bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experiences of adolescents and parents on the mental health management of depression in adolescents, North West province, South Africa
Authors: Chukwuere Precious C. , Sehularo Leepile A. , Manyedi Mofatiki E. 
Published: February 2022

Background: Living with or managing an adolescent suffering from depression predisposes the adolescent and parents to various experiences, considering the multifactorial nature of depression and associated symptoms.Objective: This study explored and described the experiences of adolescents and their parents on the mental health management of depression in the North West province (NWP), South Africa.Method: A qualitative, exploratory, descriptive, contextual research design was adopted. Data was collect from two mental health care institutions and two mental health care units attached to two general hospitals in the NWP, SA. Thirty-two participants (18 adolescents and 14 parents) were purposefully selected for the study. Data were collected through individual interviews and analysed using Tesch’s open-coding method to generate themes and categories which were presented with the concurrent support of participants direct quotations.Results: The study revealed that the experiences of adolescents with depression and their parents taking care of them at homes include the following: emotional distress, poor coping mechanisms, financial burden, repeated suicidal attempts, negative attitudes from support systems and withdrawal behaviours. Appropriate therapeutic environments, ongoing monitoring by mental healthcare practitioners and adequate support systems were suggested by participants as management approaches that could enhance the recovery of adolescents from depression.Conclusion: The findings revealed the devastating experiences of adolescents with depression and their parents taking care of them in their various homes which confirms the dire need for attention on the plights of these groups in order to facilitate adolescents’ recovery and strengthen the adolescents’ and parents’ coping mechanisms for a healthier family.
Comparative Study of Postoperative Pain Relief Using Preincisional Versus Postincisional Infiltration With 0.25% Bupivacaine in Abdominal Hysterectomy Under General Anesthesia
Authors: Mishra Smarika , Gogia Pratiksha , Yadav Sandeep , Kumar Sumit , Singh Prachi , Malviya Deepak 
Published: February 2022

Background and Aims:
Hysterectomy, probably the most common non-pregnancy related surgery performed in gynaecology, is associated with moderate to severe post-operative pain. Wound infiltration with local anaesthetic agent reduces the transmission of pain from the wound, in addition, local inflammatory response to the injury is also suppressed. The infiltration of local anaesthesia can be done either pre- or post-operatively. The present study was designed to determine the efficacy of pre-incisional infiltration versus post-incisional infiltration with 0.25% Bupivacaine in providing post-operative pain relief in patients undergoing abdominal hysterectomy.

Methods:
In Prospective Interventional Randomised study, 90 female patients posted for elective abdominal hysterectomy under general anaesthesia were randomly allocated into three equal groups of 30 patients each.

Group I:
Patients receiving subcutaneous infiltration with 40 mL of 0.25% Bupivacaine 5 mins before skin incision.

Group II:
Patients receiving subcutaneous infiltration of surgical area with 40 mL of 0.25% Bupivacaine at end of surgery (after peritoneal closure).

Group III (Control Group):
Patients receiving no local anaesthetic infiltration. Observations were made for the duration of effective analgesia from end of the surgery until the first use of rescue analgesic along with the frequency and cumulative amount of rescue analgesics in 24 hours.

Results:
We found that at baseline, pain score of patients in Group III (3.87±1.17) was maximum followed by that in Group I (2.57±0.90) and minimum in Group II (2.20±0.61). Requirement of first analgesia was earliest in Group III (79.50±23.90 minutes) followed by Group I (136.83±13.16 minutes) and last in Group II (146.17±12.78 minutes), in addition, cumulative dose of analgesia was required by patients in Group III (152.50±36.76 mg) followed by that in Group I (132.50±37.80 mg) and minimum by that in Group II (115.00±38.06 mg).

Conclusion:
Subcutaneous infiltration of Bupivacaine either pre-incisional or post-incisional, helped to reduce the immediate post-operative pain intensity, delayed the first rescue analgesic requirement, reduced the post-operative dose and frequency of rescue analgesia. However, post-incisional intervention had an edge over pre-incisional intervention.
Comparative Study to Evaluate the Effect of Ultrasound-Guided Pericapsular Nerve Group Block Versus Fascia Iliaca Compartment Block on the Postoperative Analgesic Effect in Patients Undergoing Surgeries for Hip Fracture under Spinal Anesthesia
Authors: Natrajan Pratheeba , Bhat Ravindra Rahuveera , Remadevi R. , Joseph Idhuyya Raajesh , Vijayalakshmi S. , Paulose T. Deepak 
Published: February 2022

Background:
Fractures in and around the hip are a major concern in young as well as the elderly. Ultrasound-guided (USG) peripheral nerve blocks help in early surgical fixation of these fractures by providing perioperative pain relief as well as early mobilization resulting in reduced morbidity and mortality.

Aims:
This study aims to compare the efficacy of USG pericapsular nerve group (PENG) block versus fascia iliaca compartment (FIC) block.

Setting and Design:
Prospective, randomized, double-blind, controlled study.

Materials and Methods:
Twenty-four patients above 18 years of age with hip fracture belonging to the American Society of Anaesthesiologists physical status Classes I and II scheduled for hip surgery were randomly allocated into two groups. Group 1(PENG block) received USG-guided PENG block and Group 2 (FIC block) received USG guided FIC block for postoperative pain relief. Postoperative pain relief (at rest) was evaluated by Numeric Rating Scale score from 20th min and at regular interval for 24 h. The total analgesic consumption in the first 24 h was also noted.

Statistical Analysis Used:
Data were analyzed by using nonparametric test and Chi-square test. Hemodynamic variables and pain scores were analyzed using analysis of variance for two groups and independent t-test was used for comparison between two groups.

Results:
Postoperative NRS score was higher in FIC block than PENG block which was statistically significant at 1 h (P = 0.035) and at 4 h (P = 0.001). The first requirement of analgesic was significantly late in PENG block group (8.17 ± 3.129) as compared to FIC block group (4.00 ± 1.477).

Conclusions:
PENG block provides better postoperative analgesia, with reduced requirement of rescue analgesics in 24 h as compared to FIC block in patients undergoing surgeries for hip fracture under spinal anesthesia.
Usefulness of Thromboelastography for Perioperative Evaluation of Hemostatic Profile in Patients with Primary Brain Tumors Undergoing Surgery
Authors: Khatri Vikalp , Hemlata  , Mehrotra Megha Kohli , Kohli Monica , Malik Anita , Verma Anupam 
Published: February 2022

Context:
Hemostatic abnormalities are more common in patients with brain tumors than systemic malignant diseases. Conventional coagulation tests (CCT) are poor assays for dynamic assessment of clot strength in whole blood. Thromboelastography (TEG) gives us detailed information on the dynamics of clot development, stabilization, and dissolution reflecting in vivo hemostasis. TEG can assess both thrombosis and fibrinolysis.

Aims:
This study aimed to investigate the temporal trends in hemostatic profile occurring during surgery for primary brain tumors, using a combination of TEG and CCT, and to assess perioperative blood component support.

Subjects and Methods:
A prospective, observational study was done on 40 patients with primary brain tumors larger than 4 cm in maximum diameter on computed tomography or magnetic resonance imaging. The tests (TEG and CCT [PT, INR, activated partial thromboplastin time, and platelet count]) were performed preoperatively (on the day of surgery), intraoperatively (2 h into surgery), and postoperatively (the day after surgery).

Statistical Analysis:
SPSS Version 21.0 statistical analysis software was used.

Results:
We found a universal trend toward hypercoagulability (persistent decrease in R-time, K-time and increase in MA, α-angle, Coagulation Index) in all the TEG parameters measured intraoperatively and postoperatively even though the values were within normal limits. Results of CCT had poor correlation with TEG parameters. The mean intraoperative blood loss was 737.7 ± 185.6 mL, for which PRBC was transfused in 17 patients, FFP in 13, but no platelet transfusion was done intraoperatively.

Conclusions:
We found a trend toward hypercoagulability in our study in intraoperative and postoperative period using TEG which was not evident on CCT. TEG was a useful diagnostic tool to identify coagulation abnormalities and to guide perioperative blood transfusion.
To Study the Role of Perfusion Index as a Predictor of Hypotension during Spinal Anesthesia in Lower Segment Cesarean Section – A Prospective Observational Study
Authors: Jabarulla Reehana , Dhivya D , Kumar M S Prasanth 
Published: February 2022

Background and Aims:
Spinal anesthesia has become the choice of neuraxial anesthesia for cesarean delivery. Hypotension, the most common side effect of spinal anesthesia is more in parturients. Perfusion index (PI) is one of the newest methods, used noninvasively for the prediction of hypotension postspinal anesthesia, evaluation of regional block success, and a tool for pain assessment. In our study, we have used PI for predicting the occurrence of hypotension postsubarachnoid block in elective lower segment cesarean section (LSCS).

Methods:
In this prospective observational study, parturients posted for elective LSCS under spinal anesthesia were included. Spinal anesthesia was performed at L3-L4 interspace using 25G (gauge) Quincke needle, with 1.8 mL of 0.5% hyperbaric bupivacaine plus 20 μg fentanyl. Hypotension was defined as a decrease in systolic blood pressure >25% from the baseline.

Statistical Analysis Used:
Statistical analysis was performed using the paired sample t-test, Chi-square test, and independent t-test.

Results:
From our study, we had found that a positive correlation exists between the baseline PI of the patient and the occurrence of hypotension intraoperatively. A cutoff value of 1.75 (with P < 0.001) was found to be significant; above which the occurrence of hypotension was definite. The sensitivity of this cutoff value was 75% and specificity was 71% for this value.

Conclusion:
Baseline perfusion of >1.75 can predict hypotension postspinal anesthesia in LSCS. The incidence of hypotension was about 93% in parturients whose baseline was above the cutoff value.
Comparison of Real-Time Ultrasound with Capnography to Confirm Endotracheal Tube Position in Patients in Critical Care Unit—A Cross-Sectional Study
Authors: Kuppusamy Anand , Mirunalini Gunaseelan , Koka Mohana Vatsalya , Ramamurthy Balaji 
Published: February 2022

Abstract

Background:
Confirmation of the position of the endotracheal tube is a crucial step in the management of critically ill patients. Confirmation by capnography is the gold standard but it is practically impossible in all situations. Ultrasound (USG) can be used as an effective alternative to confirm the endotracheal tube (ETT) position. We aimed to determine the sensitivity, specificity, positive and negative predictive values, and accuracy of real-time USG with capnography to determine the correct placement of the ETT.

Patients and Methods:
The study population consisted of a nonselected series of 65 consecutive patients aged above 18 years who required endotracheal intubation in the critical care unit. Outcomes measured were confirmation of ETT by USG and capnography and time taken to confirm ETT position by USG and capnography, ruling out endobronchial placement of the ETT.

Results:
The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of real-time USG of the upper airway to detect the ETT position were 98.36% (95% confidence interval [CI]: 91.20%–99.96%), 100% (95% CI: 39.76%–100%), 100%, 80% (95% CI: 36.41%–96.54%), and 98.46% (95% CI: 91.72%–99.96%), respectively. The mean time taken to detect the position of ETT by capnography (T2) was 15.91 ± 3.14 s, whereas that by real-time upper airway ultrasonogram (T1) was 11.85 ± 2.32 s, and the difference was statistically significant.

Conclusion:
Real-time tracheal USG is an alternative method to confirm the ETT position, which is not only sensitive and accurate but also faster than capnography.
Comparison of Ramosetron, Ondansetron, and Granisetron in Attenuating Maternal Hypotension after Spinal Anesthesia in Patients Undergoing Lower Segment Caesarean Section
Authors: Narendra Suvina , Singh Dipali , Prakash Jay , Priye Shio , Kumar Shailesh , Bharati Bharati 
Published: February 2022

Abstract

Background:
Spinal anesthesia (SA) has many advantages in lower segment caesarean section (LSCS), but hypotension is the main issue that can be managed in different ways. This study was conducted to know the effectiveness of three intravenous serotonin receptor antagonists (ramosetron, ondansetron, and granisetron) in the prevention of bradycardia and hypotension during LSCS under SA.

Patients and Methods:
A total of 160 parturients posted for LSCS under SA were enrolled in this study and divided equally into four groups. Five minutes before SA, Group R received intravenous (IV) 0.3 mg ramosetron, Group O received 4 mg ondansetron IV, Group G received 1 mg granisetron IV, and Group S received IV normal saline. All solutions were diluted with normal saline to 5 mL to blind the drugs. Heart rate (HR), systolic and diastolic blood pressure, and mean arterial pressure were recorded. The total consumption of vasopressor and side effects were recorded.

Results:
The decrease in mean arterial pressure and mean HR was significantly lower in group R than other groups at all intervals (P < 0.05). The incidence of hypotension was 25% in group R compared with 42.5%, 55%, and 72.5% in groups O, G, and S, respectively.

Conclusion:
Premedication with intravenous ramosetron significantly reduced hypotension, HR, and total vasopressor usage in LSCS parturients. Intravenous ondansetron and granisetron had lesser effects than ramosetron.
Arterial Blood Gases Interpretation
Authors: Ibrahem Shimaa Elsoudy , Morsy Warda Youssef Mohamed , Mohamed Reda Biomy , Seloma Yousria Abd Elsalam 
Published: February 2022

Background
Understanding the arterial blood gases’ (ABG) analysis report, its interpretation, and applying this in practice represents an essential skill for critical care nurses.

Aim
To assess critical care nurses’ knowledge and practices regarding ABG interpretation at a university hospital, Kafr-Elsheikh Governorate.

Research questions
Q1: What is the level of critical care nurses’ knowledge regarding ABG’ interpretation at a university hospital, Kafr-Elsheikh Governorate? Q2: What is the level of critical care nurses’ practice regarding ABG interpretation at a university hospital, Kafr-Elsheikh Governorate?

Design
A descriptive exploratory research design was utilized.

Sample
A sample of convenience, including all male and female critical care nurses who are working in the selected settings and willing to participate in this study.

Setting
This study was conducted at different ICUs affiliated to a University Hospital − Kafr-Elsheikh Governorate.

Tools
Three tools were developed, tested for clarity, and feasibility: (a) nurse’s personal and background data sheet, (b) nurses’ knowledge-assessment questionnaire about ABG’ interpretation, and (c) critical care nurses’ practice regarding ABG interpretation observational checklist.

Results
The majority of the studied sample (94.6 and 100%) had unsatisfactory knowledge and practice level with a mean of 9.45±2.94 and 30.5+8.7, respectively. Moreover, 29.7% of the study participants had satisfactory practice level about double-check of ABG result and had unsatisfactory practice level about analysis of ABG parameters, recording ABG results, reporting ABG results, follow-up of medical care, and double-check of ABG with a percentage of 100, 100, 94.6, 83.8, and 70.3%, respectively. Finally, knowledge level was not found to differ significantly in relation to sex (t=1.142 at P≤0.261). However, sex did not play a role in relation to practice (t=0.528 at P≤0.601).

Conclusion
Critical care nurses (in the current study) had unsatisfactory knowledge and practice scores regarding ABG interpretation.

Recommendations
Updating knowledge and practice of ICU nurses through carrying out continuing educational programs about ABG interpretation, strict observation of nurses’ practice when caring for patients with acid and base imbalance and providing feedback to maintain practices, and replication of this study on larger-probability sample selected from different geographical areas.
Clinical characteristics, management, and 1-year outcomes of patients with acute coronary syndrome admitted to a tertiary health-care center of Kerala
Authors: Kalliath Suneesh , Nair Rajesh Gopalan , Vellani Haridasan , Chakanalil Sajeev Govindan , Muneer Kader , Deshabandu Vinayakumar , Mathew Dolly , George Biju 
Published: February 2022

Background:
There are limited data on the late outcome of the acute coronary syndrome (ACS) in India. We prospectively investigated the clinical characteristics, management, and 1-year outcomes of patients with ACS admitted to a tertiary care center of South India.

Materials and Methods:
In this prospective observational study, we enrolled 3149 adults hospitalized with a diagnosis of ACS between December 1, 2014 and March 31, 2017 at Government Medical College Kozhikode, Kerala. Patients were followed up at 30 days, 6 months, and 1 year. Primary outcome was all-cause mortality at 365 days. Secondary outcomes were 30-day mortality, sudden cardiac death (SCD), and major adverse cardiac events (MACEs) at 1 year after discharge.

Results:
A total of 3149 patients with ACS were admitted during the study period (48% with ST-elevation myocardial infarction [STEMI], 37% with non-ST-elevation MI [NSTEMI], and 15% unstable angina [UA]). The patients were of ages 58 ± 11.9 years. During hospitalization, the majority of the patients received guideline recommended drugs and percutaneous coronary intervention (PCI) was performed in 28%. Reperfusion therapy was performed in 88% of patients with STEMI (53% thrombolytic therapy and 45% including primary and rescue PCI). At 1 year, all-cause mortality and composite MACE after discharge were 14.4% and 17.6%, respectively. MACE included cardiovascular death (5.4%), re-infarction (15.7%), and non-fatal stroke (0.6%) after discharge. SCD at 1 year was 1.8%. The main factors associated with 1-year all-cause mortality and MACE were older age, prior history of ACS, ventricular tachycardia or ventricular fibrillation, right bundle branch block with Q wave, and left ventricular systolic dysfunction.

Conclusion:
One-year all-cause mortality after the admission of ACS was high, but post-discharge cardiovascular mortality was comparable to other developed countries. This highlights a better secondary prevention practices and risk stratification in our population.
Prophylactic use of intracoronary sodium nitroprusside decreases incidence of no reflow after primary angioplasty in acute myocardial infarction
Authors: Kumar Sujith , Varghese Jaime S. 
Published: February 2022

Background:
Intracoronary vasodilators are used in various stages of primary angioplasty, either to treat no reflow or prophylactically to prevent no reflow. Vasodilators were ineffective during primary angioplasty to treat no reflow likely because the drug was used after plaque modification. We evaluated the intracoronary use of sodium nitroprusside (SNP) before plaque modification and microembolization.

Materials and Methods:
We conducted a retrospective case–control study of all primary angioplasty cases done at Lourdes Hospital, Kerala, India, from March 2016 to May 2018 by two operators at the hospital. We retrospectively collected the data for primary angioplasty at the hospital and analyzed the data into two groups: one operator routinely used prophylactic intracoronary SNP in stable primary percutaneous coronary intervention (PCI) patients, whereas the other used it only if there was no reflow. The drug was delivered prophylactically through guiding catheter once at least TIMI I flow was present. We compared the effect of prophylactic vs. therapeutic use of intracoronary SNP on no reflow during primary percutaneous transluminal coronary angioplasty (PTCA).

Results:
Incidence of no reflow was significantly less in the group in which SNP was used at the onset of primary PTCA when compared with those patients in whom it was not used at the onset (6.5% vs. 28.4%, P < 0.001). The TIMI frame count (21.7 vs. 24, P = 0.22) and low TIMI myocardial perfusion grade (<2) (14% vs. 20%, P = 0.272) did not reach statistical significance.

Conclusion:
Prophylactic intracoronary use of SNP, before plaque modification, reduces the incidence of no reflow phenomenon after primary angioplasty.

Brief Summary
Sodium nitroprusside (SNP) has been used during various stages of percutaneous transluminal coronary angioplasty (PTCA), with intention to treat or prevent no reflow with variable results. Use of the drug, after no flow has set in, may not allow the drug to reach the microvasculature in all cases, making the drug not very effective in the treatment of no flow. So we compared the effect of prophylactic SNP before plaque modification in preventing no reflow after primary percutaneous coronary intervention.
Impacto del Covid-19 en la educación superior: análisis bibliométrico
Authors: Martí Selva Maria Luisa , Puertas Medina Rosa , Guaita Martinez Jose Manuel , Carracedo Patricia 
Published: February 2022

El COVID-19 ha cambiado significativamente la docencia universitaria, tanto en la actividad de los alumnos, como en la forma de enseñar de los profesores. Desde marzo de 2020 hasta la actualidad han proliferado multitud de artículos que tratan de analizar el impacto del virus en el proceso de enseñanza-aprendizaje de las universidades en todo el mundo. En este contexto, el objetivo de la ponencia es presentar las principales líneas de investigación en el ámbito de estudio de la educación superior tomando como referencia las restricciones de la pandemia en España. Para ello se realiza un análisis bibliométrico con el objetivo de conocer las orientaciones que han seguido los trabajos científicos y cuáles han sido las conclusiones más importantes. Este estudio ha comenzado con una búsqueda en Scopus de las palabras clave “higher education” y “covid 19” y se han obtenido 62 documentos que hacen referencia al territorio español. Entre los resultados obtenidos, destaca que las universidades de Salamanca, Valladolid y Granada son las más fructíferas en artículos sobre la influencia del COVID-19. Las temáticas donde abundan más trabajos se centran en el área de ciencias sociales, ambientales e informática. El escaso lapso de tiempo de su publicación (2020 y 2021) da lugar a que el documento con 63 citas es el que encabeza el ranking bajo este criterio. Por último, a partir de las palabras clave del conjunto de las 62 investigaciones utilizando el software VOSviewer se ha realizado una agrupación de tres clusters que permiten identificar las principales temáticas de los artículos analizados