bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiation induced cataracts in interventionalists occupationally exposed to ionising radiation
Authors: Rose André , Rae William I.D. , Sweetlove Margaret A. , Ngetu Lumko , Benadjaoud Mohamed A. , Marais Wayne 
Published: October 2022

Background: Occupational exposure to ionising radiation may have detrimental health effects. Longer and more complex fluoroscopic procedures have placed interventionalists at increased occupational health risks especially for developing cataracts in the radiosensitive lenses of the eyes.Objectives: This study aimed to determine the prevalence of occupational related cataracts and describe the risk factors for cataracts in occupationally exposed interventionalists compared with unexposed doctors.Method: A cross-sectional study using multiple methods. A survey was conducted. The radiation workload was determined based on a self-administered questionnaire and dose area product values determined in previous studies. Both groups had slit lamp examinations. The data were analysed analytically using R software version 9.3.Results: The study included 98 interventionalists. The combined prevalence of posterior sub-capsular (PSC) and cortical cataracts was 18.8% in the exposed and 13.9% in the unexposed group. The prevalence of PSC cataracts in the exposed group was 5.9% and 2.8% in the unexposed group, with an odds ratio (OR) of 2.2 (95% confidence interval [CI]: 0.58; 8.61). Posterior sub-capsular cataracts were more common in the left eye. The increase in cataracts was not statistically significant in the exposed group but is of clinical significance.Conclusion: The findings are important as they highlight the need for greater vigilance for protecting the radiation healthcare workforce in a developing country setting.Contribution: The research is the first of its kind in South Africa and Africa and contributes to determining the prevalence in this highly skilled and occupationally vulnerable group.
ADAMTS13 levels in sickle cell anaemia
Authors: Kingsley Akaba , Ofonime Essien , Edakabasi Akaba 
Published: October 2022

Background
Sickle cell anaemia (SCA) is a hypercoaguable state characterized by a significant alternation in haemostatic parameters which may predispose to increased risk of vas-occlusive crisis (VOC). The role of ADAMTS13 in the pathogenesis of VOC has not been fully investigated in our environment.

Objective
The objective of this study is to evaluate the level of ADAMTS13 in SCD subject in Calabar and to determine their role in the pathogenesis of vaso-occlusive crisis.

Materials and methods
This is a comparative study carried out at the University of Calabar Teaching Hospital (UCTH), Calabar. In all, 60 SCA patients were evaluated in VOC and steady states well are 50 apparently healthy controls. ADAMTS13 Ag was evaluated using Assaypro enzyme-linked immunosorbent assay kits with LOT Nos 04222167 R. Data were analyzed with IBM SPSS Chicago software version 21. The study was approved by the UCTH Institution Ethical Review Board.

Results
The mean ages of the SCA subjects and controls were 23.5 + 7.2 yrs and 26.5 + 5.6 years respectively (P=0.706). There were 23 (38.3%) males in the SCA group and 21 (42.0%) females in the controls. There was no significant difference in their sex distribution (P=0.063). The mean (SD) of ADAMTS13 in VOC, steady-state, and controls were 0.61 + 0.10 ug/l, 0.44 + 0.06 ug/l, and 0.62 + 0.10 ug/l respectively. ADAMTS13 levels did not differ significantly across the groups (P=0.270).

Conclusion
ADAMTS13 level is not elevated both in steady-state and vaso-occlusive crisis
Adult idiopathic thrombotic thrombocytopenic purpura therapeutic modalities and outcome
Authors: Esheba Noha E. , Aboelnasr Mohamed S. , Elrefaey Waleed A. 
Published: October 2022

BackgroundThrombotic thrombocytopenic purpura (TTP) is a rare hematological disease that results in fatality if not treated. The studies on TTP are scarce; most of them have small numbers of patients. Since not enough data on Egyptian patients with TTP can be found in the literature, we carried out this retrospective study to define the therapeutic modalities and outcome of these patients.Patients and methodsWe studied the records of patients clinically diagnosed with TTP from 2006 to 2020. Twenty-nine patients were diagnosed with TTP. However, full records were available only for 22 patients. The primary outcome of the study was the 1-year survival. Other outcomes were the factors on which the survival seemed to depend on such as age, platelet count, lactate dehydrogenase (LDH), serum creatinine, hemoglobin, reticulocytic %, plasma volume exchange (PVE), days to start of treatment, and indirect bilirubin.ResultsPlatelet count change was negatively correlated with both the number of plasma exchange sessions and the days to start of treatment, but it was positively correlated with the volume of plasma exchange. Univariate analysis identified factors associated with better survival of the patients: LDH, reticulocytic percent, days to start of treatment, serum creatinine, PVE, and hemoglobin level. The multivariate analysis revealed that the independent factors affecting the survival were LDH, reticulocytic percent, hemoglobin level, and age.ConclusionEarly suspicion and intervention with therapeutic plasma exchange for TTP are associated with better outcomes in these patients. One and a half PVE is associated with better response than 1 PVE.
An evaluation of thrombocytopenia cases in the hematology clinic of the Ankara Numune Training and Research Hospital
Authors: Sari Öznur , Üre Ümit 
Published: October 2022

Background
Thrombocytopenia is a major disease that requires the referral of outpatient and hospitalized patients to hematology specialists.

Objectives
The present study aims to evaluate the laboratory and transfusion statuses of adult patients admitted to our hospital and receiving outpatient/inpatient treatment and diagnosed with thrombocytopenia (<100 × 109/l).

Design
Single-center, retrospective, laboratory-based study.

Patients and methods
In the study, after obtaining permission of the hospital's Non-Invasive Clinical Research Ethics Committee, the information of patients diagnosed with thrombocytopenia (platelet count <100 × 109/l) and who were examined and treated in the outpatient/inpatient settings between 2008 and 2010 were retrospectively analyzed using patient files and the hospital electronic database.

Sample size
A total of 1020 patients diagnosed with thrombocytopenia.

Results
The patients were divided into groups according to the most common diagnoses for diseases associated with thrombocytopenia (hematological malignancy, disseminated intravascular coagulation (DIC)-sepsis, immune thrombocytopenia (ITP), infection, and chronic liver disease (n=708). Chemotherapy-induced, drug-induced, nutritional (B12, folate deficiency, etc.), OKIT, pregnancy-induced thrombocytopenias and other less common causes of thrombocytopenia were evaluated in a separate group (n=312). It was found that female patients were more frequently diagnosed with ITP (71.7 vs. 28.3%). Sex distributions were similar in other groups. The highest mean age (71 years: 50/80) was observed in patients with DIC-sepsis, whereas the lowest mean age was found in patients with ITP (40 years: 30/57) (P<0.001). It was found that the most frequent need for transfusion developed in patients diagnosed with acute myeloid leukemia, acute lymphoblastic leukemia, and aplastic anemia.

Conclusion
In this study, it was determined that the prevalence of thrombocytopenia was highest in patients diagnosed with hematological malignancy, ITP, and DIC-sepsis, respectively. In cases of hematological malignancy, the need for replacement of blood products is considered to be inevitable during the treatment process of the underlying disease compared with other clinical conditions.
Assessment of megaloblastic anemia in geriatrics in Lagos State, Nigeria
Authors: Akinbami Akinsegun A , Bamiro Rafatu A , Uche Ebele I , Suleiman Aishatu M , Benjamin Augustine , Kareem Abdulateef O , Odebiyi Hassan A , Oduniyi Oludaisi A 
Published: October 2022

Background
Deficiency in some of the water-soluble vitamins such as vitamin B9 (folate) and vitamin B12 (cobalamin) is associated with multiple diseases seen in the elderly, for example, anemia, dementia, Alzheimer's disease, cancers, and osteoporosis. This study, using enzyme-linked immunosorbent assay, aimed to determine the serum levels of vitamins B9 (folate) and B12 (cobalamin)/homocysteine in the elderly. Packed cell volume and mean corpuscular volume were correlated with these vitamins.

Materials and methods
This was a descriptive, cross-sectional study done at the geriatric clinic of Lagos State University Teaching Hospital (LASUTH) Ikeja, Lagos, Nigeria. Following the receipt of the Institution's Ethics Committee approval, elderly participants, aged 65 years and above were recruited consecutively. Their blood was collected into EDTA and plain bottles for the determination of full blood count and folate and vitamin B12/homocysteine, respectively. Data were analyzed with the Statistical Package for the Social Sciences (SPSS) version 23.0. The P value was set at less than or equal to 0.05.

Results
A total of 90 participants were recruited consisting of 50 (55.6%) females and 40 (44.4%) males. The overall mean folate, vitamin B12, and homocysteine were 7.64 ± 2.39 ng/ml, 514 ± 237.95 pg/ml, and 8.37 ± 6.88, respectively. Only 2.2 and 1.1% of the elderly had vitamin 12 and folate deficiencies, respectively, and 13.3% had elevated homocysteine. Packed cell volume was statistically significantly correlated with folate, vitamin B12, mean corpuscular volume, and homocysteine (P=0.001).

Conclusion
Vitamin B12 and folate deficiencies are uncommon in the elderly population in Lagos. The incidence of hyperhomocysteinemia is also low among them.
Deceased Donor Renal Transplant Outcome in a South Indian Tertiary Care Hospital With Zonal Allocation Model - An Observational Study
Authors: Sadayandi Kandasamy , Madhavan Devdas , Murugesan Prabu , Mathavan Balamurugan , Narayanasamy Kuppurajan , Baranikumar Pollachi Balasundaraj , Murugesan Anandan , Balasundaram Sengoda G , Sengottayan Vengetesh Kilvani , Vasanthan R , Jeevithan S 
Published: October 2022

Background:
With the rising incidence of diabetes and hypertension, the prevalence of end-stage renal disease has increased greatly so as the need for renal replacement therapy. Availability of suitable living-related donors is a major problem which increases the demand for deceased donor renal transplantation (DDRT), making it a lifeline for the patients on dialysis without any living donors.

Methodology:
This is a retrospective analysis of 118 DDRT done between 2012 and 2020, in a private quaternary care hospital in a south Indian state. All patients received basiliximab induction, with maintenance immunosuppression using steroids, mycophenolate mofetil (MMF) or mycophenolate sodium, and tacrolimus.

Results:
In our study, we report unadjusted graft survival of 93.2% and 81.3%, patient survival of 94.9% and 83.1% at the end of 1 and 5 years, respectively. The recipients with age < 60 years had 5 years graft survival of 87%. The study group consisted of 15.25% of the patients with panel reactive antibody (PRA) positive and 10.16% of them with donor-specific antibody (DSA) during renal transplantation, and there was only one allograft loss in this subset of the patients.

Conclusion:
This study confirms that human leukocyte antigen matching is not very important with the current immunosuppressive protocol using tacrolimus and MMF. Early initiations of tacrolimus do not increase the incidence of delayed graft function. We report 91.6% graft survival in the DSA-positive group, with basiliximab induction and desensitization protocol.
Organ Donation-Related Psychosocial Interventions
Authors: Maarefvand Masoomeh , Poursaadati Maryam Zabihi , Niyasar Mahbubeh Ziarati , Khubchandani Jagdish 
Published: October 2022

Introduction:
Lack of consent from brain dead individuals' families is a major impediment for organ donation (OD) which is caused by several factors. Families need to receive information and support before, during, and after OD. Involving social workers in the transplantation team could be helpful.

Methods:
To develop a guideline for OD-related social work interventions, we conducted an inductive content analysis on experiences of experts providing services for families of brain dead individuals and searched scientific documents to identify eligible social work guidelines and studies. The participants were invited through purposeful and convenience sampling. Sampling was terminated when no additional information was acquired, and data saturation occurred.

Results:
Eleven experts who had experience in interviewing families of brain dead individuals participated voluntarily. In-depth and semi-structured interviews were conducted individually for each participant. We shared the draft for the social work guidelines with experts and finalized the guidelines according to their comments. Recommendations for social work interventions for brain dead individuals' families in three main phases were categorized; before donation (process initiation and family consent), during donation, and after donation (short-term and long-term interventions).

Conclusion:
Social workers can get involved in transplantation teams to improve family protection during the consent seeking process and after the family's consent about donation.
Endovascular Management of Vascular Complications in Renal Allograft - An Observational Study
Authors: Prasad Surya Nandan , Singh Vivek , Yachha Monika , Phadke Rajendra Vishnu , Bhadauria Dharmendra S 
Published: October 2022

Context:
Role of endovascular management of vascular complications in renal transplant recipients.

Aims:
To present our experience in endovascular management of vascular complications in renal transplant recipients with a literature review.

Settings and Design:
A retrospective observational study.

Materials and Methods:
This is a retrospective analysis of postrenal transplant recipients referred to our department for the evaluation and endovascular management of vascular complications from January 2010 to December 2014. Cases of transplant renal artery stenosis (TRAS) and common iliac artery (CIA) stenosis were treated with percutaneous transluminal balloon angioplasty with or without stenting. Intraparenchymal pseudoaneurysms, arteriovenous fistula (AVF), and active contrast extravasation cases were managed with coil and/or glue embolization. Treated patients were followed up with serial blood pressure measurements, serum creatinine estimation, and Doppler evaluation in the postprocedure period and at 3-month and 6-month intervals.

Results:
Among a total of ten patients, there were five TRAS, two intraparenchymal pseudoaneurysms with active contrast extravasation, one AVF, one active renal bleed with peri-graft hematoma, and one right CIA stenosis. Intraparenchymal pseudoaneurysms, AVF, and active extravasations were postbiopsy. All treated patients showed improved renal function, increased hematocrit, improved blood pressure control in the postprocedure period, and follow-up.

Conclusions:
Vascular complications in renal transplant patients may lead to graft dysfunction, increased morbidity, and even graft loss if left untreated. Endovascular interventions are first-line treatments with excellent short- and long-term outcomes.
Tuberculosis in Kidney Transplant Recipients
Authors: Surendran Sujit , Thirumalvalavan K , Anand S Murugesh , Prasad N D Srinivasa , Fernando M E Edwin 
Published: October 2022

Background:
The incidence of tuberculosis (TB) among transplant recipients varies from 5% to 15% across the globe. We conducted a retrospective study to identify the incidence of TB among kidney transplant recipients in our transplant unit.

Materials and Methods:
We assessed the patients who underwent kidney transplantation in our transplant unit during the study period from January 2014 to June 2018 and included those recipients who had bacteriologically confirmed TB. We excluded the patients who had TB before transplant and those recipients who were initiated on antituberculosis treatment (ATT) empirically. The details collected were: 1. Clinical data, the presenting symptoms, and clinical findings. 2. Diagnostic investigation: Microbiological/histopathological/radiological/bronchoalveolar lavage/fluid (pleural/peritoneal/cerebrospinal fluid) analysis. 3. Antituberculous regimen, dose, and duration of the therapy. 4. Relapse/patient and graft outcome after treatment.

Results:
The total number of patients who underwent kidney transplantation during the study period was 177. TB occurred in 21 patients after transplantation. The incidence of TB in our transplant unit was 11.86%. In these 21 recipients, 8 had pulmonary TB and the remaining 13 had extrapulmonary/disseminated TB, which included two patients with disseminated TB and one patient with allograft dysfunction with thrombotic microangiopathy which was attributed to TB as it responded to first-line antituberculous drugs. The mortality rate was 23.8%, as five patients expired. After excluding patients who expired, the graft survival at 1 year after ATT completion was 90.5%.

Conclusion:
For most developing nations, the World Health Organization's “End TB Strategy” remains far from their dream. An ideal investigation to detect TB in its early stage is essential in posttransplant recipients to reduce the morbidity and mortality associated with it.
Effectiveness of Awareness Program on The Knowledge, Awareness, and Perception of Undergraduate Paramedical and Non-Paramedical Students Toward Eye Donation - A Cross Sectional Study
Authors: Rani Anjali , Adak Pinaki , Yadav Rakesh Kumar , Chander Ashish 
Published: October 2022

Introduction:
Corneal transplantation is the only option to treat corneal blindness. However, the corneal procurement rate is much less than the requirement. Barriers to eye donation need to be studied.

Aim:
The aim of this study is to understand the knowledge, awareness, and perception toward eye donation and the determination of barriers to eye donation among university students and to conduct an awareness campaign and determination of its effectiveness.

Methods:
A cross-sectional study was conducted among 300 graduation students of paramedical and nonparamedical department with the help of questionnaire. An awareness program was carried out through PowerPoint presentation. Responses were elicited pre- and post-awareness program. Data were analyzed using the SPSS software version 16.

Results:
The findings suggest that knowledge and awareness were slightly higher among paramedical students but the willingness for eye donation was higher among nonparamedical students as compared to paramedical students. The prime source of information was doctors/optometrists and media. In both the groups, female and Hindu participants showed more willingness toward eye donation. Barriers to eye donation was the lack of awareness and inappropriate knowledge including various myths and superstitions. Knowledge, awareness, and willingness for eye donation pre- and post-awareness program was comparable between both the groups. Awareness program resulted in statistically significant increase in positive attitude and willingness toward eye donation in both the groups.

Conclusion:
Effective measures including awareness campaign need to be taken such as education on eye donation through which procurement of cornea can be increased and burden of corneal blindness can be minimized.
Behavioural and Emotional difficulties in School children during COVID 19 pandemic using narrowband dimensions of SDQ
Authors: Nath Subhashish , Gogoi Vijay , Linganna Siddeswara Bargur , Baruah Jita , Sutradhar Bikram 
Published: October 2022

ABSTRACT

Background:
Containment strategies such as lockdown during coronavirus disease 2019 (COVID-19) pandemic have forced home confinement of many children. Data on psychological difficulties in children during lockdown are scarce from this part of the country.

Aim:
The aim of the study is to describe the burden and pattern of behavioral and emotional problems of schoolchildren during COVID-19 lockdown in a small town from Northeastern India.

Materials and Methods:
Caregivers of children (4–17 years old) attending English medium schools of the town were invited to participate in the study. A descriptive cross-sectional online survey using purposive nonprobability sampling was conducted between August and September 2020. Strengths and Difficulties Questionnaire (SDQ) was used to measure behavioral and emotional difficulties of children. Responses were based on child's behaviors over the last 6 months which coincided with the ongoing lockdown period in the region.

Results:
A total of 304 responses were received, among which 242 were considered for analysis. The parent-reported SDQ showed 23.1% of children having emotional or behavioral problems during the COVID-19 lockdown. Peer problems (43.4%) were the most common, followed by conduct problems (25.6%), emotional problems (23.1%), and hyperactivity (11.1%). Type of family (nuclear/joint/extended) was significantly associated with total difficulties (χ2 = 6.608, P = 0.03), conduct problems (χ2 = 8.492, P = 0.01), and hyperactivity (χ2 = 5.908, P = 0.05). Socioeconomic status of the family was associated with hyperactivity (χ2 = 8.755, P = 0.01).

Conclusion:
Significant number of children have behavioral and emotional difficulties during COVID-19 lockdown period.
A cross-sectional survey of sleep patterns and quality and its association with psychological symptoms among doctors working in a COVID-19 care facility
Authors: Kota Sushmitha , Kumar Shankar , Gopal Archana , Rudra Prashanth Nagabhushan , Anvitha K 
Published: October 2022

ABSTRACT

Context:
The coronavirus disease 2019 (COVID-19) outbreak has led to several psychological symptoms among frontline doctors of which sleep disturbances are common. Stress due to isolation and disease-related factors are known to be associated with sleep disturbances.

Aim:
The aim of this study is to establish the prevalence of poor sleep and its association with psychological symptoms among doctors working in COVID-19 tertiary hospital.

Settings and Design:
A cross-sectional online survey was conducted among 150 doctors who were treating COVID-19 patients.

Materials and Methods:
The survey contained a semi-structured questionnaire including sociodemographic details, Depression Anxiety Stress Scale 21, and Pittsburgh Sleep Quality Index scale. Analysis was done using the SPSS v20.

Results:
Of 150 doctors, we found 67 (44.67%) and 83 (55.33%) doctors were poor sleepers and good sleepers, respectively. Those who were married (P = 0.001), had higher working hours per month (P = 0.001), the presence of family history of psychiatric illness (P = 0.008), and history of substance use (P = 0.007) were associated with poor sleep. Furthermore, poor sleep was associated with higher stress (P = 0.001), anxiety (P = 0.001), and depression (P = 0.001). A multiple logistic regression revealed that family history of psychiatric illness (odds ratio [OR]-5.44, P = 0.01) and the presence of substance use (OR-7.77, P = 0.01) predicted poor sleep.

Conclusion:
Sleep pattern abnormalities were present in 45% of the frontline COVID-19 doctors studied. Family history of psychiatric illness and substance use was associated with higher chances of having poor sleep. It is important to recognize and manage sleep abnormalities as these could be initial signs of a psychiatric disorder or manifestations of underlying stress, especially in the vulnerable population.