Intramuscular injection safety without aspiration in the ventro-gluteal region during vaccination: randomized clinical trial

ABSTRACT Objectives: to compare adverse events after administrating hepatitis A vaccine intramuscularly in the ventro-gluteal region between techniques with and without aspiration. Methods: randomized double-blind clinical trial, using hepatitis A vaccine (inactivated) in the ventro-gluteal region, with a sample of 74 participants in the intervention group, vaccinated with the slow injection technique without aspiration, and 74 participants in the control group undergoing slow injection with aspiration. Daily assessment of participants was carried out in the 72 hours after vaccination, in order to ascertain local, systemic adverse events, local and contralateral temperatures. Results: the occurrence of local and systemic adverse events was homogeneous between the groups in the three days after vaccination (p>0.05). There was no influence of sex, race, pre-existing disease and use of medication. Conclusions: the intramuscular vaccination technique without aspiration in the ventro-gluteal region is safe for adverse events following immunization compared to the conventional technique with aspiration.

A STUDY TO ASSESS THE EFFECTIVENESS OF HELFER SKIN TAP TECHNIQUE ON THE LEVEL OF PAIN REDUCTION DURING INTRA MUSCULAR INJECTION AMONG ORTHOPAEDIC PATIENT OF PANDIT DEEN DAYAL UPADHYAYA (CORONATION) GOVERNMENT HOSPITAL DEHRADUN UTTARAKHAND

Pain is an unpleasant sensory and emotional feeling accompanying existing or impending tissue damages or reference to such damage.According to WHO annual report more than 16 billion IM injections are administered throughout the word. Aim: This study is intended to determine the effectiveness of Helfer skin tap technique on the level of pain reduction during IM injection among orthopedic patient of PanditDeenDayalUpadhaya (Coronation)Government Hospital, Dehradun Uttarakhand. Methodology: An experimental approach with cross-over design was adopted for the study. The study samples were orthopedic patients who receiving IM diclofenac injection. There were 50 subjects that fulfill the inclusion and exclusion criteria are divided into two experimental groups (25 samples in each groups) by simple random sampling technique. The pain level was assessed by universal numerical pain rating scale .The pain level with the administration of intramuscular injection by Helfer skin tap technique was compared with a pain level with conventional Technique. Result:The result shows that in experimental group I majority of sample 52%perceived mild pain with Helfer skin tap technique whereas with majority of samples 64% perceived moderate pain with conventional technique. The mean pain score with Helfer skin tap technique was 3.88 was less than conventional technique 5.32.The obtained t value was 3.80 was significant at p<0.05 level of significance.Inexperimental group II majority of sample 64% perceived mild pain with Helfer skin tap technique whereas with majority of samples 68% perceived moderate pain with conventional technique. The mean pain score with Helfer skin tap technique was 3.52 was less than conventional technique 5.16.The obtained t value was 5.479 was significant at p<0.05 level of significance In period I the mean pain score using Helfer skin tap technique in experimental group I 3.88 was less than mean pain score of conventional technique in experimental group II 5.15.the obtained t value was found statistically significant at p<0.05 level. In period II the mean pain score using Helfer skin tap technique 3.52 was less than the mean pain scores of conventional technique 5.32.the obtained t value 4.5 was statistically significant at p<0.05 level of significance. There was no significant association found between level of pain during intramuscular injection with selected demographic variables. The overall result shows that Helfer skin tap technique was helpful in reducing the level of pain during intramuscular injection among orthopedic patients.

ROLE OF FIBRIN GLUE FOR BETTER SUCCESS RATE IN MYRINGOPLASTY

Objective: To see graft uptake success rate in platelet rich fibrin aided underlay myringoplasties using temporalis fascia graft compared to conventional underlay myringoplasties. Study Design: Double blind randomized controlled trial study. Place and Duration of Study: ENT department, Pakistan Naval Ship Shifa Hospital, from Jan to Jun 2019. Methodology: Sixty cases with dry central tympanic membrane perforations were recruited. The patients suffering from sensori-neural hearing loss and co-morbidities like diabetes were excluded. The sampling technique was probability simple random. Patients were divided into two groups by lottery method. Statistical analysis was performed by using SPSS. The chi square test was applied to calculate p-value. Results: Out of total 60 patients 38 were males and 22 were females. Study group’s (Fibrin) mean age was 31.77 ± 12.43 years and Control group’s mean age was 27.53 ± 11.41 years. All the patients in platelet rich fibrin group had successful graft uptake at 2 months follow-up. In control group with conventional technique 23 out of 30 patients had successful graft uptake and rest 7 patients had different issues leading to graft rejection. Conclusion: In under lay myringoplasty procedure, application of platelet rich fibrin on temporalis fascia graft edge and perforation edges has significantly improved the successful uptake rate of graft.

Comparison of Morphological Similarities and Differences between Liquid-Based Cytology and Conventional Techniques of Serous Effusion Cytology Specimens

<b><i>Introduction:</i></b> The aim of this study is to discover a fast and efficient method for the diagnosis of serous effusion cytology specimens by comparing the cytomorphological features of SurePath (SP) smears and smears prepared by cytospin. After the macroscopic features of the incoming material were recorded, it was divided into 2 for conventional technique (CT) and liquid-based technique. Cytospin was used for CT and SurePath for liquid-based technique in this study. <b><i>Materials and Methods:</i></b> 243 serous effusions (33 thoracentesis and 92 paracentesis fluids, 118 peritoneal lavage fluids) were investigated. After shaking the effusion gently, it was centrifuged for 5 min at 1,250 rpm for cytospin smear. SP smear was prepared according to the “BD PrepStain slide processor”. Two smears were prepared with these 2 methods and then stained with Papanicolaou. The smears were examined under a light microscope in terms of fixation, background, cellularity, nucleus, and structural features. All statistical analysis of the data was performed using the SPSS 17.0 software. For each microscopic feature, the χ² test was used to assess the significance of the relationship between cytospin and SP, and level of agreement in between the methods was assessed using the kappa statistic. <b><i>Results:</i></b> A statistically significant difference was observed between the 2 methods in background (<i>p</i> &#x3c; 0.001), cellularity (<i>p</i> &#x3c; 0.001), nucleus features (<i>p</i> &#x3c; 0.001), and structural features (<i>p</i> &#x3c; 0.05). There was no significant difference in fixation. Low level of agreement was observed with the kappa statistic in fixation, background, and cellularity. Moderate level of agreement was observed in the nucleus and structural feature groups with the kappa statistic. <b><i>Discussion/Conclusion:</i></b> Although there are advantages of liquid-based technique such as standardized fixation and cleaner background, since the cellular and background components required for morphological analysis and diagnosis are better preserved in cytospin, it is considered to be better to use liquid-based technique not alone but together with CT.

Mapping Arbitrary Logic Functions onto Carry Chains in FPGAs

Current Field Programmable Gate Arrays (FPGAs) provide fast routing links and special logic to perform carry operations; however, these resources can also be used to implement non-arithmetic circuits. In this paper, a new approach for mapping logic functions onto carry chains is presented. Unlike other approaches, the proposed technique can be applied to any logic function. The presented technique includes: (1) an architecture that is composed of blocks that implement AND and OR functions (called CANDs and CORs, respectively) by means of Look-Up-Tables (LUTs) and carry-chain resources; and (2) a mapping algorithm to reduce both the delay of the critical path and the number of used FPGA resources. The algorithm uses a heuristic to interconnect CORs and CANDs in order to reduce the delay. The problem of mapping the maxterms (or minterms) of a function to LUTs has been modelled as a Set Bin Packing (SBP) problem. Since SBP is NP-Hard, a greedy algorithm has been proposed, which is based on the First Fit Decreasing (FFD) heuristic. The results obtained have been compared with the conventional technique using both speed and area optimization. For this purpose, a large synthetic set of test cases has been generated. The proposed technique improves both the speed and area results for the vast majority of functions whose conventional implementation requires more than four logic levels. It is important to highlight that the improvement of one parameter (speed or area) is not achieved at the expense of the other.

Field Experience of an Innovative Downhole Energy Harvesting System

Downhole power harvesting is an enabling technology for a wide range of future production systems and applications, including self-powered downhole monitoring, downhole robotics, and wireless intelligent completions. This paper presents the field experience of an innovative energy harvesting system that was successfully deployed and tested in the harsh downhole conditions of an oil producer. There is a critical need for robust and reliable downhole power generation and storage technologies to push the boundaries of downhole sensing and control. This paper provides an analysis of available ambient energy sources in the downhole environment, and various energy harvesting techniques that can be employed to provide a reliable solution. Advantages and limitations of conventional technique like turbine are compared to advanced energy harvesting technologies. The power requirements and technical challenges related to different downhole applications have also been addressed. The field experience of the novel flow-based energy harvesting system are presented, including the details of both the lab and field prototype design, deployment and testing.

An In-vitro study to compare the effect of four moisture contaminants on the shear bond strength of composite resin

The success of an Endodontic treatment relies on the position and morphology of root canals. It is important for a clinician to be familiar with the canal morphology to negotiate and thereby filling the canals with an inert material. But, the possibility of negotiating the canals with the use of conventional technique alone is difficult. Hence, careful examination with the use of advanced techniques to enhance vision is required to minimize the rate of treatment failures. To compare the efficiency of three methods Cone-Beam computed Tomography (CBCT), clinical analysis, AND Dental Loupes in detecting the MB2 canal in maxillary first molars.One hundred and fifty extracted intact permanent molars were collected. Two examiners i.e., one Endodontist and a Radiologist examined CBCT images of teeth for the number and position of root canals. The first stage included unaided examination using an explorer and K- files. While those teeth that were failed to locate the canals were examined using dental loupes for better magnification. The results were analyzed by McNemar's tests with Bonferroni correction, and Chi-square test using SPSS software v21.Among 150 extracted teeth that were compared,MB2 was detected using CBCT in around 68% of the teeth, while with the use of naked eye and dental loupes, it was found to be around 30% and 66% respectively and the difference in the detection rates was statistically significant.With the view of the parameter under consideration, CBCT has high detection rates followed by dental loupes and naked eye vision. The efficiency of CBCT scans and dental loupes in detecting a second mesio-buccal canal, Thus making it more likely to be treated by the clinician.

Minimizing the risk of fracture of definitive casts for removable partial dentures: A dental technique

A technique is described to facilitate impression making and safely obtain the definitive cast for removable partial dentures with long, retentive, or lone-standing abutment teeth. Firstly, the individualized stock tray receives a coating of melted wax. Next, the prepared teeth are impressed with irreversible hydrocolloid, and the set impression is removed from mouth. The mold is then poured conventionally and, after the gypsum has set, is immersed in hot water to soften the wax and allow removal of the tray. The impression material is carefully cut away with a scalpel blade to expose the cast. With these straightforward and easily made changes compared with the conventional technique, the risk of fracturing the definitive cast is minimized, especially when reproducing long retentive teeth. A dental technique is presented that uses wax to coat the impression tray to facilitate the passive displacement of the cast. This results in a straightforward and precise definitive cast for removable partial dentures.

Experience Study on Long-Life Microsurfacing with High Water Resistance Performance

Microsurfacing is a standard preventive maintenance technology developed on the basis of slurry sealing technology. However, the high temperature and rainy season in Guangdong Province affect its expanded application because of its low water resistance and short service life. So, high-performance microsurfacing, a new microsurfacing technology, has been developed. The key to this technique is an appropriate proportion of water-based epoxy resin and waterborne epoxy curing agent, which could generate a chemical reaction to form a high-performance bonding network structure of space. And indoor wet-wheel wear test shows that its antiwear ability and resistance to water damage are evidently increased (to over 50%) compared with the conventional microsurfacing. Furthermore, from the long-term road performance results, the antisliding and water resistance performance of high-performance microsurfacing is much higher than the conventional technique.

CORRECCIÓN DEL DESPLAZAMIENTO ABOMASAL IZQUIERDO POR VIDEOLAPAROSCOPÍA

Correction of left abomasal displacement by video laparoscopy. This article reviews the benefits of the laparoscopic abomasopexy used for correction and fixation of the left abomasal displacement in dairy cows. The first steps are similar to the conventional technique, with sedation, analgesia and antisepsis. Two small flank incisions were made, the first one is about 10 centimeters ventral to the lumbar transverse processes in the cranial aspect of the left paralumbar fossa, and the second one, more cranial than the other and is located 7 cm ventral to the transverse processes of the lumbar vertebrae in the left 11th intercostal space, these two are the entry points of instruments and optics. This technique allows us to shorten the surgical time, reducing the tissue exposure time, the possibility of intra and post-surgical infections and iatrogenic injuries. Therefore, we saw that the recovery time was shorter; and a quick return to production is guaranteed due to the low use of antibiotics.