scholarly journals P-P26 Post-laparotomy pain: the Rectus Sheath Pocket technique compared to other analgesic modalities

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Rebecca Dalli ◽  
JoEtienne Abela
Keyword(s):  
Rectus Sheath ◽  
Adult Patients ◽  
Control Group ◽  
Study Group ◽  
Surgical Department ◽  
Pain Scores ◽  
Posterior Rectus Sheath ◽  
Catheter Dislodgement ◽  
Group A ◽  
Local Anaesthetic Solution

Abstract Background Wound pain is a major cause of morbidity after laparotomy, leading to reduced mobility, poor respiratory effort, and delayed discharge. In our centre, we have developed a safe and effective post-operative analgesia technique that reliably delivers a continuous, stable infusion of local anaesthetic solution into a pocket superficial to the posterior rectus sheath. Methods Sixty-eight adult patients were enrolled in the study. Group A, n = 38 received rectus sheath catheter (RSC) analgesia and Group B, n = 30 received standard post-operative analgesia. The pain score on day 1 and total opioid dosage over the first 72 hours post-operatively were recorded. All patients were recruited from Mater Dei Hospital which is the main acute hospital in Malta. The patients who were recruited consecutively for the study group underwent elective or emergency laparotomies within a pancreatic-biliary firm. For the control group, patients underwent elective or emergency laparotomies under the care of other teams within the same surgical department.  Results Group A displayed significantly diminished mean pain scores (2.81±2.26 vs 4.66±2.86 p = 0.003) but no statistically significant reduction in cumulative opiate usage. On further subgroup analysis, patients over 65 years of age with RSC, displayed significantly less overall cumulative opiate usage (10.09±15.71 vs 25.79±32.97, p = 0.005). Few mild complications were recorded; catheter dislodgement (5), entrapment of catheter in wound sutures (1) and a wound hematoma (1) caused upon insertion. Conclusions Although inter-cohort demographics are consistent, case heterogeneity is acknowledged as a weakness of this endeavour. In adult patients, RSC has been demonstrated to be feasible, safe, and effective at diminishing pain scores in the postoperative period, especially so in the elderly population.

Does laryngopharyngeal reflux affect healing and recovery after tonsillectomy?

2007 ◽  
Vol 122 (6) ◽  
pp. 603-608 ◽  
Author(s):  
S Elwany ◽  
Y A Nour ◽  
E A Magdy
Keyword(s):  
Wound Healing ◽  
Laryngopharyngeal Reflux ◽  
Ph Monitoring ◽  
Control Group ◽  
Study Group ◽  
Pain Scores ◽  
Blinded Study ◽  
Group A ◽  
Group B ◽  
Control Group Group

AbstractIntroduction:Laryngopharyngeal reflux is increasingly being implicated in several otolaryngological disorders.Aims:To study a potential correlation between pre-operative laryngopharyngeal reflux and wound healing and recovery after tonsillectomy, based on subjective and objective findings.Materials and methods:A prospective, blinded study was undertaken, including 60 patients scheduled for tonsillectomy, divided into two equal groups: a study group (group A) with pre-operative laryngopharyngeal reflux documented using ambulatory 24-hour pH monitoring; and a control group (group B) without laryngopharyngeal reflux.Results:Group A had significantly higher pain scores on the seventh and 14th post-operative days (p = 0.022 and p = 0.000, respectively) and took a significantly longer time to return to normal eating (p = 0.013), compared with group B. Group A also showed significantly slower healing on the seventh and 14th post-operative days, as estimated by assessing the grade of post-operative slough formation (p = 0.016 and p = 0.029, respectively). A significant correlation between the number of pharyngeal reflux episodes and the degree of post-operative slough was also found.Conclusions:Laryngopharyngeal reflux can significantly decrease wound healing following tonsillectomy. Therefore, pre-operative recognition and management of this condition is desirable in order to eliminate its negative post-operative effect.

scholarly journals Early impact of the COVID-19 pandemic and social restrictions on ambulance missions

2021 ◽  
Author(s):  
Lauri Laukkanen ◽  
Sanna Lahtinen ◽  
Janne Liisanantti ◽  
Timo Kaakinen ◽  
Ari Ehrola ◽  
...  
Keyword(s):  
Early Phase ◽  
Health Care Services ◽  
Mental Health Problems ◽  
Significant Decline ◽  
Control Group ◽  
Study Group ◽  
Time Intervals ◽  
Care Services ◽  
Group A ◽  
New Strategies

Abstract Background The SARS-CoV-2 coronavirus disease (COVID-19) has had a major impact on health care services globally. Recent studies report that emergency departments have experienced a significant decline in the number of admitted patients in the early phase of the pandemic. To date, research regarding the influence of COVID-19 on emergency medical services (EMS) is limited. The present study investigates a change in the number and characteristics of EMS missions in the early phase of the pandemic. Methods All EMS missions in the Northern Ostrobothnia region, Finland (population 295 500) between 1 March to 30 June 2020 were screened and analyzed as the study group. A control group was composed from the EMS calls between the corresponding months in the years 2016–2019. Results A total of 74 576 EMS missions were screened for the study. Within the first two months after the first COVID-19 cases in the study area, the decline in the number of EMS missions was 5.7% – 13% compared to the control group average. EMS time intervals (emergency call to dispatch, dispatch, en-route, on-scene and hospital handover) prolonged in the COVID-19 period. Dispatches concerning mental health problems increased most in the study period (+1.2%, p < 0.001). Only eleven confirmed COVID-19 infections were encountered by EMS in the study period. Conclusion Our findings suggest that the present COVID-19 pandemic and social restrictions lead to changes in the EMS usage. These preliminary findings emphasize the importance of developing new strategies and protocols in response to the oncoming pandemic waves.

scholarly journals Evaluating the Effectiveness of Childbirth Preparation Courses on Women’s Self-Efficacy among Ultra-Orthodox Jewish Religious Women in Israel

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 818
Author(s):  
Liat Korn ◽  
Gideon Koren ◽  
Ayelet Yaakov ◽  
Galit Madar ◽  
Ayala Blau
Keyword(s):  
Self Efficacy ◽  
Course Delivery ◽  
Orthodox Jewish ◽  
Control Group ◽  
Study Group ◽  
Jewish Women ◽  
Religious Women ◽  
Birth Preparation ◽  
Group A ◽  
Childbirth Preparation

Background: This study examined the effectiveness of a birth preparation course on coping with childbirth among primigravid ultra-orthodox Jewish women in Israel. Methods: In total, 130 ultra-orthodox 25–35-week primigravid women were divided into a study (n = 100, participated in birth preparation courses) and a control (n = 30, did not participate in the courses) group. A questionnaire was delivered three times: T1—before the course/delivery, T2—two–three days after delivery, and T3—a month after delivery. Results: At T3, self-efficacy among the study group was higher than in the control group. Differences in self-efficacy were found over time regardless of the group (F(2,246) = 12.83, p < 0.001), as a time–group interaction effect (F(2,246) = 10.20, p < 0.01). Self-efficacy in the study group (Mean, M = 3.40, Standard deviation, SD = 0.63 at T1) dropped to M = 3.06, SD = 0.76 at T2 and rose to M = 3.34, SD = 0.64 at T3. In the control group, self-efficacy (M = 3.53, SD = 0.56 at T1) dropped to M = 3.26, SD = 0.63 at T2 and to M = 2.95, SD = 0.76 at T3. Discussion: The childbirth preparation course was found to be effective in raising self-efficacy among primigravid ultra-orthodox religious women when compared to the control group.

scholarly journals The Role of CD68 (+) Histiocytic Macrophages in Nasal Polyp Development

2020 ◽  
Author(s):  
Nuray Bayar Muluk ◽  
Osman Kürşat Arikan ◽  
Pınar Atasoy ◽  
Rahmi Kiliç ◽  
Eda Tuna Yalçinozan
Keyword(s):  
Nasal Cavity ◽  
Nasal Polyp ◽  
Nasal Polyps ◽  
Deep Layer ◽  
Ethmoid Sinus ◽  
Adult Patients ◽  
Control Group ◽  
Study Group ◽  
Deep Layers

Abstract Objectives The aim of this study was to investigate the role of CD68 (+) histiocytic macrophages (H-M) in the nasal polyp pathogenesis. Materials and Methods The study group consisted of 24 adult patients with nasal polyposis. The control group consisted of 11 adult patients without nasal polyps. A total of 36 nasal polyp samples (10-nasal cavity, 10-maxillary sinus, and 16-ethmoid sinus) from the study group and 11 inferior turbinate samples from the control group were analyzed by immunohistochemical staining, with monoclonal antibodies against CD68 (+) H-M. Results CD68 positivity was significantly higher than the control group in the subepithelial (SE) layer of the ethmoid sinus, and deep layers of nasal cavity, maxillary, and ethmoid sinuses. In SE and deep layers of ethmoid and maxillary sinuses, CD68 positivity was significantly higher than that of the epithelial layer. In the deep layer, histiocytic macrophages tended to gather around eosinophils. Conclusion The high numbers of CD68 (+) histiocytic macrophages mainly located in deep layer of lamina propria may be responsible for the phagocytosis of eosinophils within the polyp tissue. Therefore, it may be concluded that increased macrophages in nasal polyps do not trigger the growth of nasal polyps. Instead, they may serve to reduce the number of eosinophils in already-developed nasal polyps.

scholarly journals Glisson’s capsule cauterisation is associated with increased postoperative pain after laparoscopic cholecystectomy: a prospective case–control study

2017 ◽  
Vol 99 (6) ◽  
pp. 485-489 ◽  
Author(s):  
F Basak ◽  
M Hasbahceci ◽  
A Sisik ◽  
A Acar ◽  
Y Ozel ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Case Control Study ◽  
Gallbladder Disease ◽  
Case Control ◽  
Control Group ◽  
Study Group ◽  
Pain Scores ◽  
Standard Laparoscopic Cholecystectomy ◽  
Control Study

INTRODUCTION Postoperative pain after laparoscopic cholecystectomy has three components: parietal, visceral and referred pain felt at the shoulder. Visceral peritoneal injury on the liver (Glisson’s capsule) during cauterisation sometimes occurs as an unavoidable complication of the operation. Its effect on postoperative pain has not been quantified. In this study, we aimed to evaluate the association between Glisson’s capsule injury and postoperative pain following laparoscopic cholecystectomy. METHODS The study was a prospective case–control of planned standard laparoscopic cholecystectomy with standardized anaesthesia protocol in patients with benign gallbladder disease. Visual analogue scale (VAS) abdominal pain scores were noted at 2 and 24 hours after the operation. One surgical team performed the operations. Operative videos were recorded and examined later by another team to detect presence of Glisson’s capsule cauterisation. Eighty-one patients were enrolled into the study. After examination of the operative videos, 46 patients with visceral peritoneal injury were included in the study group, and the remaining 35 formed the control group. RESULTS VAS pain score at postoperative 2 and 24 hours was significantly higher in the study group than control (P = 0.027 and 0.017, respectively). CONCLUSIONS Glisson’s capsule cauterisation in laparoscopic cholecystectomy is associated with increased postoperative pain. Additional efforts are recommended to prevent unintentional cauterisation.

scholarly journals Repeated short cycles of nonsteroidal anti-inflammatory drugs and kidney injury in patients with spinal degenerative-dystrophic diseases

2018 ◽  
Vol 12 (3) ◽  
pp. 94-97
Author(s):  
D. M. Bichurina ◽  
I. Z. Gaydukova ◽  
D. А. Patrikeeva ◽  
A. P. Rebrov
Keyword(s):  
Back Pain ◽  
Kidney Injury ◽  
Control Group ◽  
Study Group ◽  
Creatinine Ratio ◽  
Healthy Individuals ◽  
Group A ◽  
Inflammatory Drugs ◽  
The Mean ◽  
Anti Inflammatory

Objective: to evaluate kidney function in patients with spinal degenerative-dystrophic diseases (SDDDs) who take nonsteroidal anti-inflammatory drugs (NSAIDs) as repeated short cycles of treatment for severe back pain.Patients and methods. The investigation enrolled 97 patients with SDDDs who took NSAIDs for back pain (a study group). A control group consisted of sexand age-matched healthy individuals who had not used NSAIDs within the past year (n=40). Glomerular filtration rate (GFR) was estimated using the CKD-EPI equation and markers of kidney injury (albuminuria and globulinuria) were measured.Results. In the study group, GFR was decreased to <90 ml/min/1.73 m2 in 61 (62.9%) patients, to <60 ml/min/1.73 m2 in 11 (11.3%); the mean GFR was 77.5 [68.0; 89.0] ml/min/1.73 m2; in the control group, a decline in GFR to 89–60 ml/min/1.73 m2 was recorded in 35 (62.5%) cases; this indicator was >90 ml/min/1.73 m2 in the remaining 15 (37.5%) cases; the mean GFR was 82.5 [70.8; 90.0] ml/min/1.73 m2 (p≥0.05 for all pairwise comparisons). A decrease in GFR to <60 ml/min/1.73 m2 was found in 11 (11.3%) patients in the study group and in nobody in the control group (p=0.026). Elevated albuminuria was noted in 74 (76.3%) patients with SDDDs and in 9 (22.5%) healthy individuals (p<0.05). Albumin/creatinine ratio was 57.1 [33.8; 82.4] mg/g in the study group and 25.0 [17.5; 32.9] mg/g in the control group (p<0.0001). Increased globulinuria was established in all the patients with SDDDs and only in 3 (7.5%) healthy examinees. Globulin/creatinine ratio was 134.7 [77.5; 197.7] mg/g in the study group and 12.9 [0.5; 18.1] mg/g in the control group (p<0.0001).Conclusion. A decline in GFR to <60 ml/min/1.73 m2 was more often seen in the patients taking NSAIDs for spine pain caused by SDDDs than in the healthy individuals. In case of comparable GFR, the level of kidney injury markers was significantly higher in the study group than that in the control group, which suggests that patients with SDDDs who take NSAIDs have subclinical tubulointerstitial and glomerular changes.

scholarly journals A Technique for Wound Cavity Closure after Coccyx Resection in Experiment

2019 ◽  
Vol 9 (2) ◽  
pp. 157-162
Author(s):  
I. I. Khidiatov ◽  
M. V. Gerasimov ◽  
R. R. Kudoyarov
Keyword(s):  
Bone Mass ◽  
Animal Experiment ◽  
Wound Dehiscence ◽  
Control Group ◽  
Study Group ◽  
Surgical Wound ◽  
Secondary Intention ◽  
Group A ◽  
Cavity Closure ◽  
Inflammatory Changes

Introduction. Closing the wound cavity after the coccyx resection in patients with posttraumatic coccygodynia remains an issue unresolved. Closing the wound cavity with local tissues often leads to the wound dehiscence due to excessive tension which in turn leads to suppuration and prolonged healing.This paper aims to assess experimentally the effectiveness of using ground autograft bone of the coccyx removed for the closure of the surgical wound.Materials and methods. In the animal experiment the coccyx resection was performed under a combined anaesthesia in six pigs (three in the study group and three in control). In the control group the wound edges were sutured to its floor. In the study group after the coccyx resection the ground bone mass made of the coccyx resected was implanted into the wound cavity.Results and discussion. In the control group the wound dehiscence was registered in all the animals. After the animals were taken out of the experiment it was established that in the study group a new consolidated bony conglomerate was formed without any pronounced inflammatory changes around the wound. In control the wound cavity healed with secondary intention.Conclusions. The study confirms the effectiveness of using ground autograft bone for the closure of the wound cavity.

scholarly journals Utilidad diagnóstica de la relación plaquetas/linfocitos en embarazadas con preeclampsia

2021 ◽  
Vol 81 (01) ◽  
pp. 5-12
Author(s):  
Eduardo Reyna-Villasmil ◽  
◽  
Jorly Mejía-Montilla ◽  
Nadia Reyna-Villasmil ◽  
Duly Torres-Cepeda ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Predictive Value ◽  
Control Group ◽  
Study Group ◽  
Diagnostic Efficacy ◽  
Lymphocyte Ratio ◽  
Platelet Lymphocyte Ratio ◽  
A Value ◽  
Group A ◽  
Group B

Objective: To establish the diagnostic utility of the platelet-lymphocyte ratio in pregnant women with preeclampsia. Methods: A case-control study was carried out at the Hospital Central “Dr. Urquinaona” Maracaibo, Venezuela. A total of 180 pregnant women were selected. Ninety preeclamptic women were included as the study group (group A) and a control group selected for their age and body mass index similar to the study group, which consisted of 90 healthy normotensive pregnant women (group B). The general characteristics, platelet-lymphocyte ratio values and diagnostic efficacy were determined. Results: Group A patients presented lower platelet and lymphocyte values compared to group B patients (p <0.001). However, no statistically significant differences were found in platelet-lymphocyte ratio between group A patients (115.2 ± 32.7) and group B patients (122.3 ± 23.8; p = 0, 0971). A cut-off value of the platelets-lymphocyte ratio of 117 presented a value below the curve of 0.57, the sensitivity of 47.8%, the specificity of 50.0%, the positive predictive value of 48.9%, and the negative predictive value of 52.2%, with a diagnostic accuracy of 48.9%. Conclusion: Platelet-lymphocyte ratio is not a useful tool in the diagnosis of preeclampsia, since patients with the syndrome present similar values to normotensive pregnant women. Keywords: Platelet-lymphocyte ratio, Preeclampsia, Diagnosis, Pregnancy.

scholarly journals Application Value of Coagulation Function Test in Prognosis of Patients with Cardiovascular and Cerebrovascular Diseases

2021 ◽  
Vol 9 (4) ◽  
pp. 89
Author(s):  
Jing Luo
Keyword(s):  
Cerebrovascular Diseases ◽  
Good Prognosis ◽  
Control Group ◽  
Study Group ◽  
Test Results ◽  
Coagulation Function ◽  
Significant Difference ◽  
Function Test ◽  
Group A ◽  
Group B

<p><span lang="EN-US">Objective: to explore the application value of coagulation function test in the prognosis of patients with cardiovascular and cerebrovascular diseases. Methods: from December 2018 to December 2019, 100 patients with cardiovascular and cerebrovascular diseases were randomly selected as the study group. According to the follow-up results of patients, they were divided into study group A (good prognosis, n = 64) and study group B (disability or death, n = 36) 100 subjects served as the control group. The test results of coagulation function of the two groups were analyzed retrospectively. The test results of the study group before and after treatment were compared with those of the control group, and the test results of the study group A and study group B after treatment were compared. Results: the coagulation function of the study group after treatment was significantly improved compared with that before treatment (P &lt; 0.05), and there was a significant difference between the two groups before treatment (P &lt; 0.05), and there was no difference after treatment (P &gt; 0.05); after treatment, the coagulation function of study group A and study B was significantly different (P &lt; 0.05). Conclusion: coagulation function test has a certain application value for the prognosis of patients with cardiovascular and cerebrovascular diseases, and can be used as an index to judge the patient’s condition and treatment effect, which has good application value in clinical practice.</span></p>

scholarly journals The Comparative Effects of Listening to Prayer Recitation and Music Therapy Intraoperatively on Postoperative Pain

2020 ◽  
Vol 17 (2) ◽  
Author(s):  
Farah Syaza Rahman ◽  
Nurlia Yahya ◽  
Nor Mohammad Md Din ◽  
Azarinah Izaham ◽  
Wan Rahiza Wan Mat
Keyword(s):  
Blood Pressure ◽  
Postoperative Pain ◽  
Music Therapy ◽  
Demographic Data ◽  
Control Group ◽  
Pharmacological Interventions ◽  
Heart Rates ◽  
Pain Scores ◽  
Group A ◽  
Group B

Introduction: Non-pharmacological interventions are considered as successful adjuncts to manage pain. We are studying the comparative effects of listening to prayer recitation and music therapy intraoperatively as non-pharmacological interventions on postoperative pain and intraoperative haemodynamics. Materials and Methods: Seventy two muslim patients with acute appendicitis requiring open, emergency appendicectomies under general anaesthesia were recruited and randomised into three groups: Group A: patients who listened to prayer recitation, Group B: patients who listened to music, Group C: control group - patients who did not listen to any prayer or music. Intraoperative blood pressure, heart rate and postoperative pain scores were monitored. Results: The demographic data, pre- and post-headphones application haemodynamics were compared. There were significantly lower heart rates at 10, 20, 30, 40, 50, 60 minutes for Group A and at 50 and 60 minutes for Group B patients when compared to Group C. Significant reduction in postoperative pain scores were seen in Group A patients at 30 minutes and 8 hours as compared to Group C patients. No significant differences in pain scores were seen between Group B and C patients. No significant differences in additional analgesic requirements postoperatively were seen in all three groups. Conclusion: Listening to prayer recitation or music intraoperatively significantly lowered intraoperative heart rates, however only prayer recitation significantly reduced postoperative pain scores as compared to the control group.

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