scholarly journals Safety and efficacy of dialyzer reuse by manual reprocessing: an observational study

2018 ◽  
Vol 6 (9) ◽  
pp. 3047
Author(s):  
Mahim Mittal ◽  
Anoop K. Singh ◽  
Sudheer Yadav ◽  
Shilpa U. V.
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Economic Benefits ◽  
Dialysis Session ◽  
Age Group ◽  
Membrane Area ◽  
Younger Age ◽  
The Mean ◽  
Study Manual ◽  
Urea Reduction Ratio

Background: Haemodialysis is the main form of RRT in the patients of CKD. Haemodialysis is a costly procedure and is not afforded by many. Reuse of components of Haemodialysis circuit helps in reducing cost but may be associated with decreased efficacy and side effects.Methods: Prospective observational study. Manual reprocessing of dialyzer was done with either formaldehyde or peracetic acid. Single brand (Fresenius) dialyzer were used across all patients. Dialysis efficacy was calculated by URR and side effect and toxicity monitored in a predefined proforma.Results: A total 50 patients were studied (39 male and 11 female) with age ranging from 31-60 years. The mean urea reduction ratio after four dialysis session with the same dialyzer was 62.93% which is below KDOQI recommendation. The findings in our study suggest that URR was adequate upto three session of haemodialysis by reprocessed dialyzer but not beyond that. The choice of chemical for reprocessing did not affect the efficacy. As compared to F6 dialyze F8 dialyzer had better initial URR and this was maintained upto fourth reuse. Serum albumin levels correlated with the fall in efficacy of dialyzers. There were no significant complications of reuse of dialyzers across both methods of reprocessing and there was no dialyzer first use syndrome.Conclusions: ESRD affects a younger age group in our country. Use of large membrane area results in better efficacy. Dialyzer reuse with manual reprocessing is safe and also effective upto third and fourth use. Dialyzer reuse is associated with economic benefits.

scholarly journals Study of risk factors and tumor markers in ovarian malignancy in western part of Odisha: a prospective observational study

2018 ◽  
Vol 7 (4) ◽  
pp. 1571 ◽  
Author(s):  
Hemanta Kumar Pradhan ◽  
Pratibha Singh ◽  
M. S. Ravikumar ◽  
Meenakshi Gothwal
Keyword(s):  
Risk Factors ◽  
Ovarian Cancer ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Ovarian Tumour ◽  
Tumour Markers ◽  
Female Reproductive Tract ◽  
Age Group ◽  
Younger Age ◽  
Ovarian Neoplasia

Background: Ovarian cancer represents one of the most frequently seen malignancies in women and it is the fifth most common cause of cancer-related death in women. The aim of the study to determine the risk factors leading to ovarian cancer in western part of Odisha, India and show the tumour markers in this population.Methods: This is a prospective observational study included 240 ovarian masses diagnosed at Department of Obstetrics and Gynaecology, V. S. S. Medical College, Burla, Sambalpur over 3 years based on preoperative clinical, biochemical (tumour markers) and imaging study and confirm through post-operative histopathology reports.Results: Surface epithelial tumours (68.33%) followed by germ cell tumours (30.83%) are the most common ovarian tumour. Incidence of ovarian cancer is 73.58% in ≤50 years of age group and more number of cases (16.65%) also found in younger age (≤30 year). Overall number of ovarian cancer cases rising. Bilateral tubal ligation is not a protective factor for ovarian cancer (p value >0.05) and consumption of alcohol and tobacco is not increase risk for ovarian cancer. Most of ovarian tumour commonly present with vague abdominal pain (75.83%) followed by mass per abdomen (55%). Ascites mainly a presentation of malignant tumour seen in 46(63.88%) cases. CA125 is the frequently detected tumour markers and all of the tumour markers were significantly within normal limit.Conclusions: Ovarian neoplasia is one of the most common and lethal malignancy in female reproductive tract. Though it is a disease of older age but now a day more no of cases also seen in younger age group. Since most of the ovarian cancer remain asymptomatic for long period so measure should be taken for early diagnosis for best outcome. So, assessment of each regions statistical information reflecting its own profile may be important for estimation of risk for development of ovarian cancer and so useful for early preventive measure before progress to advance stage where prognosis is worst. So, relationship between the profiles of patients and types of ovarian neoplasms may give an idea about the risk factors of the disease in its region. Additionally, distribution of tumour markers might be considered for the dis-criminating of the benign or malign characters of the ovarian neoplasia.

scholarly journals Exercise Intensity during Olympic-Distance Triathlon in Well-Trained Age-Group Athletes: An Observational Study

Sports ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 18
Author(s):  
Atsushi Aoyagi ◽  
Keisuke Ishikura ◽  
Yoshiharu Nabekura
Keyword(s):  
Heart Rate ◽  
Observational Study ◽  
Exercise Intensity ◽  
Time Range ◽  
Age Group ◽  
Slow Group ◽  
H 41 ◽  
The Mean ◽  
Aerobic And Anaerobic ◽  
Very High

The aim of this study was to examine the exercise intensity during the swimming, cycling, and running legs of nondraft legal, Olympic-distance triathlons in well-trained, age-group triathletes. Seventeen male triathletes completed incremental swimming, cycling, and running tests to exhaustion. Heart rate (HR) and workload corresponding to aerobic and anaerobic thresholds, maximal workloads, and maximal HR (HRmax) in each exercise mode were analyzed. HR and workload were monitored throughout the race. The intensity distributions in three HR zones for each discipline and five workload zones in cycling and running were quantified. The subjects were then assigned to a fast or slow group based on the total race time (range, 2 h 07 min–2 h 41 min). The mean percentages of HRmax in the swimming, cycling, and running legs were 89.8% ± 3.7%, 91.1% ± 4.4%, and 90.7% ± 5.1%, respectively, for all participants. The mean percentage of HRmax and intensity distributions during the swimming and cycling legs were similar between groups. In the running leg, the faster group spent relatively more time above HR at anaerobic threshold (AnT) and between workload at AnT and maximal workload. In conclusion, well-trained male triathletes performed at very high intensity throughout a nondraft legal, Olympic-distance triathlon race, and sustaining higher intensity during running might play a role in the success of these athletes.

Aetiological Outcome of Mesenteric Lymphadenopathy and Pain Abdomen in Paediatric Population at a Tertiary Care Hospital (MRIMSHyderabad) - A Hospital Based Prospective Observational Study

2021 ◽  
Vol 8 (29) ◽  
pp. 2601-2608
Author(s):  
Dileep Kumar Allagadda ◽  
Harikrishna Appana ◽  
Ramu Pedada ◽  
Deepika Gurram ◽  
Ditin Joseph
Keyword(s):  
Abdominal Pain ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Paediatric Population ◽  
Etiological Agent ◽  
Parasitic Infections ◽  
Care Hospital ◽  
Age Group ◽  
Mesenteric Lymphadenitis

BACKGROUND Abdominal pain is a common disorder in children and adolescents worldwide with prevalence rate ranging from 20 - 25 % in school-going children in India. It is a frustrating concern to the child, parents and the physician. Even though abdominal pain is one of the most common complaints in children, it poses a diagnostic challenge owing to the variety of underlying causes. The purpose of this study was to evaluate the aetiology of abdominal pain associated with significant mesenteric lymphadenopathy in a paediatric population. METHODS This is a hospital based prospective, observational study done in Department of Paediatrics, Malla Reddy Institute of Medical Sciences (MRIMS), Hyderabad. RESULTS Out of the 65 children studied, 30.8 % were of 5 - 8 years age group, 36.9 % were 9 - 12 years age group and 32.3 % were 13 - 15 years age group. In our study, we found 50.8 % were boys and 49.2 % were girls. 20 % of them were having fever, 16.9 % were having cough, 16.9 % were having diarrhoea, 13.8 % were having sore throat, 16.9 % dysuria, and 15.4 % were having constipation. All patients in our study group underwent ultrasound of abdomen. All cases were having significant mesenteric lymphadenopathy (more than 5 mm in short axis with three or more number of lymph nodes). In 53.8 % cases, etiological agent for the mesenteric lymphadenopathy was not proved with our investigations. In the remaining 46.2 % of children, cause of mesenteric lymphadenopathy was proved and 38.5 % were bacterial infections, 6.2 % were viral infections and 1.5 % were parasitic infections. CONCLUSIONS It is important to recognise mesenteric lymphadenitis as a clinical entity in paediatric cases presenting with abdominal pain. They should be evaluated for an etiological agent and if no proven source of infection and etiological agent is found, it can be considered as functional abdominal pain. If we are able to get a proper etiological diagnosis in these cases, we could treat them and we could make huge difference in terms of quality of life. KEYWORDS Abdominal Pain, Mesenteric Lymphadenitis, Ultrasound, Significant Mesenteric Lymphadenopathy

scholarly journals Anaesthesia and Perioperative Care in Remote Health Camps- Patients’ Concerns

2010 ◽  
Vol 49 (179) ◽  
Author(s):  
Balkrishna Bhattarai ◽  
A Ghimire ◽  
BK Baral ◽  
A Shrestha ◽  
Y Dhungana
Keyword(s):  
Observational Study ◽  
Perioperative Care ◽  
Local Anaesthesia ◽  
Prospective Observational Study ◽  
Main Concern ◽  
Surgical Experience ◽  
Female Ratio ◽  
Male Female Ratio ◽  
The Mean ◽  
Remote Health

INTRODUCTION:Identifying patients' concerns and expectations regarding anaesthesia and perioperative care in mobile surgical camps is relevant for the camp workers. This prospective observational study was conducted to assess knowledge, concerns, and expectations about anaesthesia and perioperative care in patients undergoing surgery in mobile surgical camps in remote mountainous districts of Eastern Nepal.METHODS:A questionnaire with seven items related to anaesthesia and perioperative care was used for interviewing 80 individuals of age > or = 12 years, 20 from each camp at Solukhumbu, Sankhuwasabha, Khotang and Bhojpur districts.RESULTS:Data of two patients were lost leaving only 78 individuals for analysis. The mean age of the subjects was 30.5 (+/- 14.6) years with the male: female ratio of 43: 35. Fifty-eight (74.4%) patients had some gross idea about the modality of administration of anaesthetics. Twenty-six (33.3%) individuals preferred GA over local anaesthesia, whereas 22 (28.2%) were happy either way if there was no pain. Pain was the main concern for 73.1% of the patients. Of the 25 patients expressing fear of GA, death or not being able to wake up anymore was the main concern for 60.0%. Increasing age was associated with lower fear of GA (p < 0.05). Surgical experience was distressing for 17 (21.8%) patients. The overall experience of the anaesthesia and surgery was worse than expected for 25.6% of the patients.CONCLUSIONS:Patients presenting to these health camps have limited knowledge regarding anaesthesia and perioperative care but have valid concerns and expectations in respect of their safety, comfort and outcome.

scholarly journals Role of JIGSAW method of teaching in improving clinical diagnosis among final year medical students – A prospective observational study

2021 ◽  
Vol 12 (12) ◽  
pp. 44-49
Author(s):  
Appandraj S ◽  
Sivagamasundari V ◽  
Varatharajan Sakthivadivel
Keyword(s):  
Observational Study ◽  
Test Score ◽  
Prospective Observational Study ◽  
Coronary Syndrome ◽  
Post Test ◽  
Jigsaw Method ◽  
The Mean ◽  
The Difference ◽  
Didactic Lecture ◽  
Teaching Learning

Background: The Jigsaw method is a form of cooperative learning, in which students are actively involved in the teaching-learning process that improves the long-term retention of acquired knowledge. Aims and Objectives: The objective of this study was to assess the knowledge acquired by students using the Jigsaw learning method in Internal Medicine. Materials and Methods: A prospective observational study was conducted with 100 students. The acute coronary syndrome was taken for 1 h as a didactic lecture, and a pre-test was conducted. The students were divided into five groups and were put for the intervention “Jigsaw.” The pre- and post-test were conducted, and feedback was collected from the students. Paired t-test was used to perform analysis of pre- and post-test. Feedback evaluation was done by a 5-point Liker scale. P<0.05 was considered statistically significant, and the data were analyzed using CoGuide software. Results: The mean pre-test score was 8.44 ± 2.33 ranged (3–14) and the mean post-test score was 11.03 ± 2.07 (ranged 6–15). The difference of 2.39 (95% CI: 2.19–2.59) increase in marks post-test after the Jigsaw method was statistically significant (P<0.001). The satisfaction level was 50–55% on the Likert scale based on the questionnaire given. There was a significant improvement in the post-test scores of the students after Jigsaw. Conclusion: The Jigsaw method improved knowledge in the short-term by engaging students in group work and motivation to learn. Overall response based on the questionnaire about the Jigsaw method was positive.

scholarly journals Clinicopathological study on presentation, diagnosis and management of liver abscess in Bhopal region

2017 ◽  
Vol 4 (8) ◽  
pp. 2572
Author(s):  
Anshul Siroliya ◽  
Mahendra Damor ◽  
M. C. Songra
Keyword(s):  
Observational Study ◽  
Liver Abscess ◽  
Prospective Observational Study ◽  
Pyogenic Liver Abscess ◽  
Amoebic Liver Abscess ◽  
Age Group ◽  
Catheter Drainage ◽  
Liver Abscesses ◽  
Male Preponderance ◽  
Amoebic Abscess

Background: This prospective observational study is carried out to study cases of liver abscess and to determine demographic profile, spectrum of clinical presentations, aetiology, laboratory investigations. The objective of the study was to evaluate efficacy of Ultrasonographic (radiological) studies in determining the aetiology and in differentiating from other liver pathologies which may change the treatment outcome, bacteriological and serological characteristics, to study the influence of alcohol, diabetics and immunocompromised diseases (esp. HIV) leading to increased incidence of liver abscess and to evaluate efficacy, recurrence rate, complications, morbidity and mortality, duration of hospital stay associated with different management Strategies.Methods: This prospective observational study was carried out in Department of Surgery, Gandhi Medical College Bhopal and Associated Hamidia Hospital, Bhopal between July 2015 to October 2016.Results: Amoebic abscess (74%) is more common than pyogenic abscess (26%). Amoebic abscess is common in the age group of 31-50 years (73%), pyogenic in the age group of 51-70 years (73.1%). Male preponderance is found in case of amoebic liver abscess (90.5%). Right lobe involvement in common. Right upper quadrant pain, tenderness and fever are the most common clinical features. Alcoholism is most common risk factor (71.6%) and diabetes mellitus has strong association with pyogenic liver abscess (15.4%). E coli (19.2%) and klebsiella (11.5%) are the most common organisms cultured. Medical therapy is more useful in case of amoebic liver abscess (58.1%) while catheter drainage is more useful in case of pyogenic liver abscess (61.5%). Pleuropulmonary complications are much more common and complications rate is more common among pyogenic group.Conclusions: In our study, alcohol was found to be the most common predisposing factor for liver abscesses (68%), this underpin the finding of other studies. Amoebic liver abscess is a medically treated common infection prevailing in unhygienic condition, affecting people mostly between 30-40 years of age whereas pyogenic liver abscess patient commonly falls between 50-70 years age group. Both liver abscesses show a male preponderance. The present study also corroborates the catheter drainage procedure as a superior modality in treating pyogenic liver abscess.

scholarly journals Incisional Hernia Repair in Contaminated Surgical fields (I.H.R.C.S.) study using biological prostheses in emergency surgery setting with contaminated hernias: a multicenter prospective observational study

2016 ◽  
Author(s):  
Belinda De Simone ◽  
Fausto Catena ◽  
Antonio Biondi ◽  
Gianluca Baiocchi ◽  
Fabio Campanile ◽  
...  
Keyword(s):  
Observational Study ◽  
Incisional Hernia ◽  
Prospective Observational Study ◽  
Wound Complication ◽  
Hernia Recurrence ◽  
Mesh Placement ◽  
Asa Score ◽  
Surgical Field ◽  
The Mean ◽  
Biological Prostheses

There are still difficulties to find appropriate indication for prosthetic implant in hernia surgery in contaminated surgical fields. Biologic prosthetic materials have been developed and proposed for the clinical use in contaminated surgical fields with interesting outcomes. The aim of this study is to analyze data from nine Italian Emergency Surgery Units concerning patients consecutively admitted with diagnosis of strangulated incisional hernia (IH), submitted to surgery in emergency and treated with biological prostheses. This is a prospective observational study. Subjects submitted to singlestaged IH repair in a contaminated surgical field, with the use of biologic mesh, were prospectively studied over a 1-year time period. All patients enrolled in this study were submitted to bowel/intestinal resection at the same operative time for perforation. Primary end points of our study were wound complication and hernia recurrence. Seventy-one patients were enrolled (F=21, M=50); the mean age was 69.2±11.1 standard deviation (SD) years and the mean American Society of Anesthesiologist (ASA) score was 3.1±0.8 SD. Twenty-one patients (29.57%) had a wound complication, associated with high ASA score, diabetes, smoking, chronic immunosuppression, number of previous hernia repairs, dirty surgical field, sublay extra peritoneal mesh placement and no anterior fascia closure. After a mean follow up time of 27.2 months, hernia recurrence occurred in 19 patients (26.76%). Predictors of hernia recurrence included wound complications, high ASA score, diabetes, chronic immunosuppression, dirty surgical field and sublay extra peritoneal mesh placement. Use of biological prostheses in contaminated fields is safe with favorable medium term recurrence rate (26.76% in our experience). Surgical technique performed is important to decrease hernia recurrence rate.

scholarly journals Premedication practices for tracheal intubation in neonates transported by French medical transport teams: a prospective observational study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e034052 ◽  
Author(s):  
Ricardo Carbajal ◽  
Noella Lode ◽  
Azzedine Ayachi ◽  
Ourida Chouakri ◽  
Véronique Henry-Larzul ◽  
...  
Keyword(s):  
Adverse Events ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Drug Regimen ◽  
Muscle Rigidity ◽  
Neonatal Transport ◽  
Registration Number ◽  
Medical Transport ◽  
The Mean ◽  
Paris Region

ObjectivesPremedication practices for neonatal tracheal intubations have not yet been described for neonatal transport teams. Our objective is to describe the use of sedation/analgesia (SA) for tracheal intubations and to assess its tolerance in neonates transported by medical transport teams in France.SettingThis prospective observational study was part of the EPIPPAIN 2 project and collected around-the-clock data on SA practices in neonates intubated by all five paediatric medical transport teams of the Paris region during a 2-month period. Intubations were classified as emergent, semiemergent and non-emergent. Sedation level and conditions of intubation were assessed with the Tonus, Reactivity, Awareness and Conditions of intubation to Help in Endotracheal intubation Assessment (TRACHEA score). The scores range from 0 to 10 representing an increasing ladder from adequate to inadequate sedation, and from excellent to very poor conditions of intubation.Participants40 neonates intubated in 28 different centres.ResultsThe mean (SD) age was 34.9 (3.9) weeks, and 62.5% were intubated in the delivery room. 30/40 (75%) of intubations were performed with the use of SA. In 18/30 (60.0%) intubations performed with SA, the drug regimen was the association of sufentanil and midazolam. Atropine was given in 19/40 intubations. From the 16, 21 and 3 intubations classified as emergent, semiemergent and non-emergent, respectively, 8 (50%), 19 (90.5%) and 3 (100%) were performed with SA premedication. 79.3% of intubations performed with SA had TRACHEA scores of 3 or less. 22/40 (55%) infants had at least one of the following adverse events: muscle rigidity, bradycardia below 100/min, desaturation below 80% and nose or pharynx–larynx bleeding. 7/24 (29.2%) of those who had only one attempt presented at least one of these adverse events compared with 15/16 (93.8%) of those who needed two or more attempts (p<0.001).ConclusionSA premedication is largely feasible for tracheal intubations performed in neonates transported by medical transport teams including intubations judged as emergent or semiemergent.Trial registration numberNCT01346813; Results.

scholarly journals How do palliative care doctors recognise imminently dying patients? A judgement analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e024996 ◽  
Author(s):  
Nicola White ◽  
Priscilla Harries ◽  
Adam JL Harris ◽  
Victoria Vickerstaff ◽  
Philip Lodge ◽  
...  
Keyword(s):  
Palliative Care ◽  
Observational Study ◽  
Phase I ◽  
Phase Ii ◽  
Prospective Observational Study ◽  
Clinical Signs ◽  
Brier Score ◽  
Prognostic Test ◽  
Probability Of Death ◽  
The Mean

ObjectivesTo identify a group of palliative care doctors who perform well on a prognostic test and to understand how they make their survival predictions.DesignProspective observational study and two cross-sectional online studies.SettingPhase I: an online prognostic test, developed from a prospective observational study of patients referred to palliative care. Phase II: an online judgement task consisting of 50 hypothetical vignettes.ParticipantsAll members of the Association of Palliative Medicine (APM) were eligible (n=~1100). 99 doctors completed the prognostic test and were included in the phase I analysis. The top 20% were invited to participate in phase II; 14/19 doctors completed the judgement task and were included in the phase II analysis.MeasuresPhase I: participants were asked to give a probability of death within 72 hours (0%–100%) for all 20 cases. Accuracy on the prognostic test was measured with the Brier score which was used to identify the ‘expert’ group (scale range: 0 (expert)–1 (non-expert)). Phase II: participants gave a probability of death within 72 hours (0%–100%). A mixed model regression analysis was completed using the percentage estimate as the outcome and the patient information included in the vignettes as the predictors.ResultsThe mean Brier score of all participants was 0.237 (95% CI 0.235 to 0.239). The mean Brier score of the ‘experts’ was 0.184 (95% CI 0.176 to 0.192). Six of the seven prognostic variables included in the hypothetical vignettes were significantly associated with clinician predictions of death. The Palliative Performance Score was identified as being the most influential in the doctors’ prognostic decision making (β=0.48, p<0.001).ConclusionsThis study identified six clinical signs and symptoms which influenced the judgement policies of palliative care doctors. These results may be used to teach novice doctors how to improve their prognostic skills.

scholarly journals Good Tolerance of Citrate Accumulation due to Plasma Exchange among Patients with Acute-on-Chronic Liver Failure: A Prospective, Observational Study

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Yuanji Ma ◽  
Yan Xu ◽  
Fang Chen ◽  
Ying Wang ◽  
Lang Bai ◽  
...  
Keyword(s):  
Observational Study ◽  
Liver Failure ◽  
Plasma Exchange ◽  
Prospective Observational Study ◽  
Meld Score ◽  
Chronic Liver ◽  
Ionized Calcium ◽  
Chronic Liver Failure ◽  
Citrate Accumulation ◽  
The Mean

Aim. To assess the tolerance of citrate accumulation due to plasma exchange (PE) among patients with acute-on-chronic liver failure (ACLF). Methods. A prospective, observational study was conducted among patients with ACLF who received heparin anticoagulation during PE-centered therapy without filtration and dialysis. Citrate accumulation was defined as the value of total calcium (Catot) to ionized calcium (Caion) ratio (Catot/Caion) greater than or equal to 2.5 (Catot/Caion≥2.5). Results. Fifty-four patients were enrolled. The mean age and MELD score were 50.0 ± 11.3 years old and 25 ± 7, respectively. Thirty-three patients had liver cirrhosis. The total 3-month survival rate was 57.4% (31/54). The mean Catot/Caion at the time before PE was 2.05 ± 0.14. Catot/Caion≥2.5 occurred in 100.0% (54/54) and 29.6% (16/54) of patients with mean Catot/Caion of 4.34 ± 1.52 and 2.36 ± 0.32 immediately after PE and 1 hour after PE, respectively, and these levels were much higher than those before PE (p<0.01). However, all values returned to lower than 2.5 by the next morning with no difference from those before PE (2.10 ± 0.14 versus 2.05 ± 0.14, p>0.05). Hypocalcemia (ionized calcium) and mild alkalosis were the main metabolic alterations. No symptoms associated with hypocalcemia occurred. Conclusions. Citrate accumulation is well tolerated by patients with ACLF who receive PE-centered therapy without filtration and dialysis. This study is regeristed with ChiCTR-OOC-17013618.

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