bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lymphocyte count and A-DROP score in COVID-19 patients
Authors: Waikar Chandrakant , Gour Vinayak , Pranay Lal , Hingwe Sevras 
Published: June 2022

Objectives:
To determine the correlation between lymphocyte count and A-DROP score in COVID-19 patients and their role in predicting poor outcomes.

Methods:
This retrospective observational single-center study was conducted in a tertiary care hospital in Vidisha district, India. COVID-19 patients were included in this study, who were admitted to ICU and the COVID Care Centre from August 2020 to October 2020. Demographic profile, clinical characteristics, medical history, A-DROP score, complete blood counts including lymphocyte counts (on admission), the severity of the disease course, and duration of hospitalization were collected. The correlation between lymphopenia and A-DROP score was determined, and their role in predicting poor outcomes was investigated.

Results:
This study included 220 patients, among which 134 were male, and 86 were female [mean age (48.98±16.98) years, 95% CI: 46.72-51.23]. Lymphocyte count in COVID-19 patients negatively correlated with the A-DROP score (r=−0.67, P<0.001). The area under the ROC curve was 0.892 (95% CI: 0.80-0.98, P<0.001) for the lymphocyte count, and the area under the ROC curve was 0.93 (95% CI: 0.84-1.00, P<0.001) for lymphocyte count-A-DROP.

Conclusion:
Lymphocyte count along with the A-DROP score on admission could be used to predict the severity of COVID-19 pneumonia and unfavorable outcome.
Premedication with Diclofenac and Precurarization with Atracurium on Succinylcholine-Induced Myalgia in Laparoscopic Cholecystectomy
Authors: Tirkey Amit , Kumar Mukesh , Haque Ekramul , Kumar Tushar , Lakra Ladhu , Suwalka Usha 
Published: June 2022

Background and Aims:
Succinylcholine is the only available depolarizing neuromuscular blocker that has been widely used in the induction of anesthesia, and it is the drug of choice for rapid-sequence induction of anesthesia due to its rapid onset of effect and ultrashort duration of action owing to its rapid hydrolysis by acetyl-cholinesterase. Postoperative muscle pain (myalgia) and muscle stiffness are the most common side effects and are observed most frequently on the 1st postoperative day in ambulatory surgery. The use of succinylcholine in the induction of anesthesia and intubation in routine cases has been discouraged because of such adverse effects. However, because of its cost-effectiveness and easy availability, it is still used by some institutions routinely. This study aimed to study the efficacy of preoperative diclofenac along with atracurium precurarization in alleviating succinylcholine-induced myalgia.

Materials and Methods:
It is a double-blind randomized comparative study carried out in a tertiary care hospital. The study sample was 60 and divided into two equal groups. All data entered in MS-Excel Sheet and Wilcoxon signed-rank test were done for nonparametric data and one-way ANOVA for the parametric data. The normal distribution of the study sample was tested by the Shapiro − Wilk test.

Results:
The fasciculations in the test group were much less than in the control group with P < 0.00001. The results for the incidence of myalgia in the two groups were as follows: P value at 24 h was 0.00018 and at 48 h was 0.0028, respectively. Creatine kinase levels at preoperative and 24 h postoperative periods were 49.47 ± 7.24 in Group D, 53.30 ± 7.98 in Group B and 87.38 ± 15.16 in Group D, and 188.41 ± 33.27 in Group B, respectively.

Conclusion:
Succinylcholine-induced myalgia has a complex pathophysiology. However, the preemptive use of diclofenac in combination with precurarization can alleviate the incidence and severity of succinylcholine-induced myalgia. Therefore, its use may be considered in routine cases for induction of anesthesia for facilitating laryngoscopy and endotracheal intubation.
Pattern of Conventional Coagulation and Thromboelastographic Parameters in Patients with COVID-19 Diseases and Association of COVID-Associated Coagulopathy with Mortality in Intensive Care Unit
Authors: Balchandra Awale Rupali , Ghatak Tanmoy , Samanta Sukhen , Singh Ratender K. , Verma Anupam , Mishra Prabhakar , Chaudhary Rajendra , Nath Alok 
Published: June 2022

Background:
Knowledge of underlying pathophysiology of coagulopathy is evolving and the pattern of coagulation parameters in coronavirus disease 2019 (COVID-19)–associated diseases is still not very clear.

Aims:
In the present study, we aimed to find out the pattern and distribution of conventional coagulation parameters and thromboelastographic (TEG) parameters in COVID-19–associated coagulopathy (CAC) in survivors and nonsurvivors at 28 days.

Setting and Design:
The present prospective observational study was conducted at a tertiary care COVID-19 intensive care unit (ICU) facility from March 21, 2020, to July 15, 2021.

Materials and Methods:
Admission clinical and laboratory data (conventional coagulation, inflammatory and TEG parameters, and disease severity parameters) of 64 COVID-19 patients admitted to the ICU were collected. Patients were divided into two groups, i.e., survivors and nonsurvivors.

Statistical Analysis:
Data were compared between two groups, i.e., survivors versus no survivors on 28 days using Student's t-test/Mann–Whitney U-test or Chi-square test/Fisher's exact test.

Results:
Admission mean plasma fibrinogen levels (474.82 ± 167.41 mg.dL−1) and D-dimer were elevated (1.78 [0.66, 3.62] mg.mL−1) in the COVID-19 ICU patients. Overall, COVID-19 patients had mean lower normal platelet count (150 ± 50 × 103 cells.mm−3), with marginally elevated prothrombin time (16.25 ± 3.76 s) and activated partial thromboplastin time (38.22 ± 16.72 s). A 65.6% (42/64) TEG profile analysis showed a normal coagulation profile, and the rest 21.9% (14/64) and 12.5% (8/64) had hypercoagulable and hypocoagulable states, respectively. Plasma D-dimer level was markedly elevated in nonsurvivors compared to survivors (P < 0.05), while no other conventional coagulation parameters and TEG profile demonstrated statistically significant between the two groups.

Conclusion:
Markedly elevated plasma D-dimer level was observed in nonsurvivors of COVID-19 ICU patients. A large portion of COVID-19 ICU patients had a normal TEG profile. Conventional coagulation parameters and TEG profile were similar between survivors and nonsurvivors.
Preoperative Ultrasonographic Evaluation of Subclavian Vein and Inferior Vena Cava for Predicting Hypotension Associated with Induction of General Anesthesia
Authors: Rose Nadia , Chandra Mahesh , Nishanth Chris C. , Srinivasan Rangalakshmi 
Published: June 2022

Introduction:
Induction of general anesthesia is often associated with hypotension and is a common scenario faced by anesthesiologists. Intraoperative hypotension can have detrimental effects and cause various adverse effects leading to an extended hospital stay. Patients' preinduction volume status can have an effect on postinduction blood pressure. Ultrasonography is a useful tool for measuring intravascular volume status. We studied the ability of ultrasonographic measurement of subclavian vein (SCV) and inferior vena cava (IVC) diameter, collapsibility index (CI) to predict hypotension after induction of general anesthesia.

Materials and Methods:
We included 120 patients in our study. SCV measurements during spontaneous and deep inspiration and IVC measurements were taken before induction and postinduction blood pressure was monitored. Patients with mean arterial blood pressure <60 mmHg or with a 30% decrease from baseline were considered to be having hypotension.

Results:
The CI of IVC with a cutoff 37% showed sensitivity of 94% and specificity of 84% which was statistically significant. The CI of 36% of SCV during deep breathing was found to have high sensitivity and specificity of 90% and 87%.

Conclusion:
Our study in spontaneously breathing preoperative patients shows that SCV CI in deep breathing and IVC CI is very sensitive and reliable in predicting postinduction hypotension. Bedside ultrasound measurements can be easily done to obtain valuable information to recognize patients who could be at risk from postinduction hypotension.
Psychiatric comorbidity and quality of life in patients with bipolar disorder
Authors: Sengupta Gunja , Jena Shivananda 
Published: June 2022

ABSTRACT

Background:
Psychiatric comorbidity in patients with bipolar disorder (BD) has been associated with an earlier onset, rapid cycling, worsening severity and outcome, and increased suicidality. Patients with BD have been reported to have poor quality of life (QOL) even during remission.

Aims and Objectives:
Estimate the prevalence of psychiatric comorbidity and assess the QOL in patients with BD, and find the associated sociodemographic and clinical variables.

Materials and Methods:
This cross-sectional study was done in a general hospital psychiatric unit on 100 patients (both inpatients and outpatients) with DSM-IV-TR BD in partial or complete remission. Patients were assessed using a semi-structured pro forma, Mini International Neuropsychiatric Interview 6.0 - Hindi version, Hamilton Rating Scale for Depression or Young Mania Rating Scale and World Health Organization QOL instrument, short-form (WHOQOL-BREF), Hindi Version.

Results:
Sixty-one percent of the sample had at least one psychiatric comorbidity, and the commonest comorbid disorders were substance use disorders (SUD) (30%) and anxiety disorders (AD) (28%). Male gender was identified as a predictor for comorbidity in BD. The mean QOL-BREF score was 85.96 ± 14.35. Poor QOL was associated with older age at onset of comorbidity, multiple comorbidities, mixed episodes, rapid cycling, partial remission, and increased severity of depression while patients with current hypomanic symptoms were found to have better QOL. BD with comorbidity had worse QOL than those without comorbidity.

Conclusion:
The majority of patients with BD had at least one comorbidity. SUD were the most common comorbid disorders. QOL, already poor in BD patients, was poorer in cases with comorbidity.
Apthous ulcers
Authors: Kumar Amit , Kashyap Divya 
Published: June 2022

Objective:
Recurrent aphthous ulcer, also known as aphthous stomatitis or canker sores, is the most common idiopathic in nature inflammatory disease of the oral mucosa, causing a great deal of pain and discomfort to the patient. The purpose of this study was to report the prevalence of aphthous ulcers and their distribution according to gender and site in different age groups.

Materials and Methods:
The present study was conducted over a period of 7 months on patients reporting to the Dental Outpatient Department of GMC, Badaun, who came for a routine dental checkup. A pro forma was created, which contained complete demographic and clinical details of all the patients, namely recorded data for age, gender, and site affected were analyzed using the SPSS program.

Results:
Out of 7400 patients, 291 were diagnosed with recurrent aphthous ulcers, making its overall prevalence to be 3.93%. Cases were found to be higher in females (50.86%) than in males (49.14%). Maximum cases were reported in the second decade of life (36.77%). The tongue was found to be the most common site affected.

Conclusion:
The present study has provided relevant information regarding the prevalence and distribution of recurrent aphthous ulcers that will contribute to the better understanding and consequent management of the disease.
Hepatocellular and dermatological outcomes of chlormezanone
Authors: Muhammad Zohaib  
Published: June 2022

Madam,
Depression is a significantly prevalent mental disorder in our society and is often overlooked, but, medical intervention becomes a necessity in many severe cases. Chlormezanone, a non-benzodiazepine is used to treat depression-related disorders and muscle spasms. However, Chlormezanone is not free of limitations and imperfection; the drug was introduced in 1958 and its use was discontinued in many countries from 1996 on, due to rare but serious cases of toxic epidermal necrolysis1. Chlormezanone has been discontinued in many countries, including the United States, the European Union, South Africa, and Japan. Even then, authorities deemed this drug more beneficial than harmful, and this drug was marketed.
However, adding a brief history of events from the introduction to when the toxic effects were first reported and then the discontinuation may be helpful. A study published in 2022 showed how chlormezanone could induce hepatocellular and dermatological toxicity5.
Many other reports are showing similar outcomes and a number of case studies have been published in reputable journals regarding the adverse effects of this drug. Studies published by Dubey et al. and Mehboob et al. reported severe dermatoxic drug reactions2,3.
These vexatious results support the statement that chlormezanone is not a safe drug to be marketed.
The drug has been withdrawn in the US and European Union for about 24 years now but, still being prescribed in many countries including Pakistan during regular practice. Physicians should refrain from prescribing the use of chlormezanone in patients at risk of liver diseases as liver diseases are highly prevalent in Pakistan. A study published in BMJ discussed the lack of trials and inspections in Pakistan to treat anxiety disorders that involve the use of poor drugs and treatment modalities4. Furthermore, people in Pakistan have easy access to all medications and can buy drugs even without a prescription. People in Pakistan are significantly medically unaware and usually take medicines without doctor’s advice on having similar symptoms as before. If patients under the treatment of Chlormezanone experience yellowing of eyes or jaundice-like symptoms and, rashes over the skin, they should seek immediate medical attention. The concerned authorities should also investigate the matter of such drugs and work on implementing drugs with the better risk-benefit ratio in the market.
Pengaruh Jumlah Omset dan Sanksi terhadap Kepatuhan Wajib Pajak Hotel, Restoran, dan Hiburan di Kota Medan
Authors: Fajaria Annisa , Nawawi Zuhrinal M. 
Published: June 2022

Medan as one of the largest metropolitan cities in Indonesia, of course, should pay more attention to public compliance with payments and taxes, especially in this case the hotel, restaurant and entertainment tax in Medan. This study aims to determine how turnover and fines affect compliance with tax regulations, hotels and entertainment in the city of Medan. This research was conducted by using a literature search research method and using secondary data. The results showed that the imposition of fines together with the imposition of fines had a significant effect on compliance with hotel, restaurant, and entertainment taxpayer regulations in Medan. While the amount of revenue received does not affect taxpayer compliance with hotels, restaurants, and entertainment in the city of Medan.
Keywords: Hotel Tax, Restaurant Tax, Entertainment Tax, Taxpayer Compliance
Efektivitas Penerapan Sasaran Kinerja Pegawai (SKP)-Online Di Lingkungan Badan Pengelola Keuangan Dan Aset Daerah (BPKAD) Pemerintah Provinsi Sumatera Utara
Authors: Faraz Azis Ilmi Sitorus Isnaini , Akmal Tarigan Azhari 
Published: June 2022

The focus of this research is to look at the effectiveness of the implementation of Online Employee Performance Targets (SKP) in the Regional Financial and Asset Management Agency (BPKAD) of North Sumatra Province, the inhibiting factors and the efforts made in implementing SKP-Online to improve the performance of the state civil apparatus optimally in Environment of the Regional Financial and Asset Management Agency (BPKAD) of North Sumatra Province. The research uses the theory by Gibson, Donnelly, and Ivancevich regarding organizational effectiveness, then is limited to the application of SKP-Online and employee behavior. This study uses a qualitative method with a descriptive approach. In collecting data, researchers conducted observations, interviews and collected documents related to the application of SKP-Online within the Regional Financial and Asset Management Agency (BPKAD) of North Sumatra Province. The results showed that the implementation of SKP-Online in the Regional Financial and Asset Management Agency (BPKAD) of North Sumatra Province had not run well and optimally, as seen from the implementation process and supervision in the implementation of employee performance targets (SKP)-Online. Then the work environment is less productive and the apparatus resources are still incompetent and the employees' sense of responsibility towards their duties and functions as state civil servants. Efforts were made to improve employee performance in the application of SKP-Online, among others: 1. Creating an innovation by forming a group of employees of the Regional Financial and Asset Management Agency of North Sumatra Province an application on the telephone. 2. Re-socialization to all employees in the Regional Financial and Asset Management Agency of North Sumatra Province, by making a tutorial on the operation of SKP-Online by the editing section. 3. Motivating employees to want to learn how to use and operate technology facilities. Overall, the efforts made have actually been quite good. It's just that over time these efforts have not fully succeeded in improving employee performance in implementing SKP-Online. because these efforts still have not shown a significant impact in building a sense of responsibility of employees towards their duties and increasing work discipline. Therefore, there is still a need for other efforts that are more decisive and have a significant impact to achieve the objectives of implementing SKP-Online, so that the provision of TPP is more efficient and able to optimally improve the quality of employee work and create a competent and quality work environment.
Keywords: Effectiveness, SKP-Online and Employee Performance
Tip 2 diyabet hastalarında dolaşımdaki B-tipi natriüretik peptidin osteoporoz ile ilişkisi
Authors: DOĞAN Murat 
Published: June 2022

Amaç: Bu çalışmanın amacı tip 2 diabetes mellitus (T2DM) hastalarında dolaşımdaki B-tipi natriüretik peptid (BNP)’in osteoporoz ile ilişkisini değerlendirmektir.
Gereç ve Yöntem: T2DM’li 95 hasta çalışmaya dahil edildi. Hasta dosya sistemlerinde dolaşımdaki BNP seviyeleri olan ve 15 gün içerisinde kemik mineral yoğunluğu (KMY) bakılmış hastalar çalışmaya dahil edildi. Hastalar KMY skorlarına göre normal, osteopeni ve osteoporoz olarak üç gruba ayrıldı. Dolaşımdaki BNP ile diyabetik osteoporoz ve diğer parametreler arasındaki ilişki incelendi.
Bulgular: Çalışmamıza 75’i kadın, 20’si erkek olmak üzere toplam 95 hasta dahil edildi. Hastaların yaş ortalaması 66,09±5,96 idi. Gruplar arasında cinsiyet, yaş ve vücut kitle indeksi (VKİ) benzer bulundu. DM süresi osteoporoz grubunda anlamlı olarak yüksek saptandı (p
Relationship between age at menopause and breast ultrasonography results
Authors: GÜRKAN Naziye , AĞAR Mehmet , DEMİRÇİVİ BÖR Ergül 
Published: June 2022

Aim: Menopause, the natural process of women’s aging, brings many problems. With menopause, the loss of mammary glandular tissue increases rapidly, and large losses occur in the mammary glands due to atrophy, degeneration, and hyalinization. Ultrasonography (USG) helps to detect these breast changes. This study compared breast USG findings in menopausal cases before and after 40 years.
Material and Method: The files of menopausal patients who applied to the Gynecology and Obstetrics Clinic of Göztepe Prof. Dr. Süleyman Yalçın City Hospital between October 2014 and September 2020 were retrospectively scanned and analyzed. According to the age of patients entering menopause, it was divided into two groups: 1st group under 40 years old and 2nd group over 40 years old. 52 patients in the 1st group (case group) and 67 patients in the 2nd group (control group) were included in the study.
Results: The mean age of the participants in the study was 33.2 in the 1st group and 48.6 in the 2nd group. Body mass indexes (BMI) were 24.8 kg/m² in group 1 and 25.1 kg/m² in group 2. When the breast USG findings were examined, the incidence of cyst formation in the 1st group was found to be statistically significantly higher than in the 2nd group (p
Near-Peer Facilitation of a Soft Skills Program for Young Adults With Autism
Authors: Connor Annemarie , Fabrizi Sarah E. , Nasamran Amy , Sung Connie 
Published: June 2022

Abstract
Importance: Young adults with autism spectrum disorder (ASD) experience poor employment outcomes. Teaching soft skills and using peer-based interventions improve outcomes for people with ASD.
Objective: To evaluate the preliminary efficacy of a soft skills intervention and the feasibility of delivery to a group of young adults with ASD by near-peer occupational therapy master’s-level students.
Design: Pretest–posttest single-group design.
Setting: College campus.
Participants: Convenience sample of 14 young adults (M age = 21.57 yr) with ASD.
Intervention: The Assistive Soft Skills and Employment Training (ASSET) program is a 12-session, manualized, soft skills group intervention previously validated with the ASD population. Topics include communication, attitude and enthusiasm, teamwork, networking, professionalism, and stress management.
Outcomes and Measures: Social functioning, self-efficacy, and adaptive behavior were measured preintervention and immediately postintervention using standardized self-report rating scales. Participant satisfaction and experience were assessed using program-specific measures.
Results: Participants made statistically significant improvements, with medium to large effect sizes in social functioning, self-efficacy, and adaptive behavior. They reported high levels of satisfaction and a positive experience with the program content and delivery.
Conclusions and Relevance: This study provides evidence of participant satisfaction and perceived soft skills improvement and confidence, in addition to the preliminary efficacy of master’s-level students as near-peer facilitators of the ASSET program with an ASD population.
What This Article Adds: The results suggest that trained and supervised master’s-level students can effectively deliver a manualized intervention as near-peer facilitators, elicit positive feedback and high levels of participant satisfaction, and replicate and extend previously reported participant gains.
Apresentação do Dossiê – Pessoas em situação de rua: a luta pelo direito de viver
Authors: Santos de Andrade Fábio , Santos Pereira Reginaldo 
Published: June 2022

A rua sempre foi um lugar de passagem que nos conduz aos destinos. Um lugar de trabalho, de luta e de festa. Na rua, direitos foram conquistados e censurados; líderes foram eleitos e depostos. A rua sempre foi um lugar de movimento, de ação, de liberdade e de vida.
A rua também é o não-lugar dos que tiveram seus direitos básicos negados e dela e nela sobrevivem. São crianças, adolescentes, adultos e idosos, que desenvolvem táticas lícitas ou ilícitas, para garantir a vida individual ou coletiva. Essas são as pessoas que, por motivos diversos, deixaram suas casas de forma temporária ou definitiva e estão nas ruas lutando pela sobrevivência.
O fenômeno da população em situação de rua no Brasil é histórico e seus primeiros registros datam do século XVI. Com o passar dos anos as pessoas em situação de rua foram se adaptando ao tempo e espaço, tornando-se cena comum em todo o território brasileiro no século XX. No decorrer da história, essas pessoas ganharam diversos nomes como “mendigo”, “maltrapilho”, “marginal”, “esmoler”, “indigente”, “mendicante”, “pedinte”, dentre muitos outros, mas é a negação de direitos, a violência e a pobreza extrema que sempre as fizeram buscar a rua como espaço de moradia e/ou sobrevivência. Cabe destacar que as pessoas em situação de rua não são um grupo homogêneo; elas se dividem em diversos grupos com características distintas e o que os iguala é a busca pela sobrevivência na rua.