bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of Reasons for Discard of Blood and Blood Components in a Tertiary Care Hospital in South India
Authors: Mani Deepika , C Megala , R Thamil Selvi 
Published: November 2020

Background: Blood transfusion is an important and essential constituent of present health-care delivery system. Millions of lives are saved every year in regular and emergency situations by the accessibility of safe blood transfusion services. This emphasizes the need for proper utilization of blood and its components with preferably “NO” or minimal wastage. The aim of this study was to find out causes for discarding blood and blood components.

Methods: Retrospective analysis was carried out at Vinayaka Missions Medical College and Hospital Blood Bank from October 1st, 2018 to October 31st, 2019.

Results: The total number of donors from whom blood was collected during this study period was 2522. Out of which 2507 units of components were prepared. The overall discard rate of blood and its components was 5.95%. Among those 5 (33.33%) whole blood, 28 (1.25%) packed red blood cell concentrate, 93 (4.16%) fresh frozen plasma, 157 (57.51%) platelet concentrate were discarded. The common causes of discarding blood components were due to expiry date 211 (74.56%), 30 (10.60%) were due to sero-reactivity for transfusion transmitted infections, 23 (8.13%) due to leakage of components, 13 (4.59%) due to low volume and other causes were 6 (2.12%).

Conclusion: Blood being irreplaceable source, discard rate can be reduced by proper counselling of blood donors, conducting donor screening, adhering to strict donor deferral criteria, notification and counselling of permanently deferred donors. Properly implementing blood transfusion policies will help to utilize the blood components in a proper way, thus resulting in discarding a smaller number of blood bags due to expiry. Continued medical education for technicians with regards to maintenance of proper stock, quality indicators, review of blood management system will further help in reducing discard rate.
HMB-45 Negative Adrenal Angiomyolipoma With A Synchronous Adrenal Adenoma – An Unusual Association
Authors: Nair Gayathri G , Raju Sreeja , Augustine Joy , Nair Vijayalakshmi 
Published: November 2020

Background:
Angiomyolipoma (AML) is an uncommon mesenchymal tumour usually found in the kidney. The most common extrarenal site is usually the liver. We report a case of adrenal AML with a predominant vascular component co-existing with an adrenal adenoma.
Case report:
A fifty-year-old male presented with two months history of dysuria. Computed tomography showed a heterogeneous lesion involving the right adrenal gland abutting the right kidney and adjacent liver capsule. Urine noradrenaline levels were elevated. Adrenalectomy specimen showed an encapsulated mass measuring 8 x 5 x3.5 cm with a lobulated, grey to tan brown cut surface with areas of haemorrhage and tiny cystic spaces. Another yellowish nodule measuring 1.3 x 1.2 x 1 cm was also noted at one pole. Microscopy showed a neoplasm composed predominantly thick-walled vascular channels admixed with foci of smooth muscle bundles and adipocytes. Yellowish nodule showed features of adrenal adenoma. HMB-45 was negative and CD34 positivity highlighted the thick and thin walled vessels.
Conclusion:
We present the very first case of HMB-45 negative adrenal AML with a predominant vascular component and a synchronous adrenal adenoma.
Immunohistochemical Expression of Extracellular Matrix Protein-1 in Neoplastic Thyroid Lesions
Authors: Khan Nazoora , Ansari Hena Ayyub , Hasan Naba , Khan Mohammad Amanullah 
Published: November 2020

Background: Upregulated Extracellular matrix protein 1 (ECM 1) expression has been observed in several malignancies including breast, thyroid carcinoma, cutaneous melanoma and gastric carcinoma. ECM 1 expression has been evaluated in various epithelial malignancies using real time – reverse transcriptase polymerase chain reaction (RT-PCR). The purpose of current study is to evaluate the immunohistochemical expression of ECM 1 in various neoplastic lesions of thyroid.

Methods: The study included 81 neoplastic thyroid tissue specimens (21 benign and 60 malignant lesions) received over a period of 5 years (2012-2017). Hematoxylin and Eosin stained sections of the tissue specimens were carefully examined under light microscope in order to establish the histopathological diagnosis. The immunohistochemical marker ECM 1 was applied on appropriate sections and the slides were evaluated accordingly.

Result: The expression of ECM 1 was nil (grade 0, 47.62% cases) or weak (1+, 52.38% cases) in benign lesions while majority of malignant lesions (78.33%) showed strong homogenous and crisp staining (3+). The difference in the expression of ECM 1 between benign and malignant lesions was found to be statistically significant (p < 0.001). ECM 1 has a diagnostic accuracy of 0.82 and sensitivity of 100% in differentiating benign from malignant lesions.

Conclusion: ECM 1 is uniformly upregulated in all malignant thyroid neoplasms irrespective of the histological type of malignancy. Immunohistochemical expression of ECM 1 shows comparable results to RT-PCR. ECM 1 immunohistochemistry can thus serve as an important standalone marker of malignant thyroid tissue.
Diffuse Midline Glioma (H3K27M mutant) in Adult: A Diagnostic Challenge
Authors: Paul Sonal , Gadgil Nitin M , Chaudhari Chetan 
Published: November 2020

Introduction: Diffuse midline glioma (DMG), H3K27M mutant is an infiltrative midline high grade glioma with predominantly astrocytic differentiation and K27M mutation in either H3F3A or HIST1H3B/C.
Case Report: A 45-year-old female presented with complaints of headache and memory loss for 3 months. MRI was suggestive of an infiltrative mass lesion in the quadrigeminal plate cistern suggestive of pineal neoplasm. Squash and histomorphology showed a low-grade astrocytic tumour with infiltrative growth pattern. Microvascular proliferation and necrosis were absent. Immunohistochemistry showed loss of ATRX protein, focal positivity for p53 proteinand IDH1R132H negativity. On molecular analysis, H3K27M mutation was noted and the case was labelled as DMG H3K27Mmutant (WHO IV)
Conclusion: DMG (H3K27M) is a newly added entity in the WHO 4th revised editionof 2016. It presents with a diagnostic challenge as it has varied histomorphology, not requiring atypia, mitosis, endothelial hyperplasia and necrosis for diagnosis as Grade IV.
A Study to Assess the Utility of Cell Block Morphology and Immuno-Cytochemistry For Improving the Pre-Operative Diagnosis of Nodular Thyroid Lesions
Authors: Mishra Shruti , S Kishore Kumar , Das Saumik , Samaddar Aparajita , Das Nandini , Nag Dipanwita 
Published: November 2020

Background: Thyroid nodules are quite common in the general population of India with increasing incidence of malignancy worldwide. Fine Needle Aspiration [FNA] has been the primary modality of pre-operative diagnosis of such lesions till date. But it has got its own share of fallacies and pit-falls. Cell-block [CB] can be done in the same sitting and it gives the advantage of architectural assessment with easy subjectivity to immuno-cytochemical [ICC] staining.
Material and methods: FNA was done in all patients and CB was prepared by formalin method. ICC stains were used in cases with provisional diagnosis of malignancy and in all follicular neoplasm cases. SPSS v.20 was used for analysis. Sensitivity and specificity of cell block was calculated. Diagnostic correlation of both FNA and CB with respect to histopathological examination was done by using student t-test with confidence interval of 95%.
Results: CB showed a correlation coefficient of 0.704 and a p value of 0.0001while FNA showed a correlation coefficient of .464 and a p-value of .001. So, CB showed a strong positive correlation and a high statistical significance. Cell block helped in diagnosing almost all the cases showing discordance in FNA except that of papillary carcinoma where the cellular yield was poor due to cystic degeneration. Sensitivity of cell block was 89.5% and Specificity was 96.9%.
Conclusions: Cell block is definitely a good ancillary examination for thyroid nodular lesions in addition to FNA. It should be routinely performed in all thyroid cases as it improves the diagnostic yield and accuracy of cytological diagnosis.
Migration of gastric funduplicature with intratoractic perforation
Authors: Alcaide Fernando , Giordano Hernán , Campano Cruz Ildefonso , Fernández Alonso Alejandro , Meus Maurizio , Gil Iriondo Alberto , Bagur Bagur Claudia 
Published: November 2020

La cirugía antirreflujo mediante abordaje laparoscópico se considera el gold estándar para el tratamiento de la enfermedad por reflujo gastroesofágico y de la hernia de hiato. Los resultados postoperatorios presentan una morbimortalidad asociada baja y una buena satisfacción en el medio largo plazo.
Presentamos el caso clínico de un paciente de 53 años intervenido de funduplicatura laparoscópica tipo Nissen-Rossetti que en el duodécimo día postoperatorio presenta clínica de mediastinitis asociada a sepsis por perforación intratorácica de la funduplicatura gástrica migrada a tórax. El paciente es intervenido de forma urgente, realizándose drenaje torácico, laparotomía media supra-umbilical y cierre primaria de la perforación. El postoperatorio se caracteriza por una estancia de 23 días en la unidad de cuidados intensivos y por neumonía necrotizante, abscesos pulmonares y empiema pleural izquierdo. A 10 años del episodio, el paciente se encuentra asintomático y sin signos de recidiva clínica.
Aunque la incidencia de las complicaciones tempranas en la cirugía antirreflujo es relativamente baja, es obligatorio sospechar de ellas en un paciente con sepsis por mediastinitis y cirugía reciente. Antes situaciones de extrema gravedad es necesario intervenir de forma urgente aunque la re-exploración quirúrgica del hiato es considerada una cirugía compleja y de elevado riesgo de iatrogenia.
Uso de la fluorescencia con verde de indocianina en la isquemia mesentérica aguda
Authors: Bonnín-Pascual Jaime , Molina-Romero Francesc Xavier , Alvarez-Segurado Cristina , Jimenez-Segovia Marina , Bianchi Alessandro , Moron-Canis Jose Miguel , Bonnin-Pascual Francisco , Gonzalez-Argente Francesc Xavier 
Published: November 2020

Introducción: La isquemia mesentérica aguda presenta una elevada morbi-mortalidad y constituye un reto intraoperatorio en el manejo de las áreas isquémicas. En este contexto, analizamos el uso de la fluorescencia con verde de indocianina para valorar la vascularización intestinal a través de 3 casos clínicos.
Presentación de los casos: presentamos 3 casos clínicos intervenidos por isquemia mesentérica aguda. Se realiza valoración de la viabilidad intestinal bajo luz infrarroja tras la infusión endovenosa de 25 mg de verde de indocianina. El caso 1 es un varón de 42 años con múltiples antecedentes de enfermedad vascular grave, que presenta una isquemia mesentérica aguda masiva con afecación parchaeada de múltiples segmentos intestinales. La fluorescencia permite la realización de dos resecciones intestinales ajustadas con doble anastomosis intestinal. El caso 2 es una mujer de 74 años con antecedentes de fibrilación auricular no anticoagulada a la que se le decide realizar una cirugía urgente al objetivarse una neumatosis esofágica, gástrica y en sistema porta, como signos indirectos de isquemia, en la TAC urgente. Durante el acto quirúrgico se halla una isquemia de ileon terminal y colon derecho sin claros signos de afectación a nivel esófago-gástrico. La valoración tras administración de ICG discrimina la clara afectación isquémica desde ileon terminal a colon ascendente y parcheada en colon transverso e izquierdo, sin afectación esofágica ni gástrica. El caso 3 es una mujer de 49 años con enfermedad de Takayasu aortoilíaca y visceral y cirugía de revascularización del tronco celíaco. Ante el aumento del dolor abdominal, una nueva TAC evidencia neumatosis colónica. La laparotomía urgente muestra necrosis a nivel del colon izquierdo e hipoperfusión del ciego. La administración de ICG halla una falta de captación de todo el colon. Se realiza una colectomía subtotal con ileostomía y fístula mucosa.
Conclusiones: La fluorescencia con ICG aporta una mejor visualización de la vascularización intestinal en la IMA, y permite determinar los límites del tejido afecto para realizar resecciones ajustadas.
PENINGKATAN HASIL BELAJAR SISWA SEKOLAH DASAR MELALUI MODEL STUDENT FACILITATOR AND EXPLAINING BERBANTUAN MEDIA ROTAR
Authors: Ningsih Munia , Sumarwiyah Sumarwiyah , Setiawan Deka 
Published: November 2020

The reseach aims to describe the improvement of the Students outcomes at the fourth grade of SDN 1 Payaman trough the Student Facilitator and Explaining science learning models and rotar media in the seven themes indahnya keragaman di negeriku. The research design is a classroom action research that is conducted in two cycles by the number of subjects 29 students. The data collection of this study utilized the interview, observation, test, and documentation. The data analysis is qualitative and quatitative data. The result of the research showed that Students Facilitator and Explaining this science learning model and rotar media improve the students knowledge. In the cycle one the knowledge domains of IPS in classical terms the percentage got 62.06% and the mean was 72.24, while in the domain of indonesia the percentage got 65.51% and the mean was 74.82. in the cycle two for the domain of IPS was gained with a percentage of 89,65% with the mean 83.62. while on the domain of Indonesia got a percentage of 93.10% with the mean 86.03.
High Demand: Identification of Dermatology Visit Trends from 1991-2016 National Ambulatory Medical Care Surveys
Authors: Conway Jade , Roy Bipasha , Barazani Lauren , Wu Albert , Cline Abigail , Moy Janet 
Published: November 2020

Background: The field of dermatology is constantly evolving and expanding to accommodate for increased demand. In order to maximize future productivity, it is important to recognize and understand how the desires of patients and the nature of physician visits have changed over time.
Objective: To evaluate and provide evidence-based reasoning for the changes occurring in the field of dermatology.
Methods: Analysis of the 1991-2016 National Summary Tables from the National Ambulatory Medical Care Survey (NAMCS) was performed in order to identify several trends relating to dermatology visits.
Results: Annual visit rates to dermatologists have increased by 68%, while visit length has increased by 39%. Drug visits have increased by 86%, while drug mentions increased by 370.2%.
Limitations: Limitations of this paper include limited a narrow timeline for data points.
Conclusion: As the field of dermatology will continue to expand in the future, dermatologists can expect to be busier than ever before. We expect that more patients will seek care, physician visits will be longer, and chief complaints and treatment options will continue to expand and vary.
“Locked up inside home” – Head injury patterns during coronavirus disease of 2019 pandemic
Authors: Goyal Nishant , Swain Srikant Kumar , Gupta Kanav , Chaturvedi Jitender , Arora Rajnish Kumar , Sharma Suresh K. 
Published: November 2020

Background:As citizens have been forced to stay home during coronavirus disease of 2019 (COVID-19) pandemic, the crisis created unique trends in the neurotrauma patterns with changes in mode, severity, and outcome of head injured patients.Methods:Details of neurotrauma admissions under the neurosurgery department at our institute since the onset of COVID-19 pandemic in the country were collected retrospectively and compared to the same period last year in terms of demographic profile, mode of injury, GCS at admission, severity of head injury, radiological diagnosis, management (surgical/conservative), and outcome. The patients were studied according to which phase of pandemic they were admitted in – “lockdown” period (March 25 to May 31, 2020) or “unlock” period (June 1 to September 15, 2020).Results:The number of head injuries decreased by 16.8% during the COVID-19 pandemic. Furthermore, during the lockdown period, the number of admissions was 2.7/week while it was 6.8/week during the “unlock” period. RTA was the mode of injury in 29.6% patients during the lockdown, while during the unlock period, it was 56.9% (P= 0.000). Mild and moderate head injuries decreased by 41% and severe head injuries increased by 156.25% during the COVID-19 pandemic (P= 0.000). The mortality among neurotrauma patients increased from 12.4% to 22.5% during the COVID-19 era (P= 0.009).Conclusion:We observed a decline in the number of head injury admissions during the pandemic, especially during the lockdown. At the same time, there was increase in the severity of head injuries and associated injuries, resulting in significantly higher mortality in our patients during the ongoing COVID-19 pandemic.
The Effect of Polyvinyl Alcohol Concentration on the Growth Kinetics of KTiOPO4 Nanoparticles Synthesized by the Co-precipitation Method
Authors: Gharibshahian Elaheh 
Published: November 2020

KTiOPO4 nanoparticles are known as the best candidate to utilize for second-harmonic generation in multiphoton microscopes and bio labels. Size and shape are important and effective parameters to control the properties of nanoparticles. In this paper, we will investigate the role of capping agent concentration on the size and shape control of KTP nanoparticles. We synthesized KTP nanoparticles by the co-precipitation method. Polyvinyl alcohol with different mole ratios to titanium ion (1:3, 1:2, 1:1) was used as a capping agent. Products were examined by X-ray diffraction patterns and scanning electron microscopy analyses. X-ray diffraction patterns confirmed the formation of the KTP structure. The biggest (56.36nm) and smallest (39.42nm) grain size were obtained by 1:3 and 1:1 mole ratios of capping agent, respectively. Dumbly, spherical and polyhedral forms of KTP nanoparticles were observed by the change in capping agent mole ratio. The narrowest size distribution of KTiOPO4 nanoparticles was obtained at 1:1 mole ratio of capping agent. Doi: 10.28991/HIJ-2020-01-04-06 Full Text: PDF
THE STRUGGLE OF ROCKY TO SURVIVE IN DON'T BREATHE MOVIE DIRECTED BY FEDE ALVAREZ
Authors: Indriyani Furi , Mardewi Tati , Wardani Sharaswati 
Published: November 2020

The purpose of this study was to determine the struggle of the main character namely Rocky in Don't Breathe Movie. The writer uses the descriptive qualitative method in analyzing the struggles of the main characters in Don't Breathe Movie written by Fede Álvarez to make paper arrangements correctly. The procedures that the writer takes to get the best results are observing and understanding the movie, collecting data consisting of struggles, choosing theories to analyze data, analyzing data using theories, making conclusions from the analysis, and finally compiling the final project. The results of this study are the writer finds three types of struggle namely; struggle for life, struggle for love and, internal struggle. The struggle of life when the main character in the movie survives with full force in any situation, the struggle of love when the character in the movie has a feeling of love with other characters, the internal struggle when the character in the movie has desires and problems in her life. This movie teaches humans about how important the struggle in life and make a better change, never give up and despair. The main character shows people that a struggle can be motivated by certain aspects.
Keyword: Struggle, Main Character, Struggle of Life, Struggle of Love, Internal Struggle.
EFEKTIFITAS EKSTRAK DAUN KELOR (Moringa oleifera lam) DALAM MEMPERBAIKI PROFIL SERUM IRON, SATURASI TRANSFERIN, DAN TOTAL IRON BINDING CAPACITY TIKUS PUTIH JANTAN DIET RENDAH ZAT BESI
Authors: Hermayanti Diah , Syafitri Fathiyah 
Published: November 2020

Background : Iron deficinecy can cause anemia which affect health and work productivity. Moringa oleifera leaves contain a lot of iron and vitamin C, are thought to increase serum iron levels, transferin saturation, and improve total iron binding capacity.Objectives : To determine the effectiveness of Moringa oleifera lam. leaf extract on serum iron levels, transferin saturation, and total iron binding capacity in white rats (Rattus novergicus strain wistar) given a diet low in iron (Fe).Materials and methods : true experimental research using post test only control group design. The object of theis study was thirty male white mice (Rattus novergicus strain wistar) who were given a low iron diet. The study was divided into negative control group, positive control, treatment groups with a dose of Moringa leaf extract 400 mg/kg BW, 800 mg/kgBW, 1,600 mg/kg/BW, an the ferro fumaras control group (FF) 175 mg/200 BW.Results and discussion : Multivariate manova serum iron 0.001 (p<0.05), TBC 0.19 (P>0.05), and transferin saturation 0.001(p<0.05). In the post Hoc Tukey the mean serum iron and transferin saturation appeared to differ significant in the negative control group with all the other treatment groups, but did not show a significant diffrence beetwen the positive control group, FF Group, and the treatment groups.Conclusion : The adminstration of Moringa oleifera leaf extractwas less significant in improving serum iron levels, transferin saturation, and total iron binding capacity of male white mice induced by a low iron diet.
MODERATING ROLE OF SHARIAH COMMITTEE QUALITY ON THE RELATIONSHIP BETWEEN AUDIT COMMITTEE AND MALAYSIAN TAKAFUL PERFORMANCE
Authors: Eldaia Monther , Shatnawi Saddam ali , Hanefah Mustafa Mohamad , Binti Marzuki Ainulashikin 
Published: November 2020

The moderating effect of Shariah Committee Quality (SCQ) on the relationship between Audit Committee (AC) characteristics and Malaysian Takaful performance remains a challenge that is yet to be resolved. Malaysia plays a leader role in Muslim countries in Islamic Finance especially in Takaful industry and Shariah committee roles and duties. AC characteristics have a significant effect on corporate financial performance. The fundamental AC role is to supervise the corporate’s financial reporting practice, review of financial reports, auditing practice, internal accounting controls, and risk management practices. AC characteristics plays a crucial role in the overall Malaysian Takaful companies which is supposed to enhance financial performance. Hence, SCQ as part of the internal governance structure and control body of the institution, thereby, ensure Shariah compliance in all transactions and activities, and enhancing the credibility of institutions in the eyes of its shareholders and customers. SCQ can potentially moderate the relationship between AC and Malaysian Takaful performance. As an important mechanism of Corporate Governance (CG), In addition, agency theory and stewardship theory were used to develop the hypotheses. Several results of the previous literature were found fraternized, and inconsistent regarding the SCQ effect on firm performance or its effect on AC characteristics in general context, while the literature on Malaysia context remain scarce. It is expected that this SCQ moderation may considerably improve corporate performance by determining the strength or weakness of the relationship between AC characteristics and firm performance. Therefore, this paper conceptualized that ‘SCQ’ moderates the relationship between AC Chairman Specialization, Shariah Background, AC Independence and Meeting frequency, and Malaysian Takaful performance.