bluuebunny/crossref_metadata_2025 huggingface dataset:
General self-efficacy and hypertension treatment adherence in Algerian private clinical settings
Authors: Kara Said
Published: September 2022

Background. The purpose of this study was to investigate the connection between self-efficacy and treatment adherence, working on the assumption that self-efficacy plays a role in determining treatment adherence in chronic diseases. Hypertension affects one-third of the world’s population. In Africa, hypertension is a leading cause of death from a non-communicable disease. Modifications to lifestyle and behavior, as well as increased access to pharmaceuticals, are necessary for every African nation to bring the prevalence of hypertension and cardiovascular disorders under control.Methods.  In order to assess the predictive association between the two, we conducted research on 216 hypertensive patients who were treated in private clinics in Algeria. These patients were given two assessments to fill out: one was called the general self-efficacy scale (GSES), and the other was called the treatment adherence scale. Comparisons of male and female self-efficacy and adherence were made with the help of Pearson’s correlation coefficient and a sample independent t-test (self-efficacy, adherence to treatment).Conclusions.  Self-efficacy in general has been shown to be connected with adherence to hypertension therapy (r(214) = 0.496, p=0.01, 0.05). There is no significant difference between the sexes in either self-efficacy (t(214)=0.985, p=0.326, 0.05) or hypertension treatment adherence (t(214)=0.034, p=0.973, 0.05). A higher level of self-efficacy was found to have a positive correlation with a higher level of treatment adherence; it is possible to increase the medication adherence of hypertension patients by enhancing their level of self-efficacy. It is important for those working in health care to acknowledge the significance that self-care plays in overall health.
Does Moringa oleifera Lam. leaves supplementation have an impact on the weight and bone mass index of people living with HIV that are on antiretroviral therapy? A double-blind randomized control trial
Authors: Gambo Aisha , Gqaleni Nceba
Published: September 2022

Background. HIV-related weight loss and wasting were the most common malnutrition and AIDS-defining conditions before HAART. HAART has led to more obese PLHIV. HIV-positive patients should eat micro- and macronutrient-rich foods to maintain optimal nutrition. This study examined whether Moringa oleifera Lam. leaf supplementation affects PLHIV receiving ART.Methods. A randomized, double-blind, controlled trial was conducted. Two hundred patients with informed consent were randomly assigned to either the Moringa oleifera Lam. (MOG) group or the control group (COG). From baseline to six months of Moringa oleifera Lam. leaf supplementation, anthropometric parameters [weight; BMI] of the participants were assessed.Results. One hundred seventy-seven patients completed the 6-month follow-up (89 MOG versus 88 COG). During the study period, the MOG and COG had similar weights and BMIs (p0.05). At baseline and six months, most participants in both study groups had a healthy BMI (18.5-24.9). Many participants were overweight; few were underweight (BMI18.5). MOG and COG BMI differences at baseline and six months were not significant (p 0.05). All experiments were 95CI.Conclusions. Moringa oleifera Lam. leaf powder had no effect on HIV-positive adults receiving antiretroviral therapy, in accordance with this study.
Comorbid laboratory abnormalities in female pattern hair loss patients
Authors: Wang Hsin-Jou , Yeh Jui-Wen , Chang Yin-Fan , Wu Jin-Shang , Yang Chao-Chun
Published: September 2022

Background:

Female pattern hair loss (FPHL) is the main cause of alopecia in women and has a debilitating impact on the quality of life. However, certain comorbid conditions causing hair loss are often masked by FPHL and may remain undetected. Hence, it is imperative to identify them to administer appropriate treatment. The necessity of laboratory tests to evaluate these comorbidities in patients with FPHL has not been established.

Objectives:

This study aimed to identify the frequency of comorbid abnormalities detected by laboratory tests in patients with FPHL.

Methods:

Routine laboratory test results of patients with FPHL, who visit our hair clinic for the first time, were retrospectively collected and analyzed. These tests assessed the serum testosterone, thyroid-stimulating hormone, free thyroxin, zinc and ferritin levels, hemoglobin, as well as antinuclear antibody (ANA), and rapid plasma reagin test results. The correlation between age and hair loss severity and the frequency of comorbidities was evaluated using subgroup analysis.

Results:

Among the 356 patients with FPHL, coexisting zinc deficiency, iron depletion, and thyroid abnormalities were common and present in 41.7%, 39.7%, and 11.3% of them, respectively. The rate of concomitantly increased ANA titers was relatively low (4.4%), while that of syphilis and high serum testosterone levels was extremely low (0.3% and 0%, respectively). Younger patients (<50 years) with FPHL had a higher rate of coexisting iron deficiency than patients in the older age group.

Conclusion:

Testing for concomitant iron depletion, zinc deficiency, and thyroid disease is recommended in female patients with FPHL.
A rare case
Authors: Ayvaci Barış Murat , Gökdağ Eren
Published: September 2022

Descending necrotizing mediastinitis (DNM) is one of the most critical, and often lethal forms of mediastinitis that develop because of the downward spread of deep neck infections. In this article, we wanted to discuss a case report with DNM secondary to retropharyngeal abscess detected in the emergency department, in accordance with the literature. A 51-year-old male patient presented to the hospital with complaints of fever, sore throat when swallowing, and swelling in the neck. He had no history of any disease, trauma, or surgical intervention. On physical examination of our patient, diffuse hyperemia and edema in the pharyngeal area were detected with swelling, edema, redness, and warmth in the neck, which can be felt on both sides of the trachea with palpation. DNM diagnosis was made by detecting retropharyngeal abscess extending to the mediastinum, mediastinal air images and increased density in adipose tissue with intravenous (IV) contrast-enhanced neck and thorax computed tomography (CT). DNM patients most frequently present with complaints of fever, odynophagia, dyspnea, cervical edema, and pain. The most important clinical finding is edema and hyperemia in the pharynx. Our patient presented to the emergency department with complaints of fever, sore throat when swallowing, and neck swelling, and on physical examination, edema, hyperemia, and temperature increase in the neck region were observed together with hyperemia and edema in the pharyngeal area. Laboratory examinations showed high leukocyte count and C-reactive protein levels. The patient was diagnosed with DNM by performing IV contrast-enhanced cervicothoracic CT imaging and underwent an operation. It should be borne in mind that patients who present to the emergency room with fever, odynophagia, and neck swelling may have a rare but seriously life-threatening DNM.
Tachycardia origin prediction using point of care ultrasound (TOP-UP) - A novel technique
Authors: Mahalingam Sasikumar , Rajendran Gunaseelan , Nathan Balamurugan , Ayyan Manu , Pillai Vivekanandan Muthu
Published: September 2022

Narrow complex tachycardia (NCT) is often due to supraventricular tachycardia (SVT). SVT with aberrancy, preexcitation, paced rhythm, rate-dependent bundle branch block, preexisting conduction defects or SVT due to drugs, and electrolyte abnormality can also be wide complex. Wide-complex tachycardia (WCT) is often ventricular tachycardia (VT), but fascicular VT (fVT) can present as NCT. Thus, WCT can be either VT or SVT. This has been a perplexing problem for the emergency physician for ages. Here, in this case series, we describe the novel use of point-of-care ultrasound to differentiate SVT from VT.
Use of infection biomarkers in the emergency department
Authors: Ozger Hasan Selcuk , Senol Esin
Published: September 2022

The use of infection biomarkers in the emergency department is discussed in terms of their possible contributions to diagnostic-prognostic uncertainties, appropriate antibiotic treatments, and triage and follow-up planning. Procalcitonin (PCT), C-reactive protein (CRP), proadrenomedullin (proADM), and presepsin are among the most discussed infection biomarkers for use in the emergency department. Due to the variable sensitivity results and cutoff values, there are insufficient data to recommend the widespread use of CRP and procalcitonin (PCT) for the diagnosis and prognosis of infection in the emergency department. However, these biomarkers can be used for appropriate antibiotic use in selected infection groups, such as community-acquired pneumonia, especially to reduce unnecessary antibiotic prescribing. With its prognostic superiority over other biomarkers and its contribution to prognostic score systems in community-acquired pneumonia (CAP), proADM can be used to predict hospitalization, preferably within the scope of clinical studies. Although presepsin has been shown to have some advantages over other biomarkers to rule out sepsis, there are insufficient data for its clinical use in the emergency department.
Results of an advanced nursing triage protocol in emergency departments
Authors: Çetin Songül Biskin , Eray Oktay , Akiner Sengül Erdal , Gözkaya Meral , Yigit Özlem
Published: September 2022

OBJECTIVES:

The increasing number of patients admitted to emergency departments (EDs) and overcrowding of EDs lead to a global problem. Advanced nursing triage is an important solution in facilitating patient and time management, also increasing the efficiency of the ED. This study was conducted to predict the possible effects of applying advanced nursing triage modeling with predetermined protocols during the current nursing triage in the ED.

METHODS:

This was a descriptive and cross-sectional study. An advanced “triage assessment protocol,” which was developed previously, was hypothetically applied for 5 days by triage nurses in the adult ED of a university hospital. The hypothetical application was tested by triage nurses in all shifts. The nurses recorded the examination or treatment options which they thought to apply for the patient on the study form. The data recorded on the advanced triage evaluation protocol form by the triage nurses were compared with the patient outcomes and physician examination/treatment requests in the Hospital Information Management System by the researchers.

RESULTS:

In the study, it was determined that the rate of examination/treatment that could be requested according to the advanced nursing triage protocol was 46%. There were a good level of agreement on X-ray and a moderate level of agreement on urinary test and urinary beta- Human chorionic gonadotropin (hCG) test between physicians and triage nurses regarding examination/treatment requests. In addition, it was found that there was a 61.2% of agreement on decisions made for patients aged between 18 and 35. The rate of agreement between doctors and nurses regarding a gluco-stick request for patients admitted outside the prime time (92.2%) was found to be significantly higher (87.9%) than for patients admitted during prime time (P = 0.046).

CONCLUSION:

“Advanced triage” practices recommended for busy EDs were tested “hypothetically” at the national level due to the lack of legal regulations and were found to be compatible with the actual results of physicians’ practices at an acceptable level, especially for selected medical conditions. The method used in this study can be useful in planning the transition to “advanced triage” practices. These results can show the readiness of nurses for the transition to this practice.
Airway management practices among emergency physicians
Authors: Jishnu M. , Bhoi Sanjeev , Sahu Ankit Kumar , Suresh Soorya , Aggarwal Praveen
Published: September 2022

OBJECTIVES:

Emergency airway management is an integral part of patient stabilization. It is an essential skill for an emergency physician to master. There is a paucity of literature on airway management from low-to-middle-income countries like India where emergency medicine (EM) specialty is still in its infancy. We conducted this study to identify the existing airway management practices among emergency physicians in our tertiary care center. This study could pave the way for national airway registries.

METHODS:

This prospective, observational study was conducted in the emergency department (ED) of a tertiary care center in India for 16 months. We included 166 patients who underwent emergency endotracheal intubation in the ED, irrespective of their age or underlying condition. The patients were observed for 15 min after intubation to identify any associated adverse events. We collected data about patients’ demographic profile, indication for intubation, techniques of airway management, medications used, specialty of the physician performing intubation, use of preintubation and postintubation checklists, vitals before and after intubation, and any adverse events following intubation.

RESULTS:

A total of 166 patients who required definite airway management in the ED were recruited for the study. The mean age of patients was 45.5 ± 20.1 years. Males comprised 61.4% of the patients. One hundred and forty-four patients were nontrauma cases and the remaining 22 cases were related to trauma. The most common indication for emergency airway management was altered mental status among nontrauma encounters and traumatic brain injury among trauma patients. Rapid sequence intubation (RSI) was the most common method employed (72.9% of cases). The most common agents used for induction and paralysis were etomidate and rocuronium, respectively. Direct laryngoscope was used in about 95% of cases. The first pass success rate in our study was 78.3%. EM residents were able to perform orotracheal intubation for all patients and none required a surgical airway. The incidence of adverse events within 15 min of intubation was 58.4%. Common complications observed were desaturation, right mainstem bronchus intubation, and equipment failure. Postintubation cardiac arrest occurred in around 5% of cases.

CONCLUSION:

RSI remains the most common method employed for emergency airway management. There exists heterogeneity in the practice and its associated complications. Hence, regular surveillance, quality improvement, and training are imperative to provide good patient care.
Ultrasound-guided estimation of internal jugular vein collapsibility index in patients with shock in emergency department
Authors: Chawang Hannah Joyke , Kaeley Nidhi , Bhardwaj Bharat Bhushan , Chauhan Udit , Baid Himanshi , Asokan Reshma , Galagali Santosh Sadashiv
Published: September 2022

OBJECTIVE:

To correlate ultrasound-guided estimation of Internal Jugular Vein Collapsibility Index (IJV-CI) with inferior vena cava CI (IVC-CI) and invasively monitored central venous pressure (CVP) in patients with shock in the emergency medicine department.

METHODS:

A prospective observational study was done in the emergency department (ED). The study was conducted over 15 months (November 2019 to April 2021). It included patients more than 18 years presenting to the ED in shock. The IJV and IVC diameter and cross-sectional area were measured using ultrasound. The corresponding collapsibility indexes were then calculated and correlated with the invasively monitored CVP of the patient. Data were then analyzed using the Statistical Package for the Social Science (SPSS): Version 23 for windows. Pearson's correlation was used between CVP and collapsibility indexes.

RESULTS:

The mean (±standard deviation) age of the patients was 49.01 (±15.6). There was a 47 (64%) male predominance which outnumbered females 26 (36%). The correlation coefficient was statistically significant between CVP and the collapsibility indices for various IJV and IVC parameters. The highest correlation (r = −0.541, P = 0.005) was seen between IVC-CI (CI 5) and CVP. This was followed by a correlation seen at a 30° position for IJV CI (cross-sectional area) with CVP (r = −0.453, P = 0.001). Similarly, the correlation between IJV CI (AP diameter) and CVP, followed (r = −0.412, P = 0.008) was statistically significant.

CONCLUSION:

Both IJV and IVC collapsibility indices correlated significantly with invasively measured CVP. Hence, they present as an effective tool in fluid resuscitation in patients with shock in ED.
Amlodipine Overdose-Induced Acute Respiratory Distress Syndrome: A Common Calcium Channel Blockers Causing Fatal Complication
Authors: Chikkaveeraiah Shashidhara Kuppegala , Kumar H. S. Prasanna , Venkatesh C. R. , Padamati Ashika Reddy , Ashraf Anisha
Published: September 2022

Calcium channel blockers (CCBs) are commonly used cardiovascular drugs known to cause potential toxicity due to overdose. Treating overdose of CCBs can be a challenge even to experienced physicians. One such underreported toxicity of CCB use is the development of acute respiratory distress syndrome (ARDS). Here, we present a 28-year-old previously healthy woman, having taken 25 tablets of 5-mg amlodipine with intent to self-harm. On presentation to emergency, the patient was in shock and hypoxia. Arterial blood gas showed type 1 respiratory failure, and chest X-ray showed bilateral homogenous opacities consistent with ARDS. The patient was managed in the intensive care unit with noninvasive ventilation support and intravenous infusion of noradrenaline, insulin-dextrose, and calcium gluconate. The patient ultimately made full recovery. Severe poisoning with CCBs can cause bradycardia, profound hypotension, conduction blocks, acute kidney injury, and ARDS. It is important for physicians to know the rare complication of CCB like ARDS as early recognition and appropriate treatment results in better outcome.
Long COVID 19 – Persistent and Longitudinal Symptoms in Covid Infected Health Care Personnel
Authors: Suresh Roopa , Reddy A. C. Sanjay , Sreelatha P. , Reddy Y. J. Visweswara , Dhananjaya P. E. , Hashmath Arshiya Sehar
Published: September 2022

Background:

Worldwide health-care personnel are dealing with coronavirus disease 2019 (COVID-19) at various levels. From fears of protecting themselves and their family while treating COVID patients to succumbing to COVID infection themselves, they are at the receiving end of divergent ramifications of COVID infection. One such aspect that is less known is the long-haul manifestations of COVID infection in health-care workers (HCWs).

Aims:

The aim of this study was to assess the persisting symptoms in HCWs who had recovered from COVID-19 and to investigate the associated factors contributing to the persistent symptoms.

Settings and Design:

It was a longitudinal, follow-up study of HCWs who had recovered from acute COVID infection but have lingering symptoms workers in a medical college hospital.

Materials and Methods:

HCWs were evaluated using standardized questionnaires that included sociodemographic, clinical variables, and persistence of post-COVID symptoms. Health-Related Quality of Life Scale was used to evaluate the quality of life. After detailed clinical evaluation, appropriate and relevant investigations were done where necessary. The data were statistically analyzed using Microsoft Excel Sheet and Stata 14.1 version.

Results:

The most common manifestations were fatigue, generalized weakness, fever, shortness of breath, chest pain, and palpitations. In the majority, health-related quality of life was affected. Respiratory and cardiovascular systems were most affected, followed by the central nervous system.

Conclusion:

Patients with COVID 19 infection develop diverse set of symptoms that evolve over time, with infected HCWs being no exception. Recognizing these persisting and ongoing symptoms is the first step taken toward addressing and alleviating them. This highlights that care of COVID patients does not conclude at hospital discharge. Long-term follow-up of these cases is essential in identifying and managing the sequelae of COVID infection. With the growing population recovering from COVID infection, it is imperative to focus on the prolonged effects of COVID infection.
Awareness and practices regarding biomedical waste management among housekeeping staff of a tertiary care hospital in Western India
Authors: Pandve Harshal T. , Gaikwad Shruti Rajendra , Bhure Bhagyashri Suryakant , Kadam Varsha Maroti , Justin Jilu
Published: September 2022

Background:

The World Health Organization biomedical waste guidelines of 2004 emphasizes the importance of the “human factor” over technology and equipment. Housekeeping staff members are directly involved in the collection, transport, and disposal of biomedical waste and are at high risk of acquiring infections. At the same time, they are usually unskilled, uneducated, and have little to no knowledge about the segregation and disposal of biomedical waste, which further compounds their health risk.

Objective:

To assess the awareness and practices regarding biomedical waste management in housekeeping staff of a tertiary care hospital.

Subjects and Methods:

A cross-sectional study was conducted among 100 housekeeping staff members of a tertiary teaching hospital in Pune, Maharashtra, from February to April 2022. A semi-structured, pretested questionnaire was used for data collection. Knowledge of the study participants was scored on a scale of 0–10 and the median score of all the study participants was taken as a cutoff for determining good and poor knowledge. The data were entered into MS Excel 2010 and analyzed using IBM SPSS software 16-trial version. The Chi-square test was used as a test of significance.

Results:

In the present study, 73% of study participants had good knowledge regarding biomedical waste management. All the participants (100%) were following appropriate practices regarding biomedical waste management. Age and experience were found to be significantly associated with knowledge regarding biomedical waste management (P < 0.05).

Conclusion:

There is a gap in the knowledge regarding biomedical waste management among the study subjects which needs to be addressed through repeated and diligent training exercises.
Long- and Very Long-Term Unfavorable Outcomes of the Laparoscopic Adjustable Gastric Band in the Surgical Approach of Morbid Obesity
Authors: Bastos Eduardo Lemos de Souza , Viegas Fábio , Valezi Antonio Carlos , Marchesini João Caetano Dallegrave , Canavarros Juliano Blanco , Silvinato Antonio , Bernardo Wanderley Marques
Published: September 2022

Aim:

The aim is to assess the long- and very long-term rate of unfavorable outcomes associated with the laparoscopic adjustable gastric band (LAGB) in morbid obesity.

Methods:

The Preferred Reporting Items for Systematic Reviews and Meta-analyses statement was used in this systematic review. The search for evidence was performed in the MEDLINE (PubMed), EMBASE, LILACS, Clinical Trials, and Google Scholar databases from the inception to October 2021. The main eligibility criteria were obese adult undergoing LAGB, unfavorable outcomes, and a minimum follow-up of 4 years. Outcomes were aggregated using the Comprehensive Meta-Analysis software for noncomparative studies, and the quality of evidence was sorted. Heterogeneity was assumed when I
2 >50%. Because of expected differences among retrieved studies and several uncontrolled variables, the random-effects model was used to perform a proportional meta-analysis.

Results:

Data on 23,916 unfavorable outcomes were extracted from 28 studies (N = 107,370 patients). The use of the LAGB may be related to a rate of around 30% for reoperation (95% confidence interval [CI] = 20.4%–41.4%), 18% for band removal (95% CI = 13.3%–24.5%), 12% for nonresponse (95% CI = 5.2%–23.8%), 8% for port/tube complications (95% CI = 5.1%–13.6%), 7% for slippage/prolapse (95% CI = 5.3%–9.7%), 6% for pouch enlargement (95% CI = 3.4%–9.9%), and 3% for erosion/migration (95% CI = 2.0%–4.3%) in the long- and very long-term follow-up. However, the quality of evidence was considered very low.

Conclusion:

Despite the very low quality of evidence, LAGB was associated with not negligible rates of unfavorable outcomes in long- and very long-term follow-up.
Role of Echocardiography in the Transcatheter Closure of Atrial Septal Defect
Authors: Singhi Anil Kumar
Published: September 2022

Transcatheter closure of secundum atrial septal defect (ASD) is one of the most common structural cardiac interventions. Imaging the defect is the cornerstone of the procedure at different stages of the intervention. The imaging modalities most commonly used are transthoracic and transesophageal echocardiography (TTE and TEE, respectively). Less commonly used are intracardiac echocardiogram and fusion navigation techniques. From the planning stage, a detailed anatomic and hemodynamic assessment of ASD is required for deciding suitability of device closure. Intraprocedural imaging guidance again is essential for a successful device deployment. Various assisted techniques like balloon assistance also require live TEE guidance. Confirming an acceptable device deployment is imaging dependent. Long-term follow-up of the patient for different parameters is done with the help of echocardiographic screening. A detailed understanding of echocardiographic imaging at different stages of the ASD device closure is the key for success.
Histological Changes in the Background Renal Parenchyma in Neoplastic Nephrectomies and Nephroureterectomy: A 10-Year Single-Center Experience
Authors: Al Zahrani Reem A.
Published: September 2022

Background:

Nephrectomies and nephroureterectomies specimen with neoplastic diagnosis provide a great opportunity to examine the background kidney parenchyma. This will help in exploring any microscopic abnormality that may affect the functional capacity of the residual renal tissue and assess the possible need for nephrologist intervention in maximizing the function of the residual renal parenchyma.

Aim:

Evaluation of this part of the kidney is overlooked in different centers around the world.

Method:

A total of 124 specimens of nephrectomies and nephroureterectomies performed at King Abdulaziz University Hospital between January 2010 and December 2019 were reviewed. The microscopic findings in the nonneoplatic parenchyma were documented. Furthermore, the extent to which these findings were initially identified, investigated, and reported was measured.

Results:

Hypertensive and diabetic nephropathy were among the most common findings in the diseased kidney. The nonneoplastic kidney was well sampled in 95% of the cases and mentioned in the report in 25% of the cases.

Conclusion:

Although, the evaluation of this part of the kidney is essential, and of great help for the patient prognosis, and quality of kidney function, it is overlooked in different centers around the world, and the causes behind this requires further exploration.
An Assessment of COVID-19 Infection after Vaccination Amongst Health-Care Workers at a Tertiary Care Centre, Kodagu, Karnataka
Authors: Narasimha B. C. , Udayar Sharvanan Eshwar , Raja N. Sabari , Madeshan Ashwini , Katoch Jissun
Published: September 2022

Background:

The equitable COVID-19 vaccination is an effective tool to end the pandemic globally. Many studies have reported, namely, in the western population, vaccination protected against the severe form of COVID-19 infection.

Aims and Patients:

To estimate the prevalence of COVID-19 infection amongst health-care professional's post vaccination at a Tertiary Care Centre in Kodagu, Karnataka.

Methods:

A cross-sectional study was conducted amongst 336 health-care workers in a Tertiary Care Centre Kodagu from November 2021 to January 2022. A convenient sampling technique was used to collect the data using a semi structured questionnaire. Data were entered into Excel and analysed using Epi-info version 7.2.

Results:

Of 336 study participants, females were 195 (58.04%), and males were 141 (41.96%). The mean (standard deviation) age of the participants was 25.80 (4.67) years. The total prevalence of infection was 83 (24.4%); after the first dose of the vaccine was 22 (6.52%), and after the second dose was 61 (21.73%). The total number of hospital admissions after the first and second dose was 1 and 9, respectively. None of them required intensive care in the hospital.

Conclusions:

The COVID-19 infection reported after vaccination amongst health care workers was minimal. None of them required intensive care in the hospital.
Understanding Pathophysiology of Cluster Headache
Authors: Sahin Erdi , Ekizoglu Esme , Orhan Elif Kocasoy , Bilge Ahmet Kaya , Baykan Betul
Published: September 2022

Aim:

The underlying mechanisms of cluster headache (CH) have not been fully understood yet. The cranial autonomic activation suggests that both sympathetic and parasympathetic systems are impaired in the clinical presentation; however, the systemic autonomic involvement during pain-free episodes is not well-known.

Methods:

Thirty-five subjects were included in 24 h Holter monitoring and electrophysiological studies in this controlled study.

Results:

In Holter monitoring, heart rate variability parameters, RMSSD (P = 0.001), and pNN50 (P = 0.024) were significantly higher in patients compared to age and gender-matched controls. The R-R variations during breathing and deep breathing and sympathetic skin responses of all patients were normal.

Conclusions:

High RMSSD and pNN50 levels are the two indicators of increased parasympathetic activity in CH patients. Considering the intense stress because of severe pain of the CH patients, who are mostly adult men and smokers, there is an urgent need for broader studies with prospective follow-up in terms of cardiac health.
Clinical Course and Outcomes of Complicated Mild Traumatic Brain Injury in Children
Authors: Hanalioglu Sahin , Hanalioglu Damla , Elbir Cagri , Sahin Omer Selcuk , Sahin Balkan , Turkoglu Mehmet Erhan , Kertmen Huseyin Hayri
Published: September 2022

Objective:

Mild traumatic brain injury (mTBI) constitutes majority of TBI cases. A considerable portion of mTBI cases has intracranial imaging abnormalities (complicated mTBI), which pose challenges in the diagnosis and management to clinicians. Here, we aimed to evaluate the early clinical course and outcomes of pediatric complicated mTBI cases treated at a large-volume tertiary referral center.

Materials and Methods:

A single-center retrospective cohort study was conducted at a large-volume tertiary trauma referral center for 12-month period between 2017 and 2018. Pediatric mTBI cases with at least one of the following computed tomography (CT) findings were included a depressed skull fracture, pneumocephalus, intracranial hemorrhage, edema, or contusion. Demographic, clinical, and radiological data were collected and analyzed.

Results:

One hundred and twenty-four patients with complicated mTBI were identified. Falls were the leading mechanisms of trauma (71.8%). Most patients (90.3%) had a Glasgow coma score (GCS) of 15 at initial evaluation. Most frequent radiological findings on initial CT scan were epidural hematoma (EDH) (34.7%) and pneumocephalus (31.5%), followed by subdural hematoma (SDH) (19.4%), subarachnoid hemorrhage (16.9%), contusion (14.5%), and depressed skull fracture (8.1%). Radiological findings in the routine repeat CT scan were stable in 55.6% of the patients, whereas the findings progressed in 15.3% and improved in 29% of patients during this interval period (median 7 h). Neurosurgical operation was performed in 7 (5.6%) patients. Thirty-six (29%) patients were identified as having clinically important TBI (ciTBI). Average length of stay at emergency department was 9.7 ± 4.9 h, and the average length of hospital stay was 3.6 ± 2.3 days. Multivariate analysis revealed that age, GCS, pneumocephalus, depressed skull fracture, EDH, and SDH were independent predictors of ciTBI.

Conclusion:

Pediatric complicated mTBI is associated with higher rates of hospitalization and therefore ciTBI but relatively lower rates of need for neurosurgery. Effective decision-making tools and algorithms are needed to guide optimal management strategies of these patients.
Childhood Trauma, Loneliness, and Quality of Life in Adults with Euthymic Bipolar Disorder
Authors: Chein Karen , Hsieh Yi-Ting , Tseng Huai-Hsuan , Lee I Hui , Yang Yen Kuang , Chen Po See
Published: September 2022

Background:

Individuals with childhood trauma may experience loneliness throughout their lives, which can potentially aggravate mental and physical health conditions. Moreover, accumulating evidence suggests that associations exist between childhood trauma and certain features of bipolar disorder (BD), including cognitive dysfunction, severity, and clinical course. But, it remains unclear whether loneliness is associated with childhood trauma or quality of life in adult patients with BD.

Methods:

We recruited 83 patients with euthymic BD and 40 control participants from the psychiatric outpatient clinic at National Cheng Kung University Hospital. Their severity of mood symptoms was measured according to the Hamilton Depression Rating Scale (HDRS) and Young Mania Rating Scale (YMRS). All study participants completed the childhood trauma questionnaire (CTQ), World Health Organization Quality of Life (WHOQOL) Scale and University of California, Los Angeles Loneliness Scale.

Results:

Compared with controls, patients with euthymic BD had significantly higher scores of HDRS (p< 0.01), YMRS (p< 0.001), CTQ (p< 0.001), loneliness scores (p< 0.001), but significantly lower WHOQOL scores (p< 0.001). In patients with euthymic BD, a significantly positive correlation was found between loneliness and CTQ scores (p< 0.001) and a significantly negative correlation was present between loneliness and WHOQOL scores (p< 0.001). These correlations were also present in the control group (p< 0.05 andp< 0.001).

Conclusion:

Euthymic BD patients had stronger feelings of loneliness than controls overall. In both euthymic BD and control patients, loneliness was positively correlated with childhood trauma and negatively correlated with quality of life. These findings warrant further investigations to strengthen the findings of the causal relationship between childhood trauma and loneliness.
Rating Inter-Rater Reliability of Shih–Hsu Test of Attention between an Experienced Psychiatric Occupational Therapist and an Occupational Therapy Student
Authors: Shih Yi-Nuo , Wu Chia-Chun , Shih Pei-Yun , Hsu Jia-Lien , Liao Yin-Huang
Published: September 2022

Objective:

The “Shih-Hsu Test of Attention” (SHTA) is an iPad-based attention assessment tool developed by occupational therapists in recent years, and has acceptable criterion-related validity and high test–retest reliability in preliminary application. In this study, we intended to explore the inter-rater reliability of SHTA between experienced and inexperienced occupational therapists.

Methods:

We recruited 24 voluntary study participants aged 20–24 years in this study. The participants completed twice the SHTA by an experienced occupational therapist and an occupational therapy student.

Results:

Analytical results showed that the inter-rater reliability between experienced and inexperienced occupational therapists using SHTA had satisfactory reliability (intraclass correlation coefficient = 0.65).

Conclusion:

Our preliminary findings showed that the new attention assessment tool, SHTA, had satisfactory inter-rater reliability between experienced and occupational therapy students. We need to wait for a future study with more numbers of study participants in both groups to strengthen the study finding of this pilot study. At this moment, we suggest improving the guidance and training for inexperienced occupational therapists to improve accuracy, and reducing the gap when testing with experienced occupational therapists in future.
Factors Associated with the Quality of Life in Family Caregivers of People with Dementia in Taiwan
Authors: Yeh Teng-Yin , Su Jian-An , Chang Chih-Cheng
Published: September 2022

Objectives:

Previous studies showed that caregivers of patients with dementia (PWD) have lower quality of life (QoL) due to several clinical factors related to caregivers and their ill relatives. In this study, we intended to assess the associated factors of QoL in caregivers of PWD in Taiwan.

Methods:

A cross-sectional survey with 270 dyads of PWD and their caregivers was conducted. We assessed family members' depressive symptoms, anxiety, affiliate stigma, care burden, and QoL, and patients' cognition, severity of dementia, self-care, and mobility skills, as well as neuropsychiatry symptoms of PWD.

Results:

Caregivers' longer years of education were significantly associated with better QoL in environment domains (β = 0.21, p < 0.01), while the children of caregivers had significantly better QoL in physical domains compared to spouses of caregivers (β = 0.28, p < 0.05). Patients with a past history of psychiatric hospitalization (β = 0.11, p < 0.05) and longer caregiving time (β = 0.13, p < 0.05) were significantly related to better QoL in environment domain. High levels of depression were associated with significantly lower QoL in physical health (β = −0.24, p < 0.05) and psychological domains (β = −0.32, p < 0.01), while more anxiety symptoms were related to significantly lower QoL in physical health (β = −0.26, p < 0.01) and environment domains (β = −0.27, p < 0.01). Higher levels of affiliate stigma were significantly related to lower QoL of caregivers in psychological (β = −0.23, p < 0.01), social relationships (β = −0.27, p < 0.01), and environment (β = −0.19, p < 0.05) domains. Higher levels of care burden were significantly related to lower QoL of caregivers in physical health (β = −0.24, p < 0.01) and environment (β = −0.23, p < 0.05) domains.

Conclusion:

Caregiver's depression, anxiety, affiliate stigma, and care burden were found to play a critical role in maintaining QoL of family caregivers. We suggest developing effective programs as a direction of future intervention for PWD to improve their QoL.
Therapeutic options of post-COVID-19 related olfactory dysfunction: a systematic review and meta-analysis
Authors: Asvapoositkul V. , Samuthpongtorn J. , Aeumjaturapat S. , Snidvongs K. , Chusakul S. , Seresirikachorn K. , Kanjanaumporn J.
Published: September 2022

Background: Olfactory dysfunction is a typical post-COVID-19 presentation, affecting patients' quality of life. There are currently multiple treatment options in this group of patients such as oral and intranasal corticosteroids, olfactory training, oral vitamin-mineral supplementation, amongst others. This meta-analysis aims to consolidate existing evidence for current therapies in patients with persistent olfactory dysfunction related to COVID-19 infection and evaluate the possible role of corticosteroid add-on therapy in olfactory training. Methodology: A systematic review and meta-analysis to study current treatments/interventions for olfactory dysfunction in post-COVID-19 infection were conducted. Data were pooled for the meta-analysis. The outcomes include subjective or objective olfactory assessment major and minor adverse reactions. Results: Eleven studies (1414 participants) were included in this review, with six studies (916 participants) then assessed for the meta-analysis. Combined treatment of intranasal corticosteroid (INCS) with olfactory training (OT) has no benefit over OT monotherapy from both a VAS score improvement and identification component of Sniffin' Sticks test standpoint. In addition, there were no differences in improvement of TDI score between combined oral corticosteroid (OCS) with OT therapy compared to OT alone. Olfactory function was, however, significantly improved after OT. Conclusion: There were no significant differences in the improvement of olfactory scores in combination INCS+OT or OCS+OT therapies compared to OT monotherapy. However, there is improvement in olfactory function after OT.
Matej Hriberšek, Slovenski doktorji klasične filologije na dunajski univerzi v obdobju 1872–1918 (recenzija)
Authors: Rebetz Jonathan
Published: September 2022

Matej Hriberšek z monografijo Slovenski doktorji klasične filologije na dunajski univerzi v obdobju 1872–1918 razširja in nadgrajuje raziskave, ki jih je izvedel za področje klasične filologije v sklopu projekta »Zgodovina doktorskih disertacij slovenskih kandidatov v avstro-ogrski monarhiji (1872–1918)«. Izbira letnic je logična: leta 1872 je v avstro-ogrski monarhiji prišlo do korenite reforme doktorskega študija (odtlej so doktorski kandidati morali pred promoviranjem napisati znanstveno disertacijo ter uspešno opraviti dva rigoroza), leto 1918 pa zaznamuje konec monarhije. Za to obdobje je na dunajski Filozofski fakulteti evidentiranih 11 doktoratov s področja klasične filologije. Hriberškov pogoj za uvrstitev kandidata na seznam ni bil le, da slednji izvira s slovenskega narodnostnega ozemlja, ampak tudi, da je za materni jezik na vpisnici navedel slovenščino. Čeprav za dva kandidata (Janeza Maslja in Franca Omerzo) v arhivski dokumentaciji ni zapisa o promociji, sta v knjigo vseeno vključena, saj sta opravila vse oziroma večino obveznosti, ki so bile zanjo pogoj.
Filološko in prosvetno delo Josipa Pipenbacherja
Authors: Hriberšek Matej
Published: September 2022

Josip Pipenbacher se je po maturi leta 1891 vpisal na študij klasične filologije na Dunaju; tu je leta 1895 doktoriral (v disertaciji se je ukvarjal s Ksenofontovim spisom Ustava Lakedajmoncev) in opravil profesorski izpit. Najprej je kot suplent poučeval na Državni c. kr. nižji gimnaziji v Ljubljani (zdaj gimnazija Poljane), nato kot profesor na Višji c. k. gimnaziji v Novem mestu in končno znova na Drugi c. kr. državni gimnaziji v Ljubljani; to je med letoma 1921 in 1928 vodil kot direktor. Po ustanovitvi Univerze v Ljubljani je med letoma 1920 in 1939 kot honorarni predavatelj vodil latinske proseminarje in tečaje latinščine. Napisal je vrsto učnih pripomočkov, najbolj znani so latinska slovnica in štiri latinske vadnice, vse v več izdajah, sodeloval pa je tudi pri nastajanju Wiesthalerjevega Latinsko-slovenskega slovarja,  za katerega je obdelal črko R. Bil je strog ocenjevalec,  posebej odmevna je bila njegova ocena Latinske slovnice Josipa Tominška), napisal pa je tudi nekaj prispevkov s področja metodike pouka latinskega jezika. Kot šolnik se je vključeval v delo različnih društev in organizacij, vseskozi je finančno podpiral različna študentska, prosvetna in druga društva, nekaj časa pa je deloval tudi v lokalni politiki kot član ljubljanskega mestnega sveta. Zadnja leta svojega življenja je preživel na svojem posestvu v Sveti Marjeti na Dravskem polju. Umrl je 11. aprila 1949 v Mariboru.
Eksistenca literarnih likov in neverbalna motivacija v Sofoklovi tragediji
Authors: Senegačnik Brane , Valijev Sergej
Published: September 2022

Ker nimamo avtorskih didaskalij, je celoten svet drame (vključno s psihično in materialno realnostjo) predstavljen izključno z besedami, ki jih govorijo dramski liki. Roman Ingarden imenuje takšen način predstavljanja shematična reprezentacija: na ta način predstavljeni predmeti so namreč samo skicirani, nešteta nedoločena mesta v njihovi predstavitvi vabijo bralca, da jih v procesu konkretizacije alirekonstrukcije zapolni z intelektualnimi in domišljijskimi  operacijami in se pri tem opira na svoje znanje in izkušnje. Tako konkretizacijo kot rekonstrukcijo je treba ločevati od literarnega dela samega; ker ju oblikuje bralec s svojo domišljijsko dejavnostjo, predstavljata oviro pri spoznavanju dela samega. Ingardnovo teorijo so kritizirali prav zaradi tega, ker daje bralcu preveč manevrskega prostora pri konstituiranju in tudi pri rekonstrukciji literarne umetnine (Ray, Kos, Holub, Calinescu). Zdi se, da te kritike temeljijo v nekoliko poenostavljenem razumevanju Ingardnove izredno kompleksne analize, v kateri se kaže, da je vloga bralca sicer omejena s tekstom, a vendarle vitalnega pomena za sekundarno eksistenco literarne umetnine. V članku so obravnavani neverbalni dejavniki motivacije v Sofoklovi tragediji; razdeljeni so v tri skupine: značajske poteze, dramska klima in čutne izkušnje. Članek se zaključi z analizo Odisejeve neverbalne motivacije v tragediji Ajant, ki predstavlja poseben primer, saj je tu odločilni dejavnik motivacije Odisejeva izkušnja  numinoznega.
Havadaki Ca Konsantrasyonunun Tespitinde ve Trafik Yoğunluğu ile İlişkisinde Yıllık Halkaların Kullanılabilirliği
Authors: Çobanoğlu Hatice , Şevik Hakan , Koç İsmail
Published: September 2022

Makro besin elementleri sınıfında yer alan kalsiyum (Ca) bitki, eğitim ve fizyolojisi için gerekli bir element yanı sıra aynı zamanda bir ağır metaldir. Ağır metallerin düşük seviyedeki dozlarda hayvanlar için olumsuz ve olumsuz olabilir. Diğer ağır metallerde olduğu gibi, standartlar gibi kullanımları halinde ekosistem ve canlılardan alınan ürünler için uygundur. Bundan dolayı Ca elementinin havadaki bölümündeki yıllardan çapındaki son derece önemlidir.
Kastamonu'nun 39 üzerindeki bir Sedir gövdesinin gövdesinden alınan kütük üzerinde ölçümler, Ca tipinin organ ve kaynaklı olanlardan birine bağlı olarak hedeflenirler. Bu bölgede meydana gelen (dış iç kabuk) ve iç içe geçen (dış kabukki bölgede Ca çalısmaları) çalısmalar. Sonuç olarak, Ca'un organlardaki yaşamların dış kabuk >iç kabuk>odun şeklinde sıralanırken organlar arasında bu elementin transferinin çok az olduğu tespit edilmiştir. Dolayısıyla Sedir ağacının Ca ağır metalininnde uygun bir biyomonitör olduğu söylenebilir. Ayrıca, bazı bazında oluşturulmuş.
Hemşirelik Öğrencilerinin Objektif Yapılandırılmış Klinik Sınav Becerisinin Teorik ve Uygulama Başarısı ile İlişkisi
Authors: ÖZDEN Dilek , GÜROL ARSLAN Gülşah , ERTUĞRUL Büşra , ADANIR Abdülmenef
Published: September 2022

Giriş: Öğrencilerin teorik bilgilerini uygulamaya yeterince aktaramaması ve uygulama becerilerinin objektif olarak değerlendirilememesi ülkemizdeki hemşirelik eğitiminin en önemli sorunları arasında yer almaktadır. Öğrencilerin neden olabileceği hataları önlemenin yollarından biri, hastaya zarar vermeden becerilerin incelenmesine fırsat sağlayan objektif yapılandırılmış klinik sınavdır (OYKS). Amaç: Bu çalışmanın amacı, hemşirelik öğrencilerinin OYKS başarısının teorik ve uygulama başarıları ile ilişkisini incelemektir.Yöntem: Araştırmada, retrospektif inceleme yöntemi kullanılmıştır. Araştırma verilerinin toplanması, 1 Ekim 2020 - 01 Ocak 2021 tarihleri arasında OYKS kontrol listelerinin retrospektif olarak incelenmesi ile gerçekleştirilmiştir. Çalışmanın örneklemini, devamsızlık ya da bireysel nedenler sebebi ile OYKS, ara sınav ve klinik uygulamaya katılmayan öğrencilerin örneklemden dışlanması sonucunda toplamda 490 öğrenci oluşturmuştur. Bulgular: Öğrencilerin puan ortalamaları incelendiğinde, subkutan uygulamanın 35.48 ± 6.62, kan alma uygulamasının 34.83 ± 9.82, intramüsküler uygulamanın 33.24 ± 7.13 ve üçlü musluktan  intravenöz ilaç uygulamanın puan ortalaması 31.98 ± 8.6 olarak belirlenmiştir. Öğrencilerin OYKS uygulamalarından aldıkları puan ortalamasının ara sınav not ortalamaları ile anlamlı fakat çok zayıf (p < .001, r = .23), uygulama not ortalamaları ile anlamlı fakat zayıf ilişkisi olduğu bulunmuştur (p < .001, r = .26). Bunun yanında öğrencilerin 1. Ara sınav not ortalamaları ile uygulama puanları arasında da anlamlı ancak zayıf (p < .001, r = .39) ilişki olduğu bulunmuştur. Sonuç: Öğrencilerin beceri puanlarının ortalamadan yüksek olduğu görülse de, hasta güvenliğini tehlikeye atabilecek birçok noktada hataların yüksek oranda olduğu görülmektedir. OYKS sınavbaşarısının öğrencilerin teorik ve uygulama başarıları ile anlamlı olmasına rağmen çok düşük ve düşük derecede ilişkili olduğu belirlenmiştir.