrespect and abuse during childbirth and its related factors in women hospitalized in the postpartum ward.

Materials and Methods:

This descriptive cross-sectional study was performed on postpartum women admitted to Ghods Hospital, Paveh, who met the inclusion criteria from April to September 2021. Data collection tools included a demographic and obstetric characteristic questionnaire and a checklist of disrespect and abuse during childbirth, which were completed immediately before discharge by 276 participants who were selected by available sampling. The delivery provider also completed the demographic characteristic questionnaire. Data were analyzed using SPSS software version 21 and univariate and multivariate linear regression tests. P <0.05 was considered significant.

Results:

The results showed that all participants had experienced at least one type of abusive care, and the most common forms were non-consented care (100%) and neglect/abandonment (92.4%). Among the studied variables, only drug interventions during childbirth had a role in predicting disrespect and abuse during childbirth (P < 0.03).

Conclusion:

Due to the high level of disrespect and abuse during childbirth, it seems necessary to educate staff about respectful maternity care and increase supervision of respect for maternal rights, and plan to reduce midwifery interventions.
New acute onset of ocular myasthenia gravis after COVID-19 vaccine: A case report
Authors: Chaturvedi Himani T. , Patel Varsha , Vasava Rahul , Chaturvedi Chandrashekher
Published: February 2023

ABSTRACT

Reports have shown the association of coronavirus disease 2019 (COVID-19) with several neuromuscular disorders. Myasthenia gravis (MG) is an autoimmune disease in which antibodies bind to acetyl choline receptors in the postsynaptic membrane at the neuromuscular junction. The characteristic clinical feature of the disease is weakness of the ocular muscle, bulbar muscle, and extremity muscles; when the weakness is limited to the ocular muscle only, the condition is known as ocular myasthenia gravis. Diagnosis is usually confirmed by the acetylcholine receptor antibodies. Symptoms of MG may be aggravated by various types of infections and medications. Here, we are presenting a rare case of a new and acute onset of ocular MG presented after administration of Covishield vaccine.
Polycythemia vera in patients of beta-thalassemia trait and stress erythropoiesis
Authors: Khan Afaq A. , Rathod Santosh G. , Geelani Sajad A. , Roshan Reshma , Bhatt Javid R.
Published: February 2023

ABSTRACT

A 70-year-old male with a known case of beta-thalassemia trait and was on yearly follow-up was found to have a hemoglobin of 14.8 g/dL, hematocrit of 47.7%, and RBC count of 6.0 × 1012/L. Total leukocyte count (TLC) was 5 × 109/L and platelet count was 4 × 109/L. Secondary causes of polycythemia were ruled out (e.g., renal or cardiac disease and smoking). He did not have symptoms of hyperviscosity syndrome. The abdominal ultrasound showed no abnormalities. On further investigation, a JAK-2 (Exon 14) mutation was detected in this patient confirming the diagnosis of polycythemia vera (PV).
Predicting and grading liver injury in the absence of computed tomographic imaging
Authors: Newton Mario Victor , Subramanyam S. G.
Published: February 2023

ABSTRACT

Background:

Even developed countries lack computed tomography (CT) scan in rural areas. Availability, affordability and accessibility of CT scan play an important role in the management of blunt hepatic trauma.

Materials and Methods:

A descriptive observational study among 56 hepatic blunt trauma patients as Group 1 and 56 non-hepatic blunt trauma patients as Group 2 enrolled retrospectively. Observational analysis of presence of liver trauma, grades of liver injury (I–VI) and clinical course with the liver function tests are done.

Results:

Aspartate transaminase (AST) (P = 0.02) and alanine transaminase (ALT) (P = 0.003) levels were significantly elevated among Group 1. Significantly elevated levels in Group 1 than Group 2 of AST [467.5 (22–5097) vs. 95 (23–1780); P < 0.001] and of ALT [422 (28–1548) vs. 69 (20–727); P < 0.001] noted. Significant elevation of AST and ALT levels, as the AAST (American Association for the Surgery of Trauma) CT grade of liver injury increases, noted (P = 0.001). Using the ROC curve analysis, the optimal cut-off values of AST and ALT were set at ≥467.5 U/L and ≥111.5 U/L, respectively. At this cut-off, AST had sensitivity 50%, specificity 91.7%, PPV 85%, NPV 66%, ALT had sensitivity 85.3%, specificity 86.1%, PPV 85.3% and NPV 86.1% for liver injury.

Conclusion:

ALT is more sensitive for liver injury. AST peak is seen in the immediate period. Combining clinical assessment, transaminase levels and Focused Assessment with Sonography in Trauma improves the sensitivity and specificity. Transaminase levels can vary with ethnicity and local epidemiological diseases; therefore, optimal cut-off levels should be established for local population. This would predict and grade the liver injury, helping in early decision-making and avoid wasting the golden hour in trauma.
Early integration of palliative care in cervical cancer: Experiences from a pilot study
Authors: Dey Treshita , Mukerjee Anindya , Rai Bhavana , Arora Minni , Kumar Divyesh , Srinivasa GY , Ghoshal Sushmita
Published: February 2023

ABSTRACT

Introduction:

Palliative care (PC) has been classically synonymous with end-of-life care offered to patients with advanced incurable cancers with an aim to improve their quality-of-life (QoL). However, there is growing evidence to suggest that early integration of PC (EIPC) along with cancer-directed management improves patient-reported outcomes. In this study, we aim to evaluate the impact of EIPC on QoL of cervical cancer patients treated with curative intent.

Material and Methods:

Patients with locally advanced cervical cancer (stage IB2 to IIIB) having eastern cooperative oncology group (ECOG) performance score 0–2 were randomized into EIPC arm and standard of care arm of concurrent chemoradiation by a computer-generated table of random numbers. QoL was assessed by functional assessment of cancer therapy – general (FACT-G) questionnaire twice in both arms. The first assessment was done prior to starting treatment and second assessment at three months after treatment completion. The mean scores on physical, mental, emotional, social, and functional well-being subscales of FACT-G scale were calculated in both arms, and Wilcoxon test was used to evaluate differences in QoL scores within and in between the arms. This trial was registered with Clinical Trials Registry of India (CTRI) vide CTRI/2017/05/008704.

Results:

Fifty patients were enrolled in each arm. However, only 42 and 45 patients in EPIC and standard oncological care arm were evaluated in the final analysis. Comparing QoL scores between the two time points in each arm, the mean pre-treatment scores in EIPC arm was significantly higher than post-treatment scores in the domains of physical and emotional well-being, whereas social and functional well-being scores improved significantly after treatment as compared with that as baseline. However, when compared between two arms, the difference of mean scores pre- and post-treatment were almost similar for physical and functional well-being but statistically significant differences were found only in social and emotional well-being scales.

Conclusions:

Our study is a feasibility study done in an attempt to test the validity of EIPC in cervical cancers. The results are inspiring to conduct robust studies in the future to explore this new domain of integration of palliative services in curable cancers.
Implications of lifestyle medicine in medical practice
Authors: John Nitin A. , John Jyoti , Tarnikanti Madhuri , Kalpana Medala , Kamble Praful , Singhal Anish , Ganji Vidya , Gaur Archana , Umesh Madhusudhan , Katta Roja , Saktivadivel Varatharajan , Daulatabad Vandana S. , Singaravelu Vidya , Vamishidhar Immadi S.
Published: February 2023

ABSTRACT

Globally, we are seeing a rise in non-communicable diseases such as obesity, hypertension, diabetes, metabolic syndrome, chronic respiratory diseases, cancer, etc., due to stressful lifestyle in this competitive world. Most of the non-communicable diseases are associated with lifestyle behavior. Presently, the role of lifestyle medicine is very critical and important in the management of chronic lifestyle-associated disorders. Considering the above facts, we decided to review the literature to gain a deeper insight into the implications of lifestyle medicine in medical practice. A literature search was conducted on PubMed, Scopus and Google Scholar databases. We observed that lifestyle medicine intervention is a growing and newer discipline and is being employed along with conventional management of non-communicable diseases by medical practitioners today, as they are strongly associated with lifestyle behaviors and practices. Motivation for change in lifestyle is challenging because it depends on the patient’s determination and eagerness to adapt and accommodate to the newer lifestyle pattern. The medical practitioners should spend time in coaching patients on lifestyle-related health education. Guidance and coaching by medical practitioners will help patients adapt to practices of maintaining regular physical activity, a balanced diet, good sleep hygiene, and avoid addictions of tobacco and alcohol as part of life. Introducing real and progressive evidence-based behavioral changes to reduce the risks of lifestyle-related acute and chronic diseases in medical practice will reduce the burden of non-communicable disease.
Prevalence and predictors of use of cupping among patients attending a primary care center in Riyadh, Saudi Arabia
Authors: Al-Qahtani Saleh Ghufun , Alsulami Bandar A.
Published: February 2023

ABSTRACT

Background:

Cupping is a cultural/religious treatment modality in Saudi Arabia that has been recently regulated by the Ministry of Health. The objective was to determine the prevalence of cupping use, its predictors, and related beliefs among patients attending a primary care center.

Methods:

Observational cross-sectional study was conducted between January and July 2019 among patients attending Alwazarat healthcare center in Riyadh, Saudi Arabia. The data were collected using a self-completed questionnaire.

Results:

A total of 386 patients were included. Approximately 68.3% of the patients were females, and 41.8% were aged between 26 and 35 years. About 34.2% of the patients had cupping therapy before. Cupping use was higher in older age (P < 0.001), males (P = 0.002), and specific occupations (P < 0.001). The most frequent health problems treated were headache (40.5%), lethargy (13.0%), diabetes (10.7%), and hypertension (9.9%). Most (82.4%) of patients believed that the cupping they used was beneficial. Approximately 27.9% of the patients had cupping done in non-specialized centers, and 50% were not sure about infection control practices. Cupping was associated with the following encouraging factors; religious beliefs (79.8%), previous experience with relatives and friends (74.0%), culture and habits (57.8%), information in social media, and multimedia (52.9%). In multivariate logistic regression analysis, only age >35 years and previous experience of relatives and friends were independent predictors of cupping use.

Conclusions:

Cupping is a popular therapeutic modality among patients seeking primary care services in Riyadh, Saudi Arabia. Authorities are required to continue reviewing the standards of cupping clinics to ensure their license and patient safety.
Cardiovascular reactivity to stress in long-term yoga practitioners
Authors: Banerjee Arijita , Kumar Sumit
Published: February 2023

ABSTRACT

Background:

Bhramari Pranayama yogic breathing is a very simple exercise of voluntary breathing which mitigates stress reactivity through autonomic modulation of heart rate.

Aim:

To study the effects of long-term practice of the yoga breathing exercise on cardiovascular reactivity to head-up tilt (HUT) test.

Methods:

All the participants were subjected to a 10-item yoga questionnaire. Based on Likert scale scoring, 32 subjects (group I) were selected as long-term yogic breathing practitioners, and autonomic function tests using heart rate variability (HRV) and a provocative stress test and HUT test were conducted. Cardiovascular parameters obtained were compared with controls who had never been engaged in any form of yoga (group II).

Results:

A highly significant decrease in values of both high (HF) and low frequency (LF) variables was observed in group II as compared to group I. However, a highly significant rise in LF/HF has been observed in group I compared to group I (P = 0.004), further indicating a greater withdrawal of vagal tone during the HUT test and also during recovery (P = 0.001).

Discussion:

The results and discussion of HRV analysis during provocative tests concluded that autonomic imbalance was present in the subjects who were not exposed to any form of yoga. Thus, it is advisable to practice yoga in any form regularly to mitigate the early onset of autonomic dysfunction.
Psychometric validation of the hindi version of summary of diabetes self-care activities (H-SDSCA) amongst pregnant women with gestational diabetes mellitus, in Lucknow
Authors: Mallicka  , Singh Shivendra K. , Pandey Amita , Manar Manish K. , Srivastava Shalini
Published: February 2023

ABSTRACT

Objective:

The English version of the Summary of Diabetes Self-Care Activities (SDSCA) measure is the most often used self-reporting instrument assessing diabetes self-management. This study was aimed at translating English SDSCA into the Hindi version and validating and evaluating its psychometric properties.

Methods:

The Hindi version of SDSCA was developed based on the guidelines provided by the World Health Organization (2008) for translation and adaptation of tool. Following steps were adopted: (1) Cultural and linguistic validation, (2) content validity testing, (3) construct validity testing, and (4) internal validity testing. Sixty women diagnosed with GDM were selected for the purpose of this study.

Results:

The tool showed promising and satisfactory results. Of mention are the results related to Cronbach’s alpha (0.82). The exploratory factor analysis showed three factors that fit the data satisfactorily.

Conclusions:

This study provided evidence for the reliability and validity of the Hindi Summary of Diabetes Self-Care Activities instrument, which may be used in the future to assess diabetes self-management activities among the pregnant women diagnosed with gestational diabetes mellitus among Hindi-speaking population.
Risk factors for relapse in pediatric nephrotic syndrome in Ranchi
Authors: Mishra Rajeeva , Kumari Shiromani , Pathak Apeksha , Prasad Kamal Narayan , Malakar Jagrita
Published: February 2023

ABSTRACT

Introduction:

The nephrotic syndrome (NS) is a common childhood illness characterized by massive proteinuria, hyperlipidemia, and hypoalbuminemia. It is a disease of relapse, and therefore, it is a major problem to manage cases with frequent relapses. Prediction and prevention of risk factors is the key to successful management of childhood NS. An understanding of the risk factors that determine the course is useful in taking decisions regarding therapy and enables counseling.

Materials and Methods:

Sample size of 100 children of age 1-12 years of age with steroid sensitive nephrotic syndrome over duration of 1 year from April 2020 to May 2021.

Results and Conclusion:

Risk factors for relapse were presence of infection during initial attack and first relapse as well as less time interval between remission in first episode of nephrotic syndrome and first relapse.incresed risk was also associated with inadequate treatment duration and less serum albumin level and high cholesterol level.
Performance of Aerosol Boxes for Endotracheal Intubation during the COVID-19 Pandemic with Systematic Review
Authors: Christopher R. Ajay , Lohanathan Aparna , Hazra Darpanarayan , Pal Rathijit , Vegiraju Vaishnavi , Abhilash Kundavaram Paul Prabhakar
Published: February 2023

Introduction:

In the backdrop of the COVID-19 pandemic, endotracheal intubation using an aerosol box (AB) became the norm in the emergency department (ED) and the intensive care unit. We compared two models of AB with different dimensions to compare and identify a device that helps in reducing viral exposure without compromising successful airway management.

Methods:

We conducted this prospective observational study for 7 months (October 20-April 21) on 143 patients presenting with an acute airway compromise to the ED. All intubations were performed using one of the two models available. The primary outcome was time taken for intubation (TTI).

Results:

The overall median time taken to intubate using any AB was 63 (interquartile range [IQR]: 46.2-87.7) s with an 81.9% first-pass success (FPS) rate. TTI for AB I was 67 (IQR: 53-106) s with a 76.3% FPS rate, while TTI for AB II was 57 (IQR: 44-75) s with an 85.9% FPS rate. TTI was much shorter without the use of an AB (34: IQR: 24-53 s) with a 92% FPS rate. Intubations done by emergency physicians with more than 2 years of experience were faster in both with or without AB when compared to intubations done by physicians with <2 years of experience.

Conclusion:

The use of an AB is associated with a longer TTI when compared to intubations done without an AB. TTI was relatively shorter when more experienced emergency physicians performed intubation. FPS rates were low with intubations done using AB.
О связи линейной и разностной характеристик отображений двоичных векторных пространств с характеристиками рассеивания по блокам систем импримитивности группы сдвигов двоичного векторного пространства
Authors: Burov Dmitry Alexandrovich
Published: February 2023

Работа посвящена изучению связи параметров отображений $f\colon V_{n} \to V_{m} $ двоичных векторных пространств $V_{n} =\mathrm{GF}(2)^n $, ${V_{m} =\mathrm{GF}(2)^{m} }$, характеризующих нелинейность, свойств по рассеиванию систем импримитивности группы сдвигов $V_{n}^{+} $ векторного пространства $V_{n} $, а также при $m=n$ и $f\in S(V_{n} )$ свойств транзитивности и примитивности групп $\langle W^{+} ,f\rangle $, где $W^{+} $ - группа сдвигов подпространства $W<V_{n} $. Показано, что в ряде методов криптоанализа алгоритмов блочного шифрования фактически используется недостаточное рассеивание блоков системы импримитивности группы $V_{n}^{+} $.
О множествах критерия распространения для строго мажоритарных булевых функций
Authors: Isaev Gleb Andreevich
Published: February 2023

Исследуется критерий распространения для строго мажоритарных симметрических булевых функций. С помощью аппарата полиномов Кравчука доказано, что критерию распространения для строго мажоритарных функций от $n$ переменных, где $\lfloor n/2 \rfloor$ нечeтно, удовлетворяют векторы с весом Хэмминга, значение которого отличается от $n/2$ не более чем на $1/2$.
Вырождение графа, описывающего комплексную структуру
Authors: Bogatyrev Andrei Borisovich
Published: February 2023

Рассматривается клеточное разбиение пространства модулей вещественных кривых рода $2$ с отмеченной точкой на единственном вещественном овале. Клетки перечисляются определенными графами, веса которых описывают комплексную структуру на кривой. Показано, что стягивание ребра графа приводит к корневой особенности естественного отображения из весов графа в пространство модулей кривых.
Библиография: 24 названия.
Элементарный подход к локальным комбинаторным формулам для класса Эйлера кусочно линейного сферического расслоения
Authors: Panina Gaiane Yur'evna
Published: February 2023

Описан элементарный подход к локальным комбинаторным формулам для класса Эйлера послойно ориентированного триангулированного сферического расслоения. Подход основан на технике усреднения сечений и требует лишь базовых знаний теории симплициальных (ко)гомологий. Наши формулы родственны формуле Н. Мнeва.
Библиография: 9 названий.
Топологический анализ псевдоевклидова волчка Эйлера при особых значениях параметров
Authors: Altuev Murat Kazievich , Kibkalo Vladislav Alexandrovich
Published: February 2023

Изучается аналог волчка Эйлера в случае псевдоевклидова пространства. В случае равенства нулю либо геометрического интеграла, либо интеграла площадей были построены бифуркационные диаграммы отображения момента и определен класс гомеоморфности каждого слоя слоения. Для каждой из дуг бифуркационной диаграммы в случае одного из двух возможных порядков моментов инерции определены типы особенностей в прообразе ее малой окрестности (аналоги 3-атомов Фоменко), а для неособых изоэнергетических и изоинтегральных поверхностей построен инвариант грубой лиувиллевой эквивалентности (аналог грубой молекулы). Как оказалось, псевдоевклидова система Эйлера обладает некомпактными некритическими бифуркациями.
Библиография: 23 названия.
Autologous Hematopoietic Stem Cell Transplantation for Autoimmune Diseases
Authors: Ruiz Milton A , Oliveira Maria Carolina , Moraes Daniela , Dias Juliana , Piron-Ruiz Lilian , Ribeiro Andreza , Rodrigues Morgani , Hamerschlak Nelson
Published: February 2023

Autoimmune diseases are an important field for the development of hematopoietic stem cell transplantation (HSCT). The Brazilian Society for Cellular Therapy and Bone Marrow Transplantation (Sociedade Brasileira de Terapia Celular e Transplante de Medula Óssea, SBTMO) organized consensus meetings for the Autoimmune Diseases Group, to review the available literature on HSCT for autoimmune diseases, aiming to gather data that support the procedure for these patients. Three autoimmune diseases for which there are evidence-based indications for HSCT are multiple sclerosis, systemic sclerosis and Crohn’s disease. The professional stem cell transplant societies in North America (ASTCT), Europe (EBMT) and Brazil (SBTMO) currently consider HSCT as a therapeutic modality for these three autoimmune diseases. The data are here updated.
VI Consensus of the Brazilian Society of Bone Marrow Transplantation (SBTMO) - Consensus on Graft-versus-Host Disease (GVHD)
Authors: A. M. Funke Vaneuza , R. Moreira Maria Cláudia , Vaz de Macedo Antonio , Melo Andresa , Schmidt Filho Jayr , Fatobene Giancarlo , B. S. Tavares Rita de Cássia , M. Silva Marcia , M. Almeida Macedo Maria Cristina , Colella Marcos Paulo , A. R. Colturato Vergilio , De Souza Mair Pedro , Rodrigues Morgani , Piccolo Feliciano João Victor , S. Bouzas Luis Fernando , Vigorito Afonso Celso
Published: February 2023

In this 2022 Update of Version 2020 of the VI Consensus of the Brazilian Society of Bone Marrow Transplantation (SBTMO) for Graft-versus-Host-Disease (GVHD), we seek to provide evidence-based guidance on all the novel and clinically relevant advancements in both prophylaxis and therapy of Graft-versus-Host Disease for all of those who delve into the field of Hematopoietic Stem Cell Transplantation.
Hematopoietic cell transplantation for solid tumor
Authors: Arcuri Leonardo
Published: February 2023

No abstract
PELATIHAN PENGEMASAN PAKET WISATA DENGAN MEMANFAATKAN POTENSI WISATA DI DESA BONGAN, TABANAN, BALI
Authors: Nelsye Lumanauw
Published: February 2023

Di tengah pandemi Covid-19, kegiatan pendampingan desa wisata Bongan terkait pengemasan paket wisata tetap dilaksanakan oleh Politeknik Internasional Bali kerjasama dengan Kementerian Pariwisata Ekonomi dan Kreatif. Upaya ini dimaksudkan untuk membantu desa dalam pemulihan kegiatan pariwisaa dan mempercepat menjadi desa berdaya. Berdasarkan potensi wisata alam, sejarah, dan kearifan   lokal masyarakat,   desa   wisata Bongan berpeluang untuk dikunjungi oleh wisatawan melalui ketersedian paket wisata yang berkualitas. Namun, belum adanya produk wisata yang dikemas menjadi paket wisata yang menarik mengakibatkan desa wisata Bongan jarang dikunjungi wisatawan dan belum dikenal oleh para pelaku pariwisata tentang keberadaan desa. Pengemasan paket wisata dalam kegiatan Pengabdian Kepada Masyarakat oleh tim PIB menggunakan metode persiapan, pelatihan dan pendampingan. Materi pelatihan mencakup identifikasi potensi wisata desa Bongan, produk wisata desa dan pengemasan paket wisata. Pendampingan desa menghasilkan beragam paket wisata yang terangkum dalam sebuah buku, antara lain paket wisata setengah hari, satu hari dan menginap di homestay.
TEH GOBO: MENGEMAS CINDERAMATA KHAS DESA WISATA BONGAN
Authors: Rimalinda Lukitasari
Published: February 2023

Pengembangan desa wisata tidak hanya merupakan usaha untuk menjawab tren pasar, namun juga sebagai cara untuk mendorong pelaksanaan pariwisata yang berkelanjutan. Masyarakat diharapkan dapat berperan aktif dalam membangun industri pariwisata di kawasannya untuk meningkatkan taraf kehidupannya. Desa Bongan merupakan salah satu desa wisata di Kabupaten Tabanan yang masih tergolong muda. Desa ini memiliki berbagai potensi, salah satunya adalah sayur Gonda yang merupakan hasil pertanian khas di desa Bongan. Dengan prakarsa ketua Pokdarwis, daun Gonda dikeringkan dan dimanfaatkan menjadi teh yang mereka beri nama Teh Gobo, singkatan dari Gonda Bongan. Teh ini dapat menjadi produk cinderamata ikonik bagi desa Bongan, namun masih perlu diberi pendampingan dalam merancang kemasan dan branding nya. Oleh karena itu, program pengabdian kepada masyarakat ini diarahkan untuk membantu masyarakat dalam merancang Teh Gobo agar dapat menjadi produk yang memiliki daya tarik dan daya jual. Setelah pendampingan, masyarakat dapat memamerkan produk Teh Gobo tersebut dan menjualnya sebagai produk maupun cinderamata khas Bongan.
PENDAMPINGAN PENGELOLAAN DAN LEGALITAS HOMESTAY PADA MASYARAKAT DESA WISATA BONGAN, TABANAN, BALI
Authors: I Made Kresna Dana
Published: February 2023

Desa Bongan merupakan desa dalam tahap pengembangan karena potensi yang dimiliki seperti yang diuraikan pada topik pandahuluan. Salah satu sarana dan prasarana yang masih terbatas di desa wisata Bongan adalah akomodasi homestay. Selain fasilitas yang paparkan, yang perlu disiapkan penyedia homestay adalah kemampuan sumber daya manusia (SDM) dalam memberikan layanan kepada wisatawan serta legalitas homestay agar terdaftar sebagai homestay resmi. Melalui pengembangan homestay, diharapkan nantinya akan akan bertambah pengetahuan dan keterampilan pengelola homestay di desa Bongan. Pelaksanan pendampingan pengelolaan dan legalitas homestay pada desa wisata bongan dilakukan dengan metode pemaparan dan diskusi. Pemaparan dilakukan dengan memberikan beberapa materi tentang pengelolaan homestay yang dirangkum dari materi sosialisasi pendampingan desa wisata yang disediakan oleh Kementerian Pariwisata serta materi tambahan. Hasil dari pendampingan pertama ini yaitu terkait dengan peluang dan legalitas homestay ialah terbentuknya grup whats app pengelola homestay di Bongan. Grup ini dibuat untuk berbagi permasalahan, kendala dan berbagi informasi dalam pengelola homestay di Bongan. Guna mendukung keberadaan homestay di desa Bongan, Politeknik Internasional Bali membuatkan desain logo sesuai dengan permintaan peserta pendampingan dan menyumbang papan nama homestay. Logo dan papan nama ini diharapkan dapat membantu pengelola homestay dalam pengurusan ijin usaha homestay.
PENDAMPINGAN PENGEMBANGAN DESA WISATA BONGAN, TABANAN-BALI
Authors: Dinar Sukma Pramesti
Published: February 2023

Kegiatan Pengembangan Desa Wisata Bongan merupakan kegiatan kerjasama antara Kementrian Pariwisata dan Ekonomi Kreatif, Kementrian Desa, Pembangunan tertinggal dan transmigrasi serta Politeknik Internasional Bali yang dituangkan dalam kegiatan pengabdian kepada masyarakat oleh dosen Politeknik Internasional Bali. Tujuan pendampingan yang dilakukan adalah dapat membantu mengembangkan sarana dan prasarana, membantu meningkatkan kemampuan SDM agar mampu menjadi pelaku pariwisata di Bongan, mampu mengolah mengemas dan memasarkan produk khas Desa Wisata Bongan, Kabupaten Tabanan, sehingga lebih dikenal dan mampu mendatangkan wisatawan serta menjadi alternatif mata pencaharian baru untuk masyarakat Desa Bongan. Kegiatan pendampingan dilakukan dengan beberapa kegiatan yaitu kegiatan sosialisasi, pelatihan dan monitoring yang terdiri dari beberapa topik. Adapun topik pendampingan yaitu pengembangan sarana dan prasarana, pendampingan peningkatan peran aktif dan kemampuan sumber daya manusia, pendampingan pengembangan paket wisata, pendampingan promosi, pendampingan pengembangan produk unggulan Teh Gobo. Kegiatan pendampingan dilaksanakan mulai bulan Agustus sampai Desember 2020 dengan masyarakat sasar yang terdiri dari pengelola dan masyarakat desa wisata Bongan. Kedepannya diharapkan kegiatan ini dapat berkesinambungan sehingga mampu membawa Desa Bongan yang awalnya merupakan desa rintisan, mampu menjadi desa berkembang.
A Case of Simultaneous Resection of Recurrent Colorectal Liver Metastases as part of Colorectal Cancer Treatment Journey
Authors: Nugroho Adianto
Published: February 2023

Combining systemic treatments with liver resection in patients with colorectal liver metastases has been proven to be successful in delivering favorable survival outcomes. We describe a 68-year-old man who underwent six cycles of chemotherapy before developing recurrent colon cancer with liver metastases. Prior to this, he underwent a Hartmann’s procedure for obstructive malignant rectal cancer. Shortly after the initial procedure, he underwent a Hartmann’s reversal. Imaging revealed locoregional recurrence with increased CEA as well as metastatic lesions in segments 4b and 8 of the liver at the time of recurrence. After a complete multidisciplinary evaluation, the simultaneous resection of the liver metastasis and the bowel recurrence was carried out without incident, and adjuvant therapy was then administered. This case report detailed the patient’s experience with many chemotherapy treatments and an early recurrence of CRLM, followed with surgical resection of recurrent primary and liver metastatasis. As part of multidisciplinary therapy, we propose that simultaneous excision of the recurring bowel location and the liver metastases offers the potential for superior care.
Clinical Experience with Three Combination Regimens for the Treatment of High-risk Febrile Neutropenia
Authors: Serefhanoglu K , Ersoy Y , Serefhanoglu S , Aydogdu I , Kuku I , Kaya E
Published: February 2023

Introduction: The objective of this study was to compare the safety and efficacy of ceftazidime (2 g every 8 h), piperacillin/tazobactam (4 g/500 mg every 6 h), and meropenem (1 g every 8 h), when combined with amikacin (15 mg/kg once daily), in the empirical treatment of high-risk febrile neutropenic episodes in patients with haematological malignancy.

Materials and Methods : A prospective, comparative study designed in the haematology unit of a university hospital in Turkey.

Results: A total of 89 febrile episodes in 60 neutropenic patients were treated; 29 febrile episodes in 23 patients with ceftazidime plus amikacin (group 1), 30 episodes in 25 patients with piperacillin/tazobactam plus amikacin (group 2), and 30 episodes in 25 patients with meropenem plus amikacin (group 3). The 3 groups were comparable in terms of age, sex, underlying malignancy, pretherapy neutrophil counts, duration of neutropenia and types of infections. Neutropenia, since the start of fever, persisted for 10 days in all of the episodes in the 3 study groups. Nearly all of the episodes were seen in patients with acute leukaemia. In 25.8% (23/89) of the febrile neutropenia episodes, an aetiologic organism was isolated, with gram- negative bacteria being the most commonly isolated. The success without modification rates were 34.5%, 30% and 36.7% for groups 1, 2 and 3, respectively (P >0.05). After modification with a different class of antimicrobial therapy, the response rates increased to 65.5%, 63.3% and 70% for groups 1, 2 and 3, respectively (P >0.05). The mean duration of treatment and the time to defervescence were also comparable in all groups. In all arms, side effects were minimal.

Conclusions: It is concluded that the 3 regimens were equally effective and safe in the empirical treatment of high-risk febrile neutropenic episodes.

Key words: Antibiotic therapy, Haematological malignancy
Factors Associated With Functional Decline of Hospitalised Older Persons Following Discharge From an Acute Geriatric Unit
Authors: Wu HY , Sahadevan S , Ding YY
Published: February 2023

Introduction: Older persons are likely to develop functional impairment following hospitalisation. Several studies in the West have examined the factors associated with functional decline following the older person’s discharge from hospital but there are little data on Asian populations. This study aims to look at the associated risk factors in our local population, following admission to an acute geriatric unit. Materials and Methods: This is a retrospective, cohort study. Patients who were discharged from an inpatient geriatric unit over a 3-month period were recruited. Data including their demographic information, functional status prior to admission and at the time of discharge, and medical conditions were obtained from the inpatient medical notes. A follow-up telephone interview was conducted at 3 months to determine the functional status of these patients at that point in time. Results: Following hospitalisation, 40.4% of patients developed functional decline. Of those discharged, 29.6% showed functional decline at 3 months. The principal diagnosis, hypoalbuminaemia, tendency to fall, premorbid functional independence and the length of hospitalisation were associated with functional decline during hospitalisation, while hypoalbuminaemia, the presence of bedsores, institutionalisation, the length of hospitalisation and premorbid functional dependence were important factors associ- ated with functional decline between the time of discharge and 3 months after. In the multivari- able predictive model, independent predictors of functional decline at the time of discharge included patient’s tendency to fall, premorbid functional independence and the length of hospitalisation, while the presence of bedsores was the only significant predictor of functional decline 3 months post-discharge. Conclusions: Many elderly patients developed new functional impairment following hospitalisation. Several factors were found to be associated with this functional decline, though no single predictive model similar to the other published studies was identified. Key words: Admission, Functional impairment, Risk factors
The Clinical Predictors of Hypertension and Sleepiness in an Asian Population with Sleep-disordered Breathing
Authors: Leng PH , Mosharraf-Hossain AKM , Chan YH , Tan WC
Published: February 2023

Introduction: The objective of this study was to identify the clinical predictors for hypertension and sleepiness in an Asian population with sleep-disordered breathing (SDB).

Materials and Methods: This is a retrospective, consecutive case series of 228 patients with symptoms of SDB referred to a tertiary level sleep disorders unit. A full sleep history, body mass index (BMI), Epworth Sleepiness Score (ESS), apnoea-hypopnoea index (AHI) and lowest oxygen saturation were recorded. All patients had an in-hospital polysomnogram. AHI ≥5 defined SDB. ESS >8 defined sleepiness.
Results: A BMI of 25 had a positive and negative predictive value of 75% and 56%, respectively, for predicting AHI ≥5, area ROC (receiver operating curve) = 0.668. Patients with AHI >5 had 3 times the risk of developing hypertension compared to the population with AHI <5. Using stepwise multivariate analyses with constant, age, BMI and lowest oxygen desaturation were predictors for hypertension. Patients with AHI ≥5 were 1.88 times more likely to have ESS >8. After stepwise multivariate analyses, the subjective complaint of sleepiness and lowest oxygen saturation during sleep were predictors of ESS >8.
Conclusion: The lowest oxygen saturation attained during sleep was the common factor for hypertension and sleepiness in our Asian SDB population. Mild obesity predisposes to AHI ≥5 in our population, the threshold at which the risk of hypertension is 3-fold compared with AHI <5. The subjective complaint of sleepiness predicted an ESS of >8.
Septic Monoarthritis and Osteomyelitis in an Elderly Man Following Klebsiella pneumoniae Genitourinary Infection: Case Report
Authors: Chew Li-Ching
Published: February 2023

Introduction: Klebsiella pneumoniae septic arthritis and osteomyelitis, albeit uncommon in adults, are important sites of disseminated infection. Many case reports have shown K. pneumoniae as a cause of nosocomial transmitted septic arthritis in neonates and children. We report a rare case of an elderly patient with K. pneumoniae genitourinary infection spreading to the liver and other extra hepatic sites like the prostate and peripheral joint.

Clinical Picture: The patient presented with a short history of general malaise, fever and urinary symptoms, associated with an acute monoarthritis of the ankle. On admission, he was in septic shock. Investigations suggested an infective cause, as evidenced by raised total white cell count and pyuria. K. pneumoniae was cultured from both urine and ankle synovial fluid. Imaging confirmed multiple liver and prostatic abscesses, as well as osteomyelitis of the foot bones adjacent to the ankle.
Treatment: Treatment in this case included surgical drainage of the affected joint and surrounding soft tissue structures, in addition to a 6-week course of systemic antibiotics.
Outcome: The patient had good clinical response following treatment. In addition, we noted a normalisation of his laboratory parameters and resolution of the intraabdominal and pelvic abscesses.
Conclusion: This case emphasises the importance of timely and accurate diagnosis followed by appropriate treatment in disseminated K. pneumoniae infection to prevent significant morbidity and mortality.

Key words: Arthritis, Infectious, Klebsiella infections, Liver abscess
Intravitreal Triamcinolone Acetonide for the Treatment of Diffuse Diabetic Macular Oedema – A Case Report
Authors: Wang Changguan , Katz Bradley J , Turner Matthew J , Hu Jianbin , Zhang Kang
Published: February 2023

Introduction: Although laser photocoagulation is the primary treatment for diabetic macular oedema, treatment of eyes with diffuse macular oedema has been disappointing. Intravitreal injection of steroids is being investigated for the treatment of diabetic macular oedema. Preliminary results indicate that steroid injections do improve macular oedema, but it is not clear if they improve visual acuity.

Clinical Picture, Treatment, and Outcome: In this report, we describe a patient with a form of diffuse diabetic macular oedema that responded favourably to intravitreal steroid injections, with improvements in both foveal thickness and visual acuity.
Conclusion: Intravitreal steroids can be useful for the treatment of diffuse diabetic macular oedema.

Key words: Cataract, Glaucoma, Endophthalmitis, Steroids
William Chan (1920-2005)
Authors: Hin Chew Chin
Published: February 2023

Dr William Chan, formerly Senior Physician and Head, Department of Medicine I, Tan Tock Seng Hospital, Singapore, died on 26 October 2005. He was born on 16 July 1920, in Labuan, now East Malaysia.
The Natural History of Occult Choroidal Neovascularisation Associated With Age-related Macular Degeneration. A Systematic Review
Authors: Polito Antonio , Isola Miriam , Lanzetta Paolo , Gregori Dario , Bandello Francesco
Published: February 2023

Introduction: The purpose of this review is to combine the results of existing literature on the natural history of occult choroidal neovascularisation (CNV) associated with age-related macular degeneration (AMD).

Materials and Methods: Published reports evaluating eyes with occult CNV in AMD patients were selected for meta-analysis based on a computerised MEDLINE search. Pooled estimates of the proportions of eyes with a vision loss greater than 2 to 3 (moderate vision loss) or 6 lines (severe vision loss) at 1 year and 2 to 3 years, respectively, or developing a classic component on fluorescein angiography at 1 year were measured.
Results: There is no significant heterogeneity among published rates of visual loss and development of classic CNV. The overall pooled estimates (95% confidence limits) of the proportions of eyes with at least moderate or severe vision loss, respectively, were 59% (53% to 64.5%) and 34% (25% to 43%) at 1 year and 70% (64% to 76%) and 47% (40% to 54%) at 2 to 3 years; the overall pooled estimate of the percentage of eyes developing classic CNV at 1 year was 46% (39% to 54%).
Conclusion: A substantial number of patients with occult CNV from AMD will develop at least moderate visual loss at 1 year and severe visual loss within 3 years. However, visual acuity may remain stable in up to 30% of patients. These results may help us to understand the exact role of new therapies and in planning future trials.

Key words: Age-related maculopathy, Fluorescein angiography, Meta-analysis
Surgical Outcomes of 25-Gauge Transconjunctival Vitrectomy Combined With Cataract Surgery for Vitreoretinal Diseases
Authors: Oshima Yusuke , Ohji Masahito , Tano Yasuo
Published: February 2023

Introduction: To report surgical outcomes of 25-gauge transconjunctival vitrectomy combined with cataract surgery for the management of a variety of vitreoretinal diseases.

Materials and Methods: A retrospective, interventional case study was conducted. Chart review of a consecutive series of 150 eyes of 144 patients who underwent 25-gauge vitrectomy combined with phacoemulsification and intraocular lens implantation for epiretinal membrane (n = 62), refractory macular oedema associated with retinal vascular disorders (n = 29), idiopathic macular hole (n = 21), non-clearing vitreous haemorrhage (n = 18), rhegmatogenous retinal detachment (n = 11), tractional retinal detachment associated with proliferative diabetic retinopathy (n = 7), and subretinal haemorrhage (n = 2). Main outcome measures included pre- and postoperative visual acuity, operating time, intraocular pressure, intra- and postoperative complications.
Results: The mean follow-up period was 9.7 months (range, 6 to 26). The mean overall visual acuity improved from 20/100 preoperatively to 20/38 at final visit (P <0.001). Statistically significant improvement of visual acuity was also observed in each subgroup. Operative time was shortened in macular surgery. No intraoperative complications were noted attributable to small-gauge instruments and no cases required conversion to 20-gauge standard instrumentation. However, 12 eyes (8%) required suture placement to at least one sclerotomy site. Postoperative intraocular pressure remained stable in most cases except 18 eyes (13%) with transient hypotony during the first week after surgery. One case of retinal detachment but no case of endophthalmitis was observed throughout the follow-up period.
Conclusions: 25-gauge vitrectomy combined with cataract surgery is a safe and effective system for the management of a variety of vitreoretinal diseases, especially cases requiring minimal intraocular manipulation. Further study is recommended to evaluate potential postoperative complications.

Key words: Minimally invasive surgery, Vitreous surgery