HEAMODIALYSIS PATIENTS;

Background: Internal jugular vein is considered the preferred site of insertion.Prevalence of central vein stenosis following temporary double lumen catheterization at differentsites seems to be different in Asian countries. Objectives: To evaluate the number of cases havingcatheterization and stenosis after being subjected to central vein catheterization (CVC) amongPakistani population. Study Design: Cross sectional study. Period: 6 months period. Setting:Admitted in the Department of Nephrology or already undergoing maintenance hemodialysisfulfilling the inclusion criteria were included in the study. Material and Method: The samplewhich was considered suitable for this study was 150 cases after checking the inclusion criteriacarefully. The patients were advised to undergo color Doppler ultrasonography of IJV and SCVof both sides. Demographics and outcome variables were noted and recorded for the analysispurposes. Data was analyzed used SPSS 20.inc Results: The frequency of catheterization ofcatherization at IJV was found to be 128(85.3%) and frequency of catheterization at SCV was22(14.7%). The frequency of CVS at IJV was found to be 43(29.68%) and the frequency of CVSat SCV was 81(54.54%). The frequency of stenosis at SCV was found to be significantly higherwith a p value of 0.029 (<0.05). Conclusion: Internal jugular vein is the most frequent andpreferred site of temporary double lumen catheterization for haemodialysis as it is associatedwith significantly lower rate of stenosis as compared to subclavian vein.

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Catheter related infection in hemodialysis patients with double lumen catheter.

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.08.3869 ◽

2019 ◽

Vol 26 (08) ◽

pp. 1278-1282

Author(s):

Muhammad Ali ◽

Bhagwan Das ◽

Santosh Kumar ◽

Rafia Memon ◽

Bella Dayu ◽

...

Keyword(s):

Internal Jugular Vein ◽

Jugular Vein ◽

Femoral Vein ◽

Cross Sectional Study ◽

Clinical Findings ◽

Double Lumen ◽

Cross Sectional ◽

Catheter Related Infection ◽

Double Lumen Catheter ◽

Lumen Catheter

Catheter related infections are common issue, a major cause of morbidity and mortality in patients with uremia. Clinical findings, including fever, redness, or tenderness at catheter site are unreliable for the diagnosis of catheter-related infection due to poor sensitivity and specificity. Study Design: Descriptive Cross sectional Study. Setting: Department of Nephrology, Jinnah Postgraduate Medical Centre, Karachi. Period: September 2014 to March 2015. Materials and Methods: All patients with age 25-50 years of either gender undergoing hemodialysis via double-lumen catheter were enrolled. Regular monitoring of temperature and WBC counts was carried out. If a patient develops fever (100 F or more) or leukocytosis (TLC 12,000 /mcl), a through re-examination, urinalysis and chest X-ray was done to exclude other causes of infection in this patient. Blood cultures from catheter tip and a peripheral blood culture was sent. Growth of the organism from both the cultures was noted and catheter related infection was termed positive if same organism s found to be present in both the cultures. Results: Mean age of the patients was 42.69 ±6.86 years. There were 75 (58.10%) females and 54 (41.90%) males. In majority of the patients, site of catheter was right internal jugular vein 54 (41.90%), followed by femoral vein 30 (23.30%), left internal jugular vein 24 (18.60%) and subclavian vein in 21 (16.30%) patients. Frequency of catheter related infection was found to be 19 (14.70%). Conclusion: The frequency of catheter related infection was found in 19 (14.70%) patients undergoing hemodialysis via double-lumen catheter.

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Supraclavicular approach to the subclavian vein – one well forgotten technique with impressive results

Polish Journal of Surgery ◽

10.5604/01.3001.0013.2281 ◽

2019 ◽

Vol 91 (3) ◽

pp. 1-5

Author(s):

Biser Borisov ◽

Sergey Iliev

Keyword(s):

Internal Jugular Vein ◽

Subclavian Vein ◽

Jugular Vein ◽

Statistical Correlation ◽

Central Vein ◽

Chronic Complications ◽

Supraclavicular Approach ◽

Acute Complications ◽

Vein Stenosis ◽

Central Vein Stenosis

Purpose: Insertion of temporary and tunneled catheters for hemodialysis in the internal jugular vein is a gold standard. On the other hand, the supraclavicular approach to the subclavian vein is described by Yoffa in 1965. Despite its old invention, the latter technique is well forgotten for unknown reasons. The aim of this study is to present our experience with the usage of the supraclavicular approach for insertion of temporary and tunneled catheters. Material and Methods: We provide our experience on insertion of 506 temporary and 501 tunneled catheters within a five-year period (from 1st January 2010 to 31st December 2014). We use 8 (eight) different places for catheters insertion, including the subclavian vein by the supraclavicular approach following the techniques of D. Yoffa and J. Gorchynski. The collected data include age, sex, reasons for hemodialysis, number of attempts for successful cannulation, number of acute (AC) and chronic (CC) complications, and dependence on the catheter insertion location. Results: The gender distribution shows 463 (46 %) women and 544 (54 %) men with median age of 60.0 (+/- 13.2) years. In the cases of temporary catheters: 104 (20.5%) are inserted in the subclavian vein by the supraclavicular approach (SCVSC), 70 (13.8%) – in the internal jugular vein (IJV); in the cases of tunneled ones – SCVSC – 281 (56%), and IJV – 207 (41%) catheters, respectively. We found significant statistical correlation (p < 0.05 and r = 0.23) between the acute complications and the insertion position – AC are more for IJV insertion, than in SCVSC. We did not find significant correlation between the insertion place and the chronic complications. Even central vein stenosis is more frequent in the IJV than in the SCVSC, but this is not significant (p > 0.05). Primary catheter patency of temporary and tunneled catheters is higher when they are inserted in the left veins. Conclusion: We conclude that the supraclavicular approach to the subclavian vein is easier, safer and a practically more convenient method than the cannulation of the IJV. The revisit of this approach demonstrates that it should be more widely used.

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HEAMODIALYSIS PATIENTS; CENTRAL VEIN STENOSIS FOLLOWING TEMPORARY DOUBLE LUMEN CATHERIZATION IN INTERNAL JUGULAR AND SUBCLAVIAN VEINS

The Professional Medical Journal ◽

10.17957/tpmj/17.3775 ◽

2017 ◽

Vol 24 (08) ◽

pp. 1211-1215

Author(s):

AURANGZEB AFZAL ◽

ANWAR ULHAQ ◽

AIZAZMAND AHMED ◽

WASIF BAIG ◽

ADNAN ZAFAR ◽

...

Keyword(s):

Central Vein ◽

Double Lumen ◽

Vein Stenosis ◽

Central Vein Stenosis

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Tunneled Double-Lumen Silicone Hemodialysis Catheter Placement in Three Patients with Permanent Pacemaker Wires: A Case Study

The Journal of Vascular Access ◽

10.1177/112972980500600208 ◽

2005 ◽

Vol 6 (2) ◽

pp. 88-91

Author(s):

K.I. Sombolos ◽

F.N. Christidou ◽

G.I. Bamichas ◽

T.C. Anagnostopoulos ◽

I.I. Rudenko ◽

...

Keyword(s):

Vascular Access ◽

Permanent Pacemaker ◽

Catheter Placement ◽

Central Vein ◽

Double Lumen ◽

Hemodialysis Catheter ◽

Vein Stenosis ◽

Central Vein Stenosis

Permanent pacemaker wires have been described as a cause of central vein stenosis. Furthermore, in hemodialysis (HD) patients with transvenous pacemakers, permanent vascular access (VA) created at the ipsilateral arm is not always successful. We report the use of tunneled double-lumen silicone HD catheters, as permanent VA in three HD patients wearing permanent transvenous pacemakers. In one patient, the catheter was inserted ipsilateral to the pacemaker site. Catheter-related infections were the most significant complications.

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Impact of positive end expiratory pressure on left internal jugular vein size

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v7i1.20623 ◽

2018 ◽

Vol 7 (1) ◽

pp. 12-17

Author(s):

Mona Sharma ◽

Babu Raja Shrestha ◽

Sushila Lama Moktan ◽

Manan Karki

Keyword(s):

Internal Jugular Vein ◽

Jugular Vein ◽

Cross Sectional Area ◽

P Value ◽

Transverse Diameter ◽

Sectional Area ◽

Left Internal Jugular Vein ◽

Positive End Expiratory Pressure ◽

Cross Sectional ◽

The Cross

Background: Increasing the cross sectional area (CSA) of the left internal jugular vein facilitates cannulation and decreases complications. But, the literature is sparse regarding the methods to increase the cross sectional area of the left internal jugular vein.Objective: To assess the changes that occur in cross sectional area of left internal jugular vein after application of different levels of positive end expiratory pressure and compare the findings with right internal jugular vein.Methodology: Sixty-four patients were included. Antero posterior diameter, transverse diameter and cross sectional area of left and right internal jugular vein was measured using two-dimensional ultrasound before the induction of anesthesia and after intubation at positive end expiratory pressure of 0, 5, 10 and 15 cm H2O. Result: The increase in positive end expiratory pressure was associated with increase in cross sectional area, anteroposterior and transverse diameter of left internal jugular vein. At 10 cmH2 Opositive end expiratory pressure, left internal jugular vein cross sectional area increased significantly by 22.8% that is 1.34±0.53cm2(P value< 0.05). The right internal jugular vein is significantly larger than left at baseline and at all levels of studied positive end expiratory pressure. The percentage increase of cross sectional area for both internal jugular veins was similar.Conclusion: The left internal jugular vein cross sectional area increment has direct relationship with increment of positive end expiratory levels at studied points. However, above 10 cm H2O of positive end expiratory pressure, there was only non significant increase (P value > 0.05).

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Brief Overview and Experience of Visual Evoked Potential of First 67 cases at Referral Neuroscience Hospital in Bangladesh

Journal of National Institute of Neurosciences Bangladesh ◽

10.3329/jninb.v6i2.50744 ◽

2020 ◽

Vol 6 (2) ◽

pp. 74-77

Author(s):

Mohammad Enayet Hussain ◽

Bithi Debnath ◽

AFM Al Masum Khan ◽

Md Ferdous Mian ◽

Md Nahidul Islam ◽

...

Keyword(s):

Multiple Sclerosis ◽

Optic Neuritis ◽

Clinical Diagnosis ◽

Optic Neuropathy ◽

Cross Sectional Study ◽

P Value ◽

Pattern Reversal ◽

Cross Sectional ◽

The Mean ◽

Visual Evoked

Background: The visual evoked potentials (VEP) is a valuable tool to document occult lesions of the central visual channels especially within the optic nerve. Objectives: The purpose of the present study was to observe the findings of first few cases of VEP done in the neurophysiology department of the National Institute of Neurosciences (NINS), Dhaka, Bangladesh. Methodology: This cross-sectional study was conducted in the Department of Neurophysiology at the National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from September 2017 to March 2020. All patients referred to the Neurophysiology Department of NINS for VEP were included. Pattern reversal VEPs were done using standard protocol set by International Federation of Clinical Neurophysiology (IFCN). Results: The mean age of the study population was 30.70 (±12.11) years (6-68 years) with 31 (46.3%) male and 36 (53.7%) female patients. The mean duration of illness was 8.71 (±1.78) months (3 days- 120 months). Most common presenting symptom was blurring of vision (37.3%) and dimness of vision (32.8%). Patterned VEP revealed mixed type (both demyelinating and axonal) of abnormality in most cases [29(43.35)]. The most common clinical diagnosis was multiple sclerosis (29.85%) and optic neuropathy (26.87%). In the clinically suspected cases of multiple sclerosis, optic neuropathy and optic neuritis most of the cases of VEP were abnormal and the p value is 0.04 in optic neuropathy and optic neuritis. Conclusion: The commonest presentation of the patients in this series were blurring of vision and dimness of vision. The most common clinical diagnosis for which VEP was asked for, was optic neuritis and multiple sclerosis. Most abnormalities were of mixed pattern (demyelinating and axonal). Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 74-77

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THE RELATION OF COPPING STRATEGY BY LOOKING SOCIAL SUPPORT WITH STRESS LEVEL OF BREAST CANCER PATIENT WHO GONE TROUGH CHEMOTHERAPY

Elevate The International Journal of Nursing Education Practice and Research ◽

10.25077/elevate.1.1.51-54.2018 ◽

2018 ◽

Vol 1 (1) ◽

pp. 51-54

Author(s):

Sri Burhani Putri

Keyword(s):

Breast Cancer ◽

Social Support ◽

Cancer Patient ◽

Breast Cancer Patient ◽

Cross Sectional Study ◽

P Value ◽

Spiritual Support ◽

Cross Sectional ◽

Breast Cancer Chemotherapy ◽

Patient Stress

Breast cancer is one of the most common illness that killed woman. One of the therapy to cure breast cancer is chemotherapy. Chemotherapy has side effect either physical and psychology, that caused people who’s in chemo therapy, prone to stress. Stress effected by many factors, such as characteristic and chopping strategy that patient has been using. The aim of this research is to get a perspective about the relation of characteristic and chopping strategy with breast cancer patient stress, whose in chemo therapy. This research using cross sectional study and taking sample by using accidental sampling method. The data analyzed by using bavariat and multivariat with variable result shows that breast cancer patient stress who has chemo therapy realted to age characteristic (p value = 0.00) the time since they diagnosed with cancer (pvalue = 0.03), how long they have chemo therapy (pvalue = 0.00) and chopping strategyby looking social support (pvalue = 0.00) looking for spiritual (pvalue = 0.00) with dominan variable which related to stress is chopping strategy to looking spiritual support (coeffecients B = -1.139). Key words : Breast cancer, chemotherapy, stress

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Faktor Risiko Kejadian Penyakit Kulit Pada Pekerja Pengangkut Sampah Di Kota Jambi

Riset Informasi Kesehatan ◽

10.30644/rik.v6i2.87 ◽

2017 ◽

Vol 6 (2) ◽

pp. 129

Author(s):

Entia Nopa ◽

Ranissa Dwi Imansari ◽

Irwandi Rachman

Keyword(s):

Cross Sectional Study ◽

Personal Hygiene ◽

P Value ◽

Sectional Study ◽

Chi Square ◽

Cross Sectional

Faktor Risiko Kejadian Penyakit Kulit Pada Pekerja Pengangkut Sampah Di Kota Jambi 1Entianopa, 2Ranissa Dwi Imansari, 3Irwandi Rachman 123Program Studi Kesehatan Masyarakat STIKES Harapan Ibu, Jambi Abstrak Latar Belakang: Kulit merupakan organ terbesar pada tubuh manusia yang membungkus otot-otot dan organ-organ dalam serta merupakan jalinan jaringan pembuluh darah, saraf, dan kelenjar yang tidak berujung, semuanya memiliki potensi untuk terserang penyakit yang salah satunya adalah penyakit kulit. Penyakit kulit merupakan salah satu gangguan kesehatan yang sering dialami oleh pekerja pengangkut sampah. Berdasarkan komposisi sampah yang diangkut serta waktu paparan kerja. Tujuan penelitian ini untuk mengetahui hubungan antara masa kerja, pemakaian Alat Pelindung Diri (APD), dan personal hygiene dengan kejadian penyakit kulit pada pekerja pengangkut sampah di Kota Jambi. Metode: Penelitian ini merupakan penelitian kuantitatif dengan desain penelitian cross sectional study. Sampel penelitian yaitu sebanyak 62 pekerja pengangkut sampah yang berada di Kantor Pekerjaan Umum dan Penata Ruang, yang mana seluruh populasi dijadikan sampel. Data dikumpulkan berdasarkan pemeriksaan kesehatan oleh dokter dan dengan kuesioner, kemudian dianalisa menggunakan uji statistik chi-square. Hasil: Hasil menunjukan bahwa pekerja yang mengalami penyakit kulit sebanyak 35 pekerja (56,5%). Berdasarkan hasil analisis chi-square didapatkan bahwa ada hubungan yang bermakna antara masa kerja dengan kejadian penyakit kulit pada pekerja pengangkut sampah dimana nilai (p-value= 0,006), Pemakaian Alat Pelindung Diri (APD) nilai (p-value= 0,008), personal hygiene nilai (p-value= 0,008). Kesimpulan: Untuk meminimalisir risiko terjadinya penyakit kulit pada pekerja pengangkut sampah disarankan perlunya disusun standar operasional prosedur yang aman, penyediaan sarana sanitasi agar dapat mengurangi resiko terkena penyakit kulit. Pentingnya pemakaian APD dan perilaku hidup bersih dan sehat selama bekerja, serta diharapkan pekerja menggunakan APD pada saat bekerja dan lebih memperhatikan personal hygiene. Kata kunci : Masa Kerja, APD, Personal Hygiene

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Spectrum of Pathological Lesions in Uterine Specimens with Focus on Gestational Trophoblastic Disease in Karachi

Pakistan Journal of Medicine and Dentistry ◽

10.36283/pjmd9-4/005 ◽

2020 ◽

Keyword(s):

Hydatidiform Mole ◽

Endometrial Stromal Sarcoma ◽

Gestational Trophoblastic Disease ◽

Cross Sectional Study ◽

Reproductive Age ◽

P Value ◽

Cross Sectional ◽

Endometrial Polyps ◽

Trophoblastic Disease ◽

Proliferative Endometrium

Background: The most common benign pathological lesion in women of reproductive age is uterine leiomyoma. Gestational trophoblastic disease includes tumors and tumor like lesions originating from trophoblastic tissue. The aim of this study was to ﬁnd the spectrum of molar pregnancy and uterine pathologies focusing on gestational trophoblastic disease as no study has been done in the past few years. Methods: Endometrial and uterine specimens of patients (n=436) between the ages of 15-65 years were collected from a private hospital in Karachi from December 2018 to December 2019. This cross-sectional study was carried out by pathological diagnosis of patients’ samples under light microscopy using hematoxylin and eosin staining. Stratiﬁcation was done about age and nature of specimen to control the effect modiﬁers. The post stratiﬁcation Chi square test was applied and p value <0.05 was considered signiﬁcant. Results: Mean age of the patients was 36.1 years ±7.8. Total 436 uterine biopsies included 260(59.6%) hysterectomies, 56(12.8%) endometrial curetting’s, 117(26.8%) evacuation specimens and 3(0.7%) polypectomies. Common pathologies included 124(28.4%) leiomyomas, 61(14%) proliferative endometrium, 52(11.9%) adenomyosis and 32(7.3%) endometrial polyps. Gestational trophoblastic disease was seen in 9(2.06%). Seven (87.5%) were partial hydatidiform moles, one (12.5%) exaggerated placental site reaction and one choriocarcinoma. Mole was common between 26-30 years with mean age of 27.2 years and prevalence was 6/100 abortions. Conclusion: Leiomyoma was the commonest (28.4%) uterine pathology followed by proliferative endometrium (14.5%). However, endometrial stromal sarcoma and endometriosis were found 0.2% each. High prevalence of mole was seen in this study. Partial mole was most common and choriocarcinoma was least common. Keywords: Hydatidiform Mole; Pathology; Prevalence.

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Pengetahuan Mahasiswi Universitas Al Azhar Indonesia Terhadap Premenstrual Syndrome

JURNAL Al-AZHAR INDONESIA SERI SAINS DAN TEKNOLOGI ◽

10.36722/sst.v2i3.141 ◽

2015 ◽

Vol 2 (3) ◽

pp. 193

Author(s):

Riris Lindiawati Puspitasari ◽

Dewi Elfidasari ◽

Kun Mardiwati Rahayu

Keyword(s):

Premenstrual Syndrome ◽

Population Sample ◽

Reproductive Organs ◽

Cross Sectional Study ◽

Hormonal Control ◽

P Value ◽

Cross Sectional ◽

Knowledge Age ◽

Physical Changes ◽

Age Of Menarche

Abstrak – Tahap perkembangan remaja ditandai dengan perubahan fisik umum yang disertai perkembangan kognitif maupun sosial. Menstruasi merupakan proses alamiah organ reproduksi wanita dengan pengendalian hormon. Salah satu gangguan menstruasi adalah Premenstrual Syndrome atau sindrom sebelum haid atau dikenal juga sebagai ketegangan sebelum haid. Siklus menstruasi yang tidak teratur, penurunan level progesteron dan peningkatan level estrogen, stres, usia menarche yang terlalu cepat, dan status gizi merupakan beberapa faktor penyebab PMS. Penelitian ini bertujuan untuk mengetahui pengetahuan mahasiswi Universitas Al Azhar Indonesia terhadap PMS. Metodologi yang digunakan yaitu studi Cross Sectional. Populasi sampel penelitian adalah mahasiswi Universitas Al Azhar Indonesia. Variabel independen yang dipilih yaitu pengetahuan, usia menarche, siklus haid, olahraga, nutrisi, produktivitas, dan indeks massa tubuh (IMT). Berdasarkan uji bivariat dan multivariat regresi logistik tidak ditemukan hubungan yang signifikan antara pengetahuan dengan premenstrual syndrome pada mahasiswi UAI yaitu pengetahuan dengan p value 0,169; OR 0,473; 95% CI 0,163-1,374. Responden yang memiliki pengetahuan 0,473 kali lebih baik dalam penatalaksanaan premenstrual syndrome daripada responden yang memiliki pengetahuan kurang. Abstract – Adolescent developmental stage characterized by common physical changes that accompanied the cognitive and social development. Menstruation was known as a natural process of hormonal control in the female reproductive organs. One of menstrual disorders was premenstrual syndrome or syndrome before menstruation or also known as tension before menstruation. Irregular menstrual cycles, decreased levels of progesterone, increased level of estrogen, stress, menarche age, and nutritional status were informed as factors that cause premenstrual syndrome. This study aimed to determine student’s knowledge to premenstrual syndrome. The methodology used was a cross sectional study. The population sample was a student of University Al Azhar Indonesia. The independent variables were selected, namely knowledge, age of menarche, menstrual cycle, exercise, nutrition, productivity, and body mass index (BMI). Based on the test bivariate and multivariate logistic regression found no significant relationship between knowledge with premenstrual syndrome in UAI student that knowledge with p value 0.169; OR 0.473; 95% CI 0.163 to 1.374. Respondents who had knowledge 0.473 times better than others in treatment of premenstrual syndrome. Keywords: Premenstrual Syndrome, knowlwdge, menstruation, menarche.

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