Effectiveness of Hypnoanalgesia in Paediatric Dermatological Surgery

Background and objective. Stress in surgical settings has subtle psychological and physiological repercussions in children. The objective is to evaluate whether hypnosedation is effective in reducing the doses of sedation and analgesia required during the periprocedural period in children undergoing dermatological surgery, without negatively affecting pain and satisfaction. Patients and methods: A prospective, longitudinal, observational study where paediatric patients (aged 5–16 years) scheduled for dermatological surgery were analysed according to whether they received hypnosis or distraction during surgery (both common procedures at the centre). As outcome measurements we used sedation doses (propofol) during surgery and the need for analgesia; pain assessment post-surgery and at 24 h using a visual analogue scale (VAS) or revised face pain scale (FPS-r) (both 0–10) depending on age, as well as patient and guardian satisfaction (on a scale of 0–10). Results: Of the 68 patients eligible during the follow-up period, 65 were included. Of these, 33 were treated with hypnosis and 32 with distraction. Children who underwent hypnosis required less total propofol (45.5 ± 11.8 mg vs. 69.3 ± 16.8 mg; p < 0.001) and metamizole in the immediate postoperative period (34.4% vs. 65.6%; p = 0.018). After 24 h, they required less ibuprofen (9.1% vs. 28.1%; p = 0.048) and paracetamol (48.5% vs. 75.0%; p = 0.028). Mean pain according to VAS or FPS-r at 24 h was 3.1 with hypnosis vs. 4.3 with distraction (p < 0.001). Overall satisfaction was higher in the hypnosis group (8.7 ± 0.1 vs. 8.1 ± 0.2; p = 0.009). Conclusions: Hypnoanalgesia in children undergoing dermatological outpatient surgery could not only reduce sedation and analgesia requirements, but also improve child and guardian(s) satisfaction.

PENGARUH SENAM YOGA TERHADAP NYERI HAID PADA REMAJA PUTRI KELAS X MAN 2 KOTA PROBOLINGGO (Di Madrasah Aliyah Negeri 2 Kota Probolinggo)

Masa remaja berhubungan dengan suatu fenomena fisik yang berhubungan dengan pubertas. Pubertas merupakan suatu bagian penting dari masa remaja yang lebih menekankan proses biologis yang mengarah pada kemampuan reproduksi. Pada saat ini perempuan akan mengalami ovulasi dan menstruasi yang terkadang juga disertai nyeri haid (dysmenorrhea). Berdasarkan Studi Pendahuluan yang dilakukan peneliti didapatkan hasil wawancara dari 15 siswi, terdapat 13 siswi yang mengalami dysmenorrhea. Penelitian ini bertujuan untuk mengetahui Pengaruh Senam Yoga terhadap Nyeri Haid pada Remaja Putri Kelas X MAN 2 Kota Probolinggo. Jenis penelitian ini adalah pra eksperimental dengan rancangan one group pretest posttest design. Populasi penelitian ini adalah seluruh siswi kelas X MAN 2 Kota Probolinggo yang berjumlah 172 siswi. Sampel penelitian ini sejumlah 35 siswi dengan tekhnik sampling Proportional Random Sampling. Variable independent adalah Senam Yoga dan variable dependent adalah Nyeri Haid. Instrumen penelitian menggunakan pengukuran skala nyeri Face Pain Scale – Revised (FPS-R). Pengolahan data menggunakan editing, coding, scoring, tabulating dengan analisa data spearman Rank. Hasil penelitian menunjukkan bahwa sebelum dilakukan senam yoga hampir setengah dari responden mengalami nyeri haid dengan skala 3 (lebih nyeri) dengan jumlah 16 responden (45,7%). Sedangkan setelah dilakukan senam yoga hampir setengah dari responden mengalami nyeri haid dengan skala 2 (sedikit nyeri) sebanyak 12 responden (34,3%). Uji statistik Spearman rank menunjukan bahwa r value = 0,000 < α (0,05) sehingga H1 diterima.Kesimpulan penelitian ini ada Pengaruh Senam Yoga terhadap Nyeri Haid pada Remaja Putri Kelas X MAN 2 Kota Probolinggo. Kata Kunci : Senam Yoga, Nyeri Haid, Siswi Kelas X

Efficacy of the Newly Invented Eyelid Clamper in Ultra-Widefield Fundus Imaging

Background: Ultra-widefield fundus imaging is widely used for obtaining wide angle images of the retina in one single image. Although it has a potential to obtain a wide area of retinal photographs, images are often obstructed by eyelashes or eye lids. In this study, we used a newly invented eyelid clamper, which can keep an eye open without touching conjunctiva or lid margin, to assess the efficacy in clinical use by comparing with conventional tape fixation. Methods: Ultra-widefield fundus images were captured with an ultra-widefield imaging system in 19 patients who visited to the outpatient clinic of Department of Ophthalmology, Keio University Hospital with the eyelid clamper or a conventional tape fixation. The area of imaged retinas was outlined and quantified with pixels. After obtaining images, patients answered a questionnaire. Results: The average number of pixels in total areas with the eyelid clamper or with tape fixation were 4.31 ± 0.35 and 4.32 ± 0.34 mega pixels, respectively, showing no significant difference between the groups (p = 0.889). The average face pain scale of the eyelid clamper was 1.13 on a scale of 0 to 5. The number of patients who did not feel any pain was nine (47.4%). Conclusions: The eyelid clamper can be applied in clinical setting and can better support obtaining sufficiently wide fundus images compared to a conventional tape fixation.

Medic Interaction Modes and Hospitalized Children Health

<p></p><p>In the present experimental study different interaction ‘modes’ those took place between a psychologist and a child were tested for the role of these towards health recovery of the child? Following were the interaction modes, a) presenting a flower with smile plus inquiring about health, b) offering a blessing plus inquiring about health, c) making an indifferent presence plus inquiring about health with flat tone, d) inquiring about health with providing precautions about prognosis. It was assumed that all modes would differently influence health outcomes? 100 hospitalized children located in child wards of different hospitals with randomized pre-post block design interacted. One each from four interaction modes was used for a group of 25 participants each. Actual ward discharge was compared with anticipatory estimated by each ward in-charge to calculate effect of mode on outcome. Face Pain Scale, The Children Happiness Scale and a Demographic Sheet were also used. Results reflected ‘modes’ relationship with outcomes. More studies would clarify further.</p><br><p></p>

Medic Interaction Modes and Hospitalized Children Health

<p></p><p>In the present experimental study different interaction ‘modes’ those took place between a psychologist and a child were tested for the role of these towards health recovery of the child? Following were the interaction modes, a) presenting a flower with smile plus inquiring about health, b) offering a blessing plus inquiring about health, c) making an indifferent presence plus inquiring about health with flat tone, d) inquiring about health with providing precautions about prognosis. It was assumed that all modes would differently influence health outcomes? 100 hospitalized children located in child wards of different hospitals with randomized pre-post block design interacted. One each from four interaction modes was used for a group of 25 participants each. Actual ward discharge was compared with anticipatory estimated by each ward in-charge to calculate effect of mode on outcome. Face Pain Scale, The Children Happiness Scale and a Demographic Sheet were also used. Results reflected ‘modes’ relationship with outcomes. More studies would clarify further.</p><br><p></p>

The Jumping Up (J-Up) Test: Making the Diagnosis of Acute Appendicitis Easier in Children

We evaluate a new clinical test, jumping up (J-up) test, to diagnose easier appendicitis in children. A total of 407 patients, aged 5 to16 years, with right lower quadrant abdominal pain were asked to jump rising both hands and trying to reach a toy hanging down from the ceiling of the examination room. Bieri pediatric Face Pain Scale was used for recording the pain response. J-up test has sensitivity of 87% and specificity of 70%. A positive J-up test combined with leukocytosis (white blood cells count >12 000/mm3), neutrophilia >75%, neutrophil/lymphocyte >2, and C-reactive protein >5 mg/dL, achieved a posttest probability of appendicitis of 85%. A negative J-up test combined with the aforementioned blood markers within normal range had a posttest probability for non-appendicitis of 92%. J-up test is a reliable clinical test, which could be used even by an inexperienced doctor. Combined with classical blood markers, it could successfully predict which child is in urgent need or not of surgery.