scholarly journals Benefits of pre-emptive analgesia by local infiltration at day-case general anaesthetic open inguinal hernioplasty

2018 ◽  
Vol 100 (6) ◽  
pp. 450-453 ◽  
Author(s):  
RW Radwan ◽  
A Gardner ◽  
H Jayamanne ◽  
BM Stephenson
Keyword(s):  
Day Surgery ◽  
World Health ◽  
General Anaesthetic ◽  
Inguinal Hernioplasty ◽  
Day Case ◽  
Who Analgesic Ladder ◽  
Mesh Plug Repair ◽  
Significant Difference ◽  
Health Organization ◽  
Discharge Criteria

Introduction The open prosthetic repair of inguinal hernias under local anaesthesia (LA) is well established, with the concept of intraoperative ‘pre-emptive analgesia’ evolving so that patients are as comfortable as possible. We used a peri-incisional LA solution in patients undergoing day-case inguinal hernioplasty under general anaesthesia (GA) and recorded use of analgesia in the immediate postoperative period. Methods In this observational cohort study, 100 consecutive unselected men underwent open inguinal hernia repair as a day case. Of these, 75 underwent repair under GA and 25 with peri-incisional LA solution (equal mixture of 0.5% bupivacaine and 1% lignocaine with 1:200,000 adrenaline). Analgesia prescribed at induction, for maintenance and after cessation of anaesthesia was scored in accordance with the World Health Organization (WHO) analgesic ladder. Results The median age in the GA group was 59 years (range: 25–89 years) and in the GA+LA group, it was 62 years (range: 27–88 years). Of the 100 patients, 82 underwent a mesh plug repair by seven surgeons whereas 18 underwent a flat (Lichtenstein) mesh repair by two surgeons. WHO analgesic induction and postoperative scores were significantly lower in the GA+LA group (p=0.034 and p<0.001 respectively). There was also a significant difference in use of postoperative antiemetics (23% vs 0% in the GA only and GA+LA cohorts respectively, p=0.020). Six patients (8%) in the GA group failed day-case discharge criteria. Conclusions Patients undergoing contemporary day-case GA inguinal hernioplasty with pre-emptive LA solution infiltration require lower levels of postoperative opioid analgesia and antiemetics. These cases are less likely to fail discharge criteria for planned day surgery.

Household and Population-Level Behavioural Changes Due to COVID-19 Pandemic: A Smart Thermostat Based Comparative Data Analysis

2021 ◽  
Vol 10 (1) ◽  
pp. 1-6
Author(s):  
Kirti Sundar Sahu ◽  
Arlene Oetomo ◽  
Niloofar Jalali ◽  
Plinio P. Morita
Keyword(s):  
Data Analysis ◽  
Population Level ◽  
World Health ◽  
Motion Sensors ◽  
Household Level ◽  
Work From Home ◽  
Significant Difference ◽  
Health Organization ◽  
Smart Thermostat ◽  
The Impact

The World Health Organization declared the coronavirus outbreak as a pandemic on March 11, 2020. To inhibit the spread of COVID-19, governments around the globe, including Canada, have implemented physical distancing and lockdown measures, including a work-from-home policy. Canada in 2020 has developed a 24-Hour Movement Guideline for all ages laying guidance on the ideal amount of physical activity, sedentary behaviour, and sleep (PASS) for an individual in a day. The purpose of this study was to investigate changes on the household and population-level in lifestyle behaviours (PASS) and time spent indoors at the household level, following the implementation of physical distancing protocols and stay-at-home guidelines. For this study, we used 2019 and 2020 data from ecobee, a Canadian smart Wi-Fi thermostat company, through the Donate Your Data (DYD) program. Using motion sensors data, we quantified the amount of sleep by using the absence of movement, and similarly, increased sensor activation to show a longer duration of household occupancy. The key findings of this study were; during the COVID-19 pandemic, overall household-level activity increased significantly compared to pre-pandemic times, there was no significant difference between household-level behaviours between weekdays and weekends during the pandemic, average sleep duration has not changed, but the pattern of sleep behaviour significantly changed, specifically, bedtime and wake up time delayed, indoor time spent has been increased and outdoor time significantly reduced. Our data analysis shows the feasibility of using big data to monitor the impact of the COVID-19 pandemic on the household and population-level behaviours and patterns of change.

scholarly journals Secular Trends of Underweight, Overweight, and Obesity in Children and Adolescents from Ukraine

2021 ◽  
Vol 18 (6) ◽  
pp. 3302
Author(s):  
Katarzyna Dereń ◽  
Justyna Wyszyńska ◽  
Serhiy Nyankovskyy ◽  
Olena Nyankovska ◽  
Marta Yatsula ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Age Groups ◽  
Overweight And Obesity ◽  
The Body ◽  
World Health ◽  
Public Health Issue ◽  
Significant Difference ◽  
Significant Public Health ◽  
Health Organization ◽  
Obesity In Children

Overweight and obesity, as well as underweight in children and adolescents, pose a significant public health issue. This study aimed to investigate the secular trend of the incidence of underweight, overweight, and obesity in children from Ukraine in 2013/2014 and 2018/2019. The studies were conducted in randomly selected primary and secondary schools in Ukraine. In total, 13,447 children (6468 boys and 6979 girls) participated in the study in 2013/2014 and 18,144 children (8717 boys and 9427 girls) participated in 2018/2019. Measurements of body weight and height were performed in triplicate. Underweight, overweight, and obesity were diagnosed according to the standards of the World Health Organization (WHO). In the group of girls, a significant difference between 2013/2014 and 2018/2019 measurements was found only among 7-year-olds. The percentage of girls at this age exceeding the body mass index (BMI) norm was lower in the 2018/2019 study. In boys, a significant difference was also found in 7-year-olds, and, as in girls, a lower share of overweight and obesity was found in 2018/2019. But for the ages of 12, 13, and 15, the significant differences had a different character—more overweight or obese boys were found in the 2018/2019 study. The proportion of underweight children was similar for the majority of age groups in both genders and did not differ in a statistically significant way.

scholarly journals Water Quality of the Trstionica River (Bosnia and Herzegovina)

2020 ◽  
Vol 69 (7-8) ◽  
pp. 371-376
Author(s):  
Šuhreta Delibašić ◽  
Jasna Huremović ◽  
Sabina Žero ◽  
Sabina Gojak-Salimović
Keyword(s):  
Water Quality ◽  
Bosnia And Herzegovina ◽  
Limit Of Detection ◽  
Weather Conditions ◽  
Ion Exchange Resin ◽  
World Health ◽  
Mean Values ◽  
Significant Difference ◽  
Health Organization

The present study was conducted to investigate the water quality of the Trstionica River, Bosnia and Herzegovina. The physicochemical properties (temperature, pH, conductivity, total solids after evaporation at 105 °C), content of metals (calcium (Ca), cadmium (Cd), chromium (Cr), copper (Cu), iron (Fe), magnesium (Mg), manganese (Mn), sodium (Na), nickel (Ni), lead (Pb) and zinc (Zn)), and anions (chloride (Cl–), and phosphate (PO43–)) were determined in water samples collected at seven locations during two sampling periods: unstable weather conditions (precipitation), and stable weather conditions (without precipitation). There was a significant difference in the content of individual parameters in the river water depending on the sampling time. For determination of metals concentrations, which were below the limit of detection, a preconcentration method using an ion-exchange resin was applied. The metals concentrations during the rainy day were in the order Ca &gt; Mg &gt; Na &gt; Fe &gt; Cu &gt; Zn &gt; Pb &gt; Mn with mean values of 343, 6.03, 1.94, 0.18, 0.20, 0.03, 0.02, 0.01 mg dm–3, respectively, and during stable weather conditions: Ca &gt; Mg &gt; Na &gt; Cu &gt; Fe &gt; Mn &gt; Zn with mean values of 288, 7.62, 2.38, 0.11, 0.10, 0.01, 0.01 mg dm–3, respectively. Cd, Cr, and Ni concentrations were below limit of detection in both cases. Obtained values were compared with World Health Organization (WHO) regulations. The results showed that the Trstionica River in the investigated part of the stream meets most of the parameters required by the regulations. The correlation between analysed parameters was assessed, as well. Based on the calculated water quality index values, the water of Trstionica River falls into the category of excellent water.

scholarly journals Comparison of Visual Outcomes and Patient Satisfaction Between two Diffractive Trifocal Intraocular Lenses

2021 ◽  
Author(s):  
asli cetinkaya yaprak ◽  
Mustafa Unal
Keyword(s):  
Visual Acuity ◽  
Patient Satisfaction ◽  
Cataract Surgery ◽  
Intraocular Lenses ◽  
World Health ◽  
Uncorrected Distance Visual Acuity ◽  
Significant Difference ◽  
Prospective Comparative Study ◽  
Health Organization ◽  
Clinical Trials Registry

Abstract Purpose To evaluate the clinical outcomes and visual quality of patients undergoing cataract surgery with the implantation of two different models of diffractive trifocal intraocular lenses (IOLs).MethodsThis randomized prospective comparative study included 60 eyes of 15 patients who scheduled to undergo bilateral cataract surgery with the implantation of two models of diffractive trifocal IOLs (RayOne Trifocal and AcrySof IQ PanOptix IOL). Monocular and binocular corrected and uncorrected distance visual acuity (CDVA, UDVA), intermediate visual acuity (DCIVA, UIVA) at 60 and 80 cm, near visual acuity (DCNVA, UNVA), and patient satisfaction were compared over a three-month follow-up.ResultsEach group comprised 30 eyes of 15 patients. No statistically significant differences were determined between the groups in terms of CDVA, UDVA, DCNVA and UNVA. The monocular and binocular UIVA values at 60 cm were better in the PanOptix IOL group (p=0.04 and p=0.01, respectively), and the DCIVA and UIVA values at 80 cm were better in the RayOne IOL group (p=0.01, p=0.047, p<0.001, and p=0.042, respectively). No statistically significant difference was found between the groups in relation to the frequency and severity of visual symptoms evaluated. Regarding discomfort, the RayOne IOL group had more bothersome halos and starbursts (p=0.026 and p=0.01, respectively).ConclusionBoth IOLs provided very good restoration of visual acuity. However, with the AcrySof IQ PanOptix IOL, the likelihood of patients experiencing bothersome halos and starbursts was less. The RayOne Trifocal IOL might be a better choice for patients who require further intermediate vision.The study was registered under the World Health Organization international clinical trials registry platform: NCT04655274, 30/11/2020, prospectively registered.

Impact of Equine-Assisted Activities on Quality of Life and Relational Skills for Older Adults With Dementia: A Mixed-Methodology Research

2021 ◽  
Vol 75 (Supplement_2) ◽  
pp. 7512520401p1-7512520401p1
Author(s):  
Charmaine Lim ◽  
Manisha Sheth
Keyword(s):  
Quality Of Life ◽  
Mixed Methodology ◽  
World Health ◽  
Significant Difference ◽  
The Moment ◽  
Health Organization ◽  
Equine Assisted ◽  
Primary Author ◽  
Relational Skills

Abstract Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. The purpose of this research was to examine the efficacy of a 9-week equine-assisted program named "Horse in the Moment." Mixed-methodology research was conducted to explore the effectiveness of equine-assisted activities on quality of life (QOL) and relational skills for individuals diagnosed with dementia. Pre and post scores on World Health Organization QOL showed significant difference. Families of the participants also reported improvements in communication and socialization. Primary Author and Speaker: Charmaine Lim Additional Authors and Speakers: Manisha Sheth

scholarly journals Adverse reactions to docetaxel: an active survey

2015 ◽  
Vol 51 (3) ◽  
pp. 551-559
Author(s):  
Leandro Cabral Pereira ◽  
Thaísa Amorim Nogueira ◽  
Leandro Augusto de Oliveira Barbosa ◽  
Sabrina Calil-Elias ◽  
Selma Rodrigues de Castilho
Keyword(s):  
Breast Cancer ◽  
Adverse Reactions ◽  
Breast Cancer Mortality ◽  
World Health ◽  
Healthcare Team ◽  
The Third ◽  
Naranjo Algorithm ◽  
Significant Difference ◽  
Grade 3 ◽  
Health Organization

The rates of breast cancer mortality remain high in Brazil. Docetaxel is a semi-synthetic taxane used to treat various tumors, particularly tumors of the breast, lung and prostate. In this study ADR that occurred in 45 docetaxel users with breast cancer were surveyed. They were identified by type, causality (Naranjo algorithm and World Health Organization categories) and, if considered probable or defined, rated for severity according to SOBRAFO proposal (2007). A total of 325 ADR were observed: 165 in the first, 137 in the second and 23 in the third cycle. Fifty seven ADR were immediate and the others, late. Fatigue and exhaustion for more than five days, classified as Grade 3 by SOBRAFO (2007), were reported as the primary late RAM. There was no significant difference in the occurrence of immediate and late ADR between cycles (p=1 and p=0.3577, respectively). The presence of a pharmacist gave the patients a better understanding of the occurrence of RAM, especially those that occur outside the hospital, between chemotherapy cycles and are often not reported to the healthcare team, creating institutional demands and reaching the goal to track, observe and correlate the RAM for each user.

scholarly journals Wikipedia and the National Cancer Institute Website Appear to Offer Similar Osteosarcoma Information for Patients

2011 ◽  
Vol 6 (1) ◽  
pp. 78
Author(s):  
Kate Kelly
Keyword(s):  
Health Professional ◽  
Patient Information ◽  
National Cancer Institute ◽  
English Language ◽  
World Health ◽  
Language Version ◽  
Item Questionnaire ◽  
Significant Difference ◽  
Professional Information ◽  
Health Organization

A Review of: Leithner, A., Werner, M., Glehr, M., Friesenbichler, J., Keithner, K., & Windhager R. (2010). Wikipedia and osteosarcoma: A trustworthy patients' information? Journal of the Medical Informatics Association, 17(4), 373-374. Objective – To compare the completeness and accuracy of information about osteosarcoma in Wikipedia to information found on the patient and health professional versions of the U.S. National Cancer Institute (NCI) website. Design – Comparative study, test against 20 item questionnaire and expert opinion. Setting – n/a. Subjects – n/a. Methods – The authors developed a 20-item questionnaire to test the completeness and accuracy of information on osteosarcoma in Wikipedia and on the “patient version and the health professional version of the National Cancer Institute’s website as ‘official’ reference websites” (p. 373). Three independent observers, two surgeons specializing in musculoskeletal tumour surgery and a medical student, tested the English language version of Wikipedia and the NCI “websites” on April 3, 2009. Answers to the 20 questions found on the websites were scored from zero to three and were discussed with a member of the “German board for guidelines in musculoskeletal surgery” (p. 373) and verified against international guidelines published by the World Health Organization. Data was analyzed using SPSS and group comparisons were performed using Mann-Whitney U test with p-values of less than 0.05 significance. Main Results – The quality of information about osteosarcoma found in the English language version of Wikipedia was good but inferior to the patient information from NCI. Out of a total of 60 points Wikipedia scored 33, NCI patient information 40 and NCI professional information 50. There was no significant difference between the NCI patient information and Wikipedia but a significant difference (p=0.039) between Wikipedia and NCI professional information. Conclusion – Non-peer reviewed websites providing health information, such as Wikipedia, should include links to sites such as NCI and other more definitive sources such as professional and international organizations. Frequent checks should be used to ensure external links are of the highest quality.

scholarly journals Compliance and Treatment Outcomes of Various Regimens for Trichomoniasis in Trinidad and Tobago

2019 ◽  
Vol 7 (10) ◽  
pp. 97
Author(s):  
Divakaruni ◽  
Mahabir ◽  
Orrett ◽  
Adidam ◽  
Venkata ◽  
...  
Keyword(s):  
Single Dose ◽  
Side Effects ◽  
Trichomonas Vaginalis ◽  
Transmitted Disease ◽  
World Health ◽  
Sexually Transmitted ◽  
Treatment Regimens ◽  
Significant Difference ◽  
Compliance To Treatment ◽  
Health Organization

Trichomoniasis is the most common non-viral sexually transmitted disease (STD) globally and yet is not a reportable disease. Trichomonas vaginalis is an important source of reproductive morbidity and may increase risk of acquisition and transmission of human immunodeficiency viruses (HIV). The World Health Organization (WHO) and the Control Disease Center (CDC) recommend various regimens of nitroimidazole s for treatment. The common nitroimidazoles used for trichomoniasis are metronidazole and tinidazole, which vary in their cost, efficacy, and side effect profile. It is relevant to study these factors for better management of the patients. This study aimed to compare and study the efficacy, compliance of various treatment regimens, their outcomes, and side-effects for trichomoniasis, among STI clinic attendees in Trinidad. A clinical trial study was designed, and after obtaining the informed consent, a routine clinical examination was conducted and the swabs for trichomoniasis tests were collected for diagnosis from the 692 participants. Out of 692 participants, 82 patients with positive diagnosis of Trichomonas infection were treated according to the patient’s choice, using different drug regimens. Compliance to treatment, side effects, and outcome were evaluated. The prevalence of trichomoniasis in the population attending our STI clinic is 11.9% and prevalence of HIV is 9%. Of the total 82 participants for the treatment, 80% were females; nearly 90% of the patients belonged to age group 15–45 years, and over 60% were below 30 years. Among those diagnosed for Trichomonas vaginalis, 14.6% had coexistent HIV infection. The compliance with respect to single dose treatment was significantly better than the long-duration oral regimen and has a significant relation with side effects of the treatment. The outcome is generally better and comparable and shows no significant difference between different treatment regimens used in the study. Metronidazole and tinidazole are commonly used drugs in various regimens. Compliance is better with those treated with tinidazole and metronidazole single dose than with other groups. Outcome is comparable between these regimens, especially when combined with other important factors like abstinence and treatment of the partners. The treatment regimens mainly differed in the compliance side effects profile and duration of therapy, which suggests that to improve the compliance of the drugs with fewer side effects, short course regimen would be a preferred choice.

scholarly journals Comparison of the efficacy of artemether-lumefantrine vs. artesunate plus sulfadoxine-pyrimethamine in children with uncomplicated falciparum malaria

2010 ◽  
Vol 50 (2) ◽  
pp. 113 ◽  
Author(s):  
Rachmawati Rachmawati ◽  
Novie H Rampengan ◽  
Suryadi N N Tatura ◽  
Tonny H Rampengan
Keyword(s):  
Parasite Clearance ◽  
World Health ◽  
Drug Resistant ◽  
Limited Information ◽  
Clearance Time ◽  
Cure Rate ◽  
Fever Clearance Time ◽  
Significant Difference ◽  
Health Organization

Background World Health Organization (WHO) has recommendedthat countries with drug resistant malaria problem usecombination therapies, especially artemisinin-based combinationtherapy (ACT). However, there is limited information on theefficacy of ACT in North Sulawesi.Objective To compare the efficacy of artemether-lumefanttine andartesunate plus sulfadoxine-pyrimethamine (SP).Methods This was a randomized experimental study, conducted inProf. Dr. R. D. Kandou General Hospital, Manado from Januaryuntil July 2009. There were 42 patients aged less than 13 yearstreated with artemether-lumefanttine and artesunate plus SP. Bodytemperature, parasite and gametocyte count were recorded everyday until day 7 and follow-up reviews were done on day 14 and28.Results Fever clearance time showed a significant differencebetween artemether-lumefanttine group (median 27 hours) andartesunate plus SP group (median 18 hours), P<0.05). There wasno significant difference in parasite clearance time (P>0.05) andgame tocyte clearance time (P > 0. 05) . The 28 day cure rate were100% in the two groups. No side effect was found.Conclusion Both artemether-lumefanttine and artesunate plus SPcombination are effective and safe for the treatment of falciparummalaria in children.

scholarly journals Food intolerances and associated symptoms in patients undergoing Fobi-Capella technique without gastric ring

2015 ◽  
Vol 28 (1) ◽  
pp. 36-39 ◽  
Author(s):  
Marcella de Arruda MOREIRA ◽  
Patrícia Ramos Maciel ESPÍNOLA ◽  
Camila Wanderley de AZEVEDO ◽  
Cinthia Karla Rodrigues do Monte GUEDES
Keyword(s):  
Clinical Manifestations ◽  
Cross Sectional Study ◽  
Food Intolerance ◽  
World Health ◽  
Cross Sectional ◽  
Significant Difference ◽  
One Year ◽  
Health Organization ◽  
Nutritional Monitoring ◽  
Height Data

BACKGROUND: Bariatric surgery is considered the only effective method to treat refractory obesity, and especially for those in which clinical treatment was not successful. However, the appearance of food intolerances and clinical manifestations are quite common. AIM: To identify food intolerances and associated them to symptoms in patients undergoing Fobi-Capella technique without gastric ring. METHODS: This was a cross-sectional study of adult patients who had more than one year after surgery. Demographic, anthropometric, weight and preoperative height data were investigated. Nutritional status was classified according to the criteria established by the World Health Organization. It was considered food intolerance the presence of nausea, vomiting, diarrhea or bloating after eating a particular food. RESULTS: The sample consisted of 61 patients who attended the nutritional consultation of which 26 (42.6%) had food intolerance, mostly related to red meat (n=12; 34.3%) during the first six months of operation; there was a significant difference between the periods between 0 and 6 months, and 7 to 12 (p=0.02). Among the symptoms reported by patients, nausea was the most recurrent until the 6th month, but without significant differences between the two periods (p=0.06). CONCLUSION: The Fobi-Capella procedure without gastric ring promoted high frequency of intolerance to meat in general, especially for the red, chicken and fish, on this sequence; nausea was the most frequent symptom. These data suggest the need for adequate nutritional monitoring throughout the postoperative period.

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