Effect of Intraoperative Valsalva Maneuver Application on Bleeding Point Detection and Postoperative Drainage After Thyroidectomy Surgeries

The purpose of this paper was to analyze the effect of Valsalva maneuver application before finalizing thyroidectomy operations on the identification of bleeding points and postoperational drainage. One hundred patients (age range, 24–76 years) with multinodular goiter, recurrent multinodular goiter, toxic diffuse multinodular goiter, or papillary thyroid cancer were included in the study and were divided into 2 groups of 50 randomly. Both groups underwent thyroidectomy operation, only 1 group received intraoperative Valsalva maneuver application (twice, 30 seconds of 30-cm PEEP). The size of the thyroid gland, the duration of operation, hospital stay, and drain usage were reported. Postoperational occurrences of drainage, hematoma, reoperation, and additional complications were compared between the groups. Valsalva maneuver application helped to identify minor bleeding points in 32% of the cases. There was no significant difference between the study groups regarding the thyroid gland size, operation duration, hospital stay, and the duration of drain usage (P > 0.05 for all). The amount of drainage as well as the frequencies of hematoma, reoperation, and further complications was not significantly different between the study groups (P > 0.05 for all). Intraoperative application of Valsalva maneuver is only useful to detect minor bleeding points in some patients during thyroidectomy operations, but it had no effect on the duration of postoperative drain usage, the amount of drainage, and risk of hematoma. Therefore, intraoperative application of Valsalva maneuver has no beneficial effect on postoperative hemorrhagic complication after thyroidectomy operations.

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A Comparative study of the results of conservative treatment versus closed titanium elastic nailing for fractures of shaft of femur in children

Asian Journal of Medical Sciences ◽

10.3126/ajms.v8i4.17248 ◽

2017 ◽

Vol 8 (4) ◽

pp. 32-37

Author(s):

Kunal Subhas Mukherjee ◽

Amar Nath Gupta

Keyword(s):

Hospital Stay ◽

Weight Bearing ◽

Psychological Impact ◽

Femoral Shaft ◽

Study Groups ◽

Shaft Fracture ◽

First Year ◽

Titanium Elastic Nailing ◽

Significant Difference ◽

Lost To Follow Up

Background: The ideal treatment of femoral shaft fracture in children is defined as one that controls alignment and length, is comfortable for child and convenient for family and causes the least psychological impact possible.Aims and Objective: The current study was designed to evaluate outcomes prospectively in the first year following treatment of a diaphyseal femoral fracture in children between five and ten years of age treated randomly either by intramedullary titanium elastic nailing or by traction followed by spica cast.Materials and Methods: Out of 48 cases selected according to inclusion/exclusion criteria 6 patients were lost to follow up. Among the rest of 42 patients, 23 were treated by intramedullary titanium elastic nailing and the other 19 conservatively by surface traction. The patients were evaluated at the regular interval of 2, 4, 6 and 8th week post operatively and thereafter every month.Results: There was a significant difference (p< 0.001) in terms of mean hospital stay and mean weight bearing between the two study groups. The findings of outcome and maintenance of reduction, time taken for the evidence of union to appear, the range of movements, the time when weight bearing can be allowed, the functional return of the limb, the rate of complications and the number days of hospital stay were comparable to similar studies conducted earlier.Conclusion: The study concludes that closed pediatric femoral shaft fractures within the ages of 5-10 years can be treated successfully by any methods of traction followed by spica cast or intramedullary titanium elastic nailing. However, because of shorter immobilization period and earlier ambulation, internal fixation with titanium elastic nailing is recommended as the better choice to treat this fracture in school going children.Asian Journal of Medical Sciences Vol.8(4) 2017 32-37

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A Comparative Study of Valsalva Maneuver, Lidocaine, and Valsalva Maneuvers with Administration of Lidocaine to Reduce the Pain Associated with Administration of Etomidate During General Anesthesia

Anesthesiology and Pain Medicine ◽

10.5812/aapm.113408 ◽

2021 ◽

Vol In Press (In Press) ◽

Author(s):

Behzad Nazemroaya ◽

Omid Aghadavodi ◽

Azim Honarmand ◽

Sarina Ahmadian

Keyword(s):

Clinical Trial ◽

Pain Intensity ◽

Significant Relationship ◽

Valsalva Maneuver ◽

Statistical Tests ◽

Study Groups ◽

Demographic Variables ◽

Lidocaine Group ◽

Significant Difference ◽

Group 1

Objectives: The purpose of this study is a comparison of Valsalva, lidocaine, and Valsalva with administration of lidocaine to reduce the pain associated with administration of etomidate. Methods: The present study is a clinical trial study. The number of samples in each group was 30 and a total of 90 people were selected. This study was a clinical trial and the subjects were randomly divided into three groups: Group 1: Valsalva, 2: Lidocaine, 3: Valsalva and Lidocaine. Pain due to etomidate was rated on a VAS from 1 (painless) to 3 (worst imaginable pain) and their information was recorded. The collected information was entered into SPSS 22 and analyzed with appropriate statistical tests. Results: A total of 90 subjects participated in the present study and were divided into 3 groups: Valsalva, lidocaine, and Valsalva with lidocaine. No significant difference was observed between demographic variables in the study groups. There was a significant relationship between severity of pain in the three groups. According to the results, the highest pain intensity was in the Valsalva group and the lowest pain intensity was in the Valsalva with lidocaine group. Conclusions: Valsalva with lidocaine reduces the severity of pain caused by etomidate to a greater extent than other groups.

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Autologous Peripheral Blood Progenitor Cells Cryopreserved in 7.5% DMSO Give Faster Hematopoietic Reconstitution Than Cells Cryopreserved in 10% DMSO.

Blood ◽

10.1182/blood.v120.21.3018.3018 ◽

2012 ◽

Vol 120 (21) ◽

pp. 3018-3018

Author(s):

Iwona Mitrus ◽

Andrzej Smagur ◽

Sebastian Giebel ◽

Joanna Gliwinska ◽

Magdalena Prokop ◽

...

Keyword(s):

Hospital Stay ◽

Progenitor Cells ◽

Peripheral Blood ◽

Conflicts Of Interest ◽

Study Groups ◽

Platelet Recovery ◽

Peripheral Blood Progenitor Cells ◽

Significant Difference ◽

Dmso Concentration

Abstract Abstract 3018 Background: Cryopreservation of autologous peripheral blood progenitor cells (PBPCs) in 10% DMSO is a routine in most transplantation centers. During ASH 2011 Meeting, we presented the results of in vitro research, concerning the optimization of DMSO concentrations for recovery and clonogeneic potential of PBPCs after thawing. We concluded, that reduction of DMSO concentration from 10% to 7.5% may have favorable impact for cell clonogeneicity. Accordingly, we implemented new cryoprotective mixture (7.5% instead of 10% DMSO) into clinical practice. The purpose of this study was to clinically evaluate the changed protocol. Patients and Methods: In our department, between Jan 2012-Aug 2012, 56 patients were transplanted with autologous PBPCs cryopreserved in 7.5% DMSO solution (median of age: 57 years, range: 21–66). We compared the data concerning hematopoietic engraftment and the frequency of side effects with historical control – 52 subsequent patients treated with transplantation of PBPSc cells cryopreserved in 10% DMSO (median of age: 57 years, range: 21–66) in a preceding period. Both study groups did not differ significantly with regard to the diagnosis (mostly lymphoproliferative disorders) or disease status at transplantation. As well, the number of transplanted CD34+ cells was comparable: median 6.5′106/kg (range 1.5–24.7) for 7.5% DMSO and 7.5′106/kg (2.1–24.6) for 10% DMSO group, p=0.68. All received G-CSF (filgrastim) starting on day +7 after transplantation. Results: The volume of infused DMSO was significantly lower in patients who obtained PBPBc cryopreserved in 7.5% DMSO (median 22.5 ml, range 7.5–45) than 10% DMSO (median: 30 ml, range, 10–160); p=0.02. The time to leukocyte recovery >1′109/L was faster for 7.5% DMSO (median: 11 days, range: 9–12) than in 10% DMSO (median 11 days, range: 10–13), p=0.03. Similarly, reconstitution of neutrophils >0.5′109/L was faster for 7.5% DMSO group: median 11 days (range 9–13 days) vs. 11 days (range 10–13 days), respectively; p = 0.04. We didn't observe significant difference with regard to platelet recovery >50′109/L (median 12 days, range: 0–21 days for 7.5% DMSO vs. median 12.5, range: 0–19 days for 10% DMSO). Hospital stay since HSCT was shorter in case of 7.5% group (median: 14 days, range: 11–21) than 10% group (median: 15 days, range: 13–25); p=0.04. Number of RBC and platelets transfusions as well as transfusion-related complications did not differ between the groups. Adverse events after transplantation were mild and transient, usually grade 1 nausea, and occurred in 20 (38%) patients in 10% DMSO group compared to 24 (43%) in 7.5% DMSO group (p=0.7). Conclusions: The analysis of newly implemented cryopreservation protocol suggest that reduction of the DMSO concentration from 10% to 7.5% is associated with faster leukocyte and neutrophil recovery as well as shorter hospital stay. These findings require verification in a prospective, randomized trial. Disclosures: No relevant conflicts of interest to declare.

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Laparoscopic Treatment of Hydatid Liver and Pancreas Disease: Some Technical Aspects and Importance

Acta Medica ◽

10.32552/2021.actamedica.581 ◽

2021 ◽

pp. 1-6

Author(s):

Elbrus Zarbaliyev ◽

Murat Sevmis ◽

Dauren Sarsenov ◽

Payam Hacisalihoglu ◽

Mehmet Caglikulekci

Keyword(s):

Hydatid Cyst ◽

Hospital Stay ◽

Large Diameter ◽

Case Series ◽

Study Groups ◽

Complication Rates ◽

Treatment Protocols ◽

Significant Difference ◽

Duration Of Surgery ◽

Surgical Data

Objective: Hydatid cyst disease is a widespread zoonotic disease infecting humans as an intermediate host. Since the first description of this pathology, many modalities have been introduced into modern treatment protocols. Minimally invasive surgical treatment is well-described and widely used, but has many points where rationalization and modification can be applied. In this case series, we describe small differences in surgical technique and the corresponding treatment results. Materials and Methods: Out of 44 patients, 16 were included in this study. Patients were retrospectively evaluated in two groups in accordance with the preferred cyst aspiration technique, i.e. via a standard laparoscopic aspirator or a large diameter venous catheter (the control and study groups, respectively). Demographic, clinical and surgical data like duration of surgery, hospital stay and complication rates were evaluated in both groups. Results: Equal numbers of males and females participated, with a median age of 40 years. Most patients had a type III hydatid cyst (n=11, 68.75%). Surgery duration and hospital stay were significantly shorter in the study group, without a significant difference in terms of complication rates. Conclusion: Laparoscopic procedures quickly became plausible for selected hydatid cysts located in liver. Success of such procedures shows to be depending on the success and duration of the laparoscopic intervention. The latter, according to our calculations, seems to be inversely proportional to the diameter of the aspirator tip and its piping.

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Prognostic Factors and Association of Inflammatory Biomarkers with Severity and Mortality in COVID-19

Journal of Bahria University Medical and Dental College ◽

10.51985/jbumdc054 ◽

2021 ◽

Vol 12 (01) ◽

pp. 25-30

Author(s):

Hamzullah Khan ◽

Shahtaj Khan ◽

Huma Riaz ◽

Asad Rehman Khattak

Keyword(s):

Hospital Stay ◽

Blood Group ◽

Inflammatory Markers ◽

Study Groups ◽

Male Gender ◽

Inflammatory Biomarkers ◽

Age Range ◽

The Impact ◽

B Blood Group ◽

D Dimer

Objectives: To determine prognostic values and association of inflammatory markers with severity and mortality in COVID- 19 in a hospital based study. Study design and setting: This retrospective study was conducted from 1st June 2020 to 30th Sept 2020 in Department of Pathology, Qazi Hussain Ahmed Medical Complex, Nowshera and Medical Teaching Institute, Hayatabad Medical complex Peshawar. Methodology: Out of 215, 71 cases were selected that had all relevant information’s on chart available in Blood bank and department of Pathology. Results: Out of 71 patients, 54 (76.1%) were males and 17 (23.9%) females. Thirty five (49.3%) had age>55 years while 31 (43.7%) were in age range 36-55 years. The frequency of the different blood groups were; 25 (35.2%) B+ blood group followed by 19 (26.8%) A+ and 14 (19.7%) O+ blood group. The AUC for d-dimers was (0.725, 95% CI 0.599-0.855) followed by CRP (0.565 95%CI 0.422-0.7.8) and ferritin (0.519 95%CI 0.36-0.679). The median values of d-dimers was significantly higher in the deceased as compared to the survivors (p<0.05- Mann Whitney U test).The CRP and ferritin levels were not significantly different in study groups. There was a significant positive uphill correlation of the hospital stay with higher values of d-dimers (p=0.01, rs= 0.287). Conclusion: D-dimer is a main prognostic factor that predicts mortality in COVID-19 followed by CRP and serum ferritin levels. Male gender and patient with age>60 are at risk of worst outcome under the impact of deranged values of inflammatory mediators. Hospital stay and blood group of patients have no relation with outcome

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Effect of Chewing Gum on Bowel Motility in Women Undergoing Post-Operative Cesarean Section

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol03-i06/04 ◽

2018 ◽

Vol 3 (06) ◽

Author(s):

Dr.Randa Mohammed AboBaker

Keyword(s):

Cesarean Section ◽

Hospital Stay ◽

Demographic Data ◽

Length Of Hospital Stay ◽

Chewing Gum ◽

Control Group ◽

Controlled Clinical Trial ◽

Bowel Motility ◽

Gum Chewing ◽

Significant Difference

Postoperative Ileus (POI) is one of the most common problems after obstetrics, gynecologic and abdominal surgeries. Sham feeding, such as gum chewing, accelerates the return of bowel function and the length of hospital stay. The present study aims to evaluate the effect of chewing gum on bowel motility in women undergoing post-operative cesarean section. Intervention study was used at the Postpartum Department of Maternity and Children Hospital, KSA. A randomized controlled clinical trial research design. Through a convenience technique, 80 post Caesarian Section (CS) women were included in the study. Data were collected through three tools: Tool (I): Socio-demographic data and reproductive history interview schedule. Tool (II): Postoperative Assessment Sheet. Tool (III): Outcomes of gum chewing and the length of hospital stay. Method: subjects were assigned randomly into two groups of (40) the experimental and (40) the control. Subjects in the study group were asked to chew two pieces of sugarless gum for 30 min/three times daily in the morning, noon, and evening immediately after recovery from anesthesia and in Postpartum Department; while subjects in the control group followed the hospital routine care. Each woman in both groups was tested abdominally using a stethoscope to auscultate the bowel sounds and asked to report immediately the time of either passing flatus or stool. Results: illustrated that a highly statistically significant difference was observed between the two groups concerning their gum chewing outcomes. Where, P = 0.000. The study concluded that gum chewing is safe, well tolerated and appears to be effective in reducing the incidence and consequences of POI following CS.

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Pengaruh Penggunaan Model Pembelajaran dan Konsep Diri terhadap Kemampuan Berpikir Kretif Mahasiswa

Formatif Jurnal Ilmiah Pendidikan MIPA ◽

10.30998/formatif.v3i3.129 ◽

2015 ◽

Vol 3 (3) ◽

Cited By ~ 1

Author(s):

Nurul Hikmah

Keyword(s):

Significant Interaction ◽

Creative Thinking ◽

Study Groups ◽

Learning Model ◽

Descriptive Statistics ◽

Self Concept ◽

Significant Interaction Effect ◽

Significant Difference ◽

Written Test ◽

Self Learning

<p>The purpose of this study were to determine: 1) the influence of the learning <br />model of creative thinking; 2) the influence of self-concept to think creatively, and 3) the influence of the interaction and the concept of self-learning model for creative thinking. The research method used was experimental method. A sample of 80 people selected at random from the 13 study groups. The data was collected by administering a written test questions to measure variables studied. Data analysis using descriptive statistics and 2-way ANOVA. The results showed: 1) a significant difference to the learning model with the ability to think creatively sig = 0.000; 2) there is a significant effect of self-concept of <br />the ability to think creatively with sig = 0.000, and 3) there is a significant interaction effect of learning model and self-concept of the ability to think creatively with sig = 0.018. </p>

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Determination of Spreading Motive Levels of Elite Hearing-impaired Sportsmen

SPORT AND SOCIETY ◽

10.36836/uaic/fefs/10.34 ◽

2019 ◽

pp. 39-55

Author(s):

Osman Kusan ◽

Hasan Erdem Mumcu ◽

Abdulkerim Çeviker ◽

Ömer Zambak ◽

Onur Öztürk

Keyword(s):

Educational Status ◽

Hearing Impaired ◽

Validity And Reliability ◽

Male Athletes ◽

Internal Motivation ◽

National Team ◽

Older Athletes ◽

Significant Difference ◽

Level Of Significance ◽

Age Range

This study was conducted to investigate the sub-scales of sports instructions of elite athletes with hearing impairment or hearing loss due to different reasons. A total of 173 hearing-impaired athletes constituted of 54 female and 119 male athletes who are active national team athletes in the age range of 15-25 years. The study was conducted based on Self Determination Theory of Deci and Ryan [9] and on the developed Sports Motivation Scale, Pelletier et al. [24] Kazak [18] applied the validity and reliability of the scale for Turkish athletes. Accordingly, since the p_values calculated for the inner motivation sub-scale and its sub-scales are less than the value of α = .05 which is taken as the level of significance, there is a statistically significant difference in the average scores of the hearing-impaired athletes in their internal motivations and sub-scales. According to gender and educational status, there was no difference in the motivation of the hearing-impaired athletes. According to the age variable, it was seen that older athletes had more external connections. Considering the general motivation scores, the athletes in tennis and swimming were less motivated than others. Elite hearing-impaired athletes are affected by both internal and external impulses. However, internal motivation scores are higher than the external. Internal motivation scores are seen as the lowest in the branch swimming area.

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The Significance of Renal Function in Response to Cardiac Resynchronisation Therapy – The Piece of a Much Larger Puzzle

Current Vascular Pharmacology ◽

10.2174/1570161118666200414103432 ◽

2020 ◽

Vol 18 ◽

Author(s):

Agnieszka Dębska-Kozłowska ◽

Izabela Warchoł ◽

Marcin Książczyk ◽

Andrzej Lubiński

Keyword(s):

Renal Function ◽

Nyha Class ◽

Heart Association ◽

Cardiac Resynchronisation Therapy ◽

Study Groups ◽

Creatinine Concentration ◽

Significant Difference ◽

Cardiac Resynchronisation ◽

Resynchronisation Therapy

Background: Although cardiac resynchronisation therapy (CRT) is an important player in the treatment of heart failure (HF) patients, the proportion of CRT patients with no improvement in either echocardiographic or clinical parameters remains consistently high and accounts for about 30% despite meeting CRT implantation criteria. Furthermore, in patients suffering from HF, renal dysfunction accounts for as many as 30-60%. Accordingly, CRT may improve renal function inducing a systemic haemodynamic benefit leading to increased renal blood flow. Objectives: The aim of the present study was to evaluate the importance of renal function in response to resynchronisation therapy during a 12-month follow-up period. Materials and methods: The study consisted of 46 HF patients qualified for implantation of cardiac resynchronisation therapy defibrillator (CRT-D). A CRT responder is defined as a person without chronic HF exacerbations during observation whose physical efficiency has improved owing to New York Heart Association (NYHA) class improvement ≥1. Results: A statistically significant difference was noted between responders and non-responders regarding creatinine level at the 3rd month (p=0.04) and, particularly, at the 12th month (p=0.02) of follow-up (100±23 vs 139±78 μmol/l). Moreover, there was a remarkable difference between both study groups with regard to GFR CKD-EPI (glomerular filtration rate (GFR) assessed using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula) at the 6th (p=0.03) and 12th month (p=0.01) of follow-up. The reference values for initial creatinine concentrations (101 μmol/l) as well as GFR CKD-EPI (63 ml/min/1.73m2 ) were empirically evaluated to predict favourable therapeutic CRT response. Conclusions: Predictive value of GFR CKD-EPI and creatinine concentration for a positive response to CRT were found relevant.

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Success Rate of Obturation of Root Canals by Different Techniques in Primary Molars: A Comparative Clinical Study

Current Dentistry ◽

10.2174/2542579x02999200503032916 ◽

2020 ◽

Vol 2 (1) ◽

pp. 36-44

Author(s):

Satyawan G. Damle ◽

Ritika Bansal ◽

Dhanashree D. Sakhare

Keyword(s):

Success Rate ◽

Study Groups ◽

Primary Molars ◽

Control Group ◽

Second Primary ◽

Chi Square ◽

Exact Test ◽

Root Canals ◽

Significant Difference ◽

Comparative Clinical Study

Objective: To compare the success rate of different obturation procedures in primary mandibular second molars clinically and also by digital radiovisiography. Methods: A total of 40 children aged between 4-8 years with deeply carious mandibular second primary molars indicated for single session pulpectomy were selected. Canals were obturated with Metapex. The 3 study groups (Endodontic plugger, Handheld lentulospiral, Navi Tip syringe) were compared with the control group (reamer) both clinically and radiovisiographically. The data collected were statistically analyzed using Pearson’s Chi-square and Fisher’s exact test. Results: The use of Navi tip syringe led to the least number of voids followed by Endodontic plugger and Reamer and the highest number of voids was reported with Lentulospiral. Navitip presented maximum number of optimally filled cases followed by Endodontic plugger and Lentulospiral and least number of optimally filled cases with reamer. However, there was no statistically significant difference (p>0.05) in any of the groups with clinical (pain and tenderness to percussion) and radiographic parameters (presence or absence of voids and length of obturation). Conclusion: Within the limitations of the present study, though the clinical outcome was statistically insignificant, Navitip syringe exhibited encouraging results and is a promising option for obturation in primary teeth.

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