bluuebunny/crossref_metadata_2025_split huggingface dataset:
Histopathological Analysis and Scanning Electron Microscopic Study of Chlorpyrifos Exposed Kidney of Neonates in Pregnant Rats Exposed During Gestation Period
Authors: Upadhyay Jyoti , Tiwari Nidhi , Rana Mahendra , Bisht Satpal S. 
Published: December 2021

Background:
Pesticide exposure has the potential for causing acute or chronic health effects at certain developmental stages of life. It can result in irreversible damage to structure and function of an organ. The exposure of females to pesticides before or after pregnancy is a matter of concern because of the possibility of having a child born with congenital disorders and developmental defects. Prenatal exposure of any toxicants can program the developing foetus to develop diseases that manifest in later life. Very few reports are available related to the pesticide exposure induced morphological changes in kidney which has prompted us to undertake this research study.

Aim:
The aim of this study is to evaluate the effect of pesticide, chlorpyrifos on the kidney development of rat neonates after being exposed prenatally to pesticides throughout their gestational period.

Materials and Methods:
Virgin female wistar rats weighing 200-250 gms were mated with adult males. It consisted of twelve, divided into two sub groups six rats per each were treated with selected pesticides, chlorpyrifos (insecticide) readily available commercially for various agricultural and non-agricultural settings. Insecticide chlorpyrifos was given at a dose of 10mg/kg per orally to the female rats throughout their gestation period. After gestation period rat neonates were sacrificed and their kidney section was processed for histopathological analysis. The SEM study of chlorpyrifos exposed kidney section of rat neonates was performed, investigating changes in morphometric and ultra-structural features of kidney in rat neonates.

Results:
The histopathological analysis shows morphological changes in the kidneys of prenatally pesticides exposed rat neonates markedly different from control group. Chlorpyrifos exposed neonates kidney shows damaged kidney corpuscles and glomeruli.

Conclusion:
This study concluded that pesticide exposure during gestation period to pregnant rats causes significant renal toxicity in their neonates.
Stented Foley's Catheter is a Versatile, Highly Useful, Easy-To-Use Way of Double J Stenting for a Short Time
Authors: Vartak Ketan P. , Raghuvanshi Kshitij , Raval Abid , Jain Devendra Kumar 
Published: December 2021

Purpose:
A stented Foley's catheter was designed to combine two catheters into a single catheter to reduce the postureteroscopy (URS) pain and complications. This study evaluated the pain score and complications associated with the use of stented Foley's catheter in double J (DJ) stenting compared to the use of infant feeding tube (IFT) or a ureteric catheter in patients undergoing DJ stenting.

Materials and Methods:
A randomized parallel-group study was conducted in patients undergoing DJ stenting along with URS and stone fragmentation with pneumatic lithotripsy/LASER. The patients were randomized to be managed with either stented Foley's catheter or IFT along with Foley's catheter. The postoperative pain and complications were recorded.

Results:
A total of 200 patients were randomized (1:1) into Group A (100 patients with stented Foley's catheter) and Group B (100 patients with IFT). Male preponderance was observed in Group A (73%) and Group B (69%). A significantly higher number of patients from Group B (n = 20) had pericatheter leakage compared to Group A (n = 2). In Group B, the pericatheter leakage resolved in three males and three females, whereas six males and eight females continued to leak, which is managed by diapers. The number of patients with no pain was higher in Group A (52%) than Group B (36%), whereas none of the patients from both groups had severe pain scores (V or VI).

Conclusion:
The patients undergoing DJ stenting were tolerant to the use of stented Foley's catheter compared to those with the IFT.
How Safe Could Open Extravesical Bladder Cuff Resection Guarantee Complete Removal of Ipsilateral Ureteral Orifice?
Authors: Lin Yu-Chiao , Ou Chien-Hui , Yang Wen-Horng , Kao Yao-Lin 
Published: December 2021

Objectives:
The aim of this study is to report our 8-year experience in terms of the success rate of complete bladder buff resection procedures bladder cuff resection (BCR) and further oncological outcomes in patients under open extravesical BCR for the management of primary upper tract urothelial carcinoma (UTUC).

Materials and Methods:
We retrospectively reviewed patients with primary UTUC who undergone laparoscopic nephroureterectomy and open extravesical BCR in our center. Complete BCR procedures were not defined by any ureteral orifice remnant noted in postoperative cystoscopy surveillance. The rate of complete BCR procedures was calculated. Patients were divided into residual ureteral orifice group (RUO) and nonRUO group (NRUO) and the intravesical and local recurrences and distant metastasis were analyzed and compared across the two groups.

Results:
A total of 105 patients were reviewed. After operation, 67 of them (63.8%) had ipsilateral strict criteria of complete BCR procedures defined on cystoscopy. Shorter mean operative time was noted in the RUO group comparing to the NRUO group (145 ± 73 vs. 192 ± 107 min, P = 0.03). Bladder recurrence was significantly higher in the RUO group (RUO vs. NRUO: 59.7% vs. 26%, P = 0.001) during a median of 39.7 months follow-up. Most of the intravesical recurrences were superficial (94%) and more prone to be found near the RUO/scar in the RUO group rather than the NRUO group (59.7% vs. 26.3%, P = 0.04). The RUO group strongly predicted superficial intravesical recurrence (odds ratio: 4.04, 95% confidence interval: 1.57–10.37, P = 0.004). No significant difference was recorded in muscle invasive bladder tumor, local recurrence, contralateral urinary tract recurrence, or distal metastasis across the groups.

Conclusions:
Open extravesical BCR does not guarantee the complete removal of ipsilateral ureteral orifice. Increased risk of superficial intravesical recurrence is noted in patients with RUO.
Comparison of Prophylactic Antibiotics in Patients without Pyuria Undergoing Ureterorenoscopic Surgery
Authors: Li Ming-Wei , Lee Yuan-Ju 
Published: December 2021

Purpose:
The objective of this study was to evaluate the efficacy of antibiotic prophylaxis in patients with a tentative diagnosis of ureteral stones undergoing ureterorenoscopic surgery.

Materials and Methods:
This is a single-surgeon, open-label randomized controlled trial, which enrolled 109 patients from May 2014 to September 2018. The patients were equally randomized into three groups: a group with a single dose of intravenous cefazolin (1g), a group with oral cefuroxime (500 mg), and a control group with no prophylactic antibiotics. The primary end points were the rate of febrile urinary tract infections (UTIs) and postoperative pyuria.

Results:
The rate of postoperative fever was 9.4% in the cefazolin group (3 in 32), 0% in the cefuroxime group (0 in 29), and 6.9% in the control group (2 in 36). There was no statistically significant difference between the cefazolin and control groups (P = 0.1). The rate of postoperative pyuria was 64.3% in the cefazolin group, 58.3% in the cefuroxime group, and 33.3% in the control group, without statistically significant differences between the groups.

Conclusion:
Antibiotic prophylaxis could not reduce the incidence of postoperative febrile UTI and pyuria in ureterorenoscopic lithotripsy.
Conservative Management of Upper Tract Urothelial Carcinoma with Endoscopic Thulium Laser Ablation
Authors: Hsieh Yu-Che , Huang Steven K. , Su Chia-Cheng , Wang Jhih-Cheng , Feng I-Jung , Chiu Allen W. , Liu Chien-Liang 
Published: December 2021

Purpose:
The gold standard treatment for upper tract urothelial carcinoma (UTUC) is radical nephroureterectomy. The combination of ureterorenoscopy and laser ablation has recently become more accepted. This study aims at investigating the risk factors of tumor recurrence associated with the thulium laser ablation of UTUC and reporting its clinical outcomes with subgroup analyses.

Materials and Methods:
Patients who underwent endoscopic thulium laser ablation of UTUC as the primary treatment from June 2012 to November 2018 were reviewed retrospectively. Sixty-eight patients were enrolled, of whom 34 had complete data for analysis after applying the exclusion criteria. Bivariate analysis was performed to compare patients with and without recurrence. Multivariable Cox regression models were applied. Kaplan–Meier survival estimates were presented, and three tumor characteristics were used for subgroup analyses.

Results:
Fifteen patients (44%) had local tumor recurrence. Four patients (12%) had cancer-specific death. In bivariate analysis, statistical significance was noted for age, tumor grade, and tumor size (P = 0.018, 0.047, and 0.014, respectively). In multivariate analysis, statistical significance was noted for age and tumor size (P = 0.017 and 0.042, respectively). In the Kaplan–Meier estimates for subgroup analysis, statistical significance was noted only in the tumor size and tumor grade group (P = 0.0275). The study limitations included the retrospective design and small sample size.

Conclusion:
Tumor size and tumor grade are influential recurrence factors. The tumor stage did not show statistical significance in recurrence analysis. In subgroup analyses, tumor size was more influential than tumor grade with respect to the prognosis of local recurrence.
Clinical Profile of Patients with Renal Trauma
Authors: Narendra J. B. , Ratkal C. S. , Keshavamurthy R. , Karthikeyan V. S. 
Published: December 2021

Background:
Renal trauma is generally managed with conservative or surgical treatment. This study evaluated the clinicoradiological profile of renal trauma patients (Grades I–V) and their management to determine the association of grade of renal trauma with length of hospital stay and type of treatment.

Materials and Methods:
This cross-sectional prospective observational study included patients with renal trauma aged >18 years. All the study patients underwent computed tomography for identification and grading of renal injury (I–V).

Results:
A total of 121 patients with renal trauma were included in this study. The mean (standard deviation) age was 42.36 (17.95) years. The majority of the study patients (n = 101) were managed conservatively. Rib fracture (n = 15) was the most common associated injury, and the majority had unilateral renal injury (n = 117). The distribution of patients according to grades of renal trauma was 21 (17.35%) in Grade I; 32 (26.45%), Grade II; 25 (20.66%), Grade III; 38 (31.40%), Grade IV; and 5 (4.13%), Grade V. Length of hospital stay was ranging from 7 to 15 days, increasing with the severity of grades from Grade I to Grade V. Grade of renal trauma was positively correlated with length of hospital stay, respectively (r = 0.390, P = 0.003). Grade of renal injury (P = 0.019) and type of treatment (P = 0.028) significantly affected the variations in the length of hospital stay.

Conclusion:
Conservative treatment is the preferred management approach for renal trauma; grade of renal trauma and type of treatment are responsible for variation in the length of hospital stay.
Factors Affecting Hospital Stay in Patients Aged >65 Years who Underwent Urological Intervention
Authors: Bombaci Elif 
Published: December 2021

Purpose:
The geriatric patient population is predominant in urologic surgeries. The perioperative period of geriatric patients is affected by several factors. This study aimed to investigate the factors affecting morbidity and hospital stay in patients aged >65 years, who underwent urological intervention.

Materials and Methods:
The data of patients aged >65 years, who underwent urological surgery, were retrospectively evaluated. Age; sex; the American Society of Anesthesiologists (ASA) physical status; type and method of surgical intervention; duration of surgery; anesthesia method; concomitant diseases; preoperative values of blood serum albumin, potassium, creatinine, and hemoglobin (Hb); presence of infection; admission to the intensive care unit; and duration of hospital stay were recorded. The effects of the data obtained on hospital stay were evaluated.P< 0.05 was considered statistically significant.

Results:
Surgical method, duration of surgery, anesthesia method, presence of a comorbid disease, ASA physical status, preoperative values of blood serum albumin and Hb, presence of infection, and intensive care hospitalization had a significant effect on hospital stay, and particularly, long duration of surgery, ASA physical status, and low serum albumin levels were found to be the most effective factors to prolong hospital stay.

Conclusion:
In older patients who undergo a urological intervention, advanced age is not the only risk factor. The length of hospital stay is affected by a number of interrelated factors. A detailed preoperative evaluation and preparation with a multidisciplinary approach in elderly patients may prevent additional problems that may occur, ensuring the determination of the most appropriate surgical and anesthetic method.
Robot-Assisted Radical Cystectomy with Intracorporeal Urinary Diversion
Authors: Romagnoli Daniele , Bianchi Federico Mineo , Giampaoli Marco , Corsi Paolo , D'agostino Daniele , Schiavina Riccardo , Brunocilla Eugenio , Artibani Walter , Porreca Angelo 
Published: December 2021

Aim:
We report the oncological and functional outcomes of a population of elderly patients who underwent robotic-assisted radical cystectomy (RARC) with totally intracorporeal urinary diversion (IUD) at a single high-volume center with extensive experience in robotic surgery.

Patients and Methods:
Each procedure was performed by a single main surgeon, who previously attained a 30-day modified modular training program at a referring center. None technical variation was performed, and the surgical technique was performed exactly as taught. Demographics, intraoperative data, and postoperative complications were recorded for each patient of the aforementioned population.

Results:
From July 2015 to December 2018, we submitted to RARC with totally IUD at our institution 29 elderly patients (aged ≥75 years). Median age was 78 years (interquartile range [IQR]: 76–82). Eleven (37.9%), 12 (41.4%), and 6 (20.7%) patients received RARC with ureterocutaneostomy, ileal conduit, and orthotopic neobladder, respectively. Overall, median operative time was 360 min (IQR: 270–410). The median number of lymph node retrieved was 24 (17–34), the median intraoperative estimated blood loss (EBL) was 200 mL (150–300), with median hospitalization time of 7 days (IQR: 6–9). Each procedure was successfully completed without open conversion. A statistically significant reduction was found in the operative time, when compared to a population of younger patients (aged <75 years), probably reflecting the significant reduction in the choice of the nerve-sparing approach. Early (<30 days) and late (≥30 and <90 days) complication rates and cancer-specific mortality and overall mortality rates were not found statistically significant difference.

Conclusions:
In experienced hands, RARC with IUD can be safely applied to elderly patients, without a significant difference in terms of complication rates, cancer-specific survival, and overall survival.
Dorsolateral Onlay Buccal Mucosal Urethroplasty for Anterior Urethral Strictures by Unilateral Urethral Mobilization
Authors: Murugan P. Puvai , Iyyan A. Bhalaguru , Selvathangam Akash 
Published: December 2021

Purpose:
Complete urethral mobilization may endanger the lateral vascularity of the urethra in buccal mucosal graft (BMG) urethroplasty in stricture urethral disease. The present study aimed to evaluate the outcomes of BMG urethroplasty by dorsolateral onlay technique in patients with anterior urethral stricture.

Materials and Methods:
This was a prospective interventional study conducted at the Department of Urology at PSG Institute of Medical Sciences and Research between January 2015 and December 2018. Patients diagnosed with anterior urethral stricture who underwent dorsolateral onlay urethroplasty were included in this study. Results were considered satisfactory with the Qmax between 8 mL/s and 15 mL/s. Failed outcome was defined as persistent lower urinary tract symptoms, stricture on retrograde urethrogram, Qmax <8 mL/s, and requiring repeated urethra intervention.

Results:
A total of 54 patients underwent BMG urethroplasty by dorsolateral onlay graft with a mean age of 47.6 years. The patients with a range of stricture length 3–14 cm were included in this study. Short-term success rate (Qmax >15 mL/s) was achieved in 42 patients, while satisfactory results (Qmax 8–15 mL/s) were observed in nine patients and failure (Qmax <8 mL/s) occurred in three patients. Oral and perineal complications were treated conservatively with oral antibiotics and analgesia. None of the patients in this study had a postoperative perineal hematoma, graft infection, and scrotal swelling.

Conclusion:
Overall observations suggest that dorsolateral onlay BMG urethroplasty with unilateral urethral mobilization for an anterior urethral stricture is a feasible and effective option with favorable outcomes.
Modified Enhanced Recovery after Surgery Protocol Versus Nonenhanced Recovery after Surgery in Radical Cystectomy Surgery (Preliminary Study)
Authors: Pramod Sawkar Vijay , Safriadi Ferry , Hernowo Bethy S , Dwiyana Reiva Farah , Partogu Bernard 
Published: December 2021

Purpose:
Enhanced recovery after surgery (ERAS) protocol has proven to lower both length of stay and recovery time, while being cost-effective at the same time. There are three ERAS protocols implemented for radical cystectomy (RC). All of those were published by different institutions, such as the European Association of Urology, the Société Internationale d'Urologie, and the American Urological Association. We modified and proposed ERAS components from preoperative care until postoperative care to evaluate the implementation of ERAS for RC. Standard ERAS protocol is not fully applicable in Hasan Sadikin General Hospital due to financial factors and the limited list of drugs available to choose from our universal health coverage prescription system; thus, we had to make some modifications. This study aims at evaluating the preliminary results of an implementation of modified ERAS protocol in RC at our hospital.

Materials and Methods:
A cohort retrospective study of 21 consecutive patients who underwent RC (9 ERAS vs. 12 non-ERAS). The primary outcomes were the reduced length of stay (LOS) and hospitalization cost. The secondary outcomes included less intraoperative blood loss, faster bowel movement, lower transfusion rates, and decreased readmission rates.

Results:
Patients with ERAS had lower blood loss (ERAS median [range]: 1100 [500–2000] ml vs. 1650 [100–3000] ml for non-ERAS, P = 0.219), lower transfusion rates (ERAS: 55.6% vs. 91.7% for non-ERAS, P = 0.119), and fewer readmissions (ERAS: 0% vs. 8.3% for non-ERAS, P = 1.000). Bowel movement was faster in ERAS group (ERAS mean [range]: 6.11 ± 2.977 [3.00–12.00] h vs. 12.50 ± 5.385 [6.00–24.00] h for non-ERAS, P = 0.005). Duration of hospitalization was shorter with ERAS (5 [3–7] days) than without ERAS (8 [5–20] days, P = 0.003). The total mean costs were significantly higher in the non-ERAS group compared to the ERAS group ($1529 ± 346 for ERAS vs. $2580 ± 1415 for non-ERAS, P=0.028).

Conclusion:
Modified ERAS protocols for RC at our institution reduced the LOS and hospitalization cost and lead to faster bowel movement and no readmission.
KINERJA KEUANGAN CREDIT UNION KELING KUMANG BRANCH OFFICE SAYAN KABUPATEN MELAWI BERDASARKAN PEARLS
Authors: Ahie Simon 
Published: December 2021

Abstrak
Sistem penilaian kinerja keuangan yang lebih sesuai untuk mengukur kinerja keuangan Credit Union, berdasarkan PEARLS. Tujuan dari Penelitian ini dilakukan adalah untuk mengetahui kinerja keuangan Credit Union Keling Kumang Sayan. Metode pengumpulan data yang digunakan adalah Observasi langsung. Metode penelitian yang peneliti gunakan adalah metode penelitian deskriftif. Teknik analis data yang digunakan untuk menjawab kedua permasalahan tersebut adalah analisis PEARLS. Hasil penelitiaan dari perhitungan pada tahun 2016-2018 rasio Perlindungan untuk P1 dan P2 tidak ideal, Struktur Keuangan Efektif untuk E1 tidak ideal, E5, Kualitas Aset untuk A1 tidak ideal, Likuiditas untuk L1 tidak ideal, Tanda-tanda Pertumbuhan untuk S10 tidak ideal S11 tidak ideal. dengan nilai presentasenya yang berarti masuk dalam kategori buruk (tidak sehat), walaupun pada tahun 2016-2018 Untuk struktur keuangan yang efektif E5, E7, E8 ideal, nilai pengembalian dan biaya R7, R9 ideal, likuiditas L3 ideal, berarti nilai presentasenya sudah ideal / sehat karena mencapai keretria PEARLS.
Kata Kunci: Protection, Effectiv Financial Structure, Asset Quality, Rate of return and costs, Liquidity dan Signs of growth.
Optimalisasi Bimbingan Klien Pemasyarakatan Pada Masa Pandemi Covid-19 di Balai Pemasyarakatan (Studi di Balai Pemasyarakatan Kelas I Jakarta Selatan)
Authors: Tahamata Yuniati maryana 
Published: December 2021

Pandemi Covid-19 dengan korban yang semakin menigkat, berdampak pada pelaksanaan proses peradilan yang ada di Indonesia. Hal ini juga terjadi pada proses bimbingan klien pemasyarakatan. Penelitian bertujuan untuk mengetahui upaya mengoptimalkan pembimbingan oleh Pembimbing Kemasyarakatan pada masa pandemi Covid-19 di Balai Pemasyarakatan Kelas I Jakarta Selatan sehingga hak klien pemasyarakatan bisa terpenuhi dengan tetap memperhatikan protokol kesehatan. Penelitian ini merupakan penelitian deskriptif dengan metode penelitian kualitatif. Teknik pengumpulan data yang digunakan adalah wawancara, observasi, dan studi kepustakaan. Pengambilan subyek penelitian menggunakan teknik purposive sampling yaitu ditetapkan atas dasar tujuan tertentu yang mempunyai hubungan erat dengan masalah yang diteliti, yaitu Kepala Subseksi Bimbingan Klien Dewasa, Pembimbing Kemasyarakatan dan Klien Pemasyarakatan. Teknik keabsahan data menggunakan cross check dari hasil wawancara dan studi kepustakaan. Analisis data yang digunakan menggunakan analisis induktif dengan tahap reduksi data, unitisasi dan kategorisasi, serta pengambilan kesimpulan. Hasil penelitian ini menunjukkan bahwa selama masa pandemi Covid-19 terdapat beberapa perubahan prosedur pelaksanaan bimbingan klien yang dulunya dilakukan secara tatap muka menjadi melalui daring. Pembimbingan klien difokuskan pada peningkatan ketaqwaan kepada Tuhan Yang Maha Esa, peningkatan kesadaran hukum serta penanaman pola hidup bersih dan sehat guna mencegah penyebaran Covid-19. Kesimpulan penelitan menemukan kendala yang muncul selama proses pembimbingan daring ini meliputi terbatasnya informasi untuk kebutuhan asesmen, keterbatasan pemahaman petugas akan pentingnya laporan perkembangan dan asesmen, serta partisipasi klien rendah. Saran untukmelakukan optimalisasi proses pembimbinngan tersebut adalah dengan meningkatkan koordinasi dengan Aparat Penegak Hukum dan Pemerintah Daerah, peningkatan kualitas Sumber Daya Manusia, serta meningkatkan kualitas dan intensitas bimbingan.