bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Predicting Difficulty in Insertion of Real-Time-Three-Dimensional Transesophageal Echocardiography Probe in Adult Patients Undergoing Cardiac Surgery
Authors: Kiran Molli , Gadhinglajkar Shrinivas , Sreedhar Rupa , Sukesan Subin , Pillai Vivek , Panicker Varghese 
Published: May 2024

ABSTRACT

Background:
Transesophageal echocardiography (TEE) probe insertion may be associated with many complications. Demographic factors and airway conditions such as high Mallampati scores (MMC) and Cormack-Lehane grades (MCLG) are likely to have an impact on its ease of insertion. The primary aim of this study was to identify the predictive factors for difficult real-time-three-dimensional TEE probe insertion.

Methods:
A total of 153 adult patients undergoing cardiac surgery were prospectively evaluated. The upper airway manipulations required for TEE probe placement were jaw thrust, reverse Sellick's maneuver, and laryngoscopy. All the patients who required airway manipulations were grouped under difficult TEE probe placement group. We evaluated the patients’ predictive factors such as demographic characteristics and factors related to difficult intubation.

Results:
Out of 153 patients, 123 were males and 30 were females. Overall, 27.5% (n = 42) patients had difficulty in probe placement. About 31.7% (n = 39) males had difficulty in TEE probe placement against 13% (n = 4) females (P-value 0.045). Difficulty in TEE probe placement was found in 72.7% (n = 16) of obese patients (body mass index [BMI] > 30), compared to 18.6% (n = 17) in the patients with BMI less than 25 (P-value < 0.001). Probe insertion was significantly more difficult in the presence of MMC III and IV (50%, n = 18) compared to class I (19.2%, n = 10) (P-value 0.001) and MCLG III (73.3%, n = 22) compared to grade I (11.1%, n = 7) (P-value 0.001).

Conclusion:
Male gender, obesity, higher grades of MMC and MCLG were found to be the risk factors for difficult TEE probe placement in anesthetized patients.
Validation in Indonesia of Two Published Scores for Mortality Prediction after Cardiac Surgery
Authors: Widyastuti Yunita , Boom Cindy E. , Parmana I Made A. , Kurniawaty Juni , Jufan Akhmad Y. , Hanafy Dudy A. , Videm Vibeke 
Published: May 2024

ABSTRACT

Introduction:
No mortality risk prediction model has previously been validated for cardiac surgery in Indonesia. This study aimed at validating the EuroSCORE II and Age Creatinine Ejection Fraction (ACEF) score as predictors for in-hospital mortality after cardiac surgery a in tertiary center, and if necessary, to recalibrate the EuroSCORE II model to our population.

Methods:
This study was a single-center observational study from prospectively collected data on adult patients undergoing cardiac surgery from January 2006 to December 2011 (n = 1833). EuroSCORE II and ACEF scores were calculated for all patients to predict in-hospital mortality. Discrimination was assessed using the area under the curve (AUC) with a 95% confidence interval. Calibration was assessed with the Hosmer–Lemeshow test (HL test). Multivariable analysis was performed to recalibrate the EuroSCORE II; variables with P < 0.2 entered the final model.

Results:
The in-hospital mortality rate was 3.8%, which was underestimated by the EuroSCORE II (2.1%) and the ACEF score (2.4%). EuroSCORE II (AUC 0.774 (0.714–0.834)) showed good discrimination, whereas the ACEF score (AUC 0.638 [0.561–0.718]) showed poor discrimination. The differences in AUC were significant (P = 0.002). Both scores were poorly calibrated (EuroSCORE II: HL test P < 0.001, ACEF score: HL test P < 0.001) and underestimated mortality in all risk groups. After recalibration, EuroSCORE II showed good discrimination (AUC 0.776 [0.714– 0.840]) and calibration (HL test P = 0.79).

Conclusions:
EuroSCORE II and the ACEF score were unsuitable for risk prediction of in-hospital mortality after cardiac surgery in our center. Following recalibration, the calibration of the EuroSCORE II was greatly improved.
Difficult Ventilation in a Patient with a Giant Aortic Aneurysm
Authors: Montane-Muntane Mar , Ascaso María , Rivera-Vallejo Lorena , Navarro-Ripoll Ricard 
Published: May 2024

ABSTRACT
Patients with Marfan syndrome present anatomic variations that may increase the risk of a difficult airway. Moreover, they can present large aortic aneurysms, which may cause extrinsic airway compression. Therefore, difficult ventilation during general anesthesia poses a challenge in that the anesthesiologist has to promptly make a crucial differential diagnosis. Multidisciplinary preoperative assessment and planning of the airway and ventilation management are of utmost importance in such uncommon and highly complex clinical cases. Fiberoptic bronchoscopy is probably a really useful tool in order to assess the severity and extent of the airway compression, both preoperatively and intraoperatively. We present a clinical case where difficult ventilation occurred immediately after the induction of general anesthesia.
Relationship between nurses’ emotional intelligence and their perception of patient safety climate
Authors: Kamel Ahlam Esmial , Seada Abeer Mohammed , Aly Sahar Hassan 
Published: May 2024

Background
Emotional intelligence is regarded as an important characteristic for building stable and healthy emotions among nursing staff that enhances nursing performance, supports the concept of nurse–patient relationship, and encourages the nurses to be more involved in decision making in providing care. Emotional intelligence helps individuals to perform well in risky tasks and could be beneficial for patients under the care of nurses through improving the patient safety climate.

Aim
The aim was to assess the relationship between nurses’ emotional intelligence and their perception of patient safety climate.

Design
A descriptive correlational design was used for this study sample.

Patients and methods
The study was conducted at New Kasr Al-Aini Teaching Hospital, Cairo University Hospital, on a convenience sample of 250 staff nurses.

Results
The results revealed that the total mean percent of emotional intelligence of nurses was 86.64%, which indicates high level of emotional intelligence, and the total mean score of patient safety climate was 72.33%, which indicates high level of patient safety. In addition, there was a highly statistically significant positive correlation (P=0.00) between emotional intelligence and patient safety climate.

Conclusion
Nurses had high level of emotional intelligence and patient safety climate. There was a highly statistically significant positive correlation between emotional intelligence and patient safety climate.

Recommendation
There should be increased staff participation in development and training to emphasize the power of emotional intelligence. The aim should be to improve the level of self-awareness, self-management, social consciousness, and relationship management among nurses to increase emotional intelligence and maintain patient safety climate.
Impact of empowerment for pediatric nursing students on their knowledge about climate change and its impact on children health
Authors: Ibrahim Marwa A. , AbdElhafez Asmaa M.H. , Hassan Eman A. , Alaswad Nadia K. 
Published: May 2024

Background
Ensuring the safe management of global climate change is a crucial objective of sustainable development in 2030. In this endeavor, the medical team’s role is as significant as that of climate scientists. This is due to climate change’s adverse impact on the health of individuals, children, and society. Numerous diseases, including skin disorders, respiratory issues, and gastrointestinal illnesses, are closely linked to climate change.

Aim
The aim of this study was to evaluate the impact of empowerment for pediatric nursing students on their knowledge about climate change and its effect on children’s health.

Research design
The pre–posttest quasi-experimental research design was used to fulfill the aim of the current study.

Setting
The study was conducted at the Faculty of Nursing, Cairo University.

Sample
A convenience sample of 200 pediatric nursing students.

Tools
Two were used for data collection: (a) a structured interviewing questionnaire schedule and (b) a knowledge assessment (pre–posttest).

Results
The mean satisfactory knowledge score after the empowerment was 67.3±3.2 and there was statistically significant differences between students’ knowledge about climate change’s effects on child’s health before and after empowerment (P≤0.05).

Conclusion
After the implementation of empowerment for pediatric nursing students, there was a significant improvement in the level of knowledge among them regarding climate change and its effect on children’s health.

Recommendation
Raising the awareness of students about climate change and its effect on all over child’s body system function so, it is urgent to add knowledge about climate change and its impact on child’s health in the pediatric nursing education curriculum.
Nurses Fatigue Level: Causes and Consequences
Authors: Zahran Aya. S.K. , Fekry Nehad. E. , Hebashy Amal E. 
Published: May 2024

Abstract

Background
Nurses play a critical and vital role in the delivery of patient care, they exposed to workplace hazards and violence, work overload, pain, exhaustionand fatigue which affect their health and social life.

Aim
Of the present study was aimed to assess nurses fatigue level causes and consequences.

Research design
A descriptive design was used to carry out this study.

Setting
The study was conducted in multispecialty private hospital in Cairo which is supervised by Ministry of Health; bed capacity approximately (n = 200 beds).

Sample
Convenient sample of all available nursing staff (n = 300) who are working during the period of data collection.
Data collection tools: The current study data was collected using self-administered questionnaire titled Fatigue Severity Scale (FSS).

Results
The study subjects had high mean scores to all domains and total of fatigue consequences. Clarifying that the highest mean score (77.0 % and 76.6%) was regarding to fatigue and physical activities and Fatigue and lack of energy. Around half (47.3%) of nurses had moderate fatigue level. Also, (32.4%) of them had severe fatigue level. While, the least percentage (20.3%) of nurses had mild fatigue level. There was a highly statistical significant positive relation exists between the study subjects' perception of total fatigue level and their years of experiences, gender, current job position and current working unit (X2 = 15.99, P-Value = 0.00, X2 = 7.99, P-Value = 0.03 X2 = 5.94, P-Value = .015* and X2 = 10.38, P-Value = 0.04*) respectively. While, there is no statistically significant relation between the total fatigue level and their age and qualifications(X2 = 1.33, P-Value = 0.085, and X2 = 1.2 P-Value = 0.12) respectively.

Conclusion
Nurses had high mean scores to all domains and total of fatigue consequences. The highest mean score was regarding to fatigue and physical activities and, fatigue and lack of energy domains. Around half of nurses had a moderate level of fatigue, almost one third of them had a severe level of fatigue, while, the least percentage of them had mild level of fatigue. There was a highly statistically significant positive relation exists between nurses' perception of total fatigue level and their years of experiences, gender, current job position and current working unit. While, there is no statistically significant relation between the total fatigue level and their age and qualifications.

Recommendations
Unit managers should consider staff needs for monthly work scheduling and give the suitable break time during long hour shift and detect negative signs and symptoms of fatigue and how to support and manage nurses. Hospital administrators must encourage nurses to follow a healthy lifestyle, which includes a balanced diet, regular exercise, enough sleep, and stress management techniques and develop appropriate educational programs and preventive strategies for nurses to be able to control fatigue causes and consequences.
Comparing the Cerebral Resistive Index Using Doppler Ultrasound in Neonates before and after Transfusion of Red Blood Cell – A Prospective Observational Study
Authors: Panigrahi Nikita , Venkatesh HA , Patil Balote Vikrant , Kannur Netra S. , Nagesh N. Karthik , Pejaver Rajath 
Published: May 2024

ABSTRACT

Background and Objectives:
Anemia is a common morbidity seen in neonates, having an impact on cerebral circulation. Commonly, severe anemia is managed with red blood cell transfusion. This study was done to determine the cerebral hemodynamic change occurring in neonates before and after packed red blood cell transfusion.

Methods:
Neonates who had undergone blood transfusions were prospectively studied using cerebral Doppler ultrasonography. Cerebral blood flow (CBF) velocity of the middle cerebral artery was calculated before and after PRBC transfusion.

Results:
Twenty neonates of median gestational age 34 weeks (interquartile range: 24–40 weeks) with a mean birth weight of 1670 g were enrolled. Pre and post transfusion mean resistive index (RI) were 0.7 and 0.67, respectively, with confidence interval (−0.04–0.09) (P = 0.40). There was a decrease in peak systolic velocity and an increase in end diastolic velocity, though not statistically significant.

Conclusion:
The study concluded that there was no statistically significant difference in the CBF velocities, including RI pre and post PRBC transfusion.
A Survey on the Preexisting Knowledge, Attitude, and Practice of Blood Donation among Medical Students at Entry Level: A Cross-sectional Study
Authors: Wasnik Minal , Kashyap Nitin Kumar 
Published: May 2024

ABSTRACT

Background and Objective:
In India, there is a huge gap between blood demand and supply of blood. Young people form blood donors for the future as they are full of idealism and enthusiasm. Targeting medical students at the entry level itself is beneficial as they can be included in the donor pool early. Hence, we planned this survey to understand knowledge, attitude, and practice of blood donation among them.

Methods:
Data were collected using a self-administered questionnaire. A briefing about the study was given to students, followed by 15 min to complete the questionnaire. A short awareness session was also conducted. A pre- and post-session willingness for blood donation was also taken.

Results:
The median age range was 19.36 ± 1.15 years with more males than females. There was a significant difference between knowledge among 1st and 2nd year students; however, attitude and practice showed no difference. Females showed significantly higher knowledge and better attitudes but significantly low practice than males. Significant reasons for blood donation among donors were to help others, even the unknown at the time of need and health benefits for blood donors. The most common reason for nondonation cited by nondonors was fear of weakness/anemia; however, it was not statistically significant. Willingness for donation improved from 83.4% to 93% after the awareness session.

Conclusion:
The participants had a good amount of knowledge and favorable attitude toward blood donation, but the practice of blood donation was less, especially among females. Improved willingness to donate blood following awareness sessions suggests that conducting regular educational and motivational activities will be helpful.
Analysis of Human Leukocyte Antigen Frequency among Renal Transplant Recipients and Donors in Nepal
Authors: Manandhar Rekha , Pandey Gaurab , Bhatta Ranjan Raj , Jha Runa 
Published: May 2024

ABSTRACT

Background and Objectives:
Kidney transplants are effective for advanced renal failure, but graft rejection can occur when the recipient’s immune system misidentifies the kidney as a foreign object. Human leukocyte antigen (HLA), a component of the host’s immunological defense system, acts as a barrier to graft rejection. Selecting potential kidney recipients and donors for transplantation requires careful consideration of histocompatibility for the HLA-A, HLA-B, and HLA-DRB1 antigens. Mismatches between donors and recipients prolong transplant therapy, leading to lower graft survival and higher mortality. The objective of the study was to analyze HLA-A, HLA-B, and HLA-DRB1 antigens frequency in live-related renal transplant recipients and donors visiting the Department of Histocompatibility and Immunopathology at the National Public Health Laboratory, Teku, Kathmandu, Nepal.

Methods:
A retrospective study was conducted by using data from 104 renal transplant recipients and donors whose samples had previously been collected, processed, and analyzed to identify the Class I loci (HLA-A and HLA-B) and Class II loci (DRB1) between November 2021 and February 2024.

Results:
The study found that the majority of donors were female, and the majority of recipients were male. In this study, 10, 17, and 12 different HLA-A, B, and DRB1 alleles were found in recipients and donors. Alleles found more frequently are A*11 (25.00%), A*24 (23.08%), sB*15 (22.60%), B*35 (12.98%), DRB1*15 (22.60%), and DRB1*12 (21.63%).

Conclusions:
The study suggests that both donors and recipients of renal transplants in Nepal have a diverse HLA antigen distribution, which could aid in selecting a genetically closer group as potential matched donors for transplant recipients.
Monoclonal Gammopathies of Undetermined Significance and Abnormal Serum Protein Rates Prevelance in Blood Donors: For Improved Transfusion Safety
Authors: Benzouarhia Marwan , Anibat Hajar , El Maliki Bouchra , Morjan Asmaa , Kamal Nabiha , Hajout Khadija , Zahir Abdellatif , Habti Norddine 
Published: May 2024

ABSTRACT

Background and Objectives:
Protein abnormalities include monoclonal gammopathies of undetermined significance (MGUS) and malignant lymphoplasmacytic tumors such as multiple myeloma (MM), Waldenström macroglobulinemia, and amyloid light-chain amyloidosis. MGUS prevalence increases with age, especially in individuals over 50. MGUS progresses to various lymphoplasmacytic diseases, including smoldering MM and MM. Almost all blood donors (BDs) are asymptomatic but some of them could present protein abnormalities. Our objective was to assess the prevalence and impact of protein abnormalities and monoclonal gammopathies (MGs) on transfusion safety among BDs in Morocco.

Methods:
Two hundred eighty-one serum samples were collected from BDs aged over 40 years old. Total serum protein measurement and protein electrophoresis were performed using the Architect ci8200 and Capillarys-2-Piercing automated systems, respectively. Immunofixation was conducted using hydrates.

Results:
Protein levels ranged between 59 and 87 g/L (average = 71.69 ± 4.96 g/L). Our results showed 195 (69.39%) normal profiles, 6 (2.13%) MGs, 14 (4.98%) heterogeneous restriction of γ-globulins, and 66 other abnormalities (23.48%) regarding the levels of albumin and proteins from alpha and beta fractions.

Conclusion:
Our preliminary results appeal to blood transfusion professionals regarding ethical considerations and transfusion safety. BDs with abnormal protein levels should benefit systematically from diagnostic tests and therapies.
Hemangioendothelioma: A Rare Entity at an Unusual Location
Authors: Patel Jayesh , Patel Nandini Hemant , Maheshwari Jaint , Ajediya Kartik Parmanbhai , Patel Arya 
Published: May 2024

Abstract
Epithelioid hemangioendothelioma (EHE) is a rare type of vascular tumor that behaves in a manner halfway between benign hemangiomas and malignant angiosarcomas. It is histologically distinguished by angiocentricity and solid, cord-like arrangements of epithelioid cells with intracytoplasmic lumina containing red blood cells. Although uncommon in childhood, it can develop at any age and affects both sexes equally. Accurate diagnosis may require further evaluation with tru-cut biopsy due to its potential for false-positive metastatic cancer diagnoses. Treatment approaches vary based on symptomatology, ranging from regular follow-ups for asymptomatic patients to surgical resection with embolization for symptomatic cases. With the help of this case, we want to discuss the importance of considering EHE in the differential diagnosis of vascular lesions and the significance of tailored treatment strategies based on individual patient characteristics.
Atypical Presentation of Vasculitis: A Rare Case of Pediatric Critical Limb Ischemia
Authors: Sony Jithin , Satish Umesh Gheewala , Sagar Radhika , Vinay K S , Palaniswamy Poornima , Nekkanti Muralikrishna 
Published: May 2024

Abstract
Vasculitis is a systemic disorder characterized by inflammation of the blood vessels. Very rarely, it can manifest as critical limb ischemia. In this report, we present a case of a 10-year-old male child who presented with a nonhealing ulcer on his right lower limb for 2 years. After evaluation, he was diagnosed with large-vessel vasculitis and started on steroid therapy. However, the disease progressed despite immunosuppression. An angiogram revealed stenosis in the right external iliac, femoral, and popliteal arteries. Successful balloon angioplasty was performed to treat the stenosis, resulting in a significant improvement in the ankle-brachial pressure index. The patient was continued on steroids and antiplatelets, and subsequent follow-up showed both clinical and symptomatic improvement.
Superior Mesenteric Artery (Ileocolic Branch) Pseudoaneurysm with Contained Rupture Managed with Emergency Covered Stenting: A Case Report and Review of the Literature
Authors: Poornima P , Muralikrishna N , Sravan CPS , Sony Jithin , Vinay K S , Gheewala S Umesh , Vidhyasagar Radhika , Amullya K R , Babu Narendra 
Published: May 2024

Abstract
Splanchnic artery aneurysms are rare, and aneurysms of the superior mesenteric artery (SMA) and its branches are rarer. A pseudoaneurysm can occur in SMA and its branches due to various factors such as infections or inflammation, postsurgical, and posttrauma. Although rare, they can have lethal consequences. Hence, they have to be identified and managed promptly. Here, we present a rare case of pseudoaneurysm of the ileocolic artery (branch of SMA) with contained rupture in a patient postappendicectomy, which was managed endovascularly with a covered stent.
Factors Associated with Mortality among Patients with Colorectal Cancer at the Secondary Care Hospital in Southern Thailand: Hospital-Based Retrospective Cohort Study
Authors: Maimard Yameela , Woradet Somkiattiyos , Chaimay Bhunyabhadh 
Published: May 2024

Background:
Globally and in Thailand, the incidence of colorectal cancer (CRC) is third-ranked behind lung and breast cancer, respectively. This hospital-based retrospective cohort study aimed to determine factors associated with mortality among patients with CRC.

Methods:
This study was performed by using the secondary data of the cancer registry among patients with CRC registered in Phatthalung Hospital. Two hundred twenty-eight patients with CRC were diagnosed and followed up from January 2014 to December 2018. Multiple logistic regression analysis was used to analyze factors associated with mortality among subjects with CRC.

Results:
The results revealed that the proportion of mortality among subjects with CRC was 50.44% (115 cases) at six months of following up. Subjects who had an increasing age every ten years (adjusted odds ratio [ORadj] = 1.40, 95 percent confidence interval [95% CI]: 1.09–1.80) were diagnosed with CRC at stage 3 (2.64, 1.19–5.84) and at stage 4 (11.63, 2.69–50.15) more likely to die. Also, subjects who received a combination of chemotherapy and radiotherapy treatment (3.44, 1.20–9.85), combination treatment of surgery, and postoperative care (2.46, 1.22–4.94) were more likely to die. Subjects who had not had surgery treatment were more likely to die (35.00, 7.44–168.27).

Conclusions:
In conclusion, factors such as the age of patients, stage of CRC, and treatment were associated with mortality among patients with CRC. Hence, medical and health professionals should consider these factors according to the treatment and optimization in patients with CRC.