bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peripheral limb ischemia- A rare side effect of ergometrine
Authors: Kirdant Jagruti , Roy Indrani , Bhuyan Barnali , Choudhary Ankita , Patel Neelkumar 
Published: February 2022

: Drug induced vasculitis is an inflammation of blood vessels caused by use of various drugs like ergometrine, inotropes. The purpose of this review is to highlight the importance of ergotism as a cause of peripheral vascular ischemia and analyze the changes associated with this condition.Mrs. XX, 21 year old, P2L1 presented with history of normal delivery in PHC eight days back with complaints of breathlessness, fever and bluish grey discoloration of both lower extremities since her delivery. There was history of severe postpartum hemorrhage post delivery in the PHC and was medically managed with ergometrine and other oxytocics. On examination, patient had pallor, temperature and tachycardia. Dorsalis pedis pulsation was palpable in both lower limbs. Thorough workup was done which revealed hemoglobin 6.9 gm% and high total count. Doppler study of both lower limbs and ECHO were normal. Patient was managed conservatively after which she improved symptomatically but there was no improvement in the line of demarcation in both lower limbs. Due to financial constraints, patient decided to shift to government setup for further management.Ergometrine is recommended by ACOG and RCOG for use in the medical management of atonic postpartum hemorrhage after oxytocics. Ergometrine has a vasoconstrictive effect which causes progressive vasospasm leading to peripheral ischemia and gangrene which may lead to amputation of the limbs. Hence, management of postpartum hemorrhage with minimum effective dose of ergometrine should be emphasized and use of other oxytocics should be encouraged to prevent such major complications.
Study of cyto-histopathological correlation in thyroid lesions at rural tertiary care hospital
Authors: Joshi Sneha R , Nagare Mangala Rajesh 
Published: February 2022

Fine Needle Aspiration Cytology of the thyroid gland is firmly established as an important test for the evaluation of thyroid diseases and an effective test for the preoperative diagnosis of solitary thyroid nodule. : 1. To correlate cytological and histopathological finding in thyroid lesions.; 2. To find out the spectrum of thyroid lesions in our rural hospital. : Prospective study of 2 years duration was undertaken in our institution. Total 110 cases were included in this study. All had FNAC examination as an outpatient procedure. Out of 110 cases, 64 were operated and specimens were sent for histopathology.Out of the 111 patients studied, on cytology 104 were non-neoplastic lesions, 3 were neoplastic, and 3 were inadequate. Out of 111 patients, Histopathology of 65 thyroid specimens showed 28 Colloid/Nodular goiter, 14 Multinodolar goiter, 5 Lymphocytic thyroiditis, 7 Hashimoto’s thyroiditis,1 Granulomatous thyroiditis,3 follicular carcinoma, 1 undifferentiated Anaplastic carcinoma,1 Medullary carcinoma, 1 papillary carcinoma.: By comparing the result of FNAC and histopathology, FNAC had higher accuracy, sensitivity of 80% and specificity 100% in the diagnosis of neoplastic thyroid lesions. FNAC is safe, inexpensive and less invasive diagnostic method with excellent patient compliance. FNAC can be used in the management of thyroid swelling to avoid unnecessary surgery on conditions like thyroiditis. FNAC with the help of imaging techniques is helpful in diagnosis of neoplastic lesion.
Histopathological study of neoplastic lesions of upper gastrointestinal tract endoscopic biopsies
Authors: Saroha Neha , Ahamed Mohammed Afroz 
Published: February 2022

Upper gastrointestinal tract disorders are one of the most commonly encountered problems in clinical practice and are a leading cause of morbidity and mortality. A wide spectrum of disorders can affect the upper gastrointestinal tract, with inflammatory and neoplastic lesions being the most common. Endoscopy, in combination with biopsy plays an important role in timely diagnosis and early management.To study the spectrum of neoplastic lesions of upper gastrointestinal tract and its correlation with socio-demographic details.This is a cross-sectional study conducted at department of pathology, MMCRI from January 2019 to June 2020.A total of 87 upper GI endoscopic biopsies were received and were routine processed and histopathological assessment was done. Thereafter, 50 biopsies diagnosed as neoplastic lesions were included in the present study. Age of the patients varied from 41-80 years with male : female ratio of 2.3 :1. Out of 50 endoscopic biopsies, 34 cases( 68%) were from esophagus and 16 (32%) from stomach. All cases were malignant. Squamous cell carcinoma was the commonest malignancy in the esophagus while adenocarcinoma was the commonest malignancy of stomach.Endoscopy guided biopsy of upper GIT is simple, safe, cost effective, day care procedure with less complication rates and gives direct visualization of pathological site. Most of the patients with GIT malignancy have vague symptoms or no symptoms in early stage and are often diagnosed only in advanced stage. Hence, endoscopy in combination with biopsy acts as a useful diagnostic tool for upper GI lesions and has revolutionized the management of patients.
Serum uric acid levels on admission and prognosis of acute coronary syndrome: a bi-institutional report
Authors: Eskandari Ramin , Torabi Nasim , Athari Saba , Rezaei Yousef 
Published: February 2022

Objective: This study aimed to determine the association between the baseline serum uric acid (SUA) level and the short-term outcomes of patients with acute coronary syndrome (ACS).
Methods: In this retrospective, bi-institutional study, patients with a diagnosis of ACS were recruited and followed-up for 30 days regarding the development of major adverse cardiovascular and cerebrovascular events (MACCEs). The associations between the SUA level upon admission and cardiovascular morbidities and patient prognosis were examined using univariate and multivariate analyses.
Results: A total of 145 patients with ACS, with a mean age of 67.5±12.2 years, were recruited in this study. The rates of cardiovascular risk factors were higher in patients with elevated SUA levels. A cumulative MACCE was reported in 42 (29%) patients (19.5% in normal individuals and 39.7% in patients with elevated SUA levels, respectively; P=0.007). Based on the receiver operating characteristic (ROC) curve analysis, an on-admission SUA level above 6.9 mg/dL could discriminate patients with MACCE from those without MACCE during 30 days of follow-up (AUC=0.637; 95% CI: 0.553–0.715), with 64.3% sensitivity and 66% specificity. Based on multivariate logistic regression analysis, an elevated SUA level was associated with an increased risk of MACCE (odds ratio, 15.353; 95% CI: 2.026–116.328).
Conclusion: In patients with ACS, an elevated baseline SUA level was associated with a higher prevalence of cardiovascular risk factors and morbidities, as well as an increased risk of MACCE in a short-term follow-up.
Concomitant COVID-19 and acute ischemic stroke in patients transferred by emergency medical service during first wave of pandemic in Tehran, Iran; a cross-sectional study
Authors: Saberian Peyman , Seyed Hosseini Davarani Seyed Hossein , Ramezani Mahtab , Mirbaha Sahar , Zangi Mahdi , Aarabi Sepideh 
Published: February 2022

Objective: We conducted this study to evaluate the prevalence of concomitant COVID-19 in acute ischemic stroke (AIS) patients admitted to stroke centers of Tehran, Iran.
Methods: We conducted a retrospective cross-sectional study in a 45-day period. AIS patients transferred by emergency medical service (EMS) to all medical centers of the city were included. Information was recorded and compared in two groups: patients who tested positive for COVID-19 and those who were negative.
Result: Emergency medical technicians (EMTs) screened 348 patients as AIS cases, of whom, AIS was ultimately confirmed in 311 (89.4%) patients; and 58 (18.6%) of the 311 AIS patients were diagnosed with concomitant COVID-19 infection. The National Institutes of Health Stroke Scale (NIHSS) scores of COVID-19 positive AIS patients were significantly higher than non-COVID-19 AIS patients (16.3±3.7 vs. 11.8±4.3; p<0.001). There was also a significant difference in length of hospital stay between the two groups (11.1±1.8 vs. 8.8±4.3 days; p<0.001). However, data showed no significant difference regarding prevalence of in-hospital mortality between the two groups (1.6% vs. 3.5%; p=0.320).
Conclusion: Our study results showed that AIS patients with concomitant COVID-19 infection had higher NIHSS scores and longer length of hospital stay compared to patients without concomitant COVID-19 infection.
The Effect of Advertising, Perception and Consumer Knowledge on Purchasing Products
Authors: Hadinata Wahyu Annas Surya , Hariasih Misti 
Published: February 2022

Penelitian ini bertujuan untuk mengetahui Pengaruh Iklan, Persepsi dan Pengetahuan konsumen Terhadap Pembelian Produk pada PT. Javas Tripta Mandala. Alat analisis yang digunakan adalah melakukan tabulasi terhadap kuesioner, pengumpulan data yang berupa uji validitas dan reliabilitas. Hipotesis dalam penelitian ini adalah pengaruh iklan, persepsi dan pengetahuan konsumen terhadap pembelian produk. Untuk menguji hipotesis ini digunakan alat analisis regresi linier berganda. Hasil instrument penelitian yang diperoleh berdasarkan uji validitas menunjukkan seluruh pertanyaan pada kuesioner dinyatakan valid. Untuk uji reliabilitas dari semua variabel diperoleh nilai Cronbach’s Alpha> 0.6 maka dinyatakan reliable. Uji Hipotesis berdasarkan Uji F, Uji t dan Adjusted R2 menunjukan ada Pengaruh signifikan Iklan, Persepsi dan Pengetahuan konsumen terhadap pembelian produk
Developing the School Safety Perception Scale: The Validity and Reliability of Study
Authors: ERÇEK Mustafa Kemal , BİREL Fırat KIYAS 
Published: February 2022

The purpose of this research is to develop a scale to determine the perceptions of teachers working in secondary schools related to school safety. Alongside the social actors, the elements involved in achieving the goals of educational activities are important actors in the solution and implementation of the school security problems. Therefore, the actors performed in this way and were want teachers' perception of safety education activities in schools is critical. The research includes a scale development study. Certain steps in the scale of development for secondary teacher’s perceptions of school safety were monitored. Reliability and Validity Scale with work related to the development of exploratory and confirmatory factor analyzes were performed. Exploratory factor analysis of the obtained 40-item scale 54.233 discloses % of the total variance. Analyzes showed that reliability coefficients of scale factors ranged from .769 to .893. These values are enough to pass to the confirmatory factor analysis. Confirmatory factor analysis results showed that SSS is a valid tool to measure teachers’ perceptions about school safety. Structures of this study, data collected through school safety scale set Cronbach's alpha was calculated in order to determine the internal consistency. Application in terms of behavior and School Safety "Although low compared to other dimensions of size with .61, scale and reliability coefficients ranged between .80 and .93 for the dimensions have been determined to be highly reliable. İmplications for Research and Practice: With the help of the developed scale, relations between school safety perceptions and personal variables, organizational stress, school climate, use of security technologies, occupational burnout and organizational commitment can be examined. Effects of student perceptions of school safety on their academic success can be researched. Similar scales can be developed for parents, administrators, preschool, elementary school teachers, lecturers, and university students.
The Principles of Educational Leadership in the Perspective of the Qur’an
Authors: Assa'idi Sa'dullah , Hamid Abd. , Subaidi Subaidi 
Published: February 2022

Humans as inheritors of the earth regulate life and everything. With their intellects and skills, they can make the earth a place to carry out various daily activities. As the caliphs, they get the trust that must be implemented on the earth. In this study, the authors would adopt the cornerstone principles of leadership education in general and in view of the Quran. Principles of leadership in general education studied were those of integrative and cooperative capacity, rationality and objectivity, adaptability and flexibility, delegation, pragmatism, and exemplary. On average, the principles of educational leadership in the perspective of the Qur'an are the principle of tawhid, deliberation, fairy, freedom, upright, commanding the good and forbidding the evil, and a good example. From these two principles of educational leadership, they include the education for a leader who according to the morality of the Qur'an (1) is tolerant, (2) likes to do deliberation in decision-making, (3) is fair in terms of law, (4) gives freedom, (5) can be trusted, (6) is always doing good, and (7) gives good examples. An educational leader as stated in the Qur'an is the one who upholds Islamic values and leadership principles.
Energy-ecological Efficiency of Dual-Fuel Serie Plug-in Hybrid Electric Vehicle Considering WTW Emissions
Authors: Boloy Ronney Arismel Arismel Mancebo , Soares Laene , de Moraes Danielle Rodrigues , Callejo Luis Hernández 
Published: February 2022

Abstract
This paper discussed the possibility of replacing the internal combustion engine of the series plug-in hybrid electric vehicle (PHEV) powered by gasoline A and Brazilian gasoline in single-fuel mode by one fuelled with 50% bioethanol and 50% biogas in dual-fuel mode. The simulation of the combustion of the fuels selected, such as bioethanol, biogas and gasoline A, were carried out through GASEQ software to calculate the energy-ecological efficiency of the single-fuel and dual-fuel modes. The well-to-pump (WTP) emissions of the bioethanol and biogas production from sugarcane were evaluated through GREET software. The tank-to-wheel (TTW) emissions were determined to each series PHEV operating modes. Thus, the well-to-wheel (WTW) emissions were calculated through the sum of the WTP, TTW and electricity mix emissions. According to the results, the energy-ecological efficiency for the dual-fuel mode was 10.7% and 24.1% higher than that found for the single-fuel mode powered by gasoline and Brazilian gasoline, respectively. The analysis showed that the losses during the biogas production aggravate linearly the WTP emissions, and consequently the WTW emissions of the series PHEV. Besides that, the dual-fuel mode presented 15.5% and 12.8 less TTW emissions than the single-fuel mode powered by gasoline A and Brazilian gasoline, respectively. Comparing to the emission standards, the dual-fuel mode presented TTW emissions 30.5% higher than the European Union emission standard by 2021. Although the dual-fuel mode does not meet none of the emission standards, this engine mode can be an alternative to at least reduce the tailpipe emissions.
House officers’ specialist career choices and motivators for their choice– a sequential mixed methods study from Malaysia
Authors: Nadarajah Anuradha , Shankar Pathiyil Ravi , Jayaraman Sivakumaran , sreeramare chandrashekhar T 
Published: February 2022

Abstract
Background:
Shortage and maldistribution of medical specialists hampers healthcare quality. The specialist career choices of house officers determine the composition healthcare system. We studied house officers’’ specialist career choices and motivators for their choice.
Methods:
An exploratory sequential mixed methods study was done from July to December 2020 among house officers working in Hospital Selayang, Selangor, Malaysia. We conducted online in-depth interviews among seven house officers using an interview guide developed based on a literature review. The transcripts were analyzed thematically. A 33-item questionnaire was developed, and the main and sub themes identified as motivators for specialist career choice. An online survey was done among a random sample of 185 house officers. Content validation of motivators for specialist choice was done using exploratory factor analysis. First, second and third choice for specialist career were identified. Multinomial logistic regression analyses were done to determine the socio-demographic factors and motivators associated with first choice.
Results:
Two major themes identified from the in-depth interviews with house officers. Perceptions about specialist training opportunities were positive as they gain wide range of clinical competencies through a well-structured, comprehensive training programs under existing specialist training pathways. However, limited availability of Malaysian local university training opportunities and challenges of ‘on-contract’ to pursue specialist training were the main challenges. The motivational factors for first-choice specialty were related to ‘work schedule’, ‘patient care characteristics’, ‘specialty characteristics’, ‘personal factors’, ‘past work experience’, ‘training factors’, and ‘career prospects.’ Overall Cronbach’s alpha for the questionnaire on motivators was 0.85. Exploratory factor analyses retained 26 out of 33 items in seven constructs with a 64.9% variance. House officers’ first choice were specialties related to medicine (40.5%), surgery (31.5%), primary care (14.6%) and acute care (13.5%). On multivariate analysis, “younger age”, “health professional in family”, “work schedule and personal factors”, “career prospects” and “specialty characteristics” were associated with first choice.
Conclusions:
Specialties related to medical and surgical disciplines were most preferred disciplines. Motivators for first choice varied by disciplines. The information motivational factors are helpful to develop policies to encourage more doctors to choose specialties with shortage of doctors and to provide career specialty guidance.
Upper Gastrointestinal Bleeding Following Legionnaires' Disease Case Report
Authors: Aboaid Hazem , Issa Tammy , Sharma Rupam , Aboaid Shatha , Kalha Ishaan , Munoz Augustine D , Heidari Arash 
Published: February 2022

Abstract
Background: Legionnaires’ disease can involve multiple systems of the human body. However, in the majority of cases, it presents as a pneumonic illness responsible for 2–15% of community-acquired pneumonia cases that necessitate hospitalization. Herein described is a case of a 51-year-old male presenting with productive cough and headache who was later diagnosed with legionella pneumonia. He suffered from several episodes of gastrointestinal bleeding subsequently. To the best of our knowledge, prior to this case, only sixteen cases of gastrointestinal bleeding following Legionnaires’ disease have been reported. Methods: Approval was obtained from the Institutional Review Board of Kern Medical. A retrospective review of the patient’s record was performed. The literature search was conducted on PubMed and Google Scholar. These search terms were applied: Legionnaires’ disease, Legionnaires’ disease complication, gastrointestinal bleeding following Legionnaires’ disease, legionella pneumonia.Results: GI bleeding is rare in LD and the relationship between this association is uncertain. Legionella pneumophila is equipped with Dot/Icm Type IV Secretion System (T4SS), which is a cable to deliver up to 300 effector proteins into the cytoplasm of the host cells. These proteins function as virulence factors. It is worth mentioning that Helicobacter pylori (H. pylori) a known GI pathogen is also armed with a T4SS like Legionella pneumophila called H. pylori Cag T4SS.Conclusion: Further studies are needed to prove the relationship, but clinicians should search for the presence of this pathogen in other organs to understand the pathophysiology of extrapulmonary diseases. We must learn to cast a finer net when fishing for the cause of the symptoms. The etiology may be passing right through our screening methods
Patterns of adult and youth inpatient admissions before and after the COVID-19 pandemic in a psychiatric ward: an observational study
Authors: Rodrigues Carolina Alves , Rodrigues Nuno , Nascimento Miguel , Oliveira-Silva Joana 
Published: February 2022

Abstract
Background: The current pandemic situation led to deep changes not only in social relationships, but also on clinical care and access to healthcare facilities. The authors aimed to understand if this context led to a different pattern of treatment of patients with severe mental illness, measured by admissions in an acute psychiatric ward. Methods: Retrospective data collection of all patients admitted in Centro Hospitalar Psiquiátrico de Lisboa, in two different time periods: pre-COVID-19 (march 11th, 2019 to march 10th, 2020, n=1845) and COVID-19 (march 11th, 2020 to march 10th, 2021, n=1278); comparing the number of total admissions, compulsory ones, age, sex, median days of admission, median days to readmission and diagnosis at discharge. Distribution of disorders in both groups, as well as in compulsory admissions were also evaluated. The same comparisons were evaluated in the 15–25-year-old patient group. Results: Statistical significance was found regarding total number of admissions (reduction of around 30.7%), as well as compulsory ones (reduction of 14%, although the relative frequency had increased), days of admission and distribution between admissions (with lower reductions regarding dementias, schizophrenia and affective disorders, while substance use disorders and intellectual disabilities presented reductions of over 50%), with no differences between gender, median age, previous admissions or readmissions. Distribution between compulsory admissions did not present differences before and during COVID periods. For patients between 15 and 25 years of age, statistical significance was found regarding total number of compulsory ones (94 versus 44, p-value=0.01), and in all group of diagnoses (all with p-value=0.001). Conclusions: While there was a general reduction in the overall number of patients admitted, in the most severe conditions (compulsory admissions and schizophrenia diagnosis) did not present such a reduction. Difficulties in social, clinical and family networks can explain the reduction of the time to readmission. Future research could show whether there is a rebound increase number of admissions in the other diagnoses. Trial Registration: the current study was approved by the hospital’s scientific and ethics committees (CCP number 0060/2021 and CES 09/2021).