bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Quality of Life of Mothers of Down Syndrome Children with and Without Hearing Impairment in Universiti Kebangsaan Malaysia Medical Center
Authors: Hussin Nurfarissa , Ismail Aniza , Ismail Juriza , Abdullah Asma 
Published: March 2022

Aims:
The aim is to determine the quality of life (QOL) of mothers of Down syndrome (DS) children with hearing loss and without hearing loss. Another objective is to study the correlation of QOL of mothers of DS children with their characteristic of the social socioeconomic.

Settings and Design:
An experimental group of all mothers that have children with DS who were selected from The National University of Malaysia Medical Center (UKMMC).

Materials and Methods:
Observational study using the World Health Organization QOL Scale (WHOQOL-BREF) and UKMMC stress question.

Statistical Analysis Used:
This investigation is a descriptive-analytic study response to surveys by 151 mothers of DS children during 1 year period.

Results:
Eighty-three mothers (55.6%) are housewives. The mother's age ranged from 28 to 61 years, with a mean of 43 years. The QOL was described as “satisfactory” by 60% of the mothers. The following WOHQOL-BREF scores were found: Social (72.54); physical (71.27); environmental (69.21); and psychological (63.25). Of the 151 DS children, 87 (57.6%) children have a hearing impairment. The QOL was similar between mothers with DS children with and without hearing impairment.

Conclusions:
About two-thirds of mothers with DS children have a satisfactory level of QOL. The psychological domain has the lowest score in the QOL assessment, which suggested that mothers of DS require psychological support. The study also demonstrated no significant different QOL and stress level and hearing impairment was not a predictor of stress.
Comparison of Semont's Maneuver and Epley's Maneuver with and without Betahistine Therapy in Relieving Vertigo in Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo
Authors: Santhraya Mahesh G. , Suvarna Amrita H. , George Reena Valsamma 
Published: March 2022

Context:
Benign paroxysmal positional vertigo (BPPV) is a disorder characterized by attacks of vertigo and nystagmus and aggravated with changes in head posture. BPPV can be treated effectively by relocating otoconia from the semicircular canal duct into the vestibule using different repositioning maneuvers. Our study is to determine the role of maneuvers in BPPV and to study the efficacy of the maneuvers in BPPV.

Aims:
The aim of this study is (1) to determine the role of Semont's and Epley's maneuver in BPPV and (2) to study the efficacy of these maneuvers with or without betahistine therapy.

Settings and Design:
A prospective study was done on sixty BPPV patients from Department of ENT, A. J. Institute of Medical Sciences, Mangalore.

Subjects and Methods:
Inclusion criteria were positive Dix-Hallpike maneuver and normal pure tone audiometry. Exclusion criteria were cervical spondylosis, multiple canal disease, and inner ear disease. Patients were selected based on above criteria, were examined for posterior semicircular canal BPPV, and further divided into four groups by random selection. Different treatment modalities are used.

Statistical Analysis Used:
Wilcoxon signed ranks test was used for statistical analysis.

Results:
The evaluation of outcome was done at the end of 4th week and after 3 months of the initial therapy with Dix-Hallpike and the quality of life was evaluated using visual analog scale for Vertigo and Dizziness Handicap Inventory. The results were compared using the above scales before and after the treatment.

Conclusions:
Vertigo is a common symptom which has significant morbidity physically and economically. These maneuvers are safe, short, inexpensive, and effective in treating posterior semicircular BPPV and can be practiced regularly.
Safety and efficacy of manual small incision cataract surgery and phacoemulsification
Authors: Papa-Vettorazzi Mario Renato , Cruz-Rodríguez José Benjamin , Silva-Linares Gladys Lucia , Moura-Coelho Nuno , Yee-Melgar Nicolás 
Published: March 2022

Purpose:
To compare the efficacy and safety of manual small incision cataract surgery (mSICS) versus phacoemulsification in a referral center from a low-to-middle-income country.

Subjects and Methods:
A retrospective cohort of 177 eyes with visually significant cataract and ≤1.0 diopter (D) of keratometric astigmatism was intervened during 2017 by four surgeons either by mSICS or by phacoemulsification. Last follow-up was at 4–6 weeks. Outcome measures included postoperative uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refractive cylinder, spherical equivalent (SE), complications, and re-interventions.

Results:
The mSICS group included 107 eyes; the phacoemulsification group included 70 eyes. UDVA was comparable between both groups; 89.6% in the mSICS group and 95.7% in the phacoemulsification group achieved a UDVA ≥6/18 (20/60) (P = 0.06). CDVA was comparable between both groups; 100% in the mSICS cohort and 98.6% in the phacoemulsification cohort had a CDVA ≥6/18 (20/60) (P = 0.26). Although the absolute difference in postoperative refractive astigmatism between both groups was small, it was statistically significant in favor of the phacoemulsification group (P = 0.02). Postoperative refractive SE was also comparable between both cohorts (P = 0.64). One intraoperative complication was found in the phacoemulsification group (1.4%), with no complications in the mSICS group. However, there were six reoperations in the mSICS cohort (5.6%) and no reoperations in the phacoemulsification one.

Conclusions:
Both mSICS and phacoemulsification achieved excellent visual outcomes with low complication rates. Phacoemulsification gives better UDVA and lower postoperative refractive astigmatism in a larger proportion of patients at 4–6 weeks.
Pros of prone positioning with high-flow nasal oxygenation in morbidly obese patients with moderate-to-severe COVID-19 acute respiratory distress syndrome
Authors: Wadhawa Reema , Trivedi Visharad , Singh Anisha , Bhalotra Anju Romina , Wadhawa Vivek , Shah Pratik , Jadav Deepa 
Published: March 2022

Background:
Coronavirus disease-2019 has rapidly spread globally and has become a global public health crisis. Obesity is the most frequent comorbidity exhibited by severe acute respiratory syndrome coronavirus-2. Many studies have highlighted the benefits of prone position (PP) with high flow nasal oxygenation (HFNC) in patients with moderate to severe acute respiratory distress syndrome (ARDS). This further delay intubation, reduce intensive care unit (ICU) stay and decreases overall morbidity.

Methods:
In this study, we analyzed case record data of morbidly obese patients (body mass index >35Kg/m2) with moderate-to-severe ARDS over 3 months. We evaluated the efficacy of early application of PP with HFNO in morbidly obese patients with moderate-to-severe COVID-19 ARDS on PaO2/FiO2 ratio.

Results:
A total of 24 morbidly obese patients were included in the study. Patients were divided into two groups: Group F (those who were intubated) and Group S (who did not require invasive mechanical ventilation). One hour of PP along with the use of HFNO, the P/F ratio was significantly higher in Group S (78.23 ± 7.16) than in Group F (63.58 ± 15.40) (P < 0.05). The ICU stay was longer in patients who required invasive mechanical ventilation, 17.33±2.52 days in Group F as compared to 8.11±1.05 days in Group S.

Conclusion:
PP with HFNO seems safe in morbidly obese patients and may improve oxygenation more than in nonobese patients. It is important to stress the necessity to start out postural treatment as early because the patient's clinical condition permits. PP with HFNO might avoid tracheal intubation and its inherent risks and prove beneficial in resource-limited scenarios.
Effect of nitrous oxide and dexmedetomidine on the consumption of propofol during general anesthesia in adult patients
Authors: Biyani Ghansham , Bhatia Pradeep Kumar , Mohammed Sadik , Bihani Pooja , Kamal Manoj , Chhabra Swati 
Published: March 2022

Background:
Use of both nitrous oxide and dexmedetomidine as anesthetic adjuvants has shown to reduce the consumption of propofol required for the maintenance of anesthesia. The present study evaluated these two agents for their propofol sparing effect which has not been compared so far.

Materials and Methods:
Sixty adult patients undergoing elective surgery were enrolled and randomly divided into three groups. Patients in group P received propofol started at 166 μg/kg/min and then titrated to maintain the Bi-Spectral Index (BIS) value between 40 and 60, while patients in group N and in group D received nitrous oxide as carrier gas and infusion of dexmedetomidine (1 μg/kg over 10 min followed by 0.5 μg/kg/h) respectively, in addition to propofol. Primary outcome of the study was total consumption of propofol. Secondary outcomes measured were intraoperative hemodynamics, recovery profile, residual sedation, rescue analgesic requirements, and relevant side effects.

Results:
Total consumption of propofol was significantly higher in group P (139.02 ± 65.24 μg) compared to group N (94.72 ± 48.04 μg) and group D (98.31 ± 39.45 μg) (mean difference [95% confidence interval] group P and N 44.3 [17.9–44.7]; group P and D 40.71 [26.0–52.8]; group N and D 3.59 [−5.3–21.5]) (P = 0.015). Although the recovery parameters (time to extubation, time to achieve BIS of 90, and time to verbal commands) were significantly prolonged in group D (P < 0.001), time to discharge from postanesthesia care unit (PACU) was comparable among all groups (P = 0.65). When arrived in PACU, patients in group D were significantly more sedated (P = 0.0005) however, the 30 min in PACU the difference was nonsignificant. None of the patients in group D had nausea and vomiting and did not require additional analgesics.

Conclusion:
Both nitrous oxide and dexmedetomidine significantly decreased the total consumption of propofol. Hence, both these agents can be used as potential anesthetic adjuvants to decrease the side effects associated with propofol infusion. Due to the lack of any reported environmental and long-term side effects, dexmedetomidine can be a safer and better alternative to nitrous oxide.
Ultrasound versus palpation method for accurate estimation of intervertebral space
Authors: Seetha Ammu , Varughese Silvy Anna 
Published: March 2022

Background and Aims:
Spinal cord injury resulting from the central neuraxial blockade is a rare but dreadful complication. The most likely cause is believed to be misjudged level of the intervertebral space (IVS). In our study, we assessed the accuracy of IVS marked by the anesthesiologist in 170 patients who were posted for surgery under spinal anesthesia using ultrasonography.

Methodology:
This was a prospective examiner-blinded observational study in 170 patients. An anesthesiologist estimated and marked the IVS using conventional palpation method (based on intercristal line), and the level was counterchecked ultrasonically by another anesthesiologist, who was blinded to the initial marked level.

Statistical Analysis:
The agreement between the palpation method and ultrasound assessment of IVS was analyzed using the Chi-square test. P < 0.05 was considered statistically significant.

Results and Conclusion:
The IVS estimated by conventional palpation method correlated with ultrasound estimation in only 49.4% of patients.
Preprocedural ultrasound assessment of landmarks of paramedian approach for subarachnoid block in geriatric population
Authors: Ray Tapan Kumar , Saxena Shlok , Panda Amrita 
Published: March 2022

Background
: Paramedian spinal anesthesia is the preferred anesthetic technique in the elderly. This conventional approach is occasionally challenged by difficulty in identifying landmarks accurately. Neuraxial ultrasound aims to overcome these inaccuracies.

Objective
: The objective was that the routine use of preprocedural ultrasound assessment of landmarks for paramedian spinal in geriatric population improves the efficacy of spinal anesthesia by reducing the number of attempts and redirections.

Materials and Methods
: Sixty consenting elderly patients aged 60 year or above, posted for elective surgery under spinal anesthesia, were enrolled in the study. Participants were assigned at random to receive spinal anesthesia by the paramedian approach by either conventional landmark guidance (Group CP) or preprocedural ultrasound-assisted (Group PP) technique.

Results
: The number of needle redirections was not significant and the success rate at the first attempt with no redirection was higher in the ultrasound compared with the landmark group. However, the mean insertion attempts were indifferent. The preprocedural ultrasound-assisted approach required an insignificantly shorter time for administering spinal anesthesia than the landmark-guided technique (48.87s [67.65] vs. 50.67s [50.19]) [P = 0.90]. The periprocedural pain scores (2.90[2.07] vs. 2.87[1.57]) [P = 0.94] and willingness for a similar future intervention (66.7 vs. 66.7%) were comparable among the groups.

Conclusion:
The use of preprocedural ultrasonography for paramedian approach to spinal anesthesia is not superior to the conventional landmark guidance in achieving successful dural tap at L3-L4 interspace in elderly adult population and should be limited to a setting with expert operators and selected patients for whom conventional methods may be technically challenging.
Modifikasi Algoritma Kriptografi Caesar Chiper pada Deretan Simbol dan Huruf di Smarphone dan Laptop
Authors: Pamungkas Prima Giri , Muhammad Alva Hendi 
Published: March 2022

Perkembangan dalam dunia teknologi informasi memanfaatkan teknologi komputer menjadikan salah satu pilihan dalam melakukan berbagai hal yang terdapat di dalamnya dapat berupa aplikasi, sms atapun sistem pegamanan data yang menjaga keamanan dan kerahasiaan data informasi dalam ilmu pengembangan seperti kriptografi. Pada penerapan yang di lakukan tidak dari satu teknik keamanan saja melainkan dapat dilakukan dengan bebagai kombinasi ataupun modifikasi dalam keamanan data dan informasi. Konsep utama pada kriptografi yakni enkripsi dan dekripsi. Sebuah pesan , informasi ataupun data yang di enkripsi agar orang yang tidak berhak untuk membaca pesan tersebut tidak akan dapat membacanya. Dari perkembangan berbagai metode penggunaan kriptografi dapat sering kali di pecahkan dan di selesaikan oleh pihak lain yang tidak berhak di karenakan kunci dari informasi pesan data tersebut tidak sulit memecahkannya. Dalam tulisan yang di buat ini penulis memodifikasi metode Caesar chiper menggunakan beberapa symbol dan angka sehingga menghasilkan pola dengan beberapa tahap metode.
Laparoscopic management of a giant challenging ovarian dermoid cyst: A case report
Authors: Jha Sangam , Singh Akanksha , Sinha Upasna , Sinha Jayanti 
Published: March 2022

Background: Dermoid cyst accounts for 10-20 % of all ovarian tumors. Traditionally giant ovarian cysts have been removed through a midline laparotomy. Here we report a case of laparoscopy-assisted removal of a giant dermoid cyst in an adolescent girl.
Case Presentation: A 17-year-old girl presented with a complaint of abdominal distension for 7 months. Abdominal examination revealed a well-defined tense cystic mass arising from the pelvis and extending up to the epigastric region. CT scan of abdomen and pelvis reported a mature teratoma of size 25.5x19.9x35cm of the right ovary. Laparoscopic excision of the cyst was performed following extracorporeal drainage of the cyst.
Conclusion: Laparoscopy-assisted of a giant ovarian dermoid cyst is a feasible mode of treatment irrespective of its size provided malignancy has been ruled out.
Metaphor in Hamka’s Biography Novel: A Semiotic Study
Authors: Safi'i Imam , Tarmini Wini , Wanda Aulia Deyana 
Published: March 2022

This study aimed to describe language symbols having wider meaning, metaphoric meaning, and socio-cultural background of HAMKA’s biography novel. The method used was descriptive qualitative. Findings of this study showed that the language symbols consisted of: ikon, indek, and simbol; aspect of meaning consisted of conceptual and metaphoric meaning. Metaphoric meaning was reflected in rethorical utterance. Out of 18 rethotical utterances, there were 12 rhetorical utterances which contained klimaks, Antithesis, Apostrof, Seruan, Hiperbola, Litotes, Simile, Metonimi, Ironi, Paradoks, Personifikasi, and Pertanyaan Retoris. Based on analysis, metaphoric and rhetorical meaning showed socio-cultural background of society which tended to reveal personal interpretation and subjective feeling indirectly.
Identificación de los factores que aportan a la permanenciadel personal dentro de la compañía en busca de desarrollar estrategias que permitan fortalecer el vínculo laboral a largo plazo (Caso sector maderero)
Authors: Moreno Díaz Aura Luz , Saez Evelyn , Vélez Sánchez Elkin , Giraldo Efren , Jiménez Molina Daurivan , Giraldo Tabares Santiago 
Published: March 2022

La permanencia laboral es uno de los factores relevantes al momento de evaluar los costos del recurso humano de una compañía. El presente estudio analiza cuáles son los factores que influyen en la motivación de una persona que se desempeña como trabajador de la industria maderera para que permanezca en su trabajo durante el tiempo suficiente para que se vea balanceada la relación costo-beneficio para la empresa. Esto se constituye en un factor importante para cualquier oficina de recursos humanos ya que es evidente que se debe encontrar un balance entre la permanencia de personal y los costos invertidos en su capacitación, así como también, afianzar los lazos de empatia y estabilidad para la mejora del clima laboral y tener un repositorio de experiencias a través del personal más antiguo que aporte al know-how de la empresa.

En el presente estudio, busca demostrar desde el punto de vista estadístico, como las relaciones laborales a largo plazo se pueden analizar y encontrar un modelo que refleje matemáticamente la importancia de los factores fundamentales en el desempeño laboral con la permanencia en la empresa por una persona más allá del cargo o la posición laboral al interior de la organización.
تأثير التسميد النتروجيني على إنتاج محصول القطن طويل التيلة صنف معلم 2000 (.Gossypium barbadence L)
Authors: رويس محمد سالم , دولة خالد محمد , صالح محسن علي 
Published: March 2022

نفذت تجربة حقلية في المزرعة البحثية لمحطة البحوث الزراعية /الكود - السهل الساحلي الجنوبي لمحافظة أبين- خلال الموسمين 2010م و2011م، بهـدف دراسة تأثير 4 معدلات من التسميد النتروجيني (N0 ، N30 ، N60، وN90 كجم/هـ) على صفات الإنتاجية وبعض مكوناتها للقطن طويل التيلة صنف (معلم 2000).استخدمت في التجربة تصميم القطاعات كاملة العشوائية (RCBD) في 4 مكررات وكانت مساحة القطعة التجريبية (4 × 3 = 12 م2 ).ويمكن تلخيص أهم النتائج المتحصل عليها فيما يأتي:-أثّرت معاملات التسميد النتروجيني المختلفة معنويًا على صفتي عـدد اللـوز المتفتح/نبات ومحصول النبات الـواحـد في كلا الموسمين، حيث ازدادتا معنويًا بمعـدل 25.6% و17.3% للصفة الأولى وبمعـدل 24.8% و17.0% للصفة الثانية عنـد مقارنة المعاملة (N60) بمعاملة الشاهد (N0) على الترتيب لكلا موسمي الزراعة.اختلفت إنتاجية الهكتار من القطن الزهـر معنويًا تبعًا لاختلاف معاملات التسميد النتروجيني، وتحققت أعلى إنتاجية عنـد المعاملة N60)) بلغـت 5345.00 و3311.67 كجم/هـ للموسمين على الترتيب وبزيادة معنوية بلغـت نسبتها 31.2% و19.8% للموسمين على التوالي مقارنة بمعاملة الشاهد، وأظهرت النتائج أن المعدلات العالية من التسميد النتروجيني لم تحسّن من قيمة هذه الصفة.لم يكن للتسميد النتروجيني تأثيرٌ معنويٌ على وزن اللـوزة الواحـدة وتصافي الحليج في كلا الموسمين.أن التسميد النتروجيني عكس علاقة انحدار خطية معنوية نحو زيادة الإنتاجية بالإضافة إلى وجود علاقة ارتباط معنوية موجبة.
An Investigation on the Dimensionality and Structure of Service Quality in Private Banks of South Odisha
Authors: Dash Saroj Kumar , Choudhury Snigdhamayee 
Published: March 2022

The success of any organization is measured in its ability to quickly respond to market changes with more efficient satisfaction and customer retention. The subject “quality” is nowadays, in a globalized world, one of the key concerns of businessmen to face the competition on industries and service areas. Financial groups are measuring no efforts to achieve quality excellence, starting by customer services and relationship. When the expression “Quality” is used, we usually think in terms of an excellent product or service that fulfills or exceeds our expectations. These expectations are based on the intended use and the selling price. Products are determined by its quality. Hence based on observation it is considered elusive. Quality can be quantified as Q = P/E. Where Q = Quality, P = Performance and E = Expectations. Quality is a complex phenomenon based on perceptions by individuals with different perspectives on products and services. These perceptions have been built up through the past experience of individuals and consumption in various contexts. Indian banking sector opened its doors to private and international players after the economic liberalization in 1991. It has been almost 2 decades of operation of the private banks in India. Much has evolved in the overall structure of banking during this time but have the private banks delivered the type of quality that the customers expect them to. This research is an effort to evaluate the service quality of the private banks in Southern parts of Odisha of the country India. The study is based on primary data collected in the cities of South Odisha through a structured questionnaire designed on the basis of SERVQUAL Model. The banks under study are the five top private banks from South Odisha region. The study has found that none of the banks have been able to meet the customer expectations and are still dwelling on the ‘zone of pain’. The research is very useful for managers, policymakers, implementers as well as academicians. The research provides implications for managers as well as policy makers to understand the customer expectations in India. It can be a guideline for a bigger role for the BCSBI (Banking Codes and Standard Board of India). Implications for future research are also discussed. The novelty of the research lies in the context that no effort has been made so far to effect research on sector specific contribution of banks. There is also very little literature available to identify the need-service gap in this area. The study adds value to the knowledge in the field of banking service quality for development and also opens new areas of research.