Revista del Nacional (Itauguá)

Maternal anxiety and depression and its impact on breastfeeding self-efficacy

Mon, 30 Dec 2024 00:00:00 -0600

Introduction: breastfeeding self-efficacy is a crucial factor influencing success and duration. Studies have shown that maternal anxiety and depression can negatively affect breastfeeding self-efficacy, which may hinder continuation of breastfeeding. Understanding this relationship is essential in designing interventions to improve maternal well-being and breastfeeding practices.
Objective: this study aimed to explore the relationship between maternal anxiety and depression and breastfeeding self-efficacy, and to describe the sociodemographic and mental health characteristics of the participants.
Methodology: this was an observational descriptive study with a cross-sectional design was conducted on 108 breastfeeding women in Paraguay. A non-probabilistic convenience sampling method was used. Participants completed the Generalized Anxiety Disorder-7 (GAD-7), Edinburgh Postnatal Depression Scale (EPDS), and Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). Data were analyzed using SPSS, and the Mann-Whitney U test was used to determine the associations between anxiety, depression, and self-efficacy.
Results: a total of 30.6 % of the participants reported anxiety, and 48.1% showed signs of postpartum depression. Women with anxiety and depression had significantly lower breastfeeding self-efficacy scores (p=0.044 and p=0.048, respectively).
Conclusion: these results suggest that maternal anxiety and depression negatively affect
breastfeeding self-efficacy. Addressing mental health issues in breastfeeding mothers is essential to improving self-efficacy and, consequently, breastfeeding outcomes.

Obstetric and perinatal characteristics in patients with birth canal tears

Mon, 30 Dec 2024 00:00:00 -0600

Introduction: birth canal tears are undesirable complications that occur during vaginal delivery, causing aesthetic and functional problems in the perineum or in the birth canal itself. Its prevalence, far from decreasing with current knowledge of obstetric medicine, has been gradually increasing in recent years.
Objective: to determine the obstetric and perinatal characteristics in patients with birth canal tears treated at the Centro Médico Nacional– Hospital Nacional in the period of 2021-2022.
Methodology: this was an observational, descriptive, cross-sectional, and retrospective study, including women with birth canal injuries treated at the Centro Médico Nacional– Hospital Nacional in the period 2021-2022.Descriptive statistics were used for the data analysis.
Results: 198 women with birth canal injuries were identified. The most frequent age range was 19- 29 years and most of them lived in the Central department. Most of the birth canal tears were observed innulliparous women (47.5 %) and without a previous cesarean section (92.9 %); the most frequent injury was the cervical tear (64.1 %). The most common morbidity was uterine atony (20.7 %). Regarding perinatal data, normal weight and term gestational age were more frequent.
Conclusion: cervical tears were the most frequent birth canal injury in nulliparous women without previous cesarean section with an age range of 19-29 years and from the Central department.

Psychometric evidence of the Impact of Events Scale (IES-6) in Peruvian adolescents

Jonatan Baños-Chaparro, Paul Ynquillay-Lima, Tomás Caycho-Rodríguez — Mon, 30 Dec 2024 00:00:00 -0600

Introduction: symptoms of Post Traumatic Stress Disorder (PTSD) are a frequent public health problem in adolescent population. Empirical evidence shows that adverse events during adolescence can affect early adulthood and predict various psychological problems. Ongoing assessment of PTSD is essential for prevention and the availability of reliable, evidence-based psychological instruments is necessary.
Objective: to analyze the psychometric properties of the Impact of Events Scale-6 (IES-6) in the general adolescent population.
Methodology: we used an instrumental research, quantitative and cross-sectional approach. A total of 2877 adolescents from Huancavelica participated, who answered the IES-6 and other psychological instruments. Statistical analyses were performed with structural equation modeling and item response theory.
Results: the IES-6 presents adequate evidence of content validity, unidimensional structure, reliability, measurement invariance according to sex and relationship with suicidal ideation, generalized anxiety and depression. Items 5 and 3 presented the highest discrimination and information, and the scale is accurate for high levels of PTSD.
Conclusion: the IES-6 presents adequate sources of validity evidence and is a useful instrument for the assessment of PTSD symptoms in Peruvian adolescents. Its use is recommended in research and prevention and follow-up programs in public health and education.

Work stress and musculoskeletal symptoms in employees of a private company in the city of Asunción, Paraguay, 2023

Pablo Andrés Barboza Compte, Lelis Morales-Clemotte — Mon, 30 Dec 2024 00:00:00 -0600

Introduction: musculoskeletal disorders and work stress affect the quality of life of an organization's workers.
Objective: to describe the level of work stress and the degree of perception of musculoskeletal symptoms in employees of a private company in the city of Asunción.
Methodology: this was a descriptive, quantitative, observational and cross-sectional study. We used non-probabilistic convenience sampling. 45 administrative collaborators from a private company participated. The instruments used were: ILO-WHO Work Stress Scale and the Kuorinka Nordic Musculoskeletal Symptoms Questionnaire. The study variables were stress levels and musculoskeletal symptoms. MS-Excel 2016 software was used for data processing.
Results: of a sample of 45 people, 87 % (n = 39) reported a low level of stress. On the other hand, 96 % (n = 43) presented a perception of musculoskeletal symptoms.
Conclusion: the majority of employees reported a low level of stress. On the other hand, almost the entire sample perceived symptoms of musculoskeletal pain, located mainly in the lower back area. The relationship between the level of stress and the perception of musculoskeletal symptoms is a topic that requires more in-depth research to determine more precisely the effects of work stress on the human body. Kinesiology and Physiotherapy is a valid path for implementing plans for the prevention and treatment of musculoskeletal ailments in the context of organizations.

Training a neural network for estimating the homeostatic model of insulin resistance

Alberto Guevara Tirado — Mon, 30 Dec 2024 00:00:00 -0600

Introduction: the evaluation of the homeostatic model is a test very close to the gold standard (euglycemic clamp).
Objective: train a multilayer perceptron-type neural network to determine the homeostatic model of insulin resistance.
Methodology: analytical and cross-sectional study. The learning of the neural network was carried out from a database of 2004 Venezuelan adults. Subsequently, 4,363 Mexican adults were added to the database of the National Health and Nutrition Survey (ENSANUT). The variables were homeostatic model of insulin resistance (HOMA2-IR), basal insulin, and basal glucose. Multilayer perceptron-type neural networks were used.
Results: the training of the neural network model had a relative error of 0.003, while in the test it was 0.005. For qualitative HOMA2-IR, the percentage of incorrect predictions was 0.60 % in training, and 0.70 % in testing. After learning the model, insulin and basal glucose values from 4363 Mexican adults were added, observing that the HOMA2-IR values generated by multilayer perceptron maintained the efficiency of the model, obtaining a coefficient of determination R2 of 0.983, which implies that 98 % of the variation in HOMA2-IR values can be explained by HOMA2-IR values obtained using multilayer perceptron.
Conclusions: the multilayer perceptron-type neural network gives results virtually identical to those obtained using the HOMA2-IR calculator. The implementation of this algorithm can be beneficial as a tool that is easy to implement in primary and specialized care systems and in hospital environments.

Phenotypic and genotypic characterization of carbapenemases produced by Gram-negative bacterial pathogens isolated in hospitals in Paraguay

Fri, 07 Mar 2025 00:00:00 -0600

Introduction: the dissemination of Gram-negative bacteria resistant to carbapenems represents an important cause of morbidity and mortality, being a growing threat to public health and of great concern worldwide. Although resistance to carbapenems can be due to several mechanisms, the most relevant, clinically and epidemiologically, is enzyme production. The goals of this study were to phenotypically and genotypically characterize carbapenemases produced by clinically important Gram-negative bacilli (GNB) isolated in hospitals in Paraguay in 2022 and evaluate the susceptibility to colistin.
Methodology: retrospective study, carried out on 1,226 GNB strains sent to the Central Laboratory during 2022 for phenotypic and genotypic characterization. Identification studies were performed out by conventional methods, susceptibility to colistin by microdilution in broth, and molecular studies for the confirmation of resistance genes.
Results: in total, of 1226 GNB isolates, 629 (51 %) were confirmed as non-carbohydrate-fermenting GNB (89 % Acinetobacter spp.) and 597 (49 %) as carbohydrate-fermenting GNB (74 % Klebsiella pneumoniae). Carbapenemases OXA-23 (94.9 %), NDM (3.1 %), OXA-23+NDM (1.8 %) and OXA-23+NDM+OXA-58 (0.2 %) were confirmed in Acinetobacter baumannii; in K. pneumoniae: NDM (84.5 %), KPC (11.7 %), KPC+NDM (3.7 %) and NDM+OXA-48like (0.2 %); and in P. aeruginosa the prevalent was NDM (50.9 %). Colistin-associated resistance was found mainly in K. pneumoniae (24%).
Conclusions: in our country the circulation of carbapenemase-producing bacteria is endemic. The co-production of these enzymes is confirmed. NDM is prevalent in Enterobacterales and P. aeruginosa, and OXA-23 in A. baumannii. The high resistance associated with colistin in K. pneumoniae makes it imperative to have new, more effective antimicrobials for the treatment of infections.

Neurophobia in Medical Students from Paraguay

Fri, 07 Mar 2025 00:00:00 -0600

Introduction: neurophobia, defined as the fear or aversion to neurology due to its perceived complexity, poses a challenge in medical education. This study examines the prevalence and associated factors of neurophobia among medical students in Paraguay.
Objective: to explore perceptions, attitudes, and factors associated with neurophobia among medical students and identify educational strategies to enhance neurology teaching.
Methodology: this was an observational, descriptive, and cross-sectional study conducted with a sample of 413 medical students from various Paraguayan universities. Data on sociodemographic characteristics, prior experiences in neurology, and knowledge perceptions were collected using a validated questionnaire. Descriptive and inferential statistical analyses were performed.
Results: a total of 41.6 % of students reported a low likelihood of choosing neurology as a specialty, while 33.9 % expressed intermediate levels of fear toward this discipline. The main causes of neurophobia were theoretical teaching approaches (32.9 %) and the perceived difficulty of neuroanatomy (35.8 %). Additionally, 69.2 % considered neurology teaching to be insufficient, and 81.1 % reported a lack of extracurricular activities related to neurology.
Conclusions: the findings highlight the need for a more practical and interactive curriculum, emphasizing clinical simulations and extracurricular activities to foster interest and confidence in neurology. These changes could mitigate neurophobia and encourage professional development in this specialty.

Characteristics of maternal mortality in Paraguay

Sat, 22 Mar 2025 00:00:00 -0500

Introduction: maternal mortality (MM) is a critical public health indicator, especially in low- and middle-income countries. In Paraguay, although progress was made in reducing MM between 2008 and 2018, the COVID-19 pandemic reversed many of these gains. This study examines the characteristics of MM in Paraguay between 2014 and 2021.
Objectives: to describe the sociodemographic and clinical characteristics of maternal mortality in Paraguay during the period 2014-2021.
Methodology: a retrospective cross-sectional descriptive study was conducted using data from death certificates of the General Directorate of Strategic Health Information (DIGIES) of the Ministry of Public Health and Social Welfare. We analyzed 740 cases of maternal deaths registered in the 18 Health Regions of the country, considering sociodemographic variables and variables
related to causes of death.
Results: there were 740 maternal deaths, with an average ratio of 83.91 per 100,000 live births. 2021 had the highest ratio (159.98). The majority occurred in young (58.65 %) and adult women (66.31 %), with predominant causes being diseases of Respiratory System 18.11 %, toxemia 15.81 %, and hemorrhaged 12.03 %.
Conclusion: MM presented an increase after the COVID 19 pandemic, so the study highlights the urgent need to strengthen access to quality prenatal and obstetric care, especially in public institutions, and to address the socioeconomic inequalities that affect maternal health.

Gestational trophoblastic disease

María Magdalena Prieto Agüero, Karen Leticia Britez Ramírez — Mon, 30 Dec 2024 00:00:00 -0600

Placental tissue proliferation gives rise to a set of related diseases, all of which are included in the term gestational trophoblastic disease (GTD). Lesions include:hydatidiform mole (complete and partial), invasive mole, choriocarcinoma, trophoblastic tumor of the placental site, and epithelioid trophoblastic tumor. This report describes a case of invasive mole diagnosed after a manual endouterine aspiration procedure, which was detected by increasing serum levels of quantitative BCHG in its controls.
Therefore, the importance of follow-up with serial controls of quantitative BCHG blood is demonstrated, for an opportune diagnosis and treatment.

Mental health in Kinesiology and Physiotherapy Undergraduate Students at the Universidad Nacional de Asunción

Mery Leonardo Aiquipa — Mon, 30 Dec 2024 00:00:00 -0600

Today's digital environment has transformed the way young people interact and perceive reality. The excessive use of social networks, the phenomenon of “doomscrolling” and information overload have increased anxiety levels in 60% of post-pandemic youth, this scenario suggests that college students are particularly exposed to these stressors, which could influence their academic performance and overall well-being.

Reality of the Human Immunodeficiency Virus

Mon, 30 Dec 2024 00:00:00 -0600

Currently, the Human Immunodeficiency Virus (HIV) continues to be one of the public health problems; according to the World Health Organization (WHO), in the last year it has claimed the lives of 32.9 to 51.3 million people with an average of 40.4 million lives worldwide. It is estimated that by 2025, 95% of people with HIV should have been diagnosed, 95% should be on retroviral treatment and 95% should be able to suppress their viral load.