bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antibody Screening and Identification in Voluntary Blood Donors – Need of the Hour
Authors: Luhar Rakesh Kumar , Shah Ripal J. , Harimoorthy V. 
Published: April 2022

Background and Objectives:
Although unexpected antibody screening is mandatory according to the Food and Drug Administration and National Blood Policy, the prevalence of irregular red cell antibody and its specificities are not much reported in the donor population of western India. The objective of this study is to find the prevalence of unexpected antibodies in healthy blood donor population of western India.

Methods:
This is a retrospective study conducted in one of the largest stand-alone blood centers in western India. Data were retrieved from the Integrated Blood Bank Management System (powered by the blood center located in Ahmedabad) software. The data were analyzed for a period of 24 months, from March 1, 2019, to March 31, 2021. Unexpected antibody screening of all voluntary healthy blood donors was performed with fully automated blood grouping equipment Immucor NEO and Diagast EVO using commercial Capture-R Ready Indicator Red Cells (Immucor, USA) and Hemascreen Pool (Diagast, France). Further antibody identification was performed with 11 cell panels.

Results:
A total of 53,724 volunteer blood donors donated at our blood center during the study period comprised 51,185 (95.27%) male donors and 2539 (4.72%) female donors. A total of 25 (0.046%) donors showed the presence of unexpected antibodies. Most frequent alloantibodies were anti-M (n = 4, 16%) and multiple antibody (n = 4, 16%).

Conclusion:
Implementation of unexpected antibody screening in all the healthy blood donors routinely and identification of antibodies in antibody screen-positive donors helped us to understand the prevalence of antibodies in our region and its importance in providing compatible blood components which are devoid of irregular antibodies and to avoid delayed transfusion reactions.
Comparative Evaluation of Heat-Inactivated ABO Isoagglutinin Titers with Solid-Phase Red Cell Adhesion Titers
Authors: Ranjan Shweta , Pandey Prashant , Setya Divya , Kumari Supriya 
Published: April 2022

Background and Objectives:
Measurement of actual concentration of IgG requires methods like heat inactivation (HI) of serum. This study was aimed at comparing of heat-treated ABO titers performed by conventional test tube technique (CTT) and column agglutination technique (CAT) with hemagglutination (HA)/solid-phase red cell adherence (SPRCA).

Methods:
This was a prospective, observational study conducted between October 2019 and March 2020. All consecutive A, B, and O group donors who gave consent for participation in the project were included. All samples were tested by CTT and CAT before and after HI (post DTT treatment performed by CTT [pCTT] and post DTT treatment performed by CAT [pCAT]) and with HA/SPRCA.

Results:
A total of 300 donors were included: 100 each with A, B, and O blood groups. For group O, IgG titers were higher than IgM titers among group O, whereas that among group A and group B, IgM titer was found to be higher than IgG titer by both HA/SPRCA and pCTT. The titer values among all the three blood groups were highest when the test was performed by pCAT, though the results of pCTT and SPRCA, pCTT, and pCAT were significant in group O donors. For groups A and B, results of pCTT and pCAT, pCAT, and HA/SPRCA were found to be statistically significant.

Conclusion:
Results obtained by HA/SPRCA were closer to pCTT, with respect to time consumption, expertise required, and lack of inter-observer variation. Titers obtained by pCAT were higher in comparison to pCTT obviously due to its relative higher sensitivity. Hence, these methods cannot be used interchangeably.
Is Type and Crossmatch Really Necessary for Transurethral Resection of Prostate? A Retrospective Study from a Tertiary Care Center in Northern India
Authors: Srivastava Anubha , Singh Bharat , Elhence Preeti , Srivastava Aneesh , Chaudhary Rajendra 
Published: April 2022

Background and Objectives:
Rate of blood transfusion is considerably low in transurethral resection of the prostate (TURP). We follow type and crossmatch (TC) policy in TURP. The objective was to assess the suitability of TC policy along with the impact of preoperative (preop) prostate weight and hemoglobin (Hb) on the pattern of blood ordering (whether demand for TC was sent or not).

Methods:
Retrospective analysis of TURP patients was done from 2014 to 2017. Patients were divided into 2 groups on the basis of whether the demand for TC was sent or not. The age, preop prostate weight and preop Hb of patients where demand for TC sent was compared with patients where TC demand was not sent. Crossmatch to transfusion ratio (Crossmatch to transfusion ratio C/T ratio), Transfusion probability (%T) and Transfusion index (TI) were calculated.

Results:
Among the total 92 TURP patients, 42.4% (39/92) had TC samples sent preoperatively. Only three patients (3.2%, 3/92) required transfusion intraoperatively. CT ratio was 23.6, %T was 7.6% and TI was 0.07. Preop prostate weight and Hb were significantly higher and lower, respectively, for the group where request for TC was sent. Transfusion probability was also higher for this group.

Conclusion:
The blood utilization indices show the inadequate utilization of blood and that TC policy is unnecessary. Type and screen policy can be used for patients with large prostate and/or low Hb while type and hold would be appropriate for rest of the patients. Change in pretransfusion policy would reduce workforce and reagent wastage along with efficient inventory management.
Myths and Misconceptions Preventing College Going Students from Voluntary Blood Donation
Authors: Mishra Shailesh Kumar 
Published: April 2022

Background and Objectives:
Blood services are facing a shortage of blood all over the world. Demand for blood is rising day by day and current blood donation is insufficient to meet the demand. This study was planned to assess the myths of college-going students regarding blood donation, address their misconceptions, and raise awareness among college students on the importance of blood donation.

Methods:
The study population comprised 1000 students above the age of 18 years who qualify for blood donation after assessment of suitability to donate blood as per the blood donor questionnaire and consent form of the department.

Results:
Myths and misconceptions were more prevalent among nonblood donor students. The most common reason for not donating blood, as stated by nonblood donor students, was fear of needle pain in 137 (27.4%), followed by being not fit to donate in 134 (26.8%) and the fear of becoming weak in 95 (19%).

Conclusion:
The most common reason comes out to be related to health of the individual donor; almost one in two college-going students (45.8%) fear that either they are not fit enough to donate blood (26.8%) or that they will become weak (19%) after blood donation.
Validity of P-POSSUM in adult cancer surgery (PACS)
Authors: Mukherjee Sudipta , Kedia Ankit , Goswami Jyotsna , Chakraborty Arunangshu 
Published: April 2022

Background and Aims:
Objective prediction of postoperative morbidity and mortality can help clinicians for appropriate resource allocation and counseling of patients and their kin. Among different scoring systems, “Portsmouth- Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity” (P-POSSUM) includes both preoperative and intraoperative parameters for postoperative risk prediction. The aim of this study was to investigate the validity of morbidity prediction by P-POSSUM in patients requiring intensive care after undergoing major surgeries for gastrointestinal and gynecological malignancies.

Material and Methods:
All adult patients (>18 years) undergoing gastrointestinal and gynecological cancer surgeries who were shifted to intensive care unit (ICU) or high dependency unit (HDU) for postoperative care were included and P-POSSUM was measured. Postoperative complications were graded as per Clavien–Dindo (CD) grading and have been compared with predicted complications as per P-POSSUM.

Results:
143 patients were included in the study and the median P-POSSUM score was 35. The mean predicted morbidity was 55.28% (SD 25.54%) and the observed complications were 45.45%, which shows P- POSSUM has over predicted morbidity. At P-POSSUM values 60 and above, the incidence of major complications was 22.22%, compared to 6.25% for the rest (Odds ratio 4.286).

Conclusion:
P-POSSUM is not a reliable predictor of postoperative morbidity for patients undergoing major gynecological and gastrointestinal surgeries for cancer in our institution. But there is a significant incidence of major complications with P- POSSUM morbidity prediction score 60 or higher leading to the need for more stringent assessment and monitoring in that subgroup.
Trends for in-office usage of pharmacological sedation agents in India: A narrative review
Authors: Joshi Sakshi , Gupta Anil , Garg Shalini , Dogra Shikha 
Published: April 2022

Background and Aims:
Conscious sedation plays a significant role in in-office pharmacological behavior management for short-term procedures in children and apprehensive adults. The advantage conscious sedation provides is by improving quality of care provided by decreasing pain and anxiety while maintaining a patent airway and adequate spontaneous ventilation.

Methodology:
Present review was conducted to evaluate recent trends regarding use of in-office pharmacological sedation agents in India. A rigorous search was conducted through five electronic databases namely PubMed, Scopus, Web of Science, Cochrane Database, and CTRI (Clinical Trial Registry – India). The search period was defined to be last 5 years, that is, from 1st January 2014 to 31st July 2019. Terminologies “Conscious Sedation,” “In-office Sedation,” “Midazolam,” “Nitrous Oxide,” “India” were included in the search. The Boolean Operation “OR” and “AND” were applied to combine the terminologies.

Results:
A total of 20 studies were identified following strict inclusion and exclusion criteria. The included studies were evaluated for study design, speciality involved, number of individuals and their age groups, drugs compared along with route and dosage, procedures undertaken, place of study and results. Dental fraternity (13) had more number of trials conducted as compared to medical fraternity (7) in the stimulated period, with South Indian region having maximum trials registered or published.

Conclusion:
Midazolam was observed to the drug of choice for in-office sedation procedures in Indian Scenario. The limitation of study is that the published clinical studies are limited to a few states of India.
El-Ganzouri multivariate risk index based airway management in head and neck cancer patients: A retrospective analysis of 1000 patients in a tertiary care center
Authors: Gupta Raghav , Gupta Nishkarsh , Kumar Vinod , Garg Rakesh , Bharati Sachidanand J. , Mishra Seema , Bhatnagar Sushma 
Published: April 2022

Background and Aims:
Intubation in head and neck carcinoma (HNC) is difficult due to many reasons. Various guidelines recommend strategies for airway management in such anticipated difficult airway cases. However, literature is limited on airway management planning as per the level of difficulty based on airway assessment in these patients. EL-Ganzouri risk index (EGRI) has been proposed to aid in making airway management plan in HNC cases by some authors. This retrospective study was conducted to look at the data related to the pre-anesthetic airway assessment and the airway management plan executed by the anesthesiologists in 1000 patients of HNC in the previous nearly four years in order to determine how the choices made conformed to EGRI scores.

Material and Methods:
Records of all the patients with oral cancer posted for surgery over four years from January 2014 to December 2017 were retrospectively analyzed for preoperative airway assessment using El Ganzouri risk index assessment (EGRI), the intraoperative technique for nasotracheal intubation, airway management plan, and any intraoperative complications.

Results:
The risk of predicted airway difficulty was low (EGRI <4) in 38 patients and was high in the rest. The EGRI score was higher in the FOB group [4-9] as compared to DL [2-3] and VL [1-6].The patients with EGRI >7 were intubated awake and those with EGRI <7 were intubated under general anesthesia (79.8%). Overall, the technique of choice for intubation was fibreoptic bronchoscopy (54%) followed by video laryngoscopy (42.6%).

Conclusion:
The airway management plan used in a tertiary care cancer center conformed to the approach suggested by the multivariate El Ganzouri risk index (EGRI). EGRI appears to be a useful means to ascertain the appropriate strategies for intubation in head and neck cancer patients.
Comparison of effect of etomidate with propofol on hemodynamics during modified electroconvulsive therapy
Authors: Mehta Divya , Palta Sanjeev , Gupta Nitin , Saroa Richa 
Published: April 2022

Background and Aims:
Studies comparing the effect of propofol and etomidate on hemodynamic parameters during electroconvulsive therapy (ECT) have shown ambiguous results. Although some studies observed a larger increase in blood pressure and heart rate during the use of etomidate than propofol in ECT, whereas some studies have shown no difference in hemodynamic parameters with the use of etomidate or propofol. Most of the studies done to compare the hemodynamic effects of etomidate and propofol were limited by small sample size or retrospective in nature. Therefore, we conducted a prospective randomized trial to compare the effects of etomidate and propofol on hemodynamics during ECT.

Material and Methods:
A prospective randomized crossover study was conducted on 30 patients with American Society of Anesthesiologist physical status I and II, between age 18 and 65 years, suffering from a mental disorder as per International Classification of Diseases-10 and requiring bilateral ECT as per clinical decision of consultant psychiatrist. They were randomized to receive both the drugs for their successive ECT sessions and were subjected to evaluation after clubbing together the ECT sessions of propofol or etomidate as anesthetic agent.

Results:
Duration of motor seizures was significantly more in patients receiving etomidate, whereas patients receiving propofol had more stable hemodynamics.

Conclusion:
Though propofol maintains stable hemodynamics during MECT, yet clinical applicability of etomidate outstrips it by a reasonable margin due to its better effect on seizure parameters.
Terror-Related Ocular Trauma in Patients Presenting to a Tertiary Eye Center in the Middle East
Authors: Al-Amry Mohammad , Chaudhry Imtiaz A. , Al-Kahatni Eman , Al-Ghadeer Huda 
Published: April 2022

PURPOSE:
Injuries caused by explosive materials are associated with severe ocular morbidity and visual impairment. This study aims to document the ophthalmic morbidity of terrorist-related severe injuries at a tertiary eye care center in the Middle East and report specific injury patterns.

METHODS:
In a noncomparative, interventional, retrospective case series, the visual outcomes were evaluated of 36 patients treated at a tertiary eye center in the Middle East for terrorist-related injuries from January 2003 to December 2019. Data were collected on age, gender, involved eye, initial examination of ocular injuries, associated systemic injuries, presenting visual acuity, anterior and posterior segment examinations, and the type of injury (open vs. closed globe).

RESULTS:
Among the 36 patients (32 males; average age, 28.1 years), 28 (77.8%) sustained trauma to one eye and 8 (22.2%) to both eyes. Despite multiple surgical procedures (average 3.1 surgeries), all patients suffered a severe visual loss. Final visual acuity of no light perception was recorded in 28 (77.8%) eyes and both eyes of 5 patients (13.9%).

CONCLUSION:
Ophthalmic morbidity from terrorist-related injuries may be devastating, and the vast majority of patients experience a permanent loss of vision.
Violence and Mental Health among Adolescents in South East Nigeria
Authors: Ughasoro Maduka D. , Onukwuli Vivian Ozoemena , Onwujekwe Obinna E. , Uzochukwu Benjamin S. Chudi , Ebenso Bassey , Okoli Chinedu C. , Achor Chizoba F. 
Published: April 2022

Background:
There is a rise in the prevalence of mental illness among adolescents and the impact of violence on this rising trend requires to be evaluated.

Aim:
The aim of the study is to better understand the impact of violence on adolescent's mental health.

Materials and Methods:
The study was a cross-sectional school-based study. Adolescents in the selected schools were interviewed using a structured questionnaire. Information on previous experience of violence, the action is taken, and the effect on them was collected. Data were entered and analyzed using SPSS. The level of significance was at P < 0.05.

Results:
A total of 716 adolescents were studied over a one month period. The prevalence of violence was 87%. About 57.2% of the violence occurred at home, 44.2% was carried out by relatives and 49.2% happened within the past six months. Sexual abuse was 10.2%. Among the adolescents that experienced violence, 58.7% suffered some form of mental illness. There was a significant difference between the action the adolescents took after the violent incident and the action that was considered appropriate for it (P = 0.00001). Female gender (P = 0.042), not living with parents (P = 0.015) and poverty (P = 0.00001) significantly correlate with adolescent violence.

Conclusion:
Violence is high among adolescents and associated with a high prevalence of mental illness. Interventional measures targeted at reducing violence by improving poverty alleviation programs that empower families to carter for their children should be implemented.
Preventive Measures of Vaso-Occlusive Crisis Among Sickle Cell Disease Patients in South-Eastern Nigeria
Authors: Efobi Chilota Chibuife , Ugwu Angela Ogechukwu , Ugwu Ngozi Immaculata , Okoye Helen Chioma , Alo Chihurumnanya 
Published: April 2022

Background:
Vaso-occlusive crisis (VOC) is a feature of sickle cell disease (SCD), an inherited medical condition which is more common in Sub-Saharan Africa especially Nigeria and is saddled with multi-systemic complications. Knowledge and practice of preventive measures of VOC by patients may reduce the risk of morbidity and mortality.

Aim:
The purpose of this manuscript is to determine the knowledge, attitude, and practice of the various preventive measures of VOC by patients and their relationship with their frequency of painful crisis.

Materials and Methods:
A cross-sectional descriptive survey was used. This study was conducted between August, 2018, and February, 2019. Participants were selected consecutively as they came for clinic consultations. Demographic characteristics and the knowledge, attitude, and practice of various preventive measures of VOC were obtained using a structured interviewer-administered questionnaire. The analysis was performed using Statistical Package for the Social Sciences software version 23.0. Descriptive and inferential statistics were used with P < 0.05 which was considered statistically significant. Ethical clearance and informed consent were obtained before the commencement of the study.

Results:
A total of 154 SCD patients participated in the study and were made up of 73 (47.4%) males and 81 (52.6%) females, with a male-to-female ratio of 1: 1.1. Majority of the respondents (76.6%) had good knowledge of preventive measures toward VOC in SCD. This study also found that 59 (38.3%) participants had good practice of preventive measures toward VOC while 95 (61.7%) had fair practice. Majority (68% [40/59]) of those who had good practice of preventive measures were less likely to have more than three crises in a year compared to those who do not practice good preventive measures, though not statistically significant (OR = 2.489, P = 0558) (confidence interval = 0.480 – 0.637).

Conclusion:
Majority of the patients have good knowledge and practice of preventive measures of VOC and this appears to have reduced the frequency of their crisis in a year. Health education for sickle cell patients is an important tool that may reduce morbidity and mortality by reducing the frequency of crisis.
Knowledge of the Glasgow Coma Scale among Physician Interns in a Nigerian Tertiary Health Facility
Authors: Oyemolade Toyin Ayofe , Akinkunmi Mojirade A. , Ogunyileka Oluwakemi Comfort , Arogundade Folawemimo M. , Ehinola Busayo A , Adeleye Amos O 
Published: April 2022

Background:
The Glasgow coma scale (GCS) is the most utilized level of consciousness scale globally. Insufficient working knowledge of the GCS by physicians may contribute to poor outcomes in patients with altered levels of consciousness.

Aim:
This study aims to assess the knowledge of the GCS among the physician interns, also known as house officers, in a rural tertiary health facility in Nigeria.

Materials and Methods:
This was a questionnaire-based survey among physician interns in a rural tertiary hospital in Nigeria.

Results:
All the 77 respondents graduated from medical school within 2 years of the study. Seventy-two (93.5%) of the participants had been actively involved in the management of patients at the hospital's accident and emergency department within a month before the study, while 71.4% had been involved in emergency care outside the accident and emergency department within a month prior. Seventy-five (97.4%) conceded to having received didactic lectures on the GCS in the course of their medical training. About three-quarters (74.03%) of the respondents correctly defined GCS as GCS; about 85.7% were able to correctly identify all the clinical variables of the GCS, while only 15.6% could correctly describe and score all the parameters of the grading scale. The eye-opening response was the most correctly remembered (64.9%), followed by the verbal response (42.9%), while the motor response was remembered by 29.9% of the respondents (P = 0.04). Only 36 (46.8%) participants were aware of any subsequent modification to the original GCS score.

Conclusion:
The working knowledge of GCS is poor among physician interns surveyed in this study. The clinical variable of the GCS with the highest number of items, the motor response, was the least correctly remembered.