Beneficial effects of childhood selective dorsal rhizotomy in adulthood

Background: Selective dorsal rhizotomy (SDR) has been used to treat children with spastic cerebral palsy (CP) for over three decades. However, little is known about the outcomes of childhood SDR in adults.  Objectives: 1) To study the effects of childhood SDR on the quality of life and ambulatory function in adult life. 2) To determine late side effects of SDR in adults.   Methods: Adults (> 17.9 years) who underwent SDR in childhood (2 - 17.9 years) between 1987 and 2013 were surveyed in 2015. Patients completed a survey, including questions on demographic information, quality of life, health, surgical outcomes, motor function, manual ability, pain, braces/orthotics, post-SDR treatment, living situation, education level, work status, and side effects of SDR.  Results: In our study population of 294 patients (18.0 - 37.4 years), patients received SDR during the ages of 2.0 - 17.9 years and were followed up 2.2 to 28.3 years after surgery. Eighty-four percent had spastic diplegia, 12% had spastic quadriplegia, and 4% had spastic triplegia. The majority (88%) of patients reported improved post-SDR quality of life and 1% considered the surgery detrimental. Most (83%) would recommend the procedure to others and 3% would not. However, patients who would not recommend SDR to others ambulated with a walker or were not ambulatory at all prior to SDR. The majority (83%) of patients improved (30%) or remained stable (53%) in ambulation. Twenty-nine percent of patients reported pain, mostly in the back and lower limbs, with a mean pain level of 4.4 ± 2.4 on the Numeric Pain Rating Scale (NPRS). Decreased sensation in small areas of the lower limbs was reported by 8% of patients, though this did not affect daily life. Scoliosis was diagnosed in 28%, with 40% of these patients pursuing treatment. Whether scoliosis was related to SDR is not clear, though scoliosis is known to occur in patients with CP and also in the general population. Only 4% of patients underwent spinal fusion.  Orthopedic surgeries were pursued by 59% of patients. The most common orthopedic surgeries were hamstring lengthenings (31%), Achilles tendon lengthenings (18%), adductor lengthenings (16%), and derotational osteotomies (16%). Twenty-four percent of all patients later underwent hip surgery and 8% had surgeries on their knees.  Conclusion: Results of this study indicate that the beneficial effects of childhood SDR extend to adulthood quality of life and ambulatory function without late side effects of surgery

An Assessment Of The Relationship Between Primary Health Care Services And Socio-Economic Development In Bauchi Metropolis

Healthcare services encompasses the wide range of services aimed at maintaining, restoring, or promoting someone’s physical, mental, or emotional well-being, especially when performed by trained healthcare professionals. This paper was aimed at finding the relationship between the provision of healthcare services and socio-economic development in Bauchi metropolis. This paper relied solely on secondary data as its source of information. The paper identified some of the challenges bedeviling the healthcare services with the aim to find out lasting solutions to the problems identified. This paper however, recommend that, a total reshufflements on the health sector, more funding to the healthcare sector, and recruitment of more employees in to the healthcare sector.  &nbsp

Observation on analgesic efficacy and adverse effects of intrathecal administration of bupivacaine versus bupivacaine-midazolam combination in lower limb surgeries in a tertiary care hospital

Background: Postoperative pain relief can improve functionality, reduce physiological and emotional morbidity and improve quality of life. Neuraxial blocks not only reduce the incidence of venous thrombosis, pulmonary embolism, cardiac complications, bleeding transfusion requirements and respiratory depressions but also provide effective postoperative analgesia. One of the methods of providing postoperative is to prolong the duration of intrathecally administered bupivacaine by using additives such as opioids such as midazolam, clonidine and ketamine. Intrathecal administration of midazolam induces antinociceptive effects in humans. The present study was undertaken to evaluate the additive analgesic effects of intrathecal midazolam in combination with bupivacaine in lower limb surgeries in a tertiary care hospital and to compare the results with the use of bupivacaine alone. The aim of this study was to observe and compare the quality of spinal anaesthesia and occurrence of side effects in thirty cases administered with bupivacaine and thirty cases administered with bupivacaine-midazolam combination.Methods: Sixty cases admitted for lower limb surgery were divided into equal groups I and II. Cases in group I received intrathecal bupivacaine while those in group II received intrathecal combination of bupivacaine and midazolam. Data regarding quality of anesthesia and side effects were recorded and compared.Results: There was a significantly higher duration of a pain-free period in cases administered with intrathecal combination of bupivacaine and midazolam.Conclusions: Addition of preservative free midazolam to 0.5% hyperbaric bupivacaine for subarachnoid block prolongs the duration of effective analgesia as compared to bupivacaine alone. The utilization of intrathecal midazolam also decreases the incidence of postoperative nausea-vomiting.

Estudios bibliométricos en tiempos de pandemia

Bibliometric studies in times of pandemi

Exploring Grade 9 Students\u27 Perspectives on Game-Based Learning in Social Studies

This study investigates the perceptions of Grade 9 students at General de Jesus College towards game-based learning in the context of Social Studies Education. A quantitative research design was employed, utilizing a total population sampling technique that encompassed all 271 Grade 9 students of General de Jesus College for the academic year 2023-2024. The findings of this study reveal that students strongly agree that enforcing game-based learning is highly effective in increasing their engagement with the material, maintaining their concentration, and enhancing their overall interest in studying Social Studies. This suggests that incorporating game-based activities into the curriculum could be a valuable strategy for educators aiming to improve student participation and learning outcomes in this subject. The data gathered implies that this educational game approach through game-based learning has been significantly beneficial to students in studying the subject matter. Additionally, this study also suggested that educators, especially Social Studies teachers need often to utilize game-based activities such as quizzes and puzzle games to cater to students’ learning. After a thorough investigation, the study concluded that incorporating game-based learning inside the classroom significantly enhances students\u27 engagement, retains their concentration, and increases their interest in learning Social Studies

An investigation of factors affecting compassion levels of midwives

INTRODUCTION The profession of midwifery is seen as a genuinely individual-centric catalyst transforming compassion to care. Due to this, compassionate care should be the basis of midwives’ care, especially for those who care for women and children. This research investigated the compassion levels of midwives to determine the factors affecting them. METHODS This descriptive research was conducted between 10 February and 29 May 2020, with 119 midwives working in a training and research hospital in Istanbul. The data were collected using the ‘Compassion Scale’ and analyzed using the Mann-Whitney U test, Kruskal-Wallis test and logistic regression model. RESULTS The total mean score on the compassion scale of midwives participating in the study was found to be 71.46 ± 9.60. Sociodemographic data and vocational belongings of participants were compared with the mean scores of the compassion scale subdimensions. It was determined that as the age of the midwives increased, they showed more kindness and awareness of compassion (p<0.021, p<0.023, respectively). It has been determined that as the education level of midwives decreases, their compassion level also decreases and they become more insensitive (p<0.044). It was found that being married increased the kindness (p<0.023) and common humanity characteristics (p<0.032) that affect compassion. It was found that the levels of kindness (p<0.020) and awareness (p<0.048) increased for those who had children, and compassion was associated with having a child. In addition, a statistically significant relationship was found between the professional commitment and kindness of the midwives participating in the study (p<0.034). It was found that midwives’ knowledge of rules related to professional ethics increased their compassion scale scores by 1.2. CONCLUSIONS Midwifery is a profession with a high sense of spirituality. However, professional belonging, love of the profession and professional development positively affect midwives’ levels of compassion. Improving midwives’ feelings of belonging and their professional development will also contribute to the quality of maternal and infant health

Frequency of drug interactions and associated factors in the Internal Medicine Hospitalization Services of the Cayetano Heredia Hospital in July 2023

Introducción: Las interacciones medicamentos son efectos no deseables que se presentan durante la prescripción médica. Diversos estudios ponen en manifiesto las posibles interacciones medicamentosas que se suscitan con la polifarmacia. El objetivo del estudio es determinar la frecuencia de interacciones medicamentosas y factores asociados en pacientes hospitalizados en los servicios de Medicina Interna del Hospital Cayetano Heredia, en julio 2023. Materiales y métodos: El estudio será de tipo observacional, descriptivo y retrospectivo, la población estará conformada por 2480 hojas de terapéuticas en el mes de Julio de los pacientes hospitalizados en el Servicio de Medicina Interna, se utilizará un muestreo probabilístico aleatorio. Los datos serán analizados con la herramienta de “Drug interaction checker” del Medscape para determinar la posible interacción medicamentosa en los pacientes hospitalizados. Resultados esperados: se espera encontrar que haya más del 60% de las posibles interacciones medicamentosas como lo expresan los diferentes antecedentes

UID as a Guiding Metric for Automated Authorship Obfuscation

Protecting the anonymity of authors has become a difficult task given the rise of automated authorship attributors. These attributors are capable of attributing the author of a text amongst a pool of authors with great accuracy. In order to counter the rise of these automated attributors, there has also been a rise of automated obfuscators. These obfuscators are capable of taking some text, perturbing the text in some manner, and, if successful, deceive an automated attributor in misattributing the wrong author. We devised three novel authorship obfuscation methods that utilized a Psycho-linguistic theory known as Uniform Information Density (UID) theory. This theory states that humans evenly distribute information amongst speech or text so as to maximize efficiency. Utilizing this theory in our three obfuscation methods, we attempted to see how successfully we could deceive two separate attributors. Obfuscating 50 human and 50 GPT-3 generated articles from the TuringBench dataset, we observed how well each method did on deceiving the attributors. While the quality of the obfuscation in terms of semantic preservation and sensical changes was high, we were not able to find any evidence to indicate UID was a viable guiding metric for obfuscation. However, due to restrictions in time we were unable to test a large enough sample of article or tune the parameters for our attributors to comment conclusively on UID in obfuscation.Comment: 20 pages, 10 figure