A novel device for rapid, safe and precise delivery of intravitreal injections

2019 ◽  
Vol 5 (1) ◽  
pp. 8-12
Author(s):  
Salman Waqar ◽  
Ali Ayaz ◽  
Irfan Karamat ◽  
Saba Anwar ◽  
James McLeod ◽  
...  
Keyword(s):  
Nurse Practitioners ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
P Value ◽  
Current Standard ◽  
Allied Health Professionals ◽  
Novel Device ◽  
Early Use ◽  
Numerical Rating ◽  
The Mean

BackgroundDelivery of therapeutic agents via intravitreal (IVT) injections is well established as the mainstay of treatment for many ophthalmic conditions. High demand means that injections are increasingly being delivered either by ophthalmic nurse practitioners (UK) or by ophthalmologists in office-based settings (North America/mainland Europe). Most patients require frequent IVT injections, and there is a need to make the procedure more comfortable and safe.MethodsWe describe a novel device designed to ensure rapid, safe and precise delivery of injections while improving the patient experience. In addition, we present details of a local National Health Service pathway initiated to facilitate clinician-led innovations. It is hoped that this model can also be replicated internationally. We also present results from two sites: one, comparing outcomes of 25 patients who received the injection with the device, against 25 patients who received injections using the current standard method; the other a retrospective notes evaluation of 60 patients injected with the device.ResultsNo adverse events were noted and the device appears to be well tolerated by patients. Use of the guide did not result in a statistically significant increase in pain (p value > 0.05) but the mean score (on a unidimensional numerical rating scale) was noted to be slightly better. All patients gave very positive informal feedback.ConclusionsWe have described the design process and successful early-use results of a novel device developed to facilitate safe, precise and rapid delivery of IVT injections by both ophthalmologists and allied health professionals.

scholarly journals Analgesic Efficacy of Perioperative Esmolol as an Adjunct to Morphine in Mastectomy- A Prospective Observational Study

2021 ◽  
Author(s):  
Jose Tania ◽  
Vadakkoot Raghavan Hema ◽  
Prabhakaran Vineetha
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Control Group ◽  
P Value ◽  
Numerical Rating ◽  
The Mean

Introduction: Multimodal analgesia with opioids as the prime component is the mainstay of postoperative analgesia for mastectomy, which can lead to many opioid related unwanted side-effects. Esmolol infusion has been found as a useful adjunct in reducing opioid requirements. Aim: To find the effect of perioperative esmolol infusion on postoperative pain and opioid requirements. Materials and Methods: This prospective observational study was done in 140 American Society of Anaesthesiologists (ASA) physical status l and ll patients, between 20-65 years of age posted for mastectomy under general anaesthesia. Esmolol group (group E) received 0.25 mg/kg of esmolol bolus ten minutes before induction followed by continuous infusion 5 μg/kg/min till end of surgery while control group (group C) received equivalent volumes of saline. Primary outcome measures were Numerical Rating Scale (NRS) for pain, total postoperative opioid consumption and time to first rescue analgesic dosage till 24 hours. Intraoperative haemodynamics and other side-effects were secondary outcomes. Descriptive statistics of numerical rating scores and analgesic requirements were analysed in terms of mean and standard deviation. Independent t-test was used to compare numerical rating scores and analgesic requirement of the two groups. A p-value of <0.05 was considered statistically significant. Results: The mean numerical pain scores were significantly lower in the esmolol group for the first 24 hour. The mean time to first rescue analgesic was 17.59±5.012 hour in the esmolol group and 8.21±2.22 hour in the control group which was statistically significant (p<0.001). The total tramadol consumption was also significantly lesser in the esmolol group (42.14±29.03 mg), compared to control group (102.86±22.3 mg), (p=0.0001). Mean heart rate was statistically lower in the esmolol group, but there was no incidence of bradycardia requiring treatment. Mean Arterial Pressures (MAP) were comparable. Conclusion: Perioperative esmolol infusion when used as an adjunct to morphine decreased postoperative pain and analgesic requirements for the first 24 hours without any haemodynamic disturbances.

scholarly journals PENGARUH FOOTBATH TREATMENT TERHADAP NYERI POST SECTIO CAESAREA DI RUANG MELATI RSUD DR SOEKARDJO TASIKMALAYA TAHUN 2019

2020 ◽  
Vol 3 (1) ◽  
pp. 1-5
Author(s):  
Detty Chotimah ◽  
Yulia Herliani ◽  
Endang Astiriyani
Keyword(s):  
Rating Scale ◽  
Numerical Rating Scale ◽  
Sampling Technique ◽  
Sectio Caesarea ◽  
Rank Test ◽  
P Value ◽  
Abdominal Incision ◽  
Signed Rank ◽  
Numerical Rating ◽  
Signed Rank Test

Sectio caesarea is a surgical procedure in giving birth with an abdominal incision and uterus that have higher morbidity than normal childbirth. Foot bath treatment is one part of post natal spa can release endorphins in the brain which is a natural pain reliever. The purpose of this research is to determine the effect of foot bath treatment on post SC pain in Melati room RSUD dr Soekardjo Tasikmalaya. This research was used pre eksperimental with pretest posttest design. The research instrument used Numerical Rating Scale (NRS). Sampling technique was used purposive sampling with 30 respondents. Foot bath treatment is done for 15 minutes. The analyzed was by Wilcoxon Signed Rank Test. The result of this research showed that the scale of pain before getting foot bath treatment is mostly moderate pain as many as 26 peoples (87,7%). The scale of pain after getting foot bath treatment is mostly mild pain as many as 25 peoples (83,3%). The result of the statistical test showed p value 0,000 <0,05 it means there is an effect of foot bath treatment to post SC pain.

scholarly journals STIMULASI KUTANEUS LEBIH EFEKTIF MENURUNKAN NYERI DISMENORE PADA REMAJA DIBANDINGKAN DENGAN KUNYIT ASAM

2018 ◽  
Vol 7 (2) ◽  
pp. 143
Author(s):  
Natalia Devi Oktarina ◽  
Suwanti Suwanti ◽  
M. Imron Rosyidi
Keyword(s):  
Rating Scale ◽  
Numerical Rating Scale ◽  
T Test ◽  
Control Group ◽  
P Value ◽  
Control Group Design ◽  
Purposive Sampling ◽  
Group Design ◽  
Numerical Rating

Nyeri dismenore adalah nyeri di daerah panggul akibat menstruasi dan produksi zat prostaglandin yang membuat dinding rahim berkontraksi dan pembuluh darah sekitarnya terjepit (kontriksi) yang menimbulkan iskemi jaringan. Penanganan nyeri dismenore dapat dilakukan dengan nonfarmakologis diantaranya dengan pemberian minuman kunyit asam dan stimulasi kutaneus. Penelitian ini untuk mengetahui perbedaan efektivitas pemberian kunyit asam yang baisa dikonsumsi remaja dengan pemberian stimulasi kutaneusterhadap penurunan intensitas nyeri dismenore pada siswi remaja putri. Penelitian ini menggunakan desain penelitian quasy eksperiment dengan rancangan pretest-posttest with control group design. Pengambilan sampel dengan cara purposive sampling. Besarnya sampel adalah 40 remaja di Desa Candirejo Kabupaten Semarang. Instrumen penelitiannya berupa lembar observasi nyeri Numerical Rating Scale. Analisis data menggunakan uji statistik t-test independent. Hasil penelitian melalui uji statistik t-test independent menunjukkan nilai p-value 0,002  yang artinya ada perbedaan efektivitas pemberian kunyit asam dan stimulasi kutaneus terhadap penurunan intensitas nyeri haid dengan rata-rata penurunan skala nyeri lebih tinggi pada stimulasi kutaneus. Kesimpulannya adalah stimulasi kutaneus lebih efektif menurunkan skala nyeri dismenore pada remaja putri.Berdasarkan dari hasil penelitian yang dilakukan diharapkan intervensi stimulasi kutaneus dapat diterapkan dan diaplikasikan sebagai intervensi baru bagi remaja ataupun masyarakat untuk mengatasi dismenore. Kata kunci      : nyeri dismenore, kunyit asam, stimulasi kutaneus

scholarly journals EFEKTIFITAS KOMPRES SEREI HANGAT TERHADAP PENURUNAN SKALA NYERI ARTHRITIS RHEUMATOID PADA LANSIA DI DESA NAUMBAI WILAYAH KERJA PUSKESMAS KAMPAR

Jurnal Ners ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. 29-34
Author(s):  
RIDHA HIDAYAT
Keyword(s):  
Rating Scale ◽  
Numerical Rating Scale ◽  
P Value ◽  
Test Design ◽  
Purposive Sampling ◽  
Numerical Rating ◽  
Arthritis Rheumatoid

Arthritis rematoid seringkali melibatkan organ tubuh lainnya yang disertai nyeri dan kaku pada system otot dan jaringan ikat.Penelitian ini bertujuan untuk mengetahui efektifitas kompres serai hangat terhadap skala nyeri arthritis rematoid pada lansia di Desa Naumbai Wilayah Kerja Puskesmas Kampar.Metode penelitian ini adalah Quasi Eksperimen dalam satu kelompok ( one group pre test-pos test design). Populasi adalah seluruh pasien arthritis rheumatoid di Desa Naumbai dengan jumlah 127 orang. Adapun penentuan sampel menggunakan purposive sampling, jumlah sampel pada penelitian ini sebanyak 33 orang. Instrumen yang digunakan adalah lembar observasi dan Numerical Rating Scale dan Skala nyeri wajah. Analisa yang digunakan adalah analisa univariat dan bivariate dengan menggunakan uji T-Dependent. Hasil penelitian menunjukkan adanya perbedaan secara bermakna antara skala nyeri responden setelah diberikan kompres serai hangat dengan nilai p-value (0,000) < α (0,05). Diharapkan penderita arthritis rheumatoid dengan nyeri dapat mengaplikasikan kompres serai hangat untuk penurunan skala nyeri.

scholarly journals PENGARUH PEMBERIAN TEHNIK AKUPRESUR TERHADAP PENURUNAN NYERI PERSALINAN KALA I PADA IBU PRIMIPARA DI RUANG WIDYA RUMAH SAKIT CIREMAI CIREBON TAHUN 2016

2020 ◽  
Vol 7 (2) ◽  
pp. 880-886
Author(s):  
Awaludin Jahid Abdillah ◽  
Iyus Meni
Keyword(s):  
Rating Scale ◽  
Numerical Rating Scale ◽  
Labor Pain ◽  
P Value ◽  
Test Design ◽  
Research Results ◽  
Uterine Contractions ◽  
Post Test ◽  
Numerical Rating ◽  
Reduction Effect

Nyeri persalinan dapat menimbulkan stres yang menyebabkan pelepasan hormon yang berlebihan seperti katekolamin dan steroid. Hormon ini dapat menyebabkan terjadinya ketegangan otot polos dan vasokontriksi pembuluh darah. Hal ini dapat mengakibatkan penurunan kontraksi uterus,penurunan sirkulasi utero plasenta, pengurangan aliran darah dan oksigen ke uterus, serta timbulnya iskemia uterus yang membuat impuls nyeri bertambah banyak akupresur, stimulasi kulit dapat memberi efek penurunan nyeri yang efektif. Tehnik akupresur dapat dimanfaatkan sebagai menurunkan rasa nyeri pada saat persalinan. Tujuannya adalah  untuk mengetahui pengaruh  pemberian tehnik akupresur terhadap nyeri persalinan kala I pada ibu primapara. Jenis penelitian ini adalah Pre eksperiment dengan rancangan pre and post test design.  Populasi adalah  ibu bersalin kala I primipara di ruang Widya Rumah Sakit Ciremai Cirebon Tahun 2016, Sampel menggunakan tehnik total sampling dengan jumlah sampel 22 responden. Instrumen penelitian menggunakan  Numerical Rating Scale. Metode pengambilan data dalam  penelitian ini menggunakan observasi, dianalisis dengan Wilcoxon Matchead Pairs p-value ≤0.05.Dari hasil penelitian dengan menggunakan uji Wilcoxon Matchead Pairs, menunjukan nilai ρ=0.000 (0,000≤0.05), berarti ada pengaruh pemberian tehnik akupresur terhadap penurunan nyeri persalinan. Sehubungan dengan hasil penelitian diharapkan perlunya memberikan pelatihan tentang tehnik akupresur baik bagi rumah sakit, ilmu keperawatan, praktik keperawatan dan ibu bersalin primipara.Kata Kunci : intensitas nyeri, persalinan, tehnik akupresur  ABSTRACTLabor pain can cause stress which causes excessive release of hormones such as catecholamines and steroids. These hormones can cause smooth muscle strain and vasoconstriction of blood vessels. This can lead to decreased uterine contractions, decline in utero placental circulation, reducing blood flow and oxygen to the uterus, as well as the onset of ischemia of the uterus which make implus pain increased. acupressure, skin stimulation can provide effective pain reduction effect. Acupressure technique can be used as a decrease pain during labor . The purpose is to determine the effect on the provision of acupressure techniques to the first stage of labor pain in the mother primapara.This research is a Pre experimental design with pre and post test design maternity respondents in the room when I primiparas Widya Hospital Cirebon Ciremai 2016, use the technique of total smpling with a sample of 22 respondents . research instruments using Numerical Rating Scale. The method of collecting data in this study using observation, Matchead Pairs analyzed by Wilcoxon p-value ≤0.05 .From the results of research using the Matchead Pairs Wilcoxon, research results show the value ρ = 0.000 ( 0,000≤0.05 ), means that there is the effect of acupressure techniques to decrease labor pain.In connection with the research results expected need for providing training in acupressure technique is good for hospitals , nursing science, nursing practice and maternal primiparous.Keywords : pain intensity, labor, acupressure technique

scholarly journals The association of pain and stiffness with fatigue in incident polymyalgia rheumatica: baseline results from the polymyalgia rheumatica cohort study

2019 ◽  
Vol 20 ◽  
Author(s):  
J.A. Prior ◽  
S. Muller ◽  
T. Helliwell ◽  
S.L. Hider ◽  
K. Barraclough ◽  
...  
Keyword(s):  
General Practice ◽  
Cohort Study ◽  
Polymyalgia Rheumatica ◽  
Symptom Severity ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Newly Diagnosed ◽  
Fatigue Score ◽  
Numerical Rating ◽  
The Mean

AbstractWe aimed to examine the association between pain, stiffness and fatigue in newly diagnosed polymyalgia rheumatica (PMR) patients using baseline data from a prospective cohort study. Fatigue is a known, but often ignored symptom of PMR. Newly diagnosed PMR patients were recruited from general practice and mailed a baseline questionnaire. This included a numerical rating scale for pain and stiffness severity, manikins identifying locations of pain and stiffness and the FACIT-Fatigue questionnaire. A total of 652 PMR patients responded (88.5%). The mean age of responders was 72.6 years (SD 9.0) and the majority were female (62.0%). Manikin data demonstrated that bilateral shoulder and hip pain and stiffness were common. The mean fatigue score (FACIT) was 33.9 (SD 12.4). Adjusted regression analysis demonstrated that a higher number of pain sites (23–44 sites) and higher pain and stiffness severity were associated with greater levels of fatigue. In newly diagnosed PMR patients, fatigue was associated with PMR symptom severity.

Clinical and radiological outcomes of the Ivory arthroplasty for trapeziometacarpal joint osteoarthritis with a minimum of 5 years of follow-up: a prospective single-centre cohort study

2013 ◽  
Vol 38 (8) ◽  
pp. 866-874 ◽  
Author(s):  
J. F. Goubau ◽  
C. K. Goorens ◽  
P. Van Hoonacker ◽  
B. Berghs ◽  
D. Kerckhove ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Survival Rates ◽  
Trapeziometacarpal Joint ◽  
Term Survival ◽  
Numerical Rating ◽  
Trapeziometacarpal Joint Osteoarthritis ◽  
The Mean

We present the results of a 5 year prospective follow-up study on the functional outcome after total replacement of the trapeziometacarpal joint with the Ivory prosthesis (Memometal, Stryker Corporate, Kalamazoo, Michigan, USA) in 22 patients. The female to male ratio was 21:1 and the mean age was 66 (range 54–78) years. The mean follow-up period was 67 (range 60–77) months after operation. Patient satisfaction was high. The mobility of the operated thumb was restored to a range of motion comparable to the contralateral thumb. Key pinch and grip strength improved by 13% and 31%, respectively. Overall function, according to Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score, improved by 59%. Pain decreased by 85% according to the numerical rating scale. Radiological evaluation revealed no loosening of the implant after 5 years except in one patient who required revision due to polythene wear with secondary joint instability. Another patient had asymptomatic polythene wear that required no revision but remains in follow-up. The 5 year overall survival of the prosthesis was 95%. These medium-term results suggest that the Ivory arthroplasty is a reliable option for treating advanced trapeziometacarpal arthritis, because it appears to give a very good functional outcome and has the potential for long-term survival rates.

scholarly journals Strategy to prevent nerve injury and deep vein thrombosis in radiofrequency segmental thermal ablation of the saphenous veins using a new objective pain scale

2021 ◽  
pp. 026835552110105
Author(s):  
Kenji Yamamoto ◽  
Senri Miwa ◽  
Tomoyuki Yamada ◽  
Shuji Setozaki ◽  
Mamoru Hamuro ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Nerve Injury ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Pain Scale ◽  
Vein Thrombosis ◽  
Numerical Rating ◽  
Endovenous Ablation ◽  
The Mean ◽  
Deep Vein

Objective We evaluated the benefit of local anesthesia including tumescent anesthesia and active walking soon after surgery in preventing nerve injury and deep vein thrombosis caused during endovenous ablation. Methods Endovenous ablation was performed in 1334 consecutive patients. Varicectomy was performed using the stab avulsion technique. After surgery, patients were encouraged to walk 100–200 m inside the ward for 3–5 times/h. The pain was evaluated objectively using the Okamura pain scale and subjectively using the numerical rating scale. Results Stab avulsion was performed at 11.8 ± 8.0 sites and the mean operative time was 33.9 ± 15.2 min. The mean Okamura pain scale and numerical rating scale scores were 1.6 ± 1.3 and 3.0 ± 2.0, respectively. Deep vein thrombosis and pulmonary embolism were absent. The incidence of nerve injury was 0.3%. Conclusions Endovenous ablation should be performed with the patients under local anesthesia to prevent nerve injury and deep vein thrombosis.

scholarly journals PENGARUH SENAM HAMIL TERHADAP NYERI PUNGGUNG PADA IBU HAMIL

2020 ◽  
Vol 10 (1) ◽  
pp. 1259-1265
Author(s):  
Uun Kurniasih
Keyword(s):  
Back Pain ◽  
Pregnant Women ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Intervention Group ◽  
Control Group ◽  
P Value ◽  
Purposive Sampling ◽  
Post Test ◽  
Numerical Rating

Salah satu ketidaknyamanan yang sering timbul pada kehamilan adalah nyeri punggung. Nyeri punggung merupakan gangguan yang banyak dialami oleh ibu hamil sepanjang masa-masa kehamilan hingga periode pasca natal . Salah satu upaya yang bisa dilakukan untuk mengurangi nyeri punggung selama kehamilan adalah dengan melakukan senam hamil. Penelitian ini bertujuan untuk mengetahui skala nyeri sebelum dan sesudah dilakukan senam hamil dan untuk mengetahui pengaruh senam hamil terhadap nyeri punggung pada ibu hamil di UPTD Puskesmas Mundu Kabupaten Cirebon Tahun 2018.Penelitan ini menggunakan desain penelitian quasi eksperimen dengan pretest–posttest with control group. Pengambilan sampel menggunakan purposive sampling dengan jumlah sampel 28 responden, 14 subjek untuk kelompok intervensi dan 14 subjek untuk kelompok  kontrol. Teknik pengumpulan data dengan cara observasi. Sedangkan instrumen yang digunakan adalah Numerical Rating Scale (NRS). Analisa data yang digunakan adalah uji Mann – Whitney.Hasil Penelitian ini menunjukkan bahwa hasil dari pre test dan post test pada kelompok kontrol mayoritas dengan intensitas nyeri sedang yaitu 7 orang (50%) dan nyeri berat yaitu 6 orang (42%), sedangkan pada melompok intervensi mayoritas nyeri ringan yaitu 7 orang (50%) dan nyeri sedang yaitu 7 orang (50%). Berdasarkan analisa statistik didapatkan niai p value adalah  0,001 maka Ho ditolak dan Ha diterima artinya senam hamil efektif menurunkan intensitas nyeri punggung pada ibu hamill di UPTD Puskesmas Mundu Kabupaten Cirebon tahun 2018Kata Kunci   : Senam, nyeri punggung, ibu hamil  ABSTRACTLow Back pain is one of the discomfort which often occurred during pregnancy. Lowback pain is a condition experienced by many pregnant women troughout pregnancy period to the post  delivery period. One of the solutionto address this issue is by doing exercise for pregnancy women. The studi was conducted to find out the effect of pregnancy exercisseto reduce low back paint issue.This studi aims to determine the scalae of pain before and after pregnancy exercise and to determine the effect of pregnancy exercise againt back pain in pregnancy women in UPTD puskesmas Mundu Cirebon Regency 2018. This research uses quasi experimental research design with Pretest –Posttest with Control Group. Sampling using purposive sampling with the number of samples of 28 respondent, 14 for the intervention group and 14 subjects for the control group. Data collection techniques by observation. While the instrument used is the Numerical Rating Scale (NRS). The data analysis used is Mann –Whitney test. The resukt of this study indicate that resukt of pre-test and post-test in the mayoritycontrol group with moderate pain intensisity of 7 people (50%) and severe pain that is 6 people (42,9%), while in the intervention group the majority of mild pain 7 peiple (50%). Based on statistical analysis in the value of p value is 0,001, then H0 is rejected reduce the intensity of back pain in pregnant women in UPTD Puskesmas Mundu Cirebon  2018.Keywords: Exercise, back pain, pregnancy women

scholarly journals PENGARUH RELAKSASI NAPAS DALAM DENGAN AROMATERAPI LAVENDER TERHADAP TINGKAT NYERI POST APENDIKTOMI DI RUANG JANGER RSD MANGUSADA

2021 ◽  
Vol 16 (2) ◽  
pp. 369-373
Author(s):  
I Gusti Ayu Dewi Indra Lestari ◽  
I Made Dwie Pradnya Susila ◽  
A.A. Ngurah Nara Kusuma
Keyword(s):  
Rating Scale ◽  
Numerical Rating Scale ◽  
Healing Process ◽  
Sampling Technique ◽  
P Value ◽  
Nursing Interventions ◽  
Relaxation Techniques ◽  
Deep Breath ◽  
Patient Pain ◽  
Numerical Rating

Appendectomy is a surgical procedure for appendicitis. This action can cause the perception of pain so that it has an impact on the healing process and triggers further complications if left untreated. Deep breathing relaxation techniques combined with aromatherapy is one of the treatments done to help overcome post appendectomy pain. This study purposed to determine the effect of deep breath relaxation with lavender aromatherapy on the level of post appendectomy pain in the Janger Room RSD Mangusada. This study is a pre-experimental research with one group pretest and posttest design involving 32 samples selected through purposive sampling technique. Collecting data using a research instrument in the form of the Numerical Rating Scale observation sheet. The results showed that there was an effect of deep breath relaxation with lavender aromatherapy on the level of post appendectomy pain in the Janger Room at RSD Mangusada (p-value = 0,000). This research can be applied in the provision of nursing services as one of the nursing interventions to reduce post appendectomy patient pain.

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