DRAIN VERSUS NO DRAIN AFTER LAPAROSCOPIC CHOLECYSTECTOMY-A COMPARATIVE STUDY.

INTRODUCTION Gallstones are the most common conditions encountered in surgical OPD. The prevalence rose with age, except in women of 40-49 years, so that at 60-69 years, 22.4% of women and 11.5% of men had gall stones or had undergone cholecystectomy. With the help of this study, best treatment option for cholecystectomy patient (whether to insert drain or not), was ensured in terms of post lap cholecystectomy collections of bile or blood, drain site pain. The study was provide knowledge whether drain insertion was benecial or harmful to patient. MATERIALS AND METHODS This comparative study was presented to the surgery OPD and emergency department with cholelithiasis within a period of 1 year from the approval of Research committee and Ethics Committee, Adesh institute of medical sciences and research, Bathinda. The primary outcome variable used to calculate sample size is amount of collection on post-operative day 3(Quantitative Variable) in both groups. Total 100 patients were present in this study. RESULT In this present study VAS median grade in patients with drain was G4 (48%), followed by G3(47%) then G2(5%). VAS median grade in without drain group was G2 (48%), followed by G3(31%) and G1(16%). CONCLUSION There is no signicant difference as far as post operative wound infection in laparoscopic Cholecystectomy with drain or without drain. Therefore in patients undergoing laparoscopic cholecystectomy keeping drain can be avoided as it does not provide any additional benet.

Peak expiratory flow rate in children aged 6 to 14 years

Background: The objective of this study was to record the PEFR values in children aged between 6 to 14 years.Methods: A cross sectional study was conducted among 1205 children aged 6 to 14 years in department of paediatrics at a medical college hospital. In a pre-structured questionnaire, the age, sex and PEFR values were recorded. PEFR was considered as primary outcome variable. SPSS version 20 was used for data analysis.Results: Total of 1205 children, 51% were boys and 49% were girls. Ninety children of age 6 years ranged between 60 to 200 with 111.1±29.4 and 7 years ranging from 70 to 210 with 136.3±30.5. One hundred and five of age 8 years had 156.9±33.3 ranging from 90 to 230 and 126 of age 10 years with 195.7±38.8 ranging from 110 to 290. Mean PEFR for boys increased with their age and was greater than girls.Conclusions: The overall mean PEFR values for the age group 6 to 14 years was 225±90.07 l/min. Boys have higher PEFR value than girls of the same age group. Hence, PEFR values in this study can be used clinically as reference value for children aged 6 to 14 years.

A Family-Based Lifestyle Intervention Focusing on Fathers and Their Children Using Co-Creation: Study Protocol of the Run Daddy Run Intervention

Fathers play a unique and important role in shaping their children’s physical activity (PA), independent from the mother. Lifestyle interventions focusing simultaneously on PA of fathers and their children (“co-PA”) are therefore a novel and promising way to improve PA of both. A theory-based lifestyle intervention was co-created with fathers (i.e., the Run Daddy Run intervention), using the behavior change wheel as a theoretical framework. The aim of the present study is to describe the protocol of the Run Daddy Run intervention study, focusing on improving (co-)PA of fathers and children, and the prospected outcomes. The developed intervention consists of six (inter)active father-child sessions and an eHealth component, delivered over a 14-week intervention period. Baseline measurements will be conducted between November 2019–January 2020, post-test measurements in June 2020, and follow-up measurements in November 2020, with (co-)PA as the primary outcome variable. Outcomes will be measured using accelerometry and an online questionnaire. To evaluate the intervention, multilevel analyses will be conducted. This study will increase our understanding on whether a theory-based, co-created lifestyle intervention focusing exclusively on fathers and their children can improve their (co-)PA behavior and has important implications for future research and health policy, where targeting fathers might be a novel and effective approach to improve (co-)PA and associated health behaviors of both fathers and their children.

The Implementation of COVID-19 Social Distancing Measures Changed the Frequency and the Characteristics of Facial Injury: The Newcastle (Australia) Experience

Study Design: A retrospective study was undertaken of a cohort of facially injured patients using matched 8-week periods: non-COVID (2019) and COVID (2020). Objective: To determine whether there were any changes to the frequency and characteristics of facial injury due to the imposition of COVID-19 social distancing measures. Methods: The primary predictor variable was an 8-week period of COVID-19 social distancing. The primary outcome variable was the sustaining of a facial injury. Demographic (age/gender) and injury characteristics (mechanism, site, and treatment) were also studied. Descriptive statistical analysis was undertaken and comparison made using Pearson χ2 and Fisher’s exact tests. Results: The number of facial injuries decreased from 103 (2019) to 73 (2020). There were statistically significant differences in changes over time for the 8-week periods. There were some clinically apparent differences seen in the characteristics of facial injuries. Conclusions: The imposition of COVID-19 social distancing changed the frequency and characteristics of facial injury.

It Does Matter If You Win or Lose, and How You Play the (Video) Game

Most violent video game (VVG) research focuses on aggressive behaviors as the primary outcome variable of interest. Using pro-social behavior as the dependent variable, this study explores factors beyond VVG content as a contributing factor to player outcomes. Participants were randomly assigned to play VVG or non-VVG content with viewing screens obstructed by large pieces of paper to increase difficulty, or unobstructed. Screen condition accounted for 34.5% of the variance in pro-social behavior of helping to retrieve spilled pens. Players in obstructed viewing conditions experienced more in-game losses and engaged in significantly less helping behavior. Fewer pens were retrieved by participants in obstructed viewing conditions while playing either a VVG or non-VVG. The present study cautions against generalized assumptions that VVG content is a primary determinant of behavior and underscores the role of important contextual factors like failure and achievement loss to consider in future studies of this nature.

Compliance with 14 day zinc therapy for acute diarrhoea: a prospective observational study

Background: Acute diarrheal diseases remain a leading cause of global morbidity and mortality in young children. The effective implementation of provision of zinc in addition to low osmolarity ORS remains very poor.Methods: A prospective observational study was done to determine compliance with zinc therapy on 103 children aged between two months to five years with acute gastroenteritis. They were started on WHO ORS and zinc in the form of syrup (20 mg/day in those >6 months of age and 10mg/day in those <6 months of age) and advised to continue for 14 days. Further episodes of diarrhea was considered as the primary outcome variable. Number of days zinc taken was considered as the primary explanatory variable. p-value <0.05 was considered statistically significant.Results: The mean age was 19.49±14.41 months. The compliance to complete 14-day zinc therapy was 62.14%. The mean number of days zinc was taken was 11.28±3.81 days. In 11.65% of participants, there was further episodes of diarrhea. The main reasons for discontinuation were diarrhea stopped (45%), Ignorance (37.5%), URI (12.5%).Conclusions: Findings indicate that the syrup formulation is acceptable, but further efforts are required to enhance adherence. These findings also highlight the importance of guiding in ensuring adherence to zinc duration while also addressing the tendency of caregivers to terminate treatment once a child appears to have recovered from an acute diarrheal episode.

Effectiveness of the Volunteer Family Connect Program in Reducing Isolation of Vulnerable Families and Supporting Their Parenting: Randomized Controlled Trial With Intention-To-Treat Analysis of Primary Outcome Variables

Background Volunteer home visiting is a widely adopted community-based approach to support families by linking isolated or vulnerable families with community volunteers who visit their homes weekly over approximately 12 months. This study seeks to robustly evaluate the effectiveness of this model of support for families with young children. Objective This paper reports the intention-to-treat analysis of primary and secondary outcomes for a pragmatic randomized controlled trial (RCT) of the Volunteer Family Connect intervention, a volunteer home-visiting program designed to support families with young children who experience social isolation or a lack of parenting confidence and skills. Methods The RCT was conducted across seven sites in Australia. Overall, 341 families were recruited: 169 intervention (services as usual+volunteer home visits) and 172 control (services as usual) families. Intervention families received the program for 3-12 months. Participants were invited to complete six data collection points over a 15-month period. Primary outcomes were community connectedness and parenting competence. Secondary outcomes included parent physical and mental health, general parent wellbeing, parent empowerment, the sustainability of family routines, and the parent-child relationship. According to the protocol, the program would be judged to be effective if at least one of the primary outcomes was significantly positive and the other was neutral (ie, intervention families did not demonstrate positive or negative outcomes compared to the control group). Results The intervention group demonstrated significant improvement in the primary outcome variable parenting sense of competence as compared to the control group. Overall, there was no significant difference between the intervention and control groups with regard to the primary outcome variable community connectedness, other than on the “Guidance” subscale of the Social Provisions Scale. Because there were statistically significant findings for the total score of one primary outcome variable “parenting sense of competence” and largely neutral findings for the primary outcome variable “community connectedness,” the program met the previously defined criteria for program effectiveness. In relation to secondary outcomes, intervention families reported significantly higher wellbeing and were significantly more likely to feel that life was improving. Conclusions The Volunteer Family Connect intervention was considered an effective intervention, with a role to play on the landscape of services available to support vulnerable families with young children. Trial Registration Australian New Zealand Clinical Trial Registry ACTRN12616000396426; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=370304

A Systematic Review of the Tensile Strength of Surgical Sutures

Suturing the wound provides temporary mechanical support enabling natural tissue healing. Understanding the inherent material properties of the suture materials facilitates clinical adjustments in the rate of degradation to ensure proper wound healing. This review aimed to summarize the analysis of the factors that contribute to the tensile strength of surgical sutures and the implications of these factors in wound healing. Our initial search criteria used keywords Tensile or Strength or suture material and returned 494 potentially related articles, these were narrowed to just seven key articles pertaining to the analysis of the primary outcome variable which are reviewed in detail here. The physical properties of these materials are substantially affected by the biological conditions of the model system during the period of analysis. Nevertheless, under in vivo conditions decisions on suture materials should take comorbidities like dietary habits, smoking, oral hygiene maintenance into account as they can all have a significant impact on the prevailing physiological conditions at the wound site.