bluuebunny/crossref_metadata_2025 huggingface dataset:
Selección y comentario de resoluciones del orden jurisdiccional Contencioso-Administrativo. Tribunal Superior de Justicia de Extremadura. Año 2020
Authors: Villalba Lava Mercenario
Published: March 2021

Se ha llevado a cabo una selección de las resoluciones judiciales más representativas y relevantes dictadas por el Tribunal Superior de Justicia de Extremadura durante el año natural 2020. Dichas resolu-ciones corresponden al orden jurisdiccional Contencioso-Administrativo. Estas sentencias seleccionadas han sido objeto de co-mentario, dentro del contexto jurídico que las ha generado, por un destacado magistrado especializado en dicho orden jurisdiccional.
study protocol v1
Authors: Zhou Ting
Published: March 2021

Heavy occlusal force and undesirable distribution of occlusal contacts may be factors of overloading, thus possibly leading to higher susceptibility to implant bone loss, implant fractures/loss, and prosthesis failures. The study intends to further analyze and evaluate the occlusal parameters including occlusion time(OT), disclusion time(DT), distribution of force, occlusion interference (OI) after insertion of posterior single implant, and regularly assess the occlusion changes to eliminate possible risk factors to achieve balanced occlusion and stability
Spotlight on voices from the community: The importance of empowerment through the Erasmus+ Nefeli Project for Roma women
Authors: Papakonstantinou Theofano , Ladopoulos Dimitrios Alexandros
Published: March 2021

The Erasmus+ Nefeli Project held a weeklong training (September 21-25, 2020) for women from all walks of life and welcomed over 25 participants. Women from the UK, Europe and abroad attended the training and engaged in lifelong learning using the arts and intangible cultural heritage practice, learning about techniques that they can apply in their contexts. Nefeli's training was an exchange of know-how and material of Non-Formal Learning activities between organisations of the consortium and focussed on offering the participants a way to improve their methods and quality of work and gain more results in terms of agency for women from vulnerable communities.The participants all gained a Europass Mobility certificates as well CPD certificates. Prior to the training the team held a social media campaign where we asked Roma and migrant women to answer three questions around what lifelong learning means.
Medidas de mitigação ao atropelamento de fauna em rodovias federais concedidas no Brasil
Authors: Gomes Leonardo de Paula , Caixeta Fernando Ferreira , Torres Renata Rocha , Castro Daniele Nunes de , Thomé Gustavo Antunes , Lima Rodolfo Ikaro Pinto , Sousa Ana Carolina Pereira de , França Rejane Marinho , Silva Luciano Lourenço da
Published: March 2021

O desenvolvimento socioeconômico de diversos paí­ses está relacionado   expansão e manutenção da infraestrutura rodoviária. No Brasil, o modo rodoviário é o mais utilizado, todavia, as rodovias podem causar impactos negativos   biodiversidade, pois contribuem para a fragmentação de hábitats e a redução de fluxos biológicos. Dentre os principais impactos causados pelas rodovias, destaca-se o atropelamento da fauna, de forma que medidas de mitigação para esse impacto se tornam necessárias. Com base nos dados coletados até o ano de 2017, o presente estudo tem por objetivo apresentar informações quanto  s medidas mitigadoras ao atropelamento de fauna silvestre presentes nas rodovias federais concedidas do Brasil. Foram cadastradas 461 medidas de mitigação, mais 627 dispositivos de engenharia que podem ser utilizados como passagens, sendo que, desse total, 334 encontram-se nas proximidades de áreas legalmente protegidas. Existem 158 medidas em fase de planejamento para serem implementadas.
¿Lazarillo Libertin? Sobre la primera recepción en Europa del Norte: traducciones e inspiraciones anticlericales
Authors: Correard Nicolas
Published: March 2021

It has often been argued that the picaresque genre derived from the Lazarillo castigado, if not from the Guzmán de Alfarache, more than from the original Lazarillo. Such an assumption neglects the fact that the first French and English translations did rely on the 1554 text, whose influence, conveyed by the 1555 sequel also translated in French in 1598, did last until the early 17th century. Probably designed in an Erasmian circle, the anticlerical satire, enhanced by provoking allusions to certain catholic dogmas, did not pass unnoticed: the marginal comments of the translations, for instance, testify for a strong interest for this theme. It is no wonder, therefore, if the first satirical narratives freely inspired by the Lazarillo, such like The Unfortunate Traveller by Nashe, the Euphormio Lusinini Satyricon by Barclay, or the Première journée by Viau, adapted its religious satire to their own actuality: in the context of the rise of libertine thinking, characters of Jesuits and Puritans could become new targets for novelistic scenes based on an obviously “lazarillesque” model.
La justicia distributiva aristotélica en el siglo XXI
Authors: Liébana Ortiz Juan Ramón
Published: March 2021

La comunicación presenta los sistemas tradicionales de justicia informal como un ejemplo donde se constata cómo la doctrina aristotélica sobre la justicia distributiva permite justificar teleológicamente la existencia de modelos judiciales diferentes a los sistemas procesales estatales de corte liberal que, en pleno siglo XXI, aplican ordinariamente los principios esenciales del Derecho natural.
Evaluation of manuscripts- A guide to reviewers
Authors: Ahluwalia Pallavi , Gupta Bhavna
Published: March 2021

Peer-reviewed scientific publications are a source of high-quality and reliable information, especially valuable in today’s world. In this guide to reviewers, I have tried to suggest how to scientifically read a paper and review it. It will be helpful for those who are starting to participate in peer review and I have summarised various questions related to the process. What are the points that should be considered when analysing the title, abstract, introduction, results, discussion and conclusion?
To study the efficacy and post-operative sedation in intravenous and intrathecal clonidine in patients undergoing laproscopic assisted vaginal hysterectomy under general anesthesia
Authors: G Asha , Masamaddi Geethanjali S , S Amith
Published: March 2021

Advent of Laparoscopy have benefitted patients in terms of lesser tissue damage, early ambulation, decreased duration of hospital stay and reduced analgesic needs. However caproperitoneum and position of patient during laparoscopic procedure induces pathophysiological changes that may potentially complicate anesthetic management.

Various pharmacological methods have been tried to overcome complications associated with pneumoperitoneum. One among those drugs is Clonidine, a centrally acting α-adrenergic receptors agonist has sedative, anxiolytic, analgesic properties and stabilizes circulatory system. It diminishes stress response hence increases perioperative circulatory stability in patients undergoing laparoscopic surgeries. In addition, it increases cardiac bar reflex sensitivity in hypertensive individuals, and thus, stabilizes blood pressure by enhancing the role of changes in heart rate.

To study the efficacy and post-operative sedation in intravenous and intrathecal clonidine in patients undergoing laparoscopic assisted vaginal hysterectomy under general anesthesia.

Patients were divided randomly into 2 groups (A group & B group) of 30 each. Patients assigned to group a, received 50 mcg of clonidine in 50ml of normal saline over 10 minutes 10 minutes before induction. Patients assigned to group B, received intrathecal clonidine 50 mcg in 1 ml in sitting position at L3-L4 interspace using 27G quincke’s spinal needle just before induction. Intraoperative monitoring included heart rate (HR), continuous electrocardiography, noninvasive systolic (SBP), diastolic (DBP), mean blood pressure (MBP), pulse oximetry (SpO) and EtCO. Systolic, diastolic, mean arterial blood pressures and heart rate were recorded at regular interval and plotted on graph.

During capnoperitoneum, mean HR values, mean SBP values, mean DBP values, mean MAP values in (IT) group B were below the baseline and that in group A (IV) were near the baseline.

Efficacy of Intrathecal route of clonidine administration during laparoscopic hysterectomy surgeries have better control of heart rate, mean systolic and diastolic blood pressure and mean arterial pressure is better during capnoperitoneum compared to intra venous clonidine. But post-operative sedation and adverse effects in both routes are statistically insignificant.
A prospective randomized controlled trial to compare the efficacy of wound instillation with 0.25% bupivacaine, 0.2% ropivacaine and normal saline for postoperative analgesia in breast surgery
Authors: Lalit Kumar Raiger  , Mathur Shuchi , Gehlot Ravindra , Bedi Vikram
Published: March 2021

Modified Radical Mastectomy (MRM) is the commonly used surgical procedure for operable breast cancer, which involves extensive tissue dissection.We hypothesized that instillation of 0.25% bupivacaine and 0.2% ropivacaine through chest and axillary drains into the wound may provide postoperative analgesia, even better than infiltration along the line of incision.

In this prospective randomized controlled study 68 patients aged more than 18 years were divided into four groups. All patients were administered general anesthesia. At the end of the procedure, axillary and chest drains were placed before closure. Group C was the control group with no instillation, group B received 40 ml 0.25% bupivacaine, group R received 40 ml 0.2% ropivacaine and group S received 40 ml normal saline (20ml through each drain) and the drains were clamped for 10 mins. After extubation, pain score was evaluated using Visual Analogue Scale (VAS) at rest, cough and overhead abduction of the arm at 0,1,2,3,4,8,12 and 24 hours. Rescue analgesia was injection tramadol, given if the pain score ≥ 3. Statistical analysis was performed using SPSS version 21.

There was a significant difference in the cumulative analgesic requirement and the number of analgesic demands between the groups (p<0.001). The mean duration of analgesia in the ropivacaine, bupivacaine, saline group and the control group were 10.64 hours, 10.07 hours, 7.49 hours and 2.3 hours respectively.

Wound instillation with local anesthetics is a simple and effective means of providing good analgesia without any major side effects.
A comparison of hemodynamic profile of intraperitoneal instillation of ropivacaine versus bupivacaine in laparoscopic surgeries
Authors: N Ramya , Piriya K Sanmuga , S Balasubramanian , J Vigneswaran , Kumar K Suresh , B S Suresh Anand
Published: March 2021

Inadequate pain relief in the postoperative phase is a well-known problem world-wide. Aside from the suffering caused by insufficient pain relief, this is an issue with potential adverse physiological and psychological consequences for patients in addition to financial draw backs for caregivers. Poorly managed pain may interfere with postoperative complications, cause patient suffering and prolong recovery. Patients may anticipate future medical interventions with greater anxiety if pain has not been managed effectively in the past.

To assess postoperative hemodynamics of intra peritoneal instillation of Ropivacaine and bupivacaine in Laparoscopic surgeries.

The present study was conducted at Sri Manakula Vinayagar Medical College and Hospital, Pondicherry in the Department of Anaesthesia. The double blinded randomized experimental study was conducted from October 2017 to May 2019.The sample size of 50 study subjects was selected using the mean pain score at 3.6 with 80% power and 95% confidence interval. In each of the group 25 study subjects were allotted based on randomization. All patients were instilled with 30 ml of solution in a standardized manner by the operating surgeon under vision before removal of trocar at the end of the surgical procedure. Group R received 30 ml (0.2%) ropivacaine and group B received 30 ml (0.25%) bupivacaine. The drugs were prepared and given to the investigator who was blind to the identity of drugs.

The heart rate was found to be comparable between two groups at 10 min, 30 Min, 60 Min, 120 Min, 4 Hrs, 8 Hrs, 12 Hrs and at 24 hrs and the p value was found to be non-significant. The Systolic Blood pressure was found to be statistically significant between the two groups at 10 Min, 30 Min, 60 Min, 120 Min, 4 hrs, 8 Hrs and 12 hrs. Whereas at 24 hrs the difference of Systolic Blood Pressure was found to be non-significant.

Heart rate was similar in both the study groups at various time intervals. Systolic blood pressure and diastolic blood pressure was significantly high among patients in Bupivacaine group measures in most of the time intervals, while mean blood pressure differences were inconsistent over the follow up period.
Comparison of ultrasound guided costoclavicular brachial plexus block versus supraclavicular brachial plexus block for forearm and hand surgeries for surgical anaesthesia: A prospective randomised clinical study
Authors: Janardhaniyengar Sowmya M , Ramesh Shubha M , Kantharaju Shankar
Published: March 2021

Successful brachial plexus blocks (BPB) rely on proper techniques of nerve localization, needle placement and local anesthetic injection. This study aimed at comparing the efficacy of costoclavicular brachial plexus block versus supraclavicular brachial plexus block for forearm and hand surgeries for providing surgical anesthesia by evaluating the time of onset of sensory and motor blockade, nerve sparing effect and duration of analgesia in both the groups.

Fifty patients with ASA physical status 1, 2 and 3 undergoing forearm and hand surgeries were recruited. Fifty patients in Group C (n=25) and Group S (n=25) received 20 ml 0.5% ropivacaine by ultrasound guided costoclavicular and supraclavicular BPB respectively. The primary outcome measure was the time of onset of sensory and motor blockade. Secondary outcome measures included nerve sparing effect and duration of analgesia. Statistical analysis was done with student-t test, unpaired t-test and Fisher exact test.

In our study, onset of sensory blockade (8.20 ± 0.58 mins vs 9.72 ± 0.84 mins) and onset of motor blockade (11.72 ± 0.79 mins vs 12.56 ± 0.92 mins) were significantly shorter in group C when compared to group S. We did not find any nerve sparing effect in both the groups unlike other studies. Duration of analgesia (13.14±0.91 hours vs 12.84±0.93 hours) and requirement of rescue analgesics were comparable in both the groups.

: We conclude that ultrasound guided costoclavicular BPB has shorter procedural time and rapid onset of sensory-motor blockade compared to supraclavicular BPB.
Asymptomatic tracheal stenosis in a child: An anaesthesiologist’s plight
Authors: Loya Shilpa J , Bohra Palak Rajendra , Bhale Pramod V , Kulkarni Sanhita J , Kelkar Vasanti
Published: March 2021

Tracheal stenosis is a rare occurrence but maybe life threatening. Severity of this condition varies with the length of the affected trachea and the degree of luminal narrowing. Asymptomatic cases present with the highest risk as they may be diagnosed for the first time at the time of intubation. Proper history taking with a special note of any previous hospitalization or intubation, clinical examination and radiological investigations may help us prevent complications that may arise from this condition. A case of incidental finding of tracheal stenosis leading to inability to intubate in a paediatric patient posted for pyeloplasty is reported here.
Anaesthesia management of coronary artery perforation during Percutaneous Coronary Intervention (PCI)
Authors: Chodankar Ninad D , Jain Sulekha , Panthakey Harvesp D , Mehta Hemant H
Published: March 2021

Percutaneous Coronary Intervention (PCI) is an accepted modality of treatment in patient with coronary artery disease. Coronary artery perforation is very rare but serious complication that can occur while performing PCI.

We describe two cases of coronary perforation while performing PCI. In first case, coronary perforation could not be sealed with coronary stent and required emergency surgery. And in second case, we were able to seal the coronary perforation with stent and avoid surgery.

Coronary artery perforation requires team approach by cardiologist, anaesthesiologist and surgeon for early recovery and good outcome.
Paradigm shift in medical education
Authors: Ahluwalia Pallavi , Gupta Anish , Gupta Bhavna
Published: March 2021

With the introduction of telemedicine, integrated testing protocols, and clinical studies with versatile approaches to developing solutions, the COVID-19 outbreak can reflect a lasting transition in medicine. Education providers can help plan and measure the impacts of current revelations in learning and adapting new beliefs and norms to the future. Not only is now a moment to assist in improving medical training in the light of successful curriculum development and change, but it can also be a crucial moment for many clinical specialties.
Effectiveness and side-effect profile of Vilazodone and Escitalopram in major Depressive Disorder – An observational study
Authors: Kodali Madhavi , Lella Srikanth , Bodepudi Sarath , Benerji Therissa , Mohan Parvathaneni Krishna
Published: March 2021

Major depressive disorder (MDD) is characterized by a cluster of emotional, behavioral, and cognitive features causing functional impairment.Escitalopram and Vilazodone are approved drugs in management of MDD. Escitalopram is found to be efficacious in patients with MDD. However, sexual dysfunction and weight gain are of a primary concern leading to discontinuation of treatment. Vilazodone is efficacious for patients who do not respond to SSRI/SNRI monotherapy. Evidence suggests it to be associated with a better side effect profile.

To study the effectiveness and side effect profile of vilazodone and escitalopram in patients diagnosed with MDD.

All patients diagnosed with MDD and commenced for the first time on vilazodone or escitalopram were included in the study via purposive sampling. Effectiveness and side effect profiles of the patients were studied by applying HAM-D and ASEC, respectively, at baseline, at weeks 1, 2, 4, 6, and 8.

There was a statistically significant difference in weeks 2, 4, and 6 for both the drugs. On intergroup comparison, no significant difference was found in terms of response rates. The number of side-effects was more in the escitalopram group.

Taken together with our results, vilazodone appears to be equally effective as escitalopram in treating patients of MDD. However, vilazodone has the advantage of better tolerability as compared to escitalopram.

Vilazodone was found to be equally effective as escitalopram in patients with MDD and has the advantage of better tolerability as compared to escitalopram.
Assesmentof Fibro Q test, AAR & APRI indices as markers of fibrosis in chronic liver disease
Authors: Ayyali Ambresh , A Shilpa
Published: March 2021

Chronic liver disease can vary from mild hepatic inflammation without fibrosis to advanced hepatic fibrosis and cirrhosis. The use of ultrasound for the confirmation of complications during biopsy procedures increases the cost of treatment and may also increase the duration of hospitalization. Fibro Q test (FQT), Aspartate amino transferase – Alanine amino transferase ratio (AAR) & Aspartate amino transferase- platelet ratio index (APRI) are the three non-invasive and simple indices proposed for assessing fibrosis in CLD.

To know the efficacy of the indices- Fibro Q test, AAR, APRI as markers of Fibrosis in CLD. To know which among these indices would be the high sensitive marker of liver fibrosis.

This study includes 60 subjects, out of which 30 were clinically diagnosed as CLD and were confirmed by abdominal ultrasound and 30 were age matched healthy controls.

Fibro Q, AAR & APRI were significantly increased in cases compared to controls. The increase in Fibro Q test in cases was highly significant (p-0.0001) when compared to controls.

Fibro Q test, AAR & APRIindicesare efficient markers to evaluate liver fibrosis in CLD patients. Fibro Q, a novel non-invasive test, is highly sensitive marker than AAR & APRI.
Assessment of plasma fibrinogen as a marker of diabetic nephropathy
Authors: A Shilpa , Ambresh Ayyali
Published: March 2021

Diabetes is one of the most common chronic hyperglycemic syndrome. Diabetic Nephropathy is one of the major complications of DM characterized by persistent albuminuria, increased arterial blood pressure, a relentless decline in glomerular filtration rate (GFR) & a high risk of cardiovascular morbidity & mortality. The biological marker of DN is fibrinogen. Fibrinogen, is increased in diabetic patients. An increase in plasma fibrinogen levels is also considered an independent risk factor for diabetic nephropathy. Fibrinogen is the major coagulation protein in blood.

To find out whether the levels of Plasma Fibrinogen levels can be used as markers for the early diagnosis of DN.

A case control study. The study includes total of 150 patients, of which 50 were diabetic without any complications, 50 were diabetic nephropathy patients and remaining 50 were age matched healthy controls.

The mean plasma fibrinogen level in control group was 190.34 ± 72.83 mg/dl. The mean plasma fibrinogen levels in DM & DN groups were 522.76 ± 115.79 mg/dl & 657.64 ± 124.61 mg/dl respectively. In our study, fibrinogen levels were increased significantly in DM group compared to controls which was further increased in DN group. Hence above studies interpret that fibrinogen increases in diabetes with complications.

Fibrinogen correlated positively with FBS, HbA, TC, triglyceride, LDL, Blood Urea, serum creatinine, TC/HDL, LDL/HDL & urine A/C ratio in both DM & DN group, whereas there was negative correlation of fibrinogen with HDL & eGFR. Thus fibrinogen could be used as early biomarkers for the diagnosis of DN.
Hypokalemic periodic paralysis as initial manifestation of primary Sjogren’s syndrome: A case report
Authors: Saxena Rajeev , Kumar Yadav Manoj , Gahlot G.P.S. , Hariprasadh N
Published: March 2021

Sjogren’s syndrome (SS) is common autoimmune diseases manifesting with various glandular and extra glandular features which are difficult to evaluate and manage. Hypokalemic flaccid paralysis may be the rare extra glandular clinical manifestation of SS. We present a case of acute flaccid paralysis which on evaluation turned out to be primary sjogren’s syndrome (pSS). We present a case of 30 year old young woman with no known comorbidities presented with acute flaccid paralysis. Her evaluation reveals severe hypokalemia with K-1.6 meq/l, metabolic acidosis with pH-7.28 and urinary pH ≥6.5. An initial diagnosis of hypokalemic periodic paralysis (HPP) secondary to distal renal tubular acidosis (dRTA) was made. She was later found to have sjogren’s syndrome on the basis of positive ANA & Anti-Ro (SS-A) Antibody and salivary gland biopsy. She was managed with potassium supplements, sodium bicarbonate and immunomodulators. Primary Sjogren’s syndrome usually associated with distal renal tubular acidosis which may cause hypokalemia leading to HPP, rarely which may be the initial presenting symptom in young women as in our case. Early diagnosis and treatment of these patients would lead to less complication and better quality of life.
A quality of life assessment of military recruits after refractive surgery
Authors:   Department of Ophthalmology, PLA 150th Hospital, Luoyang 471031, Henan Province, China, Xiao Jian-He , Li Shi-Yang ,   Department of Ophthalmology, PLA 150th Hospital, Luoyang 471031, Henan Province, China, Xing Xing ,   Department of Ophthalmology, PLA 150th Hospital, Luoyang 471031, Henan Province, China, Zhao Ai-Hong ,   Department of Ophthalmology, PLA 150th Hospital, Luoyang 471031, Henan Province, China, Ma Hong-Li ,   Department of Ophthalmology, PLA 150th Hospital, Luoyang 471031, Henan Province, China
Published: March 2021

AIM: To evaluate the quality of life of recruits after refractive surgery.
METHODS: Population-based, cross-sectional study. Using the Quality of Life Impact of Refractive Correction (QIRC) questionnaire, the quality of life in 615 recruits underwent refractive surgery was evaluated. The overall score and each question score of QIRC were compared between subgroups of different strength of preoperative refractive error, postoperative interval, type of surgical procedure and postoperative recovery.
RESULTS: The mean overall QIRC score of recruits underwent refractive surgery was 49.15±7.89. Significant difference was found for strength of preoperative refractive error (F=4.16, P<0.05), with the low myopia group (50.67±7.59) had significantly better scores than those with high myopia (47.57±7.52, F=4.16, P<0.05). Recruits after a postoperative interval no more than 6mo (49.18±7.86) scored equally to those of more than 6mo (49.18±8.03). Recruits underwent surface ablation surgery scored lowest (46.68±6.09), but showed no significant difference when compared with all underwent refractive surgery (t=1.99, P>0.05). Scores of recruits underwent mechanical microkeratome laser in situ keratomileusis (MK-LASIK), Sub-Bowman’s keratomileusis (SBK), femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK), femtosecond lenticule extraction (ReLEx flex) or small-incision lenticule extraction (ReLEx SMILE) procedure showed no significant difference too. Recruits had adverse complaints postoperatively (45.85±6.66) scored lower when compared with all underwent refractive surgery (t=5.28, P<0.01).
CONCLUSION: The quality of life of recruits after refractive surgery was good except those with postoperative complications. Preoperative low myopia recruits had better quality of life than medium and high myopia ones.
Iranian Clinical Nurses’ and Midwives’ Attitudes and Awareness Towards Telenursing and Telehealth
Authors: Ranjbar Hossein , Bakhshi Mahmoud , Mahdizadeh Faezeh , Glinkowski Wojciech
Published: March 2021

Objectives: This study aimed to examine the attitudes and awareness of Iranian clinical nurses and midwives towards telenursing and telehealth also referred to as e-health. Methods: The cross-sectional study was conducted from February to August 2019 in Iran. Nurses and midwives were randomly recruited from hospitals affiliated with Mashhad University of Medical Sciences in Mashhad, Iran using a stratified cluster random sampling method. Data were collected using a reliable and valid Persian-language questionnaire consisting of 32 close-ended survey items to examine Internet/computer access, daily Internet use and awareness of and general attitude towards telehealth and telenursing; statistical analyses were performed. Results: A total of 523 nurses and midwives were included in this study (response rate: 94.4%). The mean age and duration of clinical practice were 33.36 ± 7.46 and 8.88 ± 6.73 years, respectively. The majority of participants recognised the definition of telenursing (66.7%) and telehealth (80.1%). A positive attitude towards telenursing and telehealth was reported by 73.0% of the participants. Clinical nurses and midwives with a master's degree were more aware of the definition of telehealth compared to those with undergraduate bachelor degrees (P = 0.03). Additionally, midwives significantly more frequently presented a positive attitude towards telehealth and telenursing compared to nurses (86.2% versus 71.2%; P = 0.01). Conclusion: The positive attitude of the current participants was an important factor in the promotion of telenursing and telehealth. The implementation of educational and infrastructure developmental programs can help speed up executional processes in these fields.
 
KEYWORDS
Telenursing; Telemedicine; Nurses; Midwives; Attitude; Awareness; Iran.
Patterns of Prescribing Co-Amoxiclav to Children in Ibri Polyclinic, Oman
Authors: Al-Yaqoubi Weaam S. , Al-Maqbali Nadia S.
Published: March 2021

Objectives: This study aimed to describe patterns of prescribing co-amoxiclav to children aged ≤5 years at a polyclinic in Oman and to assess level of adherence to the antibiotic prescription guidelines outlined by the Omani Ministry of Health (MOH). Methods: This cross-sectional retrospective study was conducted between June and December 2017 at Ibri Polyclinic (IPC) in Ibri, Oman. A random sample of 399 children aged ≤5 years who were prescribed a suspension of co-amoxiclav over the four winter months of 2016 were included in the study. The children’s electronic medical records were reviewed to determine whether the prescription complied with MOH guidelines. Results: The majority of the children were 2–3 years old (52.4%). Overall, 73.9% of prescriptions were written by general practitioners, while 26.1% were written by specialists. Co-amoxiclav therapy was the first line of management in 90.5% of cases, regardless of category of prescriber. Culture tests were ordered in only 43 cases (10.8%), of which five (11.6%) were found to be sensitive to the prescribed co-amoxiclav. Conclusion: Unnecessary antibiotics were prescribed to many paediatric patients attending IPC. Strict enforcement of the MOH antibiotic guidelines is needed to reduce irrational or discretionary prescription of this type of antibiotic. Healthcare providers should receive additional training in evidence-based methods of prescribing antibiotics.
 
KEYWORDS
Antibiotics; Children; Co-Amoxiclav; Inappropriate Prescribing; Antibiotic Resistance; Oman.
Chronic Blunt Traumatic Thoracic Aortic Injuries
Authors: Al-Adawi Sara S.H. , Naiem Ahmed , Abdelhady Ibrahim , Al-Sukaiti Rashid , Al-Hajeri Mahmood , Stephen Edwin , Al-Shamsi Sulaiman , Al-Wahaibi Khalifa
Published: March 2021

Blunt thoracic aortic injuries are potentially lethal. Those who survive may form an organised haematoma in the periadventitial space resulting in a pseudoaneurysm, which may be identified incidentally decades later. While the role of thoracic endovascular aortic repair (TEVAR) in acute settings has been established, its role in chronic cases is yet to be defined. We report three cases that were diagnosed incidentally six, nine and 18 years after the injury. Two were managed by TEVAR while the third declined intervention and is on annual followup. Patients with asymptomatic and stable pseudoaneurysms of the descending thoracic aorta should be offered surveillance versus TEVAR because the risk of rupture is not negligible, whilst taking into account the patient’s level of physical activity. These three cases highlight the importance of early diagnosis of aortic injuries in blunt trauma and its grading.
 
KEYWORDS
Thoracic Aortic Aneurysm; Endovascular Procedures; False Aneurysm; Nonpenetrating Wounds; Traffic Accidents; Oman.
Airway and Anaesthetic Challenges in a Child With Bronchus Suis and Superimposed Double Aortic Arch
Authors: Kuriakose Nigel , Al-Ismaili Mohamed , Raniga Sameer , Date Rohit , Al-Abady Ali , Al-Balushi Zainab
Published: March 2021

Bronchus suis or tracheal bronchus is an accessory bronchus arising from the trachea above the carina. Double aortic arch is a congenital vascular anomaly with persistence of both left and right aortic arches beyond fetal life which can form a vascular ring compressing the major airways and may be symptomatic. We report the case of a 16-month-old girl who had recurrent episodes of respiratory distress requiring multiple hospitalisations and was diagnosed at the Sultan Qaboos University Hospital, Muscat, Oman in 2019 with a double aortic arch compressing upon a tracheal bronchus causing symptomatic emphysema of the right upper lobe. This report presents anaesthetic and airway challenges during the patient’s lobectomy. A single lumen cuffed endotracheal tube was successfully used as a bronchial blocker to occlude the origin of the aberrant bronchus. The position of the tube was confirmed intraoperatively using fibreoptic bronchoscopy. Following her discharge, she continued to have recurrent episodes of respiratory distress and three months after her last appointment she succumbed to her illness. To the best of the authors’ knowledge, this is the first such reported case in Oman.
 
KEYWORDS
Bronchus; Trachea; Aortic Arch; Endotracheal Intubation; Bronchoscopy; Anesthesia; Lobar Pneumonia; Oman.
Spectrum and Correlation of Clinical, Radiological and Biochemical Parameters in Tuberculosis in a Hospital in South India
Authors: Sharma Anirudha , Vijapurkar Swati , Gosavi Siddharth , Samgamesh Samarth , E Aishwarya , Uttam Ritika
Published: March 2021

BACKGROUND Tuberculosis (TB) remains a major public health problem in India. TB worsens glycaemic control in patients with diabetes mellitus (DM), complicating the treatment for each condition leading to poor treatment outcomes and increase in morbidity / mortality. Human immunodeficiency virus - tuberculosis (HIV-TB) coinfections are on the rise. The objectives of the study were to describe various comorbidities in patients with tuberculosis, determine expected radiological presentations in these patients and to determine prognosis altering metabolic indicators in patients with TB. METHODS A prospective cross-sectional study using data of 40 microbiologically diagnosed TB patients admitted in wards of C.G. Hospital, JJM Medical College, Davangere, from January to March 2020 was done. Chest x-rays, clinical and haematological tests were analysed. RESULTS TB patients with DM, kidney disease, HIV presented with higher count of fibrosis, cavities and infiltrates on chest radiographs, and was worse with renal function. Hospitalisation was prolonged in patients with anaemia, multidrug-resistance tuberculosis (MDR-TB), urosepsis, and HIV as compared to patients with no comorbidities. MDR-TB showed more fibrosis. Patients with urosepsis had higher incidence of multiple lesions and effusion by 4 times. CONCLUSIONS Increased HbA1c and sugar levels lead to increase in lesions on chest x-ray in tuberculosis. Good glycaemic control in TB is a must to achieve good control of DM and reduce hospitalisation. KEYWORDS Tuberculosis, Diabetes Mellitus, HbA1c, Chest X-Ray
Prevalence of Complications of Diabetes and Risk Factors Among Patients with Diabetes in the Diabetes Clinic in Southeast of Iran
Authors: Taheri Hamed , Rafaiee Roya , Rafaiee Raheleh
Published: March 2021

Objective: Academic health services play an important role in the prevention and control of diabetes mellitus (DM) in Iran. This study aimed at determining the prevalence of DM-related complications and the associated risk factors among patients with DM in a university-affiliated outpatient diabetes clinic of a referral hospital in Southeast of Iran, Zahedan.
Materials and Methods: This cross-sectional study was conducted from January to April 2019 in an academic diabetes clinic. A total of 334 patients with DM, whose characteristics (age, sex, family history of DM, and substance abuse), as well as laboratory and clinical information, were recorded in the baseline forms, were included. The relationship between variables were assessed by Pearson’s correlation coefficient at P-value< 0.05 and using SPSS version 20.0.
Results: The mean age of the participants was 54.27 (±11.57) years. In these patients, DM type 2 was estimated at 99.1%, and the mean duration of the disease was 8.98 (±6.93) years. The findings showed that 77.2% of the patients had poor glycemic control. Also, 85.4% of the patients had fasting blood sugar (FBS) level >126 mg/dL. There was a significant relationship between insulin-dependent therapy and drug abuse (P-value <0.001). The prevalence of hyperlipidemia (68.9%), hypertension (50.6%), retinopathy (29.6%), nephropathy (11.7%), and neuropathy (12.3%) was also determined.
Conclusion: The majority of the patients (77.2%) in this study had poor glycemic control, and 69.9% of them suffered from microvascular complications, macrovascular complications, or both. Therefore, frequent visits accompanied by patient education could help to better diabetes control
Efficacy of Dialectical Behavior Therapy on Decreasing Weight in Obese Women with Emotional and Behavioral Disorders: A Quasi Experimental Study
Authors: Homayounpour Parisa , Seirafi Mohammadreza , Ghare Sahar
Published: March 2021

Objective: The growing worldwide prevalence of overweight and obesity, despite treatment strategies remain the health problem. Over the past decade, increasing attention has been paid to psychological factors and a potentially comprehensive, multimodal skills-based treatment. The purpose of this study was to evaluate the efficacy of dialectical behavior therapy (DBT) on weight loss in obese women with emotional and behavioral disorders.
Materials and Methods: In this quasi-experimental study, statistical population from convenience sampling consisted of 42 obese women with body mass index (BMI) more than 29.9 kg/m2 divided in 3 groups, behavioral, emotional and control. Descriptive and analytic statistics were computed according to demographic information, emotional eating scale and Dutch eating behavior questionnaire. Intervention included 13 sessions of 1.5hr group therapy, DBT-skills training from April to September 2019. Mixed-effect modeling ANOVA with repeated measurements was performed by statistical analyses, IBM SPSS version 24 to study changes in variables over time.
Results: The results demonstrated that the emotional such as anger, anxiety and depression, significantly decrease during the study period. (P-value<0.001) As well as behavioral eating demonstrated significant improvement in restrained eating and decrease in emotional and external eating behaviors right after the end of intervention while trial group experienced significant weight loss.
Conclusion: The present study provides some evidence that DBT-skills training can be effective in decreasing problematic eating behaviors, emotion dysregulations, decreasing BMI.
A Narrative Summary of Air Pollution Awareness: The Recent Modeling Implications
Authors: Rezaali Mostafa , Fouladi-Fard Reza
Published: March 2021

The article's abstract is not available.
Evaluating the Frequency of Ear Problems in Patients with Cleft Lip and Palate
Authors: Mirashrafi Fatemeh , Saedi Babak , Rabbani Anari Mahtab , Garmaroudi Gholamreza , Toosi Roja , Abouhamzeh Kosar
Published: March 2021

Background: Orofacial cleft is one of the most common congenital malformations of craniofacial region. Otitis media with effusion causing conductive hearing loss is a considerable challenge for many children with cleft lip and palate. The aim of this study was to evaluate the prevalence of hearing disorders and associated malformations in these patients.
Methods: The research population consisted of patients with cleft palate, between years 2012 and 2014, who were referred to Children’s Medical Center and Vali-e-Asr hospital in Tehran, Iran. Otoscopic examination, tympanometry, pure tone audiometry and echocardiography were performed for each patient.
Results: Among patients with cleft palate, 73% suffered from hearing disorders. There was no relationship between prevalence of hearing loss and sex, presence of other congenital anomalies and degree of cleft, but middle ear diseases were significantly higher in children younger than 2 years. Among patients with cleft lip or palate, 10% suffered from cleft lip, 63% suffered from cleft palate and 27% suffered from cleft lip and palate. There was at least one congenital anomaly in 53% of patients.
Conclusion: This study demonstrates high prevalence of otitis media with effusion and conductive hearing loss in patients with cleft. However, audiologic problems are alleviated when patients become older.
The Knowledge Relationship And Family Attitude with Anxiety in Caring for Family Members People with Mental Disorders in Poly Jiwa Dadi Area Specialty Hospital Province of South Sulawesi
Authors: Siatang Weni , Napolion Kens , Musmulyadi .
Published: March 2021

Mental disorders are patterns of a person’s behavior related to distress symptoms or impairments in one or more important functions of a human being. The objective of this study is to assess the knowledge and family attitude towards anxiety in caring for family members who have mental disorders. This study used an Analytical Survey method with a Cross-Sectional Study approach. The research instruments used are knowledge, attitude and anxiety. The data analysis used is univariate analysis, employed to produce the frequency and percentage of each variable, and Bivariate analysis to examine the research hypothesis to determine the relationship of dependent and independent variables by using Fisher’s Exact Test. The results of this study showed more respondents with mild anxiety of 52.5 % with a value of ρ = 0.005 which means ρ < α = 0.05. This study showed more positive attitude respondents with mild anxiety of 55.5 % with a value of ρ = 0.042 which means ρ < α = 0.05. It is recommended for further researchers to examine other variables that have not been studied with more samples.
 
Keywords: Knowledge, Attitude, Anxiety, mental disorders
Empowerment Program Toward Risk Behaviour Among Adolescent
Authors: Hadiyani Wini , Sugianti Nella
Published: March 2021

Adolescence is recognized as a time of increased risk-taking compared with other age groups. The purpose of this study was to review previous journals related to empowerment program toward risk behaviors among adolescent. This study was a literature review as a method of collecting, analyzing a previous studies. Searching strategy was carried out electronically for several journal sites published between 2014-2019. We collected the journals from the databases PubMed, and Google scholar and reported according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA; Moher, Liberati, Tetzlaff, Altman, & The PRISMA Group, 2009). The results of the assessment using the JBI format. There are five articles reviewed empowerment stating that empowerment influence family and community support factors the adolescent empowerment program has a role on self-esteem, reducing depression, smoking, drug use, and prevention of sexual behavior. Empowerment programs in adolescents impact risky behavior such as reproductive health, HIV prevention, drug / alcohol and smoking by increasing reinforcement of knowledge, peer collaboration and opportunities for self-development.
 
Keywords: adolescent, empowerment, risk behavior
Family Support for Controlling Blood Pressure of Elderly Patients in Health Facilities During the Covid-19 Pandemic in Banjarmasin
Authors: Tutpai Gertrudis , Unja Ermeisi Er , Nura Florentina
Published: March 2021

At the time of writing, Covid19 cases were steadily increasing in Banjarmasin. Elderly people were afraid to go to the health facilities to control their blood pressure because they were afraid of catching this disease. However, checking blood pressure in the elderly with hypertension is extremely important, and in the absence of qualified medical staff their families need to take on the role. This research is to find the correlation between family support and controlling blood pressure of elderly patients in health facilities. This study was a quantitative research with cross sectional design that used documentation sheets and questionnaires about family support. Selected via purposive sampling, 50 people from families with hypertension were included in this study. The research period was May to July 2020. Data analysis used Chi Square test at
Knowledge Transfer Through Mobile Application Needs: A Survey of Nurses as End Users
Authors: Fajarini Melati , Rahayu Sri
Published: March 2021

Dissemination of evidence through a mobile application in the nursing area is a promising area of development. The effectiveness of this method of knowledge transfer encourages the development of a user-friendly mobile application responding to the needs of the nurses. However, nurses’ needs have yet to be identified. This study aims to understand the needs for knowledge transfer through the mobile application of nurses. An online survey was conducted at two public and private hospitals in Depok City in August and September 2019. A questionnaire with four items of needs assessment and 12 items of application features importance was completed by 110 nurses. Descriptive analysis showed the majority of nurses reported the need for best evidence with an average of 5.41 for research summary, 5.49 for systematic review, 5.87 for clinical guidelines, and need for knowledge transfer through mobile application with an average of 5.65 on 7 ranged Likert scale. Most nurses rated 11 out of 12 features are important with a score of more than four out of five on the Likert scale. The highest mean is the feature search with keywords (4.68±0.06) and the lowest in the quiz/games feature (3.82±0.10). The study noted that knowledge transfer through a mobile application is needed by nurses. Future design of the mobile application based on the needs of nurses as end-users is feasible.
 
Keywords: evidence-based practice, evidence-based nursing, knowledge translation, mobile applications, need analysis
Application of Acupressure in Reducing Pruritus Scale in Hemodialysis Patients
Authors: Panma Yuanita , Yetti Krisna , Sukmarini Lestari
Published: March 2021

Pruritus is a common problem in patients with chronic kidney disease who undergo dialysis. It is characterized by an uncomfortable sensation that leads to scratching. Acupressure is a complementary method used to manage various symptoms and health problems, including pruritus. This study aims to identify the effect of acupressure at the LI-11 point in reducing pruritus in a hemodialysis patient. This study used pre-experimental research with pre- and post-test without control. This study occurs in a hemodialysis unit in Central Jakarta, Indonesia. The sample was comprised of 19 respondents in the hemodialysis unit who met the inclusion criteria and completed the study. Respondents received acupressure in the LI-11 point two times per week for four weeks for a total of eight sessions. Data were collected using individual characteristics questionnaire, pruritus characteristics, and Visual Analog Scale (VAS) for pruritus. The data analysis used was a dependent t-test. The majority of respondents were male with duration of hemodialysis 5 hours, mean of age 53 years, mean of length of HD is 53 months, mean of Hb level is 9.67 gr/dl, mean of urea level is 117.05 mg/dl, mean of creatinine is 10.26 mg/dl. The results indicate that acupressure has a significant effect in reducing of pruritus scale (p-value 0,000). This study recommends nurses to be able to use acupressure therapy to reduce the scale of pruritus experienced by hemodialysis patients.
 
Keywords: acupressure, pruritus, hemodialysis
Independent Urine Measurement Based on Internet of Things
Authors: Agustiyowati Tri Hapsari Retno , KD Sansri Diah , Taryudi .
Published: March 2021

This study aims to create an independent urine measuring instrument based on the internet of things (IoT). This study was to see the differences in uroflometric measurements using an independent urine measuring based IoT tool compared to uroflometry in the urology clinic. The sampling method used was consecutive sampling with a total of 32 respondents. Uroflometry measurements were carried out twice, first using an independent urine measuring device based on the IoT, secondly using the standard uroflometric peak flow rate examination in the urology clinic. The results of measuring the average amount of urine per second using an independent urine measuring device based on IoT 22.22 ml / second, the average peak flow rate using uroflometry in the urology clinic is 23.97 ml / second, this shows that an independent urine measuring instrument based on IoT is not significantly different from uroflometry in urology polyclinic with a p value of 0.411, which indicates Ho was accepted, meaning there was no difference between the mean amount of urine per second and the average peak flow rate using uroflometry in the urology clinic. This study therefore concludes that an independent urine measuring devise based on the IoT instrument is effective for measuring urine emission per second. Suggestion: Follow up on the patent and legality of measuring instruments
 
Keywords: independent urine measuring instrument, internet of things(IoT), uroflometry, urethral stricture