Aula invertida para el dominio del idioma Inglés en estudiantes de secundaria de una institución educativa distrito La Victoria – Chiclayo

El presente trabajo de investigación denominado: “Aula Invertida para el dominio del Idioma Ingles en estudiantes de secundaria de una institución educativa distrito La Victoria Chiclayo”; se realizó con el fin de mejorar el dominio del idioma Inglés en los estudiantes de la institución. Se utilizó un enfoque cuantitativo de tipo descriptivo propositivo de diseño no experimental. Se aplicó el test diagnóstico de nivel intermedio debidamente adaptado como instrumento de evaluación para medir si los estudiantes llegaban a dicho nivel. Se trabajó con una muestra de 52 estudiantes de quinto año de secundaria. Los resultados obtenidos nos muestran que los estudiantes presentan dificultades con respecto a la comprensión lectora, pues hubo un 28.8% de preguntas acertadas mientras que un 79.2% fue incorrecto. De otro lado, en la producción escrita un hubo 7.7% de respuestas respondidas acertadamente y un 92.3% de respuestas no respondidas. Los resultados demuestran que los estudiantes no alcanzan el nivel de Inglés esperado según el ministerio de educación. Es por eso que se diseñó el programa denominado “Propuesta didáctica basada en aula invertida para el dominio del idioma Inglés en estudiantes de secundaria de una institución educativa distrito La Victoria – Chiclayo” el cual fomentará el desarrollo de las habilidades comunicativas del inglés como lengua extranjera y la motivación por aprender el idioma

Where Do Medical Students Look for Information? A Study on Scientific Consultation Sources in Peru

"Introduction: Scientific consultation sources is essential in the quality of information during medical training worldwide. The sources of consultation should provide quality information to students who begin with clinical courses; however, it is unknown how and where students seek data in all medical schools in Peru. In this study, we determine the most frequent sources of scientific consultation of medical students at Norbert Wiener University. Materials and methods: We conducted a survey-based observational study in 148 volunteers (mean age 22.1±5.4 years) during 2019. A 21-items questionnaire was divided into three components: demographic data (10 questions), scientific consultation sources (7 questions), and Information search engines (4 questions). Results: Eighty (54.1%) students were between 20-30 years, and 26.8% worked < 20 hours per week. The scientific search sources considered very usefully were scientific articles (75.4%) and specialized books (49.3%), while 33% did not know Medscape. Regarding audiovisual sources, documentaries on the history of medicine and YouTube were considered useful in 41% and 48%, respectively. We found differences in the use of consultation sources (p =0.031), Medscape (p =0.001), documentaries (p=0.009), and YouTube (p=0.022) among medical years. Sixty-three percent considered Wikipedia useful, and 19.3% used PubMed, while Google was the most frequent information search engine, followed of Scielo and Google scholar. We found a correlation between year of students and SciELO (p=0.024) and Google (p=0.024) engine use. Conclusions: Our results suggest that scientific articles, specialized books and audiovisual sources (documentaries and YouTube) were convenient for medical students. In addition, we have found that as students’ progress through the years in medical school, they make less use of rigorous scientific reference sources.

Can living with COVID-19 patients in a hospital increase anxiety levels? A survey-based single-center study in Peru

"Introduction: Anxiety can affect front-line healthcare workers (HCWs) during the COVID-19 pandemic mainly in settings with influencing factors. Living with COVID-19 patients in hospital settings could affect mental health during lockdown. The present study aimed to estimate the anxiety levels of HCWs of the care center for COVID-19 Villa Panamericana during the first outbreak of COVID-19 in Peru. Methods: This is a descriptive and correlational study. Ninety-six HCWs were enrolled in this study (mean age 30±5.6 years). The care center for COVID-19 Villa Panamericana houses COVID-19 patients and HCWs in the same environment. We used the 14-item Hamilton anxiety rating scale questionnaire. Professionals were interviewed directly at the VP-19 rest towers. SPSS V.23 were used to analyze the data. Results: Fifty-four (56.3%) were male and the most frequent age group was 26-35 years (81.3%). Thirty-nine (40.6%) were nurses, 28 (29.2%) were nursing technicians, 15 (15.6%) were physicians, and 14 (14.6%) were medical technologists. Of the total, 66 (68.8%) HCWs had a mild level of anxiety, while 6 (6.3%) had severe anxiety. Medical technologists and nursing technicians had the highest level of severe anxiety (14.3% and 7.1%), while nurses had the highest level of mild anxiety (76.9%). We report that 32 (33.3%) HCWs had COVID-19 while 93.7% had symptoms of anxiety [3(9.4%) mild to moderate, 21(65.6 %) moderate to severe, and 6(18.8%) severe]. We found a significant difference in anxiety levels between HCWs with and without COVID-19 (p=0.001). Conclusions: Levels of moderate and severe anxiety significantly increased in HCWs infected with COVID-19 during their coexistence with COVID-19 patients in the health center that houses both at the same time.

Evaluation of Three Models of Follow-up of Patients with Cervical Cytological Abnormalities in a Peruvian’s Largest Teaching Women’s Hospital

"Introduction: The follow-up of squamous intraepithelial lesions (SIL) allows us to understand their progression and regression, however squamous cell atypia (ASC) can generate confusing follow-up results. We aimed to describe the evolution of ASC and SIL during cyto-histopathological follow-up in a tertiary-care hospital. Materials and methods: we conducted a retrospective study during 2016 in 156 Papanicolaou test (PAP) results under three models: 1) with ≥1 PAP and biopsies, 2) 1 PAP followed by ≥1 biopsy, and 3) ≥1 PAP and a confirmatory biopsy. Progression was defined as ASCUS to low-grade SIL (LSIL) or higher, and LSIL to high-grade SIL (HSIL) or higher; and regression as HSIL to LSIL or lower; and LSIL to ASCUS or lower. Results: In PAP, 57 (36.5%) cases were ASC and in histopathology 56 (39.9%) cases of grade 1 cervical intraepithelial neoplasia. Twenty-nine (18.6%) results were followed: 8 (27.6%), 17 (58.6%), and 4 (13.8%) with models 1, 2, and 3, respectively. The progression of the lesions was reported in ~50% for models 2 and 3. ASCUS was the main cytological finding that indicated biopsies, and for all models, the mean progression and regression time was 4 and 3.1 months, respectively. Conclusions: The follow-up of cytological alterations in three models showed progression of lesions in half of the cases analyzed with a time of four months of evolution; ASCUS was the main finding that indicated histopathological study.

COVID-19 may lower quality of life when infections and deaths increase: A longitudinal study in the Peruvian jungle

"Background: Quality of life (QoL) is a multifactorial concept on the perception of the individual’s wellbeing underpinned by environmental, psychological, and physical factors. Several studies have shown changes in QoL in the COVID-19 pandemic and may be due to increases in mortality rates, however, no study has investigated this among Peruvian jungle dwellers. Here, we have sought to estimate the QoL of individuals before and after the increase in cases and deaths from COVID-19. Methods: A questionnaire-based longitudinal study was conducted in 102 inhabitants (mean 40.75 ± 7.49 years). The Spanish version of the WHOQOL-BREF was used in two stages: April and June. The first stage was accomplished before the first confirmed case of COVID-19, and the second stage was when the daily mortality rate was 3.5% with an incidence of 87%. Results: Sixty (54.8%) participants were women, 67 (61.9%) were >31 years, and 38 (34.5%) and 32 (29.1%) participants had primary and secondary education, respectively. In the first and second stage we obtained an overall mean QoL of 46.65 ± 23.2 and 35 ± 27.7 points, respectively. Individuals had significantly lower QoL in the face of increased deaths in physical (p = 0.001), mental (p = 0.028) and environmental (p = 0.001) health domains, with the latter having the greatest impact (51.84 ± 5.81 vs. 16.66 ± 5.55 points). Conclusion: Quality of life of Peruvian jungle dwellers is reduced during periods of increased mortality and incidence by COVID-19. Preventive strategies aimed at reducing the impact of COVID-19 on the mental health and global wellbeing of individuals living in the Amazon are recommended to Peruvian authorities.

Serum levels of LDH and protein/creatinine index in pregnant women with preeclampsia: A single-center retrospective study

"Introduction: Preeclampsia is the major cause of maternal death in Latin America, which presents with hypertension and proteinuria after 20 weeks of gestation, increasing the levels of inflammatory markers.We aimed to determine the ratio of LDH and protein/creatinine index (PCI) in Peruvian pregnant women with preeclampsia at the Hospital Nacional Docente Madre Niño San Bartolomé in 2017. Materials and methods: we conducted a cross-sectional study in 3415 pregnant preeclamptic women without eclampsia or HELLP syndrome. The kinetic method was used to determine urine creatinine (mg/dl), the turbidimetric method for protein quantification (mg/dl), and the kinetic method for LDH (U/L). Kendall’s Tau-b correlation and non-paired t-test were used. Results: Of the total, 168 (4.9%) had a clinical diagnosis of preeclampsia with a higher frequency in the 25-35 age group (41.7%). We observed 9-fold frequency of multiparous pregnant women (p<0.001). In 121 (72%) pregnant women, LDH was elevated (>414 U/L). The mean LDH was 536±206.7 U/L (range: 264 to 1715 U/L). Seventy-two (42.9%) pregnant women had LDH values between 416-599 U/L, 37 (22%) had LDH values between 600-800 U/L, and 12 (7.1%) had >800 U/L of LDH. Sixty-one percent of pregnant women (n=113) had CPI alterations. We found a correlation between LDH and CPI (p<0.001) and hypertension levels (p<0.05). Conclusions:Ourresults suggest a significant correlation between LDH and CPI in Peruvian pregnant women with preeclampsia allowing the diagnosis of >60% of cases. In addition, all corresponded to the third trimester of gestation, were ≤35 years-old and mostly multiparous.

Six‑sigma and quality planning of TORCH tests in the Peruvian population: a single‑center cross‑sectional study

"Objective: To ensure the health of newborns, it is necessary to perform high-quality diagnostic tests. The TORCH panel is a set of tests that identifes infectious pathogens such as Toxoplasma (Toxo) and Cytomegalovirus (CMV) that are common in low-setting populations. We performed TORCH panel quality planning using six sigma in a reference laboratory at Peru. Results: This was a cross-sectional study. TORCH tests include Toxo, Rubella, CMV, and Herpes. We processed all samples by fourth-generation ELISA on the GEMINI XCR200 analyzer (Diatron, Budapest, Hungary). We obtained the imprecision from the annual data of the external quality assessment plan and we used the CLSI EP12-A3 guideline. In a total of 44,788 analyses, the average imprecision was 3.69±1.47%, and CMV had lower imprecision (2.3 and 2.6% for IgM and IgG, respectively). Quality planning of the TORCH panel allowed estimating the sigma value that ranged from 4 to 10 (average 7±2 sigma), where rubella had the highest values (10 for IgM and 8 for IgG) while HSV2 had the lowest values (4 for IgM and 5 for IgG). Our results suggest the optimal performance of half of the markers including Toxoplasma, Rubella, and CMV in the Peruvian population.

Fungal, parasitological, and bacterial coinfection in a severely ill COVID- 19 patient in Peru

COVID- 19 patients are prone to coinfections during their hospitalization. These coinfections are challenging as they involve longer hospital stays, high costs, and higher risk of mortality. Here, we present a case of a patient with multi- infection by resistant parasites, fungi, and bacteria during his hospitalization in a hospital in Lima, Per

"What is the perception of medical students about eLearning during the COVID-19 pandemic? A multicenter study in Peru"

"Introduction: As face-to-face medical education was restricted during the pandemic; digital tools have been deployed to continue education showing a good educational impact in most countries. However, the perception of medical students in Peru on eLearning has not yet been investigated. This study assessed the perception of 440 medical students from two national universities in Peru on the characteristics and limitations of eLearning during 2021. Materials and methods: We conducted a cross-sectional study using the self-administered survey Encuesta Virtual en Tiempos de COVID-19 (EVI-CV19) on students between the second and sixth medical year of the Universidad Nacional Mayor de San Marcos (UNMSM) and the Universidad Nacional San Luis Gonzaga (UNSLG, n=325). Results: The majority of students were under 30 years of age (93.9% vs. 97.2%, p=0.084), and female (67% vs. 64%, p=0.107). Of the total, 63.9% and 81.5% UNMSM and UNSLG students considered the virtual platform effective in favouring feedback with recorded lectures (85.2% vs. 85.5%) and the organization of documents (61.7% vs. 80.9%), respectively (p>0.05). Seventy per cent and 46.8% of UNMSM and UNSLG students perceived that teachers were nottrained (p=0.063), and 26.1% and17.2% of students perceived thatthe virtual modality affected their academic performance a lot, respectively (p=0.003). About 38% of students from both universities perceived the virtual platforms as very secure. We found differences between UNMSM and UNSLG students on whether the virtual exams were fair (28.7% vs. 52.3%, p<0.001). Conclusions: This study reported a favorable perception of medical eLearning with clear differences in the limitations of the virtual environment.

Changes in high-density lipoprotein (HDL), low-density lipoprotein (LDL) and cholesterol concentration in heavy cannabis users: A single-centre study in Cusco, Peru

Background: The effect of cannabis on cholesterol and lipid balance has been reported for decades. However, there are conflicting reports on the reduction of low-density lipoprotein (LDL-C) and total cholesterol. The purpose of this study was to determine the immediate changes of Cannabis spp. consumption by pyrolytic route in heavy users. Methods: A cross-sectional study on 20 Peruvian heavy cannabis users (mean age: 31 ± 9.5 years). The inclusion criteria were males with an average weight of 50–70 kg, normal BMI, and having used cannabis, without association with other drugs, for at least one year with a high frequency per week (use: 4–7 days/week). High-density lipoprotein (HDL-C), LDL-C, and total cholesterol were evaluated 30 and 120 min after the administration of Cannabis spp. (~0.2 g by inhalation). Results: Of the total 12 (60%), 10 (50%), and 11 (55%) had desirable total cholesterol, fairly good HDL-C (40–60 mg/dL) and fairly good LDL-C (100–129 mg/dL) values, respectively. The mean basal concentration of total cholesterol, HDL-cholesterol, and LDL-cholesterol was 193.37 ± 20.18 mg/dL, 60.05 ± 6.36 mg/dL, and 129.65 ± 14.50 mg/dL, respectively. HDL-cholesterol showed progressive increases in participants with desirable HDL-C > 60 mg/dL at 30 min (10 vs. 14 participants, p < 0.001) and at 120 min (10 vs. 16 participants, p < 0.001), while LDL-C peaked in participants with concentrations < 100 mg/dL at 30 min (desirable cholesterol: 0 vs. 2, p = 0.001). HDL-C concentration showed differences after cannabis consumption, showing increases at 30 (63.25 ± 7.68 mg/dL) and 120 min (69.15 ± 18.67 mg/dL) and total cholesterol concentration changed to 180.95 ± 19.3 mg/dL (95%CI 172.5 to 189.4) at 120 min (p = 0.007). Conclusions: HDL-C cholesterol increased 30 and 120 min after Cannabis spp. ingestion, while LDL-C and total cholesterol showed partial reductions in heavy-users from Cusco, PeruCampus Lima Centr