mparative evaluation of morning versus evening dose of levothyroxine in the treatment of hypothyroidism

Introduction: Hypothyroidism is a common endocrine disorder that results from thyroid hormone deficiency. The prevalence of overt hypothyroidism increases with age, with more than 10% of women older than 60 years having subclinical hypothyroidism. The main objective of this study was to evaluate the comparison of the morning versus evening dose of levothyroxine in the treatment of hypothyroidism. Methodology: 152 patients with previously untreated primary hypothyroidism were divided into morning (Group 1) and evening (Group 2) dosing groups and evaluated for change in biochemical profile, physical functioning, and quality of life over the course of twelve study weeks. Results: At the end of 12 weeks, 70 (90.90%) subjects from Group 1 and 72 (96%) from Group 2 reached euthyroidism. At evaluation, symptoms and total clinical prescriptions improved in both groups at the end of 6 and 12 weeks. A significant improvement in thyroid profile was demonstrated in both groups at the end of 6 and 12 weeks (P value <.0001). Conclusion: In the between-group comparison, no significant differences were observed in the thyroid profile at 6 and 12 weeks between the morning and evening dose groups. A similar dose of levothyroxine was required to achieve euthyroidism in both groups. Although early restoration of euthyroidism was reduced in the evening group, the difference compared to the morning group was not statistically significant. In the evaluation of the quality of life, a statistically significant improvement was demonstrated in several parameters in both groups. Therefore, we infer from the study that the evening dose is as effective as the morning dose and provides an alternative dosing regimen. Study area: Health Sciences.

Wendy Elizabeth Tapia Merino, Maria Teresa Rosas Romero, Vanessa Elizabeth Unaucho Panamá, Elisa Anabel Wazhima Lituma, Jessica Samantha Rea Fernández

6-18

Analysis of labor performance in masonry work in two-story houses in the city of Cuenca

Introduction. This article is based on the analysis of labor performance in masonry in housing in the city of Cuenca, which directly influences productivity and is a crucial part of the economy of a nation. The yields used in the budgets and programming of works, must be based on multiple observations and statistical analysis, in the companies dedicated to the construction many of the economic losses are affected by the human factor and many times they are not identified and quantified. Objective. To analyze the labor yields in masonry items in houses of up to two floors in the city of Cuenca, comparing the results with the information of the Chamber of Construction of Cuenca to generate strategies to improve performance. Methodology. This study was conducted in four stages: in the first stage, the collection of data and the calculation of labor performance in masonry items, in the second stage, the comparison and analysis of data with the Chamber of Construction of Cuenca, in the third stage, a literature review was conducted and a strategy was defined to improve labor performance in masonry items, in the fourth stage, recommendations of technical specifications and the correct masonry construction process are given. Results. Through the methodology applied, the results show that for the five masonry items under study: industrial brick, handmade brick, exposed brick, pumice block and mixed block (pumice-concrete), the labor yields are lower than those of the Cuenca Chamber of Construction, except for industrial brick. Conclusion. Labor yields are affected by some factors that negatively affect productivity, but by implementing the strategy of training construction workers, a significant improvement is expected.

Luis Alberto Cruz Espinoza, José David Quizhpe Campoverde, Nayra Mendoza Enríquez

35-61

Citizen perception in the personnel selection process in the Ecuadorian public sector: methodological proposal

Introduction: this research article is based on the elaboration of a methodology to know the citizen perception in the process of selecting a person in the Ecuadorian public sector. Objectives: to develop a methodological proposal that involves the citizen who was part of a personnel selection process in order to know the opinion of the participant after a selection process with the purpose of improving the selection process by the institution that carried it out. Methodology: the methodological proposal is a questionnaire whose information base was taken from the review of the technical standard of the personnel selection subsystem and this questionnaire is made up of 12 items that frame the personnel selection process from the call to selecting to the right person who has passed all the steps of the selection process. In this investigation, the Cronbach's Alpha calculation method was developed, which is a coefficient used to measure the reliability of a test and in which 45 people participated who responded to the survey carried out according to their personal experience during a personnel selection process in the that I participate Results: with the information that was obtained and through Cronbach's Alpha and a Likert analysis in each item, the developed questionnaire was validated, obtaining a score of 0.94. Conclusions: the tool has a high reliability also in the present investigation and it is proposed that at some point the tool may be useful for its implementation in human talent departments in public institutions and therefore improve the selection process. personnel and highlight possible shortcomings. Study area: Human Talent.

Fausto Benítez Troya, Yamilet Hernández Ramos

62-88

Psychometric properties of the Barthel index: systematic review

Introduction: The Barthel index was taken as the central axis of research, with the intention of knowing its contributions to patient care, the adaptations in its psychometric properties made, weaknesses in the measurement, with the intention of clarifying the theoretical and methodological route for a possible adaptation and validation to the reality of Ecuador, where there is currently no direct research on the described. Objective: The objective was to review the scientific evidence on the psychometric properties of the Barthel index. Methodology: It was based on a systematic review of the scientific literature using the PRISMA procedure, taking the most significant contributions, based on 11 articles published in PubMed, WOS, Scopus. Results: The different articles used validate the Barthel index as a method to assess the physical capacity of patients who have suffered strokes. Conclusion: The Barthel index is shown to be a reliable instrument in the researches scrutinized, including the adaptations that have been made, being considerable to be taken into account by the nursing staff with the intention of promoting a care management in accordance with providing a diligent and quality service to the patient and his family.

Gladys Esperanza Sagbay Coronel , Libia Ortega Campoverde

105-119

Carpal tunnel syndrome, management with platelet-rich plasma: Systematic review

Introduction. Carpal tunnel syndrome is a neuropathy that occurs at the level of the median nerve located in the wrist, causing pressure and, consequently, a decrease in its function. Objective. To examine a systematic review on the applicability of the platelet-rich plasma technique in carpal tunnel syndrome. Methodology. Systematic review of the descriptive and explanatory literature, following the PRISMA statement and with the help of the Descriptors in Health Sciences (DECS). Results. Treatments for carpal tunnel syndrome can be conservative or surgical. Platelet-rich plasma is one of the most widely used due to its content for tissue regeneration. According to the reviewed literature, it has its benefits between three and six months after treatment. Another of the most used conservative treatments is the splint and the splint plus PRP, where it was observed through the analog variables and the Boston scale that this symptomatology decreased significantly in both groups after 10 weeks of treatment. Conclusions. Platelet-rich plasma is a less invasive treatment that produces less pain in its application, requires less time, does not require hospitalization, and improves the discomfort of carpal tunnel syndrome.

Elvia Narcisa Godoy Durán, Francy Hollminn Salas Contreras

133-143

Risk factors of diabetic foot in older adults: clinical case

Introduction. Diabetic foot is defined as infection, ulceration or destruction of the deep tissues of the foot that may be associated with different factors. Objective.  To carry out a bibliographic analysis and treatment of the disease to determine the risk factors of diabetic foot in elderly women through a clinical case of the FUNPRA geriatric center in the city of Cañar - Ecuador. Methodology. 80-year-old female patient, widowed, from the city of Azogues and resident in Cañar-Ecuador FUNPRA (nursing home), with no education. She is treated for diabetic foot grade I superficial wound in the right foot, does not involve tendon capsule or bone, in the healing process granulation tissue is observed. Results.  She was administered a general diet, physical activity prior to healing, insulin in the morning 14 IU/dL and in the afternoon 6 IU/dL per day at the end of healing and bandaging. With 3 years of evolution DMT type II, 3 months of evolution of diabetic foot. No pathological, surgical or family history. Improvement of the patient is observed after the cures performed, control of glycemia and administration of medication appropriately. Conclusion.  A patient with diabetes mellitus type II was treated, her diabetic foot was associated with obesity, inadequate care and poor hygiene.

Veronica Huerta Chimborazo, Isabel Cristina Mesa Cano

144-155