scholarly journals The Effects of Ketamin-Midazolam and Ketamin-Propofol on Bispectral Index Score as Sedatives During Bone Marrow Puncture Procedure Among Pediatrics

2021 ◽  
Vol 2 (1) ◽  
pp. 115-134
Author(s):  
Aldiar ◽  
Fredi Heru Irwanto ◽  
Andi Miarta ◽  
Irfannuddin
Keyword(s):  
Bone Marrow ◽  
Controlled Trial ◽  
Invasive Procedure ◽  
Combination Group ◽  
Exclusion Criteria ◽  
Pediatric Leukemia ◽  
Significant Difference ◽  
Optimal Value ◽  
Before And After ◽  
The Mean

Background: Bone Marrow Puncture (BMP) is an invasive procedure associated with pain and anxiety. The ketamine-midazolam and the ketamine-propofol is an effectivecombination with minimal side effects. This study of the study aims to compare the effect of the combination of ketamine-midazolam and ketamine- propofol on sedation depth based on BIS in pediatric leukemia patients undergoing BMP. Methods: This study was a randomized controlled trial that was done single-blinded. The population was all pediatric patients diagnosed with leukemia who underwent BMP at RSMH and performed sedation. The research sample is the population that fulfill the inclusion and exclusion criteria. The sample size for each group was 25, with 50 Subjects in total. Sampling was done by block randomization. Results: This study found no differences in sex, age, and body weight between the two groups ([p=1.000], [p=0.845], and [p=0.147], respectively). In this study, there was no difference in mean MAP (p=0.592), oxygen saturation (p=0.164), heart rate (p=0.098), and respiratory rate (p=0.252) before intervention between the two groups. BIS value of the two groups had significant difference before and after the intervention where the two groups could reduce BIS to reach the optimal value of sedation <60 (p <0.05) There was no difference in BIS before intervention in the two groups (p=0.385). In this study, it was found that hypersalivation occurred more frequently in the ketamine-midazolam combination group. Conclusion: The combination of ketamine-midazolam and ketamine-propofol was equally good for sedation as indicated by a decrease in the mean BIS in patients undergoing BMP.

scholarly journals Comparison of the Effect of Inhalation Aromatherapy with 10% and 30% Peppermint Essential Oils on the Severity of Nausea in Abdominal Surgery Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Yasin Ahmadi ◽  
Jahangir Rezaei ◽  
Mansour Rezaei ◽  
Alireza Khatony
Keyword(s):  
Abdominal Surgery ◽  
Essential Oils ◽  
Controlled Trial ◽  
Control Group ◽  
Green Food ◽  
Severity Scores ◽  
Significant Difference ◽  
Before And After ◽  
The Mean ◽  
And Control

Background. One of the most common surgical complications is nausea. Regarding the contradictory findings on the effect of aromatherapy with peppermint on the severity of nausea, in the present study, we aimed at comparing the effect of aromatherapy with 10% and 30% peppermint essential oils on the severity of nausea in surgical patients. Methods. This single-blind randomized controlled trial was conducted at the surgical ward of Imam Reza Hospital in Kermanshah, Iran. A total of 120 patients undergoing abdominal surgery were randomly divided into three groups of 10% peppermint, 30% peppermint, and control (40 patients in each group) using a random number table. In each of the intervention groups, 0.2 ml of 10% and 30% peppermint essential oil was inhaled. In the control group, the same amount of distilled water colored with green food coloring was inhaled. The severity of nausea was measured by nausea visual analog scale (NVAS) before and 10 minutes after the intervention. Results. In the 10% peppermint group, the mean severity of nausea before the intervention was 52.3 ± 13.7 out of 100, which reduced to 40.5 ± 13.5 after the intervention (p<0.001). In the 30% peppermint group, the mean severity scores of nausea before and after the intervention were 60.2 ± 15.0 and 39.7 ± 12.4, respectively (p<0.001). In the control group, the mean severity scores of nausea before and after the intervention was not statistically significant. There was no significant difference between the two intervention groups in terms of the mean severity of nausea after the intervention. Conclusions. It can be concluded that 10% and 30% peppermint essential oils are equally effective on the severity of nausea.

scholarly journals Effect of Mechanical Ventilation Mode Type on Prioperative Blood Loss in Patients Undergoing Posterior Lumbar Inter body Fusion Surgery: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Manoochehr Salimian ◽  
Mohammad Hajijafari ◽  
Esmaeil Fakharian ◽  
Meghdad Rahati
Keyword(s):  
Mechanical Ventilation ◽  
Controlled Trial ◽  
Fusion Surgery ◽  
Mechanically Ventilated ◽  
Volume Controlled Ventilation ◽  
Respiratory Parameters ◽  
Significant Difference ◽  
Before And After ◽  
Surgical Bleeding ◽  
The Mean

Abstract Background this study has examined modes of mechanical ventilation, pressure or volume-controlled ventilation (PCV or VCV) on intra- and post-operative surgical bleeding in posterior lumbar inter body fusion (PLIF) surgery Methods This research was a randomized, single-blinded, and parallel study, that 78 patients were selected. They mechanically ventilated using either PCV or VCV in PLIF surgery. In this regard, a permuted block randomization was used with a computer-generated list. After induction of anesthesia in supine position, the hemodynamic and respiratory parameters were measured Results The mean bleeding was 431.281 ± 361.04cc in the PCV group and 465.26 ± 338.16 cc in the VCV group (p = 0.669). Moreover, blood transfusion rates in the PCV and VCV groups were 0.40 ± 0.74 and 0.43±78 0.78 pack cell (p = 0.836), respectively. Notably, surgeon satisfaction was more observed in the PCV group (82.1% vs. 74.4%, p = 0.548). In addition, the other variables were similar in these two groups. Conclusions The mean bleeding volume was higher in the VCV group compared to the PCV group; however, no significant difference was observed between these two groups. Hemoglobin levels in the patients included before and after surgery showed that the two groups were in a similar condition.

Antiseptic Effect of Conventional Povidone–Iodine Scrub, Chlorhexidine Scrub, and Waterless Hand Rub in a Surgical Room: A Randomized Controlled Trial

2016 ◽  
Vol 38 (4) ◽  
pp. 417-422 ◽  
Author(s):  
Jui-Chen Tsai ◽  
Yen-Kuang Lin ◽  
Yen-Jung Huang ◽  
El-Wui Loh ◽  
Hsiao-Yun Wen ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Povidone Iodine ◽  
Controlled Trial ◽  
Analysis Of Covariance ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Before And After ◽  
Hand Antisepsis ◽  
The Mean ◽  
Medical University

OBJECTIVEEffective perioperative hand antisepsis is crucial for the safety of patients and medical staff in surgical rooms. The antimicrobial effectiveness of different antiseptic methods, including conventional hand scrubs and waterless hand rubs, has not been well evaluated.DESIGN, SETTING, AND PARTICIPANTSA randomized controlled trial was conducted to investigate the effectiveness of the 3 antiseptic methods among surgical staff of Taipei Medical University—Shuang Ho Hospital. For each method used, a group of 80 participants was enrolled.INTERVENTIONSurgical hand cleansing with conventional 10% povidone–iodine scrub, conventional 4% chlorhexidine scrub, or waterless hand rub (1% chlorhexidine gluconate and 61% ethyl alcohol).RESULTSColony-forming unit (CFU) counts were collected using the hand imprinting method before and after disinfection and after surgery. After surgical hand disinfection, the mean CFU counts of the conventional chlorhexidine (0.5±0.2, P<0.01) and waterless hand rub groups (1.4±0.7, P<0.05) were significantly lower than that of the conventional povidone group (4.3±1.3). No significant difference was observed in the mean CFU count among the groups after surgery. Similar results were obtained when preexisting differences before disinfection were considered in the analysis of covariance. Furthermore, multivariate regression indicated that the antiseptic method (P=.0036), but not other variables, predicted the mean CFU count.CONCLUSIONSConventional chlorhexidine scrub and waterless hand rub were superior to a conventional povidone–iodine product in bacterial inhibition. We recommend using conventional chlorhexidine scrub as a standard method for perioperative hand antisepsis. Waterless hand rub may be used if the higher cost is affordable.Infect Control Hosp Epidemiol 2017;38:417–422

scholarly journals The effect of rTMS in the management of pain associated with CRPS

2020 ◽  
Vol 11 (1) ◽  
pp. 363-370
Author(s):  
Min Cheol Chang ◽  
Sang Gyu Kwak ◽  
Donghwi Park
Keyword(s):  
Repetitive Transcranial Magnetic Stimulation ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Pain Syndrome ◽  
Treatment Session ◽  
Cochrane Library ◽  
Exclusion Criteria ◽  
Analgesic Effects ◽  
Randomized Controlled ◽  
Before And After

AbstractBackgroundTherapeutic management of pain in patients with complex regional pain syndrome (CRPS) is challenging. Repetitive transcranial magnetic stimulation (rTMS) has analgesic effects on several types of pain. However, its effect on CRPS has not been elucidated clearly. Therefore, we conducted a meta-analysis of the available clinical studies on rTMS treatment in patients with CRPS.Materials and methodsA comprehensive literature search was conducted using the PubMed, EMBASE, Cochrane Library, and SCOPUS databases. We included studies published up to February 09, 2020, that fulfilled our inclusion and exclusion criteria. Data regarding measurement of pain using the visual analog scale before and after rTMS treatment were collected to perform the meta-analysis. The meta-analysis was performed using Comprehensive Meta-analysis Version 2.ResultsA total of three studies (one randomized controlled trial and two prospective observational studies) involving 41 patients were included in this meta-analysis. No significant reduction in pain was observed immediately after one rTMS treatment session or immediately after the entire schedule of rTMS treatment sessions (5 or 10 sessions; P > 0.05). However, pain significantly reduced 1 week after the entire schedule of rTMS sessions (P < 0.001).ConclusionrTMS appears to have a functional analgesic effect in patients with CRPS.

scholarly journals Surgery to relieve nasal obstruction: outcome for 366 patients operated on by one senior surgeon

2021 ◽  
Author(s):  
Lars Aksel Pedersen ◽  
S. Dölvik ◽  
K. Holmberg ◽  
C. Ahlström Emanuelsson ◽  
H. Johansson ◽  
...  
Keyword(s):  
Beneficial Effect ◽  
Nasal Obstruction ◽  
General Health ◽  
Surgical Skills ◽  
Nasal Endoscopy ◽  
Experienced Surgeon ◽  
Senior Surgeon ◽  
Significant Difference ◽  
Before And After ◽  
The Mean

Abstract Background Studies of patient-rated outcome in septoplasty and turbinoplasty most frequently involve several surgeons with varying surgical skills, techniques and experience. The aim of the present study was to evaluate outcome based on one experienced surgeon. Methods Three hundred and sixty-six consecutive patients referred for nasal obstruction were included. All the patients were examined with nasal endoscopy before and after decongestion, they filled out a nose VAS and rated their overall general health before and three to six months after surgery. The patients underwent septoplasty, septoplasty plus turbinoplasty or turbinoplasty. Results The mean nose VAS for nasal obstruction (0–100) preoperatively was 64.7 for all patients. Patients undergoing septoplasty (n = 159) were younger than patients undergoing septoplasty + turbinoplasty (n = 79) or patients undergoing turbinoplasty alone (n = 128). The nose VAS for nasal obstruction improved significantly in all three groups and 25% had a normal nose VAS after surgery in the septoplasty and septoplasty + turbinoplasty groups compared to only 8% in the turbinoplasty alone group. There was no significant difference in the improvement in nasal obstruction between septoplasty and septoplasty + turbinoplasty, but the septoplasty + turbinoplasty group experienced a significantly greater improvement in general health. Conclusions In 366 patients operated on by one experienced surgeon, septoplasty and septoplasty + turbinoplasty were more effective at relieving nasal obstruction than turbinoplasty alone. Septoplasty + turbinoplasty resulted in a greater improvement in general health than septoplasty alone, despite the same improvement in nasal obstruction, indicating a beneficial effect of additional turbinoplasty in septoplasty.

scholarly journals Quality of life of obstetrics fistula patients before and after surgical repair in the Jimma University Medical Center, Southwest Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tilahun Fufa Debela ◽  
Zerihun Asefa Hordofa ◽  
Aster Berhe Aregawi ◽  
Demisew Amenu Sori
Keyword(s):  
Quality Of Life ◽  
Surgical Repair ◽  
Obstetric Fistula ◽  
Medical Center ◽  
Mean Value ◽  
Significant Difference ◽  
Before And After ◽  
The Mean ◽  
Jimma University

Abstract Background The consequences of obstetric fistula on affected women are more than the medical condition. It has extensive physical, psychological, social, and economic consequences on them. Obstetric fistula affects the entire health and entire life of women. Women suffering from obstetric fistula are often abandoned by her partner, relatives, and the community. This study aimed to determine the quality of life of obstetrics fistula patients before and after surgical repair. Methods Institutional-based prospective, before and after study design was conducted in the Jimma University Medical Center from November 1, 2019–October 30, 2020. A face-to-face interview was conducted with fistula patients who visited Jimma University Medical center, fistula clinic during the study period. All fistula patients were included in the study. Accordingly, 78 women who underwent surgical repair were interviewed. The means and the standard deviation were computed using conventional statistics formulas. The unpaired t-test was used to compare two independent means, and one-way analysis of variance (ANOVA) was used to compare the quality of life before repair and after a successful repair. Linear regression analysis was done for identifying determinants of quality of life. A P value of 0.05 will be considered statistical significance. Result The overall quality of life of women was 58.17 ± 7.2 before the surgical repair and 71.20 ± 10.79 after surgical repair. The result indicates there is a significant difference in the mean value of pre and post-operative (P < 0.001). The overall satisfaction of women with their health status before the surgical repair was 22.5 ± 1.30and it has increased to 53.0 ± .90after surgical repair. The physical health dimension score was 16.51 ± 5.27 before the surgical repair while it has increased to 21.77 ± 5.38 after the surgical repair. The score of the social domain before the surgical repair was 5.19 ± 1.34 and it has increased to 7.13 ± 3.67 after the surgical repair. The score of the environmental health domain was 17.41 ± 2.89 before the surgery while it also increased to 21.65 ± 4.04 after the surgical repair. The results have shown there was a significant difference in the mean values of pre and post-operatives in both social and environmental scores (P < 0.001). The score of the psychological health domain before the surgery was 19.06 ± 1.46 and it was increased to 19.84 ± 3.21 after the surgical repair. The result showed there is a significant difference in mean value pre and post-operative (P = 0.048), though it is a slight improvement compared to other domains. Conclusion The overall quality of life of the patient with fistula was improved after successful surgical repair. Although all domains of quality of life had shown significant improvement after successful surgical repair, the psychological domain showed slight improvement.

The effectiveness of emotional freedom techniques (EFT) on depression of postmenopausal women: a randomized controlled trial

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Asieh Mehdipour ◽  
Parvin Abedi ◽  
Somayeh Ansari ◽  
Maryam Dastoorpoor
Keyword(s):  
Randomized Controlled Trial ◽  
Postmenopausal Women ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
Randomized Controlled ◽  
Moderate Depression ◽  
Before And After ◽  
The Mean ◽  
And Control

Abstract Objectives Postmenopausal women are at greater risk of depression. Depression may negatively affect the quality of life of women. An emotional freedom technique (EFT) is an evidence-based therapy combining cognitive and exposure components with acupressure. This study aimed to evaluate the effect of EFT on depression in postmenopausal women. Methods This was a randomized controlled trial in which 88 women with mild to moderate depression recruited from a menopausal clinic in Ahvaz, Iran, and randomly assigned into two groups of EFT (n=44) and control for sham therapy (n=44). Women in the EFT group received two sessions of training and asked to continue EFT for 8 weeks, one time per day. The Beck Depression Inventory (BDI2) completed by women before and after the intervention. The control group received training on sham acupressure points similar to the intervention group. Data collected using a demographic and BDI2. Women requested to complete the BDI2 before and after the intervention. The independent t-test, chi-square, and ANCOVA were used to analyze data. Results The mean depression score in the intervention group reduced from 20.93 ± 4.6 to 10.96 ± 4.38 in comparison to the control group that reduced from 19.18 ± 2.79 to 17.01 ± 6.05 after intervention (p=0.001). After the 8 week intervention, the frequency of moderate depression decreased from 56.8 to 9.35% in the intervention and from 50 to 29.5% in the control group. In total, 63.4 and 34.15% in the intervention and control groups were free of depression respectively after the intervention (p<0.001). Conclusions The results of this study showed that using EFT for 8 weeks could significantly reduce the mean score of depression in postmenopausal women. Using this method in public health centers for postmenopausal women is recommended.

SECRETION OF DIHYDROTESTOSTERONE BY HUMAN PROSTATE IN BENIGN PROSTATIC HYPERTROPHY

1974 ◽  
Vol 77 (2) ◽  
pp. 401-407 ◽  
Author(s):  
J. A. Mahoudeau ◽  
A. Delassalle ◽  
H. Bricaire
Keyword(s):  
Plasma Levels ◽  
Benign Prostatic Hypertrophy ◽  
Prostatic Hypertrophy ◽  
Human Prostate ◽  
Control Subjects ◽  
Peripheral Plasma ◽  
Significant Difference ◽  
Before And After ◽  
The Mean ◽  
And Control

ABSTRACT Plasma levels of testosterone (T) and 5α-dihydrotestosterone (DHT) were determined by radioimmunoassay in 29 patients with benign prostatic hypertrophy (BPH) and in 56 control men of various ages. No significant difference was found in T, DHT nor DHT/T ratio between BPH and control subjects of similar age. Plasma DHT was higher in the prostatic than in the peripheral veins in 8/9 patients with BPH during laparotomy, indicating a prostatic secretion of DHT. No difference in the mean T nor the mean DHT was found in peripheral plasma before and after adenomectomy.

scholarly journals Influence of Apical Patency and Cleaning of the Apical Foramen on Periapical Extrusion in Retreatment

2013 ◽  
Vol 24 (5) ◽  
pp. 482-486 ◽  
Author(s):  
Marili Doro Andrade Deonizio ◽  
Gilson Blitzkow Sydney ◽  
Antonio Batista ◽  
Roberto Pontarolo ◽  
Paulo Ricardo Bittencourt Guimarães ◽  
...  
Keyword(s):  
Material Removal ◽  
Filling Material ◽  
Mean Values ◽  
Filtration System ◽  
Root Canal Retreatment ◽  
Significant Difference ◽  
Before And After ◽  
The Mean ◽  
The Difference ◽  
Removal Technique

This study evaluated the influence of apical patency, root filling removal technique and cleaning of the apical foramen, concerning the amount of debris extruded during root canal retreatment. Forty mandibular incisors were randomly assigned to 4 groups - GIM (n=10), GIIM (n=10), GIPT (n=10) and GIIPT (n=10), which were named according to leaving (I) or not (II) apical patency during canal preparation and filling removal technique (manual - M or ProTaper system - PT). After filling material removal, each specimen of each group had the apical foramen cleaned by sizes 15, 20 and 25 instruments, generating 12 subgroups: GIM15, GIM20, GIM25, GIIM15, GIIM20, GIIM25, GIPT15, GIPT20, GIPT25, GIIPT15, GIIPT20 and GIIPT25. Extruded filling debris was collected by a Milipore filtration system, an HV-durapore, 0.45 µm pore filter with a 25 mm diameter. The filters were weighed before and after the collection on an analytical scale (10–5 g), and the difference was calculated. The mean weight of extruded filling debris was analyzed statistically by Kruskal-Wallis and Friedman ANOVA tests (α=0.05). The mean values found in the groups (in mg) were: GIM (0.95±0.94), GIIM (0.47±0.62), GIPT (0.30±0.31) and GIIPT (0.32±0.44). There was no statistically significant difference among any of the groups or subgroups (p>0.05). ProTaper provided the smallest amount of extruded filling material, regardless of presence or absence of apical patency, followed by manual technique, without and with apical patency. Additional amounts of debris were collected during cleaning of the apical foramen, regardless of the instrument, presence/absence of patency or root filling removal technique.

scholarly journals Effect of COVID-19 outbreak on emergency department attendances in an Italian academic hospital

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Poletto ◽  
G Perri ◽  
F Malacarne ◽  
B Bianchet ◽  
A Doimo ◽  
...  
Keyword(s):  
Emergency Department ◽  
Initial Phase ◽  
Mainland China ◽  
Hospital Setting ◽  
Academic Hospital ◽  
Significant Difference ◽  
Before And After ◽  
Life Threatening ◽  
The Mean ◽  
Critical Patients

Abstract Background Coronavirus disease 2019 (COVID-19) is a viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease was discovered during the 2019 outbreak in Mainland China and the first cases were reported in Italy on February 21, 2020. This study evaluates the emergency department (ED) attendances of an academic hospital in northern Italy before and after media reported the news of the first infected patients in Italy. Methods Adult attendances in ED in February 2020 were analysed dividing the period into 4 weeks (days 1-7, 8-14, 15-21, 22-28) compared with the same periods in 2019. The visits were analysed separately according to the Italian colour code of triage: white (non-critical), green (low-critical), yellow (medium critical), red (life-threatening). The mean weekly number of attendances was compared with t-test. Results February 2020 total ED attendances compared with February 2019 were 4865 vs 5029 (-3.3%), of which white codes were 834 vs 762 (+9.4%), green 2450 vs 2580 (-5.0%), yellow 1427 vs 1536 (-7.1%), red 154 vs 151 (+2.0%). February 2020 weekly mean ED attendances compared with February 2019 had statistically significant difference only in the fourth week (days 22-28) for green codes (75 vs 92, p = 0.007) and yellow codes (41 vs 52, p = 0.047), not for white (27 vs 26, p = 0.760) and red codes (5 vs 5, p = 0.817). The first three weeks of February 2020 compared with 2019 showed no statistically significant difference in weekly mean ED attendances. Conclusions There was a significant reduction of green and yellow codes attendances at ED in the fourth week of February 2020, corresponding to the initial phase of Italian COVID-19 outbreak. The fear of contracting SARS-CoV-2 by attending the ED probably acted as a significant deterrent in visits, especially for low and medium critical patients. Additional data are required to better understand the phenomenon, including the behaviour of non-critical attendances. Key messages A reduction of green and yellow codes attendances was reported during initial phase of COVID-19 outbreak in an Italian academic hospital. Fear of contracting COVID-19 infection in a hospital setting could impact on emergency department attendances.

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