bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the Relative Frequency of Preinjury Activity Recovery in Anterior Cruciate Ligament Replacement Patients: A Cohort Study
Authors: Akbari Aghdam Hossein , Shahrokh Seyedeh Ghazal , Ahmadi Omid , Rostami Koushan , Najafi Mohammad M. , Sadeghian Amirhossein , Hosseini Zahra , Anaraki Kasra Talebi
Published: November 2024

Background:

Anterior cruciate ligament (ACL) injury has an incidence of 0.05–0.08 per thousand. An inappropriate treatment plan could lead to articular cartilage damage and early knee osteoarthritis. Some surgical reconstruction techniques use different graft types; all of them try to restore the patient’s preinjury activity levels. The current study aims to evaluate the efficacy of ACL reconstruction (ACLR) using an autologous hamstring tendon.

Materials and Methods:

This is a retrospective one-center cohort study performed on consecutive patients with an ACL injury who underwent ACLR using semitendinosus and gracilis autograft. The postsurgical activity and fear were measured using Marx scale and Tampa scale of kinesophobia, respectively, during a follow-up of 18 months.

Results:

From a total of 76 patients included in our study, 40.8% were female. The mean age of the participants was 26.25-year-old. Five patients from those with kinesophobia (12.5%) and 34 patients from those with no-kinesophobia (94%) returned to the preinjury activity level (P value < 0.001). Marx scale six months after the surgery was significantly lower than the score before the surgery, but as expected, it improved during the 18-month follow-up.

Conclusion:

The current study showed that kinesophobia reduces the rate of return to preinjury levels. Maybe, overcoming this fear will help these patients to reach better results. However, we suggest implementing further trials in larger sample sizes before reaching a solid conclusion.
How Can Outdoor Air Pollutants Adversely Affect the Women’s Fertility? Systematic Review
Authors: Latifi Masoomeh , Rahim Forough , Ahmadlou Mojtaba , Pouladian Nima , Allahbakhshian Leili
Published: November 2024

In the current century, air pollution is known as one of the most critical environmental problems and it is important to find the relations of air pollution and human health. Various air pollutants, such as volatile organic compounds (VOCs), can negatively affect women’s fertility. An exhaustive electronic search was done from 2013 until July 2023 in PUBMED and The Cochrane Central Register of Controlled Trials. The following keywords were combined using Boolean hints in the databases queried: air pollution AND (fertility OR miscarriage OR embryo quality OR embryo development OR pregnancy OR implantation OR live birth). The randomized controlled trials, case-control and cohort studies analyzing the impact of air pollutants on fertility were included in the review. In this systematic review, a significant relation was found between the increase in air pollution and the reduction of fertility health, live birth rates, embryo quality, fertility, implantation rates, and miscarriage in exposed women. These results suggest low fertility health rates are associated with traffic-related air pollution. This review has concluded four components (particulate matter, nitrogen dioxide, sulfur, and carbon monoxide) of traffic pollution that can impair women’s fertility. Air pollution harms women’s fertility. These effects affect gamete’s quality at the genetic and epigenetic level. These effects also alter fetal development. Studies have also reported an effect on fetal growth with increased miscarriages. Since air pollution is everywhere and has many sources, it seems necessary to increase the awareness of people and government officials, especially in hygiene and health, to limit air pollutants as much as possible.
Optimizing Results: “Full-and-push” Venoplasty Technique for Iliac Vein Negotiation in Postthrombotic Syndrome
Authors: Balachandran Saravanan , Rajkumar Murugesan , Omprakash Shanmuganandam , Rajkumar Sharath , Tharani Megala , Arumugam Sarathkumar , Prakash Junia
Published: November 2024

Postthrombotic syndrome (PTS) is a form of chronic venous insufficiency that occurs secondary to deep vein thrombosis in up to 50% of all patients. PTS is largely attributed to the incomplete lysis of the intraluminal thrombus resulting in the formation of intimal synechiae. Although a wide range of treatment practices are available, PTS continues to adversely impact the patients’ quality of life, consequently increasing the need for optimizing existing methods of management. With regard to percutaneous transluminal venoplasty, complexities are encountered in advancing balloon dilatation catheters through the lesions due to the presence of obstructing endovenous synechiae. In this case report, a venoplasty technique is described for improving iliac vein negotiation through intimal synechiae in a young patient suffering from PTS with complete iliac vein occlusion wherein considerable difficulty was encountered during venoplasty.
Endovascular Management of Vertebral Artery Pseudoaneurysm Secondary to Penetrating Neck Injury
Authors: Sritharan Narayanan , Duraichi B Vella , Ravi Venkateshwar , Ravichandran Sasikumar , Jayachander K , Kumar P Ilaya , Vivek Ramya , Ayyavoo Harish Kumar
Published: November 2024

Vertebral artery pseudoaneurysms are uncommon, and they may arise due to penetrating or blunt trauma, arterial dissection, associated collagen vascular disease, or iatrogenic. Complications include compressive symptoms, rupture, bleeding, and posterior circulation stroke. In this case report, we present a successful endovascular treatment of a vertebral artery pseudoaneurysm in a 14-year-old boy secondary to a penetrating neck injury.
Novel mutations in the vitamin D receptor gene causing hereditary vitamin D-resistant rickets type 2A in two Indian families
Authors: Pawal Pratibha , Magar Suvarna , Lomte Nilesh Keshavrao
Published: November 2024

Hereditary vitamin D-resistant rickets type 2A (HVDRR2A; OMIM 277440) is caused by heterogeneous mutations in the vitamin D receptor (VDR) gene and is transmitted as an autosomal recessive trait. In this study, we report the clinical profile and management of two Indian cases of HVDRR2A, both presenting with alopecia and bony deformities. Blood investigations revealed hypocalcemia, elevated intact parathyroid hormone (iPTH), and high levels of 1,25-dihydroxyvitamin D [1,25(OH)2D3]. Molecular studies identified a novel homozygous c.1090 C > T (p.Gln364Ter) pathogenic variant in the VDR gene, resulting in a stop codon and premature protein truncation at the 364th amino acid position. Both patients were managed with intravenous calcium, high oral calcitriol, and cholecalciferol sachets.
A curative etiology of severe hirsutism with virilization – Sertoli Leydig cell ovarian tumor
Authors: Palanivel Sengottaiyan , Mahalakshmi N. K. , Rani Kalavathy , Muthuraman Marimuthu , Natarajan Vasanthiy , Sridhar Subbiah
Published: November 2024

Hirsutism is one of the earliest manifestations of virilization. The most common cause of hirsutism in a reproductive-age woman is polycystic ovarian disease. Androgen-producing tumors of the ovary or adrenals will cause severe hirsutism and virilization. The biochemical measurements of total testosterone and dihydro-epi androstenedione sulfate are useful to localize the source of hyperandrogenism. The medical management of severe hirsutism with virilism is difficult in the idiopathic variety. However, the prognosis is excellent for androgen-secreting benign ovarian and adrenal tumors, and surgical resection is often the treatment option in most of these cases. In this study, we report a case of a 26-year-old female presenting with secondary amenorrhea with clinical features of androgen excess with virilization. The biochemical and imaging characteristics are suggestive of an androgen-secreting ovarian tumor. Following right oophorectomy, the histopathology and immunohistochemistry confirmed benign Sertoli Leydig cell tumor, and clinical and biochemical features normalized after 3 months of the curative surgical procedure.
Type 1 Marine-Lenhart syndrome: An uncommon cause of thyrotoxicosis
Authors: Jha Vivek , Das Liza , Baruah Mintu Mani , Sood Ashwani , Bhadada Sanjay Kumar
Published: November 2024

Marine-Lenhart syndrome (MLS) refers to the simultaneous occurrence of Graves’ disease (GD) and functional thyroid nodules. This report discusses a case of Type 1 MLS characterized by hyperthyroidism, the detection of thyroid-stimulating hormone receptor antibodies, and a noticeable right thyroid nodule in a middle-aged female. A thyroid scan displayed heightened tracer uptake in this nodule and uniformly elevated uptake throughout the rest of the thyroid gland. The patient received treatment with anti-thyroid medications, followed by radioiodine ablation, and is currently on levothyroxine replacement therapy. This case illustrates the importance of considering MLS in patients with both thyroid nodules and GD, especially when they exhibit an inadequate response to standard anti-thyroid drugs.
Cutting balloon: Device, current indication, and usage
Authors: Agarwal Praveer , Mahajan Swati
Published: November 2024

The management of coronary artery disease has been revolutionized by percutaneous coronary interventions (PCI). With the advancements and availability of multiple tools in the repertoire, an interventional cardiologist tends to attempt complex of the lesions. The success of PCI, however, has been limited by restenosis, and acute ischemic events, hence prior lesion preparation and plaque modification, before stenting, becomes very important. Of the various tools available, cutting balloon (CB), developed by Barth, is increasingly being used nowadays. It is a special balloon with 3 to 4 atherotomes (blades), which tend to create longitudinal incisions in the plaque, in a controlled manner. CB finds its use in coronary as well as peripheral vascular system. It is important to understand the device, how to use it and more importantly where to use it. In this article we summarize the uses, indications and available experience with CB.
Design and validation of a self-assessment questionnaire of basic thinking skills
Authors: Vafamehr Vajiheh , Haghani Fariba , Jamshidian Sepideh
Published: November 2024

BACKGROUND:

Since assessment of basic thinking skills is crucial in identifying an individual’s cognitive capacities and comprehending their strengths and weaknesses, developing a suitable evaluating instrument holds significant importance in scheduling the training of basic thinking skills. This study aims to develop and subsequently validate a self-assessment questionnaire of basic thinking skills for medical sciences students.

MATERIALS AND METHODS:

The present study of designing and psychometrically testing the self-assessment questionnaire of basic thinking skills among medical sciences students was conducted between 2022 and 2023 at Isfahan University. For the validity review, exploratory factor analysis (EFA) was employed. The adequacy of sample size was checked with the KMO index and Bartlett’s test of sphericity. To perform EFA, principal factor analysis with Varimax rotation was performed. To obtain evidence of reliability, the internal consistency of the questionnaire was examined using Cronbach’s alpha. The instrument stability was assessed through test-retest and intra-cluster correlation coefficient (ICC) analysis.

RESULTS:

The KMO (Keyser-Meyer-Elkin) sampling index was 780, and Bartlett’s sphericity test (BT) was also significant (P = .000). In analyzing the main components and checking the value, the first five components had an eigenvalue above one. The highest percentage of the total variance (67.64%) was explained by the first five factors, while the remaining variance (33.35%) was explained by the remaining 14 factors. Cronbach’s alpha coefficient for 19 items of the final questionnaire was 0.83. Intra-cluster correlation index (ICC) for overall self-assessment of thinking skills (ICC = 0.77), self-assessment of basic thinking skills (ICC = 0.80), self-assessment of lateral thinking (ICC = 0.78), and the necessity of teaching thinking skills (ICC = 0.74)) were all above 0.7 (P < 0.001).

DISCUSSION:

This study offers the first self-assessment questionnaire for basic thinking skills of medical sciences students which can be employed as a valid and reliable instrument for self-assessment of thinking skills and gaining insight into their training experiences. While the psychometrics of this questionnaire were based on the data from medical students, this questionnaire applies to students across various academic disciplines and is not limited to medical fields.
Identifying the factors influencing the quality of education from the perspective of nursing students: A qualitative study
Authors: Rastegarimehr Babak , Mahboubi Mohammad , Raoofi Samira , Beigi Soheila , Teymourlouy Ahmad Ahmadi
Published: November 2024

BACKGROUND:

Nursing education in Iran suffers from challenges such as inadequate training time, non-scientific methods, lack of facilities, and so on. Nursing students can better discuss these issues and identify variables affecting their education. Thus, this study sought to uncover factors affecting education quality from nursing students’ perspectives.

MATERIALS AND METHODS:

This is a qualitative study that was conducted on nursing students in 2022. Purposive sampling chose 20 undergraduate nursing students from Abadan University of Medical Sciences, Abadan, Iran. The data was acquired using a semi-structured interview. Content analysis was performed using MAXQDA-10 software to extract relevant themes.

RESULTS:

The factors derived from content analysis were classified into two internal and external main themes and six sub-themes, including professors, students, the university/education department, hospitals, and the educational system.

CONCLUSIONS:

Analyzing the strengths and weaknesses of trainers and professors in practical programs and teaching new practical teaching methods can effectively enhance the quality of nursing education. Also, giving training and welfare equipment and necessities in educational hospitals and changing the headlines and contents of some nursing courses will improve education quality.
The relationship of social support with sexual assertiveness and marital satisfaction in Iranian women
Authors: Abdolalipour Somayeh , Feyzollahi Ayda , Laghusi Delara , Kalekhane Zahra Yousefi , Zamani-Zad Nasrin , Ahmadi Mobina , Mirghafourvand Mojgan
Published: November 2024

BACKGROUND:

People who receive social support in their marital life have a higher chance of experiencing more marital satisfaction. Pleasant healthy sexual relations and a couple’s sexual assertiveness are of prime significance in such satisfaction. This study aimed to determine the relationship between social support and both sexual assertiveness and marital satisfaction in married women referring to health centers in Tabriz, Iran.

MATERIALS AND METHODS:

This is a descriptive-analytical cross-sectional study on 292 women out of 22308 reproductive-age married females referring to the health centers of Tabriz in 2022. Sampling was done by cluster sampling method. Data collection instruments included a socio-personal information questionnaire, personal resource questionnaire 85 (PRQ85-Part 2) as a social support measure, Halbert index of sexual assertiveness (HISA), and enrich marital satisfaction (EMS) scale. Data were analyzed using Pearson, independent t, one-way ANOVA tests, and the general linear model.

RESULTS:

The mean (SD) of social support, marital satisfaction, and sexual assertiveness scores were 103 (19.8), 135.9 (11.8), and 52.2 (19.5), respectively. Social support had an average positive correlation with marital satisfaction (P < 0.001; r = 0.57) and a good positive correlation with sexual assertiveness (P < 0.001; r = 0.73). An adjusted general linear model showed a significant statistical relationship between social support with sexual assertiveness (B: 0.7; 95% CI: 0.6–0.8; P <0.001), and marital satisfaction, (B: 0.3; 95% CI: 0.2–0.4; P <0.001).

CONCLUSION:

An increase in social support, increases their marital satisfaction and sexual assertiveness. Focusing on social support could be an effective approach in family counseling or family education programs to improve marital satisfaction.
Assessment of the relationship between thinking styles and learning styles with academic performance in medical and nursing students of Kermanshah University of Medical Sciences
Authors: Barry Azizeh , Haji Sadra , Shahabi Maryam , Sepahi Vida , Ghasemi Mahdiyeh , Norouzi Azam , Ramezani Ghobad
Published: November 2024

BACKGROUND:

Learning and studying approaches are among the topics of great importance in medical sciences universities. Different approaches to learning can explain why some students learn better than others. This study aims to assess the relationship between learning or thinking styles and academic performance among nursing and medical students.

MATERIALS AND METHODS:

This is a quantitative and cross-sectional study that was conducted on 364 nursing and medical students of Kermanshah University of Medical Sciences in 2022–2023. The tools used in the present study are as follows: the short version of the Approaches and Study Skills Inventory for Students, the Sternberg-Wagner Thinking Styles Inventory, the Academic Performance Index including the semester grade point average and the overall grade point average. Descriptive statistics, including mean and standard deviation were employed for data analysis. Moreover, inferential statistics such as normality or correlation coefficient, independent sample t-test, and regression analysis were used to determine the predictor coefficients.

RESULTS:

A positive and significant correlation was found between nursing and medical students’ thinking or learning styles and their academic performance (P < 0.001). In addition, the two groups showed a statistically significant difference between learning styles with respect to gender (P < 0.001) and thinking styles (P < 0.001).

CONCLUSION:

Since the strategic approach is a predictor of academic performance, identifying and determining the types of approaches adopted by students using diagnostic evaluation is a method of evaluating students’ learning styles at the beginning of the educational process so that teachers can tailor the most effective approach and instructional strategies that suit the needs of students and improve academic performance.
Efficiency and coherent development as the main concepts of health care managers' readiness in passive defense; Experiences of Iranians healthcare managers
Authors: Khayeri Fereydoon , Tabibi Seyed Jamalodin , Riahi Leila , Hajinabi Kamran
Published: November 2024

BACKGROUND:

This study examines the elements of efficiency and coherent development in passive defense among healthcare managers for disaster management in Iran.

MATERIALS AND METHODS:

The study employs a qualitative method using conventional content analysis from 2021 to 2023. A purposive sample of 25 healthcare managers with experience in passive defense is selected. Data are collected through unstructured interviews and analyzed using conventional content analysis.

RESULT:

The participants’ experiences regarding the coherent efficiency development of passive defense are categorized into three main themes, namely, enhancing emergency knowledge empathic and responsible cohesion, management development planning and resources, and individual updating and flexibility.

CONCLUSION:

The role of passive defense is very decisive in crisis management through the strategy of efficiency and coherent development. This strategy is implemented using the concepts of enhancing disaster knowledge, empathic and responsible cohesion, management development planning and resources, and individual updating and flexibility.
Alexithymia and attachment on mental health of people with multiple sclerosis: The mediating role of perceived social support and loneliness
Authors: Doostdari Farnaz , Kianimoghadam Amir Sam , Arzpeyma Mahyar , Fatollahzadeh Saina , Zakibakhsh Mohammadi Nassim , Masjedi-Arani Abbas , Hajmanouchehri Reza
Published: November 2024

BACKGROUND:

Multiple sclerosis and its progressive relapsing–remitting nature for MS patients is challenging and significantly affects the mental health of people with MS. We examined the direct effects of alexithymia and attachment on mental health and the indirect effect of attachment, alexithymia, loneliness, and perceived social support on the mental health of people with MS.

MATERIALS AND METHODS:

Three hundred and forty-five diagnosed with multiple sclerosis (MS) were deemed eligible for inclusion in the study and selected through the Iranian MS Association. Measures included the Toronto Alexithymia Scale (TAS20), Attachment Style Questionnaire (ASQ), General Health Questionnaire (GHQ28), Social and Emotional Loneliness Scale for Adults (SELSA-S), and Perceived Social Support from Family and Friends Questionnaire (PSS-FA and PSS-F). The mental health of MS patients was analyzed using structural equation models (SEM), examining how alexithymia, attachment, social support, and loneliness, directly and indirectly, affect their mental health. The fit of the model to the data was analyzed using the discrepancy function divided by degrees of freedom (CMIN/DF), Normed Fit Index (NFI), Tucker–Lewis Index (TLI), Comparative Fit Index (CFI), and Root Mean Square Error of Approximation (RMSEA).

RESULTS:

The results showed that the model fit was good. Furthermore, findings indicate that 28% (R2 = 0.28) of the mental health changes are explained via study predictors. Alexithymia and attachment directly affect mental health. Attachment style indirectly affects social support and loneliness, while loneliness and family support indirectly affect the mental health of MS patients.

CONCLUSION:

The study findings provide valuable insights into the fundamental structures that influence the mental health of individuals with MS. Loneliness and social support are critical mediating factors that significantly impact the mental well-being of these patients. In the times ahead, healthcare professionals must prioritize attachment, alexithymia, social support, and loneliness in their medical and psychological interventions for individuals diagnosed with multiple sclerosis.
Differences between networks of cognitive emotion regulation strategies in medical students with and without a history of non-suicidal self-injury
Authors: Zadehparizi Reza , Kianimoghadam Amir Sam
Published: November 2024

BACKGROUND:

Non-suicidal self-injury (NSSI) is deliberate self-harm without the intent to die. NSSI is associated with mental health issues and has a higher prevalence among medical students. Understanding the cognitive emotion regulation strategies in NSSI is important for intervention and prevention. Network analysis provides a holistic perspective on these strategies.

MATERIALS AND METHODS:

Participants were 405 individuals (68.6% female) with a mean age of 22.7 years (standard deviation: 3.97, range: 17–55 years), recruited from Tehran, Iran. Upon conducting an initial screening, it was found that 68 individuals from our sample acknowledged a prior history of NSSI.

RESULTS:

A network analysis showed that that students with a history of NSSI perceived themselves to have difficulties in putting into perspective, positive reappraisal, and self-blame. Compared to students without NSSI, those with NSSI exhibited negative associations between putting into perspective and rumination (PIP__RUM: -0.240) and positive associations between positive refocusing and catastrophizing (PR__Catast: 0.61).

CONCLUSIONS:

This study discovered notable distinctions in the cognitive processing and coping strategies of medical students with and without a history of NSSI. These findings contribute to the existing literature on the link between cognitive-emotional processes and NSSI, informing the development of interventions to decrease such behaviors.
Two distinct psychological concepts: Diabetes depression and diabetes burnout profiles
Authors: Noorian Kobra , Abdolazimi-Najaf-Abadi Azam , Taghipoor Mahboobeh , Doosti-Irani Mahboobeh , Doosti-Irani Mehri , Abdoli Samereh
Published: November 2024

BACKGROUND:

Diabetes burnout represents a unique experience that shares some similarities with other psychological concepts. Differentiating diabetes burnout from depression symptoms is a challenging issue. This study aims to examine diabetes burnout profiles and their association with depression.

MATERIALS AND METHODS:

A cross-sectional study was conducted in Iran in 2023. Individuals with type 2 diabetes over 18 years old (N = 1300) were recruited through convenience sampling. Data collection was conducted through demographic information, Personal Health Questionnaire Depression Scale (PHQ), and Diabetes Burnout Scale (DBS). Unsupervised clustering methods were utilized to determine the optimal number of profiles.

RESULTS:

Five burnout profiles were found (fully burned-out, overextended, exhausted, on the threshold of burnout, and not-burned-out(. The mean burnout score increases as we move from the not-burned-out profile to the fully burned-out profile. The mean depression score was 7.04. Some individuals (n = 124) who were not-burned-out still experience different depression levels. As depression levels increase, burnout levels also tend to increase. It is noteworthy that while depressed individuals are also burned-out, not all individuals experiencing burnout are necessarily depressed. This is a crucial finding in distinguishing between these concepts.

CONCLUSION:

Addressing burnout based on profiles could be more effective for individuals with diabetes. It is a foundation for further exploring the development of diabetes burnout profiles over time and its relationship with diabetes management and outcomes.
Exploring the perceptions and cultural differences surrounding mindfulness among early childhood education informal caregivers: A qualitative study
Authors: Villalobos Jennifer P. , Valverde Patricia A. , Farewell Charlotte V.
Published: November 2024

BACKGROUND:

Early childhood education (ECE) caregivers experience high levels of stress and increased physical and emotional work demands. Promoting mindfulness practices may be an acceptable and feasible strategy to bolster mental health and well-being. The present study’s goals were to explore the 1) perceptions and 2) cultural differences surrounding mindfulness practices and mental health among Spanish-speaking Hispanic (SSH), English-speaking Hispanic (ESH), and English-speaking non-Hispanic (ESNH) informal ECE caregivers.

MATERIALS AND METHODS:

Seventeen informal caregivers participated in semi-structured individual interviews between July 2021 and January 2022. Using NVivo12 software, an inductive, qualitative thematic content analysis was conducted to identify themes in the caregivers’ discourse.

RESULTS:

All three groups of caregivers expressed the desire to make time for themselves, their physical health, and their mental health when discussing self-care. However, two main barriers and challenges related to mindfulness practices reported by all three caregiver groups included lack of time and frequently feeling tired after a long day of work. Other key results and suggestions for practicing mindfulness are provided.

CONCLUSION:

The findings from this study show that mindfulness practices among informal ECE caregivers may be deemed acceptable and considered a valuable tool to support mental health in caregiver communities.
Precision medicine and patient outcomes in intensive care unit: Culture sensitivity, antibiotics, and APACHE score IV
Authors: Zubair Sidra , Jamil Subia , Fatima Sakina , Sibtain Syed T. , Raees Hira , Eraj Asma , Nawab Amber
Published: November 2024

BACKGROUND:

In the intensive care unit (ICU), complex medical conditions require specialized care; the threat of antibiotic resistance is significant due to frequent antibiotic use. This study investigates the pivotal role of culture sensitivity testing in shaping antibiotic prescription practices and patient outcomes in ICUs.

MATERIALS AND METHODS:

By using a prospective observational-analytical design, medical data from 640 patients at a Karachi hospital for one year in 2022 were utilized. The study focused on antibiotic therapy, including empiric and targeted approaches, culture sensitivity testing, the use of the APACHE scale for mortality prediction, and changes in antibiotic regimens based on culture reports. Statistical analysis involved Fisher’s Exact and ANOVA tests.

RESULT:

The age category above 60 emerged with the highest survivorship. Contrary to expectations, age did not seem to correlate significantly with mortality rates. Staphylococcus species was the most prevalent microorganism in this study, disproportionately affecting nonsurvivors 66.7%. The clinical profile comparison between survivors and nonsurvivors offered a multifaceted perspective, with significant differences in vital parameters such as temperature, heart rate, respiratory rate, urine output, FiO2, mean arterial pH, and blood sugar levels. Survivors (44.60%) underwent complete antibiotic regimen changes, a strategy for improved patient outcomes.

CONCLUSIONS:

Complex antibiotic combinations were prescribed for broad clinical conditions. These insights pave the way for future research on antibiotic stewardship in ICUs, navigating more effective and targeted treatments.
Effectiveness of nurse-led progressive muscle relaxation on stress, anxiety, and depression in parents of adolescents with mental illness: A randomized controlled trial
Authors: George Sijesh , Govindan Radhakrishnan , Kommu John Vijay Sagar
Published: November 2024

BACKGROUND:

Prevention of depression, stress, and anxiety is a serious concern of the World Health Organization and has been a research topic over the last decades. There is a close association found between children’s mental health problems and parental stress, valid for biological and foster families. Evidence suggests that parents with children with disabilities are more stressed, depressed, or anxious than parents who do not have such children. In addition, the progressive muscle relaxation technique (PMR) is the easiest to learn and administer among the relaxation methods available for lowering stress, anxiety, and depression.

MATERIALS AND METHODS:

A randomized clinical trial (RCT) was adopted with an equivalent group pre-test and post-test design. The experimental group (n = 31) received ten sessions of Jacobson PMR, and the control group (n = 30) received treatment as usual (TAU). Data analysis: The researcher used frequency, percentage, mean, standard deviation, median, and interquartile range to describe the study subjects’ demographic profile and clinical profile. Mann-Whitney U test, Kruskal-Wallis H test, and Spearman’s Rho were used to find an association between socio-demographic and clinical variables in parents’ stress, anxiety, and depression levels. Further, Spearman’s Rho was used to find a correlation between stress anxiety and depression. In addition, the Chi-square test and Fisher’s exact test were used to compare control and experimental groups with important socio-demographic and clinical variables. Further, Fridman’s analysis of variance (ANOVA) was used to assess PMR’s effectiveness on group stress, anxiety, and depression. Finally, the Mann-Whitney U test was used to compare stress, anxiety, and depression levels between groups.

RESULTS:

Analysis revealed clinically and statistically significant (P < 0.05) reductions in the stress and anxiety scores of the parents after five sessions of the PMR technique. In addition, findings reveal that there is a statistically significant reduction (P < 0.001) in depression, anxiety, and stress scores after ten sessions of the PMR program among parents of adolescents with mental illness.

CONCLUSION:

The PMR program adopted in this study was highly effective in reducing stress, anxiety, and depression among parents of adolescents with mental illness.
Opinion on agile methodology in education among the nursing students
Authors: Thiyagarajan Suseela , Saldanha Prakash R. M. , Govindan Radhakrishnan , Leena Kunnath Chacko , Prathyusha P Vasuki
Published: November 2024

BACKGROUND:

Agile methodology (AM) is an innovative, active, project-based learning method. The scrum is a popular agile framework widely used in project management and education. This study evaluates the opinions on agile adaptation in nursing curricula among nursing students to identify how AM can be applied in higher education to facilitate learning.

MATERIALS AND METHODS:

The study employed a cross-sectional design and was conducted at two colleges affiliated with health science university, Bengaluru, India in 2021-22. A 23-item agile scrum perception tool (ASPT) was used to evaluate the opinions on AM among the nursing students after the agile training. The data were analyzed by using IBM SPSS version 28. Descriptive statistics was used to evaluate the opinion.

RESULTS:

A total of 133 students responded to the questionnaire. Nearly, 99 (74%) of the students strongly agreed the team leader’s (TL) responsibility for managing the time was good. Around 109 (82%) of the students felt that the product owner (PO)/outcome evaluator (OE) explained the course objectives well. About 107 (76%) of students strongly agreed that the learning was facilitated by AM.

CONCLUSION:

The agile scrum framework (SF) can be taught and fostered to improve collaborative learning, teamwork, leadership abilities, and educational outcomes. The policymakers should set the criteria for implementing agile in the curriculum, and nurse managers should allocate the budget for organizing the training program in the form of workshops and conferences for the nursing educators and nurses which could help to improve the self-directed learning and safe collaborative quality of patient care.
Effectiveness of “Sukhi Hrudaya – heart health guide for women” on heart health awareness in a tertiary care setting of Manipal
Authors: Menezes Henita Joshna , Padmakumar Ramachandran , Kotebagilu Namratha Pai , Garg Meenakshi , Kamath Asha , D’Souza Sonia R.B
Published: November 2024

BACKGROUND:

Cardiovascular diseases (CVDs) are a major global burden, particularly in low- and middle-income countries, leading to higher rates of chronic CVDs and increased risks of morbidity and mortality. Offering women a comprehensive Information, Education, and Communication health guide can significantly help combat CVDs by enhancing their awareness regarding heart health. Our aim was to determine the effectiveness of “Sukhi Hrudaya – heart health guide for women” on awareness regarding heart health.

MATERIALS AND METHODS:

A quasi-experimental study was conducted to determine the effectiveness of a “Sukhi Hrudaya – heart health guide for women” on awareness by using a nonprobability purposive sampling technique. Data were collected from 70 women (>18 years) who visited the cardiology outpatient department of a tertiary care setting in Manipal. Women in the experimental arm received a “Sukhi Hrudaya – heart health guide for women”. Post-test was performed after a week. The data were analyzed using Statistical Package of Social Sciences software version 25.0, employing both descriptive and inferential statistics.

RESULTS:

The effectiveness was assessed 7 days post-test with an independent samples t-test, which revealed that there were significant differences in the awareness regarding heart health (t(68) = 4.572, P < 0.01) between the experimental and control arms. The mean awareness regarding heart health of the experimental arm (M = 17.29, standard deviation [SD] =3.923) was higher than in the control arm (M = 13.11, SD = 3.708). After assuming equal variances, the mean difference was 4.171 (confidence interval: 5.992–2.351) at 0.05 level of significance.

CONCLUSION:

The positive outcomes suggest the potential integration of such interventions into broader health policies, emphasizing the need for gender-specific strategies to enhance cardiovascular health among women.
Effect of Cawthorne and Cooksey exercise on balance control and fall risk among middle-aged population: A single group pre-post experimental study
Authors: Keerthana R. , Mariarathinam Premkumar , Vellaisamy Jeyaganesh , Gopal S. Radhika
Published: November 2024

BACKGROUND:

Balance impairment is one of the causes of the risk of falls among all age groups and is a continuing threat to morbidity and mortality across the world. Previous studies stated that the vestibular system is affected in middle-aged population, which leads to imbalance and a high risk of falls. There is a lack of research in this account so this study has been done to find the effect of Cawthorne and Cooksey exercise in vestibular rehabilitation on balance control and the risk of falls among middle-age population.

MATERIALS AND METHODS:

According to the criteria of selection 30 subjects were recruited for this study. Baseline demographic measurements were recorded. Timed up and go (TUG) test time, Sway analysis using a force plate, and Morse fall scale measures were used as outcomes. Cawthorne and Cooksey exercise was given for 8 weeks 3 sessions per week. Pre and post-intervention outcome measures with 3-month follow-up were recorded for data analysis.

RESULTS:

The mean age of participants was 49.55 ± 5.67 years. The paired sample t-test showed mean values of TUG 1.86 ± 1.03, COPx 1.17 ± 1.50, COPy 1.78 ± 1.78, MFS 8.75 ± 12.23 with P value of 0.00 (P < 0.05) for all measures. The repeated measures ANOVA showed 3-month follow-up results for TUG P ≤ 0.00, COPx P ≤ 0.01, COPy P ≤ 0.00, and MFS P ≤ 0.00.

CONCLUSION:

There is a statistically significant effect of Cawthorne and Cooksey exercise on balance control and fall risk among middle-aged population of 40–60 years.
A positive psychotherapy group intervention to increase distress tolerance and reduce feelings of entrapment in patients with multiple sclerosis
Authors: Jamalooei Yaghoob Harooni , Esmaeili Maryam , Abedi Ahmad , Najafi Mohammad R.
Published: November 2024

BACKGROUND:

Multiple sclerosis is a central neurogenic demyelinating disease. This is one of the most common neurological diseases in humans and is the most debilitating at a young age. Symptoms of multiple sclerosis include vision problems, balance problems, dizziness, sensory disturbances, chronic neuropathy, and fatigue.

MATERIAL AND METHODS:

A quasi-experimental study with pretest, posttest, and one-month follow-up design was conducted to evaluate the effectiveness of positive psychotherapy on distress tolerance and feelings of entrapment in 30 patients with multiple sclerosis (MS). Patients were conveniently sampled in 2021 and randomly assigned to either an experimental or control group, with 15 patients in each. The experimental group underwent eight sessions of 90-min positive psychotherapy over consecutive weeks, while the control received no therapy. Both groups completed the Simons and Gaher Distress Tolerance Questionnaire (DTS) and feeling entrapment questionnaire before and after the intervention period as pre- and posttests. Repeated measures analysis of variance (ANOVA) was performed on the collected data using SPSS 22 software to compare changes between the groups over time and assess the impact of the psychotherapy.

RESULTS:

Repeated measures ANOVA results showed that positive psychotherapy had a significant effect in increasing distress tolerance (Sig = 0/001 and F = 545/434) and reducing feelings of entrapment (Sig = 0/001 and F = 275/05).

CONCLUSION:

Positive psychotherapy increases distress tolerance and reduces the feelings of entrapment in MS patients. It is therefore suggested that interventions based on positive psychological points should be done in different centers. The context should be repeated and include larger and more ethnically and socioeconomically diverse examples.
Infection control nurse: A scoping review
Authors: Sugunan Aswin , Raj Anil , Nayak Shalini G. , George Anice
Published: November 2024

Infection control is a crucial aspect of healthcare delivery aimed at curtailing the spread of infections within healthcare settings. The role of infection control nurses (ICNs) is reported to have a significant contribution in limiting healthcare-associated infections. Scholarly investigations have explored various domains of ICNs. However, a lack of comprehensive coverage of existing studies in the area is observed. Therefore, the current review attempts to determine the scope of the literature published on ICNs. A search was conducted on PubMed, Scopus, CINAHL, Embase, and Web of Science from January 2000 to December 2023 to retrieve research outputs on ICNs. The identified data underwent two screening stages to extract relevant articles based on the inclusion and exclusion criteria. The key outcomes were the factors that influenced the performance of ICNs and ICN programs. Out of 1869 articles, 25 were selected for the final review. The study summary identifies themes such as the roles and factors influencing ICNs and evaluating ICN programs. The review highlights a lack of high-quality evidence on ICN programs. Therefore, future studies should focus on implementing and evaluating these programs. Mapping and designing the structure, job responsibilities, and the role of ICNs demand attention from the research community.
Evaluation of the analgesic efficacy of a low dose of intrathecal morphine in laparoscopic abdominal surgery: A randomised control trial
Authors: Kumar Lakshmi , Anantharaman Ramya , Thomas Dimple Elina , Nair Anjaly S. , Kartha Anandajith P. , Kumar Karthik
Published: November 2024

Introduction:

Intrathecal opioid is an analgesic option in laparoscopic surgery. We assessed primarily the intraoperative opioid requirement amongst patients receiving intrathecal morphine (ITM) (Group M) versus standard care (Group C) for abdominal surgery. The secondary outcomes were intraoperative haemodynamic changes, extubation on table and pain scores in the intensive care unit (ICU) at 6th hourly intervals for 24 h postoperatively.

Patients and Methods:

Patients undergoing laparoscopic abdominal surgery were randomised into Group M (n = 30) that received ITM at 2 μg/kg while Group C (n = 30) was control. A rise in mean arterial pressure > 20% from baseline was treated sequentially with 0.3 mg /kg propofol and 0.5 μg/kg fentanyl intravenously (IV). Pain management in the ICU included paracetamol 1G IV 8th hourly for all patients, while nefopam 20 mg and fentanyl 0.5 μg/kg IV were the second and third tiers of pain management.

Results:

Intraoperatively, 10 patients in Group M versus 26 in Group C needed additional fentanyl (P < 0.001) and 15 versus 26 patients needed additional propofol (P = 0.0024). Pain scores were superior in Group M at all time points in the ICU and at ambulation and during incentive spirometry. Thirteen patients in Group C versus 3 in Group M needed nefopam at the time of shifting to the ICU (P = 0.004) and 10 patients versus 1 at 8 h in the ICU (P = 0.003) while pain management at 16 h and 24 h was comparable.

Conclusion:

Pre-operative ITM at 2 μg/kg reduces intraoperative opioid requirement and improves analgesia 24 h postoperatively amongst patients undergoing major laparoscopic abdominal surgery without delay in extubation or changes in haemodynamics.
Video-assisted thoracoscopic surgery in pancreaticopleural fistula: A case report
Authors: Thombare Amit Anil , Bakhshi Girish Davinder , Boricha Sumit , Hande Manish Sunil , Kishore Ram
Published: November 2024

Pancreatico-pleural fistula (PPF) is sequelae of pancreatitis. It is more commonly seen in alcoholic pancreatitis with abdominal symptoms and signs. PPF presenting with respiratory symptoms and signs in the absence of abdominal signs is rare. Moreover, trivial trauma which went unrecognised in a 14-year-old child for 3 months resulting in PPF has not been reported in the literature. This chronic PPF results in the formation of adhesions between the lung and pleura. These adhesions result in the incomplete expansion of the lungs even after thoracocentesis. The present case highlights the significance of video-assisted thoracoscopic surgery in such cases with a review of diagnostic and management guidelines.
Laparoscopic common bile duct exploration and retrieval of endoscopic lithotripsy basket after mechanical failure
Authors: Nip Lawrence , Lynch Mark , Philipose Zinu , Ceraldi Serena
Published: November 2024

Impaction of a mechanical lithotripsy basket during endoscopic retrograde cholangiopancreatography is a rare but serious complication resulting from technical failure. We describe a novel case of lithotripsy basket retrieval aided by laser fragmentation. This 87-year-old male underwent an emergency laparoscopic subtotal cholecystectomy, common bile duct (CBD) exploration and laser lithotripsy after attempts at endoscopic mechanical lithotripsy caused a stone-basket complex to become impacted within the CBD. In the absence of endoscopic salvage techniques, laparoscopic CBD exploration is a valid and safe option where surgical expertise permits.
Middle-grade led Expedited Gall bladder lists: Is it safe and feasible?
Authors: Chhabra Raunaq Sundeep , Ali Hasan , Ullah Faizan , Lorenzi Bruno , George Amal
Published: November 2024

Introduction:

Gallstone-related acute admissions account for a significant percentage of acute general surgery admissions. Providing a dedicated expedited gall bladder list service to deal with these cases appears to be not only clinically effective but also cost-effective. There are various logistical reasons why hospitals are unable to provide such dedicated lists, inadequate surgical staff being one of them. We initiated a middle-grade-led expedited gall bladder list with indirect consultant oversight at our hospital as a consultant-led list was not feasible. This study evaluates the safety and efficacy of this service post-implementation.

Patients and Methods:

A retrospective analysis was conducted on prospectively collected data from February 2022 to September 2023. Patients were triaged using a dedicated questionnaire and operated on within 2–8 weeks of admission. The outcomes measured included complications, readmissions and the need for consultant opinion and assistance.

Results:

Amongst 101 patients, the mean age was 50.59 ± 15.25 years, with a majority being female and having an American Society of Anaesthesiologists grade of 2. Consultant assistance was required in 14 cases, with 9 requiring active participation. Complications were comparable to national averages, with four cases of bile leaks and one small bowel injury. Six readmissions were recorded for various postoperative issues.

Conclusion:

The middle-grade led expedited gall bladder service demonstrated a safe and effective alternative to consultant-led lists, offering a pragmatic approach to addressing surgical demands within the constraints of staff and facility limitations.