bluuebunny/crossref_metadata_2025_split huggingface dataset:
Red Cell Requisition and Utilization Pattern in a Tertiary Care Hospital of South India
Authors: Tripathi Parmatma Prasad 
Published: April 2023

Introduction:
The equilibrium between supply and demand for red blood cells is increasing unpredictably in many countries. An understanding of trends in blood usage profile and current usage can help predict future trends in demand and to put efforts to reduce use in particular areas. This study helps in analyzing the pattern of red blood cell utilization in a tertiary care hospital.

Materials and Methods:
This retrospective study was conducted in a blood bank, tertiary care hospital over a period of 6 months. All the requests coming to blood bank with information regarding patient's demographic details, diagnosis and indication for transfusion, type of request, blood transfused or returned were collected and reviewed. Crossmatch transfusion (CT) ratio, transfusion index (TI), and transfusion probability were also calculated.

Results:
A total of 10,364 patients (20,399 requests) utilized total 32,608 units of blood and its components, out of those 14,195 units of packed red cells units were utilized. March month had maximum number of requests and utilization. Most of the requests for blood were from the inpatients (wards) and were requested and utilized in the age group of 21–30 years with male predominance. Patients in the division of medicine utilized most blood. Although the division of surgery requested most of the blood, on an average, they utilized only one-third of the requested product. Overall, anemia was the most common indication for red cell utilization. In surgical group, spine surgery had a maximum CT ratio. Neurosurgery and hand surgery had the lowest TI in all specialties. Hand surgery and spine surgery had a lowest transfusion probability. Overall, utilization rate in our study was 59.8%.

Conclusion:
A regular review of blood unit's usage is very important to estimate the blood utilization pattern in any hospital. Profile of blood utilization will act as indicator for quality management of blood bank.
Outcome and Safety of Colistin Usage in Pediatric Cancer Patients with Carbapenem-Resistant Enterobacteriaceae Bacteremia at Children Cancer Hospital Egypt
Authors: Adel Nagla , Khedr Reham , Elanany Mervat , Zaki Hala F. , Hafez Hanafy , El-Abhar Hanan 
Published: April 2023

Background:
Carbapenem resistant Enterobacteriacae (CRE) bloodstream infection (BSI) causes complicated infections, especially in immunocompromised patients. This study aimed to assess the renal toxicity and the efficacy of therapy with colistin in a cohort of pediatric cancer patients with BSIs due to CRE and sensitivity to colistin.

Patients and Methods:
This was an observational, prospective cohort study from May 2017 to October 2017 in Children's Cancer Hospital Egypt 57,357. All patients who had blood stream infections due to CRE receiving intravenous colistin were prospectively enrolled. We used a standardized case form to record patient characteristics, including age, sex, weight, underlying comorbidities, type of infection, causative organism, and antibiotic susceptibility testing. Daily doses, duration of colistin therapy, and co-administered antibiotics (aminoglycosides, vancomycin) were collected. Furthermore, clinical and microbiological responses to treatment were reported. The dosing schedule was based on a loading dose of 5 MU and a 5-MU twice-daily divided maintenance dose, titrated on renal function. Clinical cure, bacteriological clearance, and daily serum creatinine were recorded.

Results:
One hundred and forty-one Blood Stream infectious episodes mainly due to Klebsiella Species (pneumoniae and Oxytoca) (27%) and Escherichia coli (68%) were analyzed. All strains were susceptible to colistin with Minimum inhibitory concentration (MICs) of 0.19–1.5 mg/L. Patients were predominantly females (69%), with a mean age of 7 years. It was used as a combination therapy with carbapenems (69.2%) or aminoglycosides (80%). The median duration of treatment was 9 days (Range 1–50 days). Clinical and microbiological cure was observed in 110 cases (80%). Acute kidney injury developed during five treatment courses (4%) in which colistin was used in combination with amikacin. No renal replacement therapy was required and subsided within 7 days from colistin discontinuation.

Conclusions:
Our study showed that colistin had a high efficacy without significant renal toxicity in severe infections due to CRE Gram-negative bacteria.
Knowledge, Attitude, and Practice Regarding Prevention of Rheumatic Heart Disease among Primary Health-care Workers in Sokoto Metropolis, Sokoto State, Nigeria
Authors: Isezuo Khadijat Omeneke , Awosan Kehinde Joseph , Ango Umar Mohammed , Mohammed Yahaya , Sani Usman Muhammad , Waziri Usman Muhammad , Garba Bilkisu Ilah , Adamu Asma’u , Jiya Fatima Bello 
Published: April 2023

Background:
Rheumatic heart disease (RHD) is the only preventable cardiovascular disease that still causes significant morbidity and mortality in low- and middle-income countries like Nigeria where it is classified as a neglected disease. The inciting agent causes pharyngitis often not properly treated.

Aim and Objectives:
To study the knowledge and preventive practices of RHD amongst primary healthcare workers who are in contact with larger ratio of populace in order to recommend appropriate interventions.

Methodology:
A cross-sectional study conducted among health workers in primary health centres in Sokoto metropolis. Multi-stage sampling technique was used to recruit the study participants. A structured questionnaire and focus group discussion guide was used to collect the information. Data was analysed using IBM SPSS version 25.

Results:
Majority (109/182; 59.8%) had RHD inadequate knowledge of causes, risk factors and treatment of pharyngitis which predisposes to RHD. Only 49 (26.9%) of the respondents knew the name of the causative agent. The knowledge gap was related to length of training and attendance at a training (x2 = 8.38; P=0.015 & x2 = 7.92; P=0.004). Majority of the respondents with 168 out of 182 (92.3%) had positive attitude. Practice grading was adequate in only less than half of the respondents (88/182; 48.4%). Male gender and negative attitude were predictors of adequacy of preventive practices (aOR= 0.49; 95% C.I =0.267-0.929; P=0.03 & aOR= 3.87; 95% C.I =1.027-14.586; P=0.046).

Conclusion:
The health workers had inadequate knowledge and poor practice on prevention of rheumatic heart disease. It is necessary to upscale information available to them by medical specialists and upgrade their curriculum.
Iron Supplementation and Blood Donation in Nigeria
Authors: Nwagha Theresa Ukamaka , Ugwu Angela Ogechukwu , Nwaekpe Chinenye Nkemakolam 
Published: April 2023

Background:Iron-deficiency anemia is an important limiting factor to a sustainable supply of blood units, especially in low- and middle-income countries. Blood transfusion practice in Nigeria is poorly developed and structured with paucity of voluntary nonremunerated blood donors and high rate of donor deferrals resulting from low hemoglobin (Hb) levels.Aims:This study aimed to assess the effect of daily supplementation of iron using Ranferon-12 on Hb level, red blood cell (RBC) indices, iron level, ferritin level, and Hb recovery in blood donors in Nigeria.Methodology:This longitudinal study was conducted at a tertiary hospital blood transfusion center from March to July 2020. Blood samples of regular donors were collected at three points in the study for the measurement of Hb and hematocrit (HCT); RBC indices including mean cell volume (MCV), mean cell hemoglobin (MCH), and Mean cell haemoglobin concentration (MCHC); and iron stores including serum iron, serum ferritin, and serum transferrin. The first point was at recruitment before donation of one unit of blood; the second point after the blood donation; and the third point at 6 weeks post blood donation. Following donation, participants were placed on Ranferon capsules (iron fumarate - 100 mg elemental iron) and 100 mg of tablet Vitamin C, for 6 weeks.Results:There was a moderate significant positive correlation between administration of Ranferon and change in the values of HCT, MCV, MCH, red cell distribution width, ferritin, and transferring (P< 0.05). Percentage recovery of Hb, red cell indices, and iron stores parameters after 6 weeks of daily Ranferon ranged between 89% and 100%.Conclusion:Iron supplementation using Ranferon capsule daily for 6 weeks enhances recovery of Hb, red cell indices, and iron stores with attainment of benchmark Hb levels for donation.
Prospective Study of Pyrexia with Pregnancy
Authors: Mewada Bhavana N. , Gandhi Dimple , Diwan Farheen , Panchal Paresh Naranbhai 
Published: April 2023

Objectives:
Fever in pregnancy is a common clinical problem that increases the risk of morbidity for the mother and fetus. We studied variable medical complications of pregnant women suffering from fever and possible fetal complications.

Materials and Methods:
A prospective observational study of pyrexia with pregnancy in 50 patients admitted to our hospital irrespective of age, parity, reproductive characteristics, and socioeconomical conditions.

Results:
First, the majority group of the patients were of urinary tract infections and upper respiratory tract infections. The second majority group of the patients were of malaria, dengue, enteric fever, and pyrexia of unknown origin. Most of the etiologies of pyrexia were preventable. The majority of the patients had a low and moderate grade of pyrexia. Small for gestational age was the most common adverse pregnancy outcome and there were six perinatal deaths.

Conclusion:
Our study depicts that a wide range of maternal medical complications, as well as fetal and neonatal complications, occur due to pyrexia in pregnancy from various etiology.
The Effect of Collaborative Care on Treatment Outcomes of Newly Diagnosed Tuberculosis Patients with Type-2 Diabetes Mellitus and Adverse Drug Reaction Presentations
Authors: Ayeni Foluke Adenike , Oyetunde Olubukola O. , Aina Bolajoko A. 
Published: April 2023

Background:
The burdens of tuberculosis (TB) and diabetes mellitus (DM) in Nigeria are high. DM often goes unrecognized in TB patients, resulting in poorer treatment outcomes compared with TB patients only. This study set out to compare TB treatment outcomes and associated factors in TB only and TBDM patients when a collaborative care (CC) model is in place.

Methods:
A prospective quasi-experimental study, modeled after the World Health Organization and The Union's Collaborative Framework for Care and Control of TB and DM was carried out among TB patients in two chest clinics in Lagos state. Patients were grouped into TB only, who received the usual TB care, directly observed treatment, short course (DOTS), and TBDM, who received DOTS and CC. Data were analyzed with IBM Statistical Package for the Social Sciences, version 23.0. Chi-square and multivariate analysis determined the association between treatment success and CC. Statistical tests were calculated at 95% confidence intervals and considered significant when P value is < 0.05.

Results:
Of 671 participants in the study, 52 (7.7%) had DM. At TB treatment completion, there was no statistically significant difference in outcomes between TBDM and TB-only patients (P = 0.40). Patients who received CC were about 32 (OR: 31.60, 95% CI: 3.38-293), and 5 times (OR: 5.08, 95% CI: 1.35-19.17) more likely to achieve success and cure, respectively, compared to those who did not.

Conclusion:
Provision of CC with DOTS ensured improved TB treatment outcomes in TBDM patients. Recommendations of WHO/The Union are feasible in our setting.
The Effect of Glycemic Control on Clinico-Radiological Manifestations of Pulmonary Tuberculosis in Patients with Diabetes Mellitus
Authors: Saalai Kavin Mani , Mohanty Anita 
Published: April 2023

Background:
The association between diabetes mellitus (DM) and tuberculosis (TB) and their synergistic role in causing human disease has been recognized for centuries. Despite the known synergy between DM and TB, the importance of atypical clinical, radiological presentation and DM as a risk factor for TB is largely unknown. This study was undertaken to know the effect of glycemic control on TB manifestations as it will contribute to the opportunities for detection and treatment of both disease conditions appropriately.

Methods:
This cross-sectional study included 50 patients attending the pulmonary medicine department in Ispat General Hospital with pulmonary TB and DM during 6 months' period. Clinical data, chest-X ray, HbA1c values were obtained and the effect of glycemic control studied and analyzed.

Results:
Five patients had good glycemic control (HbA1c ≤7%), 45 patients had poor glycemic control (HbA1c >7%). Cough was present in all patients. Weight loss and night sweats were present in poor glycemic group and sputum smear grade was higher in higher HbA1c patients and both were statistically significant. None of the good glycemic group had lower zone lesion. The commonest type of lesion was nonhomogenous opacity, followed by cavities in both poor and good glycemic groups. Cavities were usually present in lower zones. Size and number of cavities were more as the glycemic control is poor. So, that glycemic control did have an effect on pulmonary TB manifestations, hence achieving and maintaining glycemic control is necessary for DM with pulmonary TB.
Survival of Mycobacterium Abscessus Complex Organisms on Coins
Authors: Moore John E. , Millar Beverley Cherie 
Published: April 2023

Background:
To date, there have been no reports on the occurrence of nontuberculous mycobacterial (NTM) organisms (nor tuberculosis [TB]) on money, currency, banknotes, or coins, where these may act as fomites in the potential transmission of mycobacterial organisms around communities, especially in developing nations, where physical currency is still the popular mainstay of the economy, compared to electronic and digital forms of currency transaction. It was therefore the aim of this study to examine the survival of the Mycobacterium abscessus complex organisms on coins.

Methods:
Coins from 17 countries were examined for the presence of M. abscessus complex organisms by broth enrichment in Middlebrook 7H9 for 2 months. Nickel-plated steel and copper-plated steel coins were artificially contaminated individually with M. abscessus complex (circa 107 [7 log10] organisms/coin), including M. abscessus subsp. massiliense (n = 2), M. abscessus subsp. bolletti (n = 2), and M. abscessus subsp. abscessus (n = 1) and their surviving cells enumerated at weekly period up to 5-week postinoculation.

Results:
NTM organisms were not isolated from coins from the 17 currencies examined. In all three subspecies of M. abscessus, the copper-plated steel coins caused a more rapid decline in organism numbers, which were statistically very significant (P < 0.0001), compared to the paired survival on the nickel-plated steel coins, whereby organisms were none detectable after 3-week storage on the copper-plated coins. NTM organisms survived better on the nickel-plated coins, with a mean count across all subspecies of log10 1.84 colony forming units per coin after 5 weeks of storage (range: 0.6–2.69 log10 cfu/coin). There was no statistically significant difference (P > 0.05; 5%) in the survival dynamics among the three subspecies with storage on either coin type.

Conclusions:
Health-care professionals should be aware of the survival of M. abscessus complex organisms on coins for up to 12 weeks, which may be particular relevant in high-risk areas of health-care institutions where TB or NTM is prevalent and where there are opportunities for the transmission of such organisms through contaminated fomites, including coins, through opportunities including payment for treatments/medicines/dressings, coin-operated payment facilities, such as hospital car parking, self-service vending machines, hospital canteens, coffee shops and dining halls and hospital shops, whether static or mobile onward visits. To mitigate potential infection consequences of handling coins contaminated with M. abscessus complex organisms, other NTMs organisms and TB, the authors support re-establishing the principles of basic hygiene, including proper handwashing and the avoidance of handling money when working with food or dressing wounds and skin lesions, as well as when working with respiratory devices, including nebulizers.
Genetic Diversity of Mycobacterium avium sp. Paratuberculosis by Mycobacterial Interspersed Repetitive Unit–Variable Number Tandem Repeat and Multi-Locus Short-Sequence Repeat One-Sentence Summary
Authors: Moyano Roberto Damián , Imperiale Belén Rocío , Romero Magalí , de la Paz Santangelo María , Alvarado Pinedo María Fiorella , Travería Gabriel , Romano María Isabel 
Published: April 2023

Background:
Paratuberculosis is an enteric disease caused by Mycobacterium avium sp. paratuberculosis (MAP) that affects mainly ruminant producing losses to the livestock industry. Many molecular epidemiological methods have been used to discriminate MAP isolates.

Method:
The aim of this study was to describe the genetic diversity of the Argentinean MAP isolates using a combination of two molecular systems, the mycobacterial interspersed repetitive unit–variable number tandem repeat (MIRU-VNTR) (“automated and “non-automated”) and the multi-locus short-sequence repeat (MLSSR) system.

Results:
Thirty-two isolates were identified as MAP of C type by IS900 polymerase chain reaction (PCA) and IS1311 PCA-restriction enzyme analysis. The main patterns found by both MIRU-VNTR systems were INMV1 (54.5%), INMV2 (24.2%) and INMV11 (9.1%). The INMV5, INMV8 and INMV16 were represented with one isolate each (3.0%). Only 4 MIRU-VNTR loci were polymorphic.

Conclusion:
Those isolates sharing the same INMV patterns were analyzed by MLSSR, being locus 2 the most polymorphic one showing isolates with 9, 10, 11, and more than 11 “G” repeats. Besides, the global discriminatory power among isolates could be increased using both techniques. Based on these results, a short version of the “automated” MIRU-VNTR could be used as a screening tool to group isolates genetically related and subsequently perform the SSR using locus 2 on those isolates sharing the same INMV pattern.
Investigation of Two General Venous Thromboembolism Risk-Stratification Models in Predicting Venous Thromboembolic Events in TB Patients
Authors: Sharif-Kashani Babak , Azimi Mojdeh , Tabarsi Payam , Sadr Makan , Shirzadi Shahriar 
Published: April 2023

Background:
Tuberculosis (TB) remains an infectious disease with a high prevalence worldwide and represents a major public health concern. It is known that TB causes a hyper-coagulable state due to its infective nature. Thus, patients are prone to higher incidence rates of venous thromboembolism (VTE) in comparison with the general population. Although there are many risk assessment models (RAMs) that estimate the risk of VTE incidence in the general population, none have been proven to show significant prognostic value in early and accurate VTE prediction among TB patients. This study aims to investigate the accuracy of general RAMs in prediction of VTE incidence in the population of TB-positive patients.

Methods:
The following survey is a retrospective study among patients afflicted with TB, in whom VTE had occurred either during or at the onset of admission. A total number of 865 smear-positive TB cases were recorded in hospital in a 7-year timespan, among which a total sum of 37 patients (67.6% males, age: 56.19 ± 20 years) experienced at least one episode of thromboembolic incidence. We nominated Padua and Geneva RAMs and calculated the scores with regard to their inpatient hospital records.

Results:
Of 865 adult hospitalized smear-positive TB patients, 37 patients happened to develop VTE in the course of infection, after excluding the unacceptable data. The incidence of VTE was calculated at 4.27%. Of all VTEs, 73% turned out to be deep venous thromboembolism (DVT), 18.9% were pulmonary thromboembolism (PTE), and 8.1% of patients developed both DVT and PTE during the course of disease. Among all cases, 32.4% revealed Geneva score equivalent or >3. It conveys the meaning that these patients were at greater risk for VTE development and were indicated to receive prophylactic medication. Similarly, Padua model was capable of predicting 29.7% cases scoring >4, which is alarming for elevated VTE probability. 21.6% of TB patients, who had developed VTE during the course of their disease eventually passed away.

Conclusion:
Our statistics show minimal positive predictive value for Padua and Geneva RAMs, which are seemingly in sharp contrast with the excellent validation of these models verified by numerous surveys in general population. This fact could be attributable to failing to consider TB, or in general chronic infections, as independent indicators of VTE incidence. These findings indicate the need for revising the presenting RAMs or establishing a separate RAM for VTE prediction in TB patients, resembling the VTE risk assessment model for cancer patients.
Immunotherapeutic Potential of N-Terminally Formylated ESAT-6 Protein in Murine Tuberculosis
Authors: Mir Shabir Ahmad , Sharma Sadhna 
Published: April 2023

Background:
The early secreted antigenic target-6 kDa (ESAT-6) being one of the important antigens expressed by Mycobacterium tuberculosis (MTB) has been widely investigated for its strong immunmodulatory effects. We have previously evaluated the immunotherapeutic efficacy of ESAT-6 in the murine model of experimental tuberculosis (TB). Now in the present study, we have evaluated the immunotherapeutic efficacy of N-terminally formylated form of ESAT-6 (f-ESAT-6) in murine TB.

Materials and Methods:
The production and purification of f-ESAT-6 have been discussed in our earlier report (Mir SA and Sharma S, 2014). In the present study, the MTB H37Rv-infected mice were treated with f-ESAT-6 alone or in combination with anti-TB drugs (ATDs). Four weeks postinitiation of the treatment, the experimental mice were sacrificed, and the colony-forming units (CFUs) were enumerated in their lungs and spleen as described in “materials and methods” section.

Results:
The N-terminally formylated ESAT-6 protein (f-ESAT-6) induced a moderate reduction in the bacterial load in the target organs of infected mice. Compared to the dimethyldioctadecyl ammonium bromide treated and untreated groups, the f-ESAT-6 treatment significantly reduced the CFU in the spleen and lungs of infected mice by 0.377 log10 units (P < 0.05) and 0.396 log10 units (P < 0.01), respectively. The administration of f-ESAT-6 in combination with ATDs revealed an additional immunotherapeutic effect and elicited higher therapeutic efficacy over drugs (ATDs) alone.

Conclusion:
The results of the present study clearly indicate that f-ESAT-6 protein alone as well as in combination with the conventional ATDs induce moderate therapeutic effect against experimental TB.