bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Intraorganizational Collaboration in the health sector during Disasters
Authors: Yousefian Shiva , Jahangiri Katayoun , Mehrabi Yadollah , Sohrabizadeh Sanaz 
Published: January 2022

Background:
Collaboration, as a key factor in disaster risk management, is a mechanism that prevents the loss of time, investment, and resources. The variety of units in the health sector has made collaboration a major challenge. The present study aimed at developing a tool for assessing collaboration in the health sector during disasters.

Methods:
In this mixed-methods study, a questionnaire was developed by integrating the findings of a systematic literature review and a qualitative study. Face and content validation were performed. The reliability of the tool was tested through a 15-day interval test–retest by Cronbach's alpha and intraclass correlation coefficient (ICC) with 30 participants. Confirmatory factor analysis was done to test the validity and reliability of instrument using SmartPLS in a case study with 450 health sector staff.

Results:
The factors affecting intraorganizational collaboration of the health sector were identified in six categories and 19 subcategories by searching 46 articles in the systematic review and content analysis of 16 semistructured interviews with health sector staff. The results of content validity ratio (=0.81), content validity index (=0.92), Cronbach's alpha (=0.975), and ICC (=0.970) confirmed the validity and reliability of the tool. Convergent validity, discriminant validity, and reliability were approved by AVE (average variance extracted) >0.5, Fornell and Larcker matrix, and CR (composite reliability) >0.7. According to the positive result of R
2, Q
2, and goodness-of-fit (GOF) criteria, the model fit was confirmed.

Conclusion:
The results of validity and reliability measurements approved the proposed tool. The use of this tool is recommended for developing collaboration in the health sectors of different countries.
Anatomical Variants of the Obturator Artery and Their Clinical Importance
Authors: Thampi Swapna , Oommen Aswathy Maria , Rajasekharan Sreekumar , Sarasammal Suja Robert 
Published: January 2022

Context:
The obturator artery (OA) originates from the internal iliac artery (IIA), and it runs on the lateral pelvic wall to leave through the obturator canal. It can have a varied source of origin. A small pelvic space makes it susceptible to injury during repair of femoral and inguinal hernias and pelvic surgeries. Unexpected injury of an aberrant OA can be avoided only with a thorough knowledge of its anatomy.

Aim:
This study aims to estimate the prevalence and describe the course of aberrant obturator arteries.

Settings and Design:
A descriptive, cross-sectional, cadaveric study was conducted in the Department of Anatomy, Government Medical College, Thiruvananthapuram, India.

Materials and Methods:
Sixty-four hemipelvices were dissected. Variations in the origin, course, and relations of the OA were observed and noted.

Statistical Analysis Used:
The results were tabulated, and the prevalence of each variation was calculated.

Results:
Variations were seen in 40.6% cases. OA originated from inferior epigastric artery (23.4%), external iliac artery (3.1%), posterior division of IIA and iliolumbar artery (1.5%), superior gluteal artery (6.2%), internal pudendal artery (1.5%), and inferior gluteal artery (3.1%) cases. Arterial corona mortis, a tortuous anastomotic channel connecting OA (originating from IIA) and inferior epigastric artery was seen along with venous connections in one specimen.

Conclusions:
Aberrant origins of OA pose a high risk for significant hemorrhage in trauma and various surgeries. Hence, a sound anatomical knowledge of its origin and course is vital while repairing fractures and hernias in this region.
Catheter-Directed foam Sclerotherapy in Chronic Venous Insufficiency Patients with Active Ulcer Single-Center Experience
Authors: Shahat Mohammed 
Published: January 2022

Introduction:
Varicose vein and chronic venous insufficiency (CVI) is one of the most prevalent health problems in Europe and the United States; in some studies, it may reach 60% of population.

Patients and Methods:
This prospective study involving on 51 patients (C6) is to assess the efficacy and tolerance of sclerotherapy foam in the treatment of great saphenous vein incompetence and ulcer healing in CVI patients at 6 and 12 months and to report our experience regarding the diagnosis and treatment of CVI by catheter directed sclerotherapy (CDS).

Results and Conclusion:
In our experience, CDS safely can contribute to good ulcer healing rate up to 73% at 6 months for a reasonable cost of money and time which might be considered an attractive strategy for providing efficient vascular service in clinical practice.
Comparative Study of the Effects of Two Suturing Techniques of End-to-Side Arteriovenous Anastomosis on Early Outcomes of Radio-Cephalic Fistulas
Authors: Vyahalkar Sameer Vilas , Chaudhari Avinash E , Binnani Pooja G , Kulkarni Amar Vilas , Nagarik Amit Prakash , Jawade Kailash K , Chandrashekhar Shantanu S 
Published: January 2022

Introduction:
Radiocephalic arteriovenous fistulas (AVFs) for dialysis have significantly high maturation failure rate. Many surgical technique-related factors are known to impact the outcomes of AVF surgery; anastomotic suturing technique is one such factor for which the published data is sparse.

Patients and Methods:
We retrospectively analyzed the data of patients who underwent end-to-side radio-cephalic AVF surgery during a 2-year period and grouped it according to the two techniques of anastomotic suturing: Anchor technique and parachute technique. Comparative analysis was done to study the effect of the technique on well-defined outcomes within the first 6 months of surgery.

Results:
A total of 119 AVFs (anchor technique = 65, parachute technique = 54) were included in the study. The aggregated primary patency at 6 weeks and 6 months was 85.7% and 78.1% respectively and successful use of fistula was seen in 62.2%. The parachute technique was associated with lower immediate access thrombosis (3.7% vs. 15.4%, P = 0.019) and primary failure (31.5% vs. 43%, P = 0.033) than the anchor technique. The groups did not differ statistically in outcomes like early access failure (P = 0.376), maturation failure (P = 0.105), primary patency at 6 weeks (P = 0.07) and at 6 months (P = 0.083) and successful use of fistula at 6 months (P = 0.196).

Conclusion:
In this retrospective single-center study, the parachute technique of anastomotic suturing was associated with lower incidence of immediate access failure of radio-cephalic AVF as compared to the anchor technique, although other early outcomes were similar with both techniques. The effects of different suturing techniques on surgical outcomes of AVF should be studied in large randomized trials.
Effects of two different doses of 3% hypertonic saline with mannitol during decompressive craniectomy following traumatic brain injury: A prospective, controlled study
Authors: Bhatnagar Neelesh , Bhateja Saurabh , Jeenger Lalita , Mangal Govind , Gupta Sunanda 
Published: January 2022

Background and Aims:
The current study was designed to compare the effects of two different doses of 3% hypertonic saline with mannitol on intraoperative events during decompressive craniectomy in traumatic brain injury (TBI). Primary outcome measures included assessment of intraoperative brain relaxation, hemodynamic variables, and serum electrolytes. Effect on the postoperative outcome, in terms of the Glasgow coma scale (GCS), length of stay in the ICU, and mortality were the secondary outcome measures.

Material and Methods:
Ninety patients with TBI undergoing craniotomy were enrolled. Patients were assigned to receive 300 mL (328 mOsm) of mannitol (n = 26, M) only or 300 mL of mannitol with 150 mL (482 mOsm) of 3% HS (n = 35, HS1) or with 300 mL (636 mOsm) of 3% HS (n = 29, HS2). Brain relaxation was assessed and if required, a rescue dose of mannitol (150 mL) was given. GCS was assessed preoperatively, 24 h postoperatively, and at the time of discharge from the ICU and total duration of stay was noted.

Results:
Acceptable brain relaxation was observed in 89.66% (n = 26, HS2) and 80% (n = 28, HS1) patients as compared to 46.1% (n = 12, M) patients (P < 0.001) with significantly less number of patients requiring rescue doses of mannitol in groups HS1 and HS2(n = 7 and 3, respectively) as compared to group M (n = 14) (P < 0.05). There was a significant improvement in GCS at 24 h and at the time of discharge from the ICU in patients with a severe head injury in group HS2 (P = 0.029). In patients with moderate head injury there was a significant improvement in GCS at the time of discharge among all the three groups (P < 0.05).

Conclusion:
Increasing osmotic load by addition of 3% HS to mannitol provides better intraoperative brain relaxation than mannitol alone during decompressive craniectomy. An addition of 300mL 3% HS was found to be more effective in improving GCS in patients with severe TBI.
Comparative evaluation of efficacy of oxygenation using high flow nasal cannula vs. conventional nasal cannula during procedural sedation for endoscopic ultrasound: A pilot study
Authors: Shukla Kamalendra , Parikh Badal , Kumar Alok , Nakra Monish 
Published: January 2022

Background and Aims:
High flow nasal cannula (HFNC) has numerous advantages against conventional oxygen therapy delivery systems. However, there is limited evidence supporting the use of HFNC in endoscopic ultrasound (EUS) under procedural sedation. The aims of this study is to evaluate the efficacy of two different oxygen delivery devices, that is,HFNCand conventional nasal cannula on the oxygenation status of patients during procedural sedation for EUS.

Material and Methods:
Sixty adult patients undergoing EUS for various ailments were randomized to two groups group HFNC (n=30) and group nasal cannula [NC (n = 30)]. HFNC (AIRVO2, Fisher and Paykel Healthcare, New Zealand) was used on patients in the group HFNC. Respiratory status of the patients was assessed using pulse oximetry, respiratory rate, procedural airway complications, and oxygen therapy adjustments. The endoscopist assessed the ease of performing EUS at the end of the procedure and patient satisfaction score (PSS) was assessed by using a Likert score in the post-anesthesia care unit.

Results:
SpO2 measurements in the HFNC group during the procedure were marginally better compared to the NC group but this failed to reach statistical significance. Also, no significant association was found between both groups while comparing desaturation events (P = 0.499), patient satisfaction score (PSS) and endendoscopist’s satisfaction score (ESS) (P = 0.795). Both the groups were comparable in terms of airway manipulation, use of airway adjuncts, need to increase oxygen flow rate, endoscope removal, apneic episodes, hypotension, and bradycardia. No major complications were observed in either group.

Conclusion:
HFNC use in patients undergoing EUS is not superior when compared to conventional nasal cannula oxygen therapy. HFNC failed to show any significant impact on decreasing the risk of desaturation events and airway manipulation during the procedure.
A comparative study of propofol, thiopentone sodium, and ketofol as induction agents for electro convulsive therapy
Authors: Gaddam Nagraju R. , Kelkar (Sasturkar) Vasanti P. , Kulkarni Sanhita J. , Joshi Pradnya S. , Bhale Pramod V. 
Published: January 2022

Background and Aims:
Thiopentone and propofol are most commonly used induction agents for electro convulsive therapy (ECT). Recently, ketofol, an admixture of propofol and ketamine, is being tried in ECT. We aimed to compare propofol, thiopentone, and ketofol as induction agents during ECT regarding their effects on ECT-induced hemodynamic changes, seizure duration and recovery parameters.

Material and Methods:
This prospective randomized double blind study was conducted in 30 patients between 18 and 65 years with ASA status I and II scheduled for ECT. All patients received all study agents for first three sessions of ECT. The observations were compiled as Group K (Inj. Ketofol i.e., Inj. propofol 0.5mg/kg + Inj. ketamine 0.5mg/kg), Group P (Inj. propofol 1mg/kg), and Group T (Inj. thiopentone 3mg/kg).Heart rate (HR) and blood pressure (systolic, diastolic, and mean) was recorded at pre op, 0, 5, 10, and 20 min after ECT. The seizure duration, time to spontaneous eye opening, andobeying verbal commands and agitation score were recorded.

Results:
Statistically significant difference was seen in HR at 10 min after delivery of shock; in systolic BP at 2 min after shock; in diastolic BP after administration of study drug and immediately after shock and in mean arterial pressure at post induction, 0and2 min after shock with group T showing higher values compared to group K and P (p < 0.05). At all other times HR andBP was comparable in all the three groups.Seizure duration was more in group T than Groups P and K although the difference was statistically insignificant.Time to spontaneous eye opening and obey verbal commands was comparable in all groups.Mean agitation score was highest in group T than Groups P& Kwith Group P showing least value (p = 0.003).

Conclusion:
Propofol and ketofol showed superior hemodynamic stability than thiopentone but comparable seizure duration and recovery parameters. Thus, propofol and ketofol can be effectively used as induction agents for ECT although propofol is associated with lesser agitation than ketofol.
Comparison of equipotent doses of Ramosetron, Ondansetron, and sub-hypnotic dose of Propofol for prevention of postoperative nausea and vomiting in laparoscopic cholecystectomy
Authors: Acharya Shilpa Amol , Patil Kalyani Nilesh 
Published: January 2022

Background and Aims:
For prevention of Postoperative nausea vomiting (PONV) in laparoscopic surgery, ramosetron is a selective 5-HT3 receptor antagonist with higher receptor affinity and slow dissociation than ondansetron. We compared these 2 drugs with propofol which has also shown antiemetic properties.The aim was to study ondansetron, ramosetron, and propofol with respect to incidence of PONV, its severity and the need for rescue antiemetic along with the side effects. Prospective, randomized, double blind study.

Material and Methods:
We compared antiemetic properties of ondansetron (4 mg i.v; n = 40) and ramosetron (0.3 mg i.v; n = 40) with propofol (0.5 mg/kg i.v; n = 40) on 120 ASA I/II patients scheduled for laparoscopic cholecystectomy. The side effects associated with study drugs, time to recovery from anesthesia, readiness for PACU discharge and patient satisfaction was also compared. Qualitative data variables are expressed by using frequency and percentage and quantitative data variables are expressed by using mean and SD. Quantitative data variables were compared using ANOVA test and others were compared by post hoc ANOVA Tukey’s test.

Results:
Incidence of vomiting and need for rescue antiemetic was lowest with Ramosetron and highest in Propofol group. Time to recovery was more in Propofol group which was statistically significant. Readiness for PACU discharge was comparable in all the three groups.

Conclusion:
Subhypnotic dose of propofol requires more rescue antiemetic than Ondansetron and Ramosetron because of its short duration of action. Between Ondansetron and Ramosetron the latter is more effective in PONV prevention.
Publication performance of Indian authors in high impact anesthesiology journals: Are we doing enough?
Authors: Kar Prachi , Kar Akhya Kumar , Gopinath R. 
Published: January 2022

Background and Aims:
Over the years, there is a continuing increase in the number of anesthesia journals and good quality articles are being submitted to these journals from all over the world. The aim of the study was to assess the contribution of Indian authors to high impact anesthesia journals.

Material and Methods:
The study is a literature survey design and thus ethics committee clearance was not required. Based on The Journal citation report (2017), top six anesthesia journals with highest impact factor were selected. Subspecialty journals were excluded. A search was conducted for articles published by Indian authors between September 2008 and August 2018 and subcategorized to review articles, original articles, case reports, correspondence, and miscellaneous. Corresponding author was noted in articles with authors from more than one country. The percentage of articles in each of the above categories by Indian authors were calculated and state and city wise distribution was also assessed.

Results:
The six highest impact journals were Anesthesiology, British Journal of Anaesthesia, Anaesthesia, Anaesthesia analgesia, European journal of Anaesthesia and Canadian Journal of Anaesthesia with impact factor of 6.52, 6.49, 5.43, 3.46, 3.9, 3.37, respectively. A total of 22,298 articles were published in the six journals in the study period, out of which 242 (1.08%) were authored by Indians. Majority of the articles were published as correspondence (58%). Only 20% of total publication were original articles. Most publications were contributed from Delhi (76), followed by Chandigarh (49).

Conclusion:
Publication performance of Indian authors in high impact journals is poor. There is an uneven distribution of publication across various regions.
Effect of addition of intrathecal magnesium sulphate to 0.5% hyperbaric bupivacaine and 0.5% isobaric levobupivacaine on duration of analgesia in parturients undergoing elective caesarean section: A prospective randomised study
Authors: Deepa T. , Chandran Deepa 
Published: January 2022

Background and Aims:
Addition of magnesium sulfate to local anesthetics improves the quality of spinal anesthesia for caesarean section. The aim of this study was to compare the effects of intrathecal 0.5% hyperbaric bupivacaine with 75-mg magnesium sulfate (MgSO4) and 0.5% isobaric levobupivacaine with 75-mg MgSO4 on the duration of analgesia in parturients undergoing elective caesarean section.

Material and Methods:
This prospective randomized double-blind parallel-group study was conducted in 60 parturients undergoing elective caesarean section who were randomly allocated to Group I or Group II to receive either 2 ml of 0.5% levobupivacaine with 75-mg MgSO4 or 2 ml of 0.5% hyperbaric bupivacaine with 75-mg MgSO4 intrathecally. The duration of postoperative analgesia along with sensory and motor block characteristics and hemodynamics were studied.

Results:
The duration of analgesia did not show a significant difference in the two groups (P = 0.175). The sensory onset time was faster in Group I (3.5 ± 1.3 min) as compared to that in Group II (4.8 ± 2 min; P = 0.004). The onset of motor blockade was not different in the two groups (P = 0.265), but there was a significant delay (P = 0.002) in motor recovery in Group II (267 ± 130.6 min) as compared to Group I (225 ± 85.4 min). Hemodynamics were comparable in the two groups.

Conclusion:
Intrathecal levobupivacaine with MgSO4 produces a similar duration of postoperative analgesia as compared to hyperbaric bupivacaine with MgSO4. Early motor recovery allowing early ambulation postoperatively makes isobaric levobupivacaine with MgSO4 a good alternative for caesarean sections.
Assessment of podoplanin lymphatic vessel density in oral epithelial dysplasia
Authors: Lunawat Snehal Dilip , Prakash Nilima , Pradeep G. L. , Chaware Smita Jembu , Chaudhari Nayana Rajendra , Salunkhe Vaibhavi Parikshit 
Published: January 2022

Background:
Oral squamous cell carcinoma (OSCC) can be preceded by the appearance of lesions which have the potential to develop into cancer. Recently, it was suggested that the tumor-associated lymphatic vessels formation plays an active role in tumor progression and metastasis of several human malignancies including OSCC. There is the view that, in an individual lesion, the more severe the dysplasia, the greater the likelihood is of progression to malignancy.

Aim:
This study is aimed to investigate podoplanin (PDPN) immunoexpression in lymphatic vessels of oral epithelial dysplasia (OED) and to assess the lymphatic vessel density (LVD) in histologic grades of OED.

Materials and Methods:
The study group comprised thirty histopathologically diagnosed cases of OED with various grades of differentiation and thirty cases of clinically normal oral mucosa. After immunohistochemical staining, cases of OED were immunohistochemically analyzed quantitatively for PDPN (D2-40) LVD.

Statistical Analysis:
The statistical analysis was done using Kruskal Wallis analysis of variance; pair-wise Tukey's post hoc test was applied to evaluate the significant differences among the mean values in different groups. Results with “P < 0.05” were considered to be statistically significant at 95% of confidence level.

Results:
PDPN LVD scores increased with increasing grades of dysplasia. Pair-wise comparisons of the PDPN LVD scores and the histopathologic grades of OED were found to be statistically significant (P < 0.05).

Conclusions:
Increase in PDPN LVD in OED represents a promising tool for more wide spread studies of tumor lymphangiogenesis and its role in progression of dysplastic lesion to human cancer.
Histopathologic evaluation of oral lichen planus and oral lichenoid reaction
Authors: Aravind Thara , Janardhanan Mahija , Suresh Rakesh , Savithri Vindhya , Mohan Mridula 
Published: January 2022

Background:
Lichen planus is a chronic mucocutaneous disease of unknown etiology with well-established clinical and microscopic features. Oral lichenoid reactions are a family of lesions triggered by contact with specific agents such as metallic restorative materials, resins and drugs. Oral lichenoid reactions share clinical and histological features of oral lichen planus (OLP) but has varied management options. Hence, the discrimination between these two lesions is a major challenge for clinicians as well as pathologists.

Aim:
Histopathologic categorization of OLP and oral lichenoid reaction by comparing the thickness of basement membrane and the distribution of mast cells using special stains.

Materials and Methods:
The test group consists of formalin-fixed paraffin-embedded blocks of OLP (n = 15), and oral lichenoid reactions (n = 15) obtained from the archives of the Department of Oral Pathology, Amrita School of Dentistry. Three serial sections of 4 μm thickness were cut from each block. The sections were stained with H & E, periodic acid-Schiff (PAS) and toluidine blue, respectively.

Results:
A significant increase in the maximum basement membrane thickness (BMT) was noticed in OLP when compared to oral lichenoid reaction. A definite increase was also noticed in the number of mast cells in OLP and oral lichenoid reaction when compared to normal oral mucosa. There was a statistically significant increase in the number of degranulated mast cells in the deeper connective tissue in oral lichenoid reaction when compared to OLP.

Conclusion:
OLP and oral lichenoid reactions are two different entities showing similar clinical and microscopic presentation. The histochemical analysis of basement membrane and mast cells in these lesions might provide a more authentic method for differentiating these two lesions and might be of utmost value in deciding the treatment options.