Ethical Permission Research Articles

Psychological disturbances encountered by selected undergraduates studying at the University of Ruhuna, Sri Lanka during the Covid-19 pandemic: a cross-sectional study

University undergraduates are increasingly recognized as a vulnerable population with a higher level of psychological disturbances. During the Covid-19 pandemic, universities closed all over the world, resulting in the psychological well-being of this population being severely affected across the globe. This study examined the prevalence of stress, anxiety, and depressive symptoms encountered by undergraduates of the selected five faculties at the University of Ruhuna in Southern Sri Lanka due to the Covid-19 pandemic, its associated factors, and the correlations between stress, anxiety, and depressive symptoms. An online, cross-sectional, descriptive study was conducted among undergraduates using pre-tested, self-administered questionnaires from the randomly selected five faculties: Allied Health Sciences, Engineering, Humanities and Social Sciences, Management and Finance, and Medicine. Undergraduates were invited to complete the Google Form. Socio-demographic details and a 21-item Depression, Anxiety, and Stress Scale (21-DASS) were used for data collection. Stress, anxiety, and depressive symptoms were evaluated using a Sinhala version of the 21-DASS scale. Ethical permission was granted by the Ethics Review Committee of the Faculty of Allied Health Sciences, University of Ruhuna. Among the 359 undergraduates, the majority were represented by females (62.1%). The mean age of the sample was 23.67 years (SD ± 1.6). Stress, anxiety, and depressive symptoms were found to be prevalent in 53.7%, 41.8%, and 63.8% of undergraduates respectively. Younger and female undergraduates had more impact on psychological issues than their counterparts. It revealed a significant positive correlation between anxiety and depressive symptoms (r = 0.646, p < .001), anxiety and stress (r = 0.868, p < .001), and stress and anxiety (r = 0.786, p < .001). Most undergraduates experienced considerable levels of stress, anxiety, and depressive symptoms during the Covid-19 as increasing stress, anxiety, or depressive symptoms, tend to increase all types of psychological disturbances. The development of mental health among undergraduates is essential and needs innovative strategies to improve the psychological well-being of undergraduates. The initiation of a stress management programme and expanded available counseling services are also important. Further studies are needed to be conducted on the extended topic of how the Covid-19 era is affecting the psychological well-being of undergraduates from different universities (state/non-state), locations, and different study departments.

OPTIMIZING WOUNDED ARTICULAR CARTILAGE FOR IMPROVED CARTILAGE INTEGRATION: EVALUATING CHONDROPROTECTIVE MEASURES FOR MINIMIZING IN SITU CHONDROCYTE DEATH

AbstractObjectiveThe preparation of host degenerate cartilage for repair typically requires cutting and/or scraping to remove the damaged tissue. This can lead to mechanical injury and cartilage cell (chondrocytes) death, potentially limiting the integration of repair material. This study evaluated cell death at the site of cutting injury and determined whether raising the osmotic pressure (hyper-osmolarity) prior to injury could be chondroprotective.MethodsEx vivo human femoral head cartilage was obtained from 13 patients (5 males and 8 females: 71.8 years old) with Ethical Permission and Patient consent. Cartilage wells were created using 3 or 5mm biopsy punches. Cell death at the wounded edge of the host cartilage and the edge of the extracted explants were assessed by quantifying the percentage of cell death (PCD) and measuring the width of the cell death zone at identified regions of interest (ROI) using the confocal laser scanning microscopy and image analysis software. To assess the chondroprotective effect of hyper-osmolarity, cartilage specimens were incubated in 340 or 600mOsm media, five minutes prior to injury to allow the chondrocytes to respond to the altered osmolarity. Wounded cartilage explants and cartilage wells were then cultured for a further 150 minutes following injury.ResultsIn 340mOsm media, the PCD around the 3mm cartilage wells was significantly less compared to the corresponding explants (20.05±10.24% vs 35.25±4.86%; P=0.0003). When using the 5mm biopsy punch, the PCD at the wound edges was significantly lower when compared to the 3mm cartilage wells (13.33±7.80% vs 20.05±10.24%; P=0.0121) at the same osmolarity. The width of the cell death zone for the well edges for both 3 and 5mm punches was significantly narrower when compared to their corresponding harvested cartilage explants in 340mOsm media (P&lt;0.0001; P=0.0218, respectively). Exposing cartilage to raised osmolarity (600mOsm) prior to injury significantly reduced the PCD for cartilage wells produced by the 3mm biopsy punches (from 20.05±10.24% to 12.24±6.00%; P=0.0025). In addition, the zone of cell death was marginally reduced at the edges of the 5mm cartilage wells (19.25±15.78mm to 12.72±9.09mm; P=0.0499).ConclusionsThe choice of biopsy punch and the osmolarity of the incubation medium prior to cartilage injury markedly affected the extent of chondrocyte death both at the edges of the cartilage wells and the explants. The smaller biopsy punch caused more chondrocyte death in the native cartilage wells compared to the larger punch, but this could be compensated for by the chondroprotective effect of raising the osmotic pressure. In general, there was less cell death at the wounded edges of the cartilage wells, compared to the explants. These results suggest that there is scope for further optimising the cutting implements used to create the cartilage wells and protecting chondrocytes by hyper-osmolarity in order to minimize cell death at cut edges and potentially enhance integration between cartilage repair material and host cartilage.Declaration of Interest(b) declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported:I declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

ABNORMAL CHONDROCYTE MORPHOLOGY, CLUSTERING, AND CELL SWELLING IN A SCRAPED HUMAN CARTILAGE MODEL OF OSTEOARTHRITIS

AbstractObjectivesOsteoarthritis (OA) is a complex joint disorder characterised by the loss of extracellular matrix (ECM) leading to cartilage degeneration. Changes to cartilage cell (chondrocyte) behaviour occur including cell swelling, the development of fine cytoplasmic processes and cell clustering leading to changes in cell phenotype and development of focal areas of mechanically-weak fibrocartilaginous matrix[1]. To study the sequence of events in more detail, we have investigated the changes to in situ chondrocytes within human cartilage which has been lightly scraped and then cultured with serum.MethodsHuman femoral heads were obtained with Ethical permission and consent from four female patients (mean age 74 yrs) undergoing hip arthroplasty following femoral neck fracture. Osteochondral explants of macroscopically-normal cartilage were cultured as a non-scraped control, or scraped gently six times with a scalpel blade and both maintained in culture for up to 2wks in Dulbecco's Modified Eagle's Medium (DMEM) with 25% human serum (HS). Explants were then labelled with CMFDA (5-chloromethylfluorescein-diacetate) and PI (propidium iodide) (10μM each) to identify the morphology of living or dead chondrocytes respectively. Explants were imaged using confocal microscopy and in situ chondrocyte morphology, volume and clustering assessed quantitatively within standardised regions of interest (ROI) using Imaris® imaging software.ResultsWithin 2wks of culture with HS, chondrocyte volume increased significantly from 412±9.3µm3 (unscraped) at day 0 to 724±16.6 µm3 (scraped) [N(n) = 4(380)] (P=0.0002). Chondrocyte clustering was a prominent feature of HS culture as the percentage of clusters in the cell population increased with scraping from 4.8±1.4% to 14.9±3.9% [N(n) = 4(999)] at week 2 (P=0.0116). In addition, the % of the chondrocyte population within clusters increased from approximately 38% to 60%, and the number of cells per cluster increased significantly from 3.2±0.08 to 4±0.22 (P=0.031). The development of abnormal ‘fibroblastic-like’ chondrocyte morphology demonstrating long (&gt;5µm) cytoplasmic processes also occurred, however the time course of this was more variable. For some samples, clustering occurred before abnormal morphology, but for others the opposite occurred. Typically, by the second week, 17±2.64% of the cell population had processes and this increased to 22±4.02% [N(n) = 4(759)] with scraping.ConclusionsScraping the cartilage will remove surface constituents including lubricants (e.g. lubricin, hyaluronic acid, phospholipids), extracellular matrix constituents (collagen, proteoglycans – potentially the ‘lamina splendens’) and cells (chondrocytes and mesenchymal stromal cells (MSCs)). Although we do not know which of these component(s) is important, the effect is to dramatically increase the permeation of serum factors into the cartilage matrix and signal the development of cytoplasmic processes, cell clustering and swelling. It is notable that these cellular changes are similar to those occurring in early OA[1]. This raises the interesting possibility that scraped cartilage cultured with human serum recapitulates some of the changes to in situ chondrocytes during early stages of cartilage degeneration and as such, could be a useful model for following the deleterious changes to matrix metabolism.Declaration of Interest(b) declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported:I declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Clinico Pathological Profile of Adnexal Torsion Cases- A Retrospective Analysis from A Tertiary Care Teaching Hospital in Southern India

Introduction: Adnexal torsion is a significant source of morbidity, and nonspecific signs can make diagnosis difficult. Early identification is crucial to avoid ovarian infarction and the likelihood of related infertility. Our study aims to assess the clinicopathological profile of adnexal torsion cases through retrospective analysis from a tertiary care teaching hospital in southern India. Methods: This retrospective study was carried out in the Department of Obstetrics and Gynaecology at a tertiary care teaching hospital in Tamil Nadu, India. Data was collected on women with surgically proven adnexal torsion from January 2019 to December 2022. Proper ethics permission was obtained, and informed consent was taken from all the patients prior to the commencement of the study. The subjects' confidentiality was maintained. The data was represented using detailed descriptive analyses, medians, and percentages. Statistical analysis was carried out using Microsoft Excel 2007 and IBM SPSS version 21. Conclusion: Adnexal torsion is an uncommon condition. Acute stomach discomfort, nausea, and vomiting are the most common symptoms. Adnexal torsion’s clinical and radiographic diagnosis is challenging for both doctors and radiologists. As a result, extensive clinical experience and radiological abilities are necessary. Early identification and surgical treatment save the ovary while maintaining its function.

To study dexmedetomidine’s effect on intraocular pressure after succinylcholine and endotracheal intubation

Background: One of the most important preconditions for any anesthetic operation is perioperative hemodynamic stability during laryngoscopy and intubation, which has been the subject of extensive research and documentation. Numerous approaches have been proposed to protect the patient from the sympathetic reaction, intraocular pressure (IOP) response, and catecholamine response during laryngoscopy and intubation. Aims and Objectives: To study the efficacy of two doses of intravenous dexmedetomidine premedication given as a single bolus dose over 10 min, 0.4 μg/kg and 0.6 μg/kg, 10 min before induction in preventing the rise of intraocular pressure following succinylcholine administration and endotracheal intubation. Materials and Methods: A retrospective randomized study was conducted. Ethical committee permission and signed informed consent were obtained from 60 eligible patients before the trial began. Results: Premedication with either 0.4 mcg/kg I.V. or 0.6 mcg/kg I.V. of dexmedetomidine diluted in normal saline at a 2 mcg/mL concentration administered over 10 min before induction resulted in significant obtundation of the rise in IOP associated with succinylcholine administration and intubation. Sympathetic response to laryngoscopy and intubation was also significantly diminished. The dose of 0.4 mcg/kg I.V. produced the best hemodynamic stability. Conclusion: Therefore, from the above research it can be concluded that, before succinylcholine delivery and intubation, dexmedetomidine 0.4 mcg/kg I.V. can be used as a premedication in situations where an increase in IOP could be hazardous.

Improving the performance of EM and K-means algorithms for breast lesion segmentation

Aims: Breast cancer is the most common type of cancer in women and accounts for a large portion of cancer-related deaths. As in the other types of cancer, the prevention and early diagnosis of breast cancer gain importance day after day. For this purpose, the artificial intelligence-based decision support systems become popular in recent years. In this study, an automatic breast lesion segmentation process is proposed to detect breast lesions in the images taken with magnetic resonance imaging (MRI) protocol. &#x0D; Methods: Two most popular segmentation methods: expectation maximization (EM) and K-means algorithms are used to determine the region of breast lesions. Furthermore, superpixel based fuzzy C-means (SPFCM) algorithm is applied after EM and K-means methods to improve the lesion segmentation performance.&#x0D; Results: The proposed methods are evaluated on the private database constructed by the authors with ethical permission. The performances of the utilized methods are analyzed by comparing the lesion areas determined by a radiologist (ground-truth) and areas that are achieved by automatic segmentation algorithms. &#x0D; Conclusion: Dice coefficient, Jaccard index (JI), and area under curve (AUC) metrics are calculated for performance comparison. According to the simulation results, EM, K-means, EM+SPFCM, and K-means+SPFCM methods provides good segmentation performance on breast MRI database. The best segmentation results are obtained by using EM+SPFCM hybrid method. The results of the EM+SPFCM method are 0,8711, 0,8979, and 0,9981 for JI, Dice, and AUC, respectively.

Self-Reported Side Effects of Different COVID-19 Vaccines in Bangladesh- A Vaccine Recipient Survey

Background: COVID-19 (Corona Virus disease 2019) is a newly discovered disease that originated in China and quickly spread throughout the world, killing millions of people and infecting many more. People have a new hope due to newly discovered vaccines for this fatal disease. However, the vaccines showed a number of side effects on the people receiving them. Nonetheless, it has proven to be helpful in providing protection against the fatal infection. Purpose: To analyze the probable side effects of the vaccines experienced by vaccine recipient and their belief regarding vaccine. Method: An online survey was conducted through different social media platforms and Email from 11 July’2021 to 16 July’2021. Ethical permission and consent was taken prior to the survey and data collections. Occurance and the extent of vaccine side effects were analyzed using descriptive and logistic regression analysis. Result: Among 175 vaccine recipients, 92 (52.58%) received one dose and 83 (47.42%) received two doses, with 93 (53.1) receiving SinoPharm vaccine, 78 (44.6) receiving AstraZeneca vaccine, and 4 (2.3%) receiving Pfizer vaccine. More than half of the respondents experienced side effects among which headaches (50.3%) and drowsiness (45.71%) were common followed by fever (36%) and muscle ache (32%). Female (P=0.000) and vaccine concerned group (P=0.033) experienced more side effects. Headache (68.8%), fever (40.9%) and drowsiness (50.5%) were more common among Sinopharm recipients. Fever (50%) and muscle ache (50%) were more common among Pfizer recipients while muscle ache (43.5%) and drowsiness (42.3%) were common among AstraZaneca recipients group. Conclusion: Headache, fever, muscular discomfort, soreness at the injection site, drowsiness, nausea, and other adverse effects are common with the COVID vaccination. Females are more susceptible to side effects than males, and the probability of experiencing them increases with the second dose. AstraZeneca vaccine recipient experiencing more side effects than other types of vaccine recipients. Update Dent. Coll. j: 2023; 13(2):3-8

Adölesanlarda Beslenme, Egzersiz Davranışları ile İnternet Bağımlılığı Arasındaki İlişkinin İncelenmesi

Objective: This study aims to determine the relationship between adolescents' nutritionexercise behaviors and internet addiction, as well as identify the factors affecting their eating-exercise behaviors and internet addiction. &#x0D; Material and Method: This cross-sectional descriptive correlational study was performed in Fethiye. The sample of the study consisted of 421 students attending 11 secondary schools. Data were collected using a descriptive data form, the Internet Addiction Scale and the Nutrition Exercise Behavior Scale. The data were collected by the researcher after obtaining ethical committee and institutional permissions. &#x0D; Results: The students' psychological/addictive eating behavior subscale mean score was 38.9±8.8, their healthy eating/exercise subscale mean score was 47.6±9.4, the unhealthy eating/exercise behavior subscale mean score was 49.0±7.0, and the meal pattern subscale mean score was 23.4±4.5. The internet addiction scale mean score was 19.6±7.5. The regression analysis showed that variables pertaining to the students’ psychological/ addictive eating behavior, meal patterns, unhealthy nutrition/exercise behavior, their use of the internet for social media and other purposes, their class, and their consciousness of eating during the COVID-19 pandemic explained 35.8% of internet addiction, meaning that the model was statistically significant. An inverse correlation was found between the variables of psychological/addictive eating, meal patterns, unhealthy nutrition/exercise and being conscious of what one was eating during the COVID-19 pandemic, while a positive correlation was found between the variables of using the internet for social media and class. &#x0D; Conclusion: Pediatric nurses play an important role in supporting the healthy development of adolescents by creating programs to instill healthy lifestyle habits

Assessment of Quality of Life and Long-term Health-related Problems Among Children with Intracranial Tumor

Introduction: The most prevalent type of solid tumor in children is the intracranial tumor. The treatment of pediatric intracranial tumors has acute and late side effects on the physical, cognitive, emotional, and social health of children, which negatively impact their HRQoL. Objectives: To assess the quality of life (QoL) and long-term health-related problems in children with intracranial tumors. Method: A descriptive study was conducted involving 70 children with intracranial tumors visiting OPD for their post-treatment follow-up. Ethical permission was granted from the Institutional Ethical Committee. Tools used to collect were Sociodemographic and clinical profile sheets of the children, Problem assessment proforma, and PedsQL TM Generic Core 4.0 Scale. Results: The age of children ranged from 4 to 18 years with a mean age of 11.31 + 4.28 years. Fatigue (57.1%) was the most common problem experienced by children followed by weakness (41.4%) and headache (25.7%). In neurocognitive dysfunction, decreased attention was seen in 30% of children followed by difficulty in thinking and reading/writing. Muscle power-related problems, endocrine problems, and psychological and behavioral problems were also seen in these children. The total score of QoL of children with intracranial tumors was 70.8 ± 24.6. The most affected domain of QoL was school functioning, followed by physical functioning. Conclusion: Children with intracranial tumor show average HRQoL and these children are at a higher risk for late consequences, which may influence several life domains.

ROLE OF HEMATOLOGICAL SCORING SYSTEM IN DIAGNOSIS OF NEONATAL SEPSIS

Introduction: Neonatal sepsis is a clinical syndrome resulting from pathophysiologic effects of local and systemic infection in the 1st month of life. Septicemia usually consists of bacteremia with a constellation of signs and symptoms caused by microorganisms or their toxic products in the circulation. Neonatal sepsis was one of the common causes of neonatal mortality, contributing to 16% of all intramural deaths. Early diagnosis of neonatal septicemia is a vexing problem because of its nonspecific clinical picture. Method: This study was prospective observational study of 210 Cases received from August 2020 to August 2022 for Neonatal Sepsis. This prospective study was carried out in Department of Pathology of a tertiary care teaching hospital. The ethical permission has been obtained from Institutional Ethics Committee for conducting the study. Hemogram was obtained for each case using five part automated hematology analyser. Result: Hematological scoring system was useful test in the early diagnosis of neonatal sepsis. Diagnostic accuracy was 92.39% in this study,&gt;=3 score was sensitive and &gt;=4 score was specific for early diagnosis of neonatal sepsis Conclusion: The HSS increases the diagnostic accuracy of the complete blood cell count as a screening test for sepsis and simplifies and standardizes its interpretation.

Evaluation of the incidence and risk factors of ocular disorder in primary school children: a cross-section analysis

Background: School health is an essential part of any public health program. Poor vision in childhood can affect school performance and affect children later in life. Pupils can be affected by various eye diseases such as refractive errors, strabismus, color blindness, eyelid problems and cataracts. The aim of this study is to determine the incidence and risk factors of eye diseases in children aged 6-12 years. Methods: This school-based cross-sectional study selected children aged 6-12 years from December 2018 to March 2019 from 09 primary schools in the Kanpur district. The institutional ethical clearance and appropriate permissions from the school authorities were obtained through the medical officer of Kalyanpur PHC and consent 51 from parents. Results: A total of 2,100 students from 09 different schools, 1,070 boys and 1,030 girls, were tested. The most common eye diseases are myopic astigmatism with 16.6% (348 people), myopic astigmatism with 78.2% (272 people), 192 were against the rule astigmatisms, 80 were with the rule astigmatism astigmatisms, followed by simple myopic with 15.2% (53 people) and hypermetropic astigmatism with 1.7% (6 people). The next most common disease is allergic disease with 1.6% (34). The 1.4% (30) of children have strabismus. Blindness 0.26% (5), colour blindness 0.2% (4); eyelid and adnexal disease 0.13% (3) and cataract 0.03% (1) Conclusions: Eye diseases in school-aged children can be easily detected by regular eye examinations; this research shows that vision deficiency is likely to be affected.

KNOWLEDGE REGARDING UPPER RESPIRATORY TRACT INFECTION (URI) AND ITS PREVENTION AMONG UNDER FIVE CHILDREN, IN SELECTED COMMUNITY AREA, DEHRADUN

Aim: A descriptive cross-sectional study was conducted with aim to assess the knowledge regarding upper respiratory tract infection (URI) and its prevention among mothers of under five children, in selected community area, Dehradun and to find out association between knowledge score of mothers regarding upper respiratory tract infection &amp; its prevention and selected socio-demographic profile. Materials and Methods:After obtaining the ethical permission from the ethical committee a quantitative research approach with descriptive cross-sectional study was conducted to assess the knowledge regarding upper respiratory tract infection and its prevention among mothers of under five children in selected community area of Dehradun. Total 60 mothersof under five children were selected based on inclusion criteria by using purposive sampling technique through structured knowledge questionnaire tool. The exclusion criteria for mothers of under five children were who are sick during data collection, having any chronic illness, children above five years and for children were who are physically disabled and mentally retarded children, children had URI with other disease condition. Results: In the present study revealed thatmore than (65%) mothers were between the age group of 26-33, nearly (40%) mothers were graduated andthe mother who are employed were (67%), (60%) mothers having girl child,(55%) mothers having child between 3-5 years and(75%) children were immunized up to their age. The result findings conclude that 18% (10) of mother had excellent knowledge regarding prevention of URI approximately half of 45% (27) of study participants had good knowledge 28% (17) of mothers had average knowledge and only 10% (6) of study participants had poor knowledge regarding prevention of URIThe result finding reveals that there is association between socio- demographic variables and knowledge score of mothers. Conclusion:The present study concludethathalfof the 45% (27) mothers had good knowledge regarding URI and itsprevention, 18% (10) mothers having excellent knowledge and 10% (6) mothers having poor knowledge. Thus, it is concluded that some of the mothers need training and teaching to improve knowledge regarding Upper respiratory tract infection and its prevention among mothers of under five children and decrease the childhood acute respiratory infection.

Effects of Core Stabilization Exercises on Low Back Pain, Disability and Back Muscle Endurance in Patients with Lumbar Disc Herniation

Background: Lumbar disc herniation is a common musculoskeletal disorder leading to spinal degeneration. Core stability influences lumbar biomechanics, which improves muscle endurance through decreased pain of the lower back leading to minimal chances of disability.&#x0D; Objective: To determine the effects of Core stabilizing exercises on low back pain, disability and endurance of back muscles in Lumbar Disc Herniation patients.&#x0D; Methods: Randomized controlled trial was conducted on 52 patients . it was conducted 3 times a week for 30 minutes for 6 months. Participants allocated into two equal groups by lottery method. Group A was treated with controlled conventional treatment and core stabilizing exercises. Group B received only conventional treatment. This information was collected using NPRS and ODI. Besides this Biering-Sorenson and trunk flexion endurance tests were used. Probability sampling was used .Settings included AMTH, PSRD and NHMC. The study was conducted for 6 months. Ethical permission by ethical review board. data analysis by SPSS. This included male and female patients, age 20 to 60 years with disc herniation. Participants with recent surgery, inflammatory arthritis, cauda equina syndrome and spinal tumor were excluded.&#x0D; Results: After 8-weeks of core stabilization exercises, values of Group A are 1.93 for pain, 16.08 for disability, 1.27 and 40.54 for endurance whereas Group B showed values of 4.74 for pain, 34.08 for disability, 2.15 and 34.81 for endurance. Independent t-test showed significant difference between 2 groups with p value &lt; 0.05. Results of current study showed considerable reduction in low back pain and disability, and a significant increase in back muscles endurance in the treatment group. &#x0D; Conclusion: Core stabilization exercises were effective in improving function, reducing pain, reducing functional disability and enhancing endurance in patients of lumbar disc herniation and lower back pain&#x0D;

Examination of Dysfunctional Beliefs and Attitudes About Symptoms, Sleep Quality and Sleep in Patients Receiving Hemodialysis Treatment

Objective: This study was conducted to examine the relationship between symptoms, sleep quality, and dysfunctional beliefs and attitudes about sleep in patients receiving hemodialysis treatment.&#x0D; Material and Methods: This descriptive and correlational study was conducted with 120 patients undergoing hemodialysis in a private hemodialysis center. Data were collected using the Descriptive Information Form, Dialysis Symptom Index (DSI), Pittsburgh Sleep Quality Index (PSQI), and Dysfunctional Beliefs and Attitudes About Sleep Scale-16 (DBAS-16). The statistical analysis of the data obtained as a result of the study was analyzed using number, percentage, standard deviation and arithmetic mean as descriptive statistics, Pearson correlation test and structural equation modeling in IBM SPSS 26 program. Ethics committee approval and permission from the research institution were obtained for the conduct of the study. &#x0D; Results: The most common hemodialysis-related symptoms were fatigue (70.8%), feeling irritable (61.7%), difficulty falling asleep (60.8%). The mean PSQI Global sleep score of the patients was 7.40±5.02 points. Dialysis Symptom Index explained 26.5% of the change in PSQI Global sleep score in a statistically significant way (F=42.479 p

Clinicopathological Profile of Appendicular Disease in Children: A Tertiary Health Care Center Study.

Background Acute appendicitis (AA) is the most common surgical emergency worldwide. Delay in diagnosis of disease often leads to serious complications such as perforation appendicitis (PA) and gangrenous appendicitis (GA). Aims and objectives The purpose of the study is to document clinicopathological outcomes in pediatric age group patients in a tertiary health care center. Material and method This study was a prospective observation study of 50 patients with pediatric appendicitis who had undergone emergency appendectomy from January 2022 to December 2022. All pediatric patients below 15 years of age with a diagnosis of AA were included. Institute ethical permission was granted before the study, and parent consent was taken for the surgery and also for inclusion in the study. After proper resuscitation, all patients underwent appendectomy, and necessary specimens were sent for histological examination. Based on histopathology reports, all patients were classified into four groups: AA, PA, GA, and normal appendix (NA). Results Out of 50 patients, 33 (66%) patients were males and 17 (34%) patients were females. The mean age of the patients was 10.22 ± 2.73 years. The mean age of AA, PA, GA, and NA patients were 10.25 ± 2.6 years, 9.78 ± 2.99 years, 10.00 ± 4.6 years, and 12.00 ± 2.8 years, respectively. The mean duration of symptoms at the time of hospital admission was 2.42 ± 0.97 days forhistopathologically proven AA patients, 4.67 ± 2.1 days for GA patients, 2.8 ± 0.83 for PA patients, and one day for NA patients. Overall clinical presentation was right iliac fossa (RIF) pain in 36 (72%) patients, migration of pain in 31 (62%) patients, anorexia in 37 (74%) patients, nausea and vomiting in 43 (86%) patients fever in 26 (52%) patients, RIF tenderness in 50 (100%) patients, rebound tenderness in 39 (78%) patients, guarding in 19 (38%) patients, Psoas's sign in nine (18% patients), and Rovsing's sign in 19 (38%) patients. On histopathological examination of the sent specimen, AA was found in 36 (72%) patients, PA was found in nine (18%) patients, GA was found in three (6%) patients, and NA was found in two (4%) patients. Wound infection was the most common complication and was found in five (10%) patients. The average duration of hospital stay for AA, PA, GA, and NA was 4.33 ± 1.04 days, 9.56 ± 4.2 days, 12.33 ± 8.5 days, and 3.50 ± 0.71 days, respectively. Conclusion The appendicular disease is common in teenage male children. Fever, dehydration, and rebound tenderness at the RIF are clinically significant findings. Duration of symptoms at the time of diagnosis, post-appendectomy complication, and duration of hospital stay significantly correlated with histopathological findings.

Developing a new focal vibration and heat therapy system

Abstract Vibrational heating therapy is a type of physical therapy that uses the application of heat and vibrations to stimulate the body’s healing process. The therapy is believed to promote circulation, reduce inflammation, and relieve muscle tension. It is often used to treat conditions such as arthritis, fibromyalgia, and sports injuries. This paper presents the design-decisions for a device treating muscle soreness and to increase muscle strength through a combination of heat and vibration therapy to the upper leg. The system comprises farinfrared heat elements for heat transfer and two types of eccentric rotating masses (ERMs) and a linear resonant actuator (LRA) to vibrate muscle tissue. It discusses heating and vibration capability and performance. To optimize the mechanical effects of vibration therapy, the device must excite the muscle with an acceleration of more than 2 g and with a bandwidth as wide as the range of the muscle natural frequencies. For testing the heating and vibrational systems, they were tested in the same device on six different subjects with ethics permission from Technical University of Hamburg to obtain accurate results. Both ERMs were driven by DC power and yielded a bandwidth of about 30 Hz with a linear progression of acceleration over frequency, while the LRA was driven by AC power and achieved a bandwidth of about 24 Hz in the form of a bell curve. Also the selected heating element provides the desired temperature between 40 ∘C to 50 ∘C. Overall, the initial technical study showed promising measurement results and a mechanical effect in using this combination of heat and vibration therapy. As an outlook, the technical design of the next version of the device will include multiple actuators around the leg to provide more acceleration and aims to combine multiple LRAs with slightly shifted natural frequencies into one actuator module to extend the bandwidth.

Surgical Site Bacterial Infection in a General Hospital, Al-Jouf Region, Saudi Arabia: A Retrospective Study.

Background Surgical site infection (SSI) is a major healthcare problem with a great impact on patient morbidity, mortality, and healthcare cost all over the world. It accounts for 20% of healthcare-associated infections (HAIs), with higher frequency in low- and middle-income countries where it affects about 30% of the patients undergoing surgery. Aim The current study aims to assess the prevalence of SSI in a general hospital in Sakaka, Al-Jouf region, Saudi Arabia. The types of bacteria causing SSI were also determined. Subjects and methods A retrospective cross-sectional study was done by reviewing the hospital records of patients who got SSI during the period between 2020 and 2022. Data collection was done during 2022 and 2023 after taking ethical approval and permission from the hospital management. Results The numberof patients who underwent surgical procedures during 2020, 2021, and 2022 were 689, 867, and 1119, respectively. Most of the cases were cholecystectomy and appendectomy. The cases that developed surgical site infection after cholecystectomy and/or appendectomy during 2021 and 2022 were 15.45% and 9.29% cases, respectively, and they were mainly associated with appendectomy. A culture and sensitivity test revealed methicillin-resistant Staphylococcus aureus (MRSA)and Klebsiella pneumonia. Nearly all patients have received ciprofloxacin for seven days and improved with treatment. Conclusion The number of cases that developed SSI has decreased gradually due to the application of infection control measures and strict follow-up.

Conceptual and Contextual Analysis of Spirituality in Adolescents with Grounded Theory Approach

This research aims to contribute to understanding the concept of spirituality among individuals of the Z Generation by delineating more specific boundaries within the field of spiritual studies. The connections within the minds of adolescent individuals between the concept of spirituality and the areas of socialization that start in childhood and accelerate during adolescence, within the context of their own cultural codes, have been examined to address the need for understanding. Given the developmental stage that the youth of the 21st century are in, where they construct their own concepts of value, it is noteworthy how they establish cognitive contexts, social interaction areas, and their associations with the concept of spirituality at this critical juncture. The notion of spirituality among young individuals, which is continuously discussed to a certain extent in relevant media and public domains, necessitates opening up to their world, and understanding the spiritual perception needs and expectations of young individuals, from their perspective. This study aims to reveal the perception of spirituality in adolescents, understanding the conceptual, operational, traditional, environmental, and socio-political codes of spirituality within their contexts. In line with this purpose, the behaviors attributed to spirituality by young individuals, the values they inherit as cultural, spiritual heritage, their awareness of the spiritual values of their peer groups, their perspectives on the societal order they live in, the characteristics they emphasize in their self-identifications, the relationship they establish between religion and spirituality, and their perceived levels of religiousness have been investigated. To both trace the connections of the individual and interpret the regions being studied and analyzed, a predictive paradigm was adopted, and a qualitative design was preferred. Ethical committee permission was obtained on 09.03.2023. The research was conducted between 10.04.2023 and 10.05.2023 for data collection. The sample group was composed of students attending formal education in Ankara, from Yenimahalle Tevfik İleri Anatolian Imam Hatip High School, Mamak Hüseyin Gazi Anatolian Imam Hatip High School, and Mamak Volkan Gürbüzalp Anatolian High School. Data were obtained from 36 young individuals aged between 13 and 18, through 11 fully structured open-ended questions. The data were collected using a semi-structured interview form. Following one-on-one interviews, the data obtained were analyzed through thematic coding and grounded theory analysis. As a result of the study, participants' spirituality was shaped around three core categories. When positioning their spirituality, adolescent individuals create relational connections, such as friendships, institutions (religious and national education institutions), social relationships, politics, and structural connections. They develop their concepts of spirituality by drawing on information from family, culture, and religious institutions. Furthermore, in intrinsic experiences, the concept of spirituality shaped through material phenomena, self-state, and connection with the transcendent stands apart from others. Each core category provides a detailed structure of adolescent individuals' spirituality through sub-categories. Contrary to common belief, it was observed that the concept of spirituality among adolescent individuals is similarly nourished as in adults. Additionally, feelings related to individual well-being, material possessions received as gifts, and established family and friendship bonds, were found to be part of adolescents' definitions of spirituality, distinct from a purely religious context. Feelings of individual well-being are defined as their spirituality, independent of religious sentiment. These feelings encompass the sense of belonging felt in established family and friendship bonds, the memory of gifted and cherished items, and the pride of being an individual who displays socially accepted behavior and does what is right when interacting with society. It was found that young individuals express these feelings in the form of spirituality. * This study was started in 2023 under the supervision of Assist. Assoc. Dr. Zehra Erşahin's master's thesis titled "Conceptual and Contextual Analysis of Spirituality

Introducing standard patient-reported measures (PRMs) into routine maternity care: A pre-implementation qualitative study on women’s perspectives in Finland

BackgroundSystematically using standard patient-reported measures (PRMs) in clinical routines is trending. The International Consortium for Health Outcomes Measurement (ICHOM) has developed condition-specific standard sets of patient-centred measures, one of which is the Pregnancy and Childbirth Standard (PCB) set, where standard PRMs are included. There is limited knowledge on the use of ICHOM PCB set-included PRMs (ICHOM-PCB-PRMs) in routine care. This study investigates women’s perspectives on the future implementation of standard ICHOM-PCB-PRMs in routine maternity care in Finland.MethodsSemi-structured interviews were conducted. Pregnant and postpartum women were asked to evaluate each ICHOM-PCB-PRM in several dimensions, e.g., importance and quality of questions, and to provide their views on future implementation in terms of benefits, difficulties, and practices. With the predefined topics and themes, deductive analysis was applied. Ethical committee approval (HUS 220/880/2015) and research permissions were obtained.Results22 women participated. Participants felt that most of the ICHOM-PCB-PRMs were important, relevant, understandable, and appropriately designed, and agreed that some changes in ICHOM-PCB-PRMs were needed, e.g., adding other important measures, changing the wording, and adding open-ended questions. Women would be hesitant to answer questions honestly if follow-up actions were unclear. Most “outcome” measures could be asked repeatedly as maternal health status changes over time, and “experience” measures could be asked separately for different service providers. Disagreements regarding data collection at birth were observed. PRMs were regarded as a way for women to express their thoughts and feelings. Our participants were concerned about the possible consequences of negatively answering the PREMs questions and the availability of follow-up care. Participants expected that they could answer short and easy questions digitally before appointments, and that instructions and follow-up actions based on their answers should be available.ConclusionICHOM-PCB-PRMs could be applicable in Finnish maternity care, but some modifications may be required. Careful consideration is needed regarding how and when PRMs questions are asked for eliciting more accurate and honest answers and minimizing women feeling judged, embarrassed, or offended. Follow-ups should be available according to women’s responses and needs. This study provides insights on the adoption and implementation of standard PRMs in routine maternity care.

On the ethical permissibility of in situ reperfusion in cardiac transplantation after the declaration of circulatory death

Transplant surgeons in the USA have begun performing a novel organ procurement protocol in the setting of circulatory death. Unlike traditional donation after circulatory death (DCD) protocols, in situ normothermic...