scholarly journals A Simple Method To Repair A Supraglottic Airway Device

Author(s):  
Tingting Wang ◽  
Jiang Wang ◽  
Yao Lu ◽  
Shangui Chen

Abstract Background: During the perioperative period or while in the intensive care unit, the inflation line is often cut accidentally during medical procedures or is damaged. As a result, it is not uncommon for a cuff leak to result in inadequate ventilation for the patient. The risk of using endotracheal tubes (ETTs) for secondary intubation is great, increasing the probability of respiratory tract infection and injury and even causing death in severe cases. The best method is to repair the damaged ETT to avoid secondary intubation and to ensure the safety of patients. Therefore, we recommend a practical and straightforward method to repair damage to the line or valve assembly of an endotracheal tube(ETT) and laryngeal mask airway (LMA).Methods: The distal end of a 22G vein (IV) catheter was inserted into the broken end of the inflation line. After insertion, the internal tube was withdrawn 1 mm to restore the inflation line. After 15 hours, the repaired ETT/LMA devices were tested for air leakage by measuring the pressure and load-bearing tension of the inflation line.Results: There was no difference in ETTs pressure between five intact ETTs and five repaired ETTs (Group A, ETT, mean difference = 0.2 cmH2O; 95% confidence interval 1.78 to 2.12 cmH2O; P = 0.82). When the cuff expanded to 120 cm H2O, there was no air leakage in the five ETTs after repair, and the tensile strength of the inflation line of the repaired ETTs in the experimental group was lower than that in the control group (each n = 5; mean difference = 33.3N; 95% confidence interval, 27.5 to 39.1N; P <0.001). There was no difference in LMAs pressure (Group B, LMAs, mean difference = 0.4 cmH2O; 95% confidence interval: -1.8 to −2.6 cmH2O; P = 0.67). When the cuff was expanded to 120 cmH2O, there was no air leakage from the five repaired LMAs. The tensile strength of the inflation line of the repaired LMAs in the experimental group was lower than that in the control group (n = 5; mean difference = −10; 95% confidence interval: −14 to −5.8 N; P = 0.001).Conclusion: When the ETT, LMA inflation line, or valve assembly is damaged or accidentally broken, an IV catheter can be directly inserted into the inflation line to quickly and effectively repair it. It is a safe and effective emergency remedial measure, which can be widely used in the clinic.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Roya Rahimi ◽  
Shirin Hasanpour ◽  
Mojgan. Mirghafourvand ◽  
Khalil Esmaeilpour

Abstract Background Considering the prevalence of infertility in the community and the consequences of failure of infertility treatments on women’s mental health, interventions that can control stress, anxiety and depression in infertile women with a history of IVF failure will be very helpful. This study aimed to determine the effects of hope-oriented group counseling on mental health (primary outcome) and quality of life (QoL) (secondary outcome) of women with failed IVF cycles. Method This randomized controlled trial was conducted on 60 women with failed IVF cycles visiting Infertility Clinic at Al-Zahra Teaching Hospital of Tabriz- Iran. Participants were allocated to the intervention group (n = 30) and control group (n = 30) based on a randomized block design. Hope-oriented group counseling was provided to the intervention group in six 45–60 min sessions (once a week). The control group only received routine care to undergo another IVF cycle. The Depression Anxiety Stress Scale-21 (DASS-21) and the SF-12 Quality of Life Scale were filled out by interviewing the participants before the intervention and one week and one month after the intervention. After intervention 26 participants in each group were included in the analysis. Results There was no significant difference between the intervention and control groups in the socio-demographic profile of participants (P > 0.05). The post-intervention mean score of stress (adjusted mean difference = − 1.7, 95% confidence interval: − 3.2 to − 0.3, P = 0.018) and depression (adjusted mean difference = − 1.3, 95% confidence interval: − 4.7 to − 1.5, P < 0.001) was significantly lower in the intervention group compared to the control. Although the mean anxiety score was lower in the intervention group compared to the control, the difference between them was not statistically significant (adjusted mean difference = − 1.1, 95% confidence interval: − 2.6 to 0.4, P = 0.153). The mean score of QoL was significantly higher in the intervention group than that of the control group (adjusted mean difference = 6.9, 95% confidence interval: 5.1 to 8.8, P < 0.001). Conclusion Hope-oriented group counseling was effective in reducing stress and depression and improving QoL in women with failed IVF cycles. It is recommended to use this counseling approach, along with other methods, to improve the mental health of women with failed IVF cycles. Trial registration TCT Registration Number: TCTR 20191017003, registered on October 17, 2019.


Author(s):  
Owolabi Omolara Arike ◽  
Sotunsa John

Background: Inadequate nutrition and poor feeding practices of newborn and infants has turn out to be a major public health concern that has negatively affected the lives of many children and as led to the cause of various forms of deficiencies, also the leading cause of death of most children between 1-5years of age. This study determined the effect of peer counselling on exclusive breastfeeding among mothers attending child welfare clinic in two selected general hospitals in Lagos State, Nigeria.Methods: This study adopted a two group pre-test post-test quasi experimental design. Total enumeration was used to select one hundred and seventy-four (174) participants that participated in the study. Data was collected using a self-developed questionnaire while four research questions were tested using descriptive statistics.Results: Findings indicated that the pre-intervention knowledge mean score of participants on the knowledge of exclusive breastfeeding in the control group was 15.43±4.98 (48.2%) and 14.69±5.16 (45.9%) in the experimental group with a mean difference of 0.74. The post-intervention knowledge mean score of participants on the exclusive breastfeeding in the control group was 15.58±4.83 (48.7%) and 28.97±8.31 (90.5%) in the experimental group with a mean difference of 13.39. Conclusions: The present study demonstrated a significant improvement in the exclusive breastfeeding rate among mothers due to peer counselling exposure, and the interventions have been effective in increasing knowledge and practice of breastfeeding among mothers. It was recommended that knowledge of peer counselling will influence knowledge, practice and behaviours on exclusive breastfeeding rate among mothers. 


Stroke ◽  
2020 ◽  
Vol 51 (2) ◽  
pp. 556-562
Author(s):  
Natasha A. Lannin ◽  
Louise Ada ◽  
Coralie English ◽  
Julie Ratcliffe ◽  
Steven G. Faux ◽  
...  

Background and Purpose— The aim of this trial was to determine the effect of additional upper limb rehabilitation following botulinum toxin-A for upper limb activity in chronic stroke. Methods— We conducted a multicenter phase III randomized trial with concealed allocation, blinded measurement, and intention-to-treat analysis. One hundred forty stroke survivors who were scheduled to receive botulinum toxin-A in any muscle(s) that cross the wrist because of moderate to severe spasticity after a stroke >3 months ago, who had completed formal rehabilitation and had no significant cognitive impairment. Experimental group received botulinum toxin-A plus evidence-based movement training while the control group received botulinum toxin-A plus a handout of exercises. Primary outcomes were goal attainment (Goal Attainment Scaling) and upper limb activity (Box and Block Test) at 3 months (end of intervention). Secondary outcomes were spasticity, range of motion, strength, pain, burden of care, and health-related quality of life. Results— In terms of goal attainment, the experimental group scored the same (mean difference, 2 T-score [95% CI, −2 to 7]) as the control group on the Goal Attainment Scale. In terms of upper limb activity, by 3 months the experimental group moved blocks at the same speed (mean difference, 0.00 blocks/s [95% CI, −0.02 to 0.01]) as the control group on the Box and Block Test. There were no differences between groups on any secondary outcome except strength, in favor of the experimental group (mean difference, 1.4 kg [95% CI, 0.2–2.7]). Conclusions— Findings suggest that additional intensive upper limb rehabilitation following botulinum toxin-A in chronic stroke survivors with a disabled upper limb is not effective. Registration— URL: https://www.clinicaltrials.gov . Unique identifier: ACTRN12615000616572.


2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Hao Zhang ◽  
Danying Zhang ◽  
Yudong Sun ◽  
Ye Lu ◽  
Jiaxuan Feng ◽  
...  

Objective. To explore a new treatment that can proceed from the whole, control blood pressure smoothly and coordinate the treatment of multiple factors causing blood pressure fluctuations. Method. We conducted a single-center, double-blinded, and randomized controlled clinical trial. 48 patients with acute Type B aortic dissection were randomly assigned into two groups: the experimental group, who received pinggan formula treatment, and the control group, who received placebo treatment. The drug was taken orally after meals three times a day. Only when the patients’ blood pressure fluctuated, conventional antihypertensive drugs were given to maintain the blood pressure within the target range and the dosage was recorded to convert the DDD value. Meanwhile, the international standardized score was used to evaluate the defecation, sleep, pain, anxiety, and depression of patients in the two groups during the hospitalization. Result. Univariate analysis was conducted on variables that might affect the assessment results, and it was found that grouping factors had a significant impact on the outcome variables, that is, after the intervention, the mean value of DDDs used in the perioperative period in the control group was 2.19 (0.38, 4.00). (P=0.0219), defecation score (2.13 (1.59, 2.67); P<0.0001), sleep score (0.95 (0.40, 1.50); P=0.0014), pain score (1.77 (0.61, 2.93); P=0.0045), depression score (4.04 (2.95, 5.12); and P<0.0001) were significantly higher than that of the experimental group, and the difference was statistically significant. Conclusion. Pinggan formula has a clear therapeutic regulation effect on the overall hemodynamics of acute Stanford type B aortic dissection during the perioperative period and can be recommended as an auxiliary drug for conventional antihypertensive drugs at the current stage.


2021 ◽  
Vol 14 (4) ◽  
pp. 1919-1923
Author(s):  
Mohammad Miraj

Proprioceptive Neuromuscular Facilitation (PNF) is a popular flexibility training, which involves stretching and contraction of the target muscle group. PNF stretching is effective among athletes for improving passive range of motion, flexibility, and performance. Patients who undergo total knee replacement surgeries exhibit pain, swelling, decreased range of motion, muscle weakness, and stiffness. This study aimed to investigate the effect of the hold relax PNF technique to improve the balance and muscle strength in subjects with a bilateral knee replacement. Sixty four patients were selected based on inclusion/exclusion criteria. The patients were allocated into two groups by random allocation. The experimental group A (n=32) received the Hold Relax PNF technique with conventional treatment whereas, the control group B (n=32) received only conventional treatment as a part of the Home Exercise Program (HEP). Outcome measures used for evaluation included the Visual Analogue Scale (VAS), Manual Muscle Testing (MMT), and Berg Balance Scale (BBS) Score for measuring pain, muscle strength, and balance respectively. Students t-test showed significant differences between variables mean scores from two groups after three weeks of intervention. There was a statistical significant (t(32) = 2.38, p = 0.02) change in the mean scores of VAS in the experimental group (mean difference pre-post=3.19) as compared to control group ( mean difference pre -post=3.19) with Cohen’s d = 2.744588. Similarly for MMT(t(32) = 0.415, p = 0.005) and BBS scores (t(32) = 2.628, p = 0.035). The result of the study suggests that the Hold Relax PNF technique is more effective than conventional treatment alone in decreasing pain as well as increasing balance and muscle strength in bilateral knee replacement patients.


Author(s):  
Heba Mohammed Saleh Al-Hafidh

The study aimed to know the effect of using the Scientific stations strategy in developing Deductive thinking of intermediate school students in the science subject. To achieve the aim of the research, the researcher used experimental design with two equal groups, the research sample consisted of (65) intermediate-grade students in Al Nidhal school for boys represented by (30) students of the experimental group and (35) students for the control group, the researcher equivalence of the two research groups with a set of variables including (Intelligence, parents ’educational level, previous achievement, age calculated by months and pre-test for Deductive thinking), to verify the research aim the researcher put the two hypotheses as following : 1- There is no statistical significant difference at the level of significance (0.05) between the scores mean of the members of the experimental group and the members of the control group in the post test of Deductive thinking. 2- There is no statistical significant difference at the level of significance (0.05) between the mean difference between the (pre and post) tests of both experimental and control groups in the Deductive thinking test. To verify the research hypotheses, the researcher prepared a test for Deductive thinking consisting of (20) items the researcher applied the test of Deductive thinking, collected the data, and tabulated it in tables for statistical processing and the results indicated: 1- There is a statistical significant difference between the scores mean of students in both groups in the Deductive thinking test and in favor of the experimental group. 2- There is a statistical significant difference between the mean difference between the two tests (pre - post) and in favor of the experimental group.


2020 ◽  

Introduction: The use of protocols reduces the risk of human error and increases healthcare professionals’ adherence to guidelines. In a team of only two providers, following Advanced Life Support (ALS) protocol might be challenging. Automated Chest Compressions Devices (ACCD) may increase the quality of chest compressions. The aim of this study was to evaluate if the use of ACCD in resuscitation by a two-paramedic crew improves adherence to the ALS protocol. Materials and Methods: This study was designed as a prospective randomized high-fidelity cross-over simulation trial. Fifty-two doubleperson teams were enrolled. Each team performed two full resuscitation scenarios: one with ACCD (the experimental group-ACC) and one with manual compressions (the control group-MAN). Results: ACC achieved shorter mean durations of resuscitation loops, being less prolonged in relation to recommended durations than MAN (13 vs. 23 sec over recommended respectively, P = 0.0003). ACC also achieved mean times for supraglottic airway completion significantly faster than MAN: 224 ± 66 s vs 122 ± 35 s (P < 0.0001). In ACC, the intravenous line was obtained earlier then in MAN (162 ± 35 s vs 183 ± 45 s, P = 0.0111). Moreover, the first and second doses of adrenaline (epinephrine) were administered earlier 272± 58 s vs 232 ± 57 s (P = 0.0014) for the first and 486 ± 96 s vs 424 ± 69 s (P = 0.0007) for the second doses, respectively. Mean chest compression fraction (CCF) in MAN group was significantly lower (74 ± 4%) than in ACC group (83 ± 2%) (P < 0.0001). Conclusions: In a simulated setting, ACCD used by two-person paramedic teams yielded earlier achievement of resuscitation endpoints and improved delivery time of compressions. which may have implications for effective clinical resuscitation.


2018 ◽  
Vol 35 (4) ◽  
pp. 198-204
Author(s):  
Sami A. Nizam ◽  
Rhys Branman

Neck contouring is one of the most frequent reasons patients seek cervicofacial rhytidectomy. But what makes for aesthetically pleasing youthful neck? Ellenbogen and Karlin described 5 criteria in their 1980 landmark publication, including having a cervicomental angle between 105° and 120° and a visible subhyoid depression. Recent advances in neck anatomy have revealed the existence of ligamentous like structures attaching the skin and platysma to the hyoid. These have been termed the hyoplatysmal ligament (HPL) and cervicomental suspensory angle ligament by different authors. This study was undertaken to determine whether surgically reestablishing the above structures utilizing a hyoid suspension technique resulted in statistically significant changes in cervicomental contour. A retrospective chart review was performed from January 2014 to present. After December 2016, the second author began utilizing a hyoid suspension technique where the inter- and subplatysmal fat was resected and the HPL was reestablished surgically (hyoid suspension). Cases before this date served as controls if a similar neck manipulation was performed without reestablishing the HPL. In total, 104 charts were queried, of which, 21 charts fit inclusion criteria to serve as controls and 20 as the experimental group. Before and after profile pictures were then compared for differences in cervicomental angle utilizing commercially available imaging software (Canfield Mirror, Parsippany, New Jersey). An unpaired Student t test was then performed to determine whether this 2 groups differed significantly utilizing a P value of .05 to denote statistical significance. The mean difference between pre- and postoperative cervicomental angle for the control group was 17.38° with a standard deviation of 8.05°. The mean difference between pre and postoperative cervicomental angle for the experimental group was 28.75° with a standard deviation of 15.52°. The resulting 11.37° difference in cervicomental angle between the 2 groups was found to be statistically significant with a P value of .0051. Our cosmetic surgical and anatomical knowledge continues to progress. Brant first described a ligamentous structure that attaches the platysma to the hyoid. Through biomechanical testing, he noted this ligament to be one of the weakest in the face and neck. Thereafter, in 2016 Yousif et al and Le Lourn separately described similar procedures to attach the platysma to the hyoid, in effect reestablishing this ligament. Utilizing one simple surgical maneuver, the hyoid suspension reestablishes the HPL. This surgically creates an acute cervicomental angle, resulting in less platysmal displacement postoperatively, with virtually no addition to surgical time or morbidity.


2016 ◽  
Vol 27 (1) ◽  
pp. 101-107 ◽  
Author(s):  
Patrícia Layane de Menezes Macêdo Nascimento ◽  
Micaelle Tenório Guedes Fernandes ◽  
Fabricio Eneas Diniz de Figueiredo ◽  
André Luis Faria-e-Silva

Abstract The relation between orthodontic fixed appliances use and enamel demineralization is well established. Different preventive approaches have been suggested to this problem, but controversy remains about which is the best. The aim of this study was to perform a systematic review of clinical trials that investigated the effectiveness of materials containing fluorides to lute brackets or cover the bonding interface in order to inhibit the development and progression of white spot lesions. The null hypothesis was that fluoride materials do not affect the incidence of white spot lesions around brackets. A MEDLINE search was conducted for randomized clinical trials evaluating the development of white spot lesions in patients using fixed orthodontic appliances, followed by meta-analysis comparing the results for patients for whom dental materials containing fluorides were used (experimental group) to those for whom these materials were not used (control group). The pooled relative risk of developing white spot lesions for the experimental group was 0.42 (95% confidence interval: 0.25 to 0.72); hence, when fluoride-releasing materials are used, the patient has 58% less risk of white spot lesion development. Regarding white spot lesion extent, the pooled mean difference between the experimental and control groups was not statistically significant (-0.12; 95% confidence interval: -0.29 to 0.04). In conclusion, the results of the present systematic review suggest that fluoride-releasing materials can reduce the risk of white spot lesions around brackets. However, when white spot lesions had already occurred, there is no evidence that fluoride-releasing materials reduce the extent of these lesions.


2021 ◽  
pp. 8-9
Author(s):  
Dimpalben R. Nandwana ◽  
N Sriram

Introduction: The majority of UTI is currently the most common healthcare associated infection.CAUTI accounts for more than 30% of all healthcare associated infection. Catheter associated UTI case an increased length of stay, morbidity and mortality of patients,in addition to increased bacterial resistance to antibiotic, leading to an increase in hospital and healthcare cost. Basic and specific practices to prevent bacteriuria and reducing rates of CAUTIs and Foleys catheter days. distilled vinegar wash its helpful to implement prevention methods for urinary catheterized patients. Aim: The aim of the study was evaluating the effectiveness of distilled vinegar wash of urinary drainage bag on the level of bacteriuria among urinary catheterized patients. Materials & Methods: A Quasi Experimental Pre-test and Post-test only Design. Purposive convenient sample technique 60sample.30 experimental, 30 control group. Result: The analysis revealed that when comparing pretest and post test value of bacteuria, the calculated t value (10.81) was more than the table value (2.05) at the 0.05 level of significance. There will be a significant mean difference in the experimental pre-test and post-test level of bacteriuria among experimental group is accepted and the level of bacteriuria was increased in control group. While assessing the effectiveness of distilled vinegar wash for reduction of bacteuria, the calculated t-value (14) is more than the table value (2) at the 0.05 level of significance hence there will be a significant mean difference in the post-test level of bacteriuria among experimental group and control group is accepted. So distilled vinegar treatment is effective and there is no association between the level of bacteriuria among urinary catheterized patients and demographic variables such as age (1.7673), gender (0.0339), marital status (1.5584), educational status (3.7763 ), occupation (3.8996) at the 0.05 level of significance. Conclusion: The result highlighted distilled vinegar wash to be an effective method to decrease the bacteriuria level among the urinary catheterized patients.


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