bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Profile and Short-Term Outcomes of Patients Admitted with Acute Pulmonary Embolism in a Tertiary Care Centre
Authors: Pai Vinayak , Ambekar Suyash , Nadkar Milind , Mulkalwar Alhad , Prajjwal Priyadarshi 
Published: March 2023

Background:
Venous thromboembolism is a major contributor to the global disease burden, with an incidence of around 10 million cases per year and substantially associated morbidity and mortality.

Objectives:
The study aimed to assess the clinical, laboratory, and radiological profile along with electrocardiogram and echocardiogram changes and the treatment and outcomes in patients admitted with acute pulmonary embolism (PE) in a tertiary care centre. The etiologies and risk factors of the same were also evaluated.

Materials and Methods:
This was a hospital-based prospective observational study conducted among 31 patients over a period of 18 months. The study was conducted at a tertiary care centre in the Department of General Medicine. Patients of age more than 12 years, admitted with a confirmed diagnosis of acute PE based on computed tomography pulmonary angiography (CTPA), were included in the study.

Results:
Thrombolysis was done in 12.9% cases, while anticoagulants were given in 87.1% cases. Oxygen therapy was required in 74.2% cases on day 1 while in 9.7% on day 30. Secondary pulmonary hypertension was the commonest complication observed in the study, in 54.8% cases. Severe hypoxia was seen in 35.4% cases. No complications were seen in 6.4% cases. Mortality was recorded in 9.6% of the cases.

Conclusion:
Since PE is among the leading causes of death and disability, there should be a high degree of suspicion in all clinical settings. And since prolonged immobilisation is a strong risk factor for PE patients at risk, they should be offered prophylactic anticoagulation.
Demand for Plastic Surgery Services via Inpatient Referrals in a Nigerian Teaching Hospital
Authors: Achebe Uchechukwu J. , Okwesili Obinna R. , Onumaegbu Okechukwu O. 
Published: March 2023

Background:
Plastic surgery is one of the most collaborative surgical specialties and is also considered the most consulted service in a hospital. Plastic surgeons respond to many medical consults or inpatient referrals, and the comprehensive impact of these services, when they are nonoperative, often goes unnoticed.

Objectives:
The objectives of the study were to assess the nature of demands of plastic surgery services for admitted patients in a teaching hospital and the specialties and types of patients that benefit from them.

Materials and Methods:
Clinical records of inpatients evaluated by plastic surgeons were retrieved using a compendium of consults received from other specialties within the hospital over a period of 1 year period.

Results:
The plastic surgeons received a total of 151 hand-written consults from surgeons, physicians, gynecologists, and pediatricians. The vast majority came from physicians (45.7%) and surgeons (40.4%). Among the physicians, endocrinologists sent the highest number of consults (42.5%). Ulcers constituted the commonest reason for inpatient referrals (66.2%). Over 29% of consults were for patients with primary diagnosis of diabetes mellitus, whereas 13.9% were for head injuries.

Conclusions:
The demands for the services of plastic surgeons come from virtually all the clinical specialties in a tertiary hospital. The commonest reason for such referral is for their review and management of ulcers. There is a need to utilize telemedicine in reducing the burden of reviewing these patients, especially in large tertiary hospitals.
Blood Transfusion Reactions and Institutional Hemovigilance Protocols
Authors: Aneke John C. , Chigbo Chisom G. , Emeh Perpetua O. , Ifediata Francis , Efobi Chilota C. , Chilaka Ugochinyere J. , Ibekwe Nkechinyere T. , Ezeh Theodora U. , Aneke Chiamaka B. 
Published: March 2023

Background:
Blood transfusion reactions contribute significantly to the morbidity and mortality of both in- and outpatients in hospitals globally. Developing adequate protocols for detecting and reporting this complication is key to attaining global blood transfusion safety.

Objective:
The objective of the study was to review the frequency of blood transfusion reactions and the adequacy of institutional hemovigilance efforts in a Nigerian hospital.

Materials and Methods:
Records of patients that had blood transfusion reactions (cases) and those that did not (controls) were analyzed over a 2-year period. Sociodemographic information, transfusion and admission histories, primary diagnoses, as well as transfusion reaction details (where applicable) were recorded. Data were analyzed using STATA 16.1 (StataCorp. 2019, Stata Statistical Software: Release 16, College Station, TX: StataCorp LLC). Sociodemographic characteristics were presented in frequency tables and charts, whereas relationships between study variables were compared using the Chi-square and the Person Correlation. P value less than 0.05 was considered to be statistically significant (confidence level = 95%).

Results:
One death was recorded among the cases during the study, whereas febrile nonhemolytic reactions constituted the most type of reaction (41.5%). Only 37.5% of reactions were investigated, and none was reported to the hospital blood transfusion/hemovigilance committee. There was no significant association between the study-related variables and the type of reaction or the likelihood of experiencing a new reaction with subsequent transfusions (P values all > 0.05).

Conclusion:
Febrile reactions are the commonest complication of blood transfusion in our data set; institutional hemovigilance efforts remain suboptimal and should be further strengthened.
Knowledge of Hand Hygiene and Use of Alcohol-Based Hand Rub Among Interns in a Nigerian Tertiary Health Facility
Authors: Ogugua Ifeoma J. , Achigbu Kingsley I. , Chukwumam Denning M. , Ejim Chioma A. , Enabulele Eunice O. , Friday-Edeh Chioma F. , Nwoga Hope O. , Nwazor Ernest O. , Mafuka Johnson S. , Akunne Somtochukwu R. 
Published: March 2023

Background:
Healthcare-associated infections and antimicrobial resistance are both largely prevented through hand hygiene. There are still gaps in hand hygiene knowledge and routine use of alcohol-based hand rub among healthcare workers.

Objectives:
This study assessed the knowledge of hand hygiene and the use of alcohol-based hand rub among interns at the University of Nigeria Teaching Hospital, Enugu State, Nigeria.

Materials and Methods:
A cross-sectional study was conducted among 230 interns using a structured WHO hand hygiene knowledge questionnaire. A two-stage sampling technique was employed. Descriptive and inferential statistics were carried out and p-value was set at ≤ 0.05.

Results:
Two respondents (0.9%) had good knowledge of hand hygiene while slightly more than half (117/230, 50.9%) had moderate knowledge. Also 50.9% (n = 117) used alcohol-based hand rub. Majority of the respondents, 140 (60.9%) had attended training in hand hygiene. Sex was significantly associated with the knowledge of hand hygiene (p=0.03) as male respondents had a higher proportion of good knowledge while having received training on hand hygiene was significantly associated with routine use of hand hygiene (p=0.004).

Conclusions:
Since only very few of the interns had overall good knowledge of hand hygiene, targeted structured training on hand hygiene and infection prevention and control practices to improve the knowledge of such healthcare workers is highly recommended.
Recanalization of pelvic ureter in pelvic neoplastic obstruction: Technical approach
Authors: Chatar Achraf , El Anzaoui Jihad , Akjay Ali , Ammani Abdelghani 
Published: March 2023

ABSTRACT

Introduction:
Obstruction of the lower ureter by pelvic cancer requires palliative treatment. Percutaneous derivation is often performed in an emergency context. If the obstruction is limited to the perimeatic area; the percutaneous antegrade recanalization can be performed and may require a resection of the ureteral orifice.

Objectives:
We evaluate the results of percutaneous antegrade recanalization associated with possible bladder resection in the treatment of pelvic neoplastic ureteral stenosis.

Materials and Methods:
A retrospective, descriptive study from September 2016 to January 2021 included all patients with complicated pelvic tumor with ureteric hydronéphrosis. Under general anesthesia, in Valdivia modified position, a nitinol hydrophilic guidewire is passed through the nephrostomy and retrieved from the bladder to the urethral meatus, followed by a descent of ureteral catheter under X-ray control. We might need a resection over the presumed ureteric meatus as it will help open the lower extremity of the ureter, so it can be easily catheterized with a double J. When needed, the resection is performed in the modified Valdivia position, it requires significant vigilance and the resection is controlled by fluoroscopy by visualizing the proximity of the resector and the guidewire in the ureter.

Results:
In our study, 74 patients, including 29 men and 45 women, with an average age of 65 years (52–78 years). The Karnofsky index was ≥≥80% 80% in 92% and between 80% and 60% in 8% of patients. The average extent of ureteral stenosis was 2.25 cm (1–3.5 cm). The etiologies of obstruction were dominated by cervix cancer at 58.2%, followed by prostate cancer at 33.7% and bladder cancer at 8.1%. The recanalization is carried out in 40% on the left, 60% on the right, and bilaterality in 30% of the cases. In the event of bilateral obstruction, the repermeabilization was carried out in two deferred stages, one side at a time, the priority kidney being the one which seemed more functional with a good corticomedullary index. The improvement of renal function in 82%, however, 18% progressed to chronicity. The disappearance of the dilatation was present in 85%, whereas 15% of the cases presented a residual dilation without alteration of the renal function. The resection of the ureteral meatus was performed in 75% of the cases. We had only one recanalization failure in our series because the stenosis was extensive, due to the intrinsic invasion of the ureter by the tumor. A few complications were noted: pyelonephritis (7%), isolated flank pain (10%), and bladder irritative syndrome (13%). The average survival of these patients depended essentially on pelvic cancer responsible for the obstruction, ranging from 11 months to 45 months.

Conclusion:
Percutaneous recanalization associated with bladder resection is an attractive, reproducible, and well-tolerated technique. Very few complications are reported. It provides a good quality of life to patients.
Complex urinary reconstruction in a case of genitourinary tuberculosis post micturating cystogram bladder perforation
Authors: Pirzada Faisal Masood , Shreyas N. M. , Sharma Umesh 
Published: March 2023

ABSTRACT
Voiding cystourethrogram (VCUG) is done for lower urinary tract disorders. Even though easy to perform, can be associated with serious complications if not done properly. A sound knowledge of the technicalities and what is being expected of the study is essential. Different factors such as patient age, underlying diseases, and proper technique are important factors to be kept in mind. Here, we present a 26-year-old female of genitourinary tuberculosis (GUTB) with lower urinary tract symptoms (LUTS). While undergoing evaluation for LUTS refractory to medical therapy, VCUG study was done which was complicated by bladder perforation with spillage of contrast into the peritoneal cavity. Patient was managed conservatively and later complex triple urinary reconstruction was done by left ileocalicostomy with orthotopic neobladder (ONB) with right ureteric reimplantation. While performing VCUG, proper technique should be used and due principals to be followed, especially in cases of GUTB by the attending doctor to avoid rare but grievous complications like bladder perforation. Complex reconstructive surgery is possible but is extremely challenging and should be offered to the patients with very good results.
Advances in reconstructive urology: A review of the 2022 literature
Authors: Bearrick Elizabeth , Sterling Joshua , Simhan Jay , Nikolavsky Dmitriy 
Published: March 2023

ABSTRACT
Reconstructive urology encompasses a broad spectrum of lower and upper urinary tract diseases. A recent society of genitourinary reconstructive mission statement emphasized the desire to promote and support research in the growing fields of tissue engineering, device design, patient-reported outcomes, and validated measurement tools for urethral stricture disease. The purpose of this article was to identify and highlight the high-impact recent literature published within reconstructive urology during the past year. Original research, systematic reviews, and videos from the Gold Journal, BJUI, World Journal of Urology International, SIU Journal, Neurourology Urodynamics, Journal of Urology, and European Urology were included.
Anastomotic urethroplasty as management for iatrogenic posterior urethral injuries in an infant
Authors: Desai Devang , Joshi Pankaj , Raveenthiran Sheliyan , G De Win , Kulkarni Sanjay 
Published: March 2023

ABSTRACT

Introduction:
Boys born with high imperforate anus have a rectourethral fistula, which usually occurs at the prostatomembranous junction. A recent trend has been to perform a single-stage posterior sagittal posterior anorectoplasty (PSARP) with pull-through and closure of the rectourethral fistula. Inadvertent posterior urethral injury during repair may result in traumatic obliteration of the posterior urethra. Posterior urethral injury is also possible after other procedures such as ablation of posterior urethral valves (PUVs). We evaluated our outcomes of posterior anastomotic urethroplasty in such infants.

Materials and Methods:
We managed four infants with posterior urethral injury after PSARP and one after endoscopic ablation of PUVs during 2012–2018 at our institution. Iatrogenic injury was noticed post-PSARP on the removal of the urinary catheter. Suprapubic catheter (SPC) was subsequently inserted. Retrograde urethrogram, voiding cystourethrogram, and endoscopy through the SPC tract and urethra were performed before undertaking an anastomotic urethroplasty.

Results:
Three infants required crural separation and inferior pubectomy. Four infants had an uneventful recovery. One infant had an annular narrowing at the anastomotic site and required endoscopic urethrotomy twice. We waited till the child was older (age 4) and performed urodynamics. This revealed obstructive uropathy. The patient subsequently underwent redo anastomotic urethroplasty with crural separation and inferior pubectomy. He had an uneventful recovery. Our follow-up ranged from 1 to 7 years.

Conclusions:
Iatrogenic urethral injuries are rare in infants. Anastomotic urethroplasty achieves physiological voiding and prevents complications of prolonged SPC. Even though surgery is challenging, our series suggests that it is feasible with good outcomes.
High-risk Human Papillomavirus (hrHPV) Prevalence and Genotype Distribution Among Turkish Women
Authors: Gecer Melin 
Published: March 2023

Purpose:
This study aimed to determine the rates of distribution of high-risk HPV (hrHPV) genotypes according to cervical smear samples and biopsy results in a large sample of Turkish women.

Methods:
The study was conducted with 4,503 healthy volunteer women aged 19-65 years. Samples of cervical smears were collected during the examination and liquid-based cytology was used for the Pap tests. The Bethesda system was used for reporting the cytology. High-risk HPV genotypes including HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68 were investigated in samples. The study cohort was grouped according to age in decades, with comparisons made according to these age groups, Bethesda class, and cervix biopsy results.

Results:
Among all cases, 903 (20.1%) participants were positive for 1074 hrHPV-DNA genotypes. HPV-DNA positive cases were most common in the 30-39 age group (28.0%), followed by women under the age of 30 (38.5%). HPV genotypes were determined as, in order of frequency: Other hrHPV (n = 590, 65.3%), HPV16 (n = 127, 14.1%), Other HPV + HPV16 (n = 109, 12.1%), HPV 18 (n = 33, 3.6%), and Other HPV + HPV 18 (n = 32, 3.5%). Cervical smears were reported as ASCUS in 304 (6.8%) samples and high-grade squamous intraepithelial lesion (HSIL) in 12 (0.3%) of the samples. Biopsy demonstrated the presence of HSIL in 110 (12.5%) participants, with 644 (73.3%) negative cases.

Conclusion:
This showed an increasing incidence of Other HPVs besides the known importance of HPV 16 and 18 genotypes as risk factors for cervical cancer.
Molecular Prevalence of Microsporidia Infection in Patients with Lung Cancer
Authors: Ulusan Bagci Ozlem , Muftuoglu Can , Guldaval Filiz , Serce Unat Damla , Mert Ufuk , Polat Gulru , Toz Seray Ozensoy , Moon Myeong Hee , Caner Ayse 
Published: March 2023

ABSTRACT.
Infections are still among the most important causes of morbidity and mortality in patients with lung cancer, which has the highest rate of cancer-related deaths in the world. Microsporidia, which are opportunistic parasitic fungi, primarily localize to the intestine by ingestion but can disseminate to the respiratory tract or can be acquired by spore inhalation. Cancer patients are at higher risk for microsporidia, a life-threatening infection, than the normal population is. We aimed to characterize the prevalence of microsporidia infection for the first time by evaluating the intestinal and respiratory tracts of patients with lung cancer. In this study, we investigated 98 patients with lung cancer and 103 healthy individuals for microsporidia infection and evaluated the clinical findings of patients who were found to be positive. Sputum and stool samples were tested by microscopic examination, in addition to pan-microsporidia and genus-specific polymerase chain reactions. Nine patients with lung cancer had positive results for microsporidia (9.2%), which was significantly higher than the rate in healthy individuals (P = 0.008), and most of them had clinical findings. Among these positive patients, polymerase chain reaction revealed microsporidia in the sputum samples of seven patients, the stool sample of one patient, and both the sputum and stool samples of one patient. Encephalitozoon cuniculi was identified as the predominant pathogen in 87.5% (7/8) of positive sputum samples. Microsporidia infection was significantly associated with advanced stages of cancer. However, in the control group, Encephalitozoon intestinalis was detected in the stool sample of an individual without clinical symptoms. Microsporidia, especially E. cuniculi, should be considered as a cause of respiratory tract infection as well as intestinal infection in cancer patients and should be screened in respiratory samples of these patients when they have pulmonary symptoms.
Antimicrobial Prophylaxis in Dentistry: Survey among Dental Surgeons in Porto Alegre, Brazil, and the Metropolitan Region
Authors: Sinhorelli Bethina S. , Oliveira Sílvia D. 
Published: March 2023

ABSTRACT.
The irrational use of antimicrobial drugs has become a serious epidemiological problem due to the development of bacterial resistance, causing consequences for global health. In dentistry, antibiotics are the second most common pharmacological class prescribed. Thus, we evaluated the use of antimicrobial prophylaxis by dentists in Porto Alegre, Brazil, and the metropolitan region using an online questionnaire. Dentists were asked to complete an anonymous questionnaire concerning antimicrobial prescription. The questionnaire was prepared on the Microsoft Forms platform and shared with dentists through social media and was available for a period of 40 days. The questionnaire was answered by 82 dentists, and 85.3% of them reported prescribing antibiotic prophylaxis (AP). Many different protocols were observed, but the majority of dentists prescribe amoxicillin (2 g) 1 hour before a procedure. The greatest diversity was found in the prescriptions for post-procedure prophylaxis, but most professionals prescribe 500 mg of antibiotics every 8 hours for 7 days. An overwhelming 91.5% of participants think that guidelines for prescribing antibiotics in dentistry are necessary, and 62.2% believe that the use of AP can have some impact on bacterial resistance. There is a wide range of different prescriptions for antimicrobials, suggesting a need for better aligned guidelines and education of professionals on the proper use of antimicrobials and its consequences on bacterial resistance to antibiotics.
Potensi Susu Bubuk Afkir sebagai aditif Pakan Terhadap Bobot Badan Akhir dan Kualitas Karkas Broiler
Authors: Hidayat Muhammad Nur 
Published: March 2023

Penggunaan feed aditif pakan dalam budidaya broiler bertujuan untuk meningkatkan bobot badan akhir atau panen yang lebih tinggi dan menghasilkan karkas yang berkualitas. Salah satu yang dapat digunakan sebagai alternatif aditif pakan, yaitu susu bubuk afkir berbahan dasar kedelei. Penelitian ini bertujuan untuk melihat potensi susu bubuk afkir terhadap bobot akhir dan kualitas karkas broiler. Desain penelitian yang digunakan, yaitu rancangan acak lengkap dengan 4 perlakuan dengan 5 ulangan. Setiap ulangan berisi 2 ekor broiler. Perlakuan yang diberikan meliputi ransum basal tanpa ditambahkan susu bubuk afkir (P1), ransum basal ditambahkan 2,5% susu bubuk afkir (P2), ransum basal ditambahkan susu bubuk afkir 5% (P3) dan rasum basal ditambahkan susu bubuk afkir 7% (P4). Hasil sidik ragam menunjukkan perlakuan berpengaruh nyata (P<0,05) terhadap bobot badan akhir, bobot karkas, persentase karkas, persentase daging tanpa tulang (boneless), persentase tulang, tetapi tidak berpengaruh nyata (P>0,05) terhadap rasio daging dan tulang. Pemberian susuk bubuk afkir berbahan dasar kedelei cenderung meningkatkan bobot akhir, bobot karkas, persentase karkas. Penggunaan susuk bubuk afkir berbahan dasar kedelei sebagai aditif pakan dapat ditambahkan kedalam ransum broiler sebanyak 5%.
Penggunaan feed aditif pakan dalam budidaya broiler bertujuan untuk meningkatkan bobot badan akhir atau panen yang lebih tinggi dan menghasilkan karkas yang berkualitas. Salah satu yang dapat digunakan sebagai alternatif aditif pakan, yaitu susu bubuk afkir berbahan dasar kedelei. Penelitian ini bertujuan untuk melihat potensi susu bubuk afkir terhadap bobot akhir dan kualitas karkas broiler. Desain penelitian yang digunakan, yaitu rancangan acak lengkap dengan 4 perlakuan dengan 5 ulangan. Setiap ulangan berisi 2 ekor broiler. Perlakuan yang diberikan meliputi ransum basal tanpa ditambahkan susu bubuk afkir (P1), ransum basal ditambahkan 2,5% susu bubuk afkir (P2), ransum basal ditambahkan susu bubuk afkir 5% (P3) dan rasum basal ditambahkan susu bubuk afkir 7% (P4). Hasil sidik ragam menunjukkan perlakuan berpengaruh nyata (P<0,05) terhadap bobot badan akhir, bobot karkas, persentase karkas, persentase daging tanpa tulang (boneless), persentase tulang, tetapi tidak berpengaruh nyata (P>0,05) terhadap rasio daging dan tulang. Pemberian susuk bubuk afkir berbahan dasar kedelei cenderung meningkatkan bobot akhir, bobot karkas, persentase karkas. Penggunaan susuk bubuk afkir berbahan dasar kedelei sebagai aditif pakan dapat ditambahkan kedalam ransum broiler sebanyak 5%.