bluuebunny/crossref_metadata_2025_split huggingface dataset:
Advancing Patient Blood Management: Evaluation of Ferric Derisomaltose in a Tertiary Hospital
Authors: Kambali Mohd Muhaimin , Azmi Engku Hamidah Engku Muhammad 
Published: May 2024

ABSTRACT

Background and Objectives:
One of the aims of patient blood management (PBM) programs is to improve patient outcomes by managing anemia and avoiding unnecessary blood transfusions. Ferric derisomaltose (FDI) is a treatment that allows for the injection of high doses of iron in a shorter time, which makes it a promising approach for correcting iron-deficiency anemia (IDA) more efficiently. This study aimed to assess the safety, effectiveness, and cost implications of FDI in a PBM program and its impact on transfusion requirements.

Methods:
A retrospective analysis was conducted on electronic medical records of adult patients diagnosed with IDA who received FDI as part of a PBM strategy in a tertiary hospital from November 2019 to June 2021. Descriptive statistics summarized patient characteristics and outcomes. Changes in hemoglobin (Hb) levels were evaluated using a paired t-test. Cost analysis included direct and indirect expenses associated with FDI administration compared to alternative treatments.

Results:
Out of the initially enrolled 110 patients, 67 were included in the analysis. A mean increase in Hb levels of 2.7 ± 1.9 g/dL was observed as early as 4 days post-FDI administration. The majority of patients (94.0%) tolerated FDI well, with only a few experiencing mild adverse reactions. Following FDI administration, blood transfusion was avoided by 88% of patients. Cost analysis revealed that while FDI demonstrated higher direct costs compared to alternative treatments, its potential for lower total costs became apparent when considering both direct and indirect expenses.

Conclusions:
FDI demonstrated promising results in rapidly correcting IDA within a PBM program. It reduced the need for blood transfusions, with the treatment being well-tolerated by patients. The inclusion of FDI administration in PBM programs offers a convenient, efficient, and potentially cost-effective approach to managing IDA.
Phenotypic Frequency of Clinically Significant Blood Group Antigens (Rh, Kell, Kidd, and Duffy) in Blood Donors of the Blood Center at a Tertiary Care Referral Teaching Hospital in Tirupati, Andhra Pradesh, South India
Authors: Sreedhar Babu K. V. , Praveen M. D. , Suresh Babu B. 
Published: May 2024

ABSTRACT

Background and Objectives:
The knowledge of various blood group antigen and phenotype frequencies in a population is important in selecting compatible blood in alloimmunized patients. Such information in Indian population is very limited. Hence this study was carried out to determine the frequency of clinically significant antigens. Such information in Indian population is very limited.

Methods:
This study was carried out to determine the frequencies of the D, C, c, E, e, K, k, Fya, Fyb, Jka, and Jkb antigens in 1024 blood donors at our department. Samples were collected for extended antigen typing during March 2016–February 2017 for D, C, c, E, e, K, k, Fya, Fyb, Jka, and Jkb antigens using monoclonal antisera by column agglutination technology. Antigenic and phenotypic frequencies were expressed as percentages.

Results:
Among the Rh system, “e” antigen was found in 98.6% of donors, followed by D (92%), C (89%), c (56%), and E (17%) with DCe/DCe (R1 R1, 41.4%) as the most common phenotype. “k” was found to be positive in 97% of donors, and K+k− phenotype was found in 0.1% of donors. For Kidd and Duffy blood group system, Jk(a+b+) and Fy(a+b+) were the most common phenotypes with frequency of 56.2% and 47.5%, respectively. MNS antigens were not included on account of financial constraints.

Conclusion:
Database for antigen frequency of various blood group systems in native donors helps provide antigen-negative compatible blood units to patients with multiple antibodies in order to formulate in-house red cells for antibody detection and identification and for preparing donor registry for rare blood groups.
Effectiveness of Therapeutic Plasma Exchange in Autoimmune Neurological Diseases in a Tertiary Care Hospital of South India
Authors: Bogi Murali Krishna , Kumar Kandukuri Mahesh , Vujhini Sudhir Kumar , Bonagiri Shanthi 
Published: May 2024

ABSTRACT

Background and Objectives:
Therapeutic plasma exchange (TPE) is commonly used as a treatment of certain autoimmune neurological diseases, and its main target is to remove pathogenical toxins or autoantibodies. Removed plasma with toxins and autoantibodies is replaced by crystalloids, colloids, and/or normal saline. It is more effective and cost-effective than immunoglobulins. The aim of this study was to know the effectiveness of TPE in autoimmune neurological diseases.

Methods:
This is a prospective study involving 376 autoimmune neurological cases, and the duration of this study was 5 years. All autoimmune neurological patients irrespective of age with complaints of weakness in limbs, respiratory distress, and acute myasthenia gravis (MG) crisis cases were included in the study. The Modified Rankin Score and MG Composite Score were used to analyze the severity of the disease, and the number of TPE procedures or cycles was planned.

Results:
The total number of cases included was 376 (322 newly registered cases and 54 old and relapse cases), and the total number of TPE procedures done was 1491 between the years 2017 and 2021. Male patients were 138 and female patients 238. The most number of cases were of MG, followed by Guillain–Barre syndrome. The mean number of TPE procedures done was 6.1 cycles in myasthenia crisis patients. There was a significant improvement in the patients after the treatment. The Modified Rankin Score and MG Composite Score were 1/6 and 3/50, respectively (P = 0.0321 and P = 0.0298, respectively) after completion of the TPE.

Conclusion:
TPE is the most effective method in cases of neurological autoimmune diseases. Most of the cases show improvement immediately after the first cycle, and more than half of the cases will be able to walk or do their routine activities after 2 or 3 cycles. It is a safe and cost-effective treatment modality with minimal side effects or complications.
Prevalence and Clinical Significance of Immunoglobulin G1 and Immunoglobulin G3 Subclasses of Anti-D Antibody in Rh D Alloimmunized Antenatal Women
Authors: Vaheedu A. A. Arif , John Soonam , Meena D. , Shaiji P. S. 
Published: May 2024

ABSTRACT

Background and Objectives:
Hemolytic disease of the fetus and newborn (HDFN) occurs as a result of maternal sensitization to paternal antigens. Studies have shown that the immunoglobulin G (IgG) subclass in maternal serum – particularly the presence of IgG1 and IgG3 either singly or in combination, has an impact on the presence and severity of HDFN. The column agglutination technology is used for the identification of IgG1 and IgG3 subclasses. Therefore, the prevalence of IgG1 and IgG3 subclasses in a cohort of alloimmunized Rh (D) antenatal women at our center was studied and was correlated with severity of HDFN. The aims of this study were as follows: (1) to find out the prevalence of IgG1 and IgG3 subclasses among Rh (D) alloimmunized women and (2) to assess the clinical outcome of newborns born to mothers with respect to IgG subclass.

Methodology:
This was a descriptive study done on 75 antenatal Rh (D) alloimmunized women who fulfilled the inclusion criteria. Blood samples from study participants were subjected to IgG subtyping using the “DAT IgG1/IgG3 ID card” (Bio-Rad, Switzerland), and the outcome of pregnancy was assessed by categorizing the newborns into mild, moderate, and severe HDFN. The data obtained were analyzed using SPSS version 16. Prevalence was calculated and severity of HDFN was correlated with subclass.

Results:
Among the study population, 23% of mothers had IgG1 alone. Majority (72%) had both IgG1 + IgG3 subclasses and a few (5%) had IgG2 + IgG4. When the mother had both IgG1 + IgG3 subclasses in their body most newborns had only mild HDFN. Few cases of moderate-to-severe cases of HDFN were seen. Most newborns had only mild HDFN even though there were few moderate-to-severe cases of HDFN. No significant association could be demonstrated between severity of HDFN and type of IgG subclasses.

Conclusion:
Majority of maternal IgG found in HDFN was a combination of IgG1+IgG3.Such cases exhibited stronger grades of reaction in Indirect Coombs Test. A significant association could not be demonstrated between severity of HDFN and type of IgG subclasses.
Blood Donor Counselling, Notification, and Referral: Experience from a Tertiary Care Hospital of North India
Authors: Prinja Nippun , Yadav Anshika , Singh Shailendra , Pal Lokesh 
Published: May 2024

ABSTRACT

Background and Objectives:
The concept of blood donor notification and counseling has gained recognition as an essential component of blood safety and donor care. By examining the effectiveness, feasibility, and acceptability of this intervention, valuable insights can be gained to inform future improvements in practices in the region and around the globe.

Methods:
This retrospective study was conducted at department of transfusion medicine on 18197 consecutive whole blood & component donors who visited the blood Centre between April 2018 and January 2023. The intervention involved the implementation of a blood donor notification and counseling system.

Result:
178 donors were reactive in the study period with prevalence rate of (0.9%).112 (62.9%) donors out of 178 seroreactive donors could be contacted telephonically from the blood Centre. These are called as notified donors. Remaining 66 seroreactive donors could not be contacted. 39 donors out of 178 seroreactive donors were responders and remaining 139 donors were non-responders.

Conclusion:
This study highlights the significance of an efficient and comprehensive donor referral and notification system in ensuring the safety of blood transfusions but still lot of ground work needs to be done. Effective communication, personalized counseling, and continuous education form pillars of this process. The prevalence of transfusion-transmissible infections among blood donors further emphasizes the need for prompt action and appropriate referral for further evaluation and care.
A Case of Large Arteriovenous Fistula Aneurysm at Elbow
Authors: Pinjala Nikhila , Gogineni Jyotsna Choudary , Ramakrishna Pinjala , Mallu Yougander 
Published: May 2024

Abstract
Arteriovenous (AV) fistula aneurysms are a late-onset complication of surgically created dialysis access sites. They can be of two types: true or false aneurysms (pseudoaneurysms). They can be managed either by endovascular or surgical techniques. We report a patient who presented with an expanding, painful AV fistula aneurysm at the left elbow along with features of left arm and forearm cellulitis. The fistula was ligated and the aneurysm was excised. Postsurgery, the left radial pulse was palpable. Follow-up postsurgery showed a healthy surgical scar with complete resolution of the left upper limb swelling.
COVID-19-induced Neonatal Acute Aortic Thrombosis
Authors: Kadam Sameer S , Sharma Saakshi 
Published: May 2024

Abstract
Venous thromboembolism is a well-recognized, common complication of a severe COVID-19 disease. Arterial thrombosis is a less known complication, now being reported increasingly, mostly in the form of myocardial infarction and stroke, but acute aortic occlusion is infrequent. Neonatal acute aortic thrombosis as a sequelae of COVID-19 disease has far uncommon incidence with no literature-based evidence till date. A 10-day-old male child presented to the emergency department with informant being his mother with complaints of black discoloration of his right foot for 4 days noticed first on his toes. No history of trauma, no history of fever, and no history of umbilical artery catheterization at birth was noted. Birth history-full term normal vaginal delivery, small for gestational age baby, cried immediately after birth, birth weight – 2.45 kg with no additional birth events. No history of neonatal intensive care unit stay, immunized at birth. Baby was 3rd by order of birth with no congenital anomalies noted in previous siblings. On examination, the baby was alert, afebrile, heart rate – 138/min, blood pressure – 90/60 mmHg, and SpO2 98% on room air. Local examination of the right lower limb revealed black discoloration of the right lower limb from toes up to mid-calf, CRT-delayed in the right thigh (7 s), right femoral pulsations absent, left lower limb – pink, warm, CRT – 6 s, feeble pulsations of left femoral artery and popliteal artery, absent pulsations of left anterior tibial artery, and posterior tibial artery. A Doppler study revealed the presence of partial lumen occluding thrombus (hyperechoic) in abdominal aorta below the level of renal arteries, absent flow in right lower limb, and monophasic flow in left femoral artery. A prothtrombotic screen was performed and COVID-19 antibody test was found to be positive. A systemic thrombolysis with injection reteplase was performed which showed mild improvement in circulation with propagation of clot up to origin of superior mesentric artery on a Doppler scan. An abdominal aortic embolectomy was performed, with retrieval of a long segment thrombus from distal abdominal aorta and bilateral femoral arteries following good proximal inflow and good distal backflow. Bilateral limb perfusion improved postoperatively though the gangrenous right lower limb could not be saved and a right below knee amputation was performed for the same. This case adds to the growing list of potential sites and consequences of thrombosis in COVID-19 infection. We speculate that this case of aortic thrombosis was a result of direct COVID-19-induced vascular damage in the context of a hypercoagulable state with a possibility of vertical transmission of the disease.
Pelvic Congestion Syndrome Secondary To Concomitant Posterior Nutcracker Syndrome and May Thurner Syndrome: A Case Report
Authors: Abraham Siju T , Matad Siddharth , Nazareth Vinay , Sumanth KB Raj , Anand Vivek 
Published: May 2024

Abstract
Pelvic congestion syndrome (PCS) is an overlooked condition affecting millions of women worldwide with chronic pelvic pain. Nutcracker syndrome (NCS) is an uncommon cause of PCS, which develops due to compression of the left renal vein, resulting in pelvic venous hypertension. Its association with May–Thurner syndrome (MTS), which refers to compression of the left common iliac vein by the right common iliac artery, is an extremely rare clinical entity, which may lead to further worsening of the symptoms arising out of pelvic venous congestion. We report a middle-aged female having concomitant posterior NCS and MTS leading to PCS, which was managed by endovascular percutaneous intervention.
Carotid Web – An Unusual Cause for Ischemic Stroke in a Young Woman
Authors: Sekar Natarajan , Sima Rahul Ralph , Rajan Archana , Thandeswaran Sivarajan 
Published: May 2024

Abstract
Carotid web (CW) is a rare condition where a shelf-like projection of intimal fibrous tissue is seen arising from the posterior wall of the carotid bulb. It is regarded as a high-risk factor for ischemic stroke of undetermined etiology. Although there is no clear consensus as to the management of these patients, the published literature is more in favor of intervention rather than medical management due to the higher incidence of recurrent stroke in conservatively managed patients. We present a case of a young woman with ischemic stroke due to CW who was managed successfully with thrombolysis followed by endovascular management.
The Association Between OSA and Glycemic Control in Diabetes
Authors: Mehrdad Mojtaba , Azarian Mehrnaz , Sharafkhaneh Amir , Alavi Ali , Leili Ehsan Kazemnezhad , Rad Afagh Hassanzadeh , Dalili Setila 
Published: May 2024

Background:
Obstructive sleep apnea (OSA) is the most common sleep-realted respiratory disorder. It is frequently comorbid with cardiovascular, cerebrovascular, and metabolic diseases and is commonly observed in populations with these comorbidities. Investigators aimed to assess the effect of OSA on glycemic control in patients with diabetes.

Methods:
In this cross-sectional study, 266 adult patients with diabetes mellitus (DM) attending the outpatient endocrinology clinic at the Guilan University of Medical Sciences were enrolled. Patients completed a checklist that included demographic characteristics, factors, and laboratory results in addition to Berlin and STOP-BANG questionnaires to evaluate the risk of OSA. Data were analyzed by independent t-test, Mann–Whitney U test, and Chi-squared or Fisher's exact tests using the Statistical Package for the Social Sciences (SPSS) version 17.

Results:
A total of 266 patients with DM were enrolled in this study (34.6% males, mean age 47.00 ± 19.04 years). Based on the Berlin Questionnaire, 38.6% of all participants were at high risk of developing OSA. Based on the STOP-BANG Questionnaire (SBQ), 45.1% were at moderate and high risks. Additionally, this questionnaire showed a significant difference between low and moderate-to-severe groups regarding sex, age, body mass index (BMI), neck size, other chronic diseases, types of DM, use of insulin, Berlin Questionnaire, fasting blood sugar (FBS), and mean HbA1c.

Conclusions:
Based on the SBQ, our results indicated a significant relationship between OSA and glycemic control according to mean HbA1c and FBS. Therefore, by controlling the OSA, we may find a way to acheieve better glycemic control in diabetic patients.
Scoping Review on Interventions, Actions, and Policies Affecting Return to School and Preventing School Dropout in Primary School
Authors: Eslamian Ayoub , Arshi Maliheh , Tahmasebi Siyamak , Alipour Fardin , Rafiey Hassan 
Published: May 2024

Background:
Dropout is one of the most important social problems in the world and especially in low- and middle-income countries. Efforts to prevent dropouts require giving due attention to different perspectives for applying them. The present study aims to identify the policies and interventions made in previous studies because reviewing evidence-based interventions and learning from their strengths and weaknesses is likely to play an effective role in preventing students from leaving school and returning them to school.

Methods:
This scoping review study conducted on all available studies and documents related to students' dropout. The study population includes articles searched in electronic sources that contain information related to the subject of dropout and out-of-school in primary schools. Appropriate keywords were extracted based on Mesh term and EMTREE and their synonyms and searched by a medical librarian. scientific sources and Gray literature published in Persian and English based on PRISMA standard criteria were reviewed.

Results:
A review of studies indicated that various interventions such as student interaction with school, educational interventions on students and teachers, family and local community cooperation, free nutrition, behavioral interventions, financial aid, and free education had positive effects on reducing dropout, absenteeism and encouraging students to return to schools. effect size was not reported for school dropout intervention.

Conclusions:
The findings have indicated that intervention with a combination of global and targeted strategies can affect dropout in developing countries. However, to confirm the effectiveness of this type of intervention, further research is required to be conducted in different countries and with different cultures.
Tyrosol and Olive Oil Ameliorate Sodium Arsenate-Induced Nephrotoxicity by Modulating of Oxidative Stress and Histological Changes in Mice
Authors: Zargari Mehryar , Mohammadian Mona , Malekshah Abbasali K. , Mianabadi Manijeh , Mogaddam Amir E. , Amiri Fereshteh T. 
Published: May 2024

Background:
Sodium arsenate (Na 3As0 4, Sodium As) is an important toxic substance that leads to nephrotoxicity. Due to having bioactive molecules, such as polyphenols and tyrosol, olive oil plays a significant role in scavenging free radicals. This study aimed to investigate the effects of olive oil and tyrosol on As-induced nephrotoxicity.

Methods:
In our study, 42 adult male BALB/c mice were randomly divided into six groups: control (normal saline), olive oil (0.4 ml/d, gavage), tyrosol (5 mg/kg/d), Sodium As (15 mg/kg), olive oil + Sodium As, and tyrosol + Sodium As (olive oil and tyrosol received one hour before Sodium As). Drugs were administreted once daily for 30 consecutive days. On the 31st day of the study, oxidative stress parameters in kidney tissue, FRAP in plasma, renal function parameters in serum, and histopathological assays were performed.

Results:
Sodium As-induced renal damage as characterized by a significant increase of creatinine and BUN (P < 0.001) and histopathological changes. Also, Sodium As markedly altered oxidative stress biomarkers such as a significant increase in MDA (P < 0.001) and significantly decreased in FRAP and GSH (P < 0.01). Olive oil and tyrosol administration significantly improved the renal antioxidant defense system and decreased MDA concentration, markedly preserving the tissue structure and functional markers of kidney. However, these effects were more effective for tyrosol than olive oil.

Conclusions:
Our results suggest that olive oil and tyrosol can be used as a protective agent in preventing Sodium As-induced nephrotoxicity due to antioxidant property.
Three-dimensional Evaluation of the Nasolacrimal Duct and Maxillary Sinus Ostium in Patients with Cleft Lip and Palate
Authors: Bozdemir Esin , Yarbasi Özlem 
Published: May 2024

Abstract

Objective:
Cleft lip and/or palate (CLP) is one of the most common congenital craniofacial anomalies. Individuals with CLP experience numerous problems including lack of nutrition, impaired speech, hearing loss, obstruction of nasolacrimal duct, poor dentition and facial morphology, and sinusitis. This study aimed to compare the nasolacrimal canal morphometry (nasolacrimal duct [NLD]), maxillary sinus ostium (MSO) localization, and presence of the accessory maxillary ostium (AMO) in patients with unilateral or bilateral CLP with healthy controls.

Materials and Methods:
The transversal and anteroposterior diameters and the length of the NLD were measured in 33 patients with unilateral CLP and 30 patients with bilateral CLP using cone-beam computed tomography. There were 16 (53.3%) males and 14 females (46.7%) in the bilateral CLP group and 18 males and 15 females in the unilateral CLP group. The mean ages of the patients were 17.36 ± 5.27 in patients with unilateral CLP and 18.6 ± 5.66 in patients with bilateral CLP. The anteroposterior location of the MSO and AMO was evaluated.

Results:
The transversal (P = 0.003) and anteroposterior (P = 0.002) diameters of NLD were found to be significantly different between the patients with bilateral CLP and the control group. The NLD length was found to be significantly different between the control group and the affected sides in the unilateral CLP group (P = 0.02). The MSO was found more in the middle region in the control group compared to the unilateral CLP group (P = 0.004). The AMO was found in 66.7% of the patients with bilateral CLP and 62.1% of the patients with unilateral CLP. The AMO was found more in the control group than in the bilateral CLP group (P = 0.01).

Conclusions:
Cleft lip and palate is an anomaly that can affect both the diameter and the length of the NLD and MSO localization.