Effectiveness of Ice Pack Application on Level of Pain and Bruise Formation among Patients Receiving Subcutaneous Low Molecular Weight Heparin at Selected Hospitals of City

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Girigosavi Rani Kiran ◽  
Adhav Prajakta Niranjan
Keyword(s):  
Molecular Weight ◽  
Low Molecular Weight Heparin ◽  
Pain Scale ◽  
Control Group ◽  
Low Molecular Weight ◽  
Significant Difference ◽  
Cold Application ◽  
Quasi Experimental ◽  
Experimental Group ◽  
Ice Pack

Background: Bruising is one of the most common adverse events following administration of enoxaparin sodium, which can lead to unpleasant consequences such as reduced access to various sites for injection, reduced satisfaction of patients from treatment and care provided. Cold application is helpful for better management of these side effects which could be easily accessible and economical for the patients. Cold application appears to be cheaper and easily available. Aim: The purpose of this study was to identify the effectiveness of ice pack application on level of pain and bruise formation among patients receiving subcutaneous low molecular weight heparin. Method: Quasi experimental nonequivalent control group posttest only design was adopted. The population comprised of 60 patients receiving subcutaneous low molecular weight heparin from selected hospitals of Pune. Sample of the study were 60 patients receiving subcutaneous low molecular weight heparin patients selected by convenient sampling. The patients in experimental group were provided with ice pack application before receiving subcutaneous low molecular weight heparin to reduce the level of pain and bruise formation. Data was collected by using numerical pain scale, visual analog scale and transparent ruler scale. Result: The study findings showed that average numerical pain score in experimental group was 3.87 and 6.33 in control group. Bruise size was measured in cm. In experimental group Average bruise formation size was 0.0233 after 24 hours of injection, 0.1633 after 48 hours of injection and 0.1766 after 72 hours of injection compared to control group 0.2733 after 24 hours of injection, 0.3933 after 48 hours of injection and 0.4066 after 72 hours of injection. There is significant difference in mean scores of experimental and control group. Conclusion: The findings of the study shows that the ice pack application is effective in reducing the level of pain and bruise formation among patients receiving

scholarly journals Effect of Cold Application on Pain and Bruising in Patients With Subcutaneous Injection of Low-Molecular-Weight Heparin: A Meta-Analysis

2020 ◽  
Vol 26 ◽  
pp. 107602962090534
Author(s):  
Haifeng Wang ◽  
Jingjing Guan ◽  
Xiaohan Zhang ◽  
Xinxin Wang ◽  
Tianliang Ji ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Subcutaneous Injection ◽  
Low Molecular Weight Heparin ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Control Group ◽  
Low Molecular Weight ◽  
Significant Difference ◽  
Cold Application ◽  
Larger Sample

To evaluate the effect of cold application on pain and bruising after the subcutaneous injection of low-molecular-weight heparin, 8 electronic databases were searched for randomized controlled trials and quasiexperimental studies from the inception of the databases to June 2019. Review Manager 5.3 software was used for the heterogeneity test and meta-analysis. A total of 8 studies including 694 participants were analyzed. The cold application group assessed with the Verbal Descriptor Scale pain assessment tool showed significant reductions in pain intensity immediately after injection. Compared to the control group, the cold application group showed a reduction in the occurrence of bruises at 12 hours, 24 hours, and 48 hours after injection. There was no significant difference in the area of bruising in the cold application group at 48 hours after injection, but the area of bruising at 72 hours after injection was significantly reduced. These results show that cold application can reduce the incidence of pain and bruising after subcutaneous injection of low-molecular-weight heparin and reduce the area of bruising 72 hours after injection. Additional studies with larger sample sizes are needed to confirm these findings.

scholarly journals Comparison of effects of unfractionated heparin and low molecular weight heparin on skin wound healing of rats

2012 ◽  
Vol 27 (9) ◽  
pp. 639-644 ◽  
Author(s):  
Can Engin Durmaz ◽  
Aydin Ozkan ◽  
Bugra Senel ◽  
Hasan Alper Uyar
Keyword(s):  
Molecular Weight ◽  
Wound Healing ◽  
Unfractionated Heparin ◽  
Low Molecular Weight Heparin ◽  
Skin Wound ◽  
Control Group ◽  
Low Molecular Weight ◽  
Skin Wound Healing ◽  
Significant Difference ◽  
Experimental Group

PURPOSE: To compare the effects of unfractionated heparin (UH) and a low molecular weight heparin (LMWH) on skin wound healing of rats. METHODS: Forty eight male Sprague-Dawley rats underwent 8mm full thickness dorsal skin wounds and were randomly assigned to three equal groups. In experimental group A, heparin sodium was injected at a concentration of 1000U/kg. In experimental group B, enoxaparin was injected at a concentration of 1mg/kg. Physiologic saline (0.5ml) was administered to the control group. Injections were made subcutaneously, once daily, for seven days. At 7th and 10th days tissue samples were taken from all rats. Histologic examination of these tissues was made under light microscope and scored. RESULTS: Histological examination showed a significant difference between the 7th and 10th day groups in wound healing. It was observed that wound healing of LMWH injected group is better. This difference is statistically significant at 10th day. CONCLUSIONS: Daily administration of single doses of unfractionated heparin and a low molecular weight heparin improves wound healing positively. Low molecular weight heparin induces wound healing more than unfractionated heparin.

scholarly journals The effect of prophylactic dose of a low molecular weight heparin on skin wound healing of rats

2009 ◽  
Vol 24 (6) ◽  
pp. 471-475 ◽  
Author(s):  
Ozdamar Fuad Oken ◽  
Ahmet Ozgur Yildirim ◽  
Murat Gulcek ◽  
Vuslat Sema Unal ◽  
Akin Karakuyu ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Wound Healing ◽  
Tensile Strength ◽  
Low Molecular Weight Heparin ◽  
Skin Wound ◽  
Control Group ◽  
Low Molecular Weight ◽  
Skin Wound Healing ◽  
Prophylactic Dose ◽  
Experimental Group

PURPOSE: To investigate the effect of prophylactic dose of a low molecular weight heparin, enoxaparin, on skin wound healing of rats. METHODS: Forty rats were used for the study. Rats were randomly assigned to two equal groups. Experimental group received prophylactic dose of enoxaparin. Physiologic saline was administered to the control group. Parameters of wound healing of experimental and control groups were compared. For comparison of the groups in terms of fibrosis, vascularization, inflammation, epithelization, and tensile strength test (Newton). Mann-Whitney-U test was used because variables were categorical data (fibrosis, vascularization, inflammation and epithelization). Differences between groups were analyzed with independent samples t-test (tensile strength). Significance was set at p<0.05. RESULTS: Skin wound of the experimental group presented tensile strength significantly decreased (p<0.001), histopathologic examination revealed a significant (p<0.001) delayed epithelization and decreased in fibrosis, vascularization, inflammation (p<0.001) in the experimental group. CONCLUSION: Enoxaparin delay wound healing by decreased inflammatory cells, fibroblast contents and their products (growth factors), and by promoted hemorrhage.

Systemic Thrombin Generation and Activity Resistant to Low Molecular Weight Heparin Administered Prior to Streptokinase in Patients with Acute Myocardial Infarction

1997 ◽  
Vol 77 (01) ◽  
pp. 057-061 ◽  
Author(s):  
Dennis W T Nilsen ◽  
Lasse Gøransson ◽  
Alf-Inge Larsen ◽  
Øyvind Hetland ◽  
Peter Kierulf
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Molecular Weight ◽  
Body Weight ◽  
Low Molecular Weight Heparin ◽  
Troponin T ◽  
Bleeding Complications ◽  
Control Group ◽  
Low Molecular Weight ◽  
Creatine Kinase Mb

SummaryOne hundred patients were included in a randomized open trial to assess the systemic factor Xa (FXa) and thrombin inhibitory effect as well as the safety profile of low molecular weight heparin (LMWH) given subcutaneously in conjunction with streptokinase (SK) in patients with acute myocardial infarction (MI). The treatment was initiated prior to SK, followed by repeated injections every 12 h for 7 days, using a dose of 150 anti-Xa units per kg body weight. The control group received unfractionated heparin (UFH) 12,500 IU subcutaneously every 12 h for 7 days, initiated 4 h after start of SK infusion. All patients received acetylsalicylic acid (ASA) initiated prior to SK.Serial blood samples were collected prior to and during the first 24 h after initiation of SK infusion for determination of prothrombin fragment 1+2 (Fl+2), thrombin-antithrombin III (TAT) complexes, fibrinopeptide A (FPA) and cardiac enzymes. Bleeding complications and adverse events were carefully accounted for.Infarct characteristics, as judged by creatine kinase MB isoenzyme (CK-MB) and cardiac troponin T (cTnT), were similar in both groups of patients.A comparable transient increase in Fl+2, TAT and FPA was noted irrespective of heparin regimen. Increased anti-Xa activity in patients given LMWH prior to thrombolytic treatment had no impact on indices of systemic thrombin activation.The incidence of major bleedings was significantly higher in patients receiving LMWH as compared to patients receiving UFH. However, the occurrence of bleedings was modified after reduction of the initial LMWH dose to 100 anti-Xa units per kg body weight.In conclusion, systemic FXa- and thrombin activity following SK-infusion in patients with acute MI was uninfluenced by conjunctive LMWH treatment.

scholarly journals Safety and efficacy of direct oral anticoagulants (DOACs) vs low molecular weight heparin (LMWH) in malignancy induced venous thromboembolism-a systematic review and meta analysis

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
A Abdul Razzack ◽  
N Hussain ◽  
S Adeel Hassan ◽  
S Mandava ◽  
F Yasmin ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Venous Thromboembolism ◽  
Major Bleeding ◽  
Low Molecular Weight Heparin ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Low Molecular Weight ◽  
Efficacy And Safety ◽  
Dichotomous Data ◽  
Significant Difference

Abstract Funding Acknowledgements Type of funding sources: None. Background- Low molecular weight heparin (LMWH) and direct oral anticoagulants (DOACs) have been proven to be more effective in the management of venous thromboembolism (MVTE). The efficacy and safety of LMWH or DOACs in treatment of recurrent or malignancy induced VTE is not studied in literature. Objective To compare the efficacy and safety of LMWH and  DOACs in the management of malignancy induced  VTE Methods- Electronic databases ( PubMed, Embase, Scopus, Cochrane) were searched from inception to November  28th, 2020. Dichotomous data was extracted for prevention of VTE and risk of major bleeding in patients taking either LMWH or DOACs. Unadjusted odds ratios (OR) were calculated from dichotomous data using Mantel Haenszel (M-H) random-effects with statistical significance to be considered if the confidence interval excludes 1 and p &lt; 0.05.  Results- Three studies with 2607 patients (DOACs n = 1301 ; LMWH n = 1306) were included in analysis. All the study population had active cancer of any kind diagnosed within the past 6 months. Average follow-up period for each trial was 6 months. Patients receiving DOACs have a lower odds of recurrence of MVTE as compared to LMWH( OR 1.56; 95% CI 1.17-2.09; P = 0.003, I2 = 0). There was no significant difference in major bleeding among patients receiving LMWH or DOACs  (OR-0.71, 95%CI 0.46-1.10, P = 0.13, I2 = 22%) (Figure 1). We had no publication bias in our results (Egger’s regression p &gt; 0.05). Conclusion- DOACs are superior to LMWH in prevention of MVTE and have similar major bleeding risk as that of LMWH. Abstract Figure. A)VTE Recurrence B)Major Bleeding events

scholarly journals Study of the Effectiveness of the Cognitive Behavioral Therapy on Self Efficacy and Pain among Children Suffering from Cancer

2016 ◽  
Vol 9 (5) ◽  
pp. 33
Author(s):  
Kosar Bardideh ◽  
Fatemeh Bardideh ◽  
Keivan Kakabaraee
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Self Efficacy ◽  
Behavioral Therapy ◽  
Pain Scale ◽  
Cognitive Behavioral ◽  
Control Group ◽  
Children With Cancer ◽  
Research Population ◽  
Quasi Experimental ◽  
Experimental Group

<p><strong>OBJECTIVE: </strong>The aim of the present study is to investigate the effectiveness of the cognitive behavioral therapy on pain reduction and the elevation of self efficacy among children who suffer from cancer.</p><p><strong>METHOD:</strong> The present study adopts a quasi experimental pretest-posttest two group design .The research population consists of all 9-11 year old children with cancer who admitted to Tehran specialized cancer treatment centers in 2015. From those eligible in this study 40 were selected at hand and were randomly divided to two experimental and control groups (20 for experimental group and 20 for control group). Kuris self-efficacy questionnaire and Oucher pain scale were employed for data collection and multivariate and single-variant analyses of covariance have been used for data analysis.</p><p><strong>RESULTS:</strong> The results showed that the cognitive behavioral therapy has resulted in ease of pain and rise of efficacy among the experimental group (P˂ 0.01).</p><p><strong>CONCLUSION:</strong> Based on findings it can be deduced that cognitive behavioral therapy has a significant impact on this group of patients and this treatment can be employed as an appropriate solution in order to reduce the symptoms of children with cancer and ultimately to treat cancer.</p>

scholarly journals Investigating the Effect of Teaching Aesthetic Skills to Faculty Members on Development of Their Effective Teaching Performance1

2017 ◽  
Vol 19 (2) ◽  
pp. 90-106 ◽  
Author(s):  
Hassan Eslamian ◽  
Seyed Ebrahim Mirshah Jafari ◽  
Mohammad Reza Neyestani
Keyword(s):  
Effective Teaching ◽  
Teaching And Learning ◽  
Learning Processes ◽  
Faculty Members ◽  
Control Group ◽  
Teaching Performance ◽  
Significant Difference ◽  
Quasi Experimental ◽  
The Mean ◽  
Experimental Group

AbstractThis quasi-experimental study investigated the effect of teaching aesthetic skills to faculty members on development of their effective teaching performance through a two-group pretest-posttest design. The sample included 32 faculty members at a major Iranian university who were divided into the experimental (11 participants) and control groups (21 participants). The experimental group was taught to use aesthetic skills in the teaching and learning processes; however, no intervention was applied to the control group. To evaluate the effective teaching performance of the faculty members, a tailor-made questionnaire was used in two pretest and posttest stages, where randomly chosen students were asked to express their opinions about the faculty membersí performance. The sample size of the students was 1096 in the pretest stage and 935 in the posttest stage. Paired t-test results showed that there was no significant difference between the mean effective teaching scores of the faculty members in the control group in the pretest stage and in the posttest stage. However, the mean effective teaching scores of the faculty members in the experimental group were found to be significantly higher in the posttest. In addition, although there was no significant difference between the mean effective teaching scores of the two faculty groups in the pretest, faculty members in the experimental group outperformed their counterparts in the control group. Based on the findings, applying aesthetic skills by faculty members in the teaching and learning processes can pave the way for sustainable development of their effective teaching performance. Therefore, faculty members are recommended to acquire the required knowledge and skills to better use aesthetic skills in the teaching process.

scholarly journals GeoGebra and students’ learning achievement in trigonometric functions graphs representations and interpretations

2021 ◽  
Vol 16 (2) ◽  
pp. 827-846
Author(s):  
Nthabiseng Mosese ◽  
Ugorji I. Ogbonnaya
Keyword(s):  
Control Group ◽  
Trigonometric Functions ◽  
Significant Difference ◽  
Post Test ◽  
Quasi Experimental ◽  
Equivalent Control ◽  
The Mean ◽  
Dynamic Mathematics ◽  
Students Success ◽  
Experimental Group

Making connections between the representations of trigonometric functions and an interpretation of graphs of the functions are major challenges to many students. This study explores the effectiveness of the GeoGebra on grade 12 students’ success in making connections between the representations of trigonometric functions and the interpretation of graphs. A non-equivalent control-group pre-test post-test quasi-experimental design was used. The sample of the study consisted of sixty-one grade 12 students from two schools. The results showed that there was a statistically significant difference between the mean achievements of the experimental group and the control group on making connections between representations of trigonometric functions, and on analyses and interpretations of representations of trigonometric functions, in favour of the experimental group. This study extends the findings of previous studies on the effectiveness of dynamic mathematics software on students’ learning of representations and interpretation of graphs of trigonometric functions.            Keywords: GeoGebra, functions graphs, Trigonometric functions

scholarly journals penyuluhan menggunakan media lembar balik terhadap pengetahuan dan sikap ibu balita mengenai Kadarzi

2019 ◽  
Vol 11 (1) ◽  
pp. 58
Author(s):  
Ulfah Sofindra Syahidatunnisa ◽  
Holil M Par'i ◽  
Fred Agung Suprihartono ◽  
Fred Agung Suprihartono ◽  
Rr. Nur Fauziyah ◽  
...  
Keyword(s):  
Total Sample ◽  
Wilcoxon Test ◽  
Control Group ◽  
Control Group Design ◽  
Knowledge And Attitudes ◽  
Significant Difference ◽  
Quasi Experimental ◽  
Knowledge And Attitude ◽  
Attitudinal Changes ◽  
Experimental Group

One of the factors that influence Kadarzi's achievement is the knowledge and attitudes of the toddler's mother. This study aims to determine the effect of counseling using backsheet media on the knowledge and attitudes of toddlers' mothers about Kadarzi in the Cipeundeuy Health Center District of West Bandung Regency. The research design used was quasi-experimental with a pre-post test control group design model with a total sample of 28 people each for the experimental group and the control group. The experimental group was given an intervention in the form of counseling using flipchart media, while the control group was given an intervention in the form of counseling using leaflet media. The results obtained from the Wilcoxon test in the experimental group and the t-dependent test in the control group were changes in the increase in knowledge and attitude scores in the experimental group and the control group after intervention (p <0.005). The results of the Mann-Whitney test showed no significant difference between knowledge and attitude scores in the experimental group and the control group (p> 0.005). It is better to do further research related to Kadarzi's behavior so that the application of the Kadarzi indicator can be monitored so that it can describe the results of attitudinal changes, and to increase Kadarzi's knowledge and attitudes to toddler mothers.

scholarly journals Inhibition of Plasmin Generation in Plasma By Heparin, Low Molecular Weight Heparin and a Covalent Antithrombin-Heparin Complex (ATH)

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 4217-4217
Author(s):  
Gabriela Chang ◽  
Helen M. Atkinson ◽  
Leslie R. Berry ◽  
Anthony K.C. Chan
Keyword(s):  
Molecular Weight ◽  
Plasminogen Activator ◽  
Low Molecular Weight Heparin ◽  
Conflicts Of Interest ◽  
Area Under The Curve ◽  
Low Molecular Weight ◽  
Plasminogen Activator Inhibitor 1 ◽  
Significant Difference

Abstract Introduction: Unfractionated heparin (UFH) and low molecular weight heparin (LMWH) are widely used anticoagulants for thrombosis treatment. However, these anticoagulants have limitations such as increased bleeding, variable dose response, required frequent monitoring, and, in the case of LMWH, inability to inhibit thrombin. This has led to the development of a covalent complex of antithrombin and heparin (ATH), which has been shown to overcome many of these shortcomings. ATH has faster rates of inhibition of many coagulation factors, is able to inhibit clot-bound thrombin, and is a more effective inhibitor of both venous and arterial thrombosis in animal models. Moreover, in a rabbit thrombosis model, ATH has been shown to decrease clot mass and fibrin accretion, while the contrary was observed for UFH. From these observations, it was suggested that ATH may enhance fibrin breakdown and thus led to investigations into the effects of UFH and ATH on fibrinolysis. In vitro studies have shown that UFH enhances antithrombin inhibition of plasmin. In addition, ATH displays a slightly greater inhibition of plasmin generation and activity. Such studies were conducted in purified systems, in the absence of other plasmin inhibitors naturally present in plasma. Therefore, the aim of the present study was to compare the effects of UFH, LMWH, and ATH on plasmin generation in plasma. Methods: At 37°C tissue plasminogen activator (tPA) and soluble fibrin fragments (fib) were added to normal adult pooled platelet poor plasma supplemented with 0.35, 0.7, 1.4, or 2.1 U anti-Xa/ml UFH, LMWH, or ATH, to initiate plasmin generation (8.93nM tPA and 300µg/ml fib). At various time points, subsamples were mixed with excess plasminogen activator inhibitor 1 (PAI-1) (55.12nM) to stop further plasmin generation. The plasmin concentration at each time point was determined using a plasmin-specific chromogenic substrate and a standard curve produced from purified plasmin. Results: Comparisons of mean area under the curve (AUC) for plasmin generation displayed a significant decrease in plasmin generation in the presence of all three anticoagulants at all doses tested (p<0.05). Comparing the anticoagulants at similar doses, plasmin generation was significantly decreased in the presence of ATH (15384.66±1930.23nM/min) compared to LMWH (23892.28±3090.54nM/min) at 0.7 U/ml (p<0.05). At a dose of 1.4 U/ml, there was significantly less plasmin generated, over time, in the presence of UFH (20089.49±3022.1623nM/min) and ATH (19273.86±1805.7323nM/min) when compared to LMWH (24743.18±1265.1023nM/min) (p<0.05). There was no significant difference in plasmin inhibition between UFH and ATH at any of the doses tested. Conclusion: The present study supports previous findings that UFH and ATH can facilitate antithrombin inhibition of plasmin. It is also observed that LMWH catalyzes the inhibition of plasmin by antithrombin but possibly to a lesser extent. These findings suggest that ATH has a similar inhibitory effect on plasmin generation and activity in plasma compared to UFH, despite its overall superior anticoagulant properties. Therefore, previous in vivo observations displaying decrease in clot mass with administration of ATH was due to its enhanced anticoagulant abilities and not fibrinolysis enhancement. These findings add to our understanding of ATH mechanisms of action and aid in its development for clinical use. Disclosures No relevant conflicts of interest to declare.

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