bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Incidence of Evanescent Antibodies to Red Blood Cell Antigens in a Tertiary Care Hospital in Northern India
Authors: Chowdhury Sourav , Chowdhry Mohit 
Published: November 2023

Background and Objectives:
The anti-A and anti-B are naturally occurring antibodies in the human body but alloantibodies may be formed in individuals who lacks that corresponding red cell antigen after any sensitising event like blood transfusion or pregnancy. The aim of this study was to find the incidence of evanescenct RBC alloantibodies that may not be detectable at the time of pre-transfusion screening.

Methods:
This was a retrospective observational study from January 2017 to May 2019 in a tertiary care centre from North India. The data on antibody screening and identification retrieved from the departmental records. The patients were screened for red blood cell antibody and those with a positive screening test were further investigated for antibody identification. Antibody screening was performed by solid phase method using Immucor Capture-R Ready Screen (4 cell). Confirmed positive samples were investigated with advance methods of Antibody ID using Reagent panel Red Blood Cells Capture-R Ready ID (16 Cell) in Automated Analyzer Iris or Neo (Immucor Inc. Nocross, GA, USA). As and when required other advance techniques of adsorption and elution, etc were also performed too.

Results:
The total number of patient screened during this period were 8071. Amongst them 312 were positive for antibody screening (3.8%), of those 216 (62.9%) cases had alloantibodies and 96 (30.7%) cases had autoantibodies. Among the 216 cases of alloantibody, 147 (68.1%) cases had single alloantibody and 69 (31.9%) cases had multiple alloantibodies. Amongst the patients having single alloantibody, the prevalence was highest for Anti-D 54 (36.7%), followed by Anti-E 27 (18.3%), Anti-C 8 (5.4%), Anti-c 7 (4.7%), Anti-K 9 (6.1%), Anti-Fyb 11 (7.4%), Anti-M 18 (12.2%), Anti-N 4 (2.7%), Anti-Fyb 3 (2%), Anti-Lea 3 (2%), Anti-Cw 2 (1.3%) and Anti-Mia 1 (0.6%). Of the 96 patients with autoantibody 72 had warm autoantibody, 10 had cold autoantibody and there were 8 cases of mixed warm and cold autoantibodies. There were 6 patients with warm autoantibody with underlying alloantibody.

Conclusion:
In conclusion, the high prevalence of Anti-Rh (Anti-D, E), Anti-M, Anti-Fyb antibodies in patient requiring transfusion reiterates the importance of stringent antibody screening and identification as an essential step in preventing delayed hemolytic transfusion reaction.
Monitoring Blood Transfusion Policies and Implementation of Maximum Surgical Blood Ordering Schedule
Authors: Moshfegh Fereshteh , Farahbakhsh Negar , Bahraini Mehran , Kardan-Yamchi Jalil , Fazeli Alieh , Boluki Ebrahim 
Published: November 2023

Background and Objectives:
The procedure of blood ordering is a major issue in hospitals. Hence, maximum surgical blood ordering schedule is recommended to manage the blood application process properly. The aim of this study was to evaluate the demand and rate of blood consumption in different wards of a pediatric hospital.

Methods:
This is a cross-sectional on patients ≤18 years old who underwent major surgical procedures from 2015 to 2019. Data included type of department, number of total blood bags requested as well as cross-matched and transfused units. Furthermore, indices such as cross-matched to transfusion (Cross-matched to Transfused (C/T) ratio) in various hospital departments and months were calculated.

Results:
This study revealed that the utilization rate was 77.29% of blood units among a total of 97356 cases done. The emergency department consumed only 28.08% of its requests. C/T ratio for all departments of the hospital was 1.34. The most and lowest numbers of requests were for surgery 2 department and newborn intensive care unit, respectively. Furthermore, we have observed the lowest rate of C/T ratio in December.

Conclusions:
Our data showed that in the majority of elective pediatric surgical procedures, a large number of blood units tested for antibody screening were consumed, reducing the consumption of cord blood bags as well as the financial burden for the hospital and the patients. Furthermore, our findings revealed that based on the calculated C/T ratio, the hospital used the correct procedure for blood requests in period of 1 year. In addition, the time for preparation of blood was decreased dramatically.
Ultrasonographic evaluation of diaphragmatic excursion changes after major laparoscopic surgeries in the Trendelenburg position under general anaesthesia: A prospective observational study
Authors: Rustagi Preeti Sachin , Yadav Akshay , Nellore Shalaka Sandeep 
Published: November 2023

Background and Aims:
Laparoscopic surgeries result in increased intra abdominal pressure and cephalad displacement of the diaphragm. The Trendelenburg position can augment these respiratory changes. The primary objective of this study was to compare diaphragmatic excursions before and after a major laparoscopic pelvic surgery under general anaesthesia in the Trendelenburg position using ultrasonography (USG).

Methods:
This prospective observational study included 90 patients of either gender, aged 20–60 years, with American Society of Anesthesiologists physical status I/II. M-mode USG was used to assess diaphragm inspiratory amplitude (DIA) before induction of anaesthesia and 10 minutes after tracheal extubation. Factors such as age, gender, body mass index, positive end-expiratory pressure (PEEP), pain, peak airway pressures, duration of pneumoperitoneum, duration and degree of Trendelenburg position and duration of anaesthesia were recorded. Pearson’s correlation and multiple linear regression were used to analyse the factors affecting change in DIA (ΔDIA).

Results:
The mean difference (95% confidence interval (CI)) of measured DIA was 0.70 (0.598–0.809), P < 0.001. ΔDIA had a weak positive significant correlation with age, anaesthesia duration, pneumoperitoneum, and visual analogue scale (VAS) score 10 minutes after extubation. Multiple linear regression analysis showed 14.86% of the variance in DIA. Age (β = 0.008, P = 0.049), duration of anaesthesia (β = 0.002, P = 0.02) and VAS score 10 minutes after extubation (β = 0.128, P = 0.001) were significant independent predictors.

Conclusion:
DIA decreased significantly after pelvic laparoscopic surgeries performed in the Trendelenburg position. Age, duration of anaesthesia and pain after the procedure were significant independent predictors.
Validation of Hindi version of the obstetric quality of recovery score-11 (ObsQoR-11 H) following elective caesarean section
Authors: Gupta Sunanda , Choudhary Savita , Choudhary Vidhu , Jain Kajal , Bhatia Nidhi , Gupta Apoorva 
Published: November 2023

Background and Aims:
Obstetric quality of recovery score-11 (ObsQoR-11) was developed in English to evaluate the quality of recovery in the caesarean section. We aimed to validate the Hindi version of ObsQoR-11 (ObsQoR-11H) for Hindi-speaking patients to evaluate the quality of recovery following the elective caesarean section.

Methods:
The ObsQoR-11 was translated into Hindi and assessed for validity, acceptability and feasibility. The questionnaire was administered postoperatively at 24 and 48 hours, and the Global Health Numeric Rating Scale (NRS) was used to evaluate recovery.

Results:
The mean (standard deviation [SD]) (95% confidence interval [CI]) ObsQoR-11 H was 75.94 (4.09)(95% CI 75.1, 76.7) and 80.25 (4.08)(95% CI 79.5, 81) at 24 and 48 hours, respectively. The mean (SD) (95%CI) Global Health NRS scores were 71.22 (5.97)(95% CI 70, 72.4) and 77.37 (5.79)(95% CI 76.2, 78.5) at 24 and 48 hours, respectively. Convergent validity showed a strong correlation between ObsQoR-11H and Global Health NRS (Spearman’s correlation coefficient [rs] >0.8 and 0.78) scores at 24 and 48 hours, respectively. Discriminant validity was significant in appreciating the difference between good and poor recovery (P < 0.001). Split-half coefficient of 0.69 and 0.65 and Cronbach’s alpha (α) of 0.91 and 0.82 at 24 and 48 hours suggested good score reliability. The acceptability and feasibility of the score were also good.

Conclusion:
The ObsQoR-11H discriminated well between ‘good’ and ‘poor’ recovery and correlated strongly with Global Health NRS scores. It was found to be a valid, reliable, acceptable and feasible tool for psychometric recovery evaluation after elective caesarean section in Hindi-speaking women.
Short-axis versus long-axis approach for ultrasound-guided vascular access: An updated systematic review and meta-analysis of randomised controlled trials
Authors: Mishra Aparna , Kumar Mohan , Kumar Niraj , Goyal Keshav , Soni Kapil Dev , Yadav Anuradha 
Published: November 2023

Background and Aims:
There are two approaches for ultrasound (US)-guided vessel cannulation: the short axis (SA) approach and the long axis (LA) approach. However, it remains to be seen which approach is better. Therefore, we performed the present updated systematic review and meta-analysis to assess the effectiveness and safety of US-guided vascular cannulation between the SA and LA techniques.

Methods:
We performed a comprehensive electronic database search in PubMed, Embase, Cochrane Library and Web of Science for the relevant studies from inception to June 2022. Randomised controlled trials comparing the SA approach and the LA approach for US-guided vascular access were incorporated in this updated meta-analysis. The first-attempt success rate was the primary outcome. The secondary outcomes were the overall success rate, cannulation time, number of attempts and the incidence of complications. The statistical analysis was conducted using RevMan software (version 5.4; the Nordic Cochrane Centre, the Cochrane Collaboration, Copenhagen, Denmark). The Cochrane risk of bias tool was used to evaluate each study’s potential risk for bias.

Results:
In total, 16 studies consisting of 1885 participants were incorporated in this updated meta-analysis. No statistically significant difference was found between the SA and LA vascular access techniques for first-pass success rate (risk ratio = 1.07, 95% confidence interval: 0.94–1.22). The overall cannulation success rate, complication rate, average cannulation time and average number of attempts were not significantly different between the SA and LA groups.

Conclusion:
This updated meta-analysis demonstrated that the SA and LA approaches of US-guided vessel cannulation are similar regarding first-pass success, overall cannulation success rate, total complication rate, cannulation time and the number of attempts.
A randomised, double-blind, comparative study of preoperative magnesium sulphate versus zinc sulphate gargle for prevention of postoperative sore throat following endotracheal intubation
Authors: Mondal Amit Kumar , Maiti Asim Kumar , Chattopadhyay Suman , Bhar Debasish 
Published: November 2023

Background and Aims:
Magnesium sulphate and zinc sulphate have been reported to attenuate postoperative sore throat (POST). The study aims to compare the effect of preoperative magnesium sulphate and zinc sulphate gargle on the incidence and severity of POST following endotracheal intubation within 24 h.

Methods:
After ethics committee approval, 132 patients were randomly allocated to three groups (M, Z and D). Fifteen minutes before laryngoscopy and tracheal intubation, patients assigned to groups M and Z received a solution for gargle containing magnesium sulphate 20 mg/kg and zinc sulphate containing 40 mg of elemental zinc dissolved in 20 ml of 5% dextrose solution, respectively. Group D received 20 ml of 5% dextrose solution. Incidence and severity of POST (4-point score: Grade 0- no sore throat, Grade 1- mild sore throat, Grade 2- moderate sore throat, Grade 3- severe sore throat) was assessed for 24 h after extubation. Statistica, Version 8.0 (StatSoft, Inc., Tulsa, Oklahoma, USA) was used for analysing the data.

Results:
The lowest incidence of POST in group M was 13.6% (95% confidence interval [CI] 3.5–23.7) compared to 0% in group Z, whereas the highest incidence recorded in group M was 25% (95% CI 12.2–37.7) in contrast to 13.6% (95% CI 3.5–23.7) in group Z during the first 24 h after operation. It was observed that the incidence of mild POST (POST score 1) was significantly lower (P < 0.05) in group Z compared to group M in the first 4 h postoperatively.

Conclusion:
Zinc sulphate gargle before laryngoscopy and tracheal intubation is more effective for reducing the incidence of POST than magnesium sulphate gargle.
Knowledge, attitude, and practice patterns of Indian ophthalmologists regarding medicolegal issues
Authors: Agrawal Deepanshu , Heda Aarti , Ghosh Sayantan , Kalia Sonal , Bhatia Karan , Kumar Nilesh , Tripathy Koushik 
Published: November 2023

Purpose:
To assess the knowledge, attitude, and practice patterns (KAPP) of Indian ophthalmologists regarding medicolegal issues using an initial survey.

Methods:
An online form was circulated among Indian ophthalmologists of all ages over social media and email by the Young Ophthalmologists Society of India (YOSI) and its medicolegal working group. Anonymous responses were obtained and analyzed for each question. The questionnaire comprised questions about demographic details, KAPP of medicolegal issues including how to deal with medicolegal issues (if faced), medical indemnity insurance, deviation from the recommended minimum sum assured (Rs. 1 crore for Indian ophthalmologists), and legal service providers.

Results:
A total of 109 responses were obtained. The majority of the respondents were male (60, 55%). More than 50% of respondents (58, 53.2%) were younger than 35 years. More than one-fourth of the respondents were private practitioners (29, 27%), and the majority were of senior consultant designation (45, 41%). Around 80% of respondents (89, 81.6%) were aware of professional indemnity insurance; however, only 54% (n = 59) bought the insurance cover. A majority of the respondents (38, 64.4%) had an indemnity cover of a maximum of Rs. 50 lacs. Only 20% of respondents were aware of the expert body at the state/national level that deals with medicolegal cases. Thirty percent of respondents recommended the ideal cover amount to be more than Rs. 1 crore.

Conclusion:
The current survey highlights the dismally low rate of awareness of medicolegal issues among ophthalmologists. Specifically, a majority of Indian ophthalmologists surveyed did not have recommended minimum insured cover for professional indemnity insurance. Larger studies are needed to further explore KAPP of Indian ophthalmologists in various medicolegal issues.
Impact of COVID-19 on cataract surgical competency of ophthalmology residents
Authors: Ghiasian Leila , Aghili SeyyedSaeed , Abdolalizadeh Parya 
Published: November 2023

Context:
Coronavirus disease 2019 (COVID-19) pandemic led to a decrease in elective surgeries.

Purpose:
To compare the performance of postgraduate year 4 prepandemic (2018–2019) and pandemic (2021–2022) ophthalmology residents.

Settings and Design:
This was an observational comparative study conducted at a university-based hospital.

Methods:
Ophthalmology residents of postgraduate year 4 during prepandemic (2018–2019) and pandemic (2021–2022) time periods were included. The performances of residents in phacoemulsification were scored by a single faculty assessor using the International Council of Ophthalmology's Ophthalmology Surgical Competency Assessment Rubric for phacoemulsification (ICO-OSCAR: phaco). The scores were compared between the two groups.

Statistical Analysis Used:
The comparisons between the pre- and post-pandemic groups were performed using the Chi-square and Mann–Whitney U test.

Results:
Seventy-one surgeries were rated in each group. All task-specific and global scores of the pandemic group were lower than those of the prepandemic group (all P values < 0.001). The maximum intergroup difference was in capsulorrhexis circular completion (difference of 1.21 score, P < 0.001) and tissue handling (difference of 1.21 score, P < 0.001) among task-specific and global scores, respectively. The residents of the two groups had the highest similarity in irrigation and aspiration (difference of 0.61 score, P < 0.001) from task-specific scores and central eye position from global scores (difference of 0.93 score, P < 0.001).

Conclusion:
The COVID-19 pandemic has negatively affected the surgical competency of ophthalmology residents in phacoemulsification.
Study of rhino-orbital-cerebral mucormycosis and its correlates during COVID-19 pandemic in a tertiary eye care institute of central India
Authors: Verma Vidhya , Sarkar Deepayan , Moharana Bruttendu , Singh Priti , Noyadu Richa , Sharma Bhavana 
Published: November 2023

Purpose:
To evaluate factors associated with the occurrence of ROCM in COVID-19 patients and to compare its related parameters and outcomes between active and recovered COVID-19 groups.

Methods:
A total of 35 patients of ROCM associated with COVID-19 (active and post-COVID-19) were included. This is an ambispective study with retrospective medical records review for COVID-19 analysis and prospective assessments of ROCM-associated COVID-19 during the second wave of the COVID-19 pandemic. The demographic data, clinical parameters, and outcome were recorded on MS excel sheet, and various parameters were compared between active and recovered COVID-19 groups.

Results:
ROCM in recovered COVID-19 group was higher (57.1%) as compared to active COVID-19 (42.9%) (P = 1.00). High occurrence of ROCM was seen in those who had a history of hospitalization due to severity of COVID-19 (n 33, 94.28%), oxygen support (77.14), and received systemic steroids (82.9%). The most common comorbidity was diabetes mellitus (82.9%), and new-onset hyperglycemia was noticed in 17.1% of patients. Exenteration (28.6%) was performed in severe cases who had stage IV ROCM, bilateral, and CNS involvement (RR = 7.2, 95% CI: 2.91 to 18.00). The risk of globe exenteration was 1.35 (0.7-2.29) times higher in recovered COVID-19 group, and mortality was 1.76 (0.72-3.36) times higher in active COVID-19 group.

Conclusion:
Monitored use of systemic steroids and the prompt management of hyperglycemia in COVID-19 patients are important factors for favorable outcomes with reference to globe salvage and life-saving in ROCM associated with COVID-19. Even recovered COVID-19 patients should be observed for persistent hyperglycemia and occurrence of ROCM.
Assessment of risk of obstructive sleep apnea with thyroid eye disease and its activity
Authors: Kumari Namita , Arora Nitish , Das Sima , Tiple Sweety , Singh Harshdeep , Patidar Narendra , Mishra Mihir , Majumdar Atanu 
Published: November 2023

Purpose:
To evaluate the association between obstructive sleep apnea (OSA) and thyroid eye disease (TED) and its effect on disease activity.

Methods:
A prospective case–control study was conducted from January 2020 to March 2022. All TED patients (group A) were clinically evaluated. The activity of thyroid eye disease was calculated based on the clinical activity score (CAS), and grading of severity was done according to the EUGOGO classification. All TED patients (group A) were screened for OSA using the Snoring Tired Observed Pressure (STOP)-Bang survey. Age- and gender-matched control group patients (group B) without TED were screened for OSA.

Results:
One hundred TED patients and 138 control patients without TED were included in the respective groups. Sixty-two (62%) patients in group A and 48 (34.78%) patients in group B were having high risk of OSA, and this difference was statistically significant (P = 0.001). Further, in group A patients, on univariate analysis, TED activity was significantly associated with a high risk of OSA (P = 0.009). On multivariate logistic regression analysis, OSA also showed significant association with TED activity (odds ratio [OR]: 4.14, 95% confidence interval [CI]: 1.11-18.85 at 10% level; P = 0.05).

Conclusion:
Our study showed that OSA is significantly associated with TED disease and its activity. However, no significant association was found between OSA and severity of the disease.
Serum levels of sclerostin in prediabetes and its correlation with bone mineral density
Authors: Chauhan Ajay , Bhakhar Manoj Kumar , Goyal Parul 
Published: November 2023

Background:
Diabetes is a major burden globally, more commonly so in developing countries, as its complications are detected relatively late due to underdeveloped healthcare systems. These complications, when detected, are more or less irreversible, thereby leading to increased morbidity and mortality. Among these, complications related to bones (mainly osteoporosis) start fairly early (even in the prediabetes stage) but are less emphasized, nonetheless are major contributors to morbidity in diabetics due to increased fracture risk. One of the novel bone markers recently discovered is sclerostin, which helps in the assessment of the effect of hyperglycemia on bone homeostasis. Bone mineral density (BMD) by DXA scan is a good tool to assess the status of bone health but requires modern expensive radiological equipment. In this study, we wanted to see the correlation of serum levels of sclerostin to BMD so that by a simple serum investigation, early detection of poor bone quality in treatment-naive prediabetics can be done.

Objective:
The aim of the study was to measure serum levels of sclerostin in prediabetics, compare them with normoglycemic controls, and find the correlation of serum levels of sclerostin with BMD.

Methods:
50 prediabetic patients and 50 age, sex, blood pressure, and BMI-matched controls were recruited in the study. In both the groups, serum levels of fasting blood glucose and postprandial glucose, glycated hemoglobin (HbA1c), Vitamin D, fasting insulin, and serum sclerostin levels were measured in both groups using ELISA. The obtained values were compared between the two groups. Bone mineral density is measured by DXA scan in cases and a correlation between BMD and serum levels of sclerostin was observed.

Results:
Serum sclerostin was significantly higher in the cases [18.22 (19.42) ng/ml] compared to the control group [11.08 (4.73) ng/ml] with a P value of 0.013. The mean of BMD in prediabetes is 1.06 g/cm2, T score is − 1.02, and Z score is − 0.59. There was a significant negative correlation between serum sclerostin levels and BMD in prediabetes (r = −0.404, P < 0.001).

Conclusion:
Serum levels of sclerostin are increased in prediabetes and correlate well with low BMD in prediabetes, and can therefore be used for early recognition of osteoporosis and fractures in diabetes.