Doença falciforme: cuidado com pessoas com úlcera da perna nos serviços de atenção à saúde / Sickle cell disease: caring for people with leg ulcers in heal-thcare services / Enfermedad falciforme: cuidado de personas con úlcera de pierna en los servicios de atención a la salud

Objetivo: identificar o local e os cuidados diretos recebidos por pessoas com úlceras da perna por doença falciforme nos serviços de atenção à saúde. Método: estudo transversal, realizado em 11 centros, no período de agosto de 2019 a abril de 2020. Fizeram parte do estudo 72 pessoas com úlcera da perna ativa. O estudo foi aprovado pelo Comitê de Ética em Pesquisa. Resultado: apresentavam anemia falciforme 91,7% dos participantes, com mediana de três anos de existência da úlcera; 77,8% eram redicivantes; 40,3% compravam os insumos; 66,7% trocavam o próprio curativo no domicílio; 52,8% realizavam uma ou mais trocas diárias; 45,8% dos tratamentos foram prescritos pelo médico; 37,5% eram pomada (colagenase ou antibiótico); 89% não utilizavam compressão para o manejo do edema. Conclusão: a maioria dos participantes não estava inserida na Rede de Atenção à Saúde para o tratamento da úlcera, e não recebia assistência sistematizada e nem insumos apropriados.

Objective: to identify the location and direct care received by people with leg ulcers due to sickle cell disease in health care services. Method: a cross-sectional study carried out in 11 centers from August 2019 to April 2020. The study included 72 people with active leg ulcers. The study was approved by the Research Ethics Committee. Results: a total of 91.7% of the participants had sickle cell anemia, with a median of three years of ulcer existence; 77.8% were recurrent; 40.3% bought the supplies; 66.7% changed their own dressings at home; 52.8% did one or more changes a day; 45.8% of the treatments were prescribed by physician; 37.5% were ointments (collagenase or antibiotics); and 89% did not use compression to manage edema. Conclusion: most of the participants were not included in the Health Care Network for ulcer treatment and did not receive systematized care or appropriate supplies.

Objetivo: identificar el lugar y los cuidados directos recibidos por personas con úlceras de pierna por enfermedad falciforme en los servicios de atención a la salud. Método: estudio transversal, realizado en 11 centros, en el período de agosto de 2019 a abril de 2020. Participaron 72 personas con úlcera de pierna activa. El estudio fue aprobado por el Comité de Ética en Investigación. Resultado: presentaban anemia falciforme 91,7% de los participantes, con una mediana de tres años de existencia de la úlcera; 77,8% eran recidivantes; 40,3% compraban los insumos; 66,7% cambiaban su propio vendaje en el domicilio; 52,8% realizaban uno o más cambios diarios; 45,8% de los tratamientos fueron prescritos por el médico; 37,5% eran pomada (colagenasa o antibiótico); y 89% no utilizaban compresión para el manejo del edema. Conclusión: la mayoría de los participantes no estaba integrada en la Red de Atención a la Salud para el tratamiento de la úlcera, y no recibía asistencia sistematizada ni insumos apropiados.

La Pregunta de Investigación y su Asociación con los Niveles de Evidencia y Grados de Recomendación en Estudios de Investigación Clínica / The Research Question and its Association with the Levels of Evidence and Grades of Recommendation in Clinical Research Studies

La mayoría de las preguntas de investigación (PI), conducirán a un proyecto que apunta a generar nuevo conocimiento, sin embargo el escenario, la población a estudio y la metodología pueden ser muy diferentes, lo que determinará que los resultados obtenidos y por ende, el nivel de evidencia (NE) y el grado de recomendación (GR) puedan variar notablemente. El objetivo de este artículo fue proporcionar recomendaciones para formular una PI asociada al NE y respectivos GR que se pueden desprender a partir de los resultados generados. Este artículo entregará algunos conocimientos sobre la PI y su relación con los NE y GR de la evidencia generada a partir de resultados obtenidos por un proceso de investigación en diferentes escenarios de investigación.

SUMMARY: Most research questions (RQ) will lead to a project that aims to generate new knowledge. However, the setting, study population and methodology may be very different, which will determine the results obtained and therefore, the level of evidence (LOE) and the grade of recommendation (GOR) may vary significantly. The aim of this study was to provide recommendations to formulate a RQ associated with the LOE and respective GOR that can be derived from the generated results. This article will provide some knowledge about the RQ and its relationship with the LEO and GOR of the generated evidence from results obtained by a research process in different research scenarios.

Medical hypnosis on depression and interleukin-6 levels in lung cancer patients

Background: Lung cancer patients are at high risk for depression, which is associated with poor treatment adherence. Medical hypnosis can improve symptoms of depression and affect interleukin-6 levels. This study aims to determine the effectiveness of medical hypnosis in improving depression and reducing IL-6 levels in lung cancer patients. Methods: This study is a quasi-experimental study with a pretest and post-test control group design. It assessed depressive symptoms using BDI-II scores and serum IL-6 levels in an intervention group receiving medical hypnosis and standard therapy compared to a control group receiving standard therapy. Data analysis was conducted using univariate tests, followed by Pearson correlation tests and effect size measurement with Cohen's d test. Results: The Wilcoxon test showed a decrease in IL-6 levels in the intervention group by 14.66�.45 (p=0.008) and a reduction in BDI-II scores by 8.26�78 (p=0.001). Correlation tests indicated a significant relationship between IL-6 levels and BDI-II scores (r=0.472; p=0.009). Cohen's d test showed the effect size of medical hypnosis on IL-6 levels was 0.754 (moderate=0.5<ES<0.8). Conclusions: Medical hypnosis is effective in improving depressive symptoms and reducing IL-6 levels in lung cancer patients.

Self-management practices among children and adolescents presenting with type 1 diabetes attending selected health facilities in Nairobi city county

Background: Diabetes is a high prevalence non-communicable disease (NCD), with its highest burden in low- and middle-income countries. The International Diabetes Federation estimates that the global prevalence of diabetes is approximately 537 million people. By 2030, this figure is expected to rise to nearly 643 million, and by 2045, it is projected to reach 783 million. In sub-Saharan Africa, an estimated 24 million adults have diabetes, with a regional prevalence of 4.5%. Children with diabetes in this region often remain undiagnosed, and even if diagnosed, many lack access to essential services and resources such as insulin, syringes, and monitoring equipment, leading to avoidable deaths. Methods: The study design was a descriptive cross-sectional study. The study was conducted between September 2021 and September 2022 among children and adolescents with type 1 diabetes who attended selected facilities in Nairobi City County, Kenya. Qualitative and quantitative data were obtained using a self-administered semi-structured questionnaire, focus group discussions, and key informant interviews with the participants. The data was cleaned and then exported to SPSS V.23 for analysis. Results: The study investigated the demographic and socio-economic profiles of children and adolescents with type 1 diabetes in the study area, their level of knowledge regarding self-management practices, the self-management practices carried out by these respondents and explored the relationship between demographic and socio-economic factors, knowledge levels, and self-management practices among children and adolescents with T1D. Conclusions: The study findings will be of great importance for health professionals and policymakers in designing appropriate interventions to improve self-management practices among children with T1D.

Comparative analysis of stress levels and quality of life among medical students in Southern Asia and South Caucasus

Background: Medicine is a challenging study and is known for its demanding nature. This also results in increased stress levels among students. Understanding factors that influence stress and quality of life from medical students in different regions is important for the development of effective interventions and support systems. Methods: A meticulous quantitative method approach has been utilized. This research is done via data fetched through a questionnaire. Statistical analyses are comprised of t-tests and correlation tests to employ a dissection of quantitative data while the data is subjected to analysis to uncover the underlying patterns and nuances. These results showcase crucial disparities in the stress levels between medical students in Southern Asia and the South Caucasus while imparting light on factors impacting the quality of life experienced by students in both regions. Results: The implications of this study hold primary significance for sharing information with targeted interventions with an aim at bolstering the mental health and academic performance of medical students in both the areas of Southern Asia and the South Caucasus. Conclusions: The major objective of this study is to hold comparisons of stress levels and quality aspects of life in Southern Asia and South Caucasus, with the identification of the multifaceted factors that contribute to the stress levels among students in both regions, understanding the various challenges and sharing a glimpse of actionable implications for interventions which are aimed at bolstering students’ well-being.

Algunas reflexiones sobre la atención de enfermería para la prevención terciaria de complicaciones asociadas al puerperio / Some Some reflections on nursing care for the tertiary prevention of complications associated with postpartum

La prevención incluye medidas destinadas no solo a prevenir la aparición de la enfermedad, sino también a detener su avance y atenuar las posibles consecuencias una vez diagnosticada. El modelo clásico de Leavell y Clark constituye una estrategia de prevención, que en ocasiones se usa en función de los niveles de atención médica y su complejidad; aspecto que trae confusión. En tal sentido, en el presente artículo se pretende reflexionar sobre los principales elementos a tener en cuenta en la prevención terciaria, que es la que se aplica en las unidades de cuidados intensivos, dadas las interrogantes que genera el tema.

Prevention includes measures not only dedicated to prevent the emergence of the disease, but also to stop its advance and attenuate the possible consequences once it is established. The classic pattern of Leavell and Clark constitutes a prevention strategy that is sometimes used associated with the medical care levels and its complexity; aspect that brings confusion. In such a sense, this work aims at reflecting on the main elements to take into account in the tertiary prevention that is implemented in the intensive care units, given the questions that the topic generates.

Serum placental growth factor levels and uterine artery pulsatility index at 11-13+6 weeks gestation as early predictors of pre-eclampsia: prospective observational study

Background: To detect serum placental growth factor levels and uterine artery doppler pulsatility index for predicting pre-eclampsia and assess their association with the severity of pre-eclampsia.Methods: A prospective observational study involving 160 antenatal women, from 11-13+6 weeks gestation attending antenatal clinic at tertiary care center during study period of 18 months. Serum placental growth factor levels and uterine artery doppler mean pulsatility index measured and patients were followed upto delivery and observed for the development of pre-eclampsia and its severity.Results: Placental growth factor value cut-off was 40.33pg/ml with the sensitivity of 97.5 % and specificity was 98.3%. For the pulsatility index value of 1.85, the sensitivity was found to be 74.4% and specificity was found to be 92.5%. Mean serum placental growth factor levels for pre-eclampsia patients was 25.09pg/ml and for normotensive patients mean level was 65.05pg/ml. Mean uterine artery doppler pulsatlity index for pre-eclampsia patients was 2.02 and for normotensive patients was 1.39. Mean PI value increased with increasing severity of preeclampsia.Conclusions: Early recognition of women will help initiation of prophylactic measures and enhanced surveillance. First trimester uterine artery doppler with serum placental growth factor together with maternal characteristics can be used as a reliable screening test for preeclampsia prediction and to reduce feto-maternal morbidity.

LDL levels and ejection fraction in ischemic stroke patients: a hospital based cross-sectional study

Background: Ischemic stroke is a top contributor to mortality amongst non-infectious diseases. Atherosclerosis is a major risk factor. This study aims to assess LDL levels and ejection fraction in ischemic stroke patients. Methods: This descriptive cross-sectional study was conducted in Government Thoothukudi Medical College from November, 2022 to April, 2023. 35 patients admitted in the neuromedicine ward and diagnosed as acute ischemic stroke were included in the study after informed consent and ethical clearance. Patients with acute neurological deficit and evidence of infarct on diffusion-weighted MRI were included. Patients with no evidence of infarct on DWI, those already on lipid lowering therapy, patients with a history of cerebrovascular disease or transient ischemic attacks were excluded. Blood for lipid profile taken after 8 hours of overnight fasting. Echocardiography done for all patients. Results: Of the 35 patients, 26 (74.28%) were men, mean age was 62.4. 57.14% ischemic stroke patients had their LDL levels elevated, 28.57% had decreased HDL, 28.57% had total cholesterol levels elevated, and in 14.28% triglycerides was elevated. This study also observed the cardiac status of the patients which showed 29% patients had decreased ejection fraction. Conclusions: This study concluded that most patients had elevated LDL levels which is an independent risk factor of ischemic cerebrovascular disease. LDL levels were also associated with decreased ejection fraction in a significant number of patients. Thereby it can be concluded that elevated LDL cholesterol levels can add to the cardiac risk, potentially contributing to stroke morbidity and mortality.

Relationship of IL-6 and IL-8 levels with tubal ectopic pregnancy

Background: The frequency of ectopic pregnancy (EP) has increased worldwide during the last 30 years, particularly in underdeveloped countries with low early diagnostic rates. Ectopic pregnancy is the major cause of first-trimester deaths. Interleukins are immunomodulatory cytokines that modulate inflammatory responses and help humans conceive. Aim of the study was to evaluate the predictive value of interleukin-6 and interleukin-8 in tubal ectopic pregnancy.Methods: This case control research was undertaken in the Department of Obstetrics and Gynaecology at Al-Emamein Al-Kadhemein Medical City/Baghdad from January 1, 2022 to January 1, 2023. The study analysed 30 patients with missed cycles, positive ?-HCG tests, vaginal bleeding, and ruptured tubal ectopic pregnancy diagnosed via transvaginal ultrasound (group A) and 30 patients with intrauterine missed miscarriage (group B). The control group (group C) included 30 ladies with uncomplicated intrauterine pregnancies of matched gestational age.Results: Interleukin-6 was substantially greater in ectopic pregnancy than miscarriage and normal intrauterine pregnancy. Ectopic pregnancy and miscarriage had higher levels of interleukin-8 than normal intrauterine pregnancy, but there was no difference. Interleukin-6 levels ?76.1 pg/ml were linked to 90% sensitivity and 85% specificity in predicting ectopic pregnancy. Interleukin-8 was neither sensitive nor specific for ectopic pregnancy.Conclusions: Measurement of IL-6 may have a predictive value in cases of ruptured tubal ectopic pregnancy. IL-8 was a poor predictor for ectopic pregnancy.

Monitoring and risk assessment of total α and β radioactivity levels in drinking water in the nine districts of metropolitan Chongqing in 2019-2021 / 公共卫生与预防医学

Objective To investigate the radioactivity levels of total α and total β in drinking water in nine districts of Chongqing City from 2019 to 2021, and to provide reference for the risk monitoring of drinking water in the metropolitan areas of Chongqing. Methods The total α and total β radioactivity levels in water samples were determined by the comparative measurement method and the thin source deposit method in GB/T5750.13-2006 “Standard Examination Methods for Drinking Water-Radiological Parameters”. The monitoring results were assessed according to GB5749-2006 “Standards for Drinking Water Quality” and the fourth edition of the WHO Guidelines for Drinking Water Quality. Results From 2019 to 2021, the total α activity concentration of the water samples measured in the nine districts of metropolitan Chongqing ranged from 0.002 to 0.039 Bq /L, and the total β activity concentration ranged from 0.015 to 0.190 Bq /L. There was no significant difference in the activity concentration (tα=0.545, Pα=0.591; tβ=-1.438, Pβ=0.163>0.05). From 2019 to 2021, the average value of total α radioactivity decreased year by year and its activity value was relatively low, indicating a low health risk. However, the average value of total β radioactivity increased year by year, which should be paid attention to. Conclusion The total α and total β radioactivity in water samples measured in the present study are lower than the standard recommended limits. The estimated annual average effective dose of radiation caused by drinking water is 0.005-0.010 mSv, which is lower than the limit of 0.1 mSv recommended by WHO, and this radioactivity level will not have an impact on the health of residents. However, the total β radioactivity level of the monitoring points in Banan and Shapingba is relatively high compared to other jurisdictions, and further tracking and monitoring should be carried out.

Glucocorticoid hypersensitivity syndrome: A case report and review of literature / 中华内分泌代谢杂志

This article reports a patient with typical Cushing syndrome′s manifestations and extremely low plasma cortisol level, indicating glucocorticoid hypersensitivity syndrome. After treatment with the glucocorticoid receptor antagonist mifepristone, the patient′s Cushing symptoms were significantly relieved, and cortisol levels returned to normal. The aim of this report is to enhance clinical awareness among physicians regarding glucocorticoid hypersensitivity syndrome.

Anemia-related subjective symptoms in the general adult population in Japan / Journal of Rural Medicine

Objectives: Approximately 17% of Japanese women have hemoglobin concentrations less than 12 g/dL. Therefore, anemia prevention and early intervention are crucial public health issues in Japan. This study aimed to identify the symptoms and characteristics of anemic individuals in the general adult population by comparing survey responses of individuals with anemia and without anemia visiting blood donation centers.Materials and Methods: This cross-sectional study used self-administered questionnaires. Individuals who visited two Japanese Red Cross Society blood donation centers in Fukushima Prefecture, Japan were included. Hemoglobin levels were measured at blood donation, and the levels of 13 g/dL for men and 12 g/dL for women were defined as anemia.Results: Of the 857 individuals analyzed, 530 were men and 327 were women, of whom 19 (3.6%) and 12 (3.7%) had low hemoglobin levels, respectively. Logistic regression analysis was performed in men, and the results showed that “lightheadedness” (odds ratio [OR]=8.4) and “depressive symptoms” (OR=3.6) were significantly associated with hemoglobin levels. None of the evaluated items were significantly associated with hemoglobin levels in women.Conclusion: Among healthy Japanese men, those who exhibit lightheadedness and depressive symptoms have an increased risk of anemia. Lightheadedness and depressive symptoms may be indicative of undiagnosed anemia in men, which necessitates greater clinical attention.

Effect of brachial plexus block on stress response in patients undergoing shoulder arthroscopic surgery / 局解手术学杂志

Objective To investigate the effect of brachial plexus block on stress response in patients who underwent shoulder arthroscopic surgery.Methods A total of 150 patients with shoulder arthritis who underwent shoulder arthroscopic surgery in the Shanghai Fifth People's Hospital,Fudan University from December 2021 to December 2022 were selected as the study subjects.All patients were divided into the control group and the observation group by random number table method,with 75 cases in each group.Patients in the control group were given general anesthesia,while patients in the observation group were given brachial plexus block on the basis of the control group.The mean arterial pressure(MAP),heart rate(HR),norepinephrine(NE),cortisol(Cor)before operation(T0),10 minutes after operation(T1),30 minutes after operation(T2),at the end of operation(T3)and 30 minutes after extubation(T4)of the two groups were compared.The transforming growth factor-β1(TGF-β1),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)before and 3 days after operation of the two groups were compared.The visual analogue scale(VAS)scores at postoperative wakefulness and 6,12 and 24 hours after operation of the two groups were compared.Results Compared with T0,the levels of MAP and HR at T1,T2,T3,and T4 in the observation group and the control group were obviously decreased(P<0.01),the levels of NE and Cor were obviously increased(P<0.01),while the levels of MAP,HR,NE,and Cor at T1,T2,T3,and T4 in the observation group were obviously lower than those in the control group(P<0.01).The levels of TGF-β1,TNF-α,and CRP 3 days after operation in the observation group and the control group were obviously increased compared with those before operation (P<0. 01), and the above indicators after operation in the observation group were obviously lower than those in the control group (P<0. 01). The VAS scores at postoperative wakefulness and 6, 12 and 24 hours after operation in the observation group were obviously lower than those in the control group (P<0. 01). Conclusion Ultrasound-guided brachial plexus block by interscalene approach can ensure the stability of the vital signs of patients with shoulder arthritis during shoulder arthroscopic surgery, alleviate pain, reduce stress, and reduce inflammatory response.

Correlation between low bilirubin levels and hyperthyroidism in patients with type 2 diabetes mellitus / 中国糖尿病杂志

Objective To explore the relationship between low bilirubin(T-BIL)levels and hyper-thyroidism in patients with type 2 diabetes mellitus(T2DM).Methods A total of 186 patients with T2DM admitted to the Endocrinology Department of our hospital were enrolled in this study from January 2019 to August 2022.They were divided into simple T2DM group(n=107)and hyperthyroidism group(HT,n=79)according to whether they were complicated with hyperthyroidism.The influence factors for T2DM patients complicated with hyperthyroidism were evaluated by logistic regression analysis.Results Compared with T2DM group,DM duration,FPG,the proportion of patients with salty taste and nervous increased in HT group(P<0.05),while BMI,T-BIL decreased in HT group(P<0.05).Pearson correlation analysis showed that T-BIL was positively correlated with TSH levels(P<0.05),and negatively correlated with TT3,TT4,FT3 and FT4(P<0.05).Logistic regression analysis showed that DM duration,salty taste,FPG and T-BIL were the influencing factors of T2DM patients with hyperthyroidism.The receiver operating characteristic(ROC)Curve showed that the AUC of the model was 0.812(95%CI 0.748～0.839),with sensitivity and specificity 87.4%and 82.6%respectively.Conclusion T-BIL was significantly correlated with TSH and FT3.Low T-BIL level is an independent risk factor for T2DM patients with hyperthyroidism,which is of great significance for predicting whether T2DM patients complicated with hyperthyroidism.

Evaluación de la cultura organizacional en centros públicos de salud de distinta complejidad en Chile / Avaliação da cultura organizacional em centros de saúde pública de diferente complexidade no Chile / Evaluation of the organizational culture in public health centers of different complexity in Chile

Resumen El artículo analiza la cultura organizacional en instituciones públicas de salud en Chile, estableciendo su relación con el nivel de complejidad y cobertura que presentan, utilizando la escala de cultura organizacional de Denison, aplicada en una muestra de 156 funcionarios de cuatro instituciones. Así, la institución con menor nivel de complejidad y cobertura mostró mayores niveles culturales en todas las dimensiones: implicación, consistencia, adaptabilidad y misión; así como en las perspectivas de flexibilidad/estabilidad y focos interno/externo. Alternativamente, las instituciones con mayor grado de cobertura, pero con distinto nivel de complejidad, no muestran diferencias a nivel cultura. Los resultados dan cuenta de la relación entre las características funcionales asociadas a la complejidad de las organizaciones de salud y sus rasgos culturales, demostrando diferencias particulares según el nivel de cobertura o intensidad de la demanda por las prestaciones que entregan, así como en las perspectivas de flexibilidad y estabilidad según el modelo de Denison.

Resumo O artigo analisa a cultura organizacional nas instituições de saúde pública no Chile, estabelecendo sua relação com o nível de complexidade e cobertura que apresentam, utilizando a escala de cultura organizacional de Denison, aplicada a uma amostra de 156 funcionários de quatro instituições. Assim, a instituição com menor nível de complexidade e cobertura apresentou níveis culturais mais elevados em todas as dimensões: envolvimento, consistência, adaptabilidade e missão; bem como nas perspectivas de flexibilidade/estabilidade e enfoques internos/externos. Alternativamente, as instituições com maior grau de cobertura, mas com um nível de complexidade diferente, não apresentam diferenças a nível cultural. Os resultados mostram a relação entre as características funcionais associadas à complexidade das organizações de saúde e as suas características culturais, demonstrando diferenças particulares consoante o nível de cobertura ou intensidade de procura dos serviços que prestam, bem como nas perspectivas de flexibilidade e estabilidade segundo o modelo de Denison.

Abstract The article analyzes the organizational culture in public health institutions in Chile, establishing the relationship between the organizations' cultures and their level of complexity and coverage using the Denison Organizational Culture Scale. The scale was applied to a sample of 156 workers from four institutions. The results reveal that institutions with low complexity and coverage showed higher cultural levels in all dimensions: involvement, consistency, adaptability and mission; as well as in the perspectives of flexibility/stability and internal/external focus. Alternatively, responses from workers in institutions with high coverage but different complexity did not show significant differences regarding their understanding of the organizational culture. In addition, the findings highlight the relationship between the functional characteristics associated with the complexity of health organizations and their cultural features, evidencing particular differences according to the level of coverage or intensity of demand for the services they provide, as well as perspectives of flexibility and stability according to the Denison model.

Geografías de prescripción y consumo de antidepresivos en servicios de salud pública de Montevideo (Uruguay) / Geographies of prescription and consumption of antidepressants in public health services in Montevideo (Uruguay)

El uso de antidepresivos está ampliamente extendido a nivel mundial y junto con las benzodiacepinas son los psicofármacos más prescritos. Son utilizados en un amplio rango de condiciones clínicas, observándose un aumento en su prescripción y consumo a nivel internacional, regional y nacional. En ese sentido, el enfoque que considera el espacio geográfico como dimensión activa en dicha problemática es de incipiente desarrollo. En el presente estudio y a partir de un diseño mixto se analizaron las dimensiones sociotécnicas que generaron geografías de prescripción y consumo de antidepresivos en servicios de salud pública de Montevideo, en usuarios mayores de 14 años, entre marzo 2018 y marzo 2019. Se identificaron espacios de la ciudad con diferentes niveles de consumo y la emergencia del antidepresivo como objeto cultural aglutinante de múltiples situaciones sociosanitarias, siendo nexo entre grupos sociales diversos y distintivo en el reconocimiento de áreas de la ciudad, en tanto problemáticas socioeconómicas y padecimientos psíquicos.

The use of antidepressants is widely spread worldwide; they are the most prescribed psychotropic drugs, together with benzodiazepines. They are used in a wide range of clinical conditions, with an increase in their prescription and use at an international, regional and national level. In that sense, the consideration of geographic space as an active dimension in this problem is an incipient development. In the present study and based on a mixed design, an analysis is presented of the sociotechnical dimensions that generated geographies of prescription and use of antidepressants in public health services of Montevideo, in users over 14 years of age, between March 2018 and March 2019. Authors identify city areas with different levels of antidepressants use and describe its emergence as a cultural object that brings together multiple socio-health situations, becoming a link between diverse social groups and distinctive in the recognition of city areas, with specific socioeconomic problems and psychological sufferings.

Effect of supplementation of purslane/Portulaca oleracea in hyperglycemic subjects

Background: Portulaca oleracea (Purslane) is an annual succulent medicinal plant grown all over the world containing diverse phytoconstituents. Several studies have reported its pharmacological effects like antihypertensive, anti-inflammatory, antioxidant, hypoglycemic, hypocholesterolemic, hypotriglyceridemic, neuro, hepato and nephro protective effects. Methods: Dried Portulaca oleracea leaves were incorporated into common food adjunct popularly known as karampodi/spice powder in south India. This spice powder was used for supplementation studies for 90 days (3months) among hyper glycemic subjects after obtaining a written informed consent. Biochemical parameters such as fasting, post lunch blood glucose levels, glycosylated hemoglobin, lipid profile, i.e., total cholesterol, low density lipoprotein cholesterol, triglycerides, high density lipoprotein cholesterol, very low-density lipoprotein cholesterol, kidney function test, liver function test were assessed. Baseline information, their medical history and 24-hour dietary recall was elicited from the subjects through a pretested schedule. Results: The results revealed that fasting, post lunch blood glucose levels, glycosylated hemoglobin, the total cholesterol levels and its fractions along with triglycerides were significantly decreased and HDL-C increased significantly in the test groups from pre-supplementation to during-supplementation and was stable at post-supplementation period. Conclusions: The results indicated that the spice powder which was rich in several polysaccharides, polyunsaturated fatty acids and phytochemicals/phytonutrients when supplemented to hyperglycemic subjects had a strong hypoglycemic, hypocholesterolemic and hypotriglyceridemic effect.

Fertility outcomes in microdissection testicular sperm extraction for non-obstructive azoospermia

Background: The objective of this study was to evaluate outcome of micro dissection testicular sperm extraction (micro TESE) and intracytoplasmic sperm injection (ICSI) for treatment of non-obstructive azoospermia (NOA).Methods: We retrospectively analysed data of 96 consecutive patients with clinical NOA who were treated with micro TESE by single surgeon, between January 2022 and December 2022, in Lifeline superspeciality hospital Adoor, Kerela. Embryological and clinical outcomes were demonstrated based on ICSI-IVF cycles using fresh or frozen sperms, different etiologies of NOA and various counts of sperms retrieved.Results: 96 men underwent micro TESE and 72.9% (70/96) of them had sperms retrieved. ICSI performed in 64 couples. Of those, 41 reached the stage of embryo transfer (ET). Of the couples who underwent embryo transferred, 18 (43%) resulted in biochemical pregnancies and 7 (17%) clinical pregnancies. There was a significant difference in the testicular volume and serum FSH levels between micro-TESE positive and negative groups (p=0.000). Retrieval rates were higher in group of men with normal testicular volume and FSH<12. Clinical pregnancy rate was around 11% in couples who had sperms retrieved by micro TESE. The sperm retrieval rates were higher in men with age <40 years. Similarly younger the female age more was the pregnancy rate. Out of various etiologies idiopathic NOA and Klinefelter syndrome had better sperm retrieval rate in our study which was statistically significant. Total fertilization rate and blasts rates were 79.7% and 51.6% out of ICSI.Conclusions: Microdissection testicular sperm extraction is an effective treatment for NOA with higher rate of sperm retrieval and pregnancy rate. The increasing success rates over several years indicate the importance of surgical skill and laboratory staff experience.

Effect of Tillage, Crop Residue Management and Nutrient Levels on Energetics, Microbial Growth, Dehydrogenase Activity, Weed Parameters, Quality Parameters and Soil Physico-Chemical Properties of Maize (Zea mays L.)

The field experiment on “Effect of tillage, crop residue management and nutrient levels on energetics, microbial growth, dehydrogenase activity, weed parameters, quality parameters and soil physico-chemical properties of maize (Zea mays L.)” was conducted during rabi season of 2022-23 at Maize Research Centre, Professor Jayashankar Telangana State Agriculture University, Agricultural Research Institute, Rajendranagar, Hyderabad, Telangana. The experiment comprised of 12 treatment combinations laid out in a split–plot design with three replications. The main–plot treatments included four different tillage practices:M1-Conventional tillage (Plough + Cultivator + Rotovator), M2-Residue incorporation (After 10 days of spreading the haulms, only rotovator was run), M3- Residue incorporation (After spreading the haulms, microbial consortium was sprayed and after 10 days only rotovator was run) and M4- Zero-tillage (Only microbial consortium was sprayed on the haulms). Sub–plot treatments included three nutrient levels: N1- 100% RDF (240-80-80 N-P2O5-K2O kg ha-1), N2: 100% RDN & P and 50% RDK (240-80-40 N-P2O5-K2O kg ha-1), and N3: 87.5% of RDN, 75% RDP and 75% RDK (210-60-60 N-P2O5-K2O kg ha-1). Results revealed that, among the tillage practices, residue incorporation (M3) had recorded significantly higher total microbial population, dehydrogenase activity and post-harvest soil available NPK of maize and lowest weed density and weed dry matter and it was on par with zero-tillage (M4) whereas all the parameters were significantly lower in conventional tillage (M1). However, Energy indices viz., energy use efficiency, specific energy, net energy, energy productivity, energy intensiveness was found to be the best in M1 -conventional tillage. Among the different nutrient levels, N1 (100% RDF) had shown significantly higher total microbial population, dehydrogenase activity and post-harvest soil available NPK of maize. Energy indices viz., energy use efficiency, specific energy, net energy and energy productivity was found to be the best in N1- 100% RDF. Whereas energy intensiveness was found to be best with N3- 87.5% of RDN, 75% RDP and 75% RDK. However, energy indices like energy use efficiency, energy productivity and energy intensiveness indicated non-significant effect of different nutrient levels. Tillage as well as nutrient levels did not exert any significant effect on moisture content and bulk density at sowing, tasselling & silking and at harvest stages. Similar results were followed with quality parameters. The interaction effect due to tillage and nutrient levels on soil microbial studies, enzymatic activity, weed parameters, quality parameters, soil physico-chemical parameters, and energy indices was found non- significant.