scholarly journals Evaluation of Ropivacaine versus Ropivacaine with Fentanyl for Postoperative Epidural Analgesia in Patients Undergoing Elective Lower Abdominal Oncosurgeries- A Randomised Clinical Study

Author(s):  
SS Srihari ◽  
KS Henjar Appa ◽  
BH Arathi ◽  
NR Rashmi ◽  
VB Gowda ◽  
...  

Introduction: Epidural analgesia has emerged as one of the preferred and convenient modes of intraoperative and postoperative management owing to advantage of not interfering with metabolic functions, better tolerability and decrease in reflex activity, similar analgesic properties, less motor blockade and decreased propensity of cardiotoxicity. Neuraxial opioids like fentanyl used in epidural analgesia offer advantage of augmenting local anaesthetic effect and reducing the anaesthetic and analgesic requirement. Aim: To compare the adequacy of analgesia, requirement of rescue analgesics between 0.2% ropivacaine and 0.2% ropivacaine with 2 mcg/cc fentanyl. Materials and Methods: The randomised clinical study was carried out from September 2016 to May 2018 in 70 patients (35 in each group) of American Society of Anaesthesiologists (ASA) 1 and 2 scheduled for elective lower abdominal oncological surgeries. The anaesthetic intervention in group R was 0.2 % ropivacaine and group RF was 0.2% ropivacaine with 2 mcg/cc fentanyl. All data was statistically analyzed and compared using Student t-test, Chi-square/Fisher-Exact test. The p-value <0.05 was considered to be significant. Results: Both the groups were compatible with regard to demographic data and haemodynamic variables. The mean Visual Analogue Scale (VAS) were higher in group R compared to group RF at 0, 2, 4, 12, 18 and 24 hours but the observed difference in both the groups was not statistically significant except at 1 and 6 hours. Number of rescue analgesics as epidural boluses (p-value=0.007) and paracetamol (p-value=0.022) requirement were more in group R compared to group RF respectively. Conclusion: On account of adequate postoperative analgesia, haemodynamic stability, ropivacaine with fentanyl is a better option than ropivacaine alone for epidural infusion.

2019 ◽  
Vol 12 (02) ◽  
Author(s):  
Prastiwi Putri Basuki ◽  
Triana Uminingsih

Stunting pada masa balita perlu mendapat perhatian khusus termasuk pada anak usia 24-36 bulan. Usia 24-36 bulan merupakan usia anak yang mengalami perkembangan pesat dalam kemampuan kognitif dan motorik. Banyak faktor yang mempengaruhi terjadinya kejadian stunting pada anak, antara lain karakteristik ibu. Tujuan dari penelitian ini adalah mengetahui kontribusi karakteristik ibu terhadap kejadian stunting pada anak usia 24-36 bulan. Penelitian ini merupakan penelitian observasional analitik dengan pendekatan cross sectional yang dilakukan di Desa Sendang Mulyo Minggir Sleman Yogyakarta. Sampel yang diambil sebanyak 75 anak usia 24-36 bulan dengan teknik purposive sampling. Analisis data  bivariat menggunakan Chi Square dan Fisher Exact Test dan analisis multivariat menggunakan regresi linier. Hasil penelitian menunjukkan bahwa pendidikan ibu (p value=0,000), pengetahuan ibu (p value=0,022) dan pemberian ASI Ekslusif (p value=0,011) yang artinya terdapat hubungan dengan kejadian stunting. Sedangkan status pekerjaan ibu (p value=0,217) tidak signifikan berhubungan dengan kejadian stunting. Berdasarkan analisis multivariat regresi linier menunjukkan hasil bahwa pendidikan ibu, status  pekerjaan ibu, pengetahuan ibu tentang gizi, dan pemberian ASI Ekslusif bersama-sama mempunyai kontribusi terhadap kejadian stunting sebesar 88,2%. Perlu peningkatan program multisektoral dengan melibatkan semua lapisan masyarakat untuk mengurangi kejadian stunting.


2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 9579-9579 ◽  
Author(s):  
Amit Hemadri ◽  
Huang Lin ◽  
Yan Lin ◽  
Amy Rose ◽  
Cindy Sander ◽  
...  

9579 Background: Obesity promotes PD-1–mediated T cell dysfunction but also improves tumor response to PD-1 blockade. Obesity has been linked with positive outcomes in pts treated with PD-1 blockade. To evaluate the prognostic utility of BMI, we performed a retrospective evaluation of BMI and other covariates in 172 pts with stage IV cutaneous MEL. Methods: Pts with stage IV cutaneous MEL who received anti PD-1 therapy at the University of Pittsburgh between 2014-2018 were included in this analysis. PD-1 blockade was continued until progression or intolerable toxicity. Tumor assessment was performed at baseline and every 12 weeks and response classified per RECIST v1.1. Clinical and demographic data were obtained. BMI was defined based on values at the first treatment date and dichotomized into two groups: ≥30 vs. < 30. Fisher exact test was used to evaluate the correlation between BMI group and ORR. Kaplan Meier method and Cox proportional hazard models were performed to analyzed the time-to-event outcomes (OS and PFS). Results: 172 pts with advanced MEL were evaluated. Greater BMI was associated with greater ORR, PFS and OS across various BMI cutoffs (BMI≥28, BMI≥30 and BMI≥35) although this effect was most obvious at BMI≥30. Pts with BMI≥30 achieved higher ORR than those with BMI < 30 (74% vs. 58%, p-value = 0.04). Concordantly, pts with BMI≥30 had improved PFS and OS: median PFS (BMI≥30 21.1 mos vs. BMI < 30 10.7 mos) and median OS (BMI≥30 35.4 mos vs. BMI < 30 22.8 mos). Higher BMI was independently associated with improved OS (p = 0.018) and PFS (p = 0.047) adjusting for age, Breslow thickness and sex. No significant interaction was observed between the effects of BMI and that of age, sex, or Breslow thickness. Conclusions: Increased BMI was associated with greater ORR in addition to previously reported associations with PFS/OS in a large retrospective series of advanced MEL pts treated with PD-1 blockade. This data was independent of other prognostic factors and underscore the “inflammaging” effects of obesity and age in relation to anti PD-1 therapy in advanced cancer.


2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 200-200
Author(s):  
Marcus W. Moses ◽  
Peter Steinwald ◽  
Ellen Jaeger ◽  
Whitley Hatton ◽  
Patrick Cotogno ◽  
...  

200 Background: Circulating tumor-DNA (ctDNA) in mCRPC patients (pts) provides a viable approach for examining the genetic landscape of prostate cancer. In this follow-up, we report ctDNA variants in germline tested mCRPC pts. Methods: ctDNA alterations in 73 genes were detected using Guardant360 (G360) assays. Alteration types assessed were missense, frameshift, insertions, splice variants, truncations, amplifications (amp), deletions, and other. Pts included in the analysis received germline genetic testing (Invitae Corporation, San Francisco, CA) and ctDNA assays at various treatment timepoints. Statistical analyses were performed using chi-square and fisher exact test with p-value <0.05 for significance. Results: Germline and ctDNA testing was completed in 270 mCRPC pts. 13% (35/270) of pts had pathogenic germline alterations. Germline alterations detected were BRCA2 (43%, n=15), ATM (8.5%, n=3), CHEK2 (8.5%, n=3), and BRCA1 (6%, n=2). Of the 673 alterations detected in G360 assays, TP53 (25%, n=167) and AR (17%, n=117) were most commonly observed. ctDNA alteration breakdown for germline negative/positive pts is summarized in Tables A/B. Germline negative pts had more AR alterations compared to germline positive (p = 0.023). Also, germline negative pts presented with more amps (p < 0.001) and germline positive pts with more frameshift alterations (p = 0.005). The association of ctDNA alteration to clinical outcomes in germline positive/negative pts was also assessed and is ongoing. Conclusions: Pts with germline positive alterations had few somatic AR alterations and higher frequency of deleterious mutation in comparison to their germline negative counterparts.[Table: see text][Table: see text]


2021 ◽  
Vol 13 (2) ◽  
pp. 1006-1012
Author(s):  
Ni Made Leni ◽  
Luh Nyoman Alit Aryani ◽  
Anak Ayu Sri Wahyuni ◽  
Ni Ketut Putri Ariani ◽  
Cokorda Bagus Jaya Lesmana ◽  
...  

Background: Adolescent is a transition period from childhood to adulthood, seeking self-identity, anti-social behavior, violence and substance use. Parenting style is one of the risk factors determining substance use behavior among adolescents to prevent and overcome this behavior's consequences. This study aims to determine the relationship between parenting style toward substance use among adolescents in Denpasar. Methods: This research is an analytic observational study with a case-control study design. This research sample is adolescent drug users aged 12-25 years who live with their parents aged 0-17 years. The study was carried out in/at the Class IIA Kerobokan Denpasar Prison from August 2020 to September 2020. The data sources are primary data that taken from the PSQ (Parenting Style Questionnaire) and WHO-ASSIST questionnaires. The independent variable is the parenting style, while the dependent variable is the level of substance use. The data were/are analyzed using the chi-square/Fisher exact test with p-value of <0.05 is considered as significant. Result: The results show that there is a significant relationship between unexpected parenting style according to parents/guardians and drug abuse among adolescents (r = 0.34; p <0.05) and that increased the risk of moderate-heavy drug use among adolescents (OR = 5.93; 95% CI = 1.362-25.788; p = 0.011). Conclusions: Unexpected parenting style is associated to/with higher levels of substance use due to guilt, abusive parenting, neglect, which lead to negative self-esteem in children, emotional submission, insecurity and a lack of self-control in children.


2018 ◽  
Vol 26 (1) ◽  
pp. 26
Author(s):  
Baksono Winardi ◽  
Elga Caecaria Grahardika Andani

Objectives: to identify association between knowledge of pregnant women about anemia and the adherence to consume iron tablets in BPM Titik Suharti, Surabaya, IndonesiaMaterials and Methods: Observational analysis cross sectional study. Population consisted of 55 trimester pregnant women in BPM Titik Suharti, Surabaya, in March-April 2017. Samples were recruited using consecutive sampling. The number of sample was 35 respondents. Data were analyzed using chi-square test.Results: This research showed that all of the less knowledgeable women on anemia (100.00%) were non-adherent to consume iron tablets, almost all moderately knowledgeable women (92.9%) were adherent, and all of the fully knowledgeable women (100.00%) were adherent. Fisher exact test in significance level of 0.05 revealed p value equal to 0.0001, indicating association between knowledge about anemia and adherence to consume iron tablets at BPM Titik Suharti, Surabaya, Indonesia.Conclusion: There is an association between knowledge of pregnant women about anemia with adherence to iron tablets.


Author(s):  
Dima Nassar ◽  
Nirit Tagger-Green ◽  
Haim Tal ◽  
Carlos Nemcovsky ◽  
Eitan Mijiritsky ◽  
...  

Background: In recent years, worldwide dental malpractice claims have dramatically increased. The purpose of the present study is to analyze periodontal therapy related claims in Israel that led to legal decisions. Methods: This retrospective cohort study includes malpractice claims against dental practitioners related to periodontology between 2005 and 2019. Only closed cases where a final decision was made were included. The chi-square test or Fisher exact test for categorical variables were performed and a p value of <0.05 was considered statistically significant. Results: During the study period there were 508 legal claims related to periodontal disease. Most plaintiffs were women (63.4%), and 71.3% of the patients were >35 years old. Most claims (82.8%) were settled out of court and ended in compromise. Claims concerning the treatment of periodontal disease by periodontists accounted only for 4.5% (23/508) of the cases while 95.5% (485/508) of the claims were for complications secondary to another treatment. Prosthodontic treatment was involved with the highest number 54.5%, followed by dental implants 17.7%, and endodontics 11.6%. The allegations were related to pain and distress (84.8%), aggravation of existent periodontal disease (83.3%), tooth loss (78.1%), and violation of autonomy (47%). Conclusions: The main cause for lawsuits was related to aggravation of periodontal disease during prosthetic or implant therapy and related to suspected faulty or inexistent preoperative diagnosis and planning. Practical implications: Periodontal consultation before dental treatment may reduce malpractice risks, adverse events, and un-necessary changes of treatment plans.


2018 ◽  
Vol 2 (1) ◽  
pp. 59-70
Author(s):  
Septa Decelita Wahyuni ◽  
Asparian . ◽  
M. Dody Izhar

Premenstrual syndrome (PMS) merupakan gejala yang banyak dirasakan oleh remaja selama satu minggu sebelum menstruasi. Apabila tidak diperhatikan akan berdampak menimbulkan masalah dan produktivitas. Tujuan penelitian untuk mengetahui determinan yang berhubungan dengan PMS. Jenis penelitian yaitu rancangan penelitian cros sectional. Penelitian dilakukan di SMPN 7 Kota Jambi. Waktu penelitian dari bulan  November 2017- Juni 2018. Populasinya yaitu 628 remaja putri dengan 93 sampel yang diambil menggunakan teknik stratified random sampling. Data dikumpulkan melalui wawancara menggunakan kuesioner sPAF untuk mengukur gejala PMS. Analisis data menggunaan chi square dan fisher exact test pada = 5%. Hasil: PMS tidak mengalami - ringan yaitu 71% dan gejala sedang hingga berat yaitu 29%. Remaja putri yang mengalami usia menarche prekok sebesar 4,3% , berstatus gizi gemuk sebesar 25,5%, serta memiliki gejala stres sebesar 90,3%. Hasil uji statistik yaitu tidak terdapat hubungan antara usia menarche dengan PMS dengan p-value yaitu 1,000 dengan POR 0,808. Tidak terdapat hubungan antara status gizi dan PMS dengan p-value yaitu 0,186 namun status gizi gemuk beresiko meningkatkan 2,185 PMS sedang-berat. Tidak terdapat hubungan antara stres dengan PMS pada remaja putri di SMPN 7 Kota Jambi p-value yaitu 0,276, namun stres beresiko meningkatkan 3,586 kali PMS sedang-berat. Kesimpulan: Terdapat kecenderungan gemuk dan stres dapat beresiko terhadap PMS sedang-berat. Diharapkan remaja putri mampu mengetahui siklus menstruasinya, menerapkan pola gizi seimbang dan aktif dalam memanfaatkan sarana UKS.


2020 ◽  
Vol 11 (1) ◽  
pp. 164-169
Author(s):  
Ringgo Alfarisi ◽  
Yuniastini Yuniastini ◽  
Astri Pinilih ◽  
Putri Nur Oktavia Jauhari

Latar Belakang: Latar Belakang: Energi yang adekuat pada saat sarapan pagi diperlukan untuk menunjang aktivitas belajar khusunya bagi anak sekolah. Energi diperoleh dari makanan atau minuman yang dikonsumsi oleh masing-masing anak. Anak yang seringkali melewatkan sarapan sangat tidak dianjurkan. Melewatkan sarapan membuat anak tidak berenergi karena perut kosong sehingga anak menjadi susah untuk memfokuskan pikiran di sekolah. Hal tersebut sangat tidak mendukung dalam peningkatan prestasi belajar. Tujuan Penelitian: Untuk mengetahui adakah hubungan kebiasaan sarapan pagi dengan prestasi belajar pada siswa-siswi Sekolah Dasar Negeri 01 Rajabasa di Bandar Lampung. Metode Penelitian: Jenis penelitian ini adalah penelitian kuantitatif dengan pendekatan cross sectional. Pengambilan sampel menggunakan teknik purposive sampling. Analisis bivariat yang digunakan adalah uji Chi Square. Hasil Penelitian: Dengan jumlah sampel sebanyak 60 responden, responden dengan sarapan pagi tidak rutin didapatkan 12 siswa, dimana 8 siswa (66,7%) prestasi belajar dibawah rata-rata dan 4 (33,3%) siswa prestasi belajar diatas rata-rata. Kemudian, responden yang sarapan pagi rutin didapatkan 48 siswa, dimana 6 siswa (12,5%) prestasi belajar dibawah rata-rata, dan 42 siswa (76,0%) prestasi belajar diatas rata-rata. Berdasarkan hasil uji fisher exact test hasil penelitian menunjukkan nilai p value sebesar 0,000 (≤0,05) yang berarti bahwa sarapan pagi dengan rutin mendukung dalam peningkatan prestasi belajar siswa OR = 14. Kesimpulan : Terdapat hubungan yang signifikan antara kebiasaan sarapan pagi dengan prestasi belajar siswa-siswi SDN 01 Rajabasa Bandar Lampung. Kata Kunci : Prestasi belajar, Sarapan pagi


2021 ◽  
Vol 8 (2) ◽  
pp. 164
Author(s):  
Nazulanita Rahma ◽  
Tri Murti Andayani ◽  
Arief Nurrochmad

Penggunaan warfarin dan antibiotik bersamaan diketahui dapat meningkatkan risiko perdarahan. Kejadian perdarahan mayor terkait warfarin dapat berupa perdarahan fatal hingga menyebabkan kematian. Penelitian ini bertujuan untuk menganalisis interaksi warfarin dan antibiotik dan efeknya terhadap kejadian perdarahan pada pemeriksaan pertama pasca rawat inap di RSUD Wates. Desain studi berupa kohort retrospektif pada 67 kasus penggunaan warfarin dengan/tanpa antibiotik oleh pasien rawat inap. Data berupa diagnosis, terapi, pemeriksaan pendukung, dan kejadian perdarahan saat rawat inap hingga pemeriksaan pertama diambil dari rekam medik pasien tertanggal Januari 2018 hingga September 2020. Analisis data dilakukan secara statistika menggunakan ­uji Chi-square atau uji Fisher exact test dan uji independent t-test atau uji Mann Whitney U test. Terdapat perbedaan bermakna pada kejadian perdarahan dalam waktu 7 hari pasca rawat inap antara kelompok antibiotik dan kontrol (16%; 0%; p = 0.017). Antibiotik yang digunakan oleh pasien dengan kejadian perdarahan yaitu golongan sefalosporin, kuinolon, azitromisin, dan ampisilin-sulbaktam. Kejadian perdarahan yang terjadi meliputi hematemesis melena (25%), hematuria (50%), tidak diketahui (25%). Studi ini menyimpulkan bahwa penggunaan bersamaan warfarin dan antibiotik saat rawat inap dapat berpengaruh terhadap kejadian perdarahan dalam waktu 7 hari setelah pasien dipulangkan.Penggunaan warfarin dan antibiotik bersamaan diketahui dapat meningkatkan risiko perdarahan. Kejadian perdarahan mayor terkait warfarin dapat berupa perdarahan fatal hingga menyebabkan kematian. Penelitian ini bertujuan untuk menganalisis interaksi warfarin dan antibiotik dan efeknya terhadap kejadian perdarahan pada pemeriksaan pertama pasca rawat inap di RSUD Wates. Desain studi berupa kohort retrospektif [A1] [A2] pada 67 kasus penggunaan warfarin dengan/tanpa antibiotik oleh pasien rawat inap. Data berupa diagnosis, terapi, pemeriksaan pendukung, dan kejadian perdarahan saat rawat inap hingga pemeriksaan pertama diambil dari rekam medik pasien tertanggal Januari 2018 hingga September 2020. Analisis data dilakukan secara statistika menggunakan ­uji Chi-square atau uji Fisher exact test dan uji independent t-test atau uji Mann Whitney U test. Terdapat perbedaan bermakna pada kejadian perdarahan dalam waktu tujuh hari pasca rawat inap antara kelompok antibiotik dan kontrol (16%; 0%; p = 0.017). [A3] [A4] Antibiotik yang digunakan oleh pasien dengan kejadian perdarahan yaitu azitromisin, ampisilin-sulbaktam, golongan sefalosporin, dan golongan kuinolon.[A5] [A6]  Kejadian perdarahan yang terjadi meliputi hematemesis melena (25%), hematuria (50%), tidak diketahui (25%). Studi ini menyimpulkan bahwa penggunaan bersamaan warfarin dan antibiotik saat rawat inap dapat berpengaruh terhadap kejadian perdarahan dalam waktu tujuh hari setelah pasien dipulangkan [A1]Penulis disarankan mempelajari artikel https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6398292/ untuk lebih memahami penulisan artikel dengan desain kohort. [A2]Baik, terimakasih [A3]Tampilan hasil uji dalam studi kohort (adjusted hazard ratio [AHR] = ?; 95% CI, ?; p-value = ) [A4]Tidak dilakukan analisis survival, sementara kejadian perdarahan pada control group adalah 0 sehingga RR adalah tidak terbatas [A5]Ini bukan golongan obat; untuk menghindari multitafsir..kedua obat ini ditulis di awal, sementara yang golongan obat di bagian setelahnya [A6]Sudah kami ubah redaksionalnya


2018 ◽  
Vol 26 (1) ◽  
pp. 26
Author(s):  
Baksono Winardi ◽  
Elga Caecaria Grahardika Andani

Objectives: to identify association between knowledge of pregnant women about anemia and the adherence to consume iron tablets in BPM Titik Suharti, Surabaya, IndonesiaMaterials and Methods: Observational analysis cross sectional study. Population consisted of 55 trimester pregnant women in BPM Titik Suharti, Surabaya, in March-April 2017. Samples were recruited using consecutive sampling. The number of sample was 35 respondents. Data were analyzed using chi-square test.Results: This research showed that all of the less knowledgeable women on anemia (100.00%) were non-adherent to consume iron tablets, almost all moderately knowledgeable women (92.9%) were adherent, and all of the fully knowledgeable women (100.00%) were adherent. Fisher exact test in significance level of 0.05 revealed p value equal to 0.0001, indicating association between knowledge about anemia and adherence to consume iron tablets at BPM Titik Suharti, Surabaya, Indonesia.Conclusion: There is an association between knowledge of pregnant women about anemia with adherence to iron tablets.


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