bluuebunny/crossref_metadata_2025_split huggingface dataset:
Moderate exercise mitigates cardiac dysfunction and injury induced by cyclosporine A through activation of the PGI2 / PPAR-γ signaling pathway
Authors: Nourmohammadi Khatereh , Bayrami Abolfazl , Naderi Roya , Shirpoor Alireza , Soraya Hamid 
Published: November 2023

Background and purpose:
The present study investigated the role of the prostaglandin I2/peroxisome proliferator activator receptor (PGI2/PPAR) signaling pathway in cardiac cell proliferation, apoptosis, and systemic hemodynamic variables under cyclosporine A (CsA) exposure alone or combined with moderate exercises.

Experimental approach:
Twenty-four male Wistar rats were classified into three groups, namely, control, CsA, and CsA + exercise.

Findings/Results:
After 42 days of treatment, the findings showed a significant enhancement in the expression of the β-MHC gene, enhancement in protein expression of Bax and caspase-3, and a significant decline in the protein expression of Bcl-2 expression, as well as increased proliferation intensity in the heart tissue of the CsA group compared to the control group. Systolic pressure, pulse pressure, mean arterial pressure (MAP), QT and QRS duration, and T wave amplitude, as well as QTc amount in the CsA group, showed a significant increase compared to the control group. PPAR-γ and PGI2 showed no significant changes compared to the control group. Moderate exercise along with CsA significantly enhanced the protein expression of PPAR-γ and PGI2 and declined protein expression of Bax, and caspase-3 compared to those in the CsA group. In the CsA + exercise group, systolic pressure, MAP, and Twave showed a significant decrease compared to the CsA group. Moderate exercises along CsA improved heart cell proliferation intensity and significantly reduced β- MHC gene expression compared to the CsA group.

Conclusions and implications:
The results showed moderate exercise alleviated CsA-induced heart tissue apoptosis and proliferation with the corresponding activation of the PGI2/PPAR-γ pathway.
Hyponatremia in Acute ST-elevation Myocardial Infarction – A Retrospective Observational Study
Authors: Aravind CL , Ravikiran R , Kumar Amith , Ranjith Kumar GK 
Published: November 2023

Introduction:
Hyponatremia is a common electrolyte disorder in hospitalized patients and has been linked to increased morbidity and mortality in various clinical settings. Patients with ST-elevation myocardial infarction (STEMI) are at risk of developing hyponatremia due to complex interplay of pathophysiological mechanisms. This study aimed to investigate the prevalence, risk factors, and prognostic value of hyponatremia in patients with STEMI.

Materials and Methods:
This was a retrospective study of 192 patients with STEMI who were admitted to a tertiary care hospital between July 2021 and December 2021. Patients were divided into two groups based on their serum sodium levels during hospitalization: Hyponatremia group (serum sodium <135 mEq/L) and normonatremia group (serum sodium ≥135 mEq/L). The prevalence of hyponatremia, demographic variables, ejection fraction, Killip classification, type of STEMI, and in-hospital mortality were compared between the two groups.

Results:
20.8% of patients with STEMI had hyponatremia during their hospital stay. Patients with heart failure, lower ejection fraction, and higher Killip classification at admission were more likely to have hyponatremia ([odds ratio (OR): 2.71, 95% confidence interval (CI): 1.23–5.97, P = 0.014], [P = 0.023] and P = 0.002). Patients with lateral STEMI were more likely to have hyponatremia compared to those with other types of STEMI (OR: 2.68, 95% CI: 1.06–6.81, P = 0.037). Patients with hyponatremia had higher in-hospital mortality rate (8 [22.9%], [OR: 4.27, 95% CI: 1.54–11.85, P = 0.005]) and longer hospital stays (P = 0.019) compared to normonatremia group.

Conclusion:
Hyponatremic patients with STEMI are associated with increased morbidity and mortality. Patients with heart failure, lower ejection fraction, and higher Killip classification at admission should be closely monitored for dyselectrolytemia.
A Study of Diabetes in Young Individuals with Special Reference to Type 2 Diabetes Mellitus
Authors: Babu M. Suresh , Yavasani Neil Krishna Reddy 
Published: November 2023

Background:
Type 2 diabetes mellitus (T2DM) in young individuals is a serious concern for the society. Literature suggests that the incidence of T2DM is not only increasing, but also there is a shift of age of onset of T2DM toward younger age groups in India and worldwide. However, data about the frequency of T2DM among young subjects below 25 years of age are sparse in the Indian subcontinent. Hence, the current study was undertaken to find out the frequency and clinical profile of young individuals with T2DM in the departments of internal medicine and pediatrics in a tertiary care hospital.

Aims and Objectives:
The aim of the study was to study the frequency and clinical profile of T2DM among young individuals with diabetes mellitus.

Materials and Methods:
The study was a cross-sectional observational study conducted in the Departments of General Medicine and Pediatrics at JSS Hospital, Mysuru, Karnataka, India, over a 2-year period. The subjects with age of onset of diabetes mellitus below 25 years were included in the study. They were categorized according to the C-peptide values as type 1 diabetes mellitus (T1DM) and T2DM. Maturity-onset diabetes of the young (MODY) was diagnosed with the age of onset of diabetes below 25 years with a strong family history of diabetes for three generations and no insulin requirement for metabolic control for 5 years after diagnosis. The statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS version 25).

Results:
Of the 250 patients included in the study, 208 (83.2%) subjects were T1DM, 38 (15.2%) T2DM, and 4 (1.6%) with MODY. The mean age of onset of T1DM was 13.7 ± 6.201 years and T2DM was 23.28 ± 3.68 years. Body mass index (BMI) and waist circumference of young T2DM patients were more compared to T1DM, which were statistically significant P < 0.0001, and family history showed strong positivity in patients with young T2DM compared to T1DM. Low-density lipoprotein cholesterol (LDL-C), triglycerides (TGs), and total cholesterol (TC) were more in young T2DM patients compared to T1DM which were statistically significant with P = 0.003 (LDL), P = 0.0015 (TG), and P = 0.03 (TC), respectively.

Conclusions:
T2DM, previously considered a middle-aged or elderly condition, is now commonly occurring in young adults and children, probably due to a growing epidemic of childhood obesity and lifestyle. Obesity and dyslipidemia were more in T2DM compared to T1DM among young diabetics.
Ruptured hydrosalpinx masquerading an ectopic pregnancy in a woman of reproductive age group
Authors: Kalluri Sri Sowmiya , Priyanka Yoga P , Vijayan Sharmila , Sankaralingappa Arundati 
Published: November 2023

Abstract
Acute abdomen in women of child-bearing age remains a diagnostic dilemma. Etiology of acute abdominal pain may be due to obstetric, gynecological, gastrointestinal, or genitourinary causes. Early diagnosis and decision on conservative management versus emergency laparotomy/laparoscopy should be made in cases with acute abdomen as a lifesaving approach. We report a rare case of acute abdomen with hemoperitoneum due to rupture of hydrosalpinx.
Perioperative myocardial infarction: An anesthesiologist’s nightmare!
Authors: Sebastian Geethu , Kesavan Rajesh , Thomas Dimple E , Kumar Lakshmi 
Published: November 2023

Abstract
An acute ST elevation myocardial infarction (STEMI) in the perioperative period can be challenging. Effective cardiopulmonary resuscitation with multidisciplinary support systems including percutaneous coronary intervention within the recommended times enhances recovery and outcomes. We present a case of a young patient who developed STEMI despite being a low risk for intraoperative major adverse cardiac events.
Cholecystoduodenal fistula: An incidental finding of gall stone disease in a young male
Authors: Sharma Aditya , Meena Ram N , Khanna Rahul 
Published: November 2023

Abstract
Chronic calculous cholecystitis, if left untreated for a long time, can lead to a bilioenteric fistula, which is an aberrant connection between the bile duct system and the gastrointestinal tract. These fistulas have a variety of clinical manifestations and may risk the patient’s life. Hence, the authors report a rare case of a patient presenting with a cholecystoduodenal fistula.
Evaluation of Efficacy of Low-Intensity Pulsed Ultrasound on Comorbidities Following Mandibular Impacted Third Molar Surgery: A Prospective Study
Authors: Rao Keerthana , Kumar KR Ashok , Kumar R. Mahesh , Marimallappa T. R. , Pal Supriyo , Dutta Subham 
Published: November 2023

Abstract

Introduction:
Despite several in vitro and in vivo applications of low-intensity pulsed ultrasound (LIPUS), it remains an under-studied feature of the oral and maxillofacial region. The goal of this in vivo study was to objectively investigate the efficacy of low-intensity pulsed ultrasound on wound healing and related morbidities following surgical removal of an impacted third molar.

Materials and Methods:
The following in vivo prospective, comparative, randomised controlled clinical study was carried out amongst 56 patients who reported to the Department of Oral and Maxillofacial Surgery fulfilling the inclusion criteria. Group A received sham ultrasound, whereas Group B received LIPUS therapy. Based on the group allocated LIPUS 1 MHz, pulsed 20% and dose 1.0 watts/square centimetre (W/cm2)/sham, ultrasound therapy was given on 1st, 2nd and 3rd post-operative days. The assessment of post-operative pain, oedema, trismus and wound healing on preoperative, first, third and seventh postoperative days.

Results:
The quantitative variables of the study were assessed using independent sample t-test, and qualitative variables were assessed using the Chi-square test. The P < 0.05 on third and seventh post-op days for pain, trismus and wound healing in the LIPUS group compared to control group making it statistically significant. There was no statistically significant difference in the reduction of oedema amongst the two groups.

Discussion:
Post-LIPUS application in the patients, postoperative pain was significantly reduced, trismus was noticeably improved and wound healing was satisfactory and can be employed as a complementary technique.
Correlation between Hepatitis B Viral Load and Hepatitis B Surface Antigen Levels in Asymptomatic Seropositive Blood Donors
Authors: Pandey Prashant , Setya Divya , Ranjan Shweta , Kumari Supriya , Kumar Dharmender 
Published: November 2023

Background and Objectives:
Correlation has been shown between hepatitis B surface antigen (HBsAg) and hepatitis B virus (HBV) levels in different patient categories. However, this has not been studied for donors. The aim of this study was to study the relationship between HBV DNA levels and E ratio obtained for HBsAg testing by chemiluminescence immunoassay (CLIA) performed on donor samples.

Methods:
A prospective, observational study was conducted in the department of transfusion medicine at a large tertiary health-care setup in North India from 2017 to 2021. Serological testing for HBV included HBsAg testing by CLIA. All reactive samples were tested in duplicate by electro CLIA (eCLIA). All samples found to be reactive in all three tests were then tested by a rapid diagnostic test and quantitative polymerase chain reaction.

Results:
During the study duration, 251 donors were found to be reactive for HBsAg by CLIA and eCLIA in screening. Of these 251, HBV DNA could not be detected in 85 (33.86%) samples, whereas in rest 166 (66.14%) samples, HBV DNA was detected. Mean E ratio for CLIA for all 251 samples was 5177.45, whereas mean viral copies detected were 19645858.66. The correlation for all 251 samples was found to be weak negative. The correlation for sero-reactive samples with the presence of HBV DNA was also found to be weak negative.

Conclusion:
In conclusion, we found significant but weak correlation between HBsAg results obtained by CLIA and HBV DNA levels for blood donors. The measurement of HBV DNA level is necessary for all apparently healthy donors coming for blood donation and testing reactive for HBsAg in screening assays.
Improving Turnaround Time for the Issue of Blood Components in Case of Emergency
Authors: Gnanaraj John , Kulkarni Rajendra , Sahoo Dibyajyoti , Basavarajegowda Abhishekh 
Published: November 2023

Background and Objectives:
During a surgical or medical emergency, the timely issue of crossmatched blood is crucial for efficient and satisfactory patient revival. Turnaround time (TAT) is the duration taken from the time blood requests, and samples are received in the blood center until the blood is crossmatched and available for blood transfusion. The study aimed to audit the TAT in our center, analyze and study the factors delaying TAT, and formulate plans to improve it by implementing corrective measures. These actions would directly or indirectly impact the outcomes of the delivery of patient care in emergency services.

Methods:
A record-based prospective study was performed in a tertiary care teaching hospital with trauma and all emergency services in Southwestern India. TAT was calculated for all emergency blood requests received over 16 months in a systematic sampling method. Cases with prolonged TATs, where the product issue TAT exceeded the internal policy and quality indicator standards (15 min for emergency packed red blood cells issue), were further evaluated for causes of delay and analyzed at frequent intervals.

Results:
The mean TAT at the start of the study was 17.1 min (standard deviation [SD] 1.05 min), gradually reducing to 14.9 min (SD 0.62 min) by the end of the study, and it was statistically significant with P = 0.01.

Conclusion:
It is essential to deduce the causes for delayed TAT and work on those variables amenable to modifications based on priority to improve the TAT regarding pretransfusion testing and the issue of blood products, which is crucial in emergency services.
Pilot Study of Centralized Management System in Shanghai: A Promising Solution to Platelet Collection and Supply Imbalance in Small Blood Banks
Authors: Ma Rongna , Liu Yuning , Liu Hong , Xu Zhong , Wu Xiaofei , Jia Yao , Huang Yuwen , Mo Qin , Wang Xun 
Published: November 2023

Background and Objectives:
While there exists a significant wastage of platelets on one side (volatile demands and short lifetime), there is also a shortage for use on the other (lack of donors and emergency transfusions). A new centralized management system was established to tackle this dilemma.

Methods:
To assess the function of this system, data were collected from the Fengxian Blood Bank (FBB) Collection and Supply Information System during 2016 and 2018, then analyzed by IBM SPSS Statistics version 20.

Results:
Since implementing the centralized management system, a total of 1340 units of apheresis platelets were distributed by FBB. However, the number of units collected was 2737, twice as much as what had been distributed. With the aid of the system, the excess of 1644 units of apheresis platelets were transferred to the Shanghai Blood Center (SBC) inventory at their disposal. On the other hand, 247 units (included in 1340 distributed units) were compensated by SBC during the platelet shortage. In addition, the hospital demand meeting rate shows a significant increase from 82.61% to 99.78%, especially for type AB which increases from 62% to 100%.

Conclusions:
In conclusion, the centralized management system vastly improved the efficiency of platelet collection and distribution by the regional supply and demand. Such success would be a superb example of blood banks facing similar problems.
Experience of Granulocyte Collections and Transfusions in Resource-constrained Settings
Authors: Mangwana Sadhana , Dixit Gaurav , Celluzzi Christina M. , Cui Wanxing , Bapat Asawari 
Published: November 2023

Background:
Neutrophil granulocytes are essential components of innate immune response. An absolute number of neutrophils are a fundamental indicator of host defense. With increasing severity of neutropenia, either due to the disease or as a result of chemotherapy for hematologic malignancies, there is an exponential increase in the risk of severe infection. In such conditions, granulocyte transfusion is considered a potential therapeutic option due to its phagocytic properties. The study was undertaken to analyze data of granulocyte collections and transfusions in resource-constrained Settings.

Methods:
In this observational prospective study, granulocytes were harvested by combined administration of granulocyte colony-stimulating factors and dexamethasone mobilization and transfused to severely neutropenic patients. Data on granulocyte collections and transfusion, various determinants of donor, and procedural characteristics and patient outcomes, with respect to 30-day mortality, were analyzed.

Results:
After granulocyte transfusion, patients' posttransfusion white blood cell and neutrophils increased significantly. Higher platelet counts in the harvested products resulted into significant increment of patients' platelet count and markedly reduced demands of platelet transfusions, reducing chances of alloimmunization. Eighty-five percent of patients could be saved, showed improvements in their clinical conditions, and were discharged from hospital in stable condition.

Conclusion:
Granulocyte transfusions are an important therapeutic modality in neutropenic patients with resistant infections, until spontaneous recovery of neutrophil count occurs in patients. Cost Reduction of some of the resources should be considered for LMIC as lower price will encourage more facilities willing to offer similar procedures to aid patients. Training workforce for new and novel processes is need of hour and will add value by equipping LMIC facilities in serving the patients. Granulocyte transfusions are life-saving tool and found to be safe and well tolerated by recipients. They can play a vital role in improving outcomes and saving patients in resource-constraint countries, where there is increasing emergence of multidrug-resistant bacterial infections.
Prospective Audit of Blood Transfusion Practices among Nurses and Role of Education and Intervention at a Tertiary Care Hospital
Authors: Prinja Nippun , Kaur Sarabjeet , Matthews Jyothi , Nagrath Priyanka , Pal Lokesh , Sharma Girja , Bajaj Archana 
Published: November 2023

Background and Objectives:Periodical internal audits evaluate the process flow of transfusion which arrests the spectrum of adverse events. The objective of the study was to provide evidence that blood is being ordered, handled, and administered according to transfusion guidelines and to highlight the deviations with the secondary objective of improving knowledge and practices in nursing officers.Methods:Nursing officers were audited on 50 patients each in P1 and P2 phase. Training of 243 nursing staff was done after P1 phase. Training comprised education and interventions over 45 days – 18 didactic lectures and 36 bedside classes. Nurses were audited both before and after the completion of the training.Results:One hundred and forty-five nurses had knowledge and practice score in between 11 and 15 in P1 which improved to 243 (100%) in P2. Transfusion order for one patient was not written in P1, whereas 100% compliance was seen in P2. Noncompliance in taking consent for transfusion improved from 5 to 1 in P2. Blood request error and sample labeling error reduced from 8% to 0% and 4% to 0%, respectively, in P2. Sample labeling was inappropriate in 2 patients in P1 which improved to nil in P2. Checking of vital signs check and intravenous cannula patency improved from 96% to 98%. Crosscheck of packed red blood cell nursing officers before transfusion reduced from 8% to 0% and from 30% to 2% among medical officer (P< 0.05). Delay in the initiation of transfusion, reduced from 7 to 2 patients.Conclusion:Timely audit of transfusion practices reduces mistakes and errors hence improved patient care.
Assessment of Patient's Knowledge about Blood Transfusion and Impact of Structured Information on this Knowledge: Single-Center Report from India
Authors: Gupta Shubham , Tiwari Aseem Kumar , Agnihotri Naveen , Agnihotri Ajju , Aggarwal Geet 
Published: November 2023

Background and Objectives:
Blood transfusions are frequently prescribed for acute and chronic conditions. When transfused judiciously, blood can save life and improve the health of the patient(s). However, transfusion of blood and blood components is never risk-free. Despite this, transfusion consent may not be obtained satisfactorily. We assessed the knowledge of patients about their blood transfusion and consenting process and the impact of structured information on their knowledge.

Methods:
A cross-sectional qualitative study design was employed. The study included all consenting adult patients who were intended recipients of red blood cell transfusion. Patient information sheet (PIS) along with pre- and postquestionnaire was administered to study patients.

Results:
Our study examined patients “knowledge and their attitude” about blood transfusion and recalling of their decision on consenting to transfusion. For the reason of being transfused, 58.5% were not aware, while 73% were unaware about the benefits of blood transfusion. Similarly, 85.5% were unaware about the risk of blood transfusion. There was a lack of knowledge about the “alternative option” of blood transfusion. Our findings also suggest that a standardized informed consent process was not being carried out.

Conclusion:
There is a need for strengthening IEC in the blood transfusion process. The present study has highlighted the role of printed/written information (PIS) in the native language and in imparting knowledge in the context of blood transfusion.
Adverse Blood Transfusion Reaction Reporting at a Tertiary Care Hospital, Bhutan
Authors: Yangdon Tshering , Getshen Mahrukh , Dorji Sangay , Tashi Lobzang 
Published: November 2023

Background and Objectives:
Even though Blood Transfusion Service is considered as life-saving intervention, it is associated with the occurrence of uneventful reactions from the transfusion of blood and blood units. Bhutan Blood Bank is fragmented with different levels of services provided which leads to varied levels of adverse blood transfusion reaction reported. Study on the hemovigilance system at tertiary care hospital is conducted so as to study the frequency and types of reactions over a period of three years from 1st January 2019 to 31st December 2021.

Methods:
All ATRs occurring within a period of 3 years were studied according to the Blood Bank standard operating procedure. Adverse transfusion events related to blood and blood units were analyzed and classified on the basis of their clinical features and laboratory tests. Descriptive statistics were used to represent the adverse transfusion reactions.

Results:
During this period, a total of 19,961 blood and blood components were issued and 120 adverse transfusion events were reported. Most reaction reported were febrile non-hemolytic transfusion reaction, FNHTR (59.2%) followed by allergic reaction (22.5%) occurring predominantly in females (93%). Packed red cells were the common component causing adverse events (83 %) with most observable in Group A (42.5%) blood units.

Conclusion:
Febrile and allergic reactions are the most common type of reaction reported. Although such reaction type is least harmful but fatal reaction can occur and preventive measures must be taken to avoid such reactions. This preliminary study indicates the importance of having continuous monitoring and quality assessment scheme in addressing the issues of adverse transfusion reaction. Furthermore, establishing a hospital transfusion committee is vital for delivery of safe and efficient blood transfusion services.