bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and safety of ivermectin for COVID-19
Authors: Singh Alok , Sheth Pranav G , Dhaneria Suryaprakash , Gupta Dhyuti 
Published: November 2021

Objective:
To critically evaluate the trials that have assessed the efficacy and safety of ivermectin COVID-19 and to validate the rationality of using this drug in the management of COVID-19 either as a prophylactic or therapeutic agent.

Methods:
The authors conducted a systematic search through various databases, i.e., Cochrane library, PubMed, clincialtrials.gov, and preprint servers, for publications from 2020 to May 2021. The keywords used for the search were: “COVID-19 and ivermectin” (with filter set for “trials”). All the trials assessing efficacy in prophylaxis and treatment of COVID-19 were included for analysis. The primary outcome was the proportion of patients showing disease progression. Secondary outcomes were mean duration of hospitalization and resolution of symptoms, the proportion of patients testing positive on day 5-7, the mortality rate in severe cases, incidence of serious adverse events, and contacts of COVID-19 positive patients who turned RT-PCR positive after prophylaxis treatment.

Results:
A total of 17 clinical trials were included for the evaluation. Ivermectin proved to be a beneficial add-on therapy, as it reduced the risk of disease progression (OR 0.47, 95% CI 0.30-0.74, P=0.001), led to early resolution of symptoms (MD -1.16, 95% CI -1.52--0.81, P<0.001), and had less duration of hospitalization (MD -2.21, 95% CI -3.23--1.19, P<0.001). In addition, ivermectin was better in providing effective prophylaxis (OR 0.13, 95% CI 0.05-0.30, P<0.001). The incidence of serious adverse events was low.

Conclusions:
As an adjunct to standard care, ivermectin has shown its efficacy and safety in treating and prophylaxis in COVID-19 disease. These results should be interpreted cautiously as these trials had significant shortcomings.
Prediction of malaria cases in the southeastern Iran using climatic variables
Authors: Tohidinik Hamid Reza , Keshavarz Hossein , Mohebali Mehdi , Sanjar Mandana , Hassanpour Gholamreza 
Published: November 2021

Objective:
To predict future trends in the incidence of malaria cases in the southeast of Iran as the most important area of malaria using Seasonal Autoregressive Integrated Moving Average (SARIMA) model, and to check the effect of meteorological variables on the disease incidence.

Methods:
SARIMA method was applied to fit a model on malaria incidence from April 2001 to March 2018 in Sistan and Baluchistan province in southeastern Iran. Climatic variables such as temperature, rainfall, rainy days, humidity, sunny hours and wind speed were also included in the multivariable model as covariates. Then, the best fitted model was adopted to predict the number of malaria cases for the next 12 months.

Results:
The best-fitted univariate model for the prediction of malaria in the southeast of Iran was SARIMA (1,0,0)(1,1,1)12 [Akaike Information Criterion (AIC)=307.4, validation root mean square error (RMSE)=0.43]. The occurrence of malaria in a given month was mostly related to the number of cases occurring in the previous 1 (p=1) and 12 (P=1) months. The inverse number of rainy days with 8-month lag (β=0.329 2) and temperature with 3-month lag (β=-0.002 6) were the best predictors that could improve the predictive performance of the univariate model. Finally, SARIMA (1,0,0)(1,1,1)12 including mean temperature with a 3-month lag (validation RMSE=0.414) was selected as the final multivariable model.

Conclusions:
The number of malaria cases in a given month can be predicted by the number of cases in the prior 1 and 12 months. The number of rainy days with an 8-month lag and temperature with a 3-month lag can improve the predictive power of the model.
Comparison of Ultrasound-Guided Transversus Abdominis Plane Block and Caudal Epidural Block for Pain Relief in Children Undergoing Infraumbilical Surgeries
Authors: Ganesh Bindu , Swain Sumita , Banerjee Swarna 
Published: November 2021

Background:
Caudal epidural block combined with general anesthesia remains a popular choice of anesthesia for both supraumbilical and infraumbilical surgeries. More recently transversus abdominis plane block performed under ultrasound guidance is being described as an effective technique for postoperative analgesia for lower abdominal surgeries. The present study aims to compare the efficacy of ultrasound –guided TAP block and caudal epidural for paediatric infraumbilical surgeries.

Aims and Objectives:
To compare the duration and efficacy of postoperative pain relief between TAP block and caudal epidural block in children undergoing lower abdominal surgeries.

Methods:
Fifty children of age group 2-7 years undergoing lower abdominal surgeries were randomized to groups T and C. All patients were given general anesthesia as per standardized anesthesia protocol. Group T were given ultrasound guided TAP block with 0.5 ml.kg-1 of 0.2% Ropivacaine. Group C were given 1 ml.kg-1 of 0.2% ropivacaine as caudal block. All the children were assessed using FLACC scale. Their vitals, pain scores, duration of postoperative analgesia and requirement of supplemental analgesics were noted.

Results:
Rescue analgesic requirement was significantly less in Group T compared to Group C. Mean postoperative analgesia time was significantly more in Group T (342 mins) as compared to Group C (198 mins).

Conclusion:
Ultrasound guided TAP block provides better postoperative analgesia after loer abdominal surgeries in children.
Comparative Evaluation of Analgesic Efficacy of Adductor Canal Block Versus Intravenous Diclofenac in Patients Undergoing Knee Arthroscopic Surgery
Authors: Ramanathan Aishwarya , Meena Dharam Singh , Nagalingam Natarajan , Gopalakrishnan Kuppusamy 
Published: November 2021

Background:
Adductor canal block is a new and promising approach for providing postoperative pain relief in arthroscopic knee surgery.

Aim:
The aim is to compare the postoperative analgesic efficacy of adductor canal block and intravenous (i.v.) diclofenac in patients undergoing knee arthroscopic surgeries.

Set and Design:
This was a prospective, randomized double-blinded comparative study comprising 60 American Society of Anesthesiologists Physical status Classes I and II patients posted for unilateral knee arthroscopic surgery.

Materials and Methods:
Patients were randomized into two groups of 30 patients each. Patients were given general anaesthesia with fentanyl, propofol, and vecuronium. Ultrasound (USG) guided adductor canal block with 30 ml of 0.5% ropivacaine was given in Group A patients and patients in Group B received i.v. diclofenac before extubation. After adequate recovery, patients were shifted to postanesthetic care unit. Visual Analogue Scale score was assessed at rest, on standing and on walking 3 m.

Statistical Analysis:
Student's independent t-test was employed for comparing continuous variables. Chi-square test or Fisher's exact test, whichever is appropriate, was applied for comparing categorical variables.

Results:
The mean duration of analgesia was longer in Group A as compared to Group B and mean consumption of rescue analgesic was lower in Group A. Both were statistically significant. No significant postoperative complications or local side effects related to the block were noted.

Conclusions:
Adductor canal block provides a longer duration of postoperative analgesia promotes early mobilization and has a good safety profile in unilateral knee arthroscopic surgeries.
To Study the Effect of Noninvasive Ventilation on Hemodynamics and Respiratory Parameters in Postoperative CABG Patients
Authors: Mall Krishna Pratap , Iqbal Khalid , Gangwar Richa , Priya Vansh 
Published: November 2021

Background and Aim:
Bilevel positive airway pressure (BIPAP) is emerging as a useful modality in prevention as well as the management of postoperative respiratory dysfunction in patients undergoing coronary artery bypass graft (CABG).

Materials and Methods:
A total of 50 patients who underwent CABG were managed using BIPAP during postoperative period. Acid–base gas parameters, electrolyte levels, respiratory and hemodynamic parameters, and 24 h urine output before and after BIPAP application were measured. Data were analyzed using SPSS 21.0 version. Paired “t”-test was used to compare the changes in different parameters.

Results:
The mean age of patients was 57.72 ± 9.67 years (range: 36–85 years), majority were males (84%). Mean body mass index and mean left ventricular ejection fraction of patients were 24.26 ± 3.74 kg.m −2 and 52.77 ± 10.26%, respectively. Mean pO2, pCO2, and respiratory rate before BIPAP application were 90.62 ± 12.90 torr, 40.26 ± 5.39 torr, and 25.64 ± 6.21/min, respectively, which became 158.52 ± 50.43 torr, 37.77 ± 6.98 torr, and 21.78 ± 4.79/min, respectively, after BIPAP application, thus showing a significant change (P < 0.05). No significant change in other parameters was observed. No other adverse effect was noted.

Conclusion:
BIPAP application helped in improving ventilatory parameters without any adverse impact on hemodynamics and other parameters. Its application was a safe method to prevent respiratory disturbances following cardiac surgery.
Comparison of Morphine and Dexmedetomidine as Adjuvants to Isobaric Levobupivacaine for Spinal Anesthesia in Patients Undergoing Abdominal Hysterectomy
Authors: Sinha Mamta , Kumar Mayank , Dubey Ishaan , Singha Subrat Kumar , Karim Habib Reazaul , Karoo Khushbu 
Published: November 2021

Introduction:
Various adjuvants to local anesthetics are used in spinal anesthesia for improving the quality and prolonging postoperative analgesia. We aim to compare the analgesic efficacy of morphine or dexmedetomidine given intrathecally as adjuvants to isobaric levobupivacaine.

Materials and Methods:
Seventy patients of age group 18–60 years, American Society of Anesthesiologists 1 and 2 undergoing elective abdominal hysterectomy, were randomized into two groups. Group M received spinal anesthesia with 3 mL of 0.5% isobaric levobupivacaine with 250 μg of preservative-free morphine. Group D received 3 mL of 0.5% isobaric levobupivacaine with 5 μg of dexmedetomidine. Quality of anesthesia, sensory and motor block characteristics, duration of effective analgesia, and incidence of side effects were compared.

Results:
The time for the first analgesic request was 320.80 ± 41.75 min in the dexmedetomidine group as compared to the morphine group (451.63 ± 38.55 min), P = 0.000. The analgesic requirement in the first 24 h was significantly higher in Group D as compared to Group M, P = 0.000. Adverse effects were similar in both the groups, except pruritus which was seen only in Group M.

Conclusion:
Our study shows that the use of intrathecal morphine as an adjuvant to isobaric levobupivacaine provides better analgesia than intrathecal dexmedetomidine; however, adverse effects such as nausea and pruritus may be seen.
Utilization of red cell concentrate from storage centers of South Gujarat
Authors: Panchal Yogesh , Jariwala Keyuri , Ghosh Kanjaksha 
Published: November 2021

INTRODUCTION:
Blood storage centres in remote areas of the country was started to serve the patients in those locations. Present study analyses the the utilisation of blood from such storage centres under one regional transfusion centre in south Gujrat.

MATERIALS AND METHODS:
In this retrospective study amount of blood requested, utilised, major reasons for utilisation were studied from available records and analysed.

RESULTS:
20 storage centres serving almost 2 million population per year was studied. 2197 - 3089 units of blood were requested from these centres per year with utilisation rates of 100 – 134 units/centre/year. Severe anaemia, Antenatalcare, operations and postpartum. Haemorrhage were important causes for red cell transfusion.

DISCUSSION AND CONCLUSION:
The storage centres are functioning reasonably well but utilisation of around 2500 - 3500 units packed red cell per year for 2 million population suggests under utlisation of the facility.
Donor notification and counseling
Authors: Bhasker P. M. Bala , Aluri Anamika 
Published: November 2021

BACKGROUND:
Donor notification and counseling plays a vital role in both blood safety and comprehensive donor care. This process informs donors about their status as to transfusion-transmitted infections (TTI), modes of transmission of such infections and helps prevent secondary transmission of these infections in the community.

AIMS AND OBJECTIVES:
This study was initiated to see the response rate of notified reactive donors for counseling and to propose useful recommendations that could probably improve the response rate.

MATERIALS AND METHODS:
Total of 17025 donations was screened for TTIs, namely, human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), and syphilis, by serology. All TTI reactive donors were retested and notified of their status by telephone and called for repeat testing followed by face-to-face counseling and referral for treatment.

RESULTS:
We evaluated 183(1.07%) donors with reactive screening test results, i.e., 106(57.9%) HBV, 38(20.7%) HCV, 29(15.8%) HIV, and 11(0.6%) were syphilis reactive and all (100%) were from replacement blood donations. Only 58.4%(107) of donors could be personally communicated over telephone and only 49 (45.79%) of them returned for counseling. Three (6.1%) among the reactive donors knew their results earlier and 11(22.4%) donors had history of high-risk behavior.

CONCLUSION:
In spite of strict donor screening and self-exclusion option, donors conceal their high-risk behaviors or their reactive status and continue to donate blood. It reflects the need to implement thorough predonation counseling to extract the history of high-risk factors from the donors.
Determination of mononuclear cell count using peripheral smear and flow cytometry in peripheral blood stem cell products
Authors: Krishnan Aswathi , Murugesan Mohandoss , Therayangalath Bindu , Philip Kandathil Joseph , Nayanar Sangeetha K. , Nair Chandran K. 
Published: November 2021

BACKGROUND:
Mononuclear cells (MNCs) are considered equivalent to hematopoietic stem cells, and differential count using peripheral smear was routinely practiced to enumerate MNC. Flow cytometry plots used for CD34 enumeration assay can also be used in MNC enumeration as it counts more WBC events than manual methods. The aim was to determine the relationship and degree of agreement between peripheral smear and flow cytometry in MNC enumeration of peripheral blood stem cell (PBSC) products.

METHODS:
In 63 patients, 73 PBSC products were collected between January 2017 and September 2019. The differences in MNC count estimated by peripheral smear method and from flow cytometry plots used for CD34 enumeration were analyzed using Mann–Whitney test. Agreement between the two methods for MNC enumeration was determined by regression analysis. Receiver operating characteristic curve was performed to determine MNC threshold in peripheral blood and PBSC product for adequate mobilization and harvest.

RESULTS:
There was no difference in enumeration of median MNC count between peripheral smear and flow cytometry (52% vs. 59%, P = 0.185) in PBSC product. However, regression analysis indicated a constant and proportional difference between the methods with r = 0.52. Cumulative sum test for linearity showed deviation from linearity (P = 0.04). MNC counts in peripheral blood failed to achieve discrimination capacity in predicting adequate CD34+ yield/kg body weight in product.

CONCLUSION:
Peripheral smear estimated lower MNC counts than flow cytometry with weaker agreements between the two methods. Hence, MNC count derived from flow cytometry plot can substitute peripheral smear method for MNC dose calculations. MNC dose at 3.4 × 108/kg consistently predicted >2 × 106/kg CD34+ cells collected.
Impact of COVID-19 pandemic on the pattern of blood donation and blood safety
Authors: Bharat Singh , Rahul Katharia , Indraneel Das , Anubha Srivastava , Atul Priyadarshi , Preeti Elhence , Rajendra Chaudhary 
Published: November 2021

INTRODUCTION:
Although coronavirus disease-2019 (COVID-19) pandemic does not result in increased blood needs, blood supply can be considerably compromised due to the unavailability of blood donors. The objective was to share our experience about blood donation patterns and concerns on blood safety during COVID-19 pandemic in India.

METHODS:
This was a retrospective study of approximately 4.5 months of data including both lockdown period (LD) and LD phases. LD phase was further subdivided into four phases of varying durations. Data of blood collected and various reasons for deferral of prospective donors were analyzed. The effectiveness of mitigation strategies adopted to maintain adequate blood inventory was also assessed. Events in transfusion services during the LD were compared with the pre-LD (P-LD) phase.

RESULTS:
The mean collection per day for WB and SDP was reduced by 70% and 50%, respectively, compared to pre-LD. Approximately 23% of WB and 27% of SDPs were collected on an appointment basis during LD. The proportion of indoor voluntary blood donation was increased by 7–8 times during LD compared to P-LD. Approximately 2% of total prospective donors screened were deferred after thermal scanning and due to risk of being infected with COVID-19. Donor deferrals due to high-risk behavior increased significantly in the LD phase compared to P-LD period.

CONCLUSION:
COVID-19 pandemic has a significant impact on the pattern of blood donation and blood safety. Transfusion services must develop appropriate plans to respond efficiently to various challenges posed by such pandemics.
Autoimmune hemolytic anemia in children
Authors: Arora Satyam , Dua Seema , Radhakrishnan Nita , Singh Savitri , Madan Jyotsna , Nath Devajit 
Published: November 2021

BACKGROUND:
Autoimmune hemolytic anemias (AIHA) are characterized by the destruction of red cells following the production of autoantibodies directed against them. Although AIHA in children is usually self-limiting, many still succumb to the illness due to delay in the diagnosis and treatment. AIHA in children may be secondary to autoimmune diseases, drugs, or immune deficiencies. Early diagnosis and appropriate immunohematological evaluation can aid in the diagnosis and treatment.

OBJECTIVE:
To analyze the evaluation, treatment, and outcome of AIHA in children.

METHODS:
Prospective data of patients aged 0–18 years diagnosed with AIHA between June 2017 and May 2019 were collected.

INTERVENTION:
Prednisolone was the first-line agent in all; second-line agents included cyclosporine and rituximab. Red cell transfusion was given in those with severe anemia with cardiac decompensation.

RESULTS:
Eleven patients were diagnosed during the study period. Hemoglobin ranged from 1.2 to 9 g/dl. The initial presentation was severe anemia in 8 children and moderate anemia with thrombocytopenia in 3. The trigger was infection in 5. Polyspecific direct coomb's test (DCT) was positive in 10 patients. 2/10 polyspecific DCT-positive cases on further evaluation had immunoglobulin G (IgG) and C3d positivity, whereas rest 8 had only IgG. One infant was diagnosed with DCT-negative immunoglobulin A-mediated AIHA. 4/11 attained remission following the short course of prednisolone. Cyclosporine was used as the second-line agent in 2 and rituximab was used in 3. Seven children are in sustained remission and off medication. One died within 12 h of diagnosis.

CONCLUSION:
AIHA is not an uncommon problem in children and can vary in its clinical severity. Early and correct diagnosis helps in deciding appropriate treatment.
Reducing split-thickness skin grafting donor site agony; faster healing and decreased pain-role of platelet-rich plasma
Authors: Jain Rakesh Kumar , Choudhary Ghisulal M. , Gupta Gajendra , Patil Aditya N. , Prakash Gautam D. , Jain Ayush K. 
Published: November 2021

INTRODUCTION:
The split-thickness skin graft harvested donor site is associated with prolonged healing, discomfort, and pain. Platelet-rich plasma (PRP) contains platelet-derived growth factors and has been widely used in chronic wounds and skin graft donor sites. PRP application is known to accelerate wound epithelialization rates, and also reduce postoperative wound site pain.

MATERIALS AND METHODS:
We assessed 20 patients admitted to our hospital service who underwent split-thickness skin grafting (STSGs) with proximal half of the donor site treated with PRP. The dressing was conducted on postoperative day 7, 14, and 21. The donor site healing was assessed with serial photographs and donor site pain measured by numerical rating scale.

RESULTS:
Complete healing of wounds (epithelialization) was present in 12 (60%) patients dressed with PRP. Pain on opening dressing was an average of 3.5 in PRP dressed wounds and 6.35 in control wounds. Patients dressed without PRP, none of them had complete epithelialization. All patients had partial healing and were less than the donor site dressed with PRP. Based on these results, skin graft donor site with PRP showed accelerated healing and reduced pain and discomfort compared to control without PRP.

CONCLUSION:
PRP is a beneficial adjunct for reducing donor site pain and increased healing of donor site following STSG harvest.
Risk factors associated with human immunodeficiency virus infection in blood donors in Iran
Authors: Seighali Fariba , Divkolaye Nasim Sadat Hosseini , Rezaei Negar , Kangarloo Masumeh 
Published: November 2021

BACKGROUND:
Despite setting the stringent criteria for the selection of safe donors, some human immunodeficiency virus (HIV)-positive volunteers manage to give blood. Considering the window period of screening tests, this could endanger the safety of blood supply.

MATERIALS AND METHODS:
A frequency match case–control study was conducted on HIV-positive and negative blood donors in Iran from 2007 to 2008. Overall, 61 HIV-positive and 224 HIV-negative blood donors were selected as cases and controls, respectively. Two groups were matched for confounding factors. An identical questionnaire was used to assess risk factors. Univariate regression analysis for calculating crude odds ratio (OR) and 95% confidence interval (CI) was used for detecting eligibility of risk factors to enter the final model. The exposures with P < 0.1 were entered in the logistic regression model. Adjusted ORs with P < 0.05 and 95% CIs were reported for statistically significant variables.

RESULTS:
Significant effects were detected for the following variables: education, job, tattoo, intravenous (IV) drug abuse, imprisonment, and risky sexual behavior. However, based on multiple analyses, education, IV drug abuse, imprisonment, and risky sexual behavior remain significant.

CONCLUSION:
The majority of our findings are in parallel with the other studies performed in other countries. To increase blood safety, special attention should be paid to illiterate, first-time blood donors who are in the 25–40 age range. In addition, having the history of IV drug abuse, imprisonment and risky sexual behaviors put the blood donors more at risk of infecting HIV.