bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enterococcal infections in a Tertiary Care Hospital, North India
Authors: Yadav Rajesh Kumar , Agarwal Loveleena 
Published: September 2022

Background:
The emergence of Enterococcus as an important nosocomial pathogen is mainly attributed to its inherent resistance to commonly used antibiotics and now in recent times, it has acquired resistance to other available therapeutic options as well.

Materials and Methods:

Enterococcus isolates from clinical samples received in the department of microbiology over a period of 1 year were included in the study. Isolates were identified and species determined by standard methods. Antibiotic susceptibility test was done by Kirby Bauer disc diffusion test. Epsilometer test was done to determine the minimum inhibitory concentration for vancomycin.

Results:
A total of 145 Enterococcus isolates were obtained; 73 (50.3%) isolates were identified as Enterococcus faecalis, 69 (47.5%) Enterococcus faecium, 2 (1.3%) Enterococcus durans and 1 (0.68%) as Enterococcus gallinarum. Most of the isolates were from urine samples (125, 86.2%); followed by pus (16, 11.03%). Vancomycin resistance was seen in 14 (9.6%) isolates while linezolid resistance was seen in 8 (5.5%) isolates.

Conclusion:

E. faecalis is the most common clinical species isolated from clinical samples and the emergence of linezolid-resistant enterococci from the hospital is a matter of concern as till now it is considered to be the last resort for treatment in patients infected with vancomycin-resistant enterococci.
Incidental Blast Injuries to the Hands of Hunters in Suburban Africa
Authors: Babalola Olakunle Fatai , Salawu Adedayo Idris , Hassan Adeniyi Steven , Okunlola Abiodun Idowu , Banjo Omotola Oluseyi , Fadairo Richard Oluyemi 
Published: September 2022

Background:
Civilian blast injuries are common during celebrations and festivities. In the intervening times, civilian nonterrorist blast events are rare. The aim of this report is to highlight the increasing occurrence of blast injuries to the dominant right hand of hunters and the ensuing crippling consequences.

Methodology:
A review of incidental blast injuries to the hand among hunters was conducted. The case files, clinical photographs, and radiographs of consecutive cases of blast injuries presenting to our unit over 3½ years were studied.

Result:
Six patients had incidental blast injuries to the hand within the period. All the patients were males and hunters by profession. The age range was 30–49 years. The dominant right hand was involved in all the six cases with high-energy soft tissue and bony injuries. Five patients had staged soft tissue coverage while the sixth patient, after initial resuscitation, discharged against medical advice due to economic constraints. Multiple joint stiffness and significant disability occurred in all the affected hands. None of the patients represented for secondary procedures.

Conclusion:
Incidental blast injuries to the hands of local hunters are lifestyle threatening. The dominant right hand is invariably involved with attendant crippling socioeconomic consequences. Meticulous clinical care and methodical operative intervention are primal to hand salvage.
An in vitro Comparative Assessment of Manual Hand File, Rotary ProTaper Ni-Ti, Erbium
Authors: Ismail Prabu Mahin Syed , AlMogbel Abdul Majeed , Priya Ritu , Bansal Nandita , Mattigatti Sudha , Nara Asha , AlMutairi Faris Jaser 
Published: September 2022

Background:
Selection of instruments is important to prevent any complications such as ledge formation and instrument breakage. The main drawback linked with instrumentation is smear layer formation.

Objectives:
This study was done for comparison of manual hand file, rotary ProTaper Ni-Ti, erbium:yttrium–aluminum–garnet (Er:YAG) laser, ultrasound, and CanalBrush (CB) methods for smear layer removal.

Methodology:
Sixty freshly extracted single-rooted mandibular first premolars extracted for orthodontic treatment purpose were selected and classified into six groups. Group I was negative control in which no final agitation of irrigant was performed. In Group II, solution activation was performed with ProTaper Universal System, in Group III, solution activation was done with canal brush, in Group IV, ultrasound activation was done, in Group V, solution agitation was performed with Er:YAG laser agitation, and in Group VI, canal preparation with hand files was performed. Smear layer score was evaluated after canal preparation with each method.

Results:
Score 1 was seen in 3 (30%) in Group IV and 6 (60%) in Group V, score 2 was seen in 3 (30%) in Group I, 8 (80%) in Group II, 7 (70%) in Group III, 5 (50%) in Group IV, 3 (30%) in Group V, and 4 (40%) in Group VI. Score 3 was observed in 7 (70%) in Group I, 2 (20%) in Group II, 3 (70%) in Group III, 2 (20%) in Group IV, 1 (10%) in Group V, and 6 (60%) in Group VI. A statistically significant difference was found in smear layer removal score in all groups (P < 0.05) except between Group I versus VI (P > 0.05).

Conclusion:
Complete removal of the smear layer was not observed in any of the methods used in the study; however, Er: YAG laser was found to be better as compared to other methods.
Misconception on Oxygen Administration among Patients and Their Caregivers in Ado Ekiti, Nigeria
Authors: Adeoti Adekunle Olatayo , Desalu Olufemi Olumuyiwa , Elebiyo Tobiloba , Aremu Olusegun Ayanwale 
Published: September 2022

Introduction:
Appropriate oxygen administration is a life-saving therapy; however, patients and their caregivers could decline such therapy for several reasons. Poor perceptions may delay consent to oxygen therapy. There is a lack of data on the perception of oxygen use among patients and caregivers in our setting. Hence, this study was aimed at evaluating the perception of patients and their caregivers toward emergency oxygen use in a tertiary hospital in Nigeria.

Materials and Methods:
This survey was a descriptive cross-sectional study conducted between December 2017 and May 2018 at a tertiary hospital in southwestern Nigeria. We administered a structured questionnaire to 334 eligible patients and their 539 caregivers while on admission.

Results:
A significant proportion of the patients compared to their caregivers have had oxygen therapy in the past 40.6% versus. 6.9% P < 0.0001. The majority of the participants (patients vs. caregivers 84.7% vs. 81.1% P = 0.511) believed oxygen therapy to be beneficial and safe for use (patients vs. caregivers 79.4% vs. 78.6%; P = 0.8949). However, 21.1% of patients and 19.5% of caregivers believed it is solely for terminally ill patients. More than 50% of patients and caregivers thought oxygen can cause adverse effects and fire outbreaks. Most of the respondents considered oxygen therapy as expensive (patients vs. caregivers; 78.2% vs. 87.2%; P = 0.0176) which was regarded as a possible barrier to treatment (patients vs. caregivers 81.9% vs. 85.0% P = 0.3893). <1% of both patients and their caregivers have had any form of training in basic life support.

Conclusion:
The misconceptions about oxygen use require urgent attention by raising community awareness and knowledge toward improving the acceptability of this life-saving intervention.
Promoting the use of Evidence in Health Policy-making in the Economic Commission of the West African States Region
Authors: Uneke Chigozie Jesse , Sombie Issiaka , Johnson Ermel , Uneke Bilikis Iyabo , Okolo Stanley 
Published: September 2022

Background:
The West African Health Organization (WAHO) is promoting the use of evidence in policy-making within West Africa. The need for increased understanding of the complexities of the evidence-to-policy process among policy-makers in West Africa necessitates the development of evidence-based policy-making (EBPM) guidance. The purpose of this study was to interact with policy-makers from West African countries to identify the necessity of EBPM guidance for the subregion.

Methods:
A cross-sectional qualitative study design was used to elicit the views/opinions of senior health policy-makers from across the 15 West African countries on why an EBPM Guidance is necessary for the subregion. The policy-makers were engaged during WAHO-organized regional evidence-to-policy meetings on the improvement of maternal and child health outcomes held in Senegal in 2019. Face-to-face, one-on-one interactions, interviews, and deliberations during the meeting plenary sessions were held with the policy-makers, who participated in the regional meeting.

Results:
Up to 23 policy-makers representing 15 West African countries participated in the study. Policy-makers who took part in the study supported the development of an EBPM Guidance to facilitate evidence-to-policy process. Among the identified reasons why an EBPM Guidance for West Africa is a necessity were to understand: (i) how to deal with barriers and facilitators that influence evidence to policy process; (ii) how to acquire, access, adapt, and apply available research evidence in policy-making; (iii) how to deal with contextual issues and broad range of evidence; and (iv) how to engage parliamentarians and policy legislators to promote policy development.

Conclusion:
An EBPM is a valuable tool that can provide health sector policy-makers the needed guide on the evidence-to-policy process. Studies that will evaluate the impact of EBPM guidance on the policy-making process in low- and middle-income countries are advocated.
Feasibility of high-yield plateletpheresis in routine practice
Authors: Sahoo Dibyajyoti , Noushad Shahida , Basavarajegowda Abhishekh , Toora Esha 
Published: September 2022

BACKGROUND AND OBJECTIVES:
High-yield plateletpheresis donations can reduce donor exposure and be economically beneficial as well. However, obtaining a high-yield plateletpheresis from a maximum number of donors with low basal platelet count and its effect on postdonation platelet count of donors undergoing high-yield plateletpheresis has been a matter of concern. This study aimed to assess the feasibility of making high-yield platelet donation as a routine practice.

METHODS:
It was a retrospective observational study to determine the effect of high-yield plateletpheresis on donor reactions, efficacy, and quality parameters. It was conducted from January 1, 2019 to June 30, 2021, at the Department of Transfusion Medicine in a tertiary care hospital of South India.

RESULTS:
Out of the 669 procedures, 564 (84.3%) of the collection had a platelet yield of ≥5 × 1011, 468 (70%) of the collection had a platelet yield of 5.5 × 1011, whereas 284 (42.5%) met the target of 6 × 1011 by coulter. The mean drops in platelet count were 95 ± 16 × 103/μl (77,600–113,000/μl), mean platelet recruitment was 1.31 ± 0.51. The mean collection efficiency of the procedure for the 669 cases was shown to be 80.21 ± 15.34, and the mean collection rate was 0.07 × 1011 ± 0.02 per minute. Only forty donors (5.5%) experienced adverse donor reactions.

CONCLUSIONS:
High-yield plateletpheresis can be done in routine practice with no added adverse donor reaction with effective quality products.
Influence of blood transfusion during induction chemotherapy on treatment outcomes in acute myeloid leukemia
Authors: Raghavan Vineetha , Murugesan Mohandoss , Nair Chandran K. , Nayanar Sangeetha Keloth 
Published: September 2022

Abstract

BACKGROUND:
Transfusion is an integral part of supportive care in patients undergoing aggressive chemotherapy for acute myeloid leukemia (AML). As transfusion induces immune modulation, the objective of the study was to assess whether the intensity of red blood cell (RBC) and platelet (PLT) transfusion during induction chemotherapy influences complete remission (CR) and overall survival (OS) in newly diagnosed AML patients.

METHODS:
Details of the number of RBC units and PLT events transfused from diagnosis till completion of induction chemotherapy were collected. Patients were stratified as high or low intensity for transfusion based on median RBC units and PLT events transfused per week. The influence of transfusion intensity on CR and OS was estimated using multivariate analysis and log-rank test, respectively.

RESULTS:
Among 90 patients analyzed, the median RBC unit required was 1.7 units/week and PLT transfused was 1.5 events/week. Patients requiring transfusion at disease presentation had significantly higher intensity of RBC and PLT transfusions. Only high intensity for RBC transfusion (P = 0.016) appeared among prognostic factors for achieving CR. The OS was not affected in patients requiring high intensity of RBC (P = 0.314) and PLT (P = 0.504) transfusions.

CONCLUSION:
Transfusion support was higher in patients with a high disease burden at diagnosis. The lower intensity of RBC transfusion goes along with the response to chemotherapy in terms of CR but not OS.
Human leukocyte antigen alloimmunization prevention mechanisms in blood transfusion
Authors: Adane Tiruneh , Enawgaw Bamlaku 
Published: September 2022

Abstract
In many fields of clinical medicine and blood transfusion, the human leukocyte antigen (HLA) system is crucial. Alloimmunization happens as a result of an immune response to foreign antigens encountered during blood transfusion. This gives rise to alloantibodies against red blood cells (RBCs), HLA, or human platelet antigen (HPA). HLA alloimmunization following allogeneic transfusion was shown to be a result of contaminating white blood cells (WBCs) present in the product. It is a common complication of transfusion therapy that leads to difficulties in clinical intolerance and refractoriness to platelet transfusion during patient management. Single-donor platelets, prophylactic HLA matching, leukoreduction, and irradiation of cellular blood products are some of the mechanisms to prevent HLA alloimmunization during a blood transfusion. Now, the best approach to reduce the occurrence of primary HLA alloimmunization is the removal of WBCs from the blood by filtration.
Safety and efficacy of therapeutic plasma exchange in neuromyelitis optica: A retrospective study from South India
Authors: Sahoo Dibyajyoti , Silwal Pragya , Basavarajegowda Abhishekh 
Published: September 2022

Abstract

INTRODUCTION:
Neuromyelitis optica (NMO) is an idiopathic demyelinating disorder characterized mainly by optic neuritis and myelitis, causing gradual loss of vision and deterioration of neurological function. The underlying pathogenesis mainly involves antibodies against aquaporin 4. The effectiveness of therapeutic plasma exchange (TPE) has been shown by many studies across the globe but are only a few from India. We studied ten cases of NMO retrospectively to find out the safety and efficacy of plasma exchange and to know the outcome of those patients who underwent the procedure.

MATERIALS AND METHODS:
We retrospectively analyzed ten cases of NMO who underwent TPE from January 2017 to July 2021. Out of 153 patients on whom plasma exchange procedures were done during this period, ten cases of NMO were diagnosed and managed with TPE.

RESULTS:
In our study, we found that 6 of our patients (60%) had a marked improvement noticed clinically with an increase in baseline power of limbs from 0–2/5 to 3–5/5. However, two patients expired after despite TPE. The other two did not show any improvement. Four of our patients started showing clinical improvement after the 2nd–3rd cycles of treatment. TPE was initiated early (within 5 days). There were no notable events in most of the procedures except in one procedure where the patient developed hypotension, her saturation started to drop, and the procedure had to be aborted.

CONCLUSION:
Our study supports the effectiveness of timely initiation of plasma exchange to improve the overall mortality rate of the patients.
Role of therapeutic plasma exchange in rat killer (yellow phosphorous) poisoning
Authors: Radhakrishnan Krishnamoorthy , Thokala Ravindra Prasad , Anandan Ashwin , Rengan Chandran Srinivasan 
Published: September 2022

CONTEXT:
Yellow phosphorus (YP) 3% is one of the rodenticides available, which is a potent hepatotoxin and it is fatal. Management of YP poisoning is difficult since there is no antidote available; only definitive management is liver transplantation. Therapeutic plasma exchange (TPE) helps the YP poisoning patients by removing the poison or its metabolite or the inflammatory mediators released in the body in response to toxin.

AIMS:
To determine the role of TPE in rat killer (YP) poisoning.

SETTINGS AND DESIGN:
This was a descriptive period study conducted from November 2018 to September 2020.

SUBJECTS AND METHODS:
Sixteen consecutive YP poisoning patients were included in the study (n = 16). A total of 48 sessions of TPE were carried out. Liver function tests such as serum glutamic-oxaloacetic transaminase, SGPT, total bilirubin, and direct bilirubin as well as coagulation profile such as prothrombin time, activated partial thromboplastin time, and international normalized ratio were analyzed at the time of admission, after each TPE session, and at the time of discharge.

STATISTICAL ANALYSIS USED:
The results were recorded, and it was analyzed statistically by SPSS version 17.

RESULTS:
Liver function tests improved significantly from the time of admission and after each TPE and at the time of discharge (P < 0.05). Coagulation profile improved statistically (P < 0.05). Thirteen patients were improved in their clinical status, and three patients left the hospital citing personal reasons.

CONCLUSIONS:
TPE could potentially bridge the gap between medical management and liver transplantation in cases of YP poisoning.
Establishment of normal reference range of serum hepcidin in Indian blood donors
Authors: Singh Ashutosh , Pandey Hem Chandra , Chaudhary Rajendra 
Published: September 2022

BACKGROUND:
Hepcidin-25, a polypeptide hormone, plays a major role in iron metabolism and is found to be reduced during iron deficiency; therefore, testing for hepcidin can be utilized as an indicator of bioavailability of iron. Globally, reference range values for hepcidin have been established in different communities. The aim of the present study was to establish the normal reference range values of serum hepcidin in Indian blood donors to fathom the baseline and reference point of hepcidin.

MATERIALS AND METHODS:
A total of 90 donors fulfilling the eligibility criteria were recruited in the study consisting of 28 males and 62 females. Blood samples collected were used to execute hemoglobin (Hb), serum ferritin, and hepcidin assays. Serum hepcidin-25 isoform was detected by a commercial competitive enzyme-linked immunosorbent assay kit according to the manufacturer's instructions. Hb and ferritin were evaluated by the standard methods.

RESULTS:
The mean ± standard deviation (SD) of Hb level in males was 14.62 ± 1.34 g/dL and females was 13.33 ± 0.76 g/dL. The mean ± SD of ferritin level in males was 113 ± 56.12 ng/mL and females was 62.65 ± 40.8 ng/mL. Similarly, the mean ± SD of hepcidin level in male donors was 22.18 ± 12.17 ng/mL and female donors was 10.95 ± 6.06 ng/mL. The established reference range values of Hepcidin were 6.32–46.06 ng/mL for males and 3.44–24.78 for females.

CONCLUSION:
These findings suggest that further studies with larger groups of donors are mandatory to produce reference values of hepcidin that can be précised to the whole populace in India.
Altered color of plasma component – Unnecessary wastage of a precious resource
Authors: Patel Dhara Darshan , Shah Mamta C. , Bhatnagar Nidhi M. , Patel Tarak Rameshbhai , Shah Sangita D. , Soni Shital 
Published: September 2022

BACKGROUND AND OBJECTIVES:
The present study was conducted to evaluate the etiology of altered color of plasma component of blood in transfusion practice.

MATERIALS AND METHODS:
The study was conducted at the blood center of a tertiary care teaching hospital in western India for a period of 6 months. After component separation, all the plasma units with altered color were segregated and samples were taken for further evaluation. Altered colored plasma units were divided into three – green discoloration, yellow discoloration, and lipemic plasma. Donors were called, their detailed history was taken, and necessary investigations were done accordingly.

RESULTS:
Forty plasma units out of 20,658 (0.19%) donations showed discoloration. Out of which, 3 plasma units showed green discoloration, 9 plasma units showed yellow discoloration, and the remaining 28 plasma units were lipemic. Among three donors whose plasma showed green discoloration, one female donor had a history of oral contraceptive pill usage and had higher values of copper and ceruloplasmin. All donors with yellow plasma had a higher value of unconjugated bilirubin. All the donors with lipemic plasma gave a history of intake of fatty meal prior to donating blood and showed higher values of triglyceride, cholesterol, and very-low-density lipoprotein.

CONCLUSION:
Plasma component with altered color restricts its issue to the patient and also for use in fractionation. In our study, many of the altered color plasma units were safe to transfuse, but the decision regarding transfusion was debatable on consultation with the treating doctor. Further studies with a large sample size are recommended for the use of these plasma components.
Implementation of a digital health curriculum for health-care students
Authors: Yang Karoliina X. , Rosner Benjamin I. , Chan Steven R. , Brindis Ralph G. , Lee Tiffany M. , Khanna Raman R. , Auerbach Andrew D. 
Published: September 2022

Introduction:
Digital health software technologies (DHSTs) have the potential to shift models of care delivery and improve patient outcomes. Health-care students lack training to prepare them for the growing breadth and depth of DHSTs that they will need to identify, assess, and use in their future clinical careers. The implementation of this pilot digital health curriculum aimed to provide health-care trainees skills to identify, assess, and use DHSTs in their future clinical careers.

Materials and Methods:
From June to August of 2021, the authors implemented a 10 weeks pilot educational internship in partnership with the Accelerated Digital Clinical Ecosystem (ADviCE), a multi-institutional collaborative created by physicians within University of California, San Francisco Health Informatics. Interns completed a customized digital health didactic program developed by program faculty, including a speaker series with clinical informaticists in the field, journal club discussions, and intern-led presentations. In addition, interns were given real-world educational opportunities to directly interact with DHST vendors in the process of creating a DHST registry. Interns also completed a postcourse survey to procure feedback about the pilot program’s strengths and weaknesses.

Results:
Interns learned from a didactic educational curriculum that included more than 10 h of live lectures, 3 supplemental readings, and structured interactions with 74 DHST vendors. Based on a survey to assess interns’ satisfaction with the internship, interns ranked the expert speaker series the highest with an average standard deviation ranking on a 5-point Likert scale of 4.6 (0.57) and journal club discussions the lowest with a ranking of 4.31 (0.96). Interns also gave feedback on recommending the internship to future students with a ranking of 4.6 (0.65).

Conclusion:
This first internship led to the positively favored and successful execution of a remote educational experience exploring digital health in medicine, while also giving interns direct interaction with a broad array of digital health companies.