bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serum selenium status in Graves’ disease and Hashimoto's thyroiditis in an iodine-sufficient area
Authors: Heidari Zahra , Sheikhi Vahid 
Published: December 2022

Background:
Selenium (Se) can be found in the molecular structure of selenoproteins; including thioredoxin reductase and glutathione peroxidase and also in Type I and II deiodinases. Previous studies have shown that Se deficiency has been linked to autoimmune thyroid disease (AITD). In the present study, we investigated the serum Se levels of patients with Graves’ disease (GD), Hashimoto's thyroiditis (HT), and euthyroid individuals as a control group.

Materials and Methods:
The present study was performed on patients with newly diagnosed AITD (GD and HT). The control group was matched with the case group in terms of parameters such as age and sex. Free thyroxine, free triiodothyronine, thyroid-stimulating hormone, antithyroid peroxidase, antithyroglobulin, and serum Se levels were measured in all participants. These parameters were compared between groups.

Results:
Data from 132 patients with HT, 120 patients with GD, and 120 healthy euthyroid patients as a control group were analyzed. The Se level in patients with HT (104.36 μg/l) and GD (97.68 μg/l) was significantly lower than in the control group (122.63 μg/l) (P < 0.001). The incidence of Se deficiency in patients with HT, GD, and in the control group was 15.2%, 2.5%, and 2.5%, respectively (P < 0.001). In patients with GD, 34 patients (28.33%) had Graves’ orbitopathy. Se levels in patients with orbitopathy were significantly lower than in patients without orbitopathy.

Conclusion:
The serum Se level was significantly lower in newly diagnosed patients with GD and HT than in the control group. Overall, Se deficiency can be considered a risk factor for AITDs.
Safety Assessment of Hydro-Ethanolic Extract of Falcaria vulgaris in Wistar Rats
Authors: Haghighi Meinoush Siavash , Arya Marjan Moeini , Mojarrab Mahdi , Rahimi Zohreh , Hajialyni Marzieh , Hosseinzadeh Leila , Amin Niloufar , Jalilian Fereshteh 
Published: December 2022

Background:

Falcaria vulgaris is a medicinal plant with culinary uses and widespread therapeutic applications. Despite already proven as a very promising dietary supplement, its safety and possible effects on the human body are yet to define. This study was designed to investigate the acute and subchronic toxic effects of hydroethanolic F. vulgaris in male and female Wistar rats.

Experimental:
To evaluate the safety of a hydroethanolic extract of F. vulgaris, acute and subchronic toxicity in Wistar rats treated with extract was investigated. For investigation of acute toxicity of F. vulgaris, both genders of rats were treated for 45 days with a single dose of the extract (4000 mg/kg) via gavage. Also for sub-chronic testing, the extract was administrated orally at the doses of 150, 300, and 450 mg/kg for 45 days. At the end of the study, the animals were sacrificed and the hematological, biochemical, and histopathological parameters were assayed.

Results:
After a single oral administration of F. vulgaris (4000 mg/kg), no mortality was observed in both control and groups in either sex. Also, histopathological inspection of vital organs and tissues revealed no obvious alteration in these organs. The obtained results showed a significant reduction in the weight of heart and liver in male rats that received the highest dose of the extract. The level of red blood cell distribution width (dose of 450 mg/kg) from the hematological parameters and the level of serum creatinine (dose of 150 and 450 mg/kg) from the biochemical parameters increased significantly in male rats. On the contrary, during treatment the concentration of all examined minerals remained unchanged. Histopathological inspection indicated that liver, kidney, and testis were found to be affected by subchronic exposure to F. vulgaris extract.

Conclusion:
The results of the acute study revealed that F. vulgaris may be nontoxic even at doses less than 4000 mg/kg body weight. However, the result of subchronic study confirmed the liver dysfunctions in Wistar rats and also suggested the significant effect of F. vulgaris on testicular tissue, which may cause serious male infertility. The ability to impair male fertility by such a medicinal plant has not been reported yet. It can be concluded that the no observed adverse effect level (NOAEL) of F. vulgaris are 150 and 450 mg/kg for male and female rats, respectively.
Amalgam of Ternary Solid Dispersion and P-gp Efflux Inhibition in Development of Colon-targeted Tablets of Rifaximin
Authors: Lalan Manisha S. , Shah Pranav J. , Kadam Ruchita , Patel Himan P. 
Published: December 2022

Background:
Rifaximin, a BCS class IV drug, possesses low bioavailability due to low solubility and low permeability attributable to P-gp efflux. The studies attempted to develop pH-sensitive rifaximin tablets based on ternary solid dispersion (TSD) for spatial and temporal drug release in colon.

Materials and Methods:
Rifaximin TSD was prepared using Neusilin US2 as a mesoporous carrier and Poloxamer 188 as a hydrophilic carrier and P-gp inhibitor by solvent evaporation technique employing acetone at 1:5 ratio. The TSD was assessed for P-gp inhibition using the gut sac method and Caco-2 permeability studies. The TSD was compressed into tablets and coated with pH-sensitive polymers. Coating optimization was carried out using a 32 factorial design, wherein % coating and ratio of Eudragit S100:Eudragit L100 were the independent variables and % drug release at 2 h and % drug release at 8 h were the dependent variables.

Results:
Differential scanning calorimetry, X-ray diffraction, and scanning electron microscopy studies of rifaximin TSD suggested amorphization of the drug. Gut sac studies indicated higher mucosal to serosal permeability of rifaximin from TSD. Caco-2 permeability studies demonstrated a 4.83-fold higher permeability of rifaximin from TSD (polaxamer 25% w/w and Neusilin 55% w/w of TSD) and a significant change in efflux ratio. In-vitro release studies of the coated tablets displayed controlled and site-specific release at pH of the colon.

Conclusion:
Effective, stable, pH-dependent rifaximin colon-targeted tablets with enhanced dissolution, permeability, and reduced P-gp efflux were developed. The achieved merits could translate into augmented bioavailability and dose reduction. Further in-vivo studies on this novel formulation, which is cost-effective and industrially scalable, can improve the pharmacoeconomics of inflammatory bowel disease management.
Preprocedural ultrasonography as an adjunct to landmark technique for identification of epidural space in parturients for labor analgesia
Authors: Jayanth Midathala N. , Arumulla Shiny P. , Kesana Pravallika , Kandukuru Krishna C. , Basireddy Hariprasad R. , Peddi Shreevani 
Published: December 2022

Background:
Pregnancy-induced softening of tissues and ligaments may increase the false-positive rates when identifying the epidural space in parturients by the landmark technique. To mitigate these problems, Ultrasonography (USG), which has now become the eye of anesthesiologists, can be used as a reliable tool to facilitate more accurate epidural needle placement in parturients. This study was conducted to know the efficacy of USG when compared to the traditional landmark method.

Methods:
After the approval from the institutional ethics committee and CTRI registration, 62 parturients of ASA-2 requesting labor analgesia were randomized into 2 groups of 31 each: Group-L (conventional landmark technique) and Group-U (preprocedural USG done before epidural). In group-U, Tuohy's needle was introduced through the USG predetermined insertion point and epidural space was located using the LOR technique.

Results:
USG increased the success rate of epidural at first attempt from 51.6% in group “L” to 87% in group “U.” Fewer needle attempts (P-value - 0.001) were required in group “U” as compared to group “L.” No accidental dural puncture in group-U, compared to 2 in group-L. Mean Depth of epidural space (cm) ultrasound depth (UD) = 3.89 ± 0.45 cm and needle depth (ND) = 4.05 ± 0.37 cm. Side effects profile in the ultrasound group was better.

Conclusion:
Preprocedural ultrasonography is a simple safe, accurate tool with less number of attempts to determine the needle insertion site, decrease the incidence of accidental dural punctures, and assess epidural space depth in parturients.
The role of point of care thromboelastography (TEG) and thromboelastometry (ROTEM) in management of Primary postpartum haemorrhage
Authors: Khanna Puneet , Sinha Chandni , Singh Akhil K. , Kumar Ajeet , Sarkar Soumya 
Published: December 2022

Background:
The utility of instantaneous evaluation of coagulation during primary postpartum haemorrhage (PPH) is paramount in the context of empirical blood product transfusion-related risk of dilutional and consumptive coagulopathy and circulatory overload.

Methods:
A profound screening of electronic databases till August 15, 2022 was carried out after being enlisted in PROSPERO (CRD42021275514). Randomized control studies, comparative cohort studies, and cross-sectional studies comparing point-of-care viscoelastic test guided blood product transfusion with empirical transfusion in patients with PPH were included.

Results:
We retrieved five studies, with a total of 1914 parturient with PPH. Patients receiving transfusion based upon point of care viscoelastic tests had lesser risk of having emergency hysterectomy (Odds ratio (OR) = 0.55, 95% CI 0.32–0.95, I2 = 7%), transfusion-associated circulatory overload (TACO) (OR = 0.03, 95% CI 0.00–0.50), reduced transfusion of fresh frozen plasma (OR = 0.07, 95% CI 0.04–0.14, I2 = 89%), platelets (OR = 0.51, 95% CI 0.28–0.91, I2 = 89%), packed red blood cell transfusion (OR = 0.70, 95% CI 0.55–0.88, I2 = 89%), and had better cost-effective treatment [Mean difference (MD) = −357.5, 95% CI − 567.75 to −147.25, I2 = 93%] than patient received empirical transfusion. However, there was no significant difference in the requirement of ICU admissions (OR = 0.77, 95% CI = 0.46–1.29, I2 = 82%). No mortality was detected across the studies.

Conclusions:
Point of care viscoelastic assessment guided transfusion in PPH confederates with reduced morbidity. Nevertheless, more studies on the triggering values for transfusion, long-term survival, and cost-benefit in patients with PPH are warranted to establish its utility.
Perfusion index during endotracheal intubation and extubation
Authors: Shah Prerana N. , Kezo Azho 
Published: December 2022

Introduction:
Perfusion index (PI) can be detected using a pulse oximeter. Its value decreases in response to noxious stimuli. Here, we investigated its efficacy in detecting hemodynamic responses during endotracheal intubation and extubation.

Methods:
An approval from the institutional ethics committee was obtained along with a written informed consent from the patients involved in this study. A sample size of 30 was calculated. Reading of PI, heart rate, and blood pressures (systolic, diastolic, and mean arterial) were recorded at pre-intubation, post-intubation, during neuromuscular block reversal, pre-extubation and at extubation. Clinically significant heart rate, blood pressure (systolic, diastolic, and mean) and PI was defined as increase by >10 bpm, rise by ≥15 bpm and a decrease by ≥10%, respectively, from pre-intubation value.

Results:
Clinically significant change in PI was seen at all intervals with maximum decrease in PI occurring during neuromuscular block reversal (42.6% at the start and 56.7% at the end of neuromuscular block reversal). A negative correlation was noted between PI and the other non-invasive hemodynamic parameters.

Conclusion:
PI decreases on noxious stimuli and correlates negatively with the other non-invasive hemodynamic parameters. Hemodynamic response at neuromuscular block reversal is maximum.
Combined neuraxial-general anesthesia in opsoclonus–myoclonus syndrome
Authors: Abreu João B. , Cordeiro Catarina R. , Amorim Ana I. , Catanho Tiago G. , Gama Karina D. 
Published: December 2022

Opsoclonus-myoclonus syndrome (OMS) is a very rare neurological disorder thought to be the result of autoimmune responses in the nervous system. The relationship between this disorder and anesthesia procedures has not been studied in detail. To our knowledge, there are only 4 case reports, none of them with epidural-general combined anesthesia.
We present a 9-year-old female with OMS due to low-grade neuroblastoma, for 7 years, who underwent tumor remotion due to the large size. Intravenous induction was done with alfentanil, lidocaine, propofol and rocuronium and ropivacaine was administered via lumbar epidural catheter. Adding to the sparse anesthetic management information in OMS, we now show one more possible approach, that can be valuable in high-risk cases, where general anesthesia can be involved with higher risk for the patient.
Can low dose of intratracheal dexmedetomidine be used to attenuate peri-extubation cough? - A prospective, double-blinded, randomized clinical trial
Authors: Nahar Afreen R. , Gopinath V , Ruth Merlin Shalini 
Published: December 2022

Background:
Peri-extubation cough is an undesirable event during extubation, prevention of which has been studied with multiple drugs, amongst which intravenous dexmedetomidine has emerged as one of the favourable drugs. Intratracheal route is attractive because of its ease of administration, provided it avoids the hypotension and bradycardia that occurs during intravenous bolus administration. There is a paucity of data exploring the utility, doses, and adverse effect of intratracheal dexmedetomidine.

Methods:
After obtaining ethical committee approval, 60 eligible, consenting adult patients undergoing surgery under general anesthesia in a tertiary teaching hospital were recruited and randomised into three groups—DEX0.3, DEX0.5, and NS. The plan of general anesthesia was standardized. Half an hour prior to extubation, study drug was instilled intratracheally—dexmedetomidine 0.3 mic/kg, 0.5 mic/kg, and NS in groups DEX0.3, DEX0.5, and NS, respectively. 4-point cough score was used to assess extubation response. Hemodynamic response and time to Ramsay sedation score 3 was also recorded.

Results:
Majority of patients in DEX0.3 (60%) and DEX0.5 (85%) group had no cough (cough score 0), while majority of the patients in the NS group (70%) had either mild or moderate cough (cough score 1, 2). Kruskal Wallis test followed by post-hoc pairwise comparison showed statistically significant difference in 4-point cough score between GroupDEX0.3 and GroupNS (P < 0.001) and between GroupDEX0.5 and GroupNS (P = 0.038). DEX0.5 group, compared to DEX0.3 group, had significantly higher time from reversal to extubation (P < 0.001) and time to achieve Ramsay sedation score of 3 (P < 0.001).

Conclusion:
We conclude that both 0.3 mic/kg and 0.5 mic/kg of dexmedetomidine when given intratracheally are effective in preventing peri-extubation cough. Further, 0.3 mic/kg dexmedetomidine showed a better recovery profile compared to 0.5 mic/kg dexmedetomidine when administered intratracheally.
Hubungan Tingkat Stres Dan Aktivitas Fisik Dengan Kualitas Tidur Mahasiswa Diploma Tiga Keperawatan Stikes Panti Rapih Yogyakarta
Authors: Nugraheni Hilaria Asri , Setya Widyastuti Chatarina , Maura Hardjanti Sr. Therese 
Published: December 2022

Latar Belakang: Mahasiswa tingkat akhir memiliki berbagai tugas akademik yang harus diselesaikan dengan tepat waktu. Hal ini dapat menyebabkan aktivitas fisik serta stres meningkat serta berdampak pada kualitas tidurnya.
Tujuan: Mengidentifikasi hubungan tingkat stres dan aktivitas fisik dengan kualitas tidur mahasiswa tingkat akhir Prodi Diploma Tiga Keperawatan STIKes Panti Rapih Yogyakarta.
Metode: Metode penelitian yang digunakan adalah diskriptif analitik korelatif dengan desain cross sectional. Populasi pada penelitian ini adalah seluruh mahasiswa tingkat akhir Prodi Diploma Tiga Keperawatan STIKes Panti Rapih Yogyakarta. Kemudian, pengambilan sampel dengan metode total samping sebanyak 95 mahasiswa. Pengambilan data tingkat stres menggunakan instrumen Perceived Stress Scale-10 (PSS-10), aktivitas fisik dengan International Physical Activity Questionnaire-Short Form (IPAQ-SF), dan kualitas tidur dengan Kuesioner Kualitas Tidur (KKT).
Hasil: Tingkat stres rendah sebanyak 1 (1,1%), stres sedang 63 (66,3%), dan stres berat 31 (32,6%). Selanjutnya data aktivitas sedang sejumlah 38 (40,0%) dan aktivitas tinggi 57 (60,0%). Didapatkan data pula kualitas tidur buruk sebanyak 93 (97,9%) dan kualitas tidur baik 2 (2,1%). Hasil analisis Spearman Rho menunjukan terdapat hubungan antara tingkat stres dengan kualitas tidur (r=-0,530, p= 0,000) dan terdapat hubungan antara aktivitas fisik dengan kualitas tidur (r= -0,347, p= 0,001).
Simpulan: Terdapat hubungan antara tingkat stres dan aktivitas fisik dengan kualitas tidur pada mahasiswa tingkat akhir Program Studi Diploma Tiga Keperawatan STIKes Panti Rapih Yogyakarta. Diharapkan mahasiswa melakukan manajemen stres dan menjaga aktivitas fisik agar memiliki kualitas tidur baik. Kemudian, institusi pendidikan juga dapat melakukan promosi kesehatan pada mahasiswa.
Hubungan Tingkat Kecemasan Dengan Tingkat Kepatuhan Perawat Dalam Penggunaan Alat Pelindung Diri Di Ruang Perawatan Pasien Covid
Authors: Cintyanisita Reny , Wardani Yulia , Suparmi CB Sr. Lucilla 
Published: December 2022

Latar belakang: Coronavirus disease 2019 (COVID-19) adalah penyakit menular yang menyebar secara global, menyerang pernapasan akut dengan gejala demam, batuk, sesak napas, yang disebabkan oleh SARS-CO-V-2 yang belum pernah ditemukan pada manusia. Pada tanggal 30 Januari 2020 WHO menetapkan Covid-19 sebagai Public Health Emergency of International Concern. Pada tanggal 13 April 2020 menyatakan bencana nonalam yang diakibatkan oleh penyebaran Corona Virus Disease 2019 (Covid-19) sebagai bencana nasional. Salah satu dampak pandemi Covid-19 bagi petugas kesehatan adalah berupa kecemasan akan tertularnya Covid-19, maka penggunaan alat pelindung diri yang tepat menjadi sangat penting untuk memutus rantai penularan Covid-19.
Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan tingkat kecemasan dengan tingkat kepatuhan perawat dalam penggunaan alat pelindung diri di ruang perawatan pasien Covid di salah satu Rumah Sakit Swasta Yogyakarta
Metode: Metode penelitian yang digunakan adalah desain kuantitatif, survei deskriptif korelasi, dengan pendekatan cross sectional. Metode pengumpulan data dengan kuesioner. Sampel dalam penelitian ini menggunakan total sampling sebanyak 58 perawat yang bertugas di ruang perawatan pasien Covid.
Hasil: Didapatkan hasil data demografi terbanyak adalah jenis kelamin perempuan (84,5%), berusia 17-25 tahun (41,4%), berpendidikan D3 Keperawatan (93,1%), lama bekerja> 3 bulan (53,4%), responden dengan tidak mengalami kecemasan ( 86,2%),tingkat kepatuhan baik dalam penggunaan alat pelindung diri (91,4).Hasil uji statistik menggunakan korelasi spearman didapatkan p value 0,359.
Kesimpulan: Tidak terdapat hubungan yang signifikan antara tingkat kecemasan dengan tingkat kepatuhan perawat dalam penggunaan alat pelindung diri di ruang perawatan pasien Covid di salah satu Rumah Sakit Swasta di Yogyakarta.
Electronic Health Record Dalam Pelaksanaan Handover Keperawatan Di Rumah Sakit Jakarta
Authors: Wulandari Cicilia Ika , Ardianti Sumiati Devi , Pasaribu Jesika 
Published: December 2022

ABSTRACT
Background: Electronic health record is an electronic record of health-related information that includes patient information such as biodata, medical history, allergy history, test results, and all important care information used in the implementation of Nursing Handover.
Objective: This study aims to find out more about the experience of nurses in applying electronic health records during handovers in hospitals.
Design: This study uses a qualitative method with a phenomenological approach using the colaizzi method. Sampling using purposive sampling with the number of participants 8 people. Data collection by means of focus group discussions.
Results: This study resulted in four main themes: (1) Nurses' understanding of handovers using an electronic format, (2) Advantages of using electronic health records, namely convenience, clarity, security and minimizing errors, (3) Negative and positive experiences of using electronic health records ( 4) Electronic health record constraints in handover.
Conclusion: The use of electronic health record applications at the time of handover can minimize communication errors and can improve patient safety in hospitals.
Keywords:
Electronic Health Records; Handovers; Nurse; Qualitative
La Contaminación ambiental por la Transportación Marítima en el Ecuador
Authors: Lituma Vera Victor Hugo , Flores Ledesma Katia Ninozca , Cánez Palomino Rafael Wilber , Lobo Contreras Efren Enrique 
Published: December 2022

La investigación tiene como objetivo general revisar las leyes aplicadas a la contaminación atmosférica en el Tráfico Marítimo en el Ecuador. La investigación es de tipo básico, diseño de revisión sistemática bibliográfica, basados en un enfoque cualitativo y de diseño descriptivo, para lo cual se utilizaron artículos indexados y de normas internacionales, de los buscadores bibliográficos, Mendeley quedando alineado el anexo VI del convenio MARPOL 73/78; luego de aplicar los criterios analíticos de inclusión y exclusión, con el programa Atlas.ti, se procesó los datos más comunes de texto, gráficos y fuentes bibliográficas, utilizando la técnica de análisis documental; los resultados obtenidos, en base a los objetivos planteados y del análisis técnico - legal del anexo VI del convenio internacional MARPOL, se concluye que existe la necesidad que el Estado Ecuatoriano deberá adoptar por adherirse a este anexo que es clave para aplicar las reglas de prevención a la contaminación atmosférica provocada por el tráfico marítimo en el puerto. Por lo tanto, es importante que la variable del plan de acción se interiorice a la problemática legal ambiental del Ecuador; asimismo, a sus organismos gubernamentales, operadores de control de recepción de los desechos generados de las embarcaciones y a los usuarios del Sistema Portuario Nacional, que podrán utilizar como herramienta el anexo VI, como regla de la prevención y control ambiental a todas las embarcaciones que ingresan al canal de navegación del Golfo de Guayaquil con la finalidad de preservar el ecosistema natural del sector que es patrimonio de la humanidad.
Identification of Hypertension Risk Factor at Tarowang Village, Takalar, Indonesia
Authors: Hasan Nurzakiah , Damayanti Handini , Fitrah A Ramadhan Muhammad , Risya Azzahra Putri 
Published: December 2022

The prevalence of hypertension is increasing in the world and in Indonesia. The disease, known as the silent disease, is experienced by many people, but diagnosed too late. As a result, the impact is much greater, namely death from heart disease and stroke. Lifestyle and food intake are modifiable risk factors for hypertension. In addition, gender, age, and genetic history are risk factors that cannot be changed, but by identifying them, it can increase awareness to avoid other risk factors. This study aimed to identify risk factors for hypertension in Tarowang Village. This research was conducted with a cross-sectional study design, total sample was 116 people chosen by purposive sampling method. Hypertension defined using JNC 7 category and measured by ABN Spectrum Aneroid Sphygmomanometer. The results of this study indicate that the prevalence of hypertension was 18.97%. Age and nutritional status have significant relationship with hypertension (0.004 and 0.021, respectively). The variable consumption of vegetables and fruits, although it did not show a significant relationship, the hypertension proportion was still higher in respondents who did not eat vegetables and fruit every day. Promoting healthy behavior was needed to prevent increasing hypertension prevalence. Implementation from nutrition guidelines such as maintaining weight, increasing fruit and vegetable consumption were important in Tarowang Village.