scholarly journals The effectiveness of mini-CEX assessment tool for clinical competency achievement in clinical practice among anesthesia trainee.

2020 ◽  
Vol 27 (02) ◽  
pp. 279-283
Author(s):  
Aamir Furqan ◽  
Azeem Gulzar ◽  
Bilal Nazar ◽  
Masood Alam ◽  
Rahat Akhtar ◽  
...  
Keyword(s):  
Observational Study ◽  
Prospective Observational Study ◽  
Assessment Tool ◽  
Clinical Skills ◽  
Intervention Group ◽  
Control Group ◽  
P Value ◽  
Clinical Expertise ◽  
The Mean ◽  
Preoperative Examination

Objectives: To determine the efficacy of Mini-CEX in assessing clinical expertise of anesthesia trainee during examination at Anesthesia department of Multan Hospitals. Study Design: Prospective Observational Study. Setting: Department of Anesthesia and Intensive Care Ch. Pervez Ellahi Institute of Cardiology and Nishtar Hospital Multan. Period: From January 2017 to March 2019. Material & Methods: The design of study was prospective observational study having the post-test with control group only. The size of the sample was based upon 70 trainee anesthesia being divided into two further groups: 35 trainee anesthesia were included in the control group whereas 35 trainee were part of the intervention group. The analysis of data was done by Mann Whitney test and it was descriptive type of test. Results: The mean result of Preoperative examination skills among the intervention group was greater than the control group. The mean score of Preoperative examination competence in control group was 72.11±4.56, while the mean score of Preoperative examination competence in intervention group was 81.28±2.86. The mean score of anesthesia trainees towards satisfaction of control and intervention group was 5.37±0.38 and 8.95±0.64, respectively. While the mean score of evaluators towards satisfaction of control and intervention group was 6.24±0.53 and 8.04±0.52, respectively. The difference of clinical abilities was significant among the two groups having the p value 0.000 (p<0.05). Conclusion: Clinical expertise among anesthesia trainee was significantly ameliorated after the use of Mini-CEX program. It is therefore suggested for anesthesia trainers to use the Mini-CEX program in order to determine the clinical skills among students.

scholarly journals Analgesic Efficacy of Perioperative Esmolol as an Adjunct to Morphine in Mastectomy- A Prospective Observational Study

2021 ◽  
Author(s):  
Jose Tania ◽  
Vadakkoot Raghavan Hema ◽  
Prabhakaran Vineetha
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Control Group ◽  
P Value ◽  
Numerical Rating ◽  
The Mean

Introduction: Multimodal analgesia with opioids as the prime component is the mainstay of postoperative analgesia for mastectomy, which can lead to many opioid related unwanted side-effects. Esmolol infusion has been found as a useful adjunct in reducing opioid requirements. Aim: To find the effect of perioperative esmolol infusion on postoperative pain and opioid requirements. Materials and Methods: This prospective observational study was done in 140 American Society of Anaesthesiologists (ASA) physical status l and ll patients, between 20-65 years of age posted for mastectomy under general anaesthesia. Esmolol group (group E) received 0.25 mg/kg of esmolol bolus ten minutes before induction followed by continuous infusion 5 μg/kg/min till end of surgery while control group (group C) received equivalent volumes of saline. Primary outcome measures were Numerical Rating Scale (NRS) for pain, total postoperative opioid consumption and time to first rescue analgesic dosage till 24 hours. Intraoperative haemodynamics and other side-effects were secondary outcomes. Descriptive statistics of numerical rating scores and analgesic requirements were analysed in terms of mean and standard deviation. Independent t-test was used to compare numerical rating scores and analgesic requirement of the two groups. A p-value of <0.05 was considered statistically significant. Results: The mean numerical pain scores were significantly lower in the esmolol group for the first 24 hour. The mean time to first rescue analgesic was 17.59±5.012 hour in the esmolol group and 8.21±2.22 hour in the control group which was statistically significant (p<0.001). The total tramadol consumption was also significantly lesser in the esmolol group (42.14±29.03 mg), compared to control group (102.86±22.3 mg), (p=0.0001). Mean heart rate was statistically lower in the esmolol group, but there was no incidence of bradycardia requiring treatment. Mean Arterial Pressures (MAP) were comparable. Conclusion: Perioperative esmolol infusion when used as an adjunct to morphine decreased postoperative pain and analgesic requirements for the first 24 hours without any haemodynamic disturbances.

scholarly journals Negative Air Pressure on Wet Cupping in Decreasing Blood Pressures in Hypertensive Patients

2018 ◽  
Vol 7 (2) ◽  
pp. 116
Author(s):  
Budi Darmawan ◽  
Diyah Fatmasari ◽  
Rr. Sri Endang Pujiast
Keyword(s):  
Blood Pressure ◽  
Repeated Measures ◽  
Community Health Centers ◽  
Intervention Group ◽  
Air Pressure ◽  
Control Group ◽  
P Value ◽  
Decrease Blood Pressure ◽  
Blood Pressures ◽  
The Mean

Background: Wet cupping, furthermore mentioned cupping, decreases blood pressures through the level of negative air pressures added by hydrostatics filtration pressure to reinforce the power of fluids filtration in capillaries. However, an appropriate negative air pressure to decrease blood pressure remains an uncertainty.Purpose: This study aimed to analyze negative air pressure differences on cupping in decreasing blood pressures in hypertensive patients.Methods: This is a quasi-experimental design conducted in three Community Health Centers in Langsa City, Aceh, Indonesia. The samples were 36 hypertensive males with age from 45 to 55, who were randomly stratified into two groups with cupping pressures 400 mbar (n=18) as the control group; and 540 mbar (n=18) as the intervention group. The cupping session was performed to each group on T1 (alkahil) point and in the middle line of both shoulders blade points. The systolic blood pressure (SBP) and diastolic blood pressures (DBP) were measured by validated automatic sphygmomanometer. The follow-up periods were one week and two weeks. The data were then analyzed by repeated measures ANOVA.Results: Cupping pressure of 400 mbar decreased the mean of SBP and DPB with a p-value of 0.450 and 0.026, respectively after two weeks of intervention. Meanwhile, cupping pressure of 540 mbar decreased the mean of SBP and DBP with a p-value of 0.006 and 0.057, respectively. Tests of within-subjects resulted in the p-value of 0.250 (SBP) and 0.176 (DBP) after two weeks of intervention. There were no significant differences in SBP and DBP between the intervention group and the control group.Conclusion: The cupping pressure between 400 mbar and 540 mbar could reduce blood pressure; however, the cupping pressure of 540 mbar yielded greater effect in decreasing blood pressure than the 400 mbar. Negative air vacuum pressure loads on cupping to decrease blood pressure should be considered between 400 to 540 mbar, and further studies are needed.

scholarly journals Pengaruh Jus Apel Terhadap Penurunan Tekanan Darah pada Lansia Hipertensi di Puskesmas Muara Kaman

2018 ◽  
Vol 5 (2) ◽  
pp. 121-129
Author(s):  
Siti Khoiroh
Keyword(s):  
Blood Pressure ◽  
Community Health ◽  
Apple Juice ◽  
Antihypertensive Drugs ◽  
Intervention Group ◽  
T Test ◽  
Mean Difference ◽  
Control Group ◽  
P Value ◽  
The Mean

Background : Hypertension is a condition of high blood pressure in the arteries that lasted continuously for the long term. Hypertension can be overcome in two ways: pharmacology and non-pharmacology. Pharmacology treatment usually use medicine while one of the ways for non-pharmacology treatment is to consumes apple juice.Research Objective : The aim of this research is to know the effect of apple juice on blood pressure decrease in elderly people with hypertension at Muara Kaman Community Health Center.Methods : The design of this research used quasi experimental design (quasi experiment) with pretest posttest control group design. The sample of the research was hypertensive respondents at Muara Kaman Community Health Center as many as 30 respondents were divided into 2 groups, 15 intervention groups and 15 control groups. The sampling technique used purposive sampling. The research instruments were stethoscope and sphygmomanometer, data analysis using t test dependent and t test independent.Results : There were a significant influence between pretest and posttest of apple juice in the intervention group (P value = 0,000; P <0.005). The mean difference in systolic blood pressure in the intervention group and the control group also had significant differences (P value = 0.002; P <0.05), where as the mean difference in diastolic blood pressure in the intervention group and the control group also had significant differences (P value = 0,039; P <0,05).The Conclusions : The results of this research showed that consumes apple juice gives an effect on the blood pressure of hypertensive patients by consumes regularly.The Suggestions : Nurses and the public can use apple juice as one of the ways to handling to hypertension sufferers besides antihypertensive drugs.

scholarly journals Application of platysma muscle suture after thyroidectomy

2020 ◽  
pp. 147-150
Keyword(s):  
Postoperative Pain ◽  
Wound Infection ◽  
Intervention Group ◽  
Control Group ◽  
P Value ◽  
Platysma Muscle ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
The Mean ◽  
Length Of Hospitalization

Introduction: Thyroidectomy is a common surgery in the neck area, in which the application of platysma muscle suture after thyroidectomy is still being discussed. This study was conducted to compare the application (currently common) or non-application of suture for platysma muscle. Methods: In this retrospective cross-sectional study, 117 patients underwent thyroidectomy, among which 63 cases without suturing platysma (control group) and 54 subjects with suturing platysma (Intervention group ) were examined in terms of postoperative pain based on visual analogue scale score measured 24 h post-operation. The samples were also investigated regarding hematoma and seroma, wound infection, length of hospitalization, scarring (1 year after surgery), duration of surgery, and the number of cases using opioids during the hospitalization. Patients with diabetes, previous neck surgery, coagulopathy, and radiation history were excluded from the study. The gathered data were analyzed statistically in SPSS software (version 18) using the Chi-square test and the Mann–Whitney U test. A p-value of less than (0.05) was considered significant. Results: Based on the findings, the mean age of the patients in the Intervention group was calculated at 51 years, of which 41 and 13 cases were females and males, respectively. In the Intervention group, 34 patients underwent complete thyroidectomy and 20 patients had hemithyroidectomy. The mean age score of subjects in the control group was calculated at 50 years, of which 44 and 19 patients were respectively female and male. No significant difference was revealed considering wound infection, length of hospitalization, created scarring, the amount of opioid use (opioids), and postoperative pain. However, only the length of surgery was different between the groups (P-value<0.05). Conclusions: There was no difference between wound and surgical complications and cosmetic results between both groups; nevertheless, due to the duration of the surgery and other benefits, such as consuming less thread, not suturing the platysma is recommended.

scholarly journals The individual empowerment program improves glycemic and lipid controls in admitted type 2 DM patients

2018 ◽  
Vol 21 (2) ◽  
pp. 113-117
Author(s):  
Ampornpan Theeranut ◽  
Nonglak Methakanjanasak ◽  
Pattama Surit ◽  
Wasana Ruaisungnoen ◽  
Kittisak Sawanyawisuth ◽  
...  
Keyword(s):  
Intervention Group ◽  
Control Group ◽  
P Value ◽  
Inpatient Setting ◽  
Short Term ◽  
The Mean ◽  
The Individual ◽  
Diabetes Patients ◽  
Empowerment Program

Aim. To evaluate the short-term effects of the empowerment program on glycemic and lipid profiles in an inpatient setting for DM type 2 patients. Materials and methods. This was a quasi-experimental study conducted between October 2013 and June 2015. We enrolled diabetes patients admitted to the hospital, age over 35 years, and HbA1c 7%. During the admission, the intervention group received the empowerment course three times prior to discharge, the control group received standard diabetes and nursing care. All patients body weight, HbA1c, HDL-c, and LDL levels were evaluated at three and six months after discharge. All outcomes were compared between the control and intervention group. Results. A total of 57 diabetes patients participated in the study, with 27 in the intervention group and 30 in the control group. The intervention group had significantly higher HbA1c levels than the control group (10.3% vs 8.0%; p value 0.001). After discharge, the mean HbA1c and LDL-c levels of the intervention group were significantly lower than those of the control group at three and six months, while the mean HDL-c level of the intervention group was significantly higher than that of the control group at six months (1.54 vs 1.29 mmol/L; p value 0.001). The average body mass index of the intervention group was also significantly lower than that of the control group at six months (22.74 vs 25.54 kg/m2; p value = 0.016). Conclusion. The individual empowerment program improved short-term glycemic and lipid outcomes in admitted diabetes mellitus patients.

scholarly journals Prospective Observational Study of an Eye-tracking Device for Under 12 Months of Age Infants; the Feasibility of Gazefinder

2021 ◽  
Author(s):  
Tomoo Takahashi ◽  
Kazuki Tsukamoto ◽  
Misaki Matsumura ◽  
Ryo Takigawa ◽  
Yasuo Sakai ◽  
...  
Keyword(s):  
Observational Study ◽  
Eye Tracking ◽  
Prospective Observational Study ◽  
Assessment Tool ◽  
Positive Association ◽  
Autism Spectrum ◽  
Fixation Time ◽  
Developmental Problems ◽  
Significant Difference ◽  
The Mean

Abstract Eye-tracking to evaluate gaze patterns has developed as an assessment tool for children with Autism Spectrum Disorder (ASD). Gazefinder is one of Eye-tracking devices and few studies have investigated whether it can measure the gaze data of infants under 12 months of age. We conducted a prospective observational study from April 2019 to March 2020 in a periodic health checkup in Ohchi County, Shimane, Japan. Participants included infants between 4 and 11 months of age who were not suspected the presence of developmental problems. Ninety-three participants’ datapoints were analyzed. The mean age was 6.5 months and mean developmental quotient was 88%. The mean fixation time percentage of all sequences was 81.0% (standard deviation; 4.4), and there was no significant difference in each age group. Infants in all groups showed a significantly higher predilection for eyes than for mouths. There was a positive association of age with human gaze and a negative association with geometric gaze. Moreover, we confirmed that joint attention skills were enhanced in accordance with their growth process. The eye-tracking data were almost corresponding to previous studies’ data of infant with typical development and Gazefinder could be applied to infants starting at 4 months of age.

scholarly journals Effect of Nursing Training on Improving Knowledge, Skills, and Attitudes of Clinical Nurses

2019 ◽  
Vol 2 (1) ◽  
pp. 31-38
Author(s):  
I Ketut Sudiarta ◽  
Emiliana Tarigan ◽  
Sudibyo Supardi
Keyword(s):  
Quantitative Research ◽  
Intervention Group ◽  
Mean Value ◽  
Posttest Score ◽  
Control Group ◽  
P Value ◽  
Clinical Nurses ◽  
The Mean ◽  
Increasing Knowledge ◽  
Nursing Training

Background: Clinical nurses are competent with good knowledge, skills and attitudes. These efforts are carried out through integrated training adaptation of the concept of From Novice to Expert Patricia Benner. The study aims to determine the effect of nursing training on increasing knowledge, skills and attitudes. Method: This quantitative research quasy experiment, using a non randomized control group pretest and posttest design. The study sample was 100 people, divided into two groups, namely the same intervention and control group. The research instrument was a valid and reliable questionnaire (Chronbach's alpha 0.989). Research for 12 weeks, March-June 2018 with nursing training interventions in the intervention group respondents. Results: The results of the study were the majority of respondents were female, aged 20-35, career level of clinical nurse level I. Diploma education and work period of 1-5 years. Bivariate results with the mean value of posttest score knowledge 97.20, increased by 21.6%, statistically meaningful knowledge of p value=0.000. The mean value of the posttest skill was score 92.96, increased by 23.92%, the skill statistically was significant p value=0.000 and the mean value of posttest attitude was 50.06, increased by 6.44%, statistically meaningful p value=0.000, there was an effect of nursing training on improving the knowledge, skills and attitudes of clinical nurses. The results of multivariate analysis of nursing training were statistically significant towards increasing knowledge of clinical nurses (p value=0.000), having the possibility of knowledge increasing 10 times, increasing skills statistically significant (p value=0.000), having the possibility of increasing skills 1.4 times and increasing statistically meaningful attitudes (p value=0.000), having an increased likelihood of attitudes 0.8 times compared to not getting training, no confounding variables were found. Conclusion: Based on this research, the increase in knowledge, skills and attitudes is influenced by nursing training from the aspects of material, methods, facilities, instructors and post-training evaluation methods. Thus to achieve optimal quality of knowledge, skills and attitude, it is advisable to conduct mentoring, supervision, mentoring and guidance in an integrated manner

scholarly journals Pengaruh Terapi Relaksasi Nafas Dalam Terhadap Tingkat Kecemasan Dan Lama Persalinan Kala I Dan II Di BPM Wilayah Klaten

2016 ◽  
Vol 5 (1) ◽  
Author(s):  
Henik Istikhomah ◽  
Murwati Murwati
Keyword(s):  
Intervention Group ◽  
Emotional Reaction ◽  
Wilcoxon Test ◽  
Control Group ◽  
P Value ◽  
Relaxation Techniques ◽  
Deep Breathing ◽  
Relaxation Therapy ◽  
Post Test ◽  
The Mean

Abstract: Deep Relaxation Therapy, Level Anxiety And Prolong Duration Labor Stage. Patients who will give birth had experienced psychological problems that cause form the emotional reaction as the manifestation of psychological symptoms, the actions to be carried out either surgery or childbirth aid measures constitute a potential or actual threat to the integrity of someone who can evoke physiological and psychological stress. This emotional reaction usually is generally a negative reaction, such as refuse, fear, anger, sadness, and anxiety. Giving deep breathing relaxation techniques in patients will be a decrease in tension, feeling amazingly beautiful in controlling body functions so that labor becomes smooth. Purpose of this study was to determine the effect of therapy on the breath in anxiety level and duration of labor. The design of this study using the pre and post-test only one group. analysis techniques with Wilcoxon test. using purposive sampling technique with 25 respondents. Univariate analysis results mean pre-test anxiety at 43.16 and the average post-test by 31. The mean duration of the first labor stage of the intervention group is 504 minutes and 564 minutes at control group. The Mean duration of second labor stage of the intervention group is 140 minutes and the control group was 57 minutes. Bivariate test results there is the influence between deep breathing relaxation therapy interventions with anxiety with a p value= 0.001, there is the influence of deep breathing relaxation techniques with the duration of first labor stage with p-value = 0.001, no effect of deep breathing relaxation with the duration of second labor stage with p = 0:59. In conclusion, there is the influence of deep breathing relaxation therapy to anxiety and the duration of the first stage of labor time, there is no influence therapy relaxation with the duration of the second labor stage.

Hyperhomocysteinemia in pre-eclampsia: is routine screening rational?

2017 ◽  
Vol 6 (4) ◽  
pp. 1271
Author(s):  
Sonia Miglani ◽  
Ruchira Nautiyal ◽  
Archana Prakash
Keyword(s):  
Prospective Observational Study ◽  
Placental Abruption ◽  
Vascular Diseases ◽  
Maternal Serum ◽  
Control Group ◽  
P Value ◽  
Routine Test ◽  
Mean Values ◽  
Serum Homocysteine ◽  
The Mean

Background: Hypertensive disorders complicate upto 5 to 10% of all pregnancies. Though the exact cause of pre-eclampsia is still undecided, maternal hyperhomocysteinemia has been implicated as a risk factor for pre eclampsia, placental abruption and other vascular diseases. The objectives of present study were to estimate the levels of serum homocysteine in antenatal patients and to study the above parameters in patients of pre-eclampsia.Methods: A prospective observational study was performed with 30 pre eclamptic patients and an equal number taken as control having comparable demographic characteristics. Level of homocysteine was measured by an enzymatic method, using Diazyme homocysteine 2 reagent enzymatic assay kit on Beckman coulter analyzer in all the patients. Obstetrics and neonatal outcomes were observed in all the patients. The statistical analysis was done using unpaired T test for determining level of significance.Results: Mean Serum homocysteine in the study group was 13.99±5.46 µmol/l and was 6.03±2.58 µmol/l in control group. This was statistically significant (p value 0.002). However the mean values of serum homocysteine did not correlate with severity of pre-eclampsia 14.32±6.72 µmol/l in mild pre-eclampsia and 13.60±3.77μmol/l in severe pre-eclampsia respectively (p value - 0.727).Conclusions: It appears that maternal serum homocysteine has a causal role in pathogenesis of pre eclampsia, however to recommend it as a routine test, larger studies are required.

Zinc Supplementation in Preterm Neonates with Late-Onset Sepsis: Is It Beneficial?

2020 ◽  
Author(s):  
Mohamed Shawky Elfarargy ◽  
Ghada Al-Ashmawy ◽  
Sally Abu-Risha ◽  
Haidy Khattab
Keyword(s):  
Late Onset ◽  
Intervention Group ◽  
Preterm Neonates ◽  
Control Group ◽  
P Value ◽  
Late Onset Sepsis ◽  
Sepsis Score ◽  
The Mean ◽  
And Control ◽  
Group 1

Objective Neonatal sepsis (NS) is a serious neonatal disease. The aim of this study was to detect the role of zinc (Zn) supplementation in preterm neonates with late-onset sepsis (LOS). Study Design A prospective randomized clinical trial study which was done at Tanta University Hospital from August 2016 to March 2018 on 180 preterm neonates with LOS. The studied neonates were divided into two groups: group 1 (90 neonates), which received Zn and antibiotics, and group 2 (90 neonates), which received antibiotics and placebo. In group 1, the neonates received 1.4 mg elemental Zn/kg/d orally for 10 days. Sepsis score, C-reactive protein (CRP), and procalcitonin (PCT) were done for both groups. Results As regards sepsis score, it showed that before beginning the treatment, there were 85 and 84 neonates who had high probable sepsis (HPS) in intervention and control groups, respectively, and this revealed nonstatistically significant difference (non-SSD) between both groups (p-value is 0.756) and after 10 days of treatment, there were 1 and 4 neonates who had HPS in intervention and control group, respectively, and this revealed SSD between both groups (p-value is 0.045*). As regards CRP and PCT, the results showed that before beginning the treatment, the mean ± standard deviation (SD) of CRP and PCT were 39.4 ± 10.1 mg/L and 5.2 + 1.8 ng/mL, respectively, in intervention group, while it was 39.6 + 9.9 mg/L and 5.1 + 1.9 ng/mL, respectively, in control group and this revealed non-SSD between both groups (p-value is 0.893 and 0.717, respectively) and after 10 days of treatment, the mean ± SD of CRP and PCT were 5.3 ± 1.8 mg/L and 0.39 ± 0.13 ng/mL, respectively, in intervention group and 6.1 + 2 mg/L and 0.61 + 0.22 ng/mL, respectively, in control group and this revealed SSD between both groups (p-value is 0.008* and 0.044*, respectively). Conclusion Zn supplementation in preterm neonates with LOS is beneficial in improving the clinical and laboratory finding. Recommendation Zn supplementation for preterm neonates with LOS. Key Points

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