bluuebunny/crossref_metadata_2025_split huggingface dataset:
Magnetic Resonance Imaging Downstaging, Pathological Response, and Microsatellite Instability Status in Patients with Signet-Ring Cell Carcinoma Rectum Undergoing Preoperative Long-course Chemoradiation
Authors: Rajkrishna B. , Das Saikat , Masih Dipti , Putta Tharani , Raghunath Rajat , Ram Thomas Samuel 
Published: November 2022

Aim and Objective:
To assess the magnetic resonance imaging (MRI) downstaging, pathological response, and the relationship between microsatellite instability (MSI) and radiotherapy response in signet-ring cell carcinoma rectum.

Materials and Methods:
Twenty two patients were recruited prospectively and retrospectively in this observational study. Six weeks following radiotherapy, the response was assessed using an MRI pelvis, and patients who were operable underwent total mesorectal excision followed by adjuvant chemotherapy. The outcome of radiotherapy was correlated with post radiation MRI downstaging, pathological response, and MSI status.

Results:
The post radiotherapy response assessment MRI showed tumor regression grading (TRG) 5 in 5 patients. TRG 4 seen in 12, TRG 3 in 3, and TRG 2 in 1 patient. Fifteen patients were operable and post-operativ histopathology showed that 40% had pathological complete response (pCR) and 26.7% had near-complete response. Even those who had no response in MRI had pCR. MSI done 17 patients were stable. Of the 6 patients who had complete pathological response, two were MRI TRG 5, three were MRI TRG 4, and one was MRI TRG 3. The median survival was 23 months. The 2-year and 3-year disease-free survival was 46% and 38%, respectively.

Conclusion:
The predictive value of MRI downstaging in these tumors following neoadjuvant long-course chemoradiation therapy is not often in concurrence with the histopathological response and needs to be interpreted carefully. Even though the pCR rate seen in this cohort is encouraging, this needs to be evaluated in studies with large cohorts.
Outcomes of Supraflex Sirolimus-eluting Coronary Stents
Authors: Singh Vishal Virendra , Tahir Sheikh Mohamad , Sharma Sanjiv 
Published: November 2022

Background:
The development of a sirolimus-eluting coronary stent (SES) was a big step forward in interventional cardiology. SES has been demonstrated in large, randomized clinical studies to reduce angiographic restenosis and target vessel revascularization (TVR) when compared to bare-metal stents and other drug-eluting stents (DESs). However, there is little information on the outcomes of Indian patients treated with Drug-eluting stents (DES). As a result, the study's goal was to assess the efficacy of Supraflex sirolimus-eluting coronary stents in the treatment of coronary artery disease and to identify severe adverse cardiovascular and cerebrovascular events.

Methods:
This single-center, observational, nonrandomized study enrolled unselected real-world patients at a tertiary care center who had undergone implantation with Supraflex sirolimus-eluting stents. The primary endpoint of the study was major adverse cardiovascular and cerebrovascular events (MACCE), which is a conglomeration of cardiac death, target lesion revascularization, TVR, cerebrovascular accident (CVA), and heart failure at 1-year follow-up.

Results:
A total of 100 patients were intervened successfully with sirolimus-eluting stents. Out of total patients, diabetes and hypertension were observed in 38% and 35% of patients, respectively. According to the American College of Cardiology/American Heart Association classification, there were 68% of type B lesions and 32% of type C lesions. At 1-year follow-up, major adverse cardiovascular events were 11%, a composite of 4% target lesion revascularization, 3% target vessel revascularization, 1% CVA, and 5% heart failure. Diabetes (P = 0.02), hypertension (P = 0.01), kidney dysfunction (P = 0.002), and left ventricular (LV) function (P = 0.01) strongly correlated with outcome (MACCE).

Conclusion:
There was an acceptable rate of adverse events after implantation of the Supraflex sirolimus-eluting stents, although slightly higher than in other studies. Diabetes, hypertension, kidney dysfunction, and LV function strongly correlate with the outcome (MACCE).
Undergraduate Medical Education in India During COVID-19 Pandemic
Authors: Nirupama A. Y. , Chaudhuri Sirshendu , Chittooru Chandra Sekhar , Vani K. Yashaswini , Chittem Sravana Deepthi 
Published: November 2022

Introduction:
The COVID-19 pandemic led to the disruption of medical teaching nation-wide and pushed the institutions to explore the probable role of online teaching methods. The aim of this review is to identify the untested perspectives and help in strategizing based on evidence generation for the preparation for future.

Methods:
We followed the Preferred Reporting Items for Systematic and Meta-Analysis guidelines for reporting the present review. We searched PubMed, Scopus, and Embase databases for the articles published between April 2020 and October 2021 for studies on online medical education in India during the COVID-19 pandemic.

Results:
We initially screened a total number of 1412 articles and finally recruited 45 articles for the analysis. Majority of the articles were from single institution, and reported the experience of the students and teachers on online teaching. The common teaching platform used such as Zoom and Google Meet were enumerated. Internet connectivity was the most reported challenge of online teaching. None of the selected articles reported on ethical issues related to online teaching.

Conclusion:
Even though there were some strong points reported for the successful implementation of e-learning, a more sustainable and well-informed plan should be devised for the future on online teaching.
Knowledge, Attitude, Practice, and Motivation Toward Blood Donation among Citizens of Albania
Authors: Sula Idris , Alreshidi Mateq Ali 
Published: November 2022

Background and Objectives:
Blood donation is a remarkably safe medical procedure. However, it can easily be affected by attitudes, beliefs, and level of knowledge. A knowledgeable, attitudinal, and practical survey has been used in Albania, to understand and identify (1) The factors that influence blood donation, (2) the factors stopping people from blood donation, (3) the behavior and approach of the people toward blood donation in the future, (4) the knowledge level among donors and nondonors, and (5) misconceptions related to blood donation.

Materials and Methods:
This search was conducted on online surveys using Google Forms, which were shared through social media platforms such as Facebook, WhatsApp, and Gmail, and a self-administered questionnaire was shared to random people through social media platforms.

Results:
Of the 858 people answering the questionnaire from Albania, only 32% of the people were blood donors. The motifs that encouraged the people in Albania mostly to donate were to help others in need and save lives and donations for family members. The main reasons preventing people from donation were the fact that they were not asked for and medical reasons. In Albania, 88.6% would donate if called upon.

Conclusion:
Some of these results reflected an encouraging attitude toward blood donation. Further future planning with emphasis on educational programs and more organizations of donor recruitment campaigns could result in an increase of donations and thus fulfilling the needs of the patients in the country but not only.
Comparison of Three Methods for Enumeration of Residual White Blood Cells in Single Donor Apheresis Platelets
Authors: Naikoo Nasir Nabi , Basu Sabita , Bajpayee Animesh , Mishra Deepak Kumar , Datta Suvro Sankha 
Published: November 2022

Background and Objectives:The aim of this study was to compare three platforms side-by-side: Nageotte hemocytometer, flow cytometry (FC), and standard hematology analyzer for enumeration of residual white blood cells (rWBCs) in single donor platelets (SDPs) apheresis.Materials and Methods:This was a prospective observational study conducted in a tertiary care oncology center by evaluating 36 units of SDP that were collected and tested in parallel by three different methods for the enumeration of rWBCs. All tests were performed within 24 h of collection according to the manufacturers' recommended methods. Counting by the Nageotte hemocytometer was done by: rWBC/μl = (cells counted × dilution/gridded area volume [50 μl]) and FC calculation was performed by: rWBC/μl = (total beads × total number of leukocyte events/total beads acquired × total sample volume).Results:The number of rWBCs detected by FC was between 1 white blood cell (WBC)/μl and 8 WBCs/μl; whereas, those detected by Nageotte chamber were between 3 WBC/μl and 6 WBCs/μl. The range of rWBC detected by hematology analyzer was 100 WBC/μl to 270 WBCs/μl. There was no correlation observed between the results obtained in standard hematology analyzer with any of the other two methods. The concordance correlation coefficient was measured by kappa analysis and found to be 0.71 between hemocytometry and FC. Linear regression analysis also showed a moderate correlation (R2= 0.42) between the two methods. However, the coefficient of variation was found to be 49.32% in Nageotte method compared to the 17.55% in FC (P< 0.001).Conclusion:FC followed by Nageotte chamber counting is a better method compared to the standard hematology analyzer for the enumeration of rWBCs. To overcome the cost of FC it is high time to explore the scope and feasibility of a centralized quality monitoring system in India for all leukoreduced blood components.
Effect of Donor and Patient Variables on the Platelet Increment and Percent Platelet Recovery
Authors: Sharma Sarita , Joshi Praveen Kumar , Bundas Sunita , Sharma Amit 
Published: November 2022

Background and Objectives:
Platelet (PLT) deficiency is a common cause of bleeding and PLT transfusions are often indicated for the same. PLT refractoriness is a challenging complication in patients dependent on PLT transfusions. The present study aimed to find out any effect of the donor, recipient, and machine variables on PLT increment (PI) and percent PLT recovery.

Patient and Methods:
A total of 600 apheresis PLT donors and 600 patients were included in this study; however, the PI and percent platelet recovery (PPR) were analyzed for only 535 patients. The data were collected such as the donor's age, gender, preapheresis hemoglobin (Hb), PLT count, PLT product yield, patient's age, gender, weight, pre- and posttransfusion Hb, and PLT count. PI and PPR were calculated and compared across different groups.

Results:
Refractoriness was more seen in hematological disorders in comparison to nonhematological disorders (P = 0.00001). However, no significant association of donor and recipient characteristics with PI was seen.

Conclusion:
PI does not depend on recipient characteristics such as age, gender, pretransfusion PLT count, and Hb.
Transfusion Challenges and Use of Best Match Blood Transfusion in Autoimmune Hemolytic Anemia Patients
Authors: Sahoo Dibyajyoti , Anuragaa S. , Basavarajegowda Abhishekh , Kulkarni Rajendra G. 
Published: November 2022

Background and Objectives:
In autoimmune hemolytic anemia (AIHA) patients, there is decreased survival of red blood cells (RBCs) because of increased destruction by patients' autoantibodies. Due to decreased survival of RBCs, there is an increase in erythropoiesis and other biochemical parameters of hemolysis. One of the vital tests in AIHA is direct Coombs test (DCT). In this study, we share our experience on the difficulties faced by us during the compatibility testing and providing transfusion support to these patients.

Methods:
This is a retrospective study done in the department of transfusion medicine in a tertiary care hospital of South India. Patients from January 2020 to March 2021 with the diagnosis of AIHA requiring transfusion were included in this study. A total of 136 patients with positive DCT with AIHA diagnosis requiring transfusion support were included in our study.

Results:
Out of 136 cases, 58% (n=79) of patients had incompatibility during cross matching while in 42% (n=57) had cross matched compatible unit. In all incompatible cases best match blood was transfused. Most transfusions were done for patients with DCT Grade 4+. Out of 45 patients with mixed AIHA, 40 (88.8%) patients required a transfusion (P < 0.05). Of that 104 patients with transfusion support, 66 (63%) were with primary AIHA and 38 (36.04%) with secondary AIHA.

Conclusion:
It is tough and challenging to get compatible units in AIHA patients. Best-matched blood is useful when transfusion becomes essential during life-threatening anemia.
A Study to Formulate Maximum Surgical Blood Order Schedule at a Tertiary Care Referral Teaching Institute in Andhra Pradesh
Authors: Sandhya Gudditi , Babu Bandi Suresh , Sreedhar Babu K. V. , Rajendran Arun , Chandra Abha , Narendra Hulikal , Mutheeswaraiah Y. , Reddy V. Venkatarami , Ramesh Chandra V. V. , Kumar Nallabothula Anil , Keerthi C. , Ravikanth C. , Prashanth G. 
Published: November 2022

Background and Objectives:
Blood transfusion is the mainstay of treatment for several serious illnesses, surgical, and trauma patients. The aim of this study is to develop maximum surgical blood order schedule (MSBOS) for surgeries in our institute to formulate certain guidelines to prevent the over-ordering of blood and promote reasonable ordering of blood.

Patients and Methods:
All the patients undergoing surgeries in General Surgery, Surgical Gastroenterology, surgical oncology, Cardiovascular and Thoracic Surgery, Neurosurgery, Urology, and Orthopedics Departments requesting blood were included in this study. Cross-match-to-transfusion (CT) ratios, transfusion probability (TP), and transfusion index (TI) were calculated for individual specialties and surgeries. Based on these parameters, MSBOS was formulated.

Results:
During the study period, a total of 2724 patients posted for elective surgical procedures necessitating blood among various surgical departments were included in the study. A total of 5812 units of packed red blood cells were requested and cross-matched for the study population. Among these, 1831 units were transfused with a blood utilization percentage of 31.50% (6%–60%). The overall CT ratio of our study was 4.21. The overall TP was 31.69% and the overall TI was 0.56.

Conclusion:
Implementation of MSBOS is helpful in achieving the goal of rational usage of blood. Based on the results, we grouped the surgical procedures which need type and screen, type and hold, and type and cross-match.
An Audit of Clinical Cases of Dengue Fever and the Usage of Platelets in Such Cases in a Tertiary Care Hospital in Hyderabad
Authors: Isharat Sumaiya , Sharma Aparna , Goru Bhawani , Ayatullah Molla M. D. 
Published: November 2022

Background and Objectives:
Dengue is an acute self-limited systemic viral infection caused by the dengue virus of the family Flaviviridae. The incidence of dengue fever has been increasing for the past few years and dengue has become a global problem. The current data required for further improving the treatment policies are scanty. Our study aims to capture the demographic and clinical characteristics of the patients enrolled in the study, to see any correlation between thrombocytopenia and bleeding tendencies and other transfusion-related parameters.

Methods:
The study is a prospective cohort study. All seropositive dengue cases were included in the study. A format was prepared for documenting the demographic data, history, clinical characteristics, spectrum of the disease, the laboratory details of the patient (platelet count, prothrombin time, activated partial thromboplastin time, Hematocrit, and indication). All the transfusion requirement data were collected from the blood center registers. Overall mortality in the study group, number of hospital readmissions, and episodes of exacerbation of symptoms was recorded separately.

Results:
A total of 270 cases were included in the audit who fulfilled the inclusion and exclusion criteria. The median age of the patient pool was 27 (4–66 years range). Twenty-six percent of the cases developed hemorrhages. Eighty-four single-donor platelets (SDPs) and 340 random-donor platelets (RDPs) were used. A mean of 270 ml of products was transfused per patient. The mortality rate was 0.8%. The mean duration of hospitalization was 1 week. In 72% of cases, platelet count was restored in single-unit transfusion. Ninety-nine percent of the product utilization were within the guidelines recommended.

Conclusion:
A good monthly audit of blood product utilization is a good guide for treatment. Quality control and rational use of SDPs and RDPs are important in sick and thrombocytopenic patients resulting in better clinical outcomes.
Sero-Prevalence of COVID-19 in Blood Donors of North India – Single-Center Report
Authors: Tiwari Aseem K , Pabbi Swati , Aggarwal Geet , Marik Arghyadeep , Sharma Shruti , Singh Manish , Gupta Shubham , Golia Sunil 
Published: November 2022

Background and Objectives:
COVID-19 has infected and caused the deaths of millions of people globally with India being the second most affected country in the world. The primary objective of the study was to determine the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) antibodies in healthy blood donors in North India. The secondary objective of the study was to find the association of vaccination and infection with seropositivity in the blood donors.

Methods:
All blood donor samples were screened for the presence of IgG antibodies against SARS CoV2 spike (S1) protein. Anti-SARS CoV2 IgG antibody status, demographic data, history of past COVID infection, and vaccination of all eligible donors in the study period were collected. Seroprevalence was calculated as the percentage of total number of donors positive for anti-SARS CoV2 IgG antibodies. Month-wise seroprevalence was also calculated and analyzed.

Results:
Out of 1456 donors, 874 were found to be seropositive, resulting in a seroprevalence of 60%. Seroprevalence was found to be 38.3% and 77%, respectively, in the months of April and May 21. Seropositivity was 100%, 92%, 79%, and 54% in those with a history of both COVID infection and vaccination, vaccination only, infection only, and no history of vaccination or infection, respectively.

Conclusion:
Blood donors represent an easy access to seroprevalence studies and need to be tapped at the national level to obtain a temporal picture of the COVID-19 situation to guide healthcare policies, mark regions where vaccination drives need to be intensified.
A Retrospective Audit of Red Cell Serology Requisition Forms Received at a Reference Testing Center for Work-Up
Authors: Pandey Prashant , Kumari Supriya , Setya Divya 
Published: November 2022

Background and Objectives:
Audits identify areas of problems in immunohematology workup and transfusion practice which can be corrected by the education of medical staff, formulation of guidelines, and algorithms. An audit is a series of simple, direct questions, which when answered and reviewed, tell us whether the laboratory is performing its procedures, activities, and policies correctly. The aim of this study was to analyze immunohematology request forms sent from red cell serology laboratories to our reference testing center (RTC) to ascertain their completeness.

Materials and Methods:
This was a retrospective, observational study conducted in the department of transfusion medicine at a tertiary-level health-care center from November 2019 to June 2021. We ascertained whether the immunohematology workup forms details were complete, absent, or incomplete.

Results:
The study was conducted over a period of 20 months, with 264 forms being audited. In this overall total number, almost one-third of 1894 (34.16%) of the immunohematology workup requisition form details were complete and 716 (12.91%) of these entries were incomplete. However, almost half of the overall number of 2934 (52.92%) of the requisitions were absent.

Conclusion:
From our study, we concluded that an audit of all the RTC requisitions at the point of receiving can be an important tool to detect requisition errors and results of RTC workup. We received a sample for RTC advanced immunohematological testing from all over India. There is a need for the organization of CME and training of staff to increase compliance regarding sending appropriate RTC advanced immunohematological requisitions and samples.
Agreement in Disability between World Health Organization Disability Assessment Schedule 2.0 (36 Item Version) and Indian Disability Evaluation and Assessment Scale among the Person with Severe Mental Illness
Authors: Paul Fayaz Ahmad , Bora Debashree 
Published: November 2022

Background:
The World Health Organization Disability Assessment Schedule (WHODAS 2.0) was designed to assess the functioning level in six life domains (cognition, mobility, self-care, getting along, life activities, and participation in community activities). It was used to measure functional impairment in cross-cultural studies. Universal usage of this instrument will synchronize disability data across various countries and help in international comparison.

Objective:
To check the agreement in disability between WHODAS 2.0 (36-Item Version) and Indian Disability Evaluation and Assessment Scale (IDEAS) among Persons with Severe Mental Illness.

Materials and Methods:
This was a longitudinal study. A total of 60 participants were selected using a consecutive sampling procedure. Persons diagnosed with severe mental illness as per the ICD-10 diagnosis criteria, aged above 18 to 60 years with a total duration of illness of at least 2 years were considered for inclusion in the study. Patients and their primary caregivers who gave written informed consent were included in the study. Those who refused to consent to the research study and patients not staying with primary caregivers were excluded from the study.

Results:
There is a correlation between all the similar domains of WHODAS 2.0 and IDEAS. It is statistically significant except for the correlation between the “Mobility” domain of WHODAS 2.0 (36 items) and the “Communication and Understanding” domain of the IDEAS scale.

Conclusion:
WHODAS 2.0 can be recommended either by itself instead of by IDEAS for the assessment of disability in the Indian setting as there is a highly significant agreement between WHODAS 2.0 with IDEAS. This will help the disability boards to give an exact percentage of disability; an aspect that was lacking in IDEAS where a range is available.