Dear Editor, We are writing to address the potential risk of perioperative platelet transfusion on the spread of monkeypox, with a particular emphasis on the prevalence of donated blood transfusions and the inadequate blood safety infrastructure in Asia's poorest nations. The safety of blood transfusion procedures in the area is called into question in light of the recent instance in Thailand of a healthy blood donor who was discovered to have given blood tainted with the monkeypox virus. In a recent Asian article, a 22-year-old guy who gave blood at the National Blood Center in Bangkok was found to have the monkeypox virus upon subsequent testing (DOI: 10.3201/eid3003.231539). A platelet concentrate from the tainted donation was given to an 11-year-old female recipient who was also receiving treatment for dengue infection, even though the tainted donation was quickly identified and all blood components derived from the donor were subsequently recalled. In the problematic scenario, 1,606,743 blood donors nationwide gave blood in 2023 (https://www.thairath.co.th/scoop/infographic/2758077). One case of monkeypox-contaminated blood has already been used for transfusions (DOI: 10.3201/eid3003.231539). We can use the following calculation to determine the risk of transfusion of donated blood contaminated with monkeypox: Risk is calculated as follows: total donations / number of contaminated cases. We may enter these numbers into the algorithm because there was only 1 instance of monkeypox contamination out of 1,606,743 blood donations: 1 / 1,606,743 = 0.000000623 is the risk. As a result, there is a 0.0000623% chance that donated blood contaminated with monkeypox will be transfused. This event brings to light the possible dangers of using donated blood transfusions in underdeveloped nations, where blood safety regulations might not be as strong as they are in wealthy nations. Transfusion-transmitted diseases can emerge from inadequate screening procedures and scarce resources for checking given blood for infectious organisms like the monkeypox virus, which poses a serious risk to patient safety. The potential of viral infections spreading through tainted blood products must be taken into account in the setting of clinical surgery, when patients frequently need blood transfusions to control perioperative bleeding.[1] In environments where resources may be scarce, surgeons and other healthcare professionals need to exercise extra caution to guarantee the security of blood transfusions by strictly adhering to screening and testing regulations. To sum up, this instance highlights the necessity of having a strong blood safety system in place to guard against illnesses spread by transfusions in underdeveloped nations. To guarantee the safety of blood products used in clinical operations, healthcare authorities and legislators must place a high priority on investments in blood screening and testing technologies. We can protect patient health and lower the possibility of dangerous agents like the monkeypox virus spreading through blood transfusions by fortifying blood safety procedures.[2]

Sharma, Girish; Topno, Noor; Aggarwal, Swati; Ohri, Gunvi; Anand, Madhur Author Information

Department of General Surgery, Kasturba Medical College, Manipal, Udupi, Karnataka, India Department of Surgical Gastroenterology, Kasturba Medical College, Manipal, Udupi, Karnataka, India Department of Surgical Gastroenterology, Kasturba Medical College, Manipal, Udupi, Karnataka, India Corresponding Author – Dr. Sourodip Mukharjee, Department of General Surgery, Kasturba Medical College, Manipal, Udupi, Karnataka, India; [email protected] This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Abstract Background Stress-induced hyperglycemia (SIH) is commonly observed in patients with trauma and is associated with increased morbidity and mortality. The segmented neutrophil-to-monocyte ratio (SeMo) serves as a biomarker of inflammation and potentially reflects the severity of the stress response to trauma. This study investigated the relationships between SIH, dynamic changes in SeMo, and patient outcomes in a trauma intensive care unit (ICU). Materials and Methods A retrospective analysis was conducted using data from adult patients with trauma admitted to a level I trauma center in Southern Taiwan over 13 years. Patients were divided into two groups based on the presence of SIH or nondiabetic normoglycemia (NDN). The dynamic SeMo was calculated as the difference in the SeMo from admission to 48–72 hours after admission. Outcomes were compared using descriptive statistics, chi-square tests, and Student’s t tests. Results Of the 1,030 included patients, those with SIH had a significantly higher SeMo (20.3 vs 15.2, P = .001) and a greater change in dynamic SeMo (1.2 vs −4.0, P = .017) than those with NDN. Among patients with SIH, the deceased group had a higher SeMo (26.4 vs 18.4, P = .022), but there was no difference in dynamic SeMo among the survivors. In the overall cohort and the NDN subgroups, dynamic SeMo was not associated with mortality. However, factors such as older age, lower Glasgow Coma Scale score, higher Injury Severity Score, and presence of end-stage renal disease were more strongly associated with increased mortality. Conclusions In patients with trauma in ICU, SIH was linked to an increased SeMo and greater changes in dynamic SeMo; however, these changes did not directly predict mortality. It is important to note that an elevated SeMo may be observed in patients with SIH, but not in patients with NDN. This finding should be considered to avoid unnecessary therapies.

Division of Endodontics, Department of Oral Biological & Medical Sciences Faculty of Dentistry, University of British Columbia Vancouver, Canada Conflicts of interest statement: The authors have no conflicts of interest relevant to this article to declare. ∗Corresponding author. Division of Endodontics, Department of Oral Biological & Medical Sciences, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, V6T 1Z3, Canada. Email address: [email protected] (Y. Shen) This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

1 Private Academic Consultant, Bangkok Thailand 2 Adjunct professor, Joesph Ayobabalola University, Ikeji-Arakeji, Nigeria; Adjunct professor, Chandigarh University, Punjab, India Correspondence: Pathum Sookaromdee, Private Academic Consultant, Bangkok Thailand. Email: [email protected] Acknowledgement: none Conflict of interest: none Funding: none Authors' contribution: PS 50 % ideas, writing, analyzing, approval for submissionVW 50 % ideas, supervision, approval for submission This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

1 Obstetrics and Gynecology Department - Fayoum General Hospital – Ministry of health – Fayoum – Egypt 2 General surgery department - Umm-Elmesreen General hospital - Ministry of health – Giza – Egypt Corresponding Author :-Mostafa Maged Ali, Obstetrics and Gynecology Department - Fayoum General Hospital – Ministry of health – Fayoum – Egypt. E-mail :[email protected]. ORCID-ID for corresponding author: (0009-0007-9657-7574). This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Abstract Background Over half of the patients who underwent the Partington procedure for painful chronic pancreatitis developed recurrent pain attacks. This occurs because the proximal ducts at the head of the pancreas, often containing stones, are left undrained. To overcome this pitfall, an extended Partington procedure is recommended. The aim of this study was to assess our 1-year follow-up results of the extended Partington procedure in patients with painful chronic pancreatitis. Materials and Methods This prospective study comprises patients undergoing extended Partington procedures who were followed for at least 1 year. Data were collected preoperatively and postoperatively in a fixed-interval fashion at 3 months, 6 months, and 1 year. Results Thirty-one patients underwent assessment. At 1-year follow-up, effective and complete pain relief was achieved in 81% and 55% of patients, respectively. The Izbicki pain score decreased significantly; the median dropped from 47.5 to 4.4. The quality of life using SF-12 physical and mental component summary improved significantly; the medians increased from 41.7 to 93.8, and 47.5 to 86.7, respectively. Endocrine function remained stable. Exocrine insufficiency developed in most patients as a natural progression of chronic pancreatitis. Two patients had complications directly related to surgical procedures (6%). No early postoperative deaths occurred. Conclusions Extended Partington procedure for chronic pancreatitis results in excellent pain relief and quality of life improvement, with a low morbidity rate, and does not worsen pancreatic function. It should replace the original Partington procedure in treating painful chronic pancreatitis.