bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Open Label Prospective Study on Evaluation of Safety and Efficacy of Cilnidipine Over Amlodipine in Stage 1 Hypertensive Patients
Authors: Harlalka S. , Roy U.K. , Majumdar G. , Das K. , Mandal P. 
Published: January 2021

Background Calcium channel blockers are considered the first line drug over renin-angiotensin-aldosterone system inhibitor in black population and with renin-angiotensin-aldosterone system inhibitor in non-black population with Hypertension. Amlodipine has longer biological half life and lower potential to stimulate SNS. But, is associated with reflex tachycardia and pedal oedema. Cilnidipine has potent inhibitory both on voltage gated L-type and N-type calcium channels with better anti-proteinuric effect and good tolerability. Hence, our study compared the efficacy, safety and compliance of cilnidipine over amlodipine in Stage 1 hypertensive subjects.
Objective To find out antihypertensive and renoprotective effect of cilnidipine.
Method The study was open-label, single centre, prospective, parallel design, randomized controlled was done in Outdoor Patient Department (OPD) of Medicine and Department of Pharmacology in Burdwan Medical College and Hospital (BMCH). Patients with stage 1 HTN received cilnidipine while the other group received amlodipine. There were 4 follow-up visits for each participant consisting of baseline, 1 week, 6 weeks and after 12 weeks. Clinical parameters including pulse rate, blood pressure and ankle oedema noted also laboratory investigations were done. Safety parameters with adverse events and compliance by traditional pill count method.
Result Blood pressure was effectively decreased by both amlodipine and cilnidipine. Cilnidipine significantly decreased Pulse Rate while amlodipine increased it and the difference in Pulse Rate comparing both the groups was statistically significant. None of the ADRs were statistically significant except pedal oedema. Pedal oedema was noted only in amlodipine arm and was statistically significant. Compliance to both the drugs was excellent. Total cost of therapy was higher with cilnidipine.
Conclusion Though amlodipine is preferred drug, cilnidipine should be a better alternative when we consider subjects with sympathetic over activity, proteinuria or pedal oedema.
Clinico-demographic Profile of Poisoning Cases Admitted in Intensive Care Unit of Bharatpur Hospital, A Tertiary Referral Center in Nepal
Authors: Paudyal N. , Sapkota K. 
Published: January 2021

Background Poisoning is a major cause of death in young adults. The epidemiological factors such as geography, occupation, literacy rate can influence the clinical presentation and outcome of the poisoning patients. Poisoning has a significant impact on the economic and social life of individuals.
Objective The main objective of this study is an effort to evaluate the characteristic of poisoning cases and identify the reasons for Intensive Care Unit (ICU) admission.
Method This was a prospective observational study at Bharatpur Hospital ICU over a period of one year. Demographic profiles, poison characteristics, types and reasons for poisoning, duration of hospital stay, and outcome of the patients were studied.
Result A total of 156 patients were admitted with poisoning. Females were affected more than males with a ratio of F:M= 1.6:1. The age group that consumed poison the most was 16-25 years, and the mean age group of males was 35±14 years and 29±11 years respectively. The main cause of poisoning was conflicts/quarrel. Organophosphorus compound was the most common poisoning with 53% of total cases due to it. There were 07 cases of accidental poisoning secondary to mushroom poisoning. The mean duration of stay in ICU of these patients was 04 days. The total fatality rate due to poisoning was 07%.
Conclusion The significant proportion of Intensive Care Unit admission was due to organophosphorus compounds. It was more common among females and young age groups. This calls for special health education on chemical safety among vulnerable people along with efficient supervision in regulatory controls on chemicals and its use.
Prevalence and Clinical Manifestations of Helicobacter Pylori with Reference to Histopathological Diagnosis
Authors: Makaju R , Dhakal B. , Dhakal R. 
Published: January 2021

Background Helicobacter pylori infection is on a steep decline in most of the developed countries; however, in developing countries like Nepal such steep decline is not seen. This may be due to failure of treatment regimens and emergence of drug resistance. Our previous study done in 2004/2005 showed 38% prevalence of Helicobacter pylori. The present study has been conducted to review the prevalence and clinical diagnosis of Helicobacter pylori with reference to histo-pathological diagnosis.
Method This was retrospective study done at Dhulikhel Hospital, Kathmandu University Hospital over a period of 13 years from January 2006 to December 2018. Helicobacter pylori proven cases were retrospectively analyzed with clinical features and endoscopy findings. The clinical picture were categorized into antral gastritis, gastroduodenits, erosive duodenitis, acid peptic disease, reflux esophagitis, hiatal hernia, polyp, ulcer (gastric and duodenal), acute abdomen, upper gastrointestinal bleeding and malignancy.
Result A total of 1624 upper gastrointestinal endoscopy biopsies were taken during the study period. Helicobacter pylori infection was seen in 618 (38.0%) cases out of 1624 cases. Helicobacter pylori were seen in 349 male and 269 female patients with male to female ratio of 1.29:1. Clinically, gastritis 210 (41.4%), acid peptic disease74 (42.7%), gastroduodenitis 46 (37.7%), reflux esophagitis 38 (52.7%), gastric ulcer 48 (28.4%), duodenal ulcer 34 (53.1%) and acute abdomen 50 (42.3%) cases were seen respectively.
Conclusion Most commonly Helicobacter pylori cause chronic gastritis in our context. There is no significant change in prevalence of Helicobacter pylori infection as compared to our previous study (2004/05). This needs proper management of Helicobacter pylori infection to prevent serious complication such as gastric cancer in our part of the world.
THE INFLUENCE OF SHARIA FINANCIAL LITERACY, RELIGIOSITY, AND PERCEPTION OF SAVING STUDENTS’ INTEREST IN SHARIA BANKS
Authors: Ilfita Khoiriyah , Canggih Clarashinta 
Published: January 2021

Abstract
People in Indonesia in saving activities in sharia banks are still classified in the lower category than conventional banks. It is caused by several factors. Sharia financial literacy, religiosity and perceptions can be factors influencing people's interest in saving at sharia banks. This study aimed to determine the effect of sharia financial literacy, religiosity, and perceptions of saving interest in sharia banks. This study used a quantitative approach. In this research, researchers took samples used random sampling techniques. The data analysis technique used is multiple linear regression using the SPSS program. The results showed that partially sharia financial literacy had no effect on students' interest to save at sharia banks. While religiosity and perception partially have a positive and significant effect on students' interest to save in sharia banks. Simultaneously, sharia financial literacy, religiosity, and perceptions influence the interest of students to save in sharia banks.
Acute Erythroleukemia in a Trauma Patient. A Case Report.
Authors: Taulla Eriselda 
Published: January 2021

Introduction: Acute erythroid leukemia (AEL) is a rare type of acute myeloblastic leukemia. Acute erythroid leukemia is characterized by a predominant erythroid proliferation, there are 2 subtypes: erythroleukemia (erythroid/myeloid leukemia) and pure erythroid leukemia…
Myelodysplastic syndromes (MDS) are a group of biologically and clinically heterogeneous clonal disorders characterized by ineffective hematopoiesis and peripheral cytopenia due to high apoptosis
The purpose to presenting this case is how to differentiate an acute erythroleukemia (AEL) from myelodysplastic syndrome (MDS).
Case report. A 74-year-old man came to emergency room after he falling down from the stairs and then was hospitalized with a two weeks history of severe weakness, anorexia, weight loss. He suffered of diabetes mellitus type II insulin dependent, and HTA. The physical examination showed cutaneous and conjunctival pallor, large ecchymosis in the low extremities and hepatosplenomegaly. CBC showed: pancytopenia and macrocytosis, neutrophils 60%, normoblasts 4:100 and reticulocyte count 3%.
Conclusions: The diagnosis was Acute Erythroid Leukemia. The % of myeloblasts in bone marrow was > 20% of non-erythroid cells. Erythroleukemia characterizes from hepatomegaly this is found and in our case. Differential diagnosis is based mainly in bone marrow aspiration, immunophenotyping (flow cytometry).
Demographic Profile of Hand Injuries in North India: A Tertiary Care Hospital Experience.
Authors: Singh Sandesh Bharat , Vardhan Harsha , Halageri Sameer , Singh Arun K , Kumar Vijay , Mishra Brijesh , Upadhyaya D N 
Published: January 2021

Introduction: Hand injuries are the most complex injuries when compared to other bodily injuries. A better understanding of the biological, behavioral, and socioeconomic risk factors that are associated with hand injuries is therefore needed. This data can help identify individuals at risk and define preventive measures to help reduce the incidence.
Material and Methods: We present a study of 350 consecutive patients of hand injury treated between 2017- 2018. The demographic profile of the patient along with the type & cause of the injury sustained, hand dominance, type of procedure, and requirement of hospital administration was extracted from hospital records.
Results: 159 (45.5%) of the patients were in the age group of fewer than 20 years. Out of the 350 patients, 288 (82%) were male. 302 (86%) patients were right-handed. The most common mode of injury was machine injury in 205 (59%) patients. 181 (52%) patients had crush injury, 107 (31%) had the sharp cut injury, and 32 (9%) had blast injury. 94 (27%) patients needed hospital admission for management. 119 ( 34%) patients had the injury to the thumb, 89 (25%) had injury to the middle finger. Primary suturing was done in 116 (33%) patients, tendon and nerve repair in 209 (60%), and 177 (51%) patients respectively.
Conclusions: The study describes the demography and etiology of the cases of hand injury. The study has a limitation of having absence of assessment of functional outcome. There is a necessity of hand trauma registry to quantify the burden of hand injuries and formulate a prevention strategy at the national level.
Out of Hospital Cardiac Arrest: A Case Report
Authors: Ljuhar Kenan , Zalihić Adem , Gavranović Aida , Lenjani Basri , Rashiti Premtim , Arslani Nuhi 
Published: January 2021

Introduction: Sudden OHCA (Out of hospital cardiac arrest) is the third leading cause of death in industrialized nations. With more than 60% of cardiovascular deaths resulting from cardiac arrest, it remains the leading cause of death worldwide. Heart rhythms associated with cardiac arrest are divided into two groups: shockable rhythms (ventricular fibrillation/pulseless ventricular tachycardia (VF/pVT) and non-shockable rhythms (asystole and pulseless electrical activity (PEA)). VF is the most commonly identified arrhythmia in cardiac arrest patients. Urgent medical treatment includes cardiopulmonary resuscitation and early defibrillation.
Material and Methods: Materials for this case report are data collected from the medical records of the Emergency Medical Center of Sarajevo protocol of patients.
Case report: Our case report is presented with 59 years old man who had OHCA in his apartment. The initial rhythm was VF, and cardiopulmonary resuscitation was provided due to the Advanced life support guidelines to shockable rhythms. It was delivered 3 DC Shock-s (200J, 300J, 360 J) with the biphasic defibrillator, it was administered 1mg Adrenalin and performed endotracheal intubation. After the third DC shock, we got the return of spontaneous circulation ROSC. The patient was transferred to the University hospital, were he was stabile, and PCI of the LAD was performed as per the standard protocol. Echocardiography performed in the CCU revealed hypokinesia of RV, with preserved systolic function. On hospital day 7 he had a full neurological recovery. He was conscious, oriented, with normal breathing, blood pressure 125/79mmHg, sPO2 99, ECG: sinus rhythm, fr 87/min, without pathological signs. Echocardiography revealed the reduced systolic function of the left ventricle, with mitral regurgitation MR+2.
Discussion: Out-of-hospital cardiac arrest (OHCA) is a major health problem in Europe and in the United States. The numbers of patients who have OHCA annually in these two parts of the world have traditionally been reported to be 275,000 and 420,000 respectively. The success of resuscitation depends on many factors: well-organized health care, organization of outpatient emergency services, but primarily when it comes to OHCA, education of the population on Basic life support, and early Cardiopulmonary resuscitation and use of AED (automated external defibrillator).
Incarcerated Amyand’s Hernia with Destructive Appendicitis Complicated with Myocardial Infarction. A Case Report and Review of the Literature.
Authors: Hadzhiev Dimitar , Chakarov Dzhevdet , Moshekov Evgeniy , Sakakushev Boris , Hadzhieva Elena 
Published: January 2021

Amyand hernia is a rare presentation in inguinal hernias (less than 1% of cases with inguinal hernias) which is evidenced when in herniated masses the presence of inflamed appendix is ​​ascertained or not. It was named after a French surgeon, Claudius Amyand (1660-1740), who performed the first successful appendectomy in 1735, where he found an acute appendicitis in a herniated mass. Most cases are diagnosed intraoperatively, as an accurate preoperative diagnosis rarely becomes evident.
Management is individual depending on the stage of inflammation of the appendix, the presence of abdominal sepsis and concomitant factors. The decision should be based on factors such as the patient's age, the size and anatomopathological shape of the appendix, and in the case of an inflamed appendix, standard appendectomy and retinal herniorrhage should be the gold standard of treatment.
Amyand hernia is usually misinterpreted as a common incarcerata hernia. Symptoms that mimic appendicitis may appear. Treatment consists of a combination of appendectomy and hernia repair. The inflammatory status of the appendix determines the type of hernia repair and the surgical technique. Occasional appendectomy in the case of a normal appendix is ​​not recommended.
Amyand hernia is a rare type of inguinal hernia in which the appendix is located in the hernia sac. We present a case of a recurrent incarcerated Amyand’s hernia with complicated appendicitis. The 78 old polymorbide patient with right-sided incarcerated recurrent hernia was emergently operated on and appendectomy and non-mesh hernioplasty performed, on the 3rd postoperative day for a heart attack he was placed cardio stimulator with uneventful outcome. Fifteen months follow up did not show complications or complaints.
A case report of Xanthogranulomatous Cholecystitis
Authors: Abdelmoneim Ahmed Hassan , Darweesh Adham , Kounsal Avin , Abougazia Abdelwahed Samir 
Published: January 2021

Xanthogranulomatous cholecystitis is a benign, uncommon type of chronic cholecystitis manifested by focal or diffuse severe inflammatory process of the gallbladder (GB). It is inflammatory disease of the gallbladder characterized by the infiltrations of plasma cells, lipid-laden histiocytes, and the fibroblasts proliferation in GB wall. Gallstones are present in all patients, and like most symptomatic gallbladder diseases, there is a female predominance. It is an active inflammatory process which could leads to significant morbidity. The term Xanthogranulomatous cholecystitis was initially proposed by Goodman and Ishak in 1981. The pathogenesis of XGC is the rupture of Rokitansky-Aschoff sinuses and extravasation of bile into the muscular layer. The rupture of the serosa results in adhesion to the adjacent liver, duodenum, and transverse colon. Macroscopically, it appears like yellowish masses in the wall of the GB. Radiologically it is an important mimic of gallbladder carcinoma.
The Benefits of early Extubation in OR and ICU after Cardiac Surgery
Authors: Kuci Saimir , Ibrahimi Alfred , Likaj Ermal , Llazo Stavri , Bejko Ervin , Goga Marsela , Dumani Selman , Refatllari Ali , Zeitani Jacob 
Published: January 2021

Objective: Operating room (OR) extubation after adult cardiac surgery with cardiopulmonary bypass CPB is rare. We examined the outcome, factors, and benefits of OR extubation.
Methods: We operated on 60 patients in German Hospital Tirana, from January 2019 to September 2020, who had undergone CABG cardiac operations: 52 patients, mitral valve repair 5 patients, aortic stenosis 1patient, Bentall procedure 1 patient, left atrial myxoma 1 patient. The patient's age was from 46-82 years old, there were 24 female patients and 36 male patients, 24 diabetic patients, 36 non-diabetic patients, in all cases we did not apply epidural anesthesia.
Anesthesia was used with low doses of fentanyl. in combination with propofol, sevoflurane. In all cases, neostigmine was used for decurarisation.
The quality and depth of anesthesia were assessed with obvious signs such as tachycardia, hypertension, sweating. Endogenous stress was also assessed by monitoring glycemia during the intervention.
As extubation criteria were assessed the patient's consciousness, respiratory mechanics, hemodynamic stability, diuresis, bleeding from drains.
Results: 16 patients were extubated in the OR and 44 patients were extubated 15-20 minutes after the intervention in ICU. There was no reintubation. 2 patients were transferred immediately from OR to the pavilion. 35 patients were transferred to the pavilion 3-4 hours after extubation. 23 patients were transferred to the pavilion the next morning. Patients left the hospital after 5-7 days.
Conclusions: Extubation in the OR in the early postoperative period has now become a routine in all specialized clinics. The time spent in the ICU is very low and the day spent in the ward was 5-7 days. The benefit is in the best and fastest activation of patients in the early postoperative period as well as in reduced intervention costs.
Relation between Neutrophil to Lymphocyte Ratio, Platelet to Lymphocyte Ratio and Cerebral Infarct Volume in patients with Ischemic Stroke.
Authors: Seyhan Avni Uygar , Yilmaz Erdal , Korkut Semih 
Published: January 2021

Abstract :
Objectives: The activation of inflammatory processes in ischemic stroke might be important for the pathophysiological processes of ischemic stroke. The correlation between the Neutrophil to Lymphocyte Ratio (NLR), Platelet to Lymphocyte Ratio (PLR) and stroke volume is increasingly being recognized as a prognostic biomarker for patient outcome after an ischemic stroke incidence. This retrospective study aimed at determining if there is existed correlation between the NLR, PLR and stroke volume in patients presenting with ischemic stroke at the emergency department. The results will aid emergency doctors to gain an understanding on how to rapidly identify the most high-risk patients based on the NLR and taPLR obtained from routine blood tests permitting rapidly therapeutic interventions and better long-term survival outcomes for patients with ischemic strokes.
Methods: A retrospective study was performed between May 2016-2019. Patients 18 years and older of both genders presented to the emergency department with symptoms of ischemic stroke with time of onset of symptoms within the last 24 hours of whom complete blood count (CBC) tests were conducted and ischemic stroke was confirmed by Diffusion weighted Magnetic Resonance Imaging (DWI-MRI) were enrolled. NLR and PLR were calculated from CBC tests and ischemic stroke volume was measured in mm3 using Manual Segmentation Process.
Results: A total of 489 patients were enrolled in this study of which 266 (54.5%) were male and 223 (45.6%) were female. It was observed a statistically significant correlation between the ischemic stroke volume and NLR while no significant correlation was observed between stroke volume and PLR.
Conclusion: There is a significant weak positive relationship between NLR and ischemic stroke volume. NLR is significantly correlated with cerebral ischemic stroke volume and thus can be utilized as a guide by emergency doctors in the emergency department to predict the severity and the outcome of patients diagnosed with ischemic stroke.
Emergency Medical Care and Management of Sports Injuries on the Football Court
Authors: Lenjani Basri , Rashiti Premtim , Shabani Gani , Demiri Arber , Pelaj Besarta , Demi Arban , Sylaj Rilind , Voca Mulaj Erza , Lenjani Dardan 
Published: January 2021

Introduction; Sports medicine is a clinical subspecialty that deals with the examination, monitoring, diagnosis, treatment, and prevention of injuries that occur during sports events, training and physical activities in pre-hospital settings. Managing dramatic situations with minor and multiple injuries is a challenge that requires a quick approach to a dramatic event in managing minor and multiple injuries on the football field and in other sports in support of SHME at pre-hospital and hospital level.
Purpose of the paper. Providing emergency medical care at all basic stages of managing minor and multiple injuries on the football field and in other sports in order to implement BLS, ACLS, BTLS, PTLS, ATLS care measures reducing morbidity, disability, and mortality.
Material and methods. The research is of retrospective, descriptive, qualitative type. The material was taken from the archive of the Emergency Clinic of UCCK for the period January-December 2019. Only the sick or injured in sports matches were taken in the research; Age, gender, type of illness and injury and type of medical care, equipment available, and training and education.
Result. Sports injuries are very costly, and according to the pathology with diseases were 15 cases or 21.4 %, injuries were 55 cases or 78/6 %. Injured by age. The largest number of injured with injuries in the field of football sports the most affected age was the age of 21-25 years with 28 cases or 40.00%, over 25 years were 27 cases or 38.58% and with a smaller number were aged 15-20 years15 cases or 21.42%.
Discussion and conclusions. A very important factor in sports injuries is the provision of optimal medical care for footballers and other sports in head, neck, spine, chest, abdomen, and pelvis and limb injuries and with a joint communication with the cooperation of health care professionals in the selection of priority cases. Education of medical staff, nurses, paramedics with courses, use of medical equipment, BLS, ACLS, BTLS, PTLS, ATLS as well as standard procedures for providing and transporting medical care to the hospital.