bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementing a Nurse-Driven Protocol for Pneumococcal Vaccination in an Academic Rheumatology Clinic
Authors: Joerns Elena K. , Pokala Nagendra , Bermas Bonnie , Reisch Joan , Wang Dan (Clarie) , Arasaratnam Reuben , Bajaj Puneet 
Published: November 2022

ObjectiveRheumatology patients are at high risk for complications from pneumococcal infections. The goal of this study was to assess the feasibility of implementing a nurse-driven pneumococcal vaccination protocol based on the 2012 Advisory Committee on Immunization Practices (ACIP) guidelines within an academic rheumatology clinic. Our aims were to increase (1) pneumococcal conjugate vaccine (PCV13) and pneumococcal polysaccharide vaccine (PPSV23) monthly vaccination rates in immunosuppressed patients aged 19 to 64 years, and (2) the overall proportion of immunosuppressed patients aged 19 to 64 years who have received both PCV13 and PPSV23 vaccinations by ≥ 10% over a 2-year period.MethodsWe identified eligible adults in the electronic medical record using a search protocol based on preset medication group. We obtained baseline pneumococcal vaccination rates in 2019, calculating the proportion of patients who were unvaccinated, partially vaccinated (received either PCV13 or PPSV23), or fully vaccinated. We created a pneumococcal vaccination protocol based on 2012 ACIP guidelines and converted it into a standing medical order to be implemented by the nursing staff. Postintervention vaccination rates were calculated monthly and at the end of the study period. Multiple comparison testing was performed to assess for significant postintervention changes.ResultsThe average rate of monthly vaccination with either PCV13 or PPSV23 increased from 4.3% in 2019 to 12.6% in 2021. The proportion of patients who were fully vaccinated increased from 14.6% in 2019 to 26.2% in 2021. Both changes were statistically significant.ConclusionIt is feasible to employ a nurse-driven protocol for improving pneumococcal vaccination rates in immunosuppressed patients, despite difficulties posed by coronavirus disease 2019 (COVID-19) pandemic disruptions.
Cultural Misconceptions, Attitudes, Knowledge, and Beliefs About Mental Illness Among Jordanian Nurses Working in Psychiatric Units
Authors: Rayan Ahmad 
Published: November 2022

BackgroundThis study examined cultural misconceptions and attitudes about mental illness and their correlates among Jordanian nurses working in psychiatric units.MethodA descriptive, cross-sectional, correlational research design was used. A sample of 157 mental health nurses completed the study. Participants provided information about their demographics and attitudes, knowledge, and cultural misconceptions regarding mental illness.ResultsNegative attitudes toward mental illness were associated with sex, workplace, marital status, age, income, and years of experience. Stigma toward mental illness was associated with sex, workplace, marital status, age, years of experience, and knowledge regarding mental illness. Various cultural myths and beliefs regarding mental illness were reported. Attitudes and stigma toward mental illness differed based on cultural myths and beliefs.ConclusionEducational programs to raise awareness of and reduce stigma toward mental illness are required not only for the general public but also for some health care providers working in psychiatric units.[J Contin Educ Nurs. 2022;53(11):513–520.]
Transcranial Surgery for Pituitary Tumors
Authors: Mishra Shashwat , Mishra Ramesh C , Gurjar Hitesh K , Garg Kanwaljeet 
Published: November 2022

Background:
Despite the evolution of endoscopic techniques, large pituitary adenomas with unfavorable characteristics and irregular anatomical configurations continue to pose a challenge for the dexterity, skills, and patience of endoscopic surgeons. Transcranial surgery retains a significant role in these situations where the tumor access, hemostasis, and dissection around adjoining neurovascular tissues can be controlled efficaciously.

Objective:
In this report, we describe our experience with transcranial surgery for pituitary adenomas highlighting its safety and versatility in peripheral centers.

Methods:
We accessed the case files and imaging records of pituitary tumors operated between 2001 and 2019 at a private hospital in a major Indian city. The records were analyzed with emphasis on postoperative clinical course, visual, and endocrinological outcomes. The data was analyzed with respect to differences between transcranial and transsphenoidal procedures. Categorical variables were compared with Chi-square test/Fischer's exact test and difference in means evaluated with Welch's t-test.

Results:
A total of 178 procedures were performed in 173 patients with pituitary adenoma, who were the subjects of this study. Ninety-eight (56.7%) patients were treated by transsphenoidal excision whereas 80 (46.2%) underwent transcranial procedures (75 primary and five secondary). In the patients operated transcranially, we observed three deaths and nine patients suffered from significant morbidity. Visual outcomes were similar to the group operated transsphenoidally. However, incidence of panhypopituitarism was significantly higher in transcranial procedures; the extent of resection was poorer than transsphenoidal surgeries owing to more extensive nature of tumors.

Conclusions:
In low-volume centers, the endoscopic skills required for transsphenoidal resection of large and complex pituitary adenomas may be scarce. Transcranial surgery, dependent on familiar microsurgical techniques and equipment, may still be viable, safe, and an effective option.
Country-Made Firearm (Desi-Katta)-Related Cranial Injuries
Authors: Mahakul Dibyajyoti , Doddamani Ramesh S , Meena Rajesh K , Sawarkar Dattaraj , Sharma Rajeev , Kedia Shweta , Gupta Deepak , Verma Satish , Singh Pankaj K , Agrawal Deepak , Singh Manmohan , Chandra Poodipedi S , Kale Shashank S 
Published: November 2022

Background:
Approximately, 80% of civilian cranial gunshot injuries in India are mainly due to unlicensed mostly country-made guns, called the “Desi-Kattas,” manufactured by the traditional gunsmiths. These injuries constitute a unique subgroup, with respect to the make and design along with the unique wound ballistics compared to the factory-made firearms.

Objective:
This study is aimed at defining the prognostic factors in predicting the outcomes related to cranial gunshot injuries due to these desi-kattas.

Methods:
Ten patients with kata-related cranial gunshot injury underwent surgical intervention at our institution, between 2014 and 2018. Their clinical status, imaging features, and outcomes were retrospectively analyzed.

Results:
Ten patients with kata-related gunshot injuries to the head were identified. Homicidal injuries were documented in six cases. Five had a GCS of 13–15 at presentation. Exit wounds were noted in 50% of the suicidal cases. Multilobar involvement was seen in 70% of cases, with the bullet crossing the midline in only 40% cases. Decompressive craniectomy was required in five cases. Eight patients had a Glasgow Outcome Score of four or more at 6 months of follow-up. There was one death during the follow-up period, while the other patient remains to be in vegetative state.

Conclusion:
The Katta-related cranial injuries constitute low-muzzle velocity injuries with the majority of the patients sustaining nonfatal injuries, especially homicidal. The presence of positive CT findings and the crossing of the bullet across the midline on CT brain predicts dismal prognosis. Optimal neurosurgical approach should consist of minimal local debridement and attain water seal dural closure.
Satisfaction With Telemedicine Consultation as Follow-Up Visit in Patients with Parkinsonism and Essential Tremor in during the Covid-19 Pandemic
Authors: Mayela Rodrıguez-Violante , Yamil Matuk , Amin Cervantes-Arriaga , Yazmín Riós-Solís , Arturo Abundes-Corona , Daniel Martinez-Ramirez , Lorena Zuazua-Vidal , Karla Salinas-Barboza , Manuel del Río Quiñones 
Published: November 2022

Background:Telemedicine (TM) consultations have shown to be feasible for the management of neurological conditions including movement disorders. In contrast, satisfaction with such consultations have been less studied.Objective:To assess the satisfaction of persons with a movement disorder with a TM consultation in comparison to previous experiences in face-to-face visits.Subjects and Methods:A cross-sectional multicenter study was carried out. Persons with a diagnosis of a movement disorder underwent a TM consultation. After the consultation concluded, a satisfaction survey was sent for the subject to fill out anonymously. The survey included ease of use-related items, setup-related items, and quality-of-service-related items.Results:A total of 175 survey responses were received (response rate of 71.4%), all of which were included for analysis. A total of 102 subjects considered that the TM consultation involved much less time in comparison to their previous experience with face-to-face visits. Overall, 96% reported to be satisfied with the consultation. In addition, 92% were satisfied or very satisfied with the neurologist ability to communicate recommendations. Furthermore, 93.7% indicated that the consultation was valuable, and 90.9% considered that they would recommend teleconsultation to another patient.Conclusion:Patients with a diagnosis of a movement disorder consider TM as a convenient and potential tool for health services with a high level of satisfaction.
Development and Validation of a New Stroke Outcome Scale (Stroke Impact Assessment Questionnaire)
Authors: Sasikumar Asha , Iype Thomas , Sivaram Rema D 
Published: November 2022

Background:Stroke affects the quality of life through its devastating effects on physical, psychological, social, and economic domains. Patient-reported outcome measures help to capture the patient's perspective to changes in the quality of life. The available stroke-specific outcome measures of stroke do not comprehensively measure all the domains.Objective:We describe the development and validation of the Stroke Impact Assessment Questionnaire (SIAQ) an interviewer-administered new instrument developed using patient-centered approaches to assess the long-term problems of stroke survivors.Materials and Methodology:We used a sequential exploratory mixed methods approach (QUAL → QUAN) to develop the SIAQ. The design involves an initial qualitative phase aimed at generating the item pool and a subsequent second phase aimed at testing of items using quantitative techniques (Psychometric evaluation).Result:SIAQ, a thirty-item tool, under the eight domains (sensory, motor, social, economic, emotional, behavioral, cognitive, and communication) emerged from Principal Component Analysis. The factor loadings ranged from 0.421 to 0.880. The intraclass coefficient in test–retest reliability r is 0.958 (95% CI 0.9249-0.9799) and in interobserver reliability is 0.9473 (95% CI 0.9125 – 0.9733). The internal consistency Cronbach's alpha for the final 30 item tool was 0.88.Conclusion:SIAQ is a culturally appropriate psychometrically robust questionnaire assessing the long-term outcome of stroke. However, SIAQ is applicable only in stroke survivors for up to 65 years.
The Effect Of Small Bone Window Craniotomy Removal on Lactic Acid and CRP in Patients with Hypertensive Intracerebral Hemorrhage in the Basal Ganglia
Authors: Xu Zhanyi , Sun Zhaosheng , Xu Min , Zhao Baoshuai , Wei Jianhui , Guo Hong , Li Yongqian , Mao Jianhui 
Published: November 2022

Background:
Hypertensive intracerebral hemorrhage (HICH) seriously endangers the quality of life of patients and can even lead to death. Craniotomy is a common treatment method for HICH.

Objective:
The aim of this study was to investigate the efficacy of two different sizes of craniotomy in patients with HICH, as well as to evaluate their effects on C-reactive protein (CRP) and blood lactate levels.

Materials and Methods:
A total of 72 patients with HICH in the basal ganglia were operated on in our hospital from February 2017 to March 2019 and randomly divided into two groups: the small bone window (SBW) group (n = 37) and the large bone flap group (n = 35). The curative effects of the two kinds of operations were evaluated by the length of operation, the days of hospitalization, the rate of hematoma clearance, the rate of rebleeding, and the incidence of complications. Additionally, the levels of CRP and lactate were compared between the two groups.

Results:
The results showed that the average intraoperative time, hospital stay, rebleeding rate, and postoperative complications of patients in the SBW group were less than those in the large bone flap group. Moreover, the number of patients in the SBW group with good postoperative recovery, including class V and class IV, was higher than that in the large bone flap group. Minimally invasive craniotomy with SBW reduced the lactic acid and CRP levels more quickly than the large bone flap group.

Conclusions:
An SBW was superior to a large bone flap in terms of the operative effect and lactate and CRP levels. It is concluded that an SBW has significant advantages over a large bone flap.
Insights from Magnetic Evoked Field Analysis in Patients with Wilson's Disease
Authors: Aruna R , Mariyappa N , Sinha S , Nagappa M , Velmurugan J , Saini J , Bindu P S , Mathuranath P S , Thennarasu K , Satishchandra P , Taly A B 
Published: November 2022

Aims:To study the latency, amplitude, and source localization of magnetic evoked field (MEF) responses to visual, auditory, and somatosensory stimuli in Wilson's disease (WD) using magnetoencephalography (MEG) and compare it with “healthy” controls, and correlate the observations with disease severity and brain MRI.Methods:MEF of 28 patients with neurological WD (age: 22.82 ± 5.8 years; M:F = 12:16) and 21 matched controls (age: 25.0 ± 4.6 years; M:F = 10:11) were recorded using MEG. Source localization was performed using standard models on the components of M100, M20, and M100 for visual, somatosensory, and auditory evoked fields, respectively and its latency/amplitude was correlated with disease severity.Results:There were significant differences in source location between control and WD during visual evoked field (VEF) and auditory evoked field (AEF) studies. Latencies of M20 (right-p = 0.02; left-p = 0.04) and M32 (right-p = 0.01) components of SSEF were significantly prolonged. The amplitude of M20 was significantly reduced in patients bilaterally (P= 0.001). There was a trend for the prolonged latency of M100 of VEF in patients (P= 0.09). Five patients had reduced right M145 compared to 8 controls. The left somatosensory evoked fields (SSEF) latency correlated with disease severity (P= 0.04). There was no significant correlation between major components of other MEF with disease severity or MRI score.Conclusions:This study, first of its kind to use MEF analysis in a large cohort of patients with WD, detected subclinical but a variable degree of abnormalities, most consistently of SSEF. It provides valuable insights of functioning and localization of various pathways in a disease known to have protean clinical manifestations and widespread MRI changes.
Serum Inflammatory Markers in Patients with Guillain Barre Syndrome
Authors: Dash Sambit , Kamath Ullas , Pai Aparna R. , Rao Pragna 
Published: November 2022

Background:Guillain Barre syndrome (GBS) is an immune-mediated peripheral neuropathy characterized by the demyelination and axonal damage of the peripheral neurons. The pathogenesis of GBS involves the breakdown of the blood-brain barrier after which pro inflammatory cytokines attack the neurons in the peripheral nervous system.Aims:This study aims to evaluate five markers, namely matrix metalloproteinase(MMP)-2 and MMP-9, vascular endothelial growth factor (VEGF)-A, basic fibroblast growth factor (bFGF), and SFLT-1, which could have a role in the inflammatory response in patients with GBS and healthy controls.Settings and Design:In this prospective study, patients diagnosed with GBS at the department of neurology, Kasturba Medical College, Manipal, Karnataka were enrolled.Methods and Material:The markers selected for this study were analyzed using the ELISA method and expressed as given in the kit provided by the company. Ethical clearance was obtained from the Institutional Ethical Committee.Statistical Analysis:Results were evaluated using SPSS version 17.0 and expressed as mean ± SD. Error bars for each were drawn.Results:The levels of all five parameters showed a significant increase in patients as compared to controls.Conclusions:Disruption of the basement membrane of endoneurium by MMP-2 and MMP-9, recruitment and migration of macrophages and other cytokines by VEGF-A, bFGF, and soluble fms-like tyrosine kinase-1 (SFLT-1) are plausible, which leads to inflammation process and thus neuronal damage leading to the development of GBS.
Gait Characteristics Following Stroke
Authors: Sannyasi Gourav , Ojha Rajdeep , Prakash Navin B , Isaac Joyce , Maheswari V , Mahasampath G S , Tharion George 
Published: November 2022

Background:Management of foot-drop following stroke can be addressed with ankle-foot orthosis (AFO) or functional electrical stimulation (FES) of the peroneal nerve. There is limited evidence regarding the efficacy of FES as a substitute for a conventional ankle-foot orthosis.Objective:The aim of this study was to compare efficacy of FES against AFO in management of foot-drop in patients following stroke.Materials and Methods:Twenty patients (ten per group) were enrolled in this prospective crossover trial. Group A patients received gait training with AFO during first week followed by training with FES during second week and vice-versa for group B. Outcome parameters following AFO/FES training included Ten-meter, Six-minute walk test and spatiotemporal gait parameters. Patient satisfaction level was assessed using feedback questionnaire. Friedman test and Wilcoxon signed-rank test were performed to compare outcomes between barefoot, AFO and FES. ThePvalue < 0.05 was considered statistically significant.Results:Nineteen males and one female aged 45.5 ± 9.45 years were recruited. Statistically significant improvement was observed in Ten-meter and Six-minute walk tests, gait speed, Timed up and go test (TUG), stance-swing ratio and single-limb support among users of FES as compared to AFO and barefoot. There was no statistical difference observed in other gait parameters. Physiological cost index (PCI) showed trend in improvement among FES users. Patient satisfaction scores were higher for FES users.Conclusions:Quantitative and qualitative results were in favour of FES as compared to AFO and barefoot suggesting that FES can be a potential orthotic intervention in hemiplegic patients.
An Audit of the Quality of Reporting and Bias of Studies on Yoga in Epilepsy
Authors: Das Saibal , Tiwari Sayali , Xaviar Suja 
Published: November 2022

Background:Yoga is increasingly being used as a complementary mode of treatment for epilepsy along with pharmacotherapy; however, the quality of reporting and bias of studies on yoga in epilepsy is uncertain.Objective:This study was performed to systematically evaluate the reporting quality and bias of the published studies on yoga in epilepsy.Materials and methods:PubMed and Cochrane databases were searched for studies investigating the efficacy of yoga in epilepsy or describing the patients' or caregivers' knowledge, attitude, influence, and practice of yoga in epilepsy. The reporting qualities of the studies were appraised by standard reporting checklists (CONSORT, STROBE, COREQ, and modified CONSORT) and the risks of bias were assessed using standard tools (Cochrane Collaboration's risk of bias tool, Newcastle-Ottawa scale, and ROBINS-I tool) according to the study designs.Results:Fifteen studies (four randomized control trials, seven observational studies, three non-randomized interventional studies, and one was a mixed-method study) were included. The reporting qualities of the studies which evaluated the role of yoga in epilepsy were comparatively poor from the methodological perspective and the risks of bias were comparatively high than those which described the knowledge, attitude, influence, and practice of yoga in epilepsy.Conclusion:The reporting qualities of studies in relation to yoga and epilepsy were not satisfactory and the risks of bias were high. Hence, it is imperative to be cautious before widely recommending yoga in epilepsy.
Prognostic Significance of Serial Nerve Conduction in GB Syndrome
Authors: Kalita Jayantee , Kumar Mritunjai , Misra Usha K 
Published: November 2022

Background and Aims:We evaluated dynamic changes in neurophysiology of Guillain-Barré syndrome (GBS) at different time points and the role of demyelination and axonal burden in predicting outcome.Methods:Nerve conduction study (NCS) was done in 44 GBS patients at admission and at 1 and 3 months, and were categorized into acute inflammatory demyelinating polyradiculoneuropathy (AIDP), acute motor axonal neuropathy (AMAN), acute motor sensory axonal neuropathy (AMSAN), equivocal and in-excitable motor nerve (IMN). The demyelinating and axonal burden on motor NCS at admission, 1 and 3 months were computed and correlated with disability at 3 and 6 months. Disability was assessed using Clinical Grading Scale.Results:Twenty-four (54.3%) had AIDP, 5 (11.4%) AMAN, 12 (27.3%) equivocal and 3 (6.8%) had IMN at admission. Maximum instability was noted in equivocal group; majority of whom became AIDP at three months. Neurophysiological subtypes at different time points did not correlate with 6 months disability, but demyelination burden at admission (r = -0.42;P= 0.005) and axonal burden at one month (r = 0.43;P= 0.04) correlated with six months disability.Conclusion:Inverse correlation of axonal burden at one and three months with disability suggests role of secondary axonal damage in predicting outcome. Repeat NCS at one month helps in categorizing GBS and also in prognostication.
Risk Factors for Postoperative Brain Contusion and Early Outcomes in Patients with Anterior Skull Base Meningiomas Undergoing Unifrontal Surgery
Authors: Nair Bijesh Ravindran , Ganesh Swaminathan , Moorthy Ranjith Krishna , Rajshekhar Vedantam 
Published: November 2022

Background:Though frontal lobe contusion is a major cause for morbidity and prolonged hospitalization following excision of anterior skull base meningiomas, there is only limited literature on this complication. This study aimed to find out the incidence of postoperative frontal lobe contusion, identify the risk factors for its development and its impact on early postoperative outcome.Methods:Data from 110 patients who underwent excision of anterior skull base meningiomas through a unilateral supraorbital craniotomy from 2001 to 2018 were retrospectively analyzed. The risk factors analyzed for development of postoperative contusion were tumor location, size, volume, peritumoral edema, tumor consistency, extent of resection, tumor grade and type of retraction used.Results:Simpson grade II excision was achieved in ninety-two patients (83.6%). There was no frontal lobe contusion in eighty-two patients (74.5%). Frontal lobe contusion was noted in twenty-eight patients (25.5%), but was severe in only four patients (3.6%). On multivariate analysis, fixed retractor use (OR 11.56 [1.21–110.03];P=0.03) and WHO grade II tumor (OR 3.29 [1.11–9.77];P=0.03) were independently associated with postoperative frontal lobe contusion. Patients with higher contusion grade had significantly longer postoperative hospitalization (P=.02) and lower KPS score at discharge (P=.01).Conclusions:Unilateral supraorbital craniotomy and lateral subfrontal approach is an excellent procedure for excision of anterior skull base meningiomas with minimal postoperative complications related to frontal lobe retraction. Frontal lobe contusion should be avoided with the use of dynamic retraction, since postoperative contusion prolongs hospitalization and worsens the functional outcome at discharge.