Validation of a cost-effective appendicectomy model for surgical training

2020 ◽  
Vol 65 (2) ◽  
pp. 46-51
Author(s):  
Marina Yiasemidou ◽  
Daniel Glassman ◽  
Khalid Khan ◽  
Justine Downing ◽  
Rangasamy Sivakumar ◽  
...  

Background Appendicitis is a commonly occurring condition worldwide. The gold standard treatment is appendicectomy. Although training models are commercially available for this procedure, they are often associated with high cost. Here we present a cost-effective model. Aim To establish construct validity of a cost-effective laparoscopic appendicectomy simulation model. Methods Three groups of surgeons were recruited; novices ( n = 31), of intermediate expertise ( n = 13) and experts ( n = 5) and asked to perform a simulated laparoscopic appendicectomy using the new model. Their performance was assessed by a faculty member and compared between the three groups using a validated scoring system (Global Operative Assessment of Laparoscopic Skills [GOALS] score). Results One-way ANOVA test showed a significant difference in task performance between groups ( p < 0.0001). Post-hoc comparisons after the application of Bonferroni correction (statistically significant p value <0.017) demonstrate a significant difference in performance between all groups for all GOALS categories as well as the total score. Effect size calculations showed that experience level had moderate (Eta-squared >0.5 and <0.8) and significant (>0.8) impact on the performance of the simulated procedure. Conclusion The model described in this study is cost-effective, valid and can adequately simulate appendicectomy. The authors recommend inclusion of this model to postgraduate surgical training.

2020 ◽  
Vol 20 (1) ◽  
pp. 59-64
Author(s):  
Eva Fitriana ◽  
Surahma Asti Mulasari

Latar Belakang: Lalat merupakan salah satu serangga yang memiliki populasi tinggi di lingkungan masyarakat. Lalat berperan dalam penularan penyakit pada manusia seperti disentri, tifoid, kolera infeksi cacing, conjungtivitis, trachoma kusta, mikosis, dan difteri kutaneus. Fly trap digunakan untuk pengendalian lalat dewasa dalam jumlah besar dan padat. Penerapan Fly trap dilakukan diluar rumah pada udara terbuka dan tidak terhindar dari pepohonan. Penggunaan alat ini berpasangan dengan umpan yang digunakan untuk menarik lalat dengan bau dan kandungan pada umpan. Penelitian ini dilakukan untuk mengetahui efektifitas variasi umpan pada Fly trap dalam pengendalian lalat di tempat pembuangan sementara (TPS) Jalan Andong Yogyakarta.Metode: Penelitian ini merupakan penelitian eksperimen dengan variasi umpan ikan, udang, buah nangka, terasi, dan buah mangga. Pengukuran dilakukan pada radius ± 1 Meter dari tumpukan sampah dan dibiarkan selama 2 jam selanjutnya lalat yang terperangkap dihitung menggunakan handcounter. Data yang diperoleh dianalisis menggunakan uji One Way Anova dengan derajat kesalahan α 0.05 dan dilanjutkan uji Post hoc Tamhanne.Hasil: Hasil penelitian menunjukan terdapat hasil yang signifikan rata-rata lalat yang terperangkap pada Fly trap dengan umpan terasi dan umpan udang diperoleh nilai p=0,042 (p<α). Terdapat perbedaan bermakna antara umpan terasi dan umpan udang. Lalat yang terperangkap pada Fly trap umpan terasi sebanyak 69 ekor lalat, dan lalat yang terperanfkap pada Fly trap umpan udang sebanyak 1123 ekor lalat.Simpulan: Ada perbedaan rata-rata lalat yang terperangkap pada Fly trap umpan ikan, udang, buah nangka, terasi dan buah mangga. Terdapat perbedaan bermakna rata-rata lalat yang terperangkap antara Fly trap umpan terasi dan umpan udang. ABSTRACT Title: The Effectivennes of various feed variations in the fly trap as a control of fly density at the Andong street Yogyakarta.Background: Flies are one of the insects that have a high population in the community. Flies play a role in transmitting disease to humans such a dysentery, typoid, cholera, worm infection, conjungtivitis, leprosy trachoma, mycosis and cutaneus diphteria. Fly traps are used fpr the control of large and dense adult flies. The application on fly traps is carried out outside the house in the open air and is not spared from trees. The use of this tool is paired with the bait used the attract flies to get closer to the smell and content of the bait, this research was conducted to determine the effectiveness of bait varians in the fly trap in controlling flies at the temporary disposal site (TPS) at the Andong street Yogyakarta.Method: This research was a experimental study with a variety of bait fish, shrimp, jackfruit, shrimp paste, and mango. Measurements were made at radius of ± 1 meter from the garbage pile. The data obtained were analyzed using the One Way Anova tesy with an error degree of α=0,05 and continued with the Post hoc Tamhanne test.Result: The result showed that there were significant result on the average of flies trapped in the fly trap with the shrimp paste bait and shrimp bait obtained p value = 0.042 (p<α). That there was a significant difference between shrimp paste bait and shrimp bait.Conclusions: There was a difference in the average number of flies trapped in fly traps for fish, shrimp, jackfruit, shrimp paste, mango. There was a significant difference of flies trapped between shrimp paste bait and shrimp bait. Fly trap shrimp bait is the most preferred bait by flies shrimp paste bait is the least preferred bait by flies.  


2022 ◽  
Vol 21 (1) ◽  
pp. 175-183
Author(s):  
- Pujiati ◽  
Dono Indarto ◽  
- Susilorini ◽  
Diani Retno Widyatuti ◽  
Haneda Ilzafira Damayanti ◽  
...  

Background: Asthma is a disease of the respiratory tract in the form of chronic inflammation. Chronic inflammation is one of them characterized by the remodeling of the airways mediated by the anti-inflammatory cytokine TGF-β. In addition there are also several immune cells that play a role such as macrophages, dendritic, neutrophils as producers of IL-12. The presence of the gut-lung axis allows the spread of inflammatory cytokines from the lungs to the intestines and vice versa. Lactobacillus brevis and Leuconostoc mesenteroides have the potential to modulate the immune system through its colonization of the gut. The study aimed to look at the effect of probiotics combined Lactobacillus brevis and Leuconostoc mesenteroides on the expression of TGF-β and IL-12 in the asthma model mouse ileum. Method: This experimental post-test only control group design study used 18 Sprague-Dawley mice. The mice were divided into 3 groups at random: control group (KI), asthma treatment (KII), asthma treatment with a combination of Lactobacillus brevis and Leuconostoc mesenteroides (KIII). Sensitization of asthma with OVA through intraperitoneal injection on days 0 and 14 and through inhalation on days 21 -63. Administration of combination probiotics per oral per day on days 21-63 after inhalation of OVA. The ileum network was taken on the 64th day and measured the expression of TGF-βand IL-12 with immunohistochemical methods and analyzed the percentage proportion of TGF-βand IL-12. Data analysis were conducted by One way ANOVA test and continued post hoc tests. Results: The percentage calculation of the proportion of TGF-βin thecontrol group (KI), asthma group (KII), and the combination group of L.brevis and L.mesenteroides (KIII) is 22.4 ± 15.27; 1.6 ± 2.12; 19.4 ± 6.65. While the percentage calculation of il-12 proportion in each group consecutively were 24.3 ± 19.67; 64.63 ± 9.90; 51 ± 16.62. One way ANOVA Test results on the percentage proportion of TGF-βhave a p value of 0.013 (p<0.05) which means there is a significant difference in the entire group. Furthermore, the Post Hoc Games-Howell test was conducted and obtained a p value of 0.003 (p<0.05) between the asthma group (KII) and the combination group of L.brevis and L.mesenteroides (KIII) which means there are significant differences between the two groups. One way ANOVA Test results on the percentage proportion of IL-12 have a p value of 0.011 (p<0.05) which means there is a significant difference in the entire group. Furthermore, the Post Hoc LSD test was conducted and obtained a p value of 0.001 (p<0.05) between the control group Post Hoc analyses was conducted and obtained a p value of 0.002 (p<0.05) with number of errors was 11.353 between the control group (KI) and asthma group (KII) which means there are significant differences between the two groups. Conclusion: The probiotic administration of lactobacillus brevis and Leuconostoc mesenteroides had no effect on the expression of TGF-β and had no effect on il-12 expression in the asthma model mouse ileum. It is necessary to do research on mice with asthma using combinations with other bacteria in order to get maximum effect. Bangladesh Journal of Medical Science Vol. 21(1) 2022 Page : 175-183


2021 ◽  
Vol 8 (10) ◽  
pp. 429-439
Author(s):  
Elsa Noftalina ◽  
Intan Purnamasari ◽  
Firdha Kusuma Wulandari

Background: Maternal mortality rate (MMR) is an important indicator that describes the health status and welfare of the people in a nation. WHO estimates MMR in the world every day is at 817 people. Maternal mortality is mostly caused by complications during pregnancy, childbirth, and postpartum where these complications are direct obstetric complications. Postpartum hemorrhage is the main cause of maternal death. Factors causing postpartum hemorrhage are uterine atony, retained placenta, laceration of the birth canal, and blood disorders. The delay in diagnosis and treatment of postpartum hemorrhage is mostly caused by the estimated volume of blood loss in labor that is too low and the lack of equipment or clinical skills to solve the problem. Errors in calculating the volume of bleeding lost during delivery are too late to recognize bleeding that can lead to death due to lack of skills to prevent and treat postpartum hemorrhage. Research objective to determine the effectiveness of the product (mattress) in measuring blood loss in maternity. Research Method: The type of research used was experimental research, namely one shot case study. The study was conducted in two Independent Midwife Practices located in the city of Pontianak, West Kalimantan, Indonesia from May to September 2021. The subjects of the study were maternity mothers and birth attendant midwives with a consecutive sampling technique of 30 samples divided into 3 groups with 10 samples respectively of each product. The instrument used to collect data was a questionnaire with a Likert scale which was distributed to maternity mothers as direct users of the mattress and midwives who helped use the mattress. Statistical analysis used was one way ANOVA test. Research results Based on the one way ANOVA test, it was found that the average assessment given by patients and midwives on the three mattress models had a significant difference with a p value of 0.000. In the Post Hoc Turkey HSD test, it was found that there was no difference in the mean of patient assessments between model 1 and model 2 with p value = 0.239. The case was different between model 1 and model 3 and model 2 and model 3, namely, there was a significant difference. Model 1 and model 3 have a p value = 0.009 with an average difference of 2,700 while model 2 and model 3 have a p value = 0.000 with an average difference of 4,100. In the Post Hoc Turkey HSD test, there was a significant difference in the average of the midwives' assessments on the three mattress models. Model 1 and model 2 have a p value = 0.000 with an average difference of 5,800, model 1 and model 3 have a p value = 0.000 with an average difference of 6,900, while model 2 and model 3 have a p value = 0.000 with an average difference of 12,700. Keywords: [Maternity bleeding, Measuring mattress].


2017 ◽  
Vol 11 (1) ◽  
pp. 57-64 ◽  
Author(s):  
Saja Ali Muhsin

Background: Although bonding to denture teeth after surface treatment with chemical agents is desirable, there is little information on the use of Visible Light Cure composite resin (VLC) as bonding denture materials. Objectives: To determine the effect of various surface treatments on shear bond strength between Visible Light Cure composite resin and the acrylic denture teeth interface. Methods: Forty cylindrical sticks of acrylic resin with denture teeth mounted atop were prepared. Various treatments were implemented upon the acrylic resin teeth surfaces. The samples were divided into four groups (n = 10). Light-cured composite resin (LC) was applied over all treated and untreated surfaces of tested groups. The shear bond was tested using a universal tensile testing apparatus with the knife-edge of a 0.8mm shear tester. Data were statistically analyzed using one-way ANOVA performed at a confidence level of 95% and significant P-value of (P ≤ 0.05). Results: Analysis of variance (ANOVA) showed statistically significant difference (P < 0.05) between treated and untreated teeth surfaces. The treated surfaces exhibited various levels of bond strength depending on the type of treatment. Conclusion: Application of VLC bonding agent with prior treatment of methylmethacrylate (MMA) on the acrylic resin denture teeth resulted in maximum bond strength with composite resin.


2020 ◽  
Vol 19 (03) ◽  
pp. 126-133
Author(s):  
Siska Toloan Toloan ◽  
Harimat Hendarwan

Masa nifas adalah hal sangat penting untuk diperhatikan guna untuk menurunkan angka kematian ibu dan bayi di Indonesia. Penelitian ini bertujuan untuk Mengetahui Pengaruh Senam Nifas Terhadap Penurunan Tinggi Fundus Uteri Dan Lochea Pada Ibu Pasca Bersalin Yang Mendapatkan Inisiasi Menyusu Dini Dan Mobilisasi Dini Di Praktek Bidan Mandiri Kota Depok Tahun 2019. Penelitian ini menggunakan penelitian kuantitatif yang menggunakan desain penelitian Quasy Exsperimental dengan pendekatan post test only control group design. Populasi yang diambil yaitu 65 ibu pasca bersalin. Sampel diambil dengan metode consecutive sampling besar sampel ditentukan dengan menggunakan rumus Federer setiap variabel bebas terdiri atas 3 kelompok dan setiap kelompok sebanyak 9 sampel sehingga jumlah total sampel 27 ibu pasca bersalin. Pengumpulan data berupa data primer dan uji yang digunakan yaitu uji One Way Anova. Dapat dilihat dari nilai signifikan uji One Way Anova pada penurunan tinggi fundus uteri hari pertama sampai hari kesepuluh dengan nilai signifikan yaitu p-value < 0,05 yang artinya H0 ditolak atau ada perbedaan secara signifikan dan dilihat. Hasil post hoc test tidak terdapat perbedaan signifikan pada kelompok inisiasi menyusu dini, inisiasi menyusu dini dan mobilisasi dini dan kelompok inisiasi menyusu dini, mobilisasi dini dan senam nifas terhadap penurunan tinggi fundus uteri.


2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Aditya Phadnis ◽  
Monica Forbes-Amrhein

Swallowing of amniotic fluid alters the volume of the fetal stomach; therefore an abnormal fetal stomach size can be indicative of pathology. Previous studies have used linear measurements on ultrasound to approximate stomach sizes. Fetal magnetic resonance imaging (MRI) allows for volumetric measurement of the stomach. The objective of this study was to develop a library of normal fetal stomach volumes on MRI at each gestational age. We also sought to measure stomach volumes of fetuses with esophageal atresia and compare to normal volumes at similar gestation ages (GA).  A retrospective review of fetal MRIs from patients 20-38 weeks GA was conducted.  Exclusion criteria for the controls included any impairment that would impede swallowing or alter stomach sizes.  Patients with esophageal atresia were identified and postnatal records were reviewed to confirm the diagnosis. The stomach volume was measured on T2-weighted imaging using Phillips Intellispace software. The stomach volumes of the controls at each GA were compared using one-way ANOVA with Games-Howell Post-Hoc (p<0.05).  The stomach volume in esophageal atresia was compared to controls using a T-test (p<0.001).    185 control studies, 10 at each week of gestation, and 8 patients with esophageal atresia were included. For normal fetuses, there was a trend of increased stomach size and broadened standard deviation with increasing GA.  No significant difference was found between any two sequential weeks, however the difference in second and third trimester volumes was significant (p<0.001).   The patients with esophageal atresia had significantly smaller stomach volumes compared to control patients of the same GA range (p<0.001).   This pilot study established reference values for fetal stomach volume, which was found to increase with GA. The stomach volume is significantly smaller in patients with esophageal atresia.  Thus, esophageal atresia can be identified prenatally, allowing for delivery at an appropriate acuity NICU and early intervention.   


2012 ◽  
Vol 17 (2) ◽  
Author(s):  
Cicilia Novi Primiani ◽  
Umie Lestari

Pemanfaatan sarana kontrasepsi pria dengan memanfaatkan bahan alami berasal dari tanaman sudah banyak dilakukan. Tetapi pemanfaatan biji kedelai sebagai salah satu tanaman suku Leguminoceae belum pernah dilakukan. Biji kedelai mengandung senyawa genistein, sebagai salah satu senyawa derivat isoflavon mempuyai struktur kimia mirip dengan 17β-estradiol bersifat seperti hormon steroid estrogen, mampu menyebabkan kerusakan pada sistem reproduksi jantan. Penelitian bertujuan menguji pengaruh genistein terhadap histopatologi tubulus seminiferus testis mencit jantan (Mus musculus). Penelitian dilakukan menggunakan pendekatan eksperimental, yang rancangannya mengikuti rancangan acak lengkap. Variabel bebas adalah dosis genistein 0 mg/g, 0,0035 mg/g, 0,0042 mg/g, dan 0,0049 mg/g. Variabel terikat adalah sel-sel germinal tubulus seminiferus testis. Data rerata jumlah sel-sel germinal dianalisis menggunakan Analisis Varians Satu Arah (One Way ANOVA) dengan tingkat signifikansi 95% (α 5%) dilakukan uji Post Hoc dengan Least Significant Difference (LSD) α 5%. Perubahan pada jaringan testis dianalisis secara deskriptif. Hasil penelitian menunjukkan bahwa ada pengaruh pemberian genistein terhadap rerata jumlah sel-sel germinal dan menyebabkan penghambatan proliferasi sel-sel germinal dalam tubulus seminiferus testis.


2020 ◽  
Vol 5 (1) ◽  
pp. 33
Author(s):  
Dita Puspita Sari ◽  
Didit Aspriyanto ◽  
Irham Taufiqurrahman

Background: Caries is a disease that occurs because of the fermentation carbohydrates process by microorganisms in the oral cavity. One of the bacteria that causes caries is Streptococcus sanguinis. These bacteria will colonize on the tooth surface, then form dental plaques and contribute to the causes of caries and other periodontal diseases. Kasturi leaf extract (Mangifera casturi) has various compounds such as tannins, terpenoids, alkaloids, and flavonoids that have antimicrobial substances. Purpose: The aim of this study was to determine antibacterial effectivity of kasturi leaf extract (Mangifera casturi) against the growth of Streptococcus sanguinis bacteria. Method: This research was an experimental method laboratory (true experimental), with a randomized pre test and post test with control group design using 5 treatments: kasturi leaf extract (concentration: 20 mg/ml, 25 mg/ml, and 30 mg/ml); and two groups of control: positive control and negative control. Each treatment was repeated 5 times. Antibacterial activity testing used a liquid dilution method. Measurement of minimum inhibitory concentration (MIC) used a Uv-Vis Spectrophotometer and measurement of the minimum bactericidal concentration (MBC) used a colony counter. The MIC data were analyzed using One Way Anova and continued with the Dunnet Post Hoc test. MBC data were analyzed using the Kruskal-Wallis test and continued with the Mann-Whitney Post Hoc test. Result: One-Way Anova test showed that MIC had a significant difference, and the Kruskal-Wallis test showed that MBC also had significant differences. MIC was obtained at the concentration of 20 mg/ml and MBC was obtained at the concentration of 30 mg / ml. Conclusion: There is antibacterial effectiveness in kasturi leaf extract (Mangifera casturi) against the growth of Streptococcus sanguinis.


2014 ◽  
Vol 21 (2) ◽  
Author(s):  
I Wayan Yudiana ◽  
Sunaryo Hardjowijoto ◽  
Sabilal Alif ◽  
Purwati Purwati ◽  
Willy Sandhika ◽  
...  

Objective:To investigate the effects of allogenic adipose-derived stem cell (ADSC) transplantation on urethral tissue regeneration after vaginal distension in a rat model.Material & Method:32 female wistar rats underwent vaginal distension (VD) for 4 h. Subsequently, PKH-labeled ADSCs (2 x 105 in 200 µl PBS, ADSC group, n = 18) or PBS (200 µl, placebo group, n = 18) were injected into periurethral tissue. Two and four weeks following transplantation (ADSC or PBS), voiding behavior (frequency) and muscle-collagen ratio of urethral tissue were measured to evaluate urethral sphincter regeneration. Data were analysed by paired-t test, one-way ANOVA and post hoc LSD.Results:Mean voiding frequency was significantly different in the ADSC group at two weeks (p<0.0001), but not significantly different at four weeks (p=0.448) when compared with the placebo group.Masson’s trichrome staining revealed that the muscle-collagen ratio of urethral tissue was not significantly different between study groups at two or four weeks (p=0.053 or p=0.166 respectively). Muscle-urethral ratio was more specific showing a significant difference at two weeks (p=0.043). There were significant differences about muscle-collagen or muscle-urethral ratio between control and placebo groups (p<0.05), whereas between control and ADSC groups no significant difference was observed (p>0.05).Conclusion:ADSC transplantation promotes urethral muscle-collagen ratio with development of striated muscle after vaginal distension, so that can improve voiding behavior in a rat model.Keywords:Adipose-derived stem cell, vaginal distension, rat-SUI model, muscle-collagen ratio, voiding stain on paper.


2020 ◽  
Vol 32 (2) ◽  
pp. 17-21
Author(s):  
Yasir Allabban

Background: The aim of this study is to evaluate the color change ∆E of the dental enamel following treatment with 2 kinds of protector (icon infiltrant, clinpro varnish) before fixed orthodontic treatment to avoid the possible white spot lesions. Materials and Methods: Fifty four subjects treated with fixed appliances were divided into 3 groups: the 1st group was control, while the 2nd and 3rd groups were treated with icon infiltrant and clinpro varnish before bonding procedure, respectively. Color parameters (L,a,b) were recorded for the middle and gingival thirds before and after bonding procedure to get the ∆E of each group. Results: One-way ANOVA test showed a non-significant difference in ∆E between the 3 groups at p value <0.05, while there were highly significant differences in value of ∆E between middle thirds and the gingival thirds in all groups. Conclusion: The icon infiltrant and clinpro varnish have no effect on color of the enamel when used before the bonding procedure. Color change ∆E occurring in middle third is higher than that of the gingival third. Keywords: Color change, protector, white spot lesions


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