bluuebunny/crossref_metadata_2025_split huggingface dataset:
A retrospective study to assess the impact of ABO incompatibility on outcomes of allogeneic peripheral blood stem cell transplants at a tertiary care hospital in Western Maharashtra
Authors: Nalukettil Balu B , Biswas Amit Kumar , Asthana Bhushan , Kushwaha Neerja , Baranwal Ajay Kumar , Sharma Sanjeevan 
Published: May 2022

AbstractBACKGROUND:Hematopoietic stem cell transplantation (HSCT) has emerged as a curative measure for life-threatening hematological disorders. It can be autologous or allogeneic depending on the disease characteristics. Providing transfusion support to the transplant patients can be challenging, especially in AB-mismatched allogeneic HSCT. In this study, we investigated the impact of ABO incompatibility in patients undergoing allogeneic HSCT.MATERIALS AND METHODS:A retrospective review was conducted in 76 patients with hematological diseases who underwent allogeneic HSCT. Transfusion requirements, engraftment profile, incidence of graft versus host disease (GvHD), and mortality for a period of 1 year were analyzed.RESULTS:ABO incompatibility between donor and the patient did not significantly affect the neutrophil and platelet (PLT) engraftment time (P= 0.389, 0.349, respectively), packed red blood cells transfusion requirement, and duration of initial hospital stay. However, patients of ABO-incompatible HSCT received more PLT transfusions posttransplant which was statistically significant. 29.1% of ABO compatible and 16.7% incompatible HSCT patients developed GVHD. Mortality rates in the two groups were 16.7% and 8.3%, respectively. However, differences in both the parameters were not statistically significant.CONCLUSION:Our study showed that ABO incompatibility does not significantly affect the outcome and should not be a limiting factor for selection of donor. Donor availability and human leukocyte antigen (HLA) matching remain the critical selection criteria.
Comparative study between chronic automated red blood cell exchange and manual exchange transfusion in patients with sickle cell disease
Authors: Al Mozain Nour , Elobied Yasmin , Al-Omran Amal , Aljaloud Alhanouf , Omair Alanoud Bin , Tuwaim Reema Bin , Alkhalifah Sara , Altawil Esraa S. , Abraham Sheena , Salcedo Lejardine Rose , Parena Aljoyce , Shah Farrukh , Ayyoubi M. Tayyeb , Hermelin Daniela , Al Gahtani Farjah , Alfeky Mervat Abdalhameed , El Gohary Ghada 
Published: May 2022

BACKGROUND:
Red cell transfusion remains the gold standard in managing sickle cell disease (SCD) with severe complications. Offering red blood cell exchange (RBCX) either manual exchange transfusion (MET) or automated RBCX (aRBCX) can reduce the complications of chronic transfusion and maintain target Hb thresholds. This study audits the hospital experience of overseeing adult SCD patients treated with RBCX, both automated and manual, and compares the safety and efficacy.

MATERIALS AND METHODS:
This retrospective observational study was conducted as an audit for chronic RBCX for adult patients with SCD in 2015–2019 at King Saud University Medical City, Riyadh, Saudi Arabia.

RESULTS:
A total of 344 RBCX for 20 adult SCD patients who were enrolled in regular RBCX, (11/20) patients had regular aRBCX with a total of (157) sessions, and (9/20) patients had MET with a total of (187) sessions. The median level of HbS% post-aRBCX was significantly lower than MET (24.5.9% vs. 47.3%, P < 0.010). Patients on aRBCX had fewer sessions (5 vs. 7.5, P < 0.067) with better disease control. Although the median yearly pRBC units per patient for aRBCX was more than the double needed for MET (28.64 vs. 13.39, P < 0.010), the median ferritin level was 42 μg/L in aRBCX versus 983.7 μg/L in MET, P < 0.012.

CONCLUSION:
Compared to MET, aRBCX was more effective in reducing HbS, with fewer hospital visits and better disease control. Although more pRBCs were transfused, the ferritin level was better controlled in the aRBCX group without increasing alloimmunization risk.
Reappraisal of screening strategy in hepatitis B surface antigen-negative blood donors
Authors: Alam Md. Sohrab , Samdani Tushar , Hassan Md. Sawkat 
Published: May 2022

BACKGROUND:
In spite of screening for hepatitis B surface antigen (HBsAg), transfusion-associated hepatitis B virus (TAHBV) infection remains a serious public health problem due to transmission of HBV in window period and occult HBV infection. To avoid TAHBV infection, some health-care facilities have started Hepatitis B core antibody test along with HBsAg, but this leads to a lot of potential donor rejection who are not HBV infected. Our aim is to find a new protocol of donor screening to prevent TAHBV without compromising blood availability.

MATERIALS AND METHODS:
A total of 88 HBsAg-negative anti-HBc total positive blood donors were included in this study. All samples were also tested for anti-HBs by enzyme immunoassay and for the presence of HBV-DNA viral load by real-time polymerase chain reaction.

RESULTS:
A total of 88 HBsAg negative and anti-HBc, total positive blood donors were tested for anti-HBs and HBV-DNA (Qn.). Among them, 76 donors (86.4%) (males 73 and females 3) were found to be positive for anti-HBs, while rest 12 (13.6%) showed no detectable antibody against HBsAg. HBV-DNA was found to be positive in 4 (7.7%) donor samples among 52 (60%) who have anti-HBs level <100 mIU/ml, while 36 (40%) donor samples were found to have >100 mIU/ml anti-HBs antibody with no detectable HBV-DNA.

CONCLUSION:
HBV-DNA should be implemented as a screening test of the blood donors to prevent TAHBV infection without potential donor rejection.
Therapeutic plasma exchange in HELLP syndrome
Authors: Chowdhry Mohit , Agrawal Soma , Gajulapalli Shiva Prasad , Thakur Uday Kumar 
Published: May 2022

BACKGROUND:
HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome occurs in about 0.5%–0.9% of all pregnancies, but its prevalence is higher in patients with severe preeclampsia, accounting for a substantial maternal and perinatal morbidity and mortality. According to the latest American Society for Apheresis guidelines, Therapeutic plasma exchange (TPE) performed for postpartum cases and antepartum HELLP syndrome cases fall in Categories III and IV, respectively.

MATERIALS AND METHODS:
Retrospective analysis was done at our tertiary care center from January 2014 to June 2019 for patients diagnosed with HELLP syndrome. Clinical data for age, gestational age at the time of diagnosis, type of delivery, outcome of pregnancy, history of preeclampsia /eclampsia, hemoglobin levels, AST, ALT, LDH, platelet counts, prothrombin time, activated partial thromboplastin time, international normalised ratio, complete blood count, was obtained from patients' electronic medical records. The TPE was initiated within 24 hrs of diagnosis. All TPE was done on Spectra Optia apheresis system (Terumo BCT, Inc, USA). Statistical testing was conducted with the statistical package for the social science system version SPSS 20.0 and R-3.2.0. Continuous variables were expressed as mean±SD and were compared between Pre and Post TPE records of patients by using the paired T test.

RESULTS:
Nine patients fulfilled the criteria of HELLP syndrome. Seven (77.8%) were diagnosed in the postpartum period and 2 (22.2%) during the second trimester. Out of the total nine patients, two patients (22.2%) recovered completely and were discharged on day 15 ± 7 days, whereas 4 (44.4%) patients were discharged on day 21 ± 7 days with the advice of hemodialysis. Two (22.2%) patients had an intrauterine death and were discharged 3–4 days after the demise. In all these patients (except one), the TPE was initiated within 24 h of the diagnosis. A significant increase in platelet count and decrease in the lactate dehydrogenase levels (P < 0.05) was observed post TPE.

CONCLUSION:
Our data showed that TPE improved the treatment outcome in patients with HELLP syndrome despite being a Category III and IV indication among postpartum and antenatal females, respectively. However, a timely diagnosis and management are of paramount importance for a favorable outcome. TPE needs to be performed within 24 h of the diagnosis postdelivery when the patient is not responsive to the usual therapies, especially in class I HELLP syndrome.
Identification of rare anti-f alloantibody in a tertiary care center in India
Authors: Bhardwaj Gunjan , Tewari Ashish , Tiwari Deepak , Vishwakarma Sanjay 
Published: May 2022

Abstract:
A 68-year-old male known follow-up patient of nonalcoholic steatohepatitis and carcinoma stomach was admitted to hospital for further management. The patient was planned for radical gastrectomy and required two units of packed red blood cell (PRBC), due to low hemoglobin of 6.6 g/dl. The patient blood grouping and antibody screening (ABS) were done. Patient ABS was positive. On antibody identification, using eleven-cell identification panel, resolve Panel A (Ortho Clinical Diagnostics, Johnson and Johnson, USA), “anti-f” alloantibody was identified in the patient sample. Select cells, from another resolve panel were used to rule out remaining antibodies. Anti-f antibody is produced due to the exposure of “f antigen.” Anti-f antibody can cause hemolytic disease of fetus and new-born and possible hemolytic transfusion reactions. At our center, we successfully transfused two units of anti-human globulin compatible and “c-negative” units, to the patient without any adverse reactions. Thus, the patient having anti-f antibody can be managed by transfusing “c-negative” or “e-negative” PRBC units or units lacking both the “c” and “e” antigens.
Para-Bombay blood group: Report of a rare blood group
Authors: Joibi Kimberly Fe , Noor Noor Haslina Mohd. , Hassan Mohd Nazri , Iberahim Salfarina , Rahman Wan Suriana Wan Abdul , Yusoff Shafini Mohd , Ramli Marini , Bahar Rosnah , Akbar Nurul Asyikin Nizam , Zulkafli Zefarina 
Published: May 2022

Abstract
Para-Bombay blood group is a rare blood group typically characterized by the absence of H antigens on red blood cell and the presence of ABH substances on secretion. It can be easily missed and often mistaken as blood group O without extended testing. Detection is important as it significantly affect transfusion management. We report two cases of Para-Bombay A blood group in a teaching hospital in a North-Eastern state of Malaysia.
A cross-sectional study on thrombopoietin levels in immune thrombocytopenia and its correlation with platelet count, megakaryocytes, and treatment response
Authors: Oberoi Gurleen , Jain Mili , Natu Shankar Madhav , Kushwaha Rashmi , Tripathi Anil Kumar , Kumar Ashutosh 
Published: May 2022

INTRODUCTION:
Thrombopoietin (TPO) being the major regulator of megakaryopoiesis is expected to show a compensatory increase in immune thrombocytopenia (ITP), however, it is not so observed. This study was undertaken to measure TPO levels in ITP and assesses its association with platelet count, megakaryocytes, and response to steroid therapy.

MATERIALS AND METHODS:
A total of 41 cases of ITP and twenty controls with normal platelet count were enrolled in this prospective study. Complete blood count, bone marrow examination, and ELISA for serum TPO were measured. Response to steroid therapy was evaluated for thirty cases.

RESULTS:
The TPO levels were increased in 80.5% of patients in comparison to the controls. The degree of rise, however, was variable. On analyzing low, normal, and high TPO levels with reference to platelet and megakaryocyte count no statistically significant difference was observed. Raised TPO levels were seen with significant lowering of functional megakaryocytes. The mean TPO levels in nonresponders were higher than responders but highly variable and statistically nonsignificant.

CONCLUSION:
Quantitative alterations in TPO are in a way regulated by qualitative efficacy of megakaryocytes rather than platelet or megakaryocyte count. Nonresponders with markedly increased TPO levels (due to qualitative megakaryocyte injury) are less likely to respond to TPO receptor agonist.
Transfusion-transmitted infections, its risk factors and impact on quality of life
Authors: Biswas Bijit , Naskar Narendra Nath , Basu Keya , Dasgupta Aparajita , Basu Rivu , Paul Bobby 
Published: May 2022

BACKGROUND:
Multi-transfused thalassemic children are at higher risk of acquiring transfusion-transmitted infections (TTIs). There are limited data available on TTIs among thalassemic children, especially on its impact on their quality of life (QoL).

AIM:
The aim of this study is to find out the proportion of multi-transfused β-thalassemia major (β-TM) children suffering from TTIs, its risk factors and impact on QoL.

METHODS:
This was a hospital-based, analytical observational study, cross-sectional in design, conducted among 328 β-TM children and their caregivers attending thalassemia day care unit of a medical college during May 2015–April 2016, with a structured schedule. Data were analyzed with appropriate statistical methods using the Statistical Package for the Social Sciences.

RESULTS:
Two-fifth (39.9%) of them were found to have TTIs with hepatitis C being the most common (34.5%), followed by hepatitis B (4.5%) and human immunodeficiency virus (1.8%). In the multivariable model, place of residence (adjusted odds ratio [AOR] – 2.23 [1.19–4.17]), per capita monthly family income (AOR – 1.84 [1.10–3.07]), and blood transfusion frequency (AOR – 1.19 [1.10–1.29]) were significant predictors of TTIs adjusted with their age, age at diagnosis, last pretransfusional hemoglobin level, size of spleen, and caregivers knowledge regarding the disease. The study participants with TTIs had a lower QoL compared to others as there were significant differences in between the total QoL scores ([49.9 ± 15.6 vs. 57.4 ± 15.5], P ≤ 0.001) and its various domains.

CONCLUSION:
There was high burden of TTIs among multi-transfused β-TM children and it has significant negative impact on their quality of lives.
Clinical outcomes of dual fixation of femoral shaft fracture nonunion
Authors: Elbarbary Ahmed N. , Badawy Emad B. , Badr Ismail T. 
Published: May 2022

Background
The key to success in femoral shaft nonunion cases is the achievement of mechanical stability. We aimed to provide the clinical outcome of dual-fixation femoral shaft fracture nonunion using intramedullary nailing and plate augmentation in the same setting.

Patients and methods
This was a retrospective study of 12 patients with femoral shaft fracture aseptic nonunion operated at our university hospital between January 2017 and June 2021. All patients underwent revision surgery with synchronous nailing and plate augmentation. Demographics, comorbidities, history of previous trauma, fracture healing, and complications were recorded. We also reviewed radiological images.

Results
Twelve patients (nine males and three females) with a mean age of 31.1±9.8 years were included. Six patients had a previous fixation with an intramedullary nail, five with a plate, and one with an external fixator. Ten patients had atrophic nonunion, and two patients had hypertrophic nonunion. Patients achieved fracture healing after the surgical intervention, except two patients required another surgical intervention for delayed union as bone grafting (at 6 and 8 months, respectively). At the end of the study, they achieved fracture healing in all patients. The mean healing time was 6.1±2.4 months.

Conclusion
s Good mechanical stability and hence union can be achieved with synchronous nailing and plate augmentation as a treatment option for femoral shaft fracture aseptic nonunion.
Comparative study between arthroscopic reduction and internal fixation versus open-reduction internal fixation for tibial-plateau fractures
Authors: Waly Ahmed H.T. , Gawish Hesham M. 
Published: May 2022

Background
Tibial-plateau fractures are challenging for orthopedic surgeons. The gold-standard treatment for most tibial-plateau fractures is open-reduction internal fixation using either screws only or plates and screws. Recently, arthroscopy has invaded the field of trauma as a useful aid in the management of intra-articular fractures. The main advantages of arthroscopic reduction and internal fixation for tibial-plateau fractures are direct visualization of intra-articular fractures, accurate fracture reduction, and diagnosis and treatment of meniscal and ligamentous injuries. This study was done to compare the results of open-reduction internal fixation versus arthroscopic reduction and internal fixation for tibial-plateau fractures.

Patients and methods
A prospective comparative study was held in EL Hadra University Hospital between January 2017 and December 2019 over 56 patients. In all patients, the fracture was fixed using two to three cannulated screws. In the first group, the fixation was done using arthroscopy, while in the second group, the fixation was done using arthrotomy. All cases were assessed using Rasmussen clinical and radiological forms, Lysholm, and International Knee Documentation Committee (IKDC) scores. The minimum follow-up was 24 months since index surgery.

Results
There was no statistically significant difference between the two groups regarding the clinical and radiological Rasmussen scores. Moreover, the results of the Lysholm and IKDC were comparable. However, the arthroscopic group had longer operative time than the arthrotomy group.

Conclusion
Arthroscopic fixation technique was not inferior to open technique for management of Schatzker I–III fracture types with excellent comparable clinical and radiological outcomes while avoiding the drawbacks of the open approach.
High thoracic disc herniation
Authors: Maziad Ali M. 
Published: May 2022

Aim
This article aims to describe a case of a 28-year-old male patient with progressively worsening of myelopathic symptoms owing to a large T4-5 thoracic disc herniation with severe cord compression.

Background
A 28-year-old male patient was referred to the clinic by a neurologist for worsening of bilateral lower extremity numbness, tingling, and progressive weakness over a period of few months with a clinical examination significant for severe myelopathy and imaging confirming a large thoracic disc herniation.

Procedure
T4-5 left hemilaminectomy and transfacet discectomy with unilateral right T4/T5 fixation and fusion were done.

Outcomes
The patient experienced delayed postoperative paraplegia that was reversible despite negative imaging studies, suggesting intraoperative incidental trauma to the cord or progressive postoperative cord edema.

Scientific message
Literature review of similar cases is presented as well as learning points from this challenging case. If the posterior approach is to be used, complete thorough decompression of the cord is advisable to minimize the risk of complications.
Bleeding Complications and Possible Resistance Patterns of Anti-Angiogenesis Treatments in Recurrent/Metastatic Head-and-neck Squamous Cell Carcinoma – Reflections from a Phase II Study of Pazopanib in Recurrent/Metastatic Head-and-neck Squamous Cell Carcinoma
Authors: Chen Jo-Pai , Hong Ruey-Long 
Published: May 2022

Background:
Due to smoking, alcohol, and betel nut use, head-and-neck squamous cell carcinoma (HNSCC) is a serious public health problem in Taiwan.

Materials and Methods:
We performed a single-arm Phase II trial of pazopanib in patients with platinum-refractory recurrent or metastatic HNSCC in 2011.

Results:
We screened 43 patients in about 6 months. Thirty-three of the patients were excluded due to easy bleeding and vessel contact resulting from the advanced tumor status. The remaining ten patients were included in this study. An objective response was seen in one patient; six patients had clinical benefits, which was comparable with the outcomes of sorafenib or sunitinib in this patient group. Four patients experienced at least Grade 3 bleeding. The tumor response was usually seen in the central cavity; the rim of the cavity extended outside, reflecting peripheral invasion and future resistance.

Conclusion:
The early use of anti-angiogenesis treatments is necessary for better tumor control and to prevent bleeding and potential resistance. In future, vascular endothelial growth factor receptor and/or epidermal growth factor receptor tyrosine kinase inhibitors may be used in combination with immunotherapy to increase the clinical benefits and avoid the risk of hyperprogression.
Comparison of Survival Outcomes using Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Colon Versus Rectal Cancer with Peritoneal Carcinomatosis in an Asian Medical Center
Authors: Yu Hsin-Hsien , Hsieh Mao-Chih , Su Bor-Chyuan 
Published: May 2022

Background:
The use of hyperthermic intraperitoneal chemotherapy (HIPEC) for colorectal cancer (CRC) with peritoneal carcinomatosis (PC) is still very controversial. The National Comprehensive Cancer Network guideline only recommends cytoreductive surgery (CRS) combined with HIPEC for colon cancer with PC for patients with limited metastases and can be removed with surgery. The short-term and long-term outcomes between colon versus rectal origin in this setting remain unclear. The present study compared our experience in the management of colon versus rectal cancer with PC through CRS-HIPEC and investigated whether the feasibility of extending the indication to the PC of rectal origin.

Materials and Methods:
The data of 78 and 10 patients with PC of colon and rectal origin, respectively, were collected from a prospectively maintained database of patients receiving CRS-HIPEC for peritoneal surface malignancy at any period during 2002–2018. CRS followed by HIPEC with mitomycin-C or 5-fluorouracil plus oxaliplatin was administered at 42° for 60 min. In addition, adjuvant chemotherapy was administered postoperatively. Data on sex, age, prior surgical score, preoperative or postoperative peritoneal cancer index (PCI), completeness of cytoreduction (CC) score, blood loss, operation time, transfusion unit, and hospital stay were recorded. Survival was compared between the colon and rectal groups.

Results:
The average patient was 56.4 years old, and 44 were men and 44 were women. The mean preoperative and postoperative PCI scores were 15.6 and 6.6, respectively. A complete CC score of 0-1 was achieved in 507 (56.9%) patients. The median overall survival durations were 34.0 ± 7.8 and 20.8 ± 13.2 months in the colon and rectal groups, respectively (P = 0.367). The 1-, 2-, 3-, 4-, and 5-year survival rates in the colon and rectal groups were 79% and 68%, 63% and 68%, 50% and 51%, 44% and 10%, and 44% and 0%, respectively. In multivariate analysis, the location of the primary tumor did not affect survival (P = 0.597; 95% confidence interval [CI] = 0.237–2.291); however, the postoperative PCI strongly predicted long-term survival (P = 0.001; 95% CI = 3.715–255.547).

Conclusion:
The management of CRC with PC remains challenging. CRS-HIPEC can provide similar survival benefits when applied to PC of rectal origin than when applied to PC of colon origin. The usage of mitomycin-C for HIPEC yields to a comparable survival benefit and a safe therapeutic option. However, the indication should be only extended to highly selective patients considering the possibility of adequate cytoreduction and performed in experienced centers.