scholarly journals Dexmedetomidine versus magnesium sulphate as an adjuvant to local anesthesia in single-injection percutaneous peribulbar anesthesia for cataract extraction

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Aya Abuelyossr M. ◽  
N. A. Mohammad ◽  
Khaled M. Maghawry ◽  
Maha Sadek Elderh ◽  
Mai Mohsen AbdulAziz

Abstract Background The aim of the study was to evaluate the impact of addition of dexmedetomidine or magnesium sulphate to the standard local anesthetics mixture as a primary objective and to compare between both as a secondary objective utilizing the single-injection percutaneous technique for peribulbar block. In this prospective randomized double-blinded clinical trial (RCT), sixty patients, both sexes, aged 45 to 75, with an ASA of I to III, were scheduled for cataract extraction operation. They were divided into three equal groups; each received a single injection peribulbar block of a mixture of 0.5% bupivacaine (3 ml) + 2 percent lidocaine (3 ml) + 120 IU hyaluronidase + (control group (C): 0.5 ml of normal saline; group D: 50 μg of dexmedetomidine; group M: 50 mg of magnesium sulphate in 0.5 ml) with a total injected volume of 7 ml each. The duration of sensory, motor block, need for supplementary doses, hemodynamics, and satisfaction of patients and surgeons were assessed. Results For the primary outcome, both the dexmedetomidine and magnesium groups revealed statistically significant differences from the control group with shorter onsets of sensory block and lid akinesia (p value< 0.001 for both), shorter onset of globe akinesia for dexmedetomidine (p value<0.001) and for magnesium sulphate (p value=0.022), prolonged duration of lid and globe akinesia and sensory block (p value<0.001), better patient satisfaction (p value=0.044) but insignificant difference regarding surgeons’ satisfaction (p value= 0.117) and a less frequent, but statistically insignificant need for supplementary injection (p value=0.075). The demographic and clinical hemodynamics and oxygen saturation parameters were comparable between the three groups. For the secondary outcome, dexmedetomidine was superior to magnesium sulphate regarding onset of globe and lid akinesia (p value= 0.047 and 0.003, respectively), and durations of globe akinesia and sensory block (p value= 0.02 and 0.016, respectively). No complications related to the drugs or procedure were recorded. Conclusions When compared to 50 mg magnesium sulphate, dexmedetomidine at a dose of 50 μg is a superior adjunct to local anesthetic combination in peribulbar block for cataract procedures in terms of start and duration of peribulbar block.

2020 ◽  
Vol 1 (3) ◽  
pp. 43-50
Author(s):  
Firstyono Miftahul Aziz ◽  
Suratini Suratini

For some people, dementia is considered as a disease that is common in elderly, regardless the impact of dementia. Taking care for the elderly with dementia brings stress for the family. It can cause and increase the family burden. Brain vitalization gymnastics is one of the methods to improve memory. The study aims to investigate the effect of brain vitalization activity on dementia incidence in elderly at Budi Luhur Nursing Home of Yogyakarta. The study used Quasi Experimental with Pretest-Posttest control group and randomized sampling system. The samples were taken randomly as many as 26 respondents and were divided into two groups namely 13 respondents of experimental group and 13 respondents of control group. The statistical test used Wilcoxon Match Pairs Test. The result showed that Wilcoxon Match pairs test obtained p value 0,003, which is smaller than 0,005. There is an effect of brain vitalization activity on dementia incidence in elderly at Budi Luhur Nursing Home of Yogyakarta


Pharmacy ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 86
Author(s):  
Fauna Herawati ◽  
Yuni Megawati ◽  
Aslichah ◽  
Retnosari Andrajati ◽  
Rika Yulia

The long period of tuberculosis treatment causes patients to have a high risk of forgetting or stopping the medication altogether, which increases the risk of oral anti-tuberculosis drug resistance. The patient’s knowledge and perception of the disease affect the patient’s adherence to treatment. This research objective was to determine the impact of educational videos in the local language on the level of knowledge, perception, and adherence of tuberculosis patients in the Regional General Hospital (RSUD) Bangil. This quasi-experimental study design with a one-month follow-up allocated 62 respondents in the intervention group and 60 in the control group. The pre- and post-experiment levels of knowledge and perception were measured with a validated set of questions. Adherence was measured by pill counts. The results showed that the intervention increases the level of knowledge of the intervention group higher than that of the control group (p-value < 0.05) and remained high after one month of follow-up. The perceptions domains that changed after education using Javanese (Ngoko) language videos with the Community Based Interactive Approach (CBIA) method were the timeline, personal control, illness coherence, and emotional representations (p-value < 0.05). More than 95% of respondents in the intervention group take 95% of their pill compared to 58% of respondents in the control group (p-value < 0.05). Utilization of the local languages for design a community-based interactive approach to educate and communicate is important and effective.


Viruses ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1427
Author(s):  
Paula Sobral da Silva ◽  
Sophie Eickmann ◽  
Ricardo Ximenes ◽  
Celina Martelli ◽  
Elizabeth Brickley ◽  
...  

The relation of Zika virus (ZIKV) with microcephaly is well established. However, knowledge is lacking on later developmental outcomes in children with evidence of maternal ZIKV infection during pregnancy born without microcephaly. The objective of this analysis is to investigate the impact of prenatal exposure to ZIKV on neuropsychomotor development in children without microcephaly. We evaluated 274 children including 235 ZIKV exposed and 39 controls using the Bayley-III Scales of Infant and Toddler Development (BSIDIII) and neurological examination. We observed a difference in cognition with a borderline p-value (p = 0.052): 9.4% of exposed children and none of the unexposed control group had mild to moderate delays. The prevalence of delays in the language and motor domains did not differ significantly between ZIKV-exposed and unexposed children (language: 12.3% versus 12.8%; motor: 4.7% versus 2.6%). Notably, neurological examination results were predictive of neurodevelopmental delays in the BSIDIII assessments for exposed children: 46.7% of children with abnormalities on clinical neurological examination presented with delay in contrast to 17.8% among exposed children without apparent neurological abnormalities (p = 0.001). Overall, our findings suggest that relative to their unexposed peers, ZIKV-exposed children without microcephaly are not at considerably increased risk of neurodevelopmental impairment in the first 42 months of life, although a small group of children demonstrated higher frequencies of cognitive delay. It is important to highlight that in the group of exposed children, an abnormal neuroclinical examination may be a predictor of developmental delay. The article contributes to practical guidance and advances our knowledge about congenital Zika.


2021 ◽  
Vol 22 (3) ◽  
pp. 1222
Author(s):  
Cristina Cuello ◽  
Cristina A. Martinez ◽  
Josep M. Cambra ◽  
Inmaculada Parrilla ◽  
Heriberto Rodriguez-Martinez ◽  
...  

This study was designed to investigate the impact of vitrification on the transcriptome profile of blastocysts using a porcine (Sus scrofa) model and a microarray approach. Blastocysts were collected from weaned sows (n = 13). A total of 60 blastocysts were vitrified (treatment group). After warming, vitrified embryos were cultured in vitro for 24 h. Non-vitrified blastocysts (n = 40) were used as controls. After the in vitro culture period, the embryo viability was morphologically assessed. A total of 30 viable embryos per group (three pools of 10 from 4 different donors each) were subjected to gene expression analysis. A fold change cut-off of ±1.5 and a restrictive threshold at p-value < 0.05 were used to distinguish differentially expressed genes (DEGs). The survival rates of vitrified/warmed blastocysts were similar to those of the control (nearly 100%, n.s.). A total of 205 (112 upregulated and 93 downregulated) were identified in the vitrified blastocysts compared to the control group. The vitrification/warming impact was moderate, and it was mainly related to the pathways of cell cycle, cellular senescence, gap junction, and signaling for TFGβ, p53, Fox, and MAPK. In conclusion, vitrification modified the transcriptome of in vivo-derived porcine blastocysts, resulting in minor gene expression changes.


Author(s):  
Sheila Connery ◽  
Jean Paul Tanner ◽  
Linda Odibo ◽  
Olivia Raitano ◽  
Dusan Nikolic-Dorschel ◽  
...  

Objective Silver dressings have been associated with a decrease in postoperative pain in selected populations, but it is unknown if the benefit can be observed after cesarean deliveries. We sought to evaluate the impact of silver nylon dressings in reducing postoperative pain after cesarean delivery. Study Design A secondary analysis of data from a blinded randomized clinical trial of women undergoing cesarean delivery scheduled and unscheduled at a single site was conducted. Women were recruited for participation from a single site and randomized to a silver nylon dressing or an identical-appearing gauze wound dressing. Wounds were evaluated in the outpatient clinic at 1 and 6 weeks after delivery and patient responded to the modified patient scar assessment scale. The primary outcome of this analysis was inpatient opioid and nonopioid analgesic dispensed. The secondary outcome was patient-reported pain at the 1- and 6-week postpartum visits. Data were analyzed using chi-square test, Student's t-test, Fisher's exact test, Wilcoxon–Mann–Whitney's test, and logistic regression where appropriate. A p-value of < 0.05 was considered significant. Results Among the 649 participants, women allocated to the silver nylon dressing group, when compared with the gauze group, were similar in the amount of dispensed opioid and nonopioid analgesic medications (morphine equivalent milligrams of opioids dispensed [82.5 vs. 90 mg, p = 0.74], intravenous nonsteroidal anti-inflammatory drugs (NSAIDs) [120 vs. 120 mg, p = 0.55], and oral NSAIDs [4,800 vs. 5,600 mg in the gauze group, p = 0.65]). After adjusting for confounding variables, postoperative wound infection (adjusted odds ratio [aOR]: 11.70; 95% confidence interval [CI]: 4.51–30.31) at 1-week postoperative and again at 6-week postoperative (aOR: 5.59; 95% CI: 1.03–30.31) but not gauze dressing was associated with patient-reported postoperative pain. Conclusion Among women undergoing cesarean delivery, silver nylon dressing was not associated with a reduction in postoperative pain. Key Points


2015 ◽  
Vol 123 (5) ◽  
pp. 1230-1237 ◽  
Author(s):  
Daniele Vanni ◽  
Francesco Saverio Sirabella ◽  
Renato Galzio ◽  
Vincenzo Salini ◽  
Vincenzo Magliani

OBJECT The purpose of this study was to assess the effectiveness and safety of an alternative minimally invasive technique for the treatment of carpal tunnel syndrome (CTS). METHODS This was designed as a prospective, randomized, open-label, blinded end point evaluation (PROBE) study. The active comparison was double tunnels technique (DTT) (Group A, 110 patients) versus standard open decompression of the median nerve (control [Group B], 110 patients). Patient recruitment started in January 2011. The primary outcomes were the functional Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ) scores and visual analog scale (VAS) scores for pain (pVAS) at Weeks 2 and 4, and at Months 3, 6, and 12. The secondary outcome was the aesthetics (aVAS) score at Weeks 2 and 4, and at Months 3, 6, and 12. RESULTS The Student t-test and ANOVA were used, and the results were considered statistically significant if the p value was ≤ 0.05 for continuous variables. The DTT is a tissue-sparing approach that allows the surgeon to limit the length of the incision (0.6 ± 0.05 cm) and to respect the palmar fascia and the subcutaneous tissue. Recovery from wrist pain, night pain, numbness, stiffness, and weakness was achieved more effectively and quickly compared with the standard approach. Better BCTSQ, pVAS, and aVAS scores were observed in Group A. CONCLUSIONS The DTT is a safe and effective approach for the treatment of CTS. This technique entails faster recovery times, better aesthetic outcomes, and lower risks of complications.


2018 ◽  
Vol 3 (1) ◽  
Author(s):  
Masta Hutasoit

Background: Bantul is one of the areas in Yogyakarta that is at risk of disaster. The results of interviews with the head of SD N 2 Padokan found that the school had never had any training on disaster and not yet implemented the curriculum on disaster mitigation. Children are age groups that are very vulnerable to the impact of both physical and psychological disasters. Knowledge of disaster preparedness is important for disaster preventionThe purpose of the study: to determine the effect of health education on knowledge of student preparedness to earthquake disaster events in SD N 2 Padokan, Bantul.Method: This research is quantitative research with quasi experiment design. The design used was pre test and post test nonequivalent control group. The number of samples in the intervention group and the control group were 27 students of class V. The sampling were collected by purposive sampling according to the criteria. Methods of data collection using questionnaires and using nonparametric statistical analysis Wilcoxon with the help of SPSS v.17 for Windows program.Results: The results showed no effect of health education on earthquake disaster preparedness knowledge in SD N 2 Padokan obtained p value 0.480 with α 0.05. In the intervention group the difference of knowledge before and after is indicated by p value 0.180, while for the control group 1,000.Conclusion: there is no effect of health education on disaster preparedness knowledge in SD N 2 Padokan.  


2021 ◽  
pp. 72-78
Author(s):  
Morita Wibowo ◽  
Suryo Ediyono ◽  
Heni Nur Kusumawati

Background: One of the efforts that have been carried out by the Ministry of Health in supporting the acceleration of MMR reduction is optimizing PONED. Apart from being poned, the use of the MCH Handbook is one way of maintaining health and obtaining quality maternal and child health services. The purpose of this study was to determine the impact of training on the optimization of the use of the MCH book on the attitudes of the PONED midwives in completing the MCH booklet filling by village midwives in the working area of ​​the Paser District Health Center.  Methods: A Quantitative research method uses Quasy Experiment nonequivalent control group design. By involving 1 control group and 1 treatment group with a total sample size of 43 midwives in each group, using simple random sampling. Data analysis using Wilcoxon. Instrument that use can measure attitudes of midwives with good validity and reliability. Results: The results showed that there were significant differences in attitudes before and after treatment with a p-value of 0,000, but the mean value of attitudes before and after showed that training could not change the attitudes of midwives. The training held is not sufficient to change the attitude of midwives in compliance with the filling of the MCH handbook. Conclusion: It needs further and intense training for all PONED and non-PONED midwives and further identification is needed about things that can motivate the attitudes of midwives to improve poned midwives towards the implementation of optimization MCH books.


2021 ◽  
Author(s):  
de la Cruz Peña Maria José ◽  
Luis Ignacio Gonzalez-Granado ◽  
Inmaculada Garcia-Heredia ◽  
Lucia Maestre Carballa ◽  
Manuel Martinez-Garcia

Abstract Immunoglobulin A (IgA) is the dominant antibody found in our mucosal secretions and has long been recognized to play an important role in protecting our epithelium from pathogens. Recently, IgA has been shown to be involved in gut homeostatic regulation by `recognizing´and shaping our commensal microbes. Paradoxically, yet selective IgA-deficiency is often described as asymptomatic and there is a paucity of studies only focused on the mice and human gut microbiome context fully ignoring other niches of our body and our commensal viruses. Here, we used as a model the human oral cavity and employed a holistic view and studied the impact of IgA deficiency on both the human virome and microbiome. Unexpectedly, metagenomic and experimental data in human IgA deficiency indicate minimal-moderate changes in microbiome and virome composition compared to healthy control group and point out to a rather functional, resilient oral commensal viruses and microbes. However, a significant depletion (2-fold) of bacterial cells (p-value < 0.01) and viruses was observed in IgA-deficiency. Our results challenge the view of an irreplaceable IgA role for regulating the composition and function of our commensal microbiota and pose the question whether other “back-up” Ig-independent mechanisms might exist for maintaining a functional commensal microbiome.


2020 ◽  
Vol 8 (1) ◽  
pp. 9
Author(s):  
Susanti Niman ◽  
Achir Yani S Hamid ◽  
Ice Yulia W

The prevalence of CHF is increasing every year. The impact of a psychosocial condition requiring comprehensive treatment for CHF in all aspects. One contributing factor to success is the involvement of the family. Purpose: This study aimed to determine the differences of social support towards clients with CHF who were receiving family psychoeducation.  Method: This study used a Quasi -experimental pre-post test without a control group”.  A sample of  25 respondents and sample retrieval techniques with a purposive sampling procedure. The instrument used was an ISSB questionnaire for measuring social support. The intervention group was provided with family psychoeducation that performed 5 sessions. Result and conclusion: The finding this study showed was a significant change before and after the family support family psychoeducation (p-value 0.00<α).  Characteristics of the family and the client is not associated with social support. Family psychoeducation research way recommended developed in a public hospital.


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