1 10 43 https://repository.horizon.ac.id/files/original/84b53063d3b11878c7aaeb9f356a3778.pdf a8ce838f956ade644855b624f7b1710a 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 19 Issue 1 2026 Contributor An entity responsible for making contributions to the resource PERI IRAWAN 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 Survival after multiple in-hospital cardiac arrests due to severe amitriptyline poisoning– a case report Subject The topic of the resource Severe amitriptyline toxicity, Multiple cardiac arrest, ACLS, Refractory arrhythmias, Sodium bicarbonate Description An account of the resource Abstract Background Amitriptyline, a classic tricyclic antidepressant, can produce toxic effects ranging from mild antimuscarinic symptoms to severe cardiotoxicity due to sodium channel blockade. In severe cases, toxicity may rapidly progress to cardiac arrest if not promptly recognized and managed. Case presentation We present a 25-year-old man who attempted suicide by ingesting 3.25 g of amitriptyline. He developed two episodes of cardiac arrest and recurrent life-threatening arrhythmias but was resuscitated and later discharged without neurological deficits. Management included aggressive supportive care, administration of sodium bicarbonate as the main antidotal therapy, and prolonged resuscitative efforts in the intensive care unit. Conclusion This case highlights that survival with good neurological outcome is possible even after multiple toxin-induced cardiac arrests when timely and persistent resuscitative measures are undertaken. It emphasizes the importance of early recognition of tricyclic antidepressant toxicity, prompt initiation of specific therapy, and preparedness for cardiac complications—particularly in low-resource settings. In addition, this report draws attention to the public health concern related to the accessibility and misuse of tricyclic antidepressants. Keywords Severe amitriptyline toxicity, Multiple cardiac arrest, ACLS, Refractory arrhythmias, Sodium bicarbonate Creator An entity primarily responsible for making the resource Amanuel Dagabas Wakoya1* , Tadesse G. Asenabeto1 , Hawi D. Moti1 , Negash B. Bayu1 , Fenta Wondimneh2 , Abebe D. Ayinalem1 , Alemu B. Mesekere1 , Ayto A. Negash3 and Tiliksew A. Tesfaw1 Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-025-01109-6 Date A point or period of time associated with an event in the lifecycle of the resource 2026 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 englsih Type The nature or genre of the resource text Severe amitriptyline toxicity, Multiple cardiac arrest, ACLS, Refractory arrhythmias, Sodium bicarbonate https://repository.horizon.ac.id/files/original/ec0582f1ff22a7f0cb2d2a01f90d3ca1.pdf ac5f526d2285c463ab5a98dbae14c24e 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 19 Issue 1 2026 Contributor An entity responsible for making contributions to the resource PERI IRAWAN 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 direct qualitative content analysis on the design, implementation, and evaluation of prehospital earthquake exercises aligned with the HSEEP framework Subject The topic of the resource Preparedness, Prehospital, Earthquake, Exercise Description An account of the resource Abstract Introduction Disaster exercises are a vital strategy for enhancing Emergency Medical Services (EMS) operational preparedness. This study aimed to extract “Golden Keys” for Design, Implementation and Evaluation of earthquake exercises aligning these key components with the internationally recognized Homeland Security Exercise and Evaluation Program (HSEEP) Framework from the perspective of experienced Iranian prehospital technicians. Method A qualitative study was conducted using a directed content analysis. Data were systematically gathered through in-depth semi-structured interviews with 11 prehospital technician that purposefully selected based on their demonstrated expertise in prehospital exercise management. Data analysis was conducted in five steps following Granheim and Lundman’s approach and the study used Lincoln and Guba’s recommendations to assess data trustworthiness. Result After multiple rounds of data analysis and summarization 386 initial codes, 13 subcategories, and five main categories were identified. These main categories included “Exercise Foundation and Program Governance”, “Exercise Design, Coordination, and Control”, “Operational Implementation of the Exercise”, “Performance Evaluation and Capability Assessment” and “Learning, Workforce Empowerment”, and “System Improvement”. Conclusion Earthquake preparedness exercises must be sustained as an ongoing effort to enhance prehospital system resilience. The indicators identified in this study provide an actionable, evidence-based framework for EMS managers and policymakers to design, implement, and evaluate exercises aligned with system priorities. Translating exercise outcomes into actionable evidence facilitates informed decision-making targeted resource allocation and evidence-based policy formulation. Future research should focus on contextualizing this framework within localized programs and conducting quantitative validation of the proposed indicators. Keywords Preparedness, Prehospital, Earthquake, Exercise Creator An entity primarily responsible for making the resource Asiye Aminafshar1 , Ali Moradi Chaleshtori2 , Ali Khosravizad3 , Ali Sahebi3* and Hojjat Farahmandnia4* Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-026-01135-y Date A point or period of time associated with an event in the lifecycle of the resource 2026 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 Preparedness, Prehospital, Earthquake, Exercise https://repository.horizon.ac.id/files/original/9163e032de0b9abd4aad0dbe9177aea2.pdf 188980f1e51726602f11c928e1e19e4c 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 19 Issue 1 2026 Contributor An entity responsible for making contributions to the resource PERI IRAWAN 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 Building medical toxicology capacity in Africa: a review and strategic perspective on the need for fellowship training programs Subject The topic of the resource Poisoning, Africa, Medical toxicology, Fellowship, Capacity building Description An account of the resource Abstract Introduction Toxic exposures and poisoning constitute a substantial but underestimated public health hazard throughout Africa, for which pesticides, drugs, traditional medicine, snake venom, and industrial chemicals are a disproportionate cause of avoidable disease and death. Methods This narrative review takes into account existing global models of toxicology education while considering African epidemiology and the constraints of its healthcare systems. Main findings Partly due to this disparity between burden and capacity, medical toxicology is not well established on the continent as a whole, with minimal diagnostic capability, few toxicovigilance programs, and no established fellowship training programs or poison centers. While there are advancements in global models of toxicology education, African researchers should work on a context and locally adapted solution that considers its epidemiology and the constraints of its healthcare system. Fellowship programs supported by governments, academia, and international donors can enhance patient outcomes, strengthen public health surveillance, and support health system resilience. Conclusion This review highlights the current toxicological landscape in Africa, the capacity gap in clinical and public health, and presents a strategic framework for setting up medical toxicology fellowship programs in response to the African reality. Keywords Poisoning, Africa, Medical toxicology, Fellowship, Capacity building Creator An entity primarily responsible for making the resource Belayneh Dessie Kassa1* Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-025-01098-6 Date A point or period of time associated with an event in the lifecycle of the resource 2026 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 Poisoning, Africa, Medical toxicology, Fellowship, Capacity building https://repository.horizon.ac.id/files/original/4e19c34db314bb54fb6a8db2c3d0c4cd.pdf da00fc3c2242859979ef6d92ba210d76 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 19 Issue 1 2026 Contributor An entity responsible for making contributions to the resource PERI IRAWAN 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 Comparison of two electronic medical record- based frailty assessment tools and their association with adverse outcomes in older hospitalized patients with urgent admissions Subject The topic of the resource Canadian Institute for Health Information-Hospital Frailty Risk Measure, United Kingdom-Hospital Frailty Risk Score, Urgent admission, Older, Adverse outcome Description An account of the resource Frailty assessment is crucial for predicting outcomes in acute care settings; however, its application remains challenging. Therefore, this study aims to evaluate and compare two electronic medical record-based tools— the Canadian Institute for Health Information Hospital Frailty Risk Measure (CIHI-HFRM) and the United Kingdom Hospital Frailty Risk Score (UK-HFRS)—in older patients requiring urgent admission. Methods In this retrospective cohort study, we analyzed 35,564 patients aged 65 or older from the MIMIC-IV 2.0 database. Frailty was assessed using CIHI-HFRM and UK-HFRS. Primary outcomes included in-hospital mortality, one- year post-discharge mortality, post-discharge care needs, timely hospital discharge, and one-year readmission rates. Logistic regression, Cox regression, and competing risk models were used for analysis. Results The CIHI-HFRM and UK-HFRS were significantly associated with in-hospital mortality [odds ratio (OR) per point: CIHI-HFRM 1.10 (95% confidence interval (CI) 1.07–1.13); UK-HFRS 1.06 (95% CI 1.05–1.07)] and one-year post- discharge mortality [hazard ratio (HR) per point: CIHI-HFRM 1.08 (95% CI 1.06–1.09); UK-HFRS 1.05 (95% CI 1.04–1.05)]. Both measures were associated with prolonged hospital stays and post-discharge care needs, while only CIHI-HFRM was linked to one-year readmission risk. Conclusion The CIHI-HFRM and UK-HFRS effectively stratify adverse outcomes risk in older patients requiring urgent admission. They may be considered alongside traditional measures as part of a pragmatic multimodal pathway, which represents a potential direction for clinical application. Keywords Canadian Institute for Health Information-Hospital Frailty Risk Measure, United Kingdom-Hospital Frailty Risk Score, Urgent admission, Older, Adverse outcome Creator An entity primarily responsible for making the resource Benchuan Hao1†, Yifei Xu2†, Huimin Yang3†, Liangchen Li4 , Zhong Zhang1 , Huihui Xia1 , Dapeng Song1 , Chaosheng Du1 , Zhenzhen Yang1 and Bei Zhao1* Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-025-01061-5 Date A point or period of time associated with an event in the lifecycle of the resource 2026 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 Canadian Institute for Health Information-Hospital Frailty Risk Measure, https://repository.horizon.ac.id/files/original/504b86517c806cdf9cd112c266d7a53f.pdf a8923f54e23b9aecd6eeaf0ba0109710 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 19 Issue 1 2026 Contributor An entity responsible for making contributions to the resource PERI IRAWAN 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 Evaluation of road infrastructure in Yerevan, Armenia through the lens of pedestrian and child safety: a school-based analysis Subject The topic of the resource Traffic injury, Pedestrian safety, Child safety, Safety infrastructure, QGIS, Global injury Description An account of the resource Abstract Introduction Traffic-related injury is a leading cause of morbidity and mortality globally, especially among children. In Armenia, traffic-related mortality rates are the second highest among European Union and former Soviet countries. Currently, there are no published studies on pedestrian safety in Armenia and no notable examinations of pedestrian safety infrastructure. This manuscript describes an audit of Armenia’s infrastructure using a modified Inventory for Pedestrian Safety Infrastructure (IPSI) in the Yerevan city center, focusing on areas surrounding schools. Methods Intersections (n=379) and roadways (n=623) shared by pedestrians and drivers in Yerevan’s center were audited using a 36-item modified ISPI and paired with cloud-based smartphone application QField between October 2023 and February 2024. Visual analysis of data was conducted using the open-source software QGIS with statistical analysis in R. Inter-rater reliability of the audit was calculated using Cohen’s Kappa and intra-class correlation coefficients. Incidence of each feature surrounding schools was compared to incidence overall using a one-sample z-test for continuous variables and a two-sample test of proportions for binary variables. Results Many of the features audited were not observed consistently across the audited area and were not more prevalent near schools. Lower inter-rater reliability was found with roadway and midblock data, resulting in analysis of primarily intersection features. Speed limits surrounding schools varied from 20 to 60 km/hr (12.5–37 mph). When compared to the overall audited area, crosswalks near schools demonstrated similar occurrence for traffic lights with crosswalk markings (23.3%, 95% CI: 0.157–0.309), speed bumps (11.9%, 95% CI: -0.139- 0.0338), and pedestrian signals (12.9%, 95% CI: 0.0709–0.194). Of the analyzed items, only bus stops were observed significantly more often near schools (19%, 95% CI: 0.00930-0.220). Conclusions The audit revealed an inconsistent presence of safety infrastructure, with infrastructure near schools largely reflecting the overall audited area. However, analysis was limited by low inter-rater reliability for many roadway and midblock features audited. Based on these results, infrastructure changes targeting lower speed limits and increased traffic calming measures are recommended to improve safety in school zones. Given a paucity of studies in LMICs, further work must be done to identify which high-yield features should be targeted in LMICs to prevent injury. Keywords Traffic injury, Pedestrian safety, Child safety, Safety infrastructure, QGIS, Global injury Creator An entity primarily responsible for making the resource Emily N. Terian1*, Haig J. Minasian2 , Jefrin Johny3 , Araksya Gevorgyan4 and Sharon A. Chekijian5 Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-025-01070-4 Date A point or period of time associated with an event in the lifecycle of the resource 2026 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 Traffic injury, Pedestrian safety, Child safety, Safety infrastructure, QGIS, Global injury https://repository.horizon.ac.id/files/original/582efe1b624c2d8fbae3edeecff9e038.pdf b437fa13573a5214c6883c288332f371 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 19 Issue 1 2026 Contributor An entity responsible for making contributions to the resource PERI IRAWAN 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 Revisiting Spigelian hernia with emphasis on diagnostic challenges and outcomes of open mesh repair: a case report of two patients Subject The topic of the resource Spigelian hernia, Abdominal wall hernia, Open mesh repair, Polypropylene mesh, Case report Description An account of the resource Abstract Background Spigelian hernia is a rare defect of the anterior abdominal wall, accounting for less than 2% of all abdominal wall hernias. Despite its low incidence, it carries a clinically significant risk of incarceration and strangulation due to its deep interparietal location beneath an intact external oblique aponeurosis, which often delays the diagnosis. Case presentations This report presents two surgically treated cases of Spigelian hernia and focuses on the operative outcomes and refinement of the open repair technique. Both patients were men aged 65 and 61 years, respectively, and presented with unilateral lower abdominal wall swelling that became more prominent during standing or straining. Clinical examination and preoperative ultrasonography confirmed the diagnosis in both cases, revealing fascial defects along the semilunar line, below the arcuate line. Open anterior repair was performed under spinal anaesthesia in both cases. The hernia sac was reduced without opening, and a polypropylene mesh was placed in an onlay position with adequate overlap and secured using non-absorbable sutures. In one patient, a concomitant inguinal hernia was repaired during the same surgical session. Postoperative recovery was uneventful in both patients. Follow-up at 6 and 12 months revealed no recurrence, chronic pain, or mesh-related complications. Conclusions These cases demonstrate that open mesh repair is a safe and effective treatment option for Spigelian hernias, particularly in complex or urgent clinical settings. The choice of surgical approach should be individualized based on anatomical characteristics and the overall clinical context. Clinical trial number Not applicable. Keywords Spigelian hernia, Abdominal wall hernia, Open mesh repair, Polypropylene mesh, Case report Creator An entity primarily responsible for making the resource Eren Ogut1* , Fatos Belgin Yildirim2 and Osman Memis3 Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-025-01116-7 Date A point or period of time associated with an event in the lifecycle of the resource 2026 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/327dba0157f601a05d41a35fbc9268e2.pdf d50dfaee9df62fdb34e4885b26b77941 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 19 Issue 1 2026 Contributor An entity responsible for making contributions to the resource PERI IRAWAN 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 Successful endoscopic retrieval of an accidentally ingested toothbrush in a 95-year- old male : a clinical case report Subject The topic of the resource Toothbrush, Accidental swallowing, Foreign body ingestion, Endoscopic removal Description An account of the resource Abstract Background Accidental foreign body ingestion in the paediatric age group is a common presentation to the Emergency department, with most objects being small and round. Accidental ingestion of non-organic, long, and rigid foreign bodies in adults is relatively rare, and is usually seen in patients with an underlying psychiatric illness. Such foreign bodies are unlikely to pass through the entirety of the gastrointestinal tract owing to their length and rigidity, and are therefore associated with the risk of pressure ulcers, necrosis, and perforation, which necessitates their prompt removal. Case presentation We report the case of a 95-year-old male with Parkinson’s disease, who presented to the Emergency Department with alleged history of having swallowed his toothbrush an hour prior to arrival. The patient was hemodynamically stable. An X-ray of the abdomen confirmed the presence of the toothbrush with the radio- opaque bristle end seen in the left upper quadrant. The Gastroenterologist was involved, and an endoscopic retrieval of the toothbrush was planned immediately. There were challenges encountered in the endoscopic removal owing to the smooth surface of the toothbrush. However, successful retrieval was accomplished, and patient was discharged the following day with no complications. Conclusion Accidental ingestion of toothbrush in adults is extremely rare. Owing to its length and structure, the tooth brush is unlikely to be naturally expelled from the rectum, and therefore associated with risk of complications like perforation, which necessitates prompt removal. Keywords Toothbrush, Accidental swallowing, Foreign body ingestion, Endoscopic removal Creator An entity primarily responsible for making the resource Farzin Vajifdar1*, Khursheed Vazifdar1 , Vivek Singh1 , Sagar Jaiswal1 and Sayash Nair1 Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-025-01094-w Date A point or period of time associated with an event in the lifecycle of the resource 2026 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 Toothbrush, Accidental swallowing, Foreign body ingestion, Endoscopic removal https://repository.horizon.ac.id/files/original/bea6c0bdc825e02c0181c9178a844ef1.pdf 359558bad27f245c14119561b098ca0e 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 19 Issue 1 2026 Contributor An entity responsible for making contributions to the resource PERI IRAWAN 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 Development and psychometric assessment of the household earthquake preparedness questionnaire: an exploratory sequential mixed-methods study Subject The topic of the resource Household, Preparedness, Earthquake, Hazard, Questionnaire Description An account of the resource Abstract Introduction Earthquakes may lead to fatalities and property loss often due to lack of preparedness among individuals. This study aimed to develop and assess the psychometric properies of a Household Preparedness for Earthquake Hazards Questionnaire (HPE-Q). Methods This study utilized a mixed-methods approach comprising of both qualitative and quantitative methods. The qualitative phase concentrated on item generation through semi-structured interviews conducted with Iranian households selected via purposive sampling, alongside a systematic literature review to develop a comprehensive item pool for evaluating household preparedness for earthquake hazards. The quantitative phase focused on item reduction and the assessment of the face, content, and construct validity. To evaluate the reliability of the questionnaire Cronbach’s alpha and intraclass correlation coefficients (ICC) were calculated. Results The initial item pool comprised 88 potential items. Face validity, content validity, and item analysis evaluation was performed and the number of items was reduced to 61. Exploratory Factor Analysis (EFA) further pruned the instrument by eliminating 24 items and Confirmatory Factor Analysis (CFA) mandated the removal of 1 item resulting in a finalized 36-item HPE-Q anchored by 7 main factors: knowledge, self-efficacy, social support, social participation, collective efficacy, protective motivation and behavioral intention. Cronbach’s alpha was 0.92 and Interclass Correlation Coefficient (ICC) of the total score was 0.93. Conclusion Household preparedness for earthquakes is shaped by numerous factors that can either facilitate or impede preparedness and these factors may differ across communities and households. This questionnaire can help identify key aspects of households’ preparedness for earthquakes. Keywords Household, Preparedness, Earthquake, Hazard, Questionnaire Creator An entity primarily responsible for making the resource Fatemeh Rezabeigi Davarani1 , Hamid Sharif-Nia2 , Mahmood Nekoei-Moghadam3 , Abedin Iranpour4 , Narges Khanjani5 , Parya Jangipour Afshar6 and Hojjat Farahmandnia3* Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-025-01118-5 Date A point or period of time associated with an event in the lifecycle of the resource 2026 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 Household, Preparedness, Earthquake, Hazard, Questionnaire https://repository.horizon.ac.id/files/original/b5e258eaa9b59baad3caf6a3f0da935f.pdf d1e376a7093bb17a1e83fd6e15f52ad4 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 19 Issue 1 2026 Contributor An entity responsible for making contributions to the resource PERI IRAWAN 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 Haemorrhagic stroke in the Democratic Republic of the Congo: a neglected neurosurgical emergency care in a health system with critical gaps: a mini review Subject The topic of the resource Democratic Republic of the Congo, Haemorrhagic stroke, Global neurosurgery Description An account of the resource Abstract Haemorrhagic stroke, caused by bleeding in the brain, is one of the most dangerous types of stroke. It kills many people and leaves others with lifelong disabilities. In the Democratic Republic of the Congo (DRC), this problem is serious but often ignored. While most strokes in wealthy countries are caused by blocked blood vessels, in Africa, a much larger number are caused by bleeding. In the DRC, the problem is that stroke patients often arrive late at hospitals, and most hospitals do not have brain imaging or enough specialised stroke staff to treat them promptly. The country has fewer than 20 neurosurgeons for more than 100 million people, and most of them work in major cities. People living in rural areas usually cannot access proper care. Even when patients arrive at a hospital, surgery and intensive care are often unavailable. Stroke is usually managed as part of general health programmes, but the surgical aspect of haemorrhagic stroke is rarely included. This results in many deaths that could be prevented. This paper examines haemorrhagic stroke in the DRC from a neurosurgical perspective. We highlight how the lack of specialists, equipment, and clear treatment protocols worsens the situation. Simultaneously, there are opportunities for improvement: training general doctors and nurses in basic neurosurgical care, utilising telemedicine for advice, and developing national policies that include surgery. Collecting better data and establishing global partnerships will also be beneficial. Increasing focus on haemorrhagic stroke can save lives and reduce disabilities in the DRC. Keywords Democratic Republic of the Congo, Haemorrhagic stroke, Global neurosurgery Creator An entity primarily responsible for making the resource Franck Katembo Sikakulya1*, Larrey Kasereka Kamabu1,2, Kantenga Dieu Merci Kabulo3 , Jeff Ntalaja4 and Hervé Monka Lekuya2,5 Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-025-01016-w Date A point or period of time associated with an event in the lifecycle of the resource 2026 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/3f9e8dc3102afb251abd1af6694bf60c.pdf 613305f7dc45f0601fd73f1f01bce2fd 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 19 Issue 1 2026 Contributor An entity responsible for making contributions to the resource PERI IRAWAN 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 Piperacillin-tazobactam caused post- trauma patient’s postoperative leukopenia, hypokalemia, and periodic fever: a case report Subject The topic of the resource Piperacillin-tazobactam, Periodic fever, Leukopenia, Hypokalemia, Post-trauma surgery. Description An account of the resource Abstract Background Piperacillin-tazobactam (PT), a broad-spectrum β-lactam/β-lactamase inhibitor combination, is clinically used to treat infections caused by Gram-positive and Gram-negative aerobic and anaerobic bacteria. While gastrointestinal adverse effects, skin reactions, and fever have been previously reported during PT therapy, its association with periodic fever, leukopenia, and hypokalemia specifically in post-trauma surgical patients has not been documented. Case presentation We report the case of a 55-year-old male trauma patient who received PT for 17 days pre- operatively for suspected infection. He then underwent surgical procedures including rib fracture open reduction and internal fixation, along with thoracic closed drainage. Post-operatively, on day 2, the patient developed periodic fever, occurring specifically between 20:00 and 23:00 hours each night, with normal daytime temperatures. Concurrently, during PT administration, the patient exhibited leukopenia and hypokalemia. Notably, cessation of PT led to an immediate resolution of the periodic fever, gradual normalization of leukocyte counts, and restoration of potassium levels. Although PT can cause fever, diagnosis can be challenging in the post-operative setting due to the potential for confounding factors. Conclusions This case suggests that in surgical patients presenting with periodic fever, particularly when accompanied by leukopenia and hypokalemia after exposure to PT, the drug should be considered a potential causative agent, even if other post-operative complications are being investigated. Keywords Piperacillin-tazobactam, Periodic fever, Leukopenia, Hypokalemia, Post-trauma surgery. Creator An entity primarily responsible for making the resource Hong Luo1,2†, Xu Zhang3†, Fei Zhang1* and Wuxun Peng1* Source A related resource from which the described resource is derived https://doi.org/10.1186/s12245-025-01096-8 Date A point or period of time associated with an event in the lifecycle of the resource 2026 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 Piperacillin-tazobactam, Periodic fever, Leukopenia, Hypokalemia, Post-trauma surgery.