bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of changing trends of risk factors contributing to Intellectual Disability – A retrospective study
Authors: Shankar S , Rajeswari M 
Published: March 2021

The etiology of Intellectual Disability is varied and difficult to establish. Reports from India on the spectrum of underlying causative factors are lacking. So this retrospective study was conducted to identify the various etiologies of Intellectual Disability (ID). Study was conducted at a tertiary care center. The etiology of ID was ascertained after clinical assessment. Two groups were ascertained Group A those who were born in 2000 and before and group B those who were born in 2001 and after. The spectrum of causative conditions was identified.In both groups the prevalence of ID was higher among males than in females. No major difference in domicile was noted. More than 75% children were off springs of non-consanguineous parents. Most of them belong to mild ID (45%) in both groups. The etiological yield was 18.33% in group A and 11.66% in group B with Prenatal cause, followed by perinatal 48.33% in group A and 55% in group B, being the most common and postnatal cause 8.33% and 5% in group A and B respectively .Idiopathic causes constitute 20% in group A and 25% in group B, Few cases fall under multiple etiologies. It is possible to ascertain the diagnosis in most of the cases of intellectual disability. The prenatal and postnatal causes are decreasing due to awareness of Antenatal checkup, and active treatment respectively. But the Perinatal cause, which is preventable one, is increasing, which needs active intervention; also idiopathic cause which needs thorough screening.
The Potential of Light Microscopic Features of the Oral Mucosa in Predicting Post-mortem Interval
Authors: Patro Jagganath , Panda Swagatika , Mohanty Neeta , Mishra Uma S. 
Published: March 2021

Objectives: The post-mortem interval (PMI) refers to the amount of time elapsed between death and discovery of the body. This study aimed to evaluate light microscopic cellular changes in the oral mucosa and identify the potential of this method for predicting PMI. Methods: This prospective study was conducted between July 2016 and January 2018 at the Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar, India. A total of 150 post-mortem (including 75 gingival and 75 buccal mucosa samples) and 40 ante-mortem (including 20 gingival and 20 buccal mucosa samples) tissue samples were compared using haematoxylin and eosin, periodic acid-Schiff (PAS) and van Gieson stains. Microscopic changes in the epithelium and connective tissue were categorised according to PMI stage as early (<12.5 hours since death), intermediate (12.5–20.5 hours since death) or late (>20.5 hours since death). Results: Most epithelial cellular changes occurred early, except for arc-shaped nuclei and epithelial shredding which were intermediate and late changes, respectively. However, microscopic changes in the connective tissue were only observable at ≥12.5 hours. There was a progressive decrease in intensity in van Gieson stains and an increase in intensity in PAS stains as PMI increased. Several microscopic features were found to be significant predictors of PMI including epithelial homogenisation, cytoplasmic vacuolation, nuclear degeneration, arc-shaped nuclei, chromatin clumping, red blood cell clumping and lysis, melanin incontinency, myofibril degeneration, salivary gland acini degeneration and epithelial connective tissue separation (P <0.050 each). Conclusion: These findings indicate that microscopic evaluation of the oral mucosa may be helpful for PMI prediction.

KEYWORDS
Post-mortem Changes; Light Microscopy; Oral Mucosa; Epithelial Cells; Lamina Propria; Salivary Glands; Histocytochemistry; Periodic Acid-Schiff Reaction; India.
Follow-Up Study on the Effect of Cognitive Behaviour Therapy on Haemodialysis Adherence
Authors: Valsaraj Blessy P. , Bhat Shripathy M. , Prabhu Ravindra , Kamath Asha 
Published: March 2021

Objectives: Patients with chronic kidney disease (CKD) undergoing haemodialysis often experience a myriad of psychosocial problems, resulting in poor adherence to their therapeutic regimen. This study aimed to examine the effect of cognitive behaviour therapy (CBT) on dialysis, fluid, drug and diet adherence among a previously reported sample of CKD patients undergoing haemodialysis. Methods: A randomised controlled trial was conducted between January 2013 to Febrary 2014 on a random selection of 67 CKD patients attending a tertiary multispecialty hospital in India. The experimental group (n = 33) was exposed to CBT, whereas the control group (n = 34) received non-directive counselling. A haemodialysis adherence scale was developed and used to assess adherence to the treatment regimen. The effect size was calculated using Cohen’s d statistics. Results: At six months, mean reductions from baseline were observed in the experimental group in terms of interdialytic weight gain (−1.23 kg; effect size: 0.57), systolic blood pressure (−22.18 mmHg; effect size: 0.71) and diastolic blood pressure (−10.06 mmHg; effect size: 0.72), whereas mean increases were noted in haemoglobin (+0.75 g/dL; effect size: 0.31) and adherence to dialysis (+0.94; effect size: 0.51), fluids (+16.34; effect size: 2.30), diet (+61.19; effect size: 4.75) and drugs (+10.73; effect size: 1.3). Differences from baseline were significantly higher in the experimental group compared to the control group (P = 0.001 each). Conclusion: These results show that CBT is more effective than non-directive counselling for improving therapeutic adherence and physiological, clinical parameters among CKD patients undergoing haemodialysis.

KEYWORDS
Chronic Kidney Disease; Hemodialysis; Patient Adherence; Cognitive Behavior Therapy; Hemoglobin; Weight Gain; Blood Pressure; Randomized Controlled Trial.
Prevalence and Risk Factors of Falls Among the Elderly in Unaizah City, Saudi Arabia
Authors: Alabdullgader Abdullaziz , Rabbani Unaib 
Published: March 2021

Objectives: Falls and fall-related consequences are a major public health problem in the elderly. This study aimed to measure the prevalence of falls and fall-related risk factors among elderly individuals in Saudi Arabia. Methods: This cross-sectional study was conducted between January and October 2019 among 280 elderly patients aged >60 years old attending 10 randomly selected primary healthcare centres in Unaizah City, Qassim Province, Saudi Arabia. Data were collected using the validated 10-item Missouri Alliance for Home Care (MAHC-10) fall risk assessment tool. Results: A total of 269 participants were included in the study (response rate: 96.1%). The prevalence of falls over the preceding year was 31.6%. Females fell more frequently than males (34.5% versus 28.5%) and most falls occurred indoors (84.7%). Various risk factors were associated with fall risk including being aged >80 years (adjusted odds ratio [aOR]: 5.17, 95% confidence interval [CI]: 1.66–16.14), polypharmacy (aOR: 2.40, 95% CI: 1.01–5.71) and environmental factors (aOR: 2.79, 95% CI: 1.24–6.28). However, more educated participants had a lower risk of falling (aOR: 0.26, 95% CI: 0.09–0.77). There was also a significant association with the MAHC-10 fall risk score (P = 0.043). Conclusion: There was a high prevalence of falls among the elderly in Unaizah City. Various factors were associated with falls including advanced age, polypharmacy, age-related changes and environmental factors. As the majority of fall events occurred indoors, home safety improvements are recommended. Moreover, additional larger-scale research is necessary regarding fall-related risk factors and fall prevention initiatives among elderly individuals in Saudi Arabia.

KEYWORDS
Elderly; Falls; Geriatrics; Public Health; Prevalence; Risk Factors; Saudi Arabia.
Complications and Management of Totally Implantable Central Venous Access Ports in Cancer Patients at a University Hospital in Oman
Authors: D'Souza Philomena C. , Kumar Shiyam , Kakaria Annupam , Al-Sukaiti Rashid , Al-Baimani Khalid , Hamid Rana S. , Mittal Alok K. , Al-Balushi Muna , Burney Ikram A. , Al-Moundhri Mansour S. 
Published: March 2021

Objectives: Totally implantable central venous access ports (port-a-caths) are increasingly used for the safe administration of chemotherapy; however, their use is associated with complications. This study reviews patterns of complications, reasons for premature removal and the duration of the use of port-a-caths in patients receiving cancer treatment at Sultan Qaboos University Hospital (SQUH) and compares the infection rate with the literature and the researchers’ experiences. Methods: This retrospective follow-up study included patients who had received cancer treatment through a port-a-cath and were admitted to SQUH between January 2007 and April 2019. Demographic features, underlying diagnosis, clinical stage, treatment, duration of use and the cause of premature removal of the port-a-cath were recorded. Results: A total of 516 port-a-caths were inserted in 482 cancer patients. The majority of devices were implanted by interventional radiologists (n = 459; 89.0%) and the right internal jugular vein was most frequently accessed (n = 396; 76.7%). The mean indwelling time of a port-a-cath was 288 days (range: 3–1,872 days) for patients with complications and 550 days (range: 7–3,123 days) for patients without complications. Port-a-cath-related infection was the main complication (n = 63; 12.2%). Patient age, gender, treatment intent, underlying diagnosis, clinical stage, chemotherapy regimen, number of treatment courses, operator implanting the port, the type of micro-organism isolated from the port-a-cath and body mass index were significant factors affecting catheter indwelling time (P <0.05). On multivariate analysis, however, none of the factors was found to be significant. Conclusion: Infection was the most common complication necessitating port-a-cath removal. The infection rate was much lower than the researchers’ previous experience and compares favorably with several published reports.

KEYWORDS
Port-A-Cath; Vascular Access Ports; Catheter-Related Infections; Cancer; Oman.
A Novel Technique for the Reconstructive Formation of an Annular Hymen in Cases of Postpubertal Imperforate Hymen
Authors: Darwish Atef M. 
Published: March 2021

Objectives: Imperforate hymen (IH) is a common genital tract anomaly in women which usually presents after puberty. However, surgical treatment is often considered controversial in religious or conservative communities for sociocultural reasons. This study therefore aimed to assess the efficacy of a novel reconstructive technique involving the preservation of the annular hymen. Methods: This prospective interventional study was performed between July 2013 and October 2019 at the minimally invasive surgery unit of a tertiary university hospital in Egypt. A total of 36 women presenting with primary amenorrhoea and haematocolpus were diagnosed with postpubertal IH. A circular hymenotomy was performed on each patient using a 10 mm laparoscopy trocar tip and sleeve to form a new annular hymen under general anaesthesia while preserving the annular hymen. The primary outcome measure was the persistence of hymenal patency and integrity at follow-up. The secondary outcome measure included post-operative patient satisfaction and pain relief. Results: The reported technique was feasible in all cases without intraoperative complications. Patency of the reconstructed annular hymen was confirmed at follow-up in all cases; moreover, no intraoperative complications were reported. There was a significant post-operative improvement in pain scores (P <0.001). Both the patients and their parents/guardians reported a high level of satisfaction with the technique. Conclusion: This novel technique for the correction of IH involving the reconstruction of an annular hymen was found to be a safe, minimally invasive and effective procedure. This technique should be considered a feasible alternative to a conventional hymenotomy as it allows for the resumption of normal hymenal anatomy without overtreatment.

KEYWORDS
Congenital Abnormalities; Imperforate Hymen; Hematocolpos; Amenorrhea; Colpotomy; Reconstructive Surgical Procedures; Treatment Outcome; Egypt.
Managing Vascular Surgery Emergencies and Referrals During the COVID-19 Pandemic at a Tertiary Centre in Oman
Authors: Stephen Edwin , Al-Adawi Sara S.H. , Abdelhady Ibrahim , Al Mawali Hanan , Al-Wahaibi Khalifa 
Published: March 2021

Objectives: This study aimed to discuss the different challenges faced while managing emergency vascular surgery cases during the COVID-19 pandemic and how these challenges were overcome. Methods: This study details 14 emergency cases that were managed during a period of one month from mid-March to mid-April at Sultan Qaboos University Hospital, Muscat, Oman. The cases included acute limb ischaemia, critical limb ischaemia, type B dissection of the thoracic aorta, thoraco-abdominal aneurysm, critical internal carotid artery stenosis, trauma, infected arteriovenous forearm loop graft and thrombosed arteriovenous fistulas. Results: Only one patient was confirmed to have COVID-19. Five were negative for COVID-19 while the remaining eight were not tested. Various strategies on how the vascular surgical team accommodated changes in hospital protocols and nationwide lockdown are discussed in detail. Conclusions: With the judicious use of personal protective equipment and consumable surgical and endovascular devices, communication with support services and other hospitals and implementation of triage protocols, it was possible to manage vascular surgery emergencies effectively.

KEYWORDS
COVID-19; Vascular Surgery; Emergencies; Oman.
The Influence of Demographic Features and Psychological Constructs on Observing Government-Advised Preventive Measures for COVID-19: The Case of Iran
Authors: Tabibi Zahra , Abedini Elaheh , Gholipour Fatemeh , Hojjat Seyed kaveh , Amini Mahnaz 
Published: March 2021

Background: The study aimed to assess how people change their social and health-related behavior in the context of COVID-19 epidemic in Iran. To this end, the theory of planned behavior was applied for predicting compliance with government-advised preventive measures. An attempt was made to examine how groups of people in terms of age, gender, educational level, income level, marital status, and health condition were observing the government-advised preventive measures.
Methods: Totally, 5021 people above the age of 15 years responded to an online questionnaire that included items related to demographic features, compliance with COVID-19 preventive behavioral guidelines (home quarantine, avoiding social gathering, keeping physical distance of 1.5-2 meters, frequent hand sanitization, and avoiding shopping and outside recreation), TPB constructs (behavioral attitudes, subjective norms, perceived behavioral control, intentions to do the preventive behavior), and risk perception. The study was descriptive and conducted in year 2020.
Results: T-test, ANOVA, and correlations indicated that younger individuals, men, singles, people with lower educational levels, lower income level and no health condition reported lower compliance. Regression showed that intentions, perceived behavioral control, and subjective norm were associated with higher compliance. Furthermore, in regression, young age, male gender, and lower level of education were associated with lower compliance with C-19 PB.
Conclusion: Young males with lower level of education infrequently comply with government-advised preventive measures. Also, intention, perceived behavioral control, and subjective norm are related to compliance with government-advised preventive measures.
The Relationship Between Electronic Media And Sex Behavior Among Early Adolescents In Junior High School In Tasikmalaya
Authors: Daryanti Eneng , Sansuwito Tukimin , Elba Fardila 
Published: March 2021

Based on the 2018 Survey on Adolescent Reproductive Health (SKKR) conducted by the Population and Family Planning Agency (BKKBN) as many as 29.5% of young men and 6.2% of young women have touched or stimulated their partners. As many as 48.1% of teenage boys and 29.3% of teenage girls have kissed their lips. It is during this period that a person can easily fall into social deviations, especially deviations of free sex. The purpose of this study was to determine the impact of electronic media on sexual behavior in early teens in Junior High School in Tasikmalaya. The research was correlation study with a cross-sectional approach. The population in this study were the 180 students in a Junior High School in Tasikmalaya. A total sampling technique was used, together with a questionnaire about electronic media usage and sexual behavior. The Chi Square test was used to analyze the relationship between independent and dependent variables. The results showed that there is a moderate correlation between electronic media and sexual behavior among adolescents Tasikmalaya in 2019 with a p-value of 0,000 with r= 0.425. Schools should increase supervision of their students, especially in the use of electronic media

Keywords: electronic media, sexual behavior, teenagers
The Role of the Working Mother in Preschoolers’ Play Activities
Authors: Mariana . , Boyoh Debilly Yuan 
Published: March 2021

A key preschooler activity is playtime. When the children play, assistance is needed. The role of mothers in children’s development is very important, particularly with regards to the provision of appropriate games based on the child’s age. However, this is more difficult for working mothers as their time and ability to monitor their children’s development is more limited. This study aims to determine the role of working mothers with regards to play assistance and game selection in pre-school children. The study used a quantitative correlation design. The population and sample in this study were 81 mothers working in the Bandung Advent Hospital with pre-school age children (3-6 years), and a purposive sampling method was used. Data collection consisted of a questionnaire with 12 statements for the assistance element and 10 statements for the game choice element. The data was analyzed by using univariate and bevariat analysis. The findings demonstrate that the role of mothers in children playing assistance is adequate and they generally choose games that are suitable for pre-school age children (72.8%). Moreover, there was no significant relationship between the role of working mothers in play-assistance and choosing toys in pre-school children with pValue> 0.05.

Keywords: Role of working mothers, pre-school age children, play accompaniment
Identifying Risk of Dementia Using Subjective Cognitive Decline (Scd) Instruments Among Elderly in Bandung, Indonesia
Authors: Juniarni Lia , Pujianti Risma , Ibrahim Masdum 
Published: March 2021

Cognitive decline in the elderly is often referred to as dementia. Dementia is an effect of the aging process, which impacts the brain function. The subjective cognitive decline happens when a person’s cognitive perceptions experience decline but remain within parameters considered normal. A screening process for this condition is one of the efforts which can improve welfare services for the elderly. Subjective Cognitive Decline (SCD) is cognitive self-reports that assess subjective cognitive impairment abilities by prompting the recall of frequently experienced events. SCD has a double function, as an instrument for both early detection and the prevention of disease. This study aims to identify the risk of dementia using a Subjective Cognitive Decline (SCD) instrument. This research was conducted using a quantitative descriptive method with a cross-sectional approach. 187 elderly were taken as the sample by consecutive sampling methods, and data were analyzed using univariate analysis. This study showed that most of the respondents have a poor subjective cognitive decline, with 54.0%. The domains that have the most cognitive decline were the orientation with 78.1%, 76.5% of executive function, 68.4% of memory, and 59.4% of language. Demographic data associated with subjective cognitive decline showed poorly in female gender with 55.6%, age> 90 years with 55.3%, high school education with 70.4%, married status with 57.1%, and unemployed with 53.2%. This study concludes that the results of SCD with poor subjective cognitive decline have a risk of developing dementia.

Keywords: Dementia, elderly, subjective cognitive decline
Blended Learning Models to Improve Student Learning Outcomes During the Covid-19 Pandemic
Authors: Agustina Ayuda Nia 
Published: March 2021

The COVID-19 pandemic has affected various aspects of life, one of which is education. Direct face-to-face contact needs to be reduced to prevent transmission of COVID-19, while educational institutions must continue to organize learning courses. This study identifies the effect of the blended learning model on learning outcomes of level II students in child-nursing courses during the COVID-19 pandemic. This study used a pre-experiment, one-group pre-test post-test, the sample was selected using the cluster random sampling method involving 105 students of level II of the Fatmawati Academy of Nursing. Data were analyzed using SPSS-24 software with the Wilcoxon test. The instrument used was a written test consisting of a pre-test and a post-test, a child-nursing procedure skills test. The results showed pre-test mean value is 74.74 and post-test mean value is 80,133. From these results, it can be concluded that there is the use of the blended learning model improved the learning outcomes of child nursing in Fatmawati Nursing Academy students during the COVID-19 pandemic. This can be seen from the average post-test result value, which is higher than the pre-test result value (p = 0.000).

Keywords: Blended learning, COVID-19, student learning outcomes, pandemic, learning
Snapshot of Nurse Readiness for the Covid-19 Pandemic in Indonesia: A Qualitative Study
Authors: Kholis Anja Hesnia , Hidayah Nurul , Priyanti Ratna Puji , Asri . , Kurdi Fahruddin , Hidayat Wahyu , Sarbani . , Arianti . 
Published: March 2021

During the Covid-19 pandemic, nurses who served as frontline healthcare providers are experiencing issues with extreme workload demand and under-provision of protective resources. This study aims to understand nurse readiness for the Covid-19 pandemic in Indonesia. The study uses a qualitative phenomenology approach with purposive sampling. Participants were recruited from the regional hospital in East Java, Indonesia. The criteria of participants were nurses who worked face-to-face with Covid-19 patients from various wards. The total sample size is 20 participants. In-depth interviews were conducted to gather the data, which was analyzed using Colaizzi’s phenomenological method. Five themes emerged: (1) fear of getting infected; (2) PPE adequacy supply; (3) unclear patient distribution flow; (4) nurse supporting ecosystem; (5) education and training in infectious diseases. The evaluation of nurses’ readiness concerned their knowledge, the supply of safety equipment, and support from various ecosystems. Nurses were concerned about various elements including catching the disease themselves, adjusting to the environment and new work procedures, physical discomfort due to special protective equipment, witnessing the suffering and death of patients, and long-term separation from family members. They need an integrated support system to help them fighting Covid-19. Attention from fellow nurses who help each other in crises, family support, and institution support are the support systems that determine the readiness of nurses.

Keywords: covid-19, nurse readiness, pandemic, qualitative study