bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors associated with adequacy of stem cell harvest in patients undergoing hematopoietic stem cell transplantation in a tertiary care hospital in Southern India
Authors: Nadeem Naadia Fatima , Kannan Narasimhapriyan , Basavarajegowda Abhishekh , Kayal Smita , Manivannan Prabhu 
Published: August 2024

Abstract

BACKGROUND:
Hematopoietic stem cell transplantation (HSCT) is a treatment modality for many hematologic diseases. Peripheral blood (PB) stem cells are its recommended source and enumerated using flow cytometry preapheresis which could predict the final yield. There are numerous factors affecting this process, and the aim was to explore and analyze the effect of various factors which were known to affect and predict the adequacy of stem cells.

MATERIALS AND METHODS:
This was a retrospective study, in which a total of 78 patients who had undergone HSCT were included, and flow cytometric CD34+ stem cell enumeration was done on the PB preapheresis and postapheresis in the final harvest using single-platform International Society for Hematotherapy and Graft Engineering protocol.

RESULTS:
Among all factors analyzed, we found that the preapheresis PB CD34+ cell count had the best and significant correlation with the final adequacy of stem cell dose in overall analysis, allogeneic, and autologous subgroups separately. Among the other factors studied, preapheresis total leukocyte count, platelet count, weight, and body mass index (BMI) had a significant correlation with the adequacy of stem cell dose in the final harvest in overall analysis, whereas only BMI was significant in allogeneic subgroup analysis. The autologous subgroup did not show any significant correlating factors other than the preapheresis PB CD34 count.

CONCLUSION:
The preapheresis PB CD34+ cell count came out as the most reliable factor, and the institutional cutoff of 10.35 CD34+ cells/μL was established with the sensitivity and specificity of 86.2% and 55%, respectively, in predicting the adequacy of stem cells in the final harvest.
Comparison of platelet indices in dengue fever patients based on platelet transfusion
Authors: Asha J. , Baiju Nithya M. , Innah Susheela J. , Rafi Aboobacker , John Bins M. 
Published: August 2024

CONTEXT:
Dengue fever is the most prevalent mosquito-borne viral disease in humans. Platelet indices (PIs) are given by the cell counters but are often not reported which is possibly due to under-recognition of the utility of these parameters.

AIMS:
This study aimed to compare PIs in patients with dengue fever to assess their role in the outcome such as hospital stay and platelet transfusion requirements.

SETTINGS AND DESIGN:
Prospective observational study in a tertiary care center, Thrissur, Kerala.

SUBJECTS AND METHODS:
A group of 250 dengue patients was studied over a period of 18 months. The platelet parameters (platelet count, mean platelet volume [MPV], platelet distribution width [PDW], platelet large cell ratio [PLCR], plateletcrit [PCT] and immature platelet fraction [IPF]) were measured with Sysmex XN-1000 and followed up every 24 h. The clinical features, duration of hospital stay and platelet transfusion requirements details were collected.

STATISTICAL ANALYSIS USED:
Independent t-test, Chi-square test, Karl Pearson correlation coefficient.

RESULTS:
A total of sample size was 250. The study showed normal PDW and MPV, low platelet count and PCT, and high PLCR and IPF in dengue patients. There were significant differences in PIs (lower platelet count and PCT, higher MPV, PDW, PLCR, and IPF) in comparison between dengue patients based on platelet transfusion.

CONCLUSIONS:
PIs may act as a predictive tool in the diagnosis and predicting outcomes in dengue fever. Low platelet count and PCT, high PDW, MPV, PLCR, and IPF in transfused dengue patients were found to be statistically significant. Clinicians need to be sensitized about the utility and limitations of these indices and rationalize the need for red cell and platelet transfusions in dengue.
Transfusion medicine hackathon: Nurturing the innovative ideas to revolutionize voluntary blood donation
Authors: Shastry Shamee , Gupta Gajendra Nath , Mangwana Sadhana , Choudhury Nabajyoti , Shanbhag Arun , Sachdev Suchet 
Published: August 2024

Abstract

BACKGROUND AND OBJECTIVE:
Blood transfusion is an essential component of health care. However, several issues can hamper the promotion and sustainability of voluntary blood donation programs. This article is about a hackathon in the field of transfusion medicine that was designed to stimulate original ideas to promote voluntary blood donation.

MATERIALS AND METHODS:
The transfusion medicine hackathon was conducted as a joint project of an educational institute, the Asian Association of Transfusion Medicine, and the Innovation Center. It was conducted in eight main phases, which included planning and preparation, choosing the problem statement, participant recruitment and registration, launch, and mentoring as the first steps. Participants presented their ideas in the ideation phase, and the top five teams were selected for the prototyping phase. Selection was based on innovation/originality (10 points), feasibility (10 points), and social impact (5 points). In the prototype phase, two teams were selected as winners and were awarded by the organizers.

RESULTS:
A total of 36 multidisciplinary teams representing various parts of India pitched innovative ideas. The majority have proposed new strategies for the retention of blood donors to maintain the donor pool and teams came up with novel ideas aimed at enhancing the overall blood donation experience. One of the winning teams completed the project and launched the product.

CONCLUSION:
Health-care hackathons promote interdisciplinary education and innovation. This is a first-of-its-kind effort from the field of transfusion medicine to explore a hackathon platform to promote voluntary blood donation.
Dealing with blood group discrepancies in donor populations in a resource-poor blood center, practical approach: A single blood center study from Eastern India
Authors: Mukherjee Sourav , Bhattacharya Prasun , Mukherjee Krishnendu , Biswas Durba 
Published: August 2024

Abstract

BACKGROUND:
ABO and RhD grouping are the most important pretransfusion tests. Discrepancies in blood grouping are one of the major causes of transfusion reactions. Although ABO and RhD blood group discrepancies are not a very frequent phenomenon, an overall prevalence in the healthy populations was not known in the south-eastern part of West Bengal, India.

AIMS:
To analyze the overall prevalence of ABO-Rh (D) blood group discrepancies in healthy blood donor populations, serological methods to resolve them and to supply blood in emergency circumstances to such persons.

MATERIALS AND METHODS:
In this study, a total of 8000 voluntary blood donors were chosen by the simple random sampling from South-Eastern part of West Bengal and blood grouping was done by the conventional tube technique method. Discrepancies were found among 24 blood donors with overall incidence of 0.3%. Resolution of group discrepancies done by extended incubation, weak D testing, subgroup detection with specific antisera, adsorption elution technique, secretor status by inhibition technique, etc., Direct immunoglobulin test (DAT) was done on all the samples by the polyspecific gel card method.

RESULTS:
Most of the discrepancies were due to weak or missing serum reactivity, (11 samples, incidence 0.13%), extra serum or red cell activity found in 6 samples (incidence 0.07%), subgroups causing weak red cell activity found in 4 samples (incidence 0.05%), and weak D antigen found in three samples (incidence 0.03%). One sample was DAT positive with no grouping anomaly.

CONCLUSION:
Here, in this study, blood group discrepancies were resolved using simple serological techniques. This study may help to resolute group discrepancies in day to day transfusion practices where modern facilities are not available.
Unraveling complexity: A case report on ABO hemolytic disease of the fetus newborn in a preterm neonate and delayed hemolytic transfusion reaction in the beta thalassemic mother due to alloanti kidd a antibody
Authors: Nayana V. K. , Prakash Satya , Mukherjee Somnath , Sahu Ansuman , Varghese K. Stephy , Mishra Debasish 
Published: August 2024

Abstract:
ABO hemolytic disease of the fetus and newborn (HDFN) generally occurs due to transplacental passage of maternal IgG ABO antibodies causing fetal and newborn red cell hemolysis. Preterm, premature neonates born to O blood group mothers with a high titer of anti-A and/or anti-B antibodies are more prone to developing ABO HDFN. This is a case of ABO HDFN in a preterm, premature, and low birth weight B-positive baby of an O-positive, HbE-beta thalassemic mother. The mother had a very high titer of anti-B antibodies, leading to ABO HDFN. The mother was also allo-immunized with anti-Jk (a) antibodies from past packed red blood cell (PRBC) transfusions she received for thalassemia. This anti-Jk (a) antibody was not detected in the antenatal period, probably due to the low titer of the antibody. The mother had an anamnestic response to the PRBCs provided in the antenatal period, and thus, the anti-Jk (a) became identifiable during the pretransfusion workup for the baby. Even if the baby was Jk (a) antigen positive, the baby developed HDFN mostly due to ABO incompatibility. The baby was managed with a double-volume exchange transfusion with reconstituted whole blood and phototherapy. During the postnatal period, the mother developed a delayed hemolytic transfusion reaction (DHTR) due to the anti-Jk (a) antibodies, as she had received Jk (a) antigen-positive PRBC transfusions in the antenatal period. Later, the mother responded well to the Jk (a) antigen-negative PRBC transfusions and conservative management for the DHTR.
Time-deferred consequences: A deep dive into delayed adverse reactions among whole blood donors
Authors: Jain Romesh , Gupta Anubhav , Bava Davood , Patil Vilasini , Sinha Pratul , Garg Sachin , Mishra Snehashish , Jain Shubhangi 
Published: August 2024

Abstract

BACKGROUND:
The Blood Donor Health is an important component in blood transfusion services. The retention of blood donors is important, if not less than the recruitment of new blood donors. Despite the recognized importance of donor health, several challenges impede the retention of donors. These include the donor experience in the form of adverse reactions ranging from mild to severe which can be immediate or delayed. Such experiences can deter blood donors from returning to donor pool. Our study focuses on the incidence, types, and impacts of delayed adverse reactions (DARs) among whole blood donors in an Indian context, aiming to enhance donor retention through improved safety and experience.

MATERIALS AND METHODS:
A prospective observational study was conducted at a premier tertiary care and research institute in Central India. The study included 1615 whole blood donors over 6-month period and used telephonic interviews on day 7 for postdonation follow-up. Statistical analysis was performed using Epi Info software, focusing on donor demographics, incidence, and types of DARs, and their association with various factors.

RESULTS:
The study found a 6.31% incidence of DARs, the most common being generalized weakness, followed by bruising and painful arms. A higher body mass index (BMI) significantly associated with an increased incidence of DARs. Notably, 75.5% of donors who experienced DARs expressed reluctance toward future blood donations, compared to 2.8% of those without DARs, highlighting the impact of DARs on donor retention.

CONCLUSION:
This study underscores the importance of monitoring and managing DARs to enhance donor safety and experience, thereby improving retention rates. It suggests the need for systematic follow-up protocols, focused strategies for high-risk groups, enhanced support for female donors, standardization in definitions, and robust donor education programs. The findings contribute to the knowledge base on DARs in blood donation, ensuring a reliable blood supply crucial for healthcare.
Increased Occurrence of Functional Movement Disorders during the COVID-19 Pandemic
Authors: Divya K. P. , Cherian Ajith , Paramasivan Naveen K. , Krishna S. , Amod R. , Sundaram Soumya 
Published: August 2024

Abstract

BACKGROUND:
An increase in functional movement disorders (FMDs) was perceived during the pandemic and an objective assessment of the same was performed.

OBJECTIVE:
To assess the frequency of FMDs during the coronavirus disease 2019 (COVID-19) pandemic compared to the pre-pandemic period and to identify the factors causing its increased incidence.

METHODS:
This cross-sectional comparison study conducted during the COVID-19 pandemic included patients attending the neurology outpatient department at a tertiary care center over a 6-month period. Those with FMDs documented by video evidence were compared against a baseline in the pre-pandemic period. Demographics, clinical features, duration of FMDs, presence of psychiatric comorbidity, as well as anxiety [by the Hospital Anxiety and Depression Scale (HADS-A)], depressive symptoms (HADS-D), and sleep quality by the Pittsburgh sleep quality index (PSQI) were recorded.

RESULTS:
Twenty-two out of 382 patients [64% women; age, 24.7 years (4–68)] examined during the pandemic (6 months) had FMDs compared to 31/1462 [67% women; age, 26.9 years (5–63)] examined in the pre-pandemic period, showing a 2.71-time increase. Among FMDs, functional myoclonus was the most common (36.4%), followed by functional gait disorder (27.2%), functional tremor (18.2%), functional dystonia (9.1%), and mixed phenotype (9.1%). Furthermore, 90.9% had an abnormal score (>11) on HADS-A or HADS-D and 86.3% had a score of >5 on PSQI, indicating poor sleep quality. There was a strong correlation between higher anxiety scores (P < 0.001) and poor sleep quality (P < 0.005) with an increase in frequency of FMD during the pandemic.

CONCLUSION:
The frequency of FMDs was 2.71 times higher during the pandemic, suggesting the vulnerability of predisposed patients (as evidenced by their elevated HADS scores) during stressors. Coexistent anxiety and depression increase the risk of FMDs, of which functional myoclonus was the most common phenotype, followed by gait disorders and functional tremor. Recognizing this entity will help avoid unnecessary work-up, which can be economically draining in such trying times.
Validity of using serum D-dimer titer in prefatory to computed Tomography pulmonary angiography scans in the early identification of pulmonary embolism amid emergency room patients: a single-center retrospective observational study
Authors: Seyam Sameh H. , Razein Hassan , Abdelhamid Ali Mohammed , Elkousy Islam , Singh Shailender , Gebaly Ihab , Ashok Rajini 
Published: August 2024

Background and aim
Pulmonary embolism emerges when a thrombus forms in the veins or right heart and travels to the pulmonary arteries. The study aims to ascertain the robustness of D-dimer testing for PE compared with CTPA and identify the threshold values to support its use.

Patients and methods
The positivity threshold for D-dimer was above 250 ng/ml. CTPA was performed after performing blood sampling. Patients were managed in the ICU with anticoagulants by parenteral use. The most commonly used items were heparin, either unfractionated (UFH) or low-molecular-weight heparin (LMWH).

Results
Twenty-four patients of the total number of cases were positive for CTPA, while four patients were negative for PE by CTPA. Embolism was detected in the anterior, posterior, medial, and lateral basal segmental branches of the right lung, the lateral, posterior, and anterior basal segmental branches of the left lung, and the posterior segmental branch of the left lung. The D-dimer test and CTPA both provided similarly accurate PE diagnoses with no significant differences between them. There were 28 patients in total, three of those patients had D-dimer levels below the cutoff value of 250 ng/ml, whereas the remaining 25 had D-dimer levels over the diagnostic threshold. Those with a positive CTPA diagnosis of PE had greater levels of D dimers than those with a negative CTPA diagnosis of PE.

Conclusion
D-dimer levels can help in guiding the option of CTPA and the initiation of treatment for patients with suspected PE.
Assessment of prevalence of surgical site infections among diabetes patients in Nigeria hospitals
Authors: Olorunfemi Olaolorunpo , Akpor Oluwaseyi A. , Kolapo Kehinde S. , Sodimu Jeminat O. , Osunde Ngozi R. 
Published: August 2024

Background and AimSurgical site infections (SSIs) among diabetes patients are found to be the leading type of infection among hospitalized patients globally. Careful handling of surgical equipment reduces the chances of SSIs, and those who incorporate best practices can reduce the morbidity and mortality associated with SSIs. To assess the factors responsible for the high prevalence of SSIs among diabetes patients in Nigeria.MethodsThe data for this study were from published studies. Electronic databases of Medline, Scopus, PubMed, CINAHL, and Google Scholar were searched using the keywords: SSI, medical litigation, and literature were retrieved and screened for eligibility. The data limit considered in the literature search was from 2018 to 2022 to capture only the variables identified in this study objective.ResultsThis study found that SSI among diabetes patients results from medical negligence or malpractice, which is a recurrent challenge in the field of medical practice in Nigeria. This occurs as a result of failure to carry out due diligence and professional responsibility in the acts or omissions of medical practitioners while discharging their duties in the treatment and care of their patients.ConclusionNurses and other medical personnel must be aware that their practice could be a major trap for their litigation because most patients are becoming more aware of their rights, and the public will not forgive them when perceived harm to patients is as a result of medical negligence, or malpractice. There is a need to instill best practices that will reduce the morbidity and mortality associated with SSIs as a result of a breach of professional obligations.
Management of spinal trauma in resource-limited circumstances during the COVID-19 pandemic
Authors: Maziad Ali M. 
Published: August 2024

Background data
In December of 2019, Covid-19 virus was discovered in the district of Wuhan, China. Within a few weeks, it affected almost every country in all six continents and was declared a pandemic by the World Health Organization (WHO). As of the date of writing this paper, there have been more than 85 million confirmed cases and more than 1.7 million deaths worldwide. Given the very high contagiousness of the virus, strict precautions to avoid its spread among the population and particularly in health care facilities have been implemented around the world. Such measures proved to be helpful in providing some control over the spread. Still they were not fail proof in many situations whether in developed or developing countries, thus leading to further spread of the contagion and increased mortality.

Purpose
On February 14, 2020, the first Covid-19 case was reported in Egypt. In this article, we review the steps taken to limit the spread of Covid-19 at a busy tertiary hospital in Cairo, Egypt, and present a case series of patients with spinal trauma presenting during the peak phase of the pandemic in spring of 2020 and the rationale of their management including the first Covid-19 case in Egypt with acute spinal trauma and complete paraplegia operated upon in isolation.

Study design
This was a case series.

Patients and methods
The study was performed for short-term follow-up.

Results
Satisfactory results were obtained in this patient series with good clinical and radiological outcomes.

Conclusion
Precautionary measures are mandatory during the Covid-19 pandemic. TLICS classification is a simple algorithm that can help guide proper management.
Surgical management of proximal tibial epiphyseal fracture in children
Authors: Badawy Ahmed , Akar Ahmed , Adam Mostafa 
Published: August 2024

Background
Fractures of the proximal tibial physis require a significant amount of force, and therefore, these injuries account for less than 1% of all physeal separations. The proximal tibial physis has intrinsic varus–valgus and side-to-side translational stability because of the collateral ligaments and the lateral fibular buttress.

Purpose
The aim was to evaluate operative treatment of children who have proximal tibial epiphyseal fracture (indications, techniques, advantage, disadvantages, complications, and results).

Patients and methods
From December 2015 to February 2018, a prospective case series study was performed at Al Mataria Teaching Hospital and Al-Hussein University Hospital. A total of 20 patients with proximal epiphyseal fractures were admitted and treated.

Results
The mean operative time was 54±22.45 min (range: 25–90 min), with average intraoperative blood loss of 25 ml (range: 20–30 ml). The method of fixation changes according to the type of fixation. K-wire accounts for ∼75%, whereas cannulated screw 4.5 accounts for ∼25% in the physeal group. In the tubercle group, cannulated screw 4.5 accounts for ∼50%, cannulated 4.5+ tension band accounts for ∼25%, and K-wire accounts for ∼25%.

Conclusion
Fractures of the proximal tibial epiphysis are rare, and the potential complications in this young population are limb threatening. Constant monitoring of neurovascular status is essential to identify acute and delayed compromise. A low tolerance should be taken in to account to use supplementary fixation, such as K-wires, in view of the difficulty in maintaining the reduction and the potential for poor outcomes should this be lost.
Minimally invasive antegrade intramedullary fixation for unstable subcapital fracture of the fifth metacarpal by single elastic nail
Authors: Ewais Waleed M. , Romaih Mohammed A.-E. 
Published: August 2024

Background
Fractures of the neck of the fifth metacarpal are common and mainly occur in young men. The injury often occurs through aggression, such as a fist fight or punching a hard object. The aim of this study was to assess clinical and radiological outcomes of fifth metacarpal neck fractures using minimally invasive antegrade single intramedullary fixation prepending elastic nails in the selected patients and to explore the ideal puncture point to avoid iatrogenic ulnar nerve injury.

Patients and methods
A single elastic nail with suitable diameter was used in 24 cases of fifth metacarpal neck fractures with dorsal angulation over 45°. An initial entry point was perforated at the ulnar-dorsal base of the metacarpal. The nail was inserted in an antegrade approach. The nail was usually removed at about 8 weeks postoperatively.

Results
This study reported the results of 24 patients who were affected by closed fractures of the neck of the fifth metacarpal bone (boxer’s fracture) and were treated with percutaneous single elastic intramedullary nailing to verify the effectiveness of this surgical treatment. The average follow-up period was 20.75 months. The parameters evaluated included angulation, rotational alignment, postoperative metacarpophalangeal range of motion, and time to union. At the final follow-up, no patient reported residual pain, and all fractures proceeded to bony union.

Conclusion
The authors recommend that this percutaneous single elastic intramedullary nailing was a minimally invasive and reliable fixation technique for fifth metacarpal neck fractures with good functional results and low morbidity.