Butorphanol in Labour Analgesia

Introduction: Labour is the process where uterine contractions lead to expulsion of product of conception through the vagina into the outer world. Labour pain is one of the most severe pains which has ever been evaluated and its fear is one of the reasons women wouldn’t go for natural delivery. Delivery is a painful experience for all of the women except a few of them. The labor pain results from some physiological-psychological causes. Different pharmacological and non-pharmacological methods have been tried for pain relief in labour. The objective of this study is to see the effect of butorphanol injection in labour pain. Methods: It is a descriptive cross-sectional study conducted in B.P. Koirala institute of health sciences. We observed 200 pregnant women meeting the inclusion criteria and giving the informed consent who were on 1 mg butorphanol i.m. at the onset of active stage of labour every 4 hourly and on demand. Pain assessment was done by Numerical Pain analogue scale measured from 1 to 10. Fetal heart rate monitoring was done according to the hospital protocol. Caesarean section was performed for obstetrical indication. Neonatal outcome was evaluated by on duty pediatrician and APGAR score were noted at 1 and 5 min.Results: The pain scores in first, second, third, fourth hour were (8.83±0.773), (9.84±0.544), (9.94±0.338), (9.6±0.298) respectively, where 1st and 2nd hour is statistically significant.Conclusions: Butorphanol is an effective labour analgesia without significant adverse effects on women and the neonatal outcome.

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Awareness and perception of epidural labor analgesia among pregnant women visiting antenatal clinic in National Referral Hospital

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v16i1.37410 ◽

2021 ◽

Vol 16 (1) ◽

pp. 10-15

Author(s):

Tandin Tshomo ◽

Karma Tenzin ◽

Jamphel Tshering

Keyword(s):

Pain Relief ◽

Epidural Analgesia ◽

Pregnant Women ◽

Labour Pain ◽

Good Method ◽

Antenatal Clinic ◽

Cross Sectional Study ◽

Labour Analgesia ◽

Cross Sectional ◽

Labour Epidural Analgesia

Aims: To assess the awareness and perception of labour epidural analgesia among pregnant women visiting the antenatal clinic. Methods: This was an observational cross-sectional study. Study participants included pregnant women visiting the antenatal clinic during 2nd and 3 rd trimester conducted from 21 st September 2018 till 20 th September 2019. Data were collected by using an interviewer-administered questionnaire. Ethics approval was granted by the research Ethics Board of health, Bhutan. Results: Total 450 parturients participated in this study; 61.4% of the participants knew that labour epidural services were available and 37.5% got information through media. A total of 57.3% of respondents had severe fear about labour pain; 62.4% had severe fear about delivery complication; 85.2% thought that epidural labour analgesia was a good method of pain relief; and 67% were willing to accept it for their current pregnancy. However, 86.6% would recommend epidural labour analgesia as an option of pain relief to other pregnant women. Conclusion: Awareness about the availability of labour epidural analgesia services needs to be improved, as a majority of the parturient was keen to avail epidural analgesia after the information about its availability was provided.

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Knowledge and attitude towards pain relief in labor among final year midwifery students: A cross-sectional study

10.21203/rs.2.14255/v1 ◽

2019 ◽

Author(s):

Nigussie Simeneh Endalew ◽

Hailu Yimer Tawye ◽

Zewuditu Abdissa Denu

Keyword(s):

Pain Relief ◽

Statistical Significance ◽

Univariate Analysis ◽

Labour Pain ◽

Cross Sectional Study ◽

Labour Analgesia ◽

Sectional Study ◽

Cross Sectional ◽

Knowledge And Attitudes ◽

Knowledge And Attitude

Abstract Background: Poor attitudes and lack of knowledge about labour pain has long been demonstrated to burden the health professionals, as well as the women. In developing countries, labour analgesia practice is not well established and undermined. Therefore, the aim of this study was to explore final year midwifery students’ knowledge and attitudes towards pain relief during labour, at University of Gondar, Northwest Ethiopia.Methods: A cross-sectional study was conducted among final year undergraduate midwifery students using structured, and self-administered questionnaire(n=130). Descriptive statistics were performed. Results were presented using narrations, means and standard deviations, percentage, figure and tables. Univariate analysis was used to assess the association between demographic variables with poor knowledge and attitudes. P-value below 0.05 level of significance was used to identify the statistical significance of factors for knowledge and attitude about pain relief during labour.Results: Of 130 students participated, the majority, 88% of respondents understood that women can feel moderate to severe pain during labour. However, only less than half of the participants had knowledge of labour pain should be relieved. The majority, 70% of students did not have awareness about the methods of labour analgesia.Conclusion: Although the majority of final year midwifery students were agreed with women can feel moderate to severe labour pain, almost more than half of the students were not aware of the painless labour in hospital. Most of the students believed that pharmacologic methods of labour analgesia will affect the labour, baby, and mother. Therefore, considerable attention in preservice teaching and training about labour pain and analgesia for midwifery students is recommended.

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Comparison of Heffner Criteria and Light Criteria in Differentiating Exudative and Transudative Pleural Effusion

Nepal Medical College Journal ◽

10.3126/nmcj.v22i3.32638 ◽

2020 ◽

Vol 22 (3) ◽

pp. 141-145

Author(s):

Krishna Chandra Devkota ◽

S Hamal ◽

PP Panta

Keyword(s):

Pleural Effusion ◽

Cross Sectional Study ◽

Pleural Space ◽

Sectional Study ◽

Inclusion Criteria ◽

Cross Sectional ◽

Medical College ◽

The Common ◽

The Mean ◽

Exudative Pleural Effusion

Pleural effusion is present when there is >15ml of fluid is accumulated in the pleural space. It can be divided into two types; exudative and transudative pleural effusion. Tuberculosis and parapneumonic effusion are the common cause of exudative pleural effusion whereas heart failure accounts for most of the cases of transudative pleural effusion. This study was a hospital based cross sectional study performed at Nepal Medical College during the period of January 2016-December 2016. A total of 50 patients who fulfilled the inclusion criteria were enrolled. Pleural effusion was confirmed by clinical examination and radiology. After confirmation of pleural effusion, pleural fluid was aspirated and was analysed for protein, LDH, cholesterol. The Heffner criteria was compared with Light criteria to classify exudative or transudative pleural effusion. Among 50 patients, 30 were male and 20 were female. The mean age of patient was 45.4±21.85 years. The sensitivity and specificity of using Light criteria to detect the two type of pleural effusion was 100% and 90.9%, whereas using Heffner criteria was 94.87%, 100% respectively(P<0.01). There are variety of causes for development of pleural effusion and no one criteria is definite to differentiate between exudative or transudative effusion. In this study Light criteria was more sensitive whereas Heffner criteria was more specific to classify exudative pleural effusion. Hence a combination of criteria might be useful in case where there is difficulty to identify the cause of pleural effusion.

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Assessment of Saudi Parents’ Beliefs and Behaviors towards Management of Child Fever in Saudi Arabia—A Cross-Sectional Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105217 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5217

Author(s):

Mohamed N. Al Arifi ◽

Abdulrahman Alwhaibi

Keyword(s):

Saudi Arabia ◽

Side Effects ◽

Febrile Seizures ◽

Cross Sectional Study ◽

Sectional Study ◽

Inclusion Criteria ◽

Online Questionnaire ◽

Cross Sectional ◽

Electronic Thermometer ◽

And Behavior

Objective: Fever alone can lead to rare serious complications in children, such as febrile seizures. The aim of this study is to assess the knowledge, beliefs, and behavior of parents toward fever and its management. Methods: A cross-sectional study using an online questionnaire was applied over a period of 3 months, from January to March 2018, to parents who were living in Saudi Arabia. The inclusion criteria were a parent who is a resident of Saudi Arabia, with at least one child aged 6 years or less, while incomplete questionnaires, having a child aged more than 6 years, or parents who were not living in Saudi Arabia were excluded. Results: A total of 656 parents completed the questionnaire. More than two-thirds of the subjects were female, the majority of whom were aged between 25–33 years old. The best-reported place to measure the temperature of children was the armpit (46%), followed by the ear (28%) and the mouth (10.7%). More than half of the parents considered their children feverish at a temperature of 38 °C. The majority of parents (79.7%) reported that the most serious side effects of fever were seizure, brain damage (39.3%), coma (29.9%), dehydration (29.7%), and death (25%). The most common method used to measure a child’s temperature was an electronic thermometer (62.3%). The most common antipyretic was paracetamol (84.5%). Conclusions: Our study demonstrates the good knowledge of parents in identifying a feverish temperature using the recommended route and tools for measuring body temperature.

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Violence Against Women During COVID-19 Pandemic

Journal of Interpersonal Violence ◽

10.1177/0886260521997953 ◽

2021 ◽

pp. 088626052199795

Author(s):

Marwan Akel ◽

Jana Berro ◽

Clara Rahme ◽

Chadia Haddad ◽

Sahar Obeid ◽

...

Keyword(s):

Violence Against Women ◽

Married Couples ◽

Self Esteem ◽

Cross Sectional Study ◽

Economic Factors ◽

Sectional Study ◽

Inclusion Criteria ◽

Cross Sectional ◽

Living Together ◽

Stress Score

The objectives of this study were to correlate several factors - including depression, anxiety, stress and self-esteem levels in both men and women - with the occurrence of domestic violence against women (VAW) during quarantine. This cross-sectional study was carried out in April 2020, in the midst of the COVID-19 pandemic when lockdown procedures were implemented; 86 married couples participated in this study amounting to 172 responses in total. A different questionnaire was set for women and men; the couple filled out their respective questionnaire simultaneously, but privately where one did not see the answers of the other. Inclusion criteria included married couples of all ages that are living together during the lockdown of COVID-19. The results of this study showed that a higher total abuse score was found in 39 females (45.3%; CI: 0.34 - 0.56). Being a Muslim female (Beta =24.80) and females having higher anxiety (Beta=0.97) were significantly associated with higher total abuse scores, whereas higher stress score in female (Beta=-0.61) was significantly associated with lower total abuse scores. In conclusion, this study focuses on VAW as a serious problem while demonstrating its further emergence during quarantine. This study also focused on the effects brought on by lockdown policies, including social and economic factors, and their implications in the increase of VAW during this pandemic.

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Smartphone usage duration is not associated with increased pain or proprioception deficit in young adults with chronic mechanical low back pain: a cross-sectional study

Bulletin of Faculty of Physical Therapy ◽

10.1186/s43161-020-00010-y ◽

2020 ◽

Vol 25 (1) ◽

Author(s):

Mina Magdy Wahba ◽

Dina Othman Shokri Morsi Galal ◽

Aliaa Rehan Youssef

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Cross Sectional Study ◽

Task Completion ◽

Smartphone Addiction ◽

Low Back ◽

Cross Sectional ◽

Pain Scores ◽

Smartphone Use ◽

Continuous Use

Abstract Background Smartphone use has been associated with pain in the upper quadrant; however, the relationship between usage duration and low back pain is still unclear. This study investigated the association between continuous smartphone use up to 30-min and back pain severity and proprioception acuity in patients with chronic low back pain. Fifty-eight patients with chronic mechanical LBP played a game for 10- and 30-min. In each session, pain and back repositioning errors were measured at baseline and immediately after task completion. Results Pain significantly but slightly increased following smartphone use, regardless to the duration (after 10 min: mean increase = 0.75 ± 1.17, P value < 0.001, 95% CI 0.44–1.06; after 30 min: mean increase = 0.96 ± 1.93, P value < 0.001, 95% CI 0.44–1.46). However, changes in perceived pain scores were not significantly different between the two tested durations (P value = 0.42). Proprioception repositioning error was not significantly different within the same testing session (mean change = 0.08 ± 1.83, 0.13 ± 1.77, P value = 0.73, 0.58, 95% CI − 0.40–0.56, − 0.60–0.33, for the 10 and 30 min, respectively). The changes in proprioception were not significant between the two-tested durations (P value = 0.56). Further, smartphone addiction did not significantly affect changes in pain and proprioception after game playing, regardless of the duration (P > 0.05). Conclusions These findings show that smartphone use slightly increases back pain immediately after continuous use; with no effect on back proprioception within the duration tested in this study. Changes in pain and proprioception were not influenced by smartphone addiction.

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Comparison of Working Length Determination in Mandibular Single-Rooted Teeth

Journal of Gandhara Medical and Dental Science ◽

10.37762/jgmds.8-2.164 ◽

2021 ◽

Vol 8 (2) ◽

pp. 19-23

Author(s):

Ruqayya Sana ◽

Farzana Rehman ◽

Rashid Javaid

Keyword(s):

Sampling Technique ◽

Cross Sectional Study ◽

Study Data ◽

Inclusion Criteria ◽

Cross Sectional ◽

Conventional Radiograph ◽

Anterior Teeth ◽

Working Length ◽

The Mean ◽

Electronic Apex Locator

OBJECTIVES: The objective of this study was to compare working length calculated with conventional radiographs and an electronic apex locator (IPEX II) during the root canal treatment of mandibular anterior teeth. METHODOLOGY: A cross-sectional study was done in the Department of Operative Dentistry, Sardar Begum Dental Hospital, Peshawar during February and March 2018. A consecutive sampling technique was used for sampling. Only 30 patients fulfilled the inclusion criteria of our study. Detailed medical and dental history was taken. Only patient fulfilling inclusion criteria were enrolled in the study. Data were analyzed using SPSS version 20. RESULTS: The mean age for patients was 45.33±5.16. 33% out of 30 patients (10) were male and 20 were females. The mean working length calculated from radiographs was 22.25±1.29 (min 20.09-max 24.10). The mean working length calculated by the electronic apex locator (IPEX II) was 22.17±1.28 (min 20.00-max 24.07). The mean difference between working length calculated by radiograph and electronic apex locator was -0.084mm, which means the working length determined by radiographs and by electronic apex locator has no difference in mandibular anterior teeth with single canals. CONCLUSION: Both the methods can be used effectively in endodontics for single-rooted mandibular teeth, but if both are used in combinations can lead to an improvement in the working length accuracy, which may significantly reduce the number of radiographs exposure, and increase the success and comfort for endodontic patients. KEYWORDS: Working Length, Apex Locator, Conventional Radiograph

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28 Assessment of Pain and Provision of Non-Pharmacologic Analgesia to Children by Prehospital Providers in Southwestern Ontario: A Cross-Sectional Study

Paediatrics & Child Health ◽

10.1093/pch/pxab061.022 ◽

2021 ◽

Vol 26 (Supplement_1) ◽

pp. e21-e21

Author(s):

Karina Burke ◽

Branka Vujcic ◽

Jonathan Hamilton ◽

Charlotte Mace ◽

John Teefy ◽

...

Keyword(s):

Primary Outcome ◽

Rating Scale ◽

A Priori ◽

Numeric Rating Scale ◽

Cross Sectional Study ◽

Subject Area ◽

Stepwise Logistic Regression ◽

Tertiary Referral Centre ◽

Cross Sectional ◽

Pain Scores

Abstract Primary Subject area Emergency Medicine - Paediatric Background There is abundant evidence that provision of pharmacologic analgesia by prehospital providers to children is suboptimal. Most paediatric calls are performed by primary care paramedics (PCPs) who are unable to administer pharmacologic analgesia to children but can administer non-pharmacologic therapies. Objectives Our objective was to describe the provision of non-pharmacologic analgesia to children by prehospital providers. Design/Methods We reviewed all ambulance call reports (ACRs) of children 0-17 years with acutely painful conditions (headache, abdominal pain, injury, head/ears/eyes/nose/throat pain, and back pain) who were transported to a paediatric tertiary referral centre serving a catchment of > 1 million from 2017-2019. Data collection was recorded by two blinded assessors using a study-specific Excel™ sheet. The primary outcome was the proportion of children offered non-pharmacologic analgesia. We performed a stepwise logistic regression on the primary outcome using covariates defined a priori: age, sex, visible deformity, type of crew, complaint, pain score, call time, and prior analgesia. Results All 11,084 ACRs from January 1, 2017 to December 31, 2019 were reviewed. The sample included 5887/11084 (53.1%) males, ranging from 1 month to 17 years, with a mean (SD) age of 10.5 (5.6) years. Calls involved mainly PCPs [8576/11084 (77.4%)]. Non-trauma-related musculoskeletal injuries were most common, comprising 2743/11,084 (24.7%) of calls. Pain scores were documented in 6947/11084 (62.7%) of calls. The verbal numeric rating scale (0-10) was used in 5022/6947 (72.3%) of calls, with a mean (SD) score of 5.2 (3.2). Non-pharmacologic analgesia was provided in 2926/11084 (26.4%) of calls, most commonly splint (1115/2926, 38.1%) and ice (931/2926, 31.8%). Pharmacologic analgesia was provided in 458/11084 (4.1%) of calls. In the multivariate model, mild (OR: 3.2; 95% CI 2.3-4.4; p < 0 .001) and moderate pain (OR: 1.7; 95% CI 1.3-2.2) (versus no pain) were significant predictors of non-pharmacologic analgesia, whereas visible deformity (OR: 0.5; 95% CI 0.3-0.6; p < 0 .001) was a significant negative predictor. Conclusion The provision of non-pharmacologic analgesia to children in Southwestern Ontario by prehospital providers is suboptimal, despite moderate to severe pain. There is a clear need for education surrounding approaches to non-pharmacologic analgesia in children among prehospital providers.

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Synovitis is associated with constant pain in knee osteoarthritis: a cross-sectional study of OMERACT knee ultrasound scores

The Journal of Rheumatology ◽

10.3899/jrheum.210285 ◽

2021 ◽

pp. jrheum.210285

Author(s):

Holly T. Philpott ◽

Trevor B. Birmingham ◽

Ryan Pinto ◽

Codie A. Primeau ◽

Dominique Arsenault ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Multinomial Logistic Regression ◽

Cross Sectional Study ◽

Cross Sectional ◽

Logistic Regression Models ◽

Knee Oa ◽

Pain Scores ◽

Constant Pain ◽

Secondary Analyses ◽

Pain Experiences

Objective To examine the association between ultrasound (US)-detected knee inflammation and intermittent and constant pain experiences in patients with knee osteoarthritis (OA). Methods Participants with radiographically early- (KL ≤ 2) and late-stage (KL ≥ 3) disease and frequent symptoms underwent musculoskeletal US measures of inflammation using the OMERACT knee US scoring system. Pain experiences were captured using the Intermittent and Constant OA Pain (ICOAP) tool. We assessed the association between US-synovitis and ICOAP pain experiences using a series of linear, logistic, or multinomial logistic regression models (as appropriate for each variable), while adjusting for age, sex, body mass index (BMI), and radiographic stage. Secondary analyses were performed similarly by radiographic stage. Results Pain and synovitis measures from 248 patients (453 knees) were included. Worse synovitis was associated with higher ICOAP constant pain scores (β 8.05 [95%CI 0.67, 15.43]), but not intermittent pain scores. Moderate-to-severe synovitis was associated with a 4.73-fold increased relative risk [95%CI 1.06, 8.80] of a constant pain pattern. In secondary analyses, moderate-to-severe synovitis in early radiographic OA was associated with 2.70-higher odds [95%CI 1.04, 7.02] of any constant pain, 3.28-higher odds [95%CI 1.43, 7.52] of any intermittent pain, and with higher intermittent (β 10.47 [95%CI 1.03, 19.91]) and constant (β 12.62 [95%CI 3.02, 22.23]) pain scores. No associations identified for synovitis in those with late radiographic OA. Conclusion In patients with knee OA, moderate-to-severe synovitis is most strongly associated with constant pain. Inflammation may play context-specific roles across pain experiences, especially in earlier radiographic stages of knee OA.

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