bluuebunny/crossref_metadata_2025 huggingface dataset:
Needs of Patients with Opioid Dependence
Authors: Oomen Denny Mariam , Gupta Sandhya , Sarkar Siddharth , Devi Y. Surbala
Published: September 2023

Context:

There are more than ten thousand opioid-dependent patients visiting the study setting annually, depicting the serious public health issue associated with opioid use. The upheaval in all phases of life of a patient necessitates active involvement of both patient and caregiver. The importance of need assessment of patient by patients themselves and their caregivers need to be separately assessed to provide holistic care to patients.

Aim:

The aim of the study was to assess the needs of patients with opioid dependence syndrome as perceived by patients themselves and their family caregivers.

Setting and Design:

A comparative cross-sectional study conducted in a drug dependence treatment facility in India.

Subjects and Methods:

The needs of 105 opioid-dependent patients perceived by patients themselves and their family caregivers were assessed using Camberwell Assessment of Need Short Appraisal Schedule.

Results:

The most common unmet needs of patients as rated by patients themselves were physical health, money, and company. The most common unmet needs of patients rated by caregivers were money, looking after home and daytime activities. The agreement of needs of patient was poor in domains such as self-care (k = 0.17), looking after home (k = 0.16), company (k = 0.13), physical health (k = 0.10), money (k = 0.09), and psychological distress (k = 0.06).

Conclusion:

Addressing the needs of patients with opioid dependence might help in developing a more holistic management plan which will improve treatment outcomes. Nurses should be active part of communication system and fill the gap existing in the needs of patients.
A Study to Assess the Prevalence of Nomophobia among Nursing Students in Kollam
Authors: Anand S. , Anoopa K. R , Joseph Praveen George , Raju Sajini
Published: September 2023

Introduction:

Nomophobia is an emerging human behavior stemming from widespread mobile phone use. Discovering the prevalence of nomophobia among nursing students is important as the use of smartphone in clinical practice may cause distraction affecting the quality of care and putting patients' safety at risk. Furthermore, it can lead to poorer academic performance.

Materials and Methods:

Quantitative approach with descriptive cross-sessional design was used in this study. The study was conducted in Bishop Benziger College of Nursing, Upasana College of Nursing, VNSS College of Nursing, and Holy Cross College of Nursing, Kollam, Kerala. The target populations were BSc nursing students. The purposive sampling technique was used to collect the data. Formal permission was taken by the institutional ethics committee and consent from the nursing students and data were collected through Google Forms. The tools used consisted of Demographics Pro forma and Standardized Nomophobia Questionnaire which is 7-point self-reporting questionnaire (not at all nomophobia, mild nomophobia, moderate nomophobia, and severe nomophobia). The collected data were analyzed using descriptive and inferential statistics.

Results:

The mean age of the participants was 21 years. More than 50% of nursing students use smartphone for about 5 h daily. Totally, 42% of nursing students having the habit of checking their smartphone <10 times/day. Nursing students affected by severe nomophobia were very minimal that were only 2%. (moderate 33%, mild 54%, and no nomophobia 11%). The prevalence rate of nomophobia among nursing students was 34.84. Significant association was found between nomophobia among nursing students and demographic variables such as level of study, smartphone use duration, frequency of checking phones, and frequency of checking phone episodes at 0.05 level.

Conclusion:

Smartphone addiction is a growing phenomenon in the current world. Online classes are influencing the duration of smartphone use. More than 50% of the private college nursing students are having mild nomophobia.
Effectiveness of Structured Teaching Program on Nurses' Knowledge on Safe Handling of Psychotropic Drugs
Authors: Harsharaja S. V. , Govindan Radhakrishnan , Ramu Rajalakshmi , Damodharan Dinakaran , Kandasamy Arun
Published: September 2023

Background:

Nurses play a major role in the management of psychiatric patients including the administration and handling of psychotropic drugs. They are in a pivotal position to educate the patient and family members about the medication and they should possess knowledge and competencies of psychotropic drugs to ensure safety.

Materials and Methods:

The authors have applied quantitative approach, preexperimental design, one group pre-test and post-test design for this study. Fifty-two newly recruited nursing officers were participated in this study. The authors have assessed the nurses' baseline knowledge on psychotropic drugs and the safe handling of such drugs. Followed by that, structured Teaching Program (STP) was designed, developed, and imparted to improve the nurses' knowledge and skills on psychotropic drugs by the authors. A post-STP assessment was conducted to identify the change in nurses' knowledge.

Results:

Baseline assessment revealed that the nurses were obtained poor scores in knowledge on psychotropics scale and safe handling of psychotropics scale. The median pretest score was seven on knowledge of psychotropics scale and four on the safe handling of the psychotropics scale. Two weeks' posttest scores were 15 and 11, respectively. The results showed significant difference between pre-test and posttest median scores and Wilcoxon signed-rank test (P < 0.001). Sociodemographic variable such as the age of the participants was correlated positively with baseline scores of safe handlings of psychotropic drugs and their post-graduate training in psychiatric nursing was associated with knowledge score.

Conclusion:

The results of the study revealed that the STP me about knowledge on psychotropic drugs and safe handling of psychotropic drugs was effective in improving the knowledge of newly recruited staff nurses. Continuing nursing education on psychotropic drugs and its safe handling skill among nurses may result in better psychiatric nursing care outcomes.
Bilateral Congenital Pulmonary Airway Malformation in an Adult
Authors: Chetambath Ravindran , Kumar Jesin , Shivashankaran Sanjeev
Published: September 2023

Congenital pulmonary airway malformations (CPAMs) are considered part of a spectrum of bronchopulmonary foregut malformations. Diagnosis is usually made during the antenatal or neonatal period, and is rarely diagnosed in adults. The spectrum of clinical presentations varies from asymptomatic cases to recurrent respiratory tract infections or respiratory insufficiency in adulthood. Here, we report the case of an adult female who presented with a history of recurrent respiratory tract infections since childhood. Radiological findings were in favor of bilateral CPAM. Bilateral CPAM in an adult patient is extremely rare, and it is mostly managed as bronchiectasis.
Magnetic Resonance Imaging evaluation of Patients with Anterior knee pain
Authors: Ojha Ritu , Patel Rahul , Kumar Ishan , Bhardwaj Vritika , Verma Ashish , Shukla Ram Chandra
Published: September 2023

Anterior knee pain (AKP) is one of the most common clinical conditions related to knee pathology among the athletes and young adults. The identification of pain provoking factor is crucial for the better outcome of the treatment. Many patients with AKP have disabling pain and significant disability, but the physical signs and radiological findings are unremarkable. Its aetiology is still not fully understood, but there are some major factors that can be attributed to its aetiology. Accurate diagnosis of the condition is needed before any decision regarding its management is undertaken. Diagnosis is usually suspected clinically and is confirmed by imaging. Although, radiography, ultrasonography, computed tomography scan and magnetic resonance imaging (MRI) are the available modalities for the evaluation of AKP, MRI is considered the gold standard for pain imaging and can provide important information regarding individually tailored treatment. The present study is a prospective descriptive compilation of the role of available imaging modalities, particularly MRI in the evaluation of different pathological conditions related to AKP. The present study demonstrated that patellofemoral instability was a major cause for origin of AKP.
Evaluation of Radiological and Clinical Outcome of Minimally Invasive Plate Osteosynthesis (MIPO) for Metaphyseal Fracture of Distal Femur and Proximal Tibia
Authors: Verma Ajeet Kumar , Agarwal Saumya , Garg Apoorv Mohan , Prakash Shivank , Choubisa Raghvendra
Published: September 2023

Background:

Metaphyseal fracture of distal femur and proximal tibia results from high-velocity road traffic accidents. Using minimally invasive plate osteosynthesis (MIPO), the complex fracture zone is left untouched and length, alignment, and rotation are restored. As the fracture site is not explored, the osteogenic tissues surrounding the fracture are well protected and their blood supply is well preserved. This accelerates fracture healing.

Materials and Methods:

Thirty-five patients within the span of 3 years underwent internal fixation of distal end femur and proximal tibia by locking compression plate (LCP) using MIPPO technique. All the patients were assessed using Johner–Wruhs’ criteria and lower extremity functional scale (LEFS).

Results:

The mean time of partial weight bearing in fractures of distal femur was 10.14 weeks and proximal tibia was 9.71 weeks, respectively. The mean time of full weight bearing in fractures of distal femur was 16 weeks and in proximal tibia was 15.28 weeks. The mean time of bone union in fractures of distal femur was 18.14 weeks and in proximal tibia it was 18.57 weeks. The overall average LEFS score comes out to be 67 out of 80 points. According to Johner Wruhs’ criteria, results were excellent in 14 (40%), good in 16 (45.7%), fair in 4 (11.4%), and poor in 1 patient.

Conclusion:

MIPO techniques represent a fascinating new armamentarium in fracture fixation, which is made easier with the LCP technology and the different available minimally invasive surgical instruments, which were developed to cause less additional damage to the soft tissue and the bone.
Study of Early Infection in Open Fractures of Long Bones
Authors: Maheshwari Rajesh , Agarwal Digvijay , Ratra Rohan
Published: September 2023

Introduction:

The complications associated with open fracture make the task of a surgeon difficult and also increase the financial burden. Underlying bone is exposed to contaminating agents due to breakdown of the tissue barrier between the fracture zone and the environment. It leads to an increased risk of complications such as wound infections and nonunion.

Materials and Methods:

We performed a prospective observational study on 82 patients presenting with open fractures of long bones treated in the year 2019 in the Department of Orthopedics, Himalayan Institute of Medical Sciences. Patients presenting with long bone open fractures within 72 h from injury to the Emergency were included in the study. All patients were clinically and radiologically followed for a period of 6 weeks.

Results:

Of the 82 cases, 26 developed an infection (31.70%). Fracture classified as Type IIIa had the highest infection rate (50%), whereas Type 1 had the lowest infection rate (14.3%). Infection rate in patients presenting 24 h after injury was higher than those presenting within 24 h from injury but a significant association could not be established between infection rate and late presentation from injury. Enterococcus species were the most commonly identified organism in both intraop and postop swabs (31.57%).

Discussion:

Trauma patients can present with chest, abdomen, or head injury, which may require emergency intervention precludes early debridement for open fracture. In our study, no significant decrease in infection rate was observed in patients undergoing debridement within 6 h from injury. However, it was also observed that open fractures presenting 24 h after injury had a higher infection rate than those presenting before it, which is in accordance with previous literature. Organisms finally causing established infection in bone were isolated mostly from postop swabs and were gram negative, which further strengthens the fact that most infections are nosocomial in origin.

Conclusion:

This paper furnishes the literature by validating facts, theories, and guidelines given in the past to manage open fractures. The study has limitation that the numbers of patients presenting with open fractures were less, and especially patients having common risk factors such as diabetes and anemia due to which correlation with infection rate could not be assessed effectively.
To Evaluate the Efficacy of Antibiotic-coated Intramedullary Locking Nail in the Compound Fracture of Tibia
Authors: Pal Chandra Prakash , Dinkar Karuna Shankar , Kapoor Rajat , Kumar Shailesh , Verma Ashutosh , Patel Jaydeep
Published: September 2023

Introduction:

Soft tissue with skeletal infections remains a big problem for orthopaedic surgeons. Bone provides a unique milieu for bacteria, with low vascularity and turnover rate. Biofilm-forming bacteria cause most orthopaedic trauma infections. When biofilm is formed, it protects the microorganism from antimicrobial treatment thus leading to chronic infections. Antibiotic-coated interlocking nail locally releases gentamycin + PDLLA at initial high concentrations followed by a period of constant release. The biodegradable polymer (PDLLA) is excreted from the body through the tricorboxylic acid cycle cycle, combined with gentamycin for sustained release.

Materials and Methods:

This was a prospective interventional study conducted between September 2018 and August 2020. In this period, we analyzed the hospital records to find out the cases treated by antibiotic-coated intramedullary locking nails. A total of 30 cases of compound tibia fracture were included in our study. Patients were routinely followed at definite intervals and specifically assessed for radiographic and functional evaluation by using the RUST score.

Results:

Out of 30 patients, radiological union at 6 months using the RUST score was 4 in 10.00% patients, 8 in 13.33% patients, 10 in 23.33% patients and 12 in 53.33% patients and final functional outcome was “excellent” in 53.33% patients, “good” in 23.33% patients, “fair” in13.33 % patients and “poor” in 10.00% patients.

Conclusion:

Antibiotic-coated tibia interlocking nail yields good functional outcomes with fewer complications in these fractures. Antibiotic tibia interlocking nail is a good treatment option and should be used whenever indicated.
Changing practices of delivering orthopedic and coronavirus disease 2019 care
Authors: Keshav Kumar , Sharma Pulak , Kumar Amit , Baghel Anurag , Kaustubh Kumar , Huda Najmul , Mishra Prabhaker
Published: September 2023

Purpose:

Coronavirus disease 2019 (COVID-19) pandemic has caused severe disruption of services for other health-related ailments. This study was done to assess change in practices of orthopedic surgeons, availability of proper training and personal protective equipment (PPEs), and changes in hospital setup/preparedness for the management of COVID-19 patients.

Materials and Methods:

A pan-India online survey was done among practicing orthopedic surgeons. Orthopedicians not practicing in India, trainees, and those who had left their practice before the pandemic were excluded from the study. Survey MonkeyR questionnaire and Google FormsR were sent to 10,055 orthopedicians, during the 7th week of nationwide lockdown in the month of May, 2020. Complete responses were received from 407 participants who were included in the final analysis.

Results:

Only a quarter (n = 100/407, 24.6%) of the doctors were visiting hospitals at a frequency similar to that before the pandemic. Onus of orthopedic care among COVID-19 suspected/diagnosed cases and routine COVID-19 patients were mainly borne by the government sector. Only 38.8% (n = 158/407) doctors felt that they received adequate training while 64.9% (n = 264/407) of the doctors had adequate supply of PPE kits. “Designation of specific areas of their hospitals exclusively for COVID-19 patients” was opined by 43.7% (n = 178/407), urgent diagnostic facilities by 52.8% (n = 215/407), and exclusive operation theaters by only 28.3% (n = 115/407) of the respondents.

Conclusion:

This study has shown a drastic fall in the frequency of hospital visits by orthopedic surgeons, predominant involvement of government sector orthopedicians, inadequate training of doctors and inadequate availability of PPE kits, lack of proper designated areas, operation theaters, and urgent diagnostic facilities for the management of COVID-19 patients.
Neglected Quadriceps Tendon Rupture
Authors: Singh Siddharth , Sharma Pulak
Published: September 2023

Quadriceps tendon rupture is an unusual injury, mostly occurring in the middle-aged population involved in athletic activities. Patients with such injuries present with a history of trauma, which may be direct or indirect, associated with swelling and inability to actively extend the knee. When associated with minor trauma, the concurrent presence of chronic diseases and the long-term use of certain medications should be looked for. Neglected traumatic quadriceps tendon rupture is very rare. Our patient presented with a neglected quadriceps tendon rupture of the left knee due to injury sustained 6 months. Consent was taken from him to be used as a case report. The patient had full recovery after surgery and physiotherapy. The index case report is important as the patient had delayed presentation in such a rare injury.
Role of Needle Aponeurotomy and Buddy Taping as a Natural Continuous Passive Mobilization Machine in Dupuytren’s Contracture
Authors: Lal Hitesh , Kumar Jaswant , Goyal Rakesh , Mehta Nitin
Published: September 2023

Purpose:

Needle aponeurotomy (NA) for Dupuytren’s contracture is gaining popularity and is becoming the standard primary treatment. We present a short series of patients with Dupuytren’s contracture managed by NA and elucidate the augmenting role of buddy taping as a natural anatomic continuous passive motion machine in maintaining the improvement in DASH (Disabilities of the Arm, Shoulder and Hand) scores.

Materials and Methods:

Four patients (five hands) with Dupuytren’s contracture all of whom were diabetic are included in the short case series. All patients had their contracture released by NA and the operated finger was buddy taped to adjacent finger.

Results:

The mean age of the patients was 48.75 years. Out of four patients, three had unilateral involvement and one had bilateral involvement of ring finger. The mean flexion contracture at the metacarpophalangeal (MCP) joint was 61°(50°–70°), whereas at PIP joint it was 36° (30°–40°) which improved to mean of 0° and 2° immediately after release and 0° and <5°, respectively, at the final follow-up. The mean DASH score improved from 16.25 to 3.77 at the final follow-up. We did not encounter any neurovascular injury in any of our patients related to the procedure though one patient complained of tingling sensation in all fingers and one patient had 1–2 mm of skin rupture. There was no relapse and no patient required secondary release.

Conclusion:

Patients with Dupuytren’s contracture released by NA have good clinical results. The mobilization of the taped buddy finger allows early, superior, cost-efficient rehabilitation and prevents relapse.

Type of Study/Level of Evidence:

Therapeutic IV
A Rare Case Report
Authors: Kumar Deepak , Singh Shailendra , Deshwal Siddharth , Abbas Zohaib , Kumar Ashish
Published: September 2023

The ischial tuberosity and ischiopubic ramus represent one of the rarest sites of giant cell tumors of bone. A rare case is presented here. The unusual site and characteristic features of giant cell tumors and current treatment options are reviewed.
To Assess the Functional and Radiological Outcomes in Patients of Medial Compartment Osteoarthritis of Knee Undergoing Medial Open-Wedge High Tibial Osteotomy
Authors: Huda Najmul , Islam Mir Shahid Ul , Aggarwal Shubham , Bishnoi Sandeep , Beri Sudhir , Dholariya Ravi
Published: September 2023

Background:

Varus malalignment at the knee can lead to medial compartment overload and progression of ipsilateral compartment osteoarthritis (OA). In such cases, a valgus-producing medial open-wedge high tibial osteotomy (MOWHTO) has been proposed to restore neutral mechanical alignment and alleviate excess load on the medial compartment. One distinct advantage of this procedure is the ability to correct deformities in the sagittal and coronal planes. The present study was conducted with the aim to analyze the difference in the pre- and postoperative functional scores and to estimate the changes in the pre- and postoperative radiological alignment in the patients managed by MOWHTO for uni/medial compartmental OA knee.

Materials and Methods:

Fifteen patients with medial compartment OA knee Kellgren–Lawrence Grade II and III with a mean age of 54.46 years were managed with MOWHTO. Clinical assessment was done using the Knee Society Score (KSS) preoperatively and postoperatively at 3, 6, and 9 months. Radiological assessment was done using the Puddu technique on the load-bearing lower limb antero-posterior X-ray extending from the hip joint up to the ankle preoperatively at postoperatively at 3 and 9 months.

Results:

All patients had pain relief and improvement in walking ability after the procedure. The mean KSS significantly improved from 35.50 ± 9.78 preoperatively to 55.07 ± 9.13, 67.14 ± 10.06, and 74.14 ± 4.09 at 3, 6, and 9 months postoperatively, respectively (P < 0.01). The mean varus angle significantly improved from 9.06° preoperatively to 1.43° varus at 3 months postoperatively (P = 0.001) and 1.64° varus at 9 months postoperatively and was found to be significant.

Conclusion:

After a follow-up of 9 months, we found that the MOWHTO of the tibia is an effective method to treat the medial compartment OA knees. It leads to significant improvement in both the clinical and radiological outcomes.
Bilateral Anterior Shoulder Dislocation Following Seizures in Eclampsia
Authors: Khan Mohammad Jesan , Singhal Ujjawal , Aziz Mohd Hadi , Asif Sidra
Published: September 2023

Pain in the shoulders following seizure episodes should raise suspicion of a shoulder dislocation. As these injuries can be missed very easily in an unconscious patient, thorough clinical examination is of paramount importance in such cases. This is a case report of a 26-year-old female patient diagnosed as a case of bilateral anterior shoulder dislocation secondary to seizures as a complication of eclampsia. Patient was managed by closed reduction under anesthesia and reduction was performed successfully. A case report is mentioned in the literature about unilateral shoulder dislocation following seizures in eclampsia but to the best of our knowledge, no such case is mentioned about bilateral shoulder dislocation.
Comparitive Study of Functional and Radiological Outcome of Open-Wedge High Tibial Osteotomy Versus Proximal Fibular Osteotomy in Patients with Osteoarthritis Knee
Authors: Jaiswal Sparsh , Mangal Parit , Swarup Arunim , Rastogi Avinash
Published: September 2023

Aim:

Proximal fibular osteotomy (PFO) and valgus high tibial osteotomy (HTO) are the well-established treatment options for patients with K-L grade 2, 3 medial compartment knee osteoarthritis where replacement may not be the treatment of choice. The aim of the present study was to compare the radiological and clinical outcomes following HTO and PFO.

Materials and Methods:

During the duration of 2 years, two groups of 30 patients each undergoing PFO with a mean age of 53.9 years (range 40–65 years) and HTO with a mean age of 54.7 years (range 40–65 years) were compared and followed up for 1 year. They were compared on the basis of preoperative and postoperative range of walking distance, Numerical Pain Rating Score, American Knee Society Score, Knee Injury and Osteoarthritis Outcome Score, femorotibial angle, and medial joint space narrowing.

Results:

In PFO group, immediate postoperative functional scores improved and maintained for 3 months during follow-up. Following which there was the decline in the functional score up to 1-year follow-up, whereas in the HTO group, the improvement is seen with a gradual increase in postoperative functional scores that progressed positively for the entire follow-up period of 1 year.

Conclusion:

Both PFO and HTO lead to good and comparable radiological and functional results. However, HTO provided slow but long-term success in terms of functional and radiological scores after the follow-up period of 1 year.
Psychological impacts of the COVID-19 on health care providers
Authors: Alizadeh Azizeh , Barati Mohammad , Hadian Arash , Almasi Reza , Salehi Safora , Javanmard Yavar , Azizi Maryam
Published: September 2023

BACKGROUND:

Psychological distress, functional impairment, reduced quality of life, and subjective well-being were the most common negative psychological effects during the COVID-19 outbreak. The present study was to investigate the impact of job stress, hospital resources, and fear of infection on job burnout of medical staff in Iran during the Covid-19 pandemic.

MATERIALS AND METHODS:

In this cross-sectional study, 223 hospital staff from several public and private hospitals in Tehran and Mazandaran provinces, selected through convenience sampling. The questionnaire included the validated “Maslach Burnout Inventory (MBI)”, “job stress scale (Parker and DeCotiis, 1983)”, and the questions about “hospital resources”, and “fear of infection” developed by the researcher wereused to collect data. Data were analyzed by correlation and regression methods using SPSS software.

RESULTS:

The results revealed that there was a significant difference in the scores on the burnout scale, in the dimension of emotional exhaustion, but the differences were not significant in the dimensions of depersonalization and self-accomplishment. Also, job stress and fear of infection significantly correlated with job burnout in the dimensions of emotional exhaustion and personal-accomplishment. However, the correlation between the adequacy of hospital resources and job burnout in these two dimensions was not significant. None of the three variables of the study showed a significant correlation with the dimension of depersonalization.

CONCLUSION:

It is essential to consider the package of psychological interventions which, primarily includes finding the sources of stress to resolve them through stress management programs, based on education and training in stress coping and management strategies.
An exploratory study of the experiences of emergency medical care (EMC) students transitioning through the COVID-19 pandemic in South Africa
Authors: Bhagwan Raisuyah , Rowkith Shannal
Published: September 2023

BACKGROUND:

The COVID-19 pandemic coalesced into increased mental health problems, particularly anxiety, stress, and depression for university students. Students from the emergency medical care (EMC) department encountered these difficulties, more intensely, particularly those in WIL or clinical placements, as they worked at the interface of illness, trauma, and grief during the pandemic. While empirical research has burgeoned in relation to healthcare practitioners within this context, little exists on EMC students at South African higher education institutions (HEIs), within the context of the COVID-19 pandemic. This qualitative study aimed to explore the academic and psychosocial challenges experienced by EMC students, as they transitioned through the COVID-19 pandemic and the ensuing lockdown during 2021.

MATERIALS AND METHODS:

A qualitative approach with an exploratory descriptive design was used to guide the study. A sample of students from all levels of the EMC Department in the Faculty of Health Sciences was recruited. This was done using non-probability sampling techniques, which includes purposive sampling. Data saturation was reached after interviewing 15 participants using a virtual platform. Interviews were recorded, transcribed, and analyzed using thematic analysis.

RESULTS:

Our results revealed five broad themes and six subthemes which reflected the psychosocial experiences that EMC students faced. The themes and (subthemes) included encountering COVID-19 during WIL or clinical, infection or loss of loved ones, psychological effects of living and working at the interface of COVID-19 (negative emotional toll of the pandemic, misinformation, isolation and social disconnectedness, and sense of responsibility/duty to work) and disruption to academic life (online learning challenges and challenges related to clinical training experiences) and financial impact of the pandemic.

CONCLUSIONS:

The findings suggested that there is a critical need for HEIs to develop strategies that ensure EMC students' well-being amidst their academic journey within the context of the pandemic. This study will therefore assist EMC departments at higher education institutions to formulate strategies in relation to the pandemic.
Effectiveness of behavioral activation therapy and acceptance and commitment therapy on depression and rumination as a tool for health promotion on mothers with cerebral palsy children
Authors: Alirahmi Mostafa , Aibod Sehat , Azizifar Akbar , Kikhavani Sattar
Published: September 2023

BACKGROUND:

Since in most families, mothers are more responsible for taking care of children and they have more responsibility than fathers for monitoring the child; taking care of a disabled child can have a more negative effect on the psychological state of mothers. The purpose of the present study is to investigate the effectiveness of behavioral activation therapy (BAT) and acceptance and commitment therapy (ACT) on depression and rumination on mothers with children with cerebral palsy in the city of Ilam.

MATERIALS AND METHODS:

The design of this research was pretest and post-test quasi-experimental with a control group. The research sample was 60 mothers who referred to occupational therapy centers in the city of Ilam in 2022, who were randomly divided into two experimental groups (N = 40 for each) and a control group (N = 20). One of the experimental groups, received behavioral activation group therapy method; and the other received the group therapy method based on acceptance and commitment for eight sessions lasted for 90 minutes in week. Data were collected using the Beck depression questionnaire (BDI-II) and the rumination questionnaire in two stages before the intervention and after the intervention. In this research, covariance analysis was used for data analysis.

RESULTS:

The results of covariance analysis showed that behavioral activation therapy and acceptance and commitment-based therapy reduced depression (P < 0.01) and rumination (P < 0.01), and the two experimental groups were compared with the control group in the post-test phase.

CONCLUSION:

It seems that behavioral activation therapy and acceptance and commitment therapy are effective in reducing depression and rumination in the subjects of the present study. Therefore, these treatments are suggested as complementary treatments along with drug treatments to improve psychological symptoms.
Lived experiences of post-mastectomy women: A qualitative study of Western Rajasthan
Authors: Patiyal Neha , Pandey Vandna , Kumar Ashok
Published: September 2023

BACKGROUND:

Women's breasts have biological functions to lactate, socially and culturally seen as sensual, and the essence of her femininity. In the world, breast cancer is the most constantly occurring non-cutaneous cancer among women. The qualitative phenomenological study aimed to explore the lived experiences of post-mastectomy women.

MATERIAL AND METHODS:

A total of 14 post-mastectomy women were recruited through non-probability convenience sampling based on data saturation, at the radiation unit of a tertiary care hospital, in Basni, Jodhpur, Rajasthan, from September to November 2020. The data was collected using an in-depth interview schedule. It was firstly audio-recorded and transcribed, and then themes and subthemes were extracted. Experiences of women were recorded and analyzed using Colaizzi”s framework (1978) and ATLAS ti. 9 scientific software.

RESULT:

This revealed five main themes and their subthemes: Body image changes, physical impacts, emotional impacts, treatment impacts, and coping and support sources.

CONCLUSION:

In India, the lack of exploration regarding this topic is due to the stigmatization of very private parts, i.e., breast involvement and people rarely discuss it. Thus, there is a need for more such studies to be done, and more attention is required on the role of nurses to assist post-mastectomy women psychologically, spiritually, and physically to cope with their conditions. Findings highlight that mastectomy as a surgical treatment may negatively affect a woman's body image. It's highly recommended to address individual women's psychosocial needs and preferences before undergoing mastectomy in educational sessions by physicians involving nurses with them. Also, proper knowledge about reconstructive procedures should be provided to improve their body image. The counseling sessions can be conducted pre and post-mastectomy by a professional counselor.
Association between cognitive capacity and metabolic indices in patients with neuropsychiatric disorders
Authors: Rajabi Fatemeh , Rahimi Somayyeh , Maracy Mohammad R. , Barekatain Majid
Published: September 2023

BACKGROUND:

Although previous studies suggested the relationship between metabolic indices and cognitive capacity, results have been conflicting. The prevalence of metabolic and cognitive disorders is high in patients with neuropsychiatric disorders. We aimed to assess the relationship between laboratory metabolic indices and specific areas of cognitive capacity.

MATERIALS AND METHODS:

This was a retrospective review of the medical records of 423 from 452 patients with neuropsychiatric disorders who were admitted to the neuropsychiatry unit, Ayatollah Kashani Hospital, Isfahan, Iran, from September 1, 2018, to September 30, 2022. We extracted demographic factors, laboratory metabolic indices, and scores of the Neuropsychiatry Unit Cognitive Assessment tool (NUCOG). We utilized a generalized linear model (GLM) to demonstrate the effect of metabolic indices on the risk of reduction in cognitive domains. Due to the presence of missing data in the metabolic indices, we used the multiple imputation method.

RESULTS:

The regression coefficient of NUCOG total score and subscale scores for metabolic indices using GLM after multiple imputation method demonstrated that among the metabolic indicators, fasting blood sugar (FBS) had the reverse relationship with the total score of NUCOG (β = -.05). Among the NUCOG subscales, executive functioning had the strongest relationship with FBS (β = -.01). Also, there was a negative relationship between patients' age and the total score of NUCOG (β = -.38). Educational level had a positive relationship with the total NUCOG score (β =10.2).

CONCLUSIONS:

The main metabolic factors that might reduce cognitive capacity were higher FBS.
Effects of Patient and Seizure-Related Factors on Drug Load in Seizure-Free Patients with Idiopathic Generalized Epilepsy
Authors: Eren Fulya , Gül Günay
Published: September 2023

Introduction:

Idiopathic generalized epilepsies (IGEs) include four different epilepsy syndromes and IGE have mostly a good response to antiepileptic drugs (AEDs). The most common IGE subgroup is juvenile myoclonic epilepsy (JME). It generally responds well to low doses of AEDs; however, some patients need higher doses of medication. In this study was hypothesized that patient and epilepsy characteristics of seizure-free patients with high drug load might differ from those with low drug load. For this purpose, it was aimed to compare patients with JME and patients with other generalized epilepsies (non-JME IGE) regarding these factors concerning drug load.

Patients and Methods:

The records of the epilepsy outpatient clinic from 2010 to 2020 were retrospectively evaluated for patients with IGEs. Patients without any epileptic seizures in the last year were accepted as seizure-free. Drug load is calculated by dividing the prescribed daily dose by defined daily dose (PDD/DDD). A total drug load (TDL) equal to one and greater was considered as a high TDL (≥1, high-TDL group), where a drug load of below one was considered as a low TDL (<1, low-TDL group). The high-TDL and low-TDL groups in patients with JME and non-JME IGE were compared in terms of sociodemographic characteristics, personal and family histories, duration of epilepsy, seizure characteristics, epilepsy syndromes, electroencephalography findings, and AEDs and doses.

Results:

In this study, 119 patients (69 females, 50 males) with a mean age of 30.11 (range, 18–65) years were included. The mean age of onset and duration of the disease was 16.21 (range, 3–47) years and 13.6 (1–45) years, respectively. Sixty-three of the patients were diagnosed as having JME, and 56 patients were diagnosed as having non-JME IGE (39 with generalized tonic-clonic seizures alone, 17 juvenile absence epilepsy). According to the TDL, 35 patients were classified in the low-TDL group and 84 patients in the high-TDL group. The age of disease onset was higher in the non-JME IGE group (P = 0.027). Triple-type seizures were significantly more common in the JME group (P < 0.001). No statistically significant differences were found between the low- and high-TDL groups regarding patient and epilepsy characteristics in the JME and non-JME IGE groups.

Conclusion:

Most seizure-free patients had low-TDL in the JME and non-JME IGE groups. No association was observed in the JME and non-JME IGE groups regarding the total AED load.
Long-Term Surgical Outcomes and Predictors of Surgical Treatment in Temporal Lobe Epilepsy
Authors: Yildirim Irem , Gurses Asli Akyol , Ataoglu Esra Erkoc , Kurt Gokhan , Akdemir Umit Ozgur , Oner Ali Yusuf , Hirfanoglu Tugba , Atay Lutfiye Ozlem , Serdaroglu Ayşe , Bilir Erhan
Published: September 2023

Background:

Surgical treatment of epilepsy is a favored modality in the management of refractory temporal lobe epilepsy (TLE) and known to be quite effective. The aim of this study was to evaluate the long-term outcomes in surgical treatment of TLE and to identify prognostic factors influencing postoperative seizure remission.

Materials and Methods:

The patients who underwent anterior temporal lobectomy (ATL) with the diagnosis of refractory TLE in our center between the years of 2006 and 2020 were included. Preoperative workup process was carried out by a multidisciplinary team and consisted of neuropsychological examination, long-term electroencephalography, brain magnetic resonance imaging (MRI), and fluorodeoxyglucose positron emission tomography (FDG-PET) for each patient. Postoperative assessment of seizure control was repeated every year following surgery and categorized according to Engel's outcome classification. The predictive value of baseline demographic, clinical, laboratory, imaging, and histopathological parameters on postoperative seizure control was also evaluated.

Results:

One hundred and forty-three patients who underwent ATL with the diagnosis of TLE were included. According to Engel's classification, the seizure freedom rate was found to be 83.2% at the 2nd year, 81.3% at the 4th year, and 79.2% at the 10th year after surgery. In the univariate analysis, febrile seizure (FS) history, unilateral interictal epileptiform discharges (IEDs), hippocampal sclerosis (HS) on MRI, unilateral temporal hypometabolism (HM) on FDG-PET, and HS in histopathology were predictors of seizure control at the postoperative 2nd and 10th years. FS history, unilateral localization of IEDs, and unilateral FDG-PET findings of temporal HM were found to be the independent predictors of postoperative seizure control on multivariate analysis.

Conclusions:

In the current study, we revealed that epilepsy surgery provides effective seizure control and represents a beneficial therapeutic option in refractory TLE. Our results also suggested that FS history, unilateral IEDs, and unilateral FDG-PET findings of temporal HM were independent predictors of seizure remission in these patients.
Asymptomatic Median Neuropathy in Patients with Diabetic Polyneuropathy
Authors: Alemdar Murat
Published: September 2023

Aim:

This study aims to investigate whether asymptomatic median neuropathy (AMN) in patients with diabetic peripheral polyneuropathy (DPNP) is a result of polyneuropathic involvement of median nerve (MN) or its true entrapment.

Subjects and Methods:

We determined the grades of the Michigan severity scale and the rates of peripheral nerve conduction abnormalities in study subgroups, including patients with carpal tunnel syndrome (CTS), AMN, and normal MN conductions to highlight if the severity of polyneuropathic involvement was different between them. In addition, the results of conventional and comparative nerve conduction studies (NCSs) were compared between these study subgroups.

Results:

Distributions of Michigan grades and rates of abnormalities in peroneal and sural NCSs were similar between the subgroups (P > 0.05 for all analyses). Abnormality rates of ulnar NCSs were higher in the AMN group than in the other groups, whereas those of comparative transcarpal NCSs were higher in the CTS group. The mean distal sensory latency (DSL) and motor latency (DML) of MN were longer, sensory conduction velocity (SCV) was slower in the CTS group than AMN group, whereas MN motor conduction velocity (MCV) was slower, UN DSL was longer, SCV was slower, SNAP amplitude was smaller, DML was longer, and MCV were slower in the AMN group (P < 0.05 for all analyses).

Discussion:

Our findings reveal that grade of polyneuropathic involvement is more prominent in AMN, whereas transcarpal MN conduction delay is greater in CTS. The results of the study suggest that the prominence of polyneuropathic impairment in addition to a lesser degree of MN sheet compression obscures the clinical signs in patients with diabetes with AMN.
Assouad–Nagata dimension and gap for ordered metric spaces
Authors: Erschler Anna , Mitrofanov Ivan
Published: September 2023

We prove that all spaces of finite Assouad–Nagata dimension admit a good order for the travelling salesman problem, and provide sufficient conditions under which the converse is true. We formulate a conjectural characterization of spaces of finite AN-dimension, which would yield a gap statement for the efficiency of orders on metric spaces. Under the assumption of doubling, we prove a stronger gap phenomenon about all orders on a given metric space.
Guide to Temperature Monitoring in Aircraft Gas Turbine Engines
Authors:   E-32 Aerospace Propulsion Systems Health Management
Published: September 2023

This SAE Aerospace Information Report (AIR) provides an overview of temperature measurement techniques for various locations of aircraft gas turbine engines while focusing on current usage and methods, systems, selection criteria, and types of hardware.
Guideline for Counterfeit Electrical, Electronic, and Electromechanical (EEE) Parts; Avoidance, Detection, Mitigation, and Disposition Systems
Authors:   G-19 Counterfeit Electronic Parts Committee
Published: September 2023

The content of ARP6328 contains guidance for implementing processes used for risk identification, mitigation, detection, avoidance, disposition, and reporting of counterfeit electrical, electronic, and electromechanical (EEE) parts and assemblies in accordance with AS5553 Revision D. This document may also be used in conjunction with other revisions of AS5553. This document retains guidance contained in the base document of AS5553, updated as appropriate to reflect current practices. This is not intended to stand alone, supersede, or cancel requirements found in other quality management system documents, requirements imposed by contracting authorities, or applicable laws and regulations unless an authorized exemption/variance has been obtained.
The Properties of Exosomes Derived from Mesenchymal Stem Cells Preconditioned with L-Ascorbic Acid and Cobalt (II) Chloride
Authors: Barlian Anggraini , Amsar Rizka Musdalifah , Prawitasari Salindri , Wijaya Christofora Hanny , Ana Ika Dewi , Wungu Triati Dewi Kencana
Published: September 2023

Extracellular vesicles including exosomes, are produced by cells for intracellular communication. Preconditioning of parental cells influences exosome properties. The purpose of this study was to examine the effects of L-ascorbic acid (LAA) and cobalt (II) chloride (CoCl2) on human Wharton’s jelly mesenchymal stem cell (hWJ-MSC)-derived exosomes and their ability to promote stem cell differentiation into chondrocytes. The cells were isolated from the umbilical cord and characterized according to the criteria for mesenchymal stem cell.  The cells were cultured in a serum-free medium containing LAA and CoCl2. Cell-produced exosomes were isolated and characterized. hWJ-MSCs can grow in serum-free medium containing LAA and CoCl2. Exosomes derived from hWJ-MSCs had a round morphology, particle size within the exosome range, CD 63 expression, and the capacity to be internalized by cells. The production of exosomes by hWJ-MSCs was enhanced by LAA treatment. LAA and CoCl2 promoted stem cell differentiation into chondrocytes, as indicated by the production of collagen type II and glycosaminoglycans. LAA and CoCl2 affect the properties of MSC-derived exosomes. LAA induces cells to produce exosomes in greater quantities, which have the potential to promote chondrogenic differentiation of stem cells.
Determinants of youth participation in agribusiness activities in Ikwuano Local Government Area, Abia State, Nigeria
Authors: Nnamani N.G. , Obediah C.P.
Published: September 2023

Young people perceive agriculture as a profession of intense labour, not profitable and unable to support their livelihood compared to  what white collar jobs offer. The study was on determinants of youth participation in agribusiness activities in Ikwuano Local Government  Area, Abia State, Nigeria. Specifically, the study examined the socio-economic characteristics of youths in the study area;  identified various agro-related enterprises participated by the youths and estimated factors that influence youth participation in agro- related enterprises. Random sampling technique was used to select 90 respondents for the study. Data were analyzed using both descriptive statistics and Probit regression model. Majority (62.42%) of the youths were male. Mean age of the respondents was 23 years.  About 90% of the youths were single with diverse levels of formal education. The agribusiness enterprises mostly participated in by the  youths were animal production (51.1%) and crop production (23.33%). Result of Probit regression showed that age, household size,  access to land, non-farm income, empowerment were 1% respectively and sex (5%) were significant variables influencing youth  participation in agribusiness activities. It was recommended that youth in the study area enhance their livelihood sources through  diversifying into other agro-related enterprises such as sale of agro-inputs and agro-processing.