bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validación de escala pronóstica de conversión a cirugía abierta en colecistectomía laparoscópica
Authors: Andrade Salinas Roberto Paúl 
Published: December 2019

Introducción: La conversión a cirugía abierta es una complicación de la colecistectomía laparoscópica, ya sea por dificultad en la disección o por la falta de experticia del cirujano. Actualmente es complicado predecir la dificultad de una cirugía laparoscópica de vesícula biliar.
Objetivo: Evaluar la sensibilidad de la ecografía para colecistitis y colelitiasis y su relación con los hallazgos transoperatorios en cirugías de vesícula biliar
Material y Métodos: Se realizó un estudio observacional retrospectivo con la revisión de las historias clínicas de aquellos pacientes intervenidos quirúrgicamente por patologías de vesícula biliar y que presenten ecografía como medio diagnóstico en el Hospital General Docente Ambato de Junio a Diciembre de 2018.
Se evalúo la posible dificultad quirúrgica con una escala pronóstica ecográfica y posteriormente se comparó con los hallazgos quirúrgicos y la existencia de conversión.
Resultados: La correlación de la dificultad quirúrgica (cirugía mayor a 90 min o convertida) en relación con la escala predictiva (posible cirugía complicada score ≥5) es de 73% (sensibilidad) y la probabilidad que la escala prediga una cirugía no complicada es del 71% (especificidad), con un OR: 7.785 (IC: 0.789 – 78.511), con un test de Fisher (X2 modificado) de 2.225 con una p = 0.074. La relación no es estadísticamente significativa.
Conclusiòn La escala pronóstica ecográfica utilizada en los pacientes del Hospital General Docente Ambato no predice la dificultad quirúrgica de los pacientes sometidos a cirugía laparoscópica de vesícula
Persistencia de vena cava superior izquierda: ¿marcador ecocardiográfico de malformaciones fetales cardiacas y extra-cardiacas?
Authors: Vaca Nuñez Carlos Stalin , Deiros Bronte L , Vaca Pazmiño Carlos , Vaca Núñez A. 
Published: December 2019

Introducción: La vena cava superior izquierda persistente (VCSIP) es la malformación vascular congénita más frecuente, observada en el 0.3% de autopsias en la población general y en el 4 -8 % de pacientes con cardiopatías congénitas. Durante el desarrollo embriológico temprano el retorno venoso de la cabeza y los brazos normalmente drena en la aurícula derecha por las venas cardinales anteriores izquierda y derecha.
Objetivo: Relacionar la Persistencia de Vena Cava Superior Izquierda (VCSIP) diagnosticada por estudio ecocardiográfico fetal, con la presencia de anomalías intra y extracardiacas.
Metodología: Se realiza un estudio descriptivo, retrospectivo en 75 casos obtenidos de la base de datos del departamento de Medicina Perinatal del Hospital Universitario La Paz (Madrid –España), durante el periodo comprendido entre 2006 - 2017 con diagnóstico prenatal de (VCSIP). A los 75 pacientes se realiza estudio ecocardiográfico, a 32 amniocentesis y a 2 biopsia de velocidades coriónicas y, se establece su relación o no, con anomalías congénitas cardiacas y extracardiacas. El análisis estadístico se realiza mediante el programa STATA.
Resultados: Se analizaron ecográficamente 75 fetos con diagnóstico de VCSIP, con una media de edad gestacional al diagnóstico de 26,6 semanas (DE: 5,87; IC: 95%). En 14 pacientes (18.67%) no se detectaron malformaciones; en 27 pacientes (36%) se evidenciaron alteraciones cardiacas; 15 pacientes (20%), presentaron malformaciones extra cardiacas y 19 pacientes (25.33%), presentaron malformaciones extra e intracardiacas.
Conclusiones: La ecografía prenatal tiene un gran impacto para el diagnóstico temprano de afectaciones y variaciones anatómicas como la vena cava superior izquierda. El diagnóstico de esta alteración obliga a realizar despistaje y seguimiento de otras anomalías fetales asociadas ya sean intra y extra-cardiacas. Con un buen screening ecográfico prenatal no sería imperativo indicar a los pacientes con VCSIP aislada una prueba invasiva prenatal.
Cognitive impairment as a function of sleep quality and gender
Authors: Akhil R. , Nair B.P. 
Published: December 2019

Background: The study aims at finding whether there is any significant difference between sub-groups classified on the basis of sleep quality (good sleep quality and poor sleep quality) and gender in the performance of various cognitive functioning tests like Visual N Back Test (N Back 1and N Back 2 test) for working memory, Triad test for divided attention, Digit Vigilance Test for sustained attention and Reaction time test (simple reaction time and choice reaction time).
Materials and methods: The sample consisted of 30 participants, both males (N=13) and females (N=17) in the age range between 18 to 30 years, randomly drawn from Thiruvananthapuram and Kollam districts of Kerala. The participants of the study are screened and categorized into two groups of 15 members each on the basis of the scores obtained in the Pittsburgh Sleep Quality Index (PSQI). t-test and two-way ANOVA were performed to test the significance of the hypotheses.
Results: The results showed that the participants with poor sleep quality significantly differed from those with good sleep quality and committed more number of errors in the triad test of divided attention and took more time and committed more errors in the completion of the digit vigilance test of sustained attention.
Conclusion: A gender advantage favoring females was seen on the test of working memory, test for sustained attention and the test for choice reaction time. An interaction between sleep quality and gender was noticed only on the test of divided attention. It was seen that males with poor sleep quality are more impaired in divided attention tasks than females with poor sleep quality.
Defense mechanisms of persons with locomotor disabilities
Authors: Eranimos Boban , Thankappan Surya 
Published: December 2019

Background: According to World Health Organization 1, billion people -15% of the World population lives with various disabilities. Disabilities restricts individual’s participation of social life and this create limiting the maximum utilization of resources and hence the person crippled with psychological issues. Persons with disabilities were used various defense mechanisms as coping strategies to survive and compensate with their disabilities. The present study investigates the types of defense mechanisms used by persons with locomotor disabilities.
Materials and methods: The total sample consists of 100 participants which include 50 males and 50 females. Among them 46 participants were congenitally disabled and 54 were acquired disabled. The participant’s age ranges between 18-60 years. The descriptive survey method was used for the present study and purposive sampling method adopted for sample selection. Defensive Behaviour Rating Scale (Sathya Giri Rajan, 1991) was used for data collection. The data was analysed by using Statistical Package for Social Sciences (SPSS) Version 16 for windows.
Results: Female participants with locomotor disability have reported more reaction formation than male participants with locomotor disability. In the comparison of defense mechanisms of participants with locomotor disability with respect to their gender, male participants have reported more compensation, projection, identification, belittling and reaction formation and significantly lower repression than females. Females have reported significantly more daydreaming than males. Persons with congenital disability have higher sublimation than persons with an acquired disability.
Conclusion: Researchers have long been fascinated by man’s defense mechanisms. Defense mechanisms are commonly used to protect the sense of self and help to defend people from painful emotions. In the present study, the investigator attempts to find out defense mechanisms of persons with locomotor disability and evaluation were made how they cope with the situation in relation to their nature of disability. The present study found that people with locomotor disability use both adaptive and maladaptive defense mechanisms, predominantly maladaptive defenses.
Developmental disabilities: Barriers in early identification
Authors: Mathew Rincymol 
Published: December 2019

Background: A healthy active child is a promise for healthy and productive future generation. But sometimes a baby is born with apparent defects or develop disturbances in intellectual, motor and social functioning in early childhood. This may be due to due to impaired development of the nervous system. It is estimated that in India 2.21% of the population is affected with disabilities out of which a major portion is contributed by disabilities of childhood origin. Developmental disabilities include limitations in function resulting from disorders of the developing nervous system. These limitations manifest during infancy or childhood as delays in reaching developmental milestones or lack of function in one or multiple domains including cognition, motor performance, vision, hearing and behavior. Early identification of the disabilities combined with initiation of appropriate medical, educational, social and psychological interventions can maximize the health outcome and minimize the impact of disability. This paper discusses the barriers identified in early intervention of developmental disabilities.
Materials and methods: Qualitative Sample: Parents of children affected with developmental disabilities, Primary School Teachers, Special Educators, Nursing personnel working in the clinical setting. Sample subjects were selected from local schools, and hospital by purposive sampling. Method of data collection: Focus group discussion. Instruments used: Self developed questionnaire to conduct discussion.
Results: The major themes evolved as the barriers in adoption of early intervention programmes were grouped under 7 categories namely intellectual, attitudinal, social, cultural, technological, political and economic barriers.
Conclusion: The study findings suggest direction regarding possible steps to facilitate enhancement of early intervention services by an exploration of the role played by different barriers.
Effect of guideline on positioning of neonates in the neonatal intensive care unit
Authors: Soniya P.S. 
Published: December 2019

Background: Developmentally Supportive Care is a broad category of interventions that is designed to minimize the stress of the NICU environment which include care such as control of external stimuli, clustering of nursery care activities, and positioning or swaddling of the preterm infant so as to provide a sense of containment similar to the intrauterine experience. The preterm neonates often lack adequate muscle tone and are at risk for developing abnormal movement pattern as well as skeleton deformation. Positioning is one of the important aspects of Developmentally Supportive Care to keep the baby comfortable. It is a basic neonatal nursing care and includes keeping the baby in supine, prone and side lying. As postural stability is a foundational milestone for motor development and premature infants are unable to exhibit postural stability without support, standardizing the definition of optimal positioning will lead to consistency in practice. A neonatal positioning guideline implemented in NICU will help in the growth and development of preterm neonates.
Materials and Methods: A prospective study was conducted in NICU of a tertiary medical College Hospital, Bangalore. It was an experimental study. Neonatal nurses who were involved in preterm infants care were selected by purposive sampling. Sample size was calculated based on the study by Jeansonetal. Pretest and posttest practices were assessed by taking the average of two observations for each nurse using infant positioning Assessment tool (IPAT). The nurses were trained by lecture followed by practical demonstration of neonatal positioning guidelines. After one week post test was repeated. Paired T test was used for comparing the positioning in pre and post intervention.
Results: Pre-test practice concludes that100% (25) of the staff nurses were in the category of ‘need for repositioning’ and 100% (25) of the nurses were in the category of ‘acceptable positioning’ in post-test (P <0.001) with respect to all the positioning parameters. The mean Pretest score was 4.14 ±1.02 and post test mean score was 10.17 ± 0.57(P <0.001). There was a significant association in practice score with respect to years of experience in NICU (P<0.05).
Conclusion: There was a significant improvement in the infant positioning scores in the post test after introducing the positioning guidelines and training the nurses, compared to the pretest scores.
Effectiveness of Entonox use in pain and comfort level of parturient mothers during first stage of labor
Authors: James Sruthi 
Published: December 2019

Background: Natural childbirth is a beautiful experience with many safe options and benefits. Labor pain is widely viewed as being nothing more than the perception of unpleasant sensation. Many methods have been used for pain relief which constitutes non-pharmacological methods such as relaxation therapy and others are by pharmacological agents. Entonox, homogenous gas mixture of 50:50 nitrous oxide and oxygen, a form of inhalation analgesia is very effective in reducing pain and thereby progressing to painless vaginal delivery. The usage of Entonox is known worldwide, however its usage in Kerala is comparably very less. The objective of the study was to assess the effectiveness of inhalation analgesia (Entonox) in pain and comfort during first stage of labor among parturient mothers.
Materials and methods: A quasi-experimental pretest – posttest control group with 60 mothers (30 each in experimental and control) was the adopted design with parturient mothers in 37-40 weeks of gestation from selected hospitals in Kollam, Kerala. Demographic proforma, visual analogue scale and comfort assessment checklist were the tools used. The statistically significant relationships were identified by descriptive and inferential statistics. Ethical clearance was granted by the committee in Kollam, Kerala.
Results: Out of 60, 45% of the mothers were in the age group of 24-29 years, 35 % had undergone upper primary education, 61.7% were primi gravidae and 55% of them were in the gestational age of 39-40 weeks. The mean post interventional pain score of the experimental group was lower than that of control group (4.07/9.93, p < 0.05). Also, the mean post interventional comfort score of the experimental group was lower than that of control group (7.37/15.77, p < 0.05).
Conclusion: Entonox provides significant pain relief and improves comfort and it can be quickly implemented during painful labor. By further exploration and research studies would help the mothers be free to choose the harmless Entonox during labor.
Poly cystic ovarian disease (PCOD) - a modifiable risk factor of infertility: A quasi-experimental research from South India
Authors: Betty K.D. 
Published: December 2019

Background: India has a population of 1.2 billion, nearly 30 million couples in the country suffer from infertility, in which female infertility is caused mainly by PCOD (40%). In Kerala, adolescent girls’ population comprises 7% and the prevalence is 15% (Annual vital report of statistics report 2015). The unhealthy eating habits and lack of exercise leads to PCOD. Therefore, as a nurse, the investigator has a pivotal role in creating awareness about the modification of lifestyle and prevention of future complications. The investigator observed that many students are diagnosed with PCOD during their physical training screening.
Materials and methods: Quantitative research approach, using quasi-experimental one group pre-test – post- test design was adopted to collect data by non-probability convenient sampling from 48 adolescent girls between 17-20 years those who were studying first year B.Sc. nursing in a private nursing college, Kerala. Demographic characteristics were age, religion, weight, family history, previous knowledge and knowledge questionnaire consisted of 30 questions with 4 options regarding poly cystic ovarian disease.
Results: Out of 48 subjects, majority (79.2%) were in the age group of 19-20 years, 47.9% were in the group of weight from 50-60 kg and 33.3% had menstrual problems. Majority 89.6% were not having family history and only 38.3% had previous knowledge. Pre- test showed that majority (97.91%) had average level of score, whereas in the post test majority (91.6%) adolescents had good knowledge regarding poly cystic ovarian disease. The calculated t value 19.79 at 0.05 level of significance indicated that the structured teaching programme was effective. The chi- square value was lower than the table value at 0.05 level showed that there was no significant association between knowledge and their selected demographic variables.
Conclusion: Structured teaching programme regarding had improved the knowledge level of adolescent girls about poly cystic ovarian disease.
Potential challenges in conducting clinical trials with mixed methods approach
Authors: Ibnas Muhamed , Asim M. , Sathian B. 
Published: December 2019

Background: Clinical trial is being conducted to assess the safety, efficacy and/or dosage regimen of a drug or therapeutic intervention in human subjects which are carefully selected on predetermined criteria. On the other hand, qualitative research is open-ended focuses on the depth of understanding of issues that are beyond the scope of quantitative analysis. Although, quantitative method is predominated in clinical research; over the past decade qualitative approach is being recognized for its value and unique contributions and is increasingly incorporated in clinical research. The combination of these two approaches in a single study is referred as Mixed Method design. Herein, we aim to explore the major challenges and pitfalls in conducting clinical trials with mixed method approach.
Materials and methods: We reviewed the published literature in English language through the research engines (PubMed and Google Scholar) involving clinical trials/studies with mixed method approach to look for the potential challenges and issues identified during the conduct of mixed method research (MMR).
Results: There are various issues in conducting clinical trials with mixed methods approach as it is time consuming, requires expertise, skills and methodological training for both quantitative and qualitative research. Also, there are a number of challenges observed while conducting MMR, such as obtaining informed consent, safety events reporting, data retrieval, study documentation, data confidentiality and storage, inappropriate integration and interpretation of the data as well as incorrect ordering, preferences and objective of each method.
Conclusion: Use of hybrid approach in clinical trial can provide deeper understanding and insights of research question with higher validity and reliability. MMR has certain challenges which can be overcome by in-depth methodological training and collaboration. Therefore, strong collaboration between clinical and social scientists in necessary to design a competitive funding grant for mixed method research. Finally, integration and implementation of MMR is crucial for conducting pragmatic trials.
Quality of life patients on hemodialysis in Kerala
Authors: Mathews Tessy Grace , Mathew E. 
Published: December 2019

Background: End Stage Renal Disease (ESRD) is on the rise in the recent years which carries with it emotional, physical, psychological, social, and existential burdens that impact their Quality of life (QOL). The QOL describes life satisfaction and life concerns and are affected by health and illness. Maintenance of QOL with the effects of chronic illness is a challenging, multifaceted, complex endeavour for patients, their families and the health professionals. Objective: To assess the kidney disease related quality of life in patients with ESRD, its association with selected demographic, socio economic, disease and treatment related characteristics of ESRD patients.
Materials and methods: Descriptive survey was conducted on 112 participants diagnosed with ESRD and on hemodialysis at least for a minimum duration of 1 month, were recruited from both government and private hospitals through purposive sampling as per the inclusion and exclusion criteria. The Kidney Disease Quality of Life (KDQOLTM-36) and Personal Data Sheet were used to assess the QOL and to obtain information as per the objectives. Descriptive analysis and Chi square test were used to analyze the data.
Results: Majority of the ESRD subjects had poor quality of life in all the domains, higher proportion being in the burden of illness (71.4%) and effects of illness (68.8%) domains. There was a significant association between the burden of illness and marital status(p=.01), type of bystander(p=.01); symptom and type of bystander(p=.03)
Conclusion: Majority of the ESRD patients had low KDQOL scores indicating poor quality of life in all the domains requiring intervention. This emphasizes the need to identify as well as manage QOL among them and develop appropriate intervention
Retirement time planning of Indian expatriate in Umm Al Quwain region, a quasi experimental study from UAE
Authors: Thundiparampil Smitha J. 
Published: December 2019

Background: United Nations (2015) projected that the numbers of older persons (60+) grow from 901 million to 1.4 billion by 2030 and reach 2.1 billion in 2050 (WHO). Help Age India reported that the elderly population will reach to 143 million by 2021. Kerala has highest percentage of elderly almost 12.6 per cent of the population (Ministry of statics, 2016). Today’s changed work-life, youngster’s attitude, family and social structures, emigration of young family members has resulted in exclusion and emotional deprivation among the elderly forced to lead a lonely life. The survey was an attempt to investigate the Expatriate Keralite Individual attitude on their post retirement time planning.
Materials and methods: A quasi-experimental study was used to assess the attitudes of post retirement time plans among the 20 selected expatriate Keralite by using interview technique.
Result: Only 35% of the sample feels that it is necessary to plan for our retirement period. Half of the sample works for private firms and there is no security for them once they leave their job. Even though there is a need for planning their post retirement period they have not even think about it because they perceived that their family members feel sad to hear that they are coming back because they are only the source of income for their dependents. Ninety percentage of the sample did not realized that they have completed almost half part of their life and it is time for them to think wisely to plan ahead for their time left out to live.
Conclusion: Majority had not even started to think on about changes in life styles, activities and relationships. They need to be counseled to plan their time in post-retirement by time calculator and Middle age is the correct period to start planning what he or she will do in their second half of life.