scholarly journals Ultrasonographic Assessment of Metoclopramide Administration Effectiveness in Accelerating Gastric Emptying Before Urgent Surgery in Patients with Insufficient NPO Time

2020 ◽  
Vol 10 (5) ◽  
Author(s):  
Shahram Sayyadi ◽  
Masoomeh Raoufi ◽  
Ali Arhami Dolatabadi ◽  
Marzieh Rostami ◽  
Elham Memary

Background: Aspiration is one of the important complications of general anesthesia, although infrequent as well as accompanying high morbidity and mortality. The volume of gastric content is considered as a risk factor in this regard. Therefore, it is normally mostly recommend to consider proper fasting time before induction of general anesthesia. Objectives: This study was conducted to assess the effect of metoclopramide on reducing gastric contents in patients with incomplete fasting before induction of general anesthesia. Methods: This quasi-experimental study was conducted on patients with urgent surgical indications with incomplete NPO time. Every other patient received metoclopramide or placebo. Patients in the intervention group received 10 mg (2 ml) of intravenous metoclopramide, and patients in the control group received 2 ml of distilled water as a placebo. Patients in both groups underwent ultrasonography before starting surgery by an expert radiologist to calculate gastric antral grade (GAG) and cross-sectional antral area (CSA). These measurements were then taken for the second time 30 minutes after intervention, before starting the surgery. The values were compared statistically. Results: The data of 60 patients were analyzed, of which 30 were in each group. The mean age, body mass index, type of the last consumed food (solid or fluid), NPO time in the two groups were not significantly different (P value > 0.05). The number of patients in the metoclopramide group with higher GAG (P value = 0.001) and the mean CSA (P value = 0.004) before the intervention was more than the control group. The GAG and mean CSA after intervention were not significantly different between the two groups; but the mean difference of decrease in CSA in the metoclopramide group was more than the control group (4.3 vs. 0.99; P value = 0.001), and changes of GAG after intervention to lower levels in the metoclopramide group was more than the control group (P value < 0.05). Conclusions: In the current study in which ultrasonographic indexes, including GAG and CSA, were assessed as a suboptimal gastric emptying test method, it was found that metoclopramide could accelerate gastric emptying compared to placebo in patients with incomplete fasting before induction of general anesthesia.

2018 ◽  
Vol 7 (2) ◽  
pp. 116
Author(s):  
Budi Darmawan ◽  
Diyah Fatmasari ◽  
Rr. Sri Endang Pujiast

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.


2018 ◽  
Vol 5 (2) ◽  
pp. 121-129
Author(s):  
Siti Khoiroh

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.


2020 ◽  
pp. 147-150

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.


2018 ◽  
Vol 21 (2) ◽  
pp. 113-117
Author(s):  
Ampornpan Theeranut ◽  
Nonglak Methakanjanasak ◽  
Pattama Surit ◽  
Wasana Ruaisungnoen ◽  
Kittisak Sawanyawisuth ◽  
...  

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.


2019 ◽  
Vol 2 (1) ◽  
pp. 31-38
Author(s):  
I Ketut Sudiarta ◽  
Emiliana Tarigan ◽  
Sudibyo Supardi

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


2016 ◽  
Vol 5 (1) ◽  
Author(s):  
Henik Istikhomah ◽  
Murwati Murwati

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.


2021 ◽  
Vol 5 (1) ◽  
pp. 69-81
Author(s):  
Irwin Fitriansyah ◽  
Dovy Djanas ◽  
Hafni Bachtiar

Introduction : Albumin main function is maintaining the plasma colloid oncotic pressure. Preeclampsia cause a decrease in serum albumin in the pregnant woman. Low albumin levels increase mortality, longer wound healing and longer hospital stays. The intake of oral albumin is expected to be effective in increasing the level of albumin in the blood.Objective : To determine the effect of freeze dryer method intake compared to liquid snakehead fish extract in patients with preeclampsia and hypoalbuminemia.Material and methods : Using pre and post-test control group design.The total sample was 38 patients with severe preeclampsia with hypoalbuminemia, divided into control and intervention groups. Control was given the intake of liquid snakehead fish extract, in the intervention was given the Freeze dryer method. The research data were analyzed using the Mann Whitney test method and the Wilcoxon test.Results : In the intervention group the mean pretest albumin level was 2.66 ± 0.17 gr / dl and on the 4th day it was 3.13 ± 0.16 gr / dl (p = 0.000). In the control group the mean pretest albumin level was 2.72 ± 0.15 gr / dl and on the 4th day it became 3.06 ± 0.14 gr / dl (p = 0.000). On the 4th day after treatment, the increase in serum albumin levels in the intervention group was 0.47 ± 0.19 gr / dl; whereas in the control group was 0.34 ± 0.10 gr / dl with a value of p = 0.031 (p <0.05).Conclusion : The freeze dryer method (freeze dryer method ) for the Cork Fish Extract resulted in a higher increase in albumin levels than the liquid snakehead fish extract.Keywords: Preeclampsia, Hypoalbuminemia, freeze dryer method of Snakehead Fish Extract


Author(s):  
Mohamed Shawky Elfarargy ◽  
Ghada Al-Ashmawy ◽  
Sally Abu-Risha ◽  
Haidy Khattab

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


2020 ◽  
Vol 10 (2) ◽  
pp. 119-129
Author(s):  
Halimah Wenny Yulina Astuti ◽  
Murti Agustin ◽  
Sri Padma Sari ◽  
Diyan Yuli Wijayanti ◽  
Widodo Sarjana ◽  
...  

Background: Hope has an essential role in the recovery journey for people with schizophrenia. Current studies showed that people with schizophrenia reported having low hope. There is growing evidence that mindfulness has favorable effects on mental health in populations with chronic illness, including people with schizophrenia. However, the studies evaluating effects of mindfulness on hope and recovery for people with schizophrenia are limited.Purpose: This study aimed to examine the effects of mindfulness on hope and recovery among people with schizophrenia.Methods: This quasi-experimental study was carried out on 54 patients with schizophrenia based on purposive sampling in a psychiatric hospital in Indonesia. The respondents were divided into two groups with 27 patients each in the intervention and the control group. The intervention group received 2-session mindfulness, while the control group received standard care. The data were collected using the demographic questionnaire, the Schizophrenia Hope Scale (SHS-9), and Recovery Assessment Scale (RAS), and analyzed using the Chi-Square and Mann-Whitney tests. Results: After mindfulness therapy, the intervention group showed a higher mean score of hope than the control group (14.30±2.50 and 9.04±2.15, respectively) as well as in the mean of recovery (86.78±4.00 and 73.56±6.04, respectively). There were significant differences in hope and recovery levels between the two groups with p-value <0.001.Conclusion: This study showed that mindfulness is an effective strategy to stimulate hope and recovery among people with schizophrenia. Nurses can apply mindfulness as one of the nursing interventions for helping the recovery process among this population. 


2021 ◽  
Vol 4 (1) ◽  
pp. 1
Author(s):  
Barto Mansyah ◽  
Fetty Rahmawati

Efforts to increase knowledge and attitudes in adolescents require a learning media that can not only be used in the world of education but also in the health sector, especially in the prevention of DM where one of the risk factors for DM is an unhealthy diet. One of the media that can be used is audio visual. This study aims to analyze the effect of audio-visual media on diet on the level of knowledge and attitudes of adolescents in preventing type 2 diabetes. This type of research is a quasi-experimental study with a pretest-posttest with control group design. The results showed that there were significant differences in the mean value of knowledge (p value 0,039 <0,005) and attitude score (p value 0,001 <0,005) which were significant between the intervention group and the control group. The mean increase in the knowledge value of the intervention group was 16,27 higher than the control group was 9,20. In the attitude variable, the mean score of attitudes in the intervention group was 13,27 higher than the mean value in the control group, namely 9,20, so it can be concluded that the intervention group in the form of audio-visual health education showed better results in increasing knowledge and attitudes about diet in the prevention of type 2 diabetes.


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