25 10 255 https://repository.horizon.ac.id/files/original/9b32c52070699eb90f79d0037f219881.pdf b2ad0c6167f541f705692800396d984d Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Volume 18 Issue 1 2025 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Percutaneous closure of a traumatic ventricular septal defect: a case report and literature review Subject The topic of the resource Penetrating cardiac trauma, Ventricular septal defect, Emergency thoracotomy, Percutaneous closure, Echocardiography Description An account of the resource Abstract Background Penetrating cardiac trauma is an entity with high pre and intrahospital mortality due to complications such as cardiac tamponade and massive hemothorax. A ventricular septal defect (VSD) occurs in 1–5% of cases and can present early or late. The management strategy for VSD resulting from penetrating cardiac trauma is uncertain. Case presentation A 19-year-old man was admitted in cardiorespiratory arrest after a precordial stab wound. Cardiopulmonary resuscitation was initiated achieving return of spontaneous circulation. eFAST evaluation revealed cardiac tamponade, he was taken to emergency left thoracotomy finding a perforation of the free wall of the left ventricle and a tear of the upper lobe of the left lung that were sutured. The patient was discharged and six days later was readmitted with fever and dyspnea. During treatment for a surgical site infection a new-onset pansystolic murmur was found: A transthoracic echocardiogram revealed a 13-mm VSD with left-to-right shunt. A multidisciplinary team recommended percutaneous closure of the defect which was successfully performed without complications. Conclusions Traumatic VSD is a rare complication of penetrating cardiac trauma. A thorough clinical and echocardiographic evaluation is essential for its diagnosis and characterization. Symptomatic septal defects, those 10 mm or larger, with Qp: Qs greater than 1.5, or causing complications such as pulmonary hypertension or valvular involvement, are usually closed to prevent progression of heart failure. Management of traumatic VSD has traditionally been surgical. However, a percutaneous intervention is a viable alternative in selected stable patients. Unlike ischemic VSD, early intervention after patient stabilization generally yields favorable outcomes. Keywords Penetrating cardiac trauma, Ventricular septal defect, Emergency thoracotomy, Percutaneous closure, Echocardiography Creator An entity primarily responsible for making the resource Camilo Andres Calderon-Miranda1,2*, Maria Juliana Reyes-Cardona3 , Gabriel Roberto Lopez-Mora2,4, Fernando Andrés Guerrero-Pinedo2,5, Jairo Sanchez-Blanco1,2, Carlos Enrique Vesga-Reyes1,2, Jorge Alexander Zambrano-Franco1,2 and Pastor Olaya1,2 Source A related resource from which the described resource is derived Abstract Background Penetrating cardiac trauma is an entity with high pre and intrahospital mortality due to complications such as cardiac tamponade and massive hemothorax. A ventricular septal defect (VSD) occurs in 1–5% of cases and can present early or late. The management strategy for VSD resulting from penetrating cardiac trauma is uncertain. Case presentation A 19-year-old man was admitted in cardiorespiratory arrest after a precordial stab wound. Cardiopulmonary resuscitation was initiated achieving return of spontaneous circulation. eFAST evaluation revealed cardiac tamponade, he was taken to emergency left thoracotomy finding a perforation of the free wall of the left ventricle and a tear of the upper lobe of the left lung that were sutured. The patient was discharged and six days later was readmitted with fever and dyspnea. During treatment for a surgical site infection a new-onset pansystolic murmur was found: A transthoracic echocardiogram revealed a 13-mm VSD with left-to-right shunt. A multidisciplinary team recommended percutaneous closure of the defect which was successfully performed without complications. Conclusions Traumatic VSD is a rare complication of penetrating cardiac trauma. A thorough clinical and echocardiographic evaluation is essential for its diagnosis and characterization. Symptomatic septal defects, those 10 mm or larger, with Qp: Qs greater than 1.5, or causing complications such as pulmonary hypertension or valvular involvement, are usually closed to prevent progression of heart failure. Management of traumatic VSD has traditionally been surgical. However, a percutaneous intervention is a viable alternative in selected stable patients. Unlike ischemic VSD, early intervention after patient stabilization generally yields favorable outcomes. Keywords Penetrating cardiac trauma, Ventricular septal defect, Emergency thoracotomy, Percutaneous closure, Echocardiography Date A point or period of time associated with an event in the lifecycle of the resource 2025 Contributor An entity responsible for making contributions to the resource Peri Irawan Format The file format, physical medium, or dimensions of the resource pdf Language A language of the resource english Type The nature or genre of the resource text Penetrating cardiac trauma, Ventricular septal defect, Emergency thoracotomy, Percutaneous closure, Echocardiography https://repository.horizon.ac.id/files/original/ba5c6c1d053baffeb2ff480f76fc024f.pdf ff512aa4832ba5c2a10624dcf52db80b Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Volume 18 Issue 1 2025 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Lack of standardization in the nomenclature of dating strokes or the desperate search for a common language Subject The topic of the resource reading radiology Description An account of the resource Introduction When reading radiology reports from various medical institutions across Europe, a pronounced lack of consen- sus emerges regarding the definition of stroke and infarc- tion stages. This ambiguity persists despite significant advancements in stroke management and the develop- ment of novel time frames for mechanical thrombectomy procedures. Terms such as “hyperacute,” “acute”, and “subacute” are employed in varying and often overlap- ping contexts, leading to confusion among practitioners. Consequently, many thrombectomy research studies have resorted to using the time of symptom onset in con- junction with the Alberta Stroke Program Early CT Score (ASPECTS) as a proxy to delineate the timing and nature of stroke interventions [1]. Methods We have summarized the terminology com- monly used in our neuroradiological clinical practice regarding the state of strokes / infarcts in a graphic. It could serve as a proposal for standardization. Creator An entity primarily responsible for making the resource Eya Khadhraoui1* and Sebastian Johannes Müller1 Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-024-00803-1 Date A point or period of time associated with an event in the lifecycle of the resource 2025 Contributor An entity responsible for making contributions to the resource Peri Irawan Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource ENGLISH Type The nature or genre of the resource TEXT eading radiology https://repository.horizon.ac.id/files/original/2e8161ec7209dc6cfee38933bc0457af.pdf 08b3eaa9e1aa4706c8798254cf9d76aa Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Volume 18 Issue 1 2025 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource A novel tool for assessing pediatric emergency care in low- and middle-income countries: a pilot study Subject The topic of the resource Pediatric emergency medicine, Pediatric readiness, Low-income countries, Middle-income countries, Health resources / supply and distribution Description An account of the resource Abstract Background Globally, most children seek emergency care at general rather than specialized pediatric emergency departments. There remains significant variation in the provision of pediatric emergency care, particularly in resource- constrained settings. The objective of this study is to pilot a self-assessment tool to evaluate pediatric emergency care capabilities in low- and middle-income country (LMIC) hospitals on the African Continent. Methods This was a prospective cross-sectional descriptive study using a convenience sample of sub-Saharan African hospitals. The assessment tool was developed by operationalizing the technical contents of existing stand- ards and guidelines from international bodies including the World Health Organization and International Federa- tion of Emergency Medicine. The pilot was conducted at emergency departments located across different regions on the African continent. Descriptive statistics were used to evaluate different domains of pediatric emergency care capabilities including pediatric triage, protocols, staffing, training, equipment, consumables, and medicines. Results Sixteen hospitals with emergency departments completed the assessment tool (participation rate of 76%). The hospitals were in nine different countries across four regions of sub-Saharan Africa. National/academic hospitals comprised 56.3% of the participating hospitals. The majority, 44%, of these hospitals saw pediatric patient volumes of 2,000–4,999 patients per year. Dedicated pediatric triage spaces and resuscitation spaces were available at 37.5% and 56.3%, respectively. Formal pediatric resuscitation guidelines were used at 62.5%. Doctors on the self-assessment teams came from primarily pediatrics and general practitioner training backgrounds (both 68.8%). Basic respiratory and airway support equipment (e.g. oxygen, bag-valve mask devices) were available in all participating hospitals, whereas advanced airway equipment (e.g. pediatric intubation equipment) was available in 37.5% of hospitals. Most medicines from the World Health Organization Essential Medicines list were available at participating hospitals. Conclusions To date, this is the first assessment tool dedicated to the comprehensive evaluation of pediatric emergency care in LMICs. This pilot provides a first approach to evaluate pediatric emergency healthcare capabilities in the hospital setting with future directions to improve the tool based on qualitative feedback. Keywords Pediatric emergency medicine, Pediatric readiness, Low-income countries, Middle-income countries, Health resources / supply and distribution Creator An entity primarily responsible for making the resource Sonia Y. Jarrett1*, Andrew Redfern2 , Joyce Li1 , Camilo E. Gutierrez3 , Priyanka Patel4 , Olurotimi Akinola5 and Michelle L. Niescierenko1 Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-024-00802-2 Date A point or period of time associated with an event in the lifecycle of the resource 2025 Contributor An entity responsible for making contributions to the resource Peri Irawan Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource ENGLISH Type The nature or genre of the resource TEXT Pediatric emergency medicine, Pediatric readiness, Low-income countries, Middle-income countries, https://repository.horizon.ac.id/files/original/f48b11627c19ff2e2fc924af1e2bfc6c.pdf 2817cb95cae5ccf66cb77b1c0be60702 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Volume 18 Issue 1 2025 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource A prospective, longitudinal, comparative analysis of the World Health Organization / International Committee of the Red Cross Basic Emergency Care Course on emergency medicine knowledge and confidence among recent medical school graduates Subject The topic of the resource Emergency medicine education, Training, Emergency care Description An account of the resource Abstract Background The Basic Emergency Care (BEC) course was created by the World Health Organization (WHO) in col- laboration with the International Committee of the Red Cross (ICRC) and the International Federation for Emergency Medicine (IFEM) to train frontline providers in low-resource settings. This study aims to evaluate long-term retention and maintenance of emergency care knowledge and confidence among University of Nairobi School of Medicine graduates after completing the BEC course. Methods This longitudinal, prospective, comparative study was conducted with recent graduates of the Univer- sity of Nairobi School of Medicine from October 2021 to May 2023. Participants’ retention of emergency medicine knowledge was assessed comparing a pre/post course test and a multiple-choice examination 12 to 18 months after completing the BEC course. A survey assessed participants’ confidence in managing patients with emergencies 12–18 months after completing the BEC course using a 4-point Likert scale. These results were compared to a control group of recent University of Nairobi School of Medicine graduates who did not take the BEC course. Results The follow-up test scores were lower than the immediate post-course test scores, which suggests some knowledge loss over time. Compared to the control group, the BEC participants had higher test scores during the fol- low-up period although the difference was not significant. There was no difference between most of the immedi- ate post-course and follow-up survey responses. On follow-up evaluation, BEC participants reported a significant decrease in confidence in understanding emergency drugs and managing an obstructed airway and a patient requir- ing immobilization. However, compared to the control group, BEC participants had significantly higher self-reported confidence in most areas assessed by the survey. Creator An entity primarily responsible for making the resource Nichole Michaeli1 , Andrew Beck2 , Giovanna De Luca2 , Mary Gitau3 , Derek Lubetkin4 , Derick Ochieng5 , Grace W. Wanjiku2 and Justin G. Myers6* Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-024-00797-w Date A point or period of time associated with an event in the lifecycle of the resource 2025 Contributor An entity responsible for making contributions to the resource Peri Irawan Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource ENGLISH Type The nature or genre of the resource TEXT Emergency medicine education, Training, Emergency care https://repository.horizon.ac.id/files/original/4ae7b895fc80fd013720926b78b453c3.pdf 1d67dadab1d64a0da3549a65f05d64e8 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Volume 18 Issue 1 2025 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Clinical and demographic profiling of snakebite envenomation in a tertiary care centre in northern India Subject The topic of the resource Snake bite, Hemotoxic, Neurotoxic, ASV, Plasmapheresis, HBOT Description An account of the resource Abstract Background Snake bites are a major cause of emergency visits in tropical countries like India, with actual mortality and morbidity likely higher due to underreporting. The aim of the study was to analyze the clinical and demographic profiles of snake bites at the Department of Emergency Medicine, AIIMS Rishikesh, over two years (July 2021 to July 2023). Methods Patients aged over 18 with witnessed or suspected snake bites were included. Data on demographics, clinical history, laboratory parameters, treatment, and outcomes were collected. Results Most patients were male (68.3%) and aged 31–50 years (35.6%). Farmers made up 57.4% of the cohort. Bites occurred mostly in the evening (46.5%) and during the monsoon (71.3%). Symptoms varied: 48.5% were asymptomatic, 31.7% had hemotoxic symptoms, and 15.8% experienced neurotoxic symptoms, including ptosis. Hemotoxic bites frequently involved bleeding at the bite site (93.8%) and gum bleeding (46.9%). Local complications were noted in 7.9% of cases. Neuroparalytic bites required ventilatory support in 62.5%. Blood products were administered to 31% of patients with hemotoxic bites, hemodialysis to 19%, and plasmapheresis and hyperbaric oxygen therapy to 6.3%. Out of the 69 symptomatic patients (68.3%) who received anti-snake venom (ASV), 28 (40.6%) patients developed adverse reactions. Conclusion This study provides a detailed analysis of suspected snakebites in Uttarakhand and surrounding areas, highlighting the importance of early recognition, prompt treatment, and timely referral to prevent fatalities. The administration of anti-snake venom (ASV) is identified as the most critical intervention, though lack of awareness in rural areas complicates management. The study calls for targeted public health campaigns to educate communities about early snakebite recognition and the role of ASV. It also stresses the need for region-specific protocols and improved healthcare access, emphasizing the importance of referral systems for advanced interventions like hemodialysis and intubation. Overall, the study advocates for enhanced public awareness and healthcare infrastructure to reduce snakebite incidence and mortality in rural populations. Keywords Snake bite, Hemotoxic, Neurotoxic, ASV, Plasmapheresis, HBOT Creator An entity primarily responsible for making the resource Parvathy Sasidharan1 , Nidhi Kaeley1*, Prakash Mahala1 , Jewel Rani Jose1 , Takshak Shankar1 , Silpa Santhalingan2 , Ankit Sharma1 , Balwant Kumar1 , Mallapu Ajay Kumar1 and Minakshi Dhar1 Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-024-00796-x Date A point or period of time associated with an event in the lifecycle of the resource 2025 Contributor An entity responsible for making contributions to the resource Peri Irawan Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource ENGLISH Type The nature or genre of the resource TEXT Snake bite, Hemotoxic, Neurotoxic, ASV, Plasmapheresis, HBOT https://repository.horizon.ac.id/files/original/338b13d953a24f49a0595516b633f798.pdf 5c488a563dc7213271c74da591507415 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Volume 18 Issue 1 2025 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource From thrombosis to tamponade: unveiling severe pericardial effusion in a misdiagnosis case Subject The topic of the resource Pericardial effusion, Tamponade, Thromboembolism, Misdiagnosis, Case report Description An account of the resource Abstract Background Anticoagulants increase the risk of cardiac tamponade in patients with pericardial effusion (PE). Therefore, inappropriate administration of them in the presence of PE can lead to a catastrophic outcome. This study presents a patient with a provisional misdiagnosis of venous thromboembolism (VTE). Case Presentation An 83-year-old Iranian female was transferred to the emergency department of a tertiary cardiology hospital complaining of neck swelling concomitant with chest pain and dyspnea. The patient had been diagnosed with jugular vein thrombosis in another local center, and since the chief complaint was neck swelling, she underwent Doppler sonography, and the diagnosis was confirmed. Subsequently, the treatment with unfractionated heparin was started. After 5 h, considering the worsening of symptoms with the suspicious diagnosis of COVID-19 based on her symptoms and laboratory data, a chest computed tomography scan was requested, which showed a massive PE. Subsequently, transthoracic echocardiography confirmed the diagnosis. The patient was immediately transferred to the operating room and underwent pericardiotomy. The post-surgery period was uneventful, and she was discharged 5 days later. Conclusion Patients with viral infections, specifically COVID-19, are at risk of undiagnosed severe pericardial effusions. Venous stasis in the jugular veins due to PE can mimic jugular vein thromboembolism, causing a wrong diagnosis. Since treating thrombosis can exacerbate tamponade to hemodynamic instability and collapse, sufficient investigation before starting anticoagulants is necessary. Clinical key message Distinguishing VTE from PE is not always straightforward. Therefore, it is important to ensure physicians have reached an appropriate level of certainty about their diagnosis by performing precise diagnostics before using anticoagulants. Mismanagement with anti-thrombotics can result in catastrophic consequences. Therefore, taking an accurate history, performing a precise physical examination, and using rapid and available diagnostic modalities can avoid delays in definitive management. Keywords Pericardial effusion, Tamponade, Thromboembolism, Misdiagnosis, Case report Creator An entity primarily responsible for making the resource Amin Bagheri1,2, Morteza Sheikhi Nooshabadi1,3, Pouya Ebrahimi2 , Roozbeh Nazari1 , Pedram Ramezani4 and Toktam Alirezaei5* Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-024-00794-z Date A point or period of time associated with an event in the lifecycle of the resource 2025 Contributor An entity responsible for making contributions to the resource Peri Irawan Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource ENGLISH Type The nature or genre of the resource TEXT Pericardial effusion, Tamponade, Thromboembolism, Misdiagnosis, Case report https://repository.horizon.ac.id/files/original/18528c7424ef9ea4247d71be5cd034ea.pdf 62b60c5a93f9078e9dd98eaea7c13dc8 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Volume 18 Issue 1 2025 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Seizure aggravation by ampicillin/sulbactam in an elderly patient with status epilepticus Subject The topic of the resource Seizure aggravation, Antibiotic-associated encephalopathy, Ampicillin/sulbactam, Status epilepticus, Continuous electroencephalogram monitoring, Critical care EEG, Density spectral array Description An account of the resource Abstract Background Ampicillin/sulbactam (ABPC/ SBT) is one of the most common β-lactam antibiotics for patients with status epilepticus complicated with aspiration pneumonia. It is known that β-lactam antibiotics such as penicillin aggravate epileptic seizures or status epilepticus. Here, we investigated whether ABPC/SBT aggravates seizures using electroencephalography (EEG) monitoring. Case presentation An 84-year-old male with status epilepticus who presented with a new onset of clonic seizures mainly of his left side and underwent continuous video EEG was analyzed. He had been suffering from severe ulcerative colitis and infectious enteritis, delirium, atrial fibrillation and deep venous thrombosis. His cerebrospinal fluid analysis was unremarkable. Four days after starting levetiracetam, he had a cluster of seizures with impaired consciousness, consistent with status epilepticus. We started fosphenytoin and phenobarbital. We also administered ABPC/SBT twice a day, ten times in total, for aspiration pneumonia while monitoring the patient. He died twelve days after the seizure onset. We analyzed the number and duration of seizures in two hours before and after starting ABPC/SBT for each administration using EEG with trendgraph. After administration of ABPC/SBT, number of seizures significantly increased from 3.2±4.7 to 7.3±9.7 (mean±SD, p=0.047, Wilcoxson’s signed-rank test) per 2 h. Duration of seizures showed a tendency of increase from 199±275 to 406±536 s (p=0.079). Conclusions In this elderly male patient with status epilepticus, administration of ABPC/SBT aggravated his seizures. EEG monitoring using a trendgraph is useful for evaluation of seizure severity and for analysis of causative factors. Keywords Seizure aggravation, Antibiotic-associated encephalopathy, Ampicillin/sulbactam, Status epilepticus, Continuous electroencephalogram monitoring, Critical care EEG, Density spectral array Creator An entity primarily responsible for making the resource Kaoru Obata1,2, Masako Kinoshita3* , Akiyo Shinde1 and Toshihiko Suenaga1 Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-024-00793-0 Date A point or period of time associated with an event in the lifecycle of the resource 2025 Contributor An entity responsible for making contributions to the resource Peri Irawan Format The file format, physical medium, or dimensions of the resource PDF Language A language of the resource ENGLISH Type The nature or genre of the resource TEXT Seizure aggravation, Antibiotic-associated encephalopathy, Ampicillin/sulbactam, Status epilepticus, https://repository.horizon.ac.id/files/original/256ea8b2dead13d9b5b3595199f04475.pdf 14f7ae385a32a450e0a52469113f6077 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Volume 18 Issue 1 2025 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Coexistence of adenomyomatosis in a left- sided gallbladder: a case report Subject The topic of the resource Left-sided gallbladder, Adenomyomatosis, Congenital anomaly, Cholecystectomy, Hepatocellular carcinoma Description An account of the resource Abstract Introduction The coexistence of gallbladder (LSG) and adenomyomatosis (ADM) is extremely uncommon presenting a novel clinical dilemma that has not been previously documented. LSG refers to a anomaly where the gallbladder is situated to the left of the round ligament deviating from its usual position. This anomaly is rare, with reported occurrences ranging between 0.04% and 1.1%. Identifying LSG before surgery poses challenges. It is often discovered incidentally during procedures necessitating surgical expertise to safely manage anatomical variations. Case presentation We report an old man with a history of hepatitis C, carcinoma and liver cirrhosis complained of sudden epigastric pain. A CT scan revealed the presence of an LSG, which’s a congenital anomaly. During the cholecystectomy procedure surgeons encountered variations and observed the existence of ADM complicating the operation. The patient recovered smoothly post surgery. Discussion This case shows how complicated it can be to diagnose and treat the combination of LSG and ADM. Identifying these conditions before surgery is tough so surgeons often have to adjust their approach during the operation. Although laparoscopic cholecystectomy for LSG is usually safe it requires care to avoid problems like bile duct injuries. For patients at risk a conservative treatment approach might be better. In cases where surgery is necessary surgeons need to adapt their techniques to address the unique anatomical issues. Conclusion The combination of LSG and ADM in a setting poses an intricate challenge. Surgeons need to be ready to recognize and address these abnormalities effectively for the well being of the patient and favorable results. This particular case highlights the importance of staying alert and flexible during surgery when dealing with gallbladder variations. Keywords Left-sided gallbladder, Adenomyomatosis, Congenital anomaly, Cholecystectomy, Hepatocellular carcinoma Creator An entity primarily responsible for making the resource Mohamed Tolba1 , Hadeer Hafez2* and John Adel3 Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-024-00785-0 Date A point or period of time associated with an event in the lifecycle of the resource 2025 Contributor An entity responsible for making contributions to the resource Peri Irawan Format The file format, physical medium, or dimensions of the resource pdf Language A language of the resource english Type The nature or genre of the resource text Left-sided gallbladder, Adenomyomatosis, Congenital anomaly, Cholecystectomy, Hepatocellular carcinoma https://repository.horizon.ac.id/files/original/c26685388a2290886c3622fdd6528c8c.pdf c843988ffd042dace87f665a4640e76e Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Volume 18 Issue 1 2025 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Emergency department crowding in the Netherlands; evaluation of a real-time ambulance diversion dashboard Subject The topic of the resource Crowding, Emergency Service, Ambulance diversions, Emergency department, Emergency room, Humans, The Netherlands Description An account of the resource Abstract Background Emergency department (ED) crowding is a growing concern worldwide and associated with negative effects. In 2013, 68% of Dutch ED-managers experienced crowding on several days of the week. This resulted into the introduction in phases of an ambulance diversion dashboard, in order to influence ED input. Increasing numbers of Dutch EDs have implemented this dashboard, visualizing regional ambulance diversions by means of a traffic light. Methods This is a descriptive study of a nationwide online survey of Dutch EDs, conducted between January and October 2023. It included both qualitative and quantitative questions. The outcomes and analysis are derived from descriptive data of respondents’ experience of crowding as well as their usage and perceived effectiveness of the ambulance diversions dashboard. Results At the time of the survey, 62 of 82 Dutch EDs (75.6%) actually used the dashboard, of which 56 EDs responded (90.3% response rate). 69.7% Of ED managers experienced ED crowding more than three times a week. Of the respondents using the dashboard, 52.8% reported it only occasionally alleviates ED inflow. The purported reasons are the limited number of patients affected by the red light (ambulance diversion) and the presence of regional crowding. The effects of the orange light (impending ambulance diversion) on ED input differ greatly among hospitals, mostly due to their own internal agreements. In accordance, many respondents (53.6%) expressed dissatisfaction with the resources available to them to alleviate crowding. Conclusion After conducting a national survey, ED crowding is reported as a persisting nationwide problem with its prevalence largely unchanged since the introduction of the ambulance diversion dashboard. Most hospitals reported having insufficient resources to alleviate it. The effects of the ambulance diversion dashboard to decrease crowding are apparently limited because it affects a small portion of total ED presentations and because of the influence of regional crowding. The main function of the orange light is to increase ED throughput and output rather than reducing ED input. Keywords Crowding, Emergency Service, Ambulance diversions, Emergency department, Emergency room, Humans, The Netherlands Creator An entity primarily responsible for making the resource E. C. M. Baan-Kooman1*, S. Mol1 , M. C. van der Linden2 , M. I. Gaakeer3 and V. A. de Ridder4 Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-024-00784-1 Date A point or period of time associated with an event in the lifecycle of the resource 2025 Contributor An entity responsible for making contributions to the resource Peri Irawan Format The file format, physical medium, or dimensions of the resource pdf Language A language of the resource english Type The nature or genre of the resource text https://repository.horizon.ac.id/files/original/c7355f2a7556ccd339abc6a53bf4e97b.pdf 31b9ba42d8d5e1b10b66d206e50d9118 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Volume 18 Issue 1 2025 Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Management of acute ischemic stroke in the emergency department: optimizing the brain Subject The topic of the resource Acute ischemic stroke, Blood pressure management, Thrombolysis Description An account of the resource Abstract Acute ischemic stroke is a devastating condition that afflicts more than 12 million people every year. Globally, stroke is the 2nd leading cause of death and 3rd leading cause of disability worldwide. While not all patients can avail them- selves of existing acute therapies, all patients can benefit from brain optimization measures. This paper details the 12 steps in the management of acute ischemic stroke in the emergency department. Keywords Acute ischemic stroke, Blood pressure management, Thrombolysis Creator An entity primarily responsible for making the resource Latha Ganti1,2* Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-024-00780-5 Date A point or period of time associated with an event in the lifecycle of the resource 2025 Contributor An entity responsible for making contributions to the resource Peri Irawan Format The file format, physical medium, or dimensions of the resource pdf Language A language of the resource english Type The nature or genre of the resource text Acute ischemic stroke, Blood pressure management, Thrombolysis