1539 Flexible Nasoendoscopy – Is It Clean? Can You Prove It?

Abstract Aim Flexible Nasoendoscope (FNE) is an essential device routinely used to assess patients who present acutely to the Ear, Nose and Throat (ENT) department with signs and symptoms of ENT pathologies that may compromise the patient’s airway. It is imperative the scope is decontaminated before and after each use. The “Tristel Trio Wipe” decontamination methodology is employed by most ENT departments in UK and the process utilises an audit logbook to correctly document the sterilisation process as well as allowing accurate patient traceability. The audit aim was to conduct a review of documentation of patient traceability and FNE sterilisation after each use on ENT patients in the acute setting. Method Retrospective audit over one-month periods 11/10/2019 –10/11/2019 (Audit 1) and 26/12/2019 – 21/01/2020 (audit 2). Tristel audit logbook and electronic patient note on PPM+ were used for data collection. Data was analysed using Microsoft excel. Results 100% of FNE decontaminations used correct Tristel Trio Wipes. However, audit one demonstrated 54.5% compliance with correct documentation of FNE sterilisation process and 0% had recorded all traceability information. Following intervention of easier identification of FNE scopes and their storage; as well teaching ENT Senior House Officers and registrar about the correct documentation of decontamination process, compliance improved to 81%, while traceability increased to 39% during the re-audit. Conclusions As a department, we have significantly improved our compliance with both correct documentation of FNE sterilisation and patient traceability information following the intervention above. A further 3rd audit cycle is planned.

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Real-world effectiveness and tolerability of Zelesse cream® for treating vulvovaginitis in adult women: an observational, prospective study

Journal of International Medical Research ◽

10.1177/03000605211013226 ◽

2021 ◽

Vol 49 (5) ◽

pp. 030006052110132

Author(s):

Ana Rosa Masero ◽

Luís Manuel San Frutos ◽

Ernesto Vizcaíno ◽

María Palma ◽

Syra Velasco-Ortega ◽

...

Keyword(s):

Antimicrobial Therapy ◽

Vaginal Discharge ◽

Signs And Symptoms ◽

Controlled Trials ◽

Adult Women ◽

Global Score ◽

Point Scale ◽

Vaginal Cream ◽

Before And After ◽

Larger Sample

Objective To assess the efficacy, acceptability, and tolerability of a vaginal cream based on plant extracts for treating signs and symptoms of vulvovaginitis (VV) (Zelesse cream®), either as monotherapy (non-infectious VV) or adjuvant to antimicrobial therapy (infectious VV). Methods This prospective, observational, multicenter study included women who attended outpatient offices for VV. The severity of signs (vaginal discharge, erythema, and edema) and symptoms (pruritus, burning, and dysuria) was assessed before and after 15±5 days of daily treatment with Zelesse cream on a 4-point scale (18-point global score). Results The study included 58 women aged 43.0±13.2 years, including 42 who were treated with Zelesse cream only and 16 who used Zelesse cream as adjuvant to antimicrobial therapy. All participants showed significantly reduced scores and absolute prevalence of individual signs and symptoms in both groups. Similarly, the median signs/symptoms decreased by 4.0 and 8.0 points in women using Zelesse only and those using Zelesse plus antimicrobial therapy, respectively. This product was well tolerated and had high acceptability. Conclusions Zelesse cream relieves signs and symptoms of VV, either as monotherapy in non-infectious VV or as adjuvant to antimicrobial therapy in infectious VV. Future randomized, placebo-controlled trials with larger sample sizes are warranted.

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AB0571 IS RITUXIMAB AN ADEQUATE GLUCOCORTICOID SPARING AGENT IN IDIOPATHIC INFLAMMATORY MYOPATHIES?

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.4038 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1582.1-1582

Author(s):

B. H. Egeli ◽

S. Ergun ◽

Y. K. Gursoy ◽

A. Cetin ◽

S. Ugurlu

Keyword(s):

Disease Activity ◽

Alternative Treatment ◽

Statistical Power ◽

Signs And Symptoms ◽

Small Sample ◽

Idiopathic Inflammatory Myopathies ◽

Inflammatory Myopathies ◽

Treatment Methods ◽

Before And After

Background:Idiopathic inflammatory myopathies (IIM) are essentially treated aiming improvement of muscle function and extra muscular disease manifestations. The backbone of the treatment is corticosteroids enhancing the survival and patient quality of life. The lack of consensus on target-specific immunosuppressive treatment highlights the need for further studies evaluating alternative treatment methods. Rituximab is potentially a glucocorticoid-sparing agent which was reviewed in multiple studies with small sample sizes due to the rarity of the disease.Objectives:Higher statistical power can enhance the trustworthiness of alternative treatment methods yielding the main objective of this study.Methods:This retrospective study was conducted at a tertiary rheumatology center. Patients were diagnosed with an idiopathic inflammatory myopathy (dermatomyositis [DM], polymyositis [PM]) and were treated with rituximab in order to be included in this study. Clinical signs and symptoms of the presentation were noted during the first patient encounter as well as the follow-up. Parameters of disease activity including acute phase reactants, muscle enzyme levels, and disease-specific autoantibodies were analyzed.Results:The study includes 28 patients (20 DM, 8 PM). The age of diagnosis was 43.44 ± 15.77 years, follow-up duration was 60.7 ± 70.7 months. The presenting signs and symptoms of the patients are shown in Figure 1. The parameters of disease activity before and after treatment are summarized in Table 1. The mean corticosteroid dose decreased from 31.429 ±23.934 mg to 10.278 ±12.001 (p=0.001). Other treatment methods were methotrexate (n=18), Intravenous Immunoglobulin (IVIG) (n=7), and cyclophosphamide (n=2). There were not any deaths during the follow-up. Two patients were lost to follow-up.Table 1.The Parameters of Disease Activity Before and After TreatmentBefore TreatmentAfter TreatmentP ValueCPK, mean ± std (U/L)1426 ± 2049.92263.44 ± 265.630.004LDH, mean ± std (U/L)557.5 ± 365379.78 ± 192.10.03AST, mean ± std (U/L)62.52 ± 5930.16 ± 27.590.01ALT, mean ± std (U/L)56.48 ± 49.2127.64 ± 24.520.008ESR, mean ± std (mm/hour)26.38 ± 28.9820.39 ± 18.760.36CRP, mean ± std (mg/L)19.23 ± 46.1512.53 ± 26.670.5RF, mean ± std (U/mL)0 (0)N/AN/AANA, n (%)3 (10.71)N/AN/AFigure 1.The Presenting Signs and Symptoms of the PatientsConclusion:Rituximab is shown to be effective in treating myositis along with corticosteroids as well as a corticosteroid-sparing agent in retrospective studies and open-label clinical trials; however, lack of statistical power should be underlined. Long term decrease in steroid use and decrease in disease activity markers hints the effective use of rituximab as a glucocorticoid sparing agent as well as its safety with minimal side effects.Disclosure of Interests:None declared

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COMPARATIVE STUDY OF THE EFFICACY OF TOPICAL LOTEPREDNOL ETABONATE AND FLUOROMETHOLONE IN THE TREATMENT OF VERNAL KERATOCONJUNCTIVITIS : A RANDOMISED CONTROLLED STUDY

10.36106/ijsr/5403062 ◽

2021 ◽

pp. 8-10

Author(s):

Nandita Chaturvedi ◽

Nidhi Nidhi ◽

Malobika Bhattacharya

Keyword(s):

Side Effects ◽

Signs And Symptoms ◽

Subjective Symptom ◽

Controlled Study ◽

Vernal Keratoconjunctivitis ◽

Topical Steroids ◽

Loteprednol Etabonate ◽

Randomised Controlled Study ◽

Before And After ◽

Randomised Controlled

Introduction:Vernal keratoconjunctivitis(VKC) is a chronic, recurrent, inammatory disease of ocular surface showing seasonal exacerbation, affecting young children. Topical steroids are the mainstay in the treatment of ocular allergy, but their use should be judicious since they carry serious side effects . Loteprednol and uorometholone carry better safety prole. Present study was conducted with the aim of comparing the efcacy of these two widely used steroids.Objectives:To compare total subjective symptom score (TSSS), total objective sign score (TOSS) and side effects of medications before and after treatment at each visit.Materials & Methods:A prospective randomised controlled study was performed on 92 patients of VKC over four weeks. Patients were allotted to either of the two arms of treatment (i.e. LP 0.5% or FML 0.1%). Subjective and objective assessments of the signs and symptoms of VKC were done using standard scoring methodologies at 7, 14, 21 and 28 days post treatment. The main outcome measure was measured in terms of TSSS and TOSS before and after treatment at each visit. Secondary outcomes included side effects. Statistical analysis of the data collected was carried out.Results: Loteprednol showed greater reduction in symptoms initially but by the end of study there was no statistically signicant difference in effect between the two drugs.Conclusions: Final improvement in clinical features and safety prole, at the end of 4 weeks was similar in eyes treated with either of the two drugs. Hence, both the drugs can be safely used in the treatment of VKC.

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Impact of educational intervention regarding anaemia and its preventive measures among pregnant women: an interventional study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20175137 ◽

2017 ◽

Vol 6 (12) ◽

pp. 5317 ◽

Cited By ~ 1

Author(s):

Pankajkumar B. Nimbalkar ◽

Jaldhara N. Patel ◽

Nilesh Thakor ◽

Mansi Patni

Keyword(s):

Pregnant Women ◽

Preventive Measures ◽

Signs And Symptoms ◽

Contributory Factor ◽

Interventional Study ◽

Post Intervention ◽

Medical College ◽

Maternal Morbidity And Mortality ◽

Before And After ◽

Baseline Knowledge

Background: Iron deficiency anaemia (IDA) is the most common nutritional deficiency in pregnancy and major contributory factor to maternal morbidity and mortality. Objective of present study was to assess knowledge of pregnant women regarding anaemia and its preventive measures before and after educational interventional training.Methods: The present study was an interventional study undertaken in purposively selected pregnant women attending the out patient Department of Obstetrics and Gynecology Department of GMERS Medical College, Gandhinagar During the month of October 2017. Total 100 pregnant women were included after written informed consent. Baseline knowledge of pregnant women regarding anaemia and its preventive measures was assessed by pre-designed, pre-tested and semi structured questionnaire. Single educational interventional training for 45 minutes was given to selected pregnant women. Post– intervention knowledge of pregnant women for the same was assessed after training. Thus, collected data was analyzed /using Epi info 7.Results: Baseline knowledge of the pregnant women regarding causes, signs and symptoms of anemia and dietary sources of iron was 21%, 23% and 40% respectively which was significantly increased to 64%, 66% and 72% respectively after the intervention. Baseline knowledge of the pregnant women regarding factors which inhibit and increase iron absorption was 25% and 4% respectively which was significantly increased to 55% and 41 % respectively after the intervention. Baseline knowledge of the pregnant women regarding treatment of anaemia was 30% which was significantly increased to 79 % after the intervention.Conclusions: There was significant improvement in the knowledge regarding anaemia and its preventive measures among pregnant women after our single educational session.

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Stereotactic Intratumoral Photodynamic Therapy for Recurrent Malignant Brain Tumors

Neurosurgery ◽

10.1227/00006123-199111000-00008 ◽

1991 ◽

Vol 29 (5) ◽

pp. 688-696 ◽

Cited By ~ 46

Author(s):

Stephen K. Powers ◽

Sharon S. Cush ◽

Diana L. Walstad ◽

Lester Kwock

Keyword(s):

Photodynamic Therapy ◽

Magnetic Resonance ◽

Malignant Gliomas ◽

Signs And Symptoms ◽

Resonance Spectroscopy ◽

Normal Brain ◽

Hematoporphyrin Derivative ◽

Neurological Sequelae ◽

Computed Tomographic ◽

Before And After

Abstract Photodynamic therapy (PDT) using purified hematoporphyrin derivative and stereotactic intratumorally implanted optical laser fiber(s) was used to treat patients with recurrent malignant gliomas and metastatic melanoma of the brain. Tumor response to PDT was evaluated by recording changes in the volume and pattern of tumor enhancement between computed tomographic and magnetic resonance imaging scans done before and after PDT, metabolic changes in tumor tissue by31 P magnetic resonance spectroscopy, and patient outcome. Toxicity of PDT to brain was evaluated on the basis of changes in the patients' neurological examinations and correlated with changes in brain adjacent to tumor seen on postoperative imaging studies. Dramatic tumor responses to PDT were seen in all gliomas, but no response of tumor to treatment was seen with melanoma. Transient signs and symptoms of increased peritumoral cerebral edema caused by PDT were seen in all patients. Two patients suffered permanent neurological sequelae, monocular blindness and a partial visual field defect, as a result of treatment. Two patients with recurrent anaplastic astrocytomas remain in remission at 45 and 35 weeks after PDT. We conclude that intratumoral photoradiation therapy of hematoporphyrin derivative-photosensitized malignant gliomas effectively produces necrosis of the solid component of malignant gliomas: however, intratumoral photoradiation may not reach the portion of tumor that invades normal brain.

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Statistical Analysis using traditional technique, Microsoft Excel and Predictive Analytic Software

UIC Research Journal ◽

10.17158/514 ◽

2016 ◽

Vol 19 (2) ◽

Author(s):

Jovelyn M. Durango ◽

Carlito P. Yurango

Keyword(s):

Statistical Analysis ◽

Completion Time ◽

Microsoft Excel ◽

Instructional Tools ◽

Traditional Technique ◽

Significant Difference ◽

Before And After ◽

Computer Based ◽

The One ◽

Time Required

The advent of technology has improved the way statistics is taught and learned. It is claimed that the use of computer-based instructional tools can actively explore the meaning of statistical concepts among the students, as well as enhance their learning experiences. This study aimed to compare three methods of statistical analysis namely, the traditional technique (use of the calculator), Microsoft Excel and Statistical Package for Social Sciences (SPSS) software. This investigation utilized the experimental design, specifically the One-Group Pretest – Posttest Design. There were six education students who self-assessed their attitude before and after the introduction of the use of various computation techniques and performed the statistical analysis considering also the completion time required for each process. Results of the study revealed an increase in the level of attitude among the respondents form the pretest to the posttest. Also, the cognitive level regardless of the approach was very high. However, the t-test failed to establish a significant difference in the attitude among the respondents. On the other hand, there were significant differences in both the test scores and completion time of the respondents in the three methods in favor of SPSS. Keywords: Information technology, statistics, traditional technique, Microsoft excel, SPSS, comparative analysis, experimental research design, Davao City, Philippines.

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Studi Perbandingan Kadar Ni dan Fe Berdasarkan Sampel Cek Pit dan Sampel Cek Stock Pile Mining Nikel pada PT. Bintangdelapan Mineral Sulawesi Tengah

Ge-STRAM: Jurnal Perencanaan dan Rekayasa Sipil ◽

10.25139/jprs.v4i1.3163 ◽

2021 ◽

Vol 4 (1) ◽

pp. 41

Author(s):

Villa Evadelvia Ginal Sambari

Keyword(s):

Field Research ◽

Analysis Tool ◽

Microsoft Excel ◽

Preparation Stage ◽

Stock Pile ◽

Collection Data ◽

Nickel Mining ◽

Mineral District ◽

The Village ◽

Central Sulawesi

Nickel mining in PT. Bintangdelapan Mineral District located in the village Fatufia Bahodopi Morowali, Central Sulawesi. The purpose of this research study sampling techniques and sample checks pit stock pile, and aimed to compare the levels of Ni, Fe. The authors limit the issues on comparative levels of Ni, Fe, based on sampling and sample checks pit mining production and production sample port stock pile, using the analysis tool Minipal. Field research methods consisting of the preparation stage, the stage of data collection, data processing stage and phase of Thesis. Results in getting the checks on the sampling pit, mining samples, and sample port is an increase in levels, this is because the mining PT. Bintangdelapan Minerals has applied to both selective mining mining methods. In this sample, the researcher applied sampling method and sample check stock pile pit nickel laterite operations in accordance with standard PT. Bintangdelapan Minerals, the data obtained is processed using Microsoft Excel and then presented in the form of reading SPSS (Statistical Product And Service Solution).

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Detection of Leishmania infantum amastigotes in neutrophil from peripheral blood in a naturally infected dog

Revista Brasileira de Parasitologia Veterinária ◽

10.1590/s1984-29612021060 ◽

2021 ◽

Vol 30 (3) ◽

Author(s):

Gilsan Aparecida de Oliveira ◽

Vitória Aline Santos Sarmento ◽

Ericka Wanessa da Silva Costa ◽

Rômulo Pessoa-e-Silva ◽

Rayana Carla Silva de Morais ◽

...

Keyword(s):

Peripheral Blood ◽

Leishmania Infantum ◽

Late Phase ◽

Clinical Status ◽

Rapid Test ◽

Signs And Symptoms ◽

Terminal Phase ◽

Therapeutic Implications ◽

Before And After ◽

Hematological And Biochemical Parameters

Abstract Canine visceral leishmaniasis (CVL) is a zoonotic disease of high lethality caused by Leishmania infantum in the Americas. In the infected dog, the amastigotes are scarce in blood, especially in the late phase of the disease. This study aimed to report a rare case of L. infantum amastigotes found in neutrophils from peripheral blood of a naturally infected dog in terminal phase of CVL, also describing its clinical status before and after treatment with miltefosine 2%. The dog, which presented as polysymptomatic and with classical signs and symptoms of CVL was submitted to the following tests: Dual Path Platform (DPP) rapid test, ELISA and parasitological examination of peripheral blood. Hematological and biochemical parameters were obtained before and after treatment. All diagnostic tests were positive for CVL. The identification of L. infantum amastigotes inside neutrophils from peripheral blood was confirmed through microscopy, and the species was confirmed by molecular analysis. At the end of the treatment, peripheral parasitemia was not detected, and improvements were observed in clinical and laboratorial parameters. Finally, this atypical finding can be used as example to raise discussions about the real immunological role of neutrophils in late phases of CVL and its clinical/therapeutic implications.

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Compliance with the Data Protection Acts in a psychiatric department: a complete audit cycle

Irish Journal of Psychological Medicine ◽

10.1017/ipm.2014.12 ◽

2014 ◽

Vol 31 (2) ◽

pp. 125-130

Author(s):

A. Hassab Errasoul ◽

M. Cannon ◽

D. Cotter

Keyword(s):

Data Protection ◽

Working Hours ◽

Educational Interventions ◽

Hospital Data ◽

Staff Members ◽

Before And After ◽

Audit Cycle ◽

Collection Practices ◽

Psychiatric Department ◽

The Impact

Aim1) to assess compliance with the Data Protection Acts (DPA) by a Department of Psychiatry in a general hospital, 2) to implement measures that are likely to maximize compliance with the hospital data protection policy, 3) to close the audit cycle by assessing the impact of such measures on departmental compliance with the DPA over five months period.MethodAn individual, anonymised staff questionnaire on data collection practices, procedure of disclosure of data to third parties and previous training on DPA was used to collect information from the department staff. The premises were inspected at different times over a week period using structured checklist. Default points were recorded during each inspection. Post-audit interventions included a mixture of educational interventions and practical solutions. A re-audited took place five months later using the same method.ResultsThe baseline audit demonstrated significant lack of compliance with the DPA among staff members and lack of staff training on the DPA. Following the interventions, staff awareness of the requirements of the act rose which in turn lead to better adherence to recommend practices in data handling and to mean default points dropped significantly. Management of manual files appears to constitute the biggest problem in this audit. Daytime breaks were found to pose higher risk to stored data compared with before and after working hours.ConclusionsA combination of educational and practical interventions including training of staff on the DPA results in overall improvement in compliance and reduction in default points. However, management of manual (physical) data proves to be more difficult and hence will need more input.

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