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2022 ◽  
Vol 6 (4) ◽  
pp. 10-15
Ira Febriyanti ◽  
Saifuddin Sirajuddi ◽  
Hasnawati Amqam

Background: Nutrition of pregnant women is very influential on fetal growth, one of which is iron deficiency anemia. Iron deficiency increases in pregnant women with increasing age in pregnancy. Significantly low intake of nutrients will make pregnant women experience Chronic Energy Deficiency. The nutritional content of tempeh can be used to meet the nutritional needs of pregnant women. Objective: The aim of this study was to analyze the effect of giving steamed tempeh to the increase in hemoglobin and Body Weight levels in pregnant women at the Kalar-kalar Health Center, Aru Islands Regency. Method: This type of research is a quasi-experimental with a pre-posttest control group design. The intervention was given to the respondents as many as 24 people with 12 people in the control group and 12 people in the treatment group. Sampling purposive sampling. Subjects were taken from two villages in the working area of ​​the Kalar-Kalar Public Health Center which have relatively the same geography and socioeconomic status and only pregnant women with Hb <11 G/dL were selected. The form of treatment was giving 100 G of steamed tempeh 2 times a week for 30 days while the control group was given biscuits for pregnant women 2 times per week 100 G. Data analysis used univariate and bivariate analysis with paired T test and Mann Whitney. Results: Mann Whitney test results of the effect of steamed tempeh on weight gain in the treatment group obtained a p-value of 0.050 (p=0.05). Differences in hemoglobin levels in anemic pregnant women with a p-value of 0.018 (<0.05) with a mean difference of 0.42 G/dL in the pre-posttest treatment group and the control group with a p-value of 0.217 (<0.05) with a mean difference of 0.21 G/d dL. Conclusion: There is an effect of giving steamed tempeh to increase hemoglobin and body weight in pregnant women. Keywords: Anemia, Pregnant women, Hemoglobin, Body Weight, Tempeh.

2022 ◽  
Vol 19 (1) ◽  
pp. 13-17
Sandeep Gurung ◽  
Gopal Sagar DC

Introduction: Surgical treatment of thoracolumbar fracture without neurological damage has resulted in better clinical and radiological outcome than conservative treatment. Traditional open approach is associated with extensive paravertebral muscle damage and postoperative morbidity so percutaneous pedicle screw fixation is highly valuable alternatives. Aims: to evaluate the efficacy and outcome of percutaneous pedicle screw fixation in the treatment of traumatic thoracolumbar fracture without neurological deficit. Methods: This study was conducted in Nepalgunj Medical College, Nepalgunj in a time span of one year; total of 40 patients were included and treated with percutaneous pedicle screw fixation and followed up for 6months. They were evaluated clinically and radiologically. Results: 40 patients with thoracolumbar fractures were managed with percutaneous pedicle screw fixation with a mean operative time of 77.30 min and intraoperative blood loss was 88.38ml. There was significant improvement in cobb’s angle (mean difference 13.92 degree), vertebral body height loss (mean difference 37.7%) and visual analogue scale (mean difference 3.55) postoperatively. These improvements remained statically significant at 6months follow up. Conclusion: Percutaneous pedicle screw fixation is safe, valid and effective treatment of thoracolumbar fracture without neurological deficit.

2022 ◽  
Vol 19 (1) ◽  
pp. 30-33
Jyoti Adhikari ◽  
Mohan Belbase ◽  
Shikha Rijal

Introduction: Anemia is one of the most prevalent nutritional deficiency problem affecting pregnant women. It is defined by World Health Organization as hemoglobin (Hb) level of less than 11 g/dl. Hemoglobin level of 9.0- 10.9 g/dl is mild, 7.0-8.9 g/dl is moderate and less than 7 g/dl is severe anemia respectively. Maternal anemia in pregnancy is commonly considered as a risk factor for poor pregnancy outcome and can result in complications that threaten the life of both mother and fetus. Aims: To find out neonatal outcome delivered to anemic mothers. Methods: A prospective case control study was carried out among 75 newborns delivered to pregnant women with hemoglobin below 10.9g/dL. Another 75 newborns were taken delivered at the same time, matched age and sex wise as a control group to mothers whose hemoglobin was more than 11g/dl. Results: Out of total 75 cases 35(46.7%) mothers had mild, 32(42.6%) had moderate and 8(10.7%) had severe anemia respectively. Similarly, the risk of having preterm baby among anemia group was 4.42 times higher than that in control group (p 0.033). The risk of having low birth weight in anemia group was 3.9 times higher than that in control group (p 0.04). The mean of head circumference (HC) among the anemia group was 33.9cm +1.40 (Mean+SD) and among the control group was 34.4cm+1.24(Mean+SD) with a mean difference of 0.5cm (p 0.032). The mean of length among anemia group was 45.3cm+1.97 (Mean+ SD) and among the control group was 46.2cm+1.69 (Mean+ SD) with a mean difference of 0.9 cm (p 0.003). Conclusion: Maternal anemia in pregnancy is associated with increased risk of adverse neonatal outcome. Efforts must be made to reduce the prevalence of anemia especially during pregnancy to reduce neonatal morbidity and mortality.

2022 ◽  
Vol 22 (1) ◽  
Dinithi Vidanage ◽  
Shamini Prathapan ◽  
Priyadarshika Hettiarachchi ◽  
Sudharshani Wasalathanthri

Abstract Background Regular exercise is a key element in the management of type 2 diabetes mellitus (T2DM). Although the importance of regular exercises on glycemic control in people with diabetes is studied extensively, evidence is lacking on its impact on sweet taste perception. Thus, the aim of this study was to determine the impact of aerobic exercises on taste perception for sucrose in people with diabetes. Methods A sample of 225 people with diabetes aged 35-60 years was assigned randomly into 3 groups; aerobic exercise, combined exercise and a control group. The outcomes of the combined exercise group is not reported. The aerobic exercise group performed brisk walking 30min/day, 4-5days/week for 6 months. The primary outcome measures were supra-threshold intensity ratings and preference for sucrose assessed at baseline, at 3 and 6 months using ‘general Labeled Magnitude Scale’ and ‘Monell 2-series-forced choice method’ respectively. Glycated haemoglobin (HbA1c) level was assessed at baseline and at 6 months to determine glycemic control. Results Aerobic exercise group showed significantly increased ratings (mm) for higher sucrose concentrations at 3 months (mean difference for 2.02M; +6.63±2.50, p=0.048 and for 0.64M; +7.26±2.76, p=0.026) and at 6 months (mean difference for 0.64M; +7.79±4.49, p= 0.044) compared to baseline and also when compared to controls (mean difference for 2.02M between baseline and 3 months; intervention: +6.63±2.50, control: -4.01±1.79, p=0.02 and between baseline and 6 months for 2.02M; intervention: +3.15±0.57, control: -7.96±0.40, p=0.022 and for 0.64M; intervention: +7.79±4.49, control: -8.98±0.99, p=0.003). A significantly reduced preference (mol/L) was seen both at 3 (mean difference; -0.03±0.02, p= 0.037) and at 6 months (mean difference; -0.05±0.12, p=0.011) compared to baseline within the intervention group. Also, a significant reduction was seen in the intervention group compared to controls at 6 months (mean difference; intervention: -0.05±0.12, control: 0.01±0.03, p=0.044). HbA1c was significantly reduced in the intervention group compared to controls at 6 months (mean difference; intervention -0.43±1.6%, control +0.33±1.8%, p=0.018). Conclusion Regular aerobic exercises increase the sweet taste sensitivity, especially for higher concentrations of sucrose and decrease sweet taste preference in people with diabetes . These alterations in sweet taste perception, are likely to contribute to a better glycemic control in people with diabetes. Trial registration This trial was registered at the Sri Lanka Clinical Trial registry on 16/12/2015. (Trial registration number- SLCTR/2015/029,

2022 ◽  
Vol 2022 ◽  
pp. 1-8
Seung Cheol Lee ◽  
Tae Hyung Kim ◽  
So Ron Choi ◽  
Sang Yoong Park

To enhance the duration of single-shot spinal anesthesia, intrathecal fentanyl and intravenous dexmedetomidine are widely used as adjuvants to local anesthetics. This noninferiority trial evaluated whether hyperbaric ropivacaine alone can produce a noninferior duration of sensory block in comparison to hyperbaric ropivacaine with intrathecal fentanyl in patients under dexmedetomidine sedation. Methods. Fifty patients scheduled for elective lower limb surgery under spinal anesthesia were randomly assigned in a double-blind fashion to receive either hyperbaric ropivacaine 15 mg (Group R) or hyperbaric ropivacaine 15 mg with intrathecal fentanyl 20 μg (Group RF). Intravenous dexmedetomidine (1 μg/kg for 10 min, followed by 0.5 μg/kg/h) was administered in both groups. The primary outcome of this study was the time to two-dermatomal regression of sensory block. The noninferiority margin for the mean difference was −10 min. Characteristics of the block, intraoperative and postoperative side effects, postoperative pain score, and analgesic consumption were assessed as secondary outcomes. Results. There was no difference in the two-dermatomal regressions of sensory block between the two groups (Group R 70.4 ± 10.2 min, Group RF 71.2 ± 12.4 min, p  = 0.804) with a mean difference of 0.8 min (−7.2 to 5.6, 95% confidence interval). Thus, the noninferiority of hyperbaric ropivacaine alone was established. There were no significant differences in the secondary outcomes between the two groups. Conclusions. Under intravenous dexmedetomidine sedation, the duration of spinal anesthesia with hyperbaric ropivacaine alone was noninferior to that of hyperbaric ropivacaine with intrathecal fentanyl. This suggests that addition of intrathecal fentanyl to hyperbaric ropivacaine may not be necessary in patients receiving intravenous dexmedetomidine.

2022 ◽  
Vol 4 (1) ◽  
Kevin F. Boehnke ◽  
Laura Yakas ◽  
J. Ryan Scott ◽  
Melissa DeJonckheere ◽  
Evangelos Litinas ◽  

Abstract Background The wide heterogeneity of available cannabis products makes it difficult for physicians to appropriately guide patients. In the current study, our objective was to characterize naturalistic cannabis use routines and explore associations between routines and reported benefits from consuming cannabis. Methods We performed a mixed methods analysis of n=1087 cross-sectional survey responses from adults with self-reported chronic pain using cannabis for symptom management in the USA and Canada. First, we qualitatively analyzed responses to an open-ended question that assessed typical cannabis use routines, including administration routes, cannabinoid content, and timing. We then sub-grouped responses into categories based on inhalation (smoking, vaporizing) vs. non-inhalation (e.g., edibles). Finally, we investigated subgroups perceptions of how cannabis affected pain, overall health, and use of medications (e.g., substituting for opioids, benzodiazepines). Substitutions were treated as a count of medication classes, while responses for both pain and health were analyzed continuously, with − 2 indicating health declining a lot or pain increasing a lot and 2 indicating that health improved a lot or pain decreased a lot. Results Routines varied widely in terms of administration routes, cannabinoid content, and use timing. Overall, 18.8%, 36.2%, and 45% used non-inhalation, inhalation, and non-inhalation + inhalation routes, respectively. Those who used inhalation routes were younger (mean age 46.5 [inhalation] and 49.2 [non-inhalation + inhalation] vs. 56.3 [inhalation], F=36.1, p<0.001), while a higher proportion of those who used non-inhalation routes were female (72.5% non-inhalation vs. 48.3% inhalation and 65.3% non-inhalation + inhalation, X2=59.6, p<0.001). THC-rich products were typically used at night, while CBD-rich products were more often used during the day. While all participants reported similarly decreased pain, participants using non-inhalation + inhalation administration routes reported larger improvements in health than the non-inhalation (mean difference = 0.32, 95% CI: 0.07–0.37, p<0.001) and inhalation subgroups (mean difference = 0.22, 95% CI: 0.07–0.37, p=0.001). Similarly, the non-inhalation + inhalation group had significantly more medication substitutions than those using non-inhalation (mean difference = 0.62, 95% CI: 0.33–0.90, p<0.001) and inhalation administration routes (mean difference = 0.45, 95% CI: 0.22–0.69, p<0.001), respectively. Conclusions Subgrouping medical cannabis patients based on administration route profile may provide useful categories for future studies examining the risks and benefits of medical cannabis.

Leonardo Henrique Fernandes Carvalho ◽  
Roberto Moriggi Junior ◽  
Júlia Barreira ◽  
Brad Jon Schoenfeld ◽  
John Orazem ◽  

The purpose of this paper was to conduct a systematic review and meta-analysis of studies that compared muscle hypertrophy and strength gains between resistance training protocols employing very low (VLL<30% of 1RM or >35 RM), low (LL30%-59% of 1RM, or 16–35 RM), moderate (ML60%-79% of 1RM, or 8 -15RM) and high load (HL≥80% of 1RM, or ≤7 RM) with matched volume loads (sets x reps x weight). A pooled analysis of the standardized mean difference for 1RM strength outcomes across the studies showed a benefit favoring HL vs. LL and vs. ML; and favoring ML vs. LL. Results from LL and VLL indicated little difference. A pooled analysis of the standardized mean difference for hypertrophy outcomes across all studies showed no differences between the training loads. Our findings indicate that, when volume load is equated between conditions, the highest loads induce superior dynamic strength gains. Alternatively, hypertrophic adaptations are similar irrespective of the magnitude of load. NOVELTY BULLETS: • Training with higher loads elicits greater gains in 1RM muscle strength when compared to lower loads, even when volume load is equated between conditions. • Muscle hypertrophy is similar irrespective of the magnitude of load, even when volume load is equated between conditions.

2022 ◽  
Vol 2022 ◽  
pp. 1-10
Liguo Liu ◽  
Litao Pan ◽  
Minne Tian ◽  
Xiuhua Chen ◽  
Liming Lu ◽  

Aim. To provide available quantitative evidence of efficacy and safety of acupuncture treatments for improving sacroiliac joint malposition. Methods. Databases such as the China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (CQVIP), Wanfang Database (Wanfang), China Biology Medicine disc (CBMdisc), PubMed, Web of Science, EMBASE, and Cochrane Library were searched by computer to collect the reports on acupuncture treatment of sacroiliac joint malposition from the database creation to July 20, 2021. The selection of included studies, data extraction and coding, and bias risk assessment were conducted independently by two reviewers. RevMan5.4 software was used for meta-analysis, and the results were expressed as mean difference (MD) or standardized mean difference (SMD), with a confidence interval (CI) of 95%. Results. A total of 10 randomized controlled clinical trials (RCTs) with 1019 participants were included. Their overall quality of methodology was not high, and there may be publication bias. Meta-analysis showed that the total effective rate of the treatment group was higher than that of the control group ( OR = 2.74 , 95% CI 2.00 to 3.74, P < 0.00001 ). The treatment group was better than the control group in improving VAS score ( WMD = − 1.56 , 95% CI -2.18 to -0.94, P < 0.00001 ). The ODI score of the treatment group was lower than that of the control group ( WMD = − 6.04 , 95% CI -7.05 to -5.02, P < 0.00001 ). With the improvement of the JOA score, the difference of iliac transverse diameter of sacroiliac joint dislocation and the index of sacroiliac joint malposition in the treatment group were better than those in the control group ( P < 0.05 ). There was no significant heterogeneity among the studies. Conclusion. Acupuncture may have therapeutic advantages in improving sacroiliac joint malposition. Acupuncture and acupotomy provide a safe way to improve the related clinical symptoms and functional disorders in activity of sacroiliac joint dislocation. However, due to the low quality of the included literature, this conclusion still needs to be further verified by more high-quality and large-sample RCTs.

2022 ◽  
Vol 22 (1) ◽  
Gladis Kabil ◽  
Steven A. Frost ◽  
Deborah Hatcher ◽  
Amith Shetty ◽  
Jann Foster ◽  

Abstract Background Early intravenous fluids for patients with sepsis presenting with hypoperfusion or shock in the emergency department remains one of the key recommendations of the Surviving Sepsis Campaign guidelines to reduce mortality. However, compliance with the recommendation remains poor. While several interventions have been implemented to improve early fluid administration as part of sepsis protocols, the extent to which they have improved compliance with fluid resuscitation is unknown. The factors associated with the lack of compliance are also poorly understood. Methods We conducted a systematic review, meta-analysis and narrative review to investigate the effectiveness of interventions in emergency departments in improving compliance with early fluid administration and examine the non-interventional facilitators and barriers that may influence appropriate fluid administration in adults with sepsis. We searched MEDLINE Ovid/PubMed, Ovid EMBASE, CINAHL, and SCOPUS databases for studies of any design to April 2021. We synthesised results from the studies reporting effectiveness of interventions in a meta-analysis and conducted a narrative synthesis of studies reporting non-interventional factors. Results We included 31 studies out of the 825 unique articles identified in the systematic review of which 21 were included in the meta-analysis and 11 in the narrative synthesis. In meta-analysis, interventions were associated with a 47% improvement in the rate of compliance [(Random Effects (RE) Relative Risk (RR) = 1.47, 95% Confidence Interval (CI), 1.25–1.74, p-value < 0.01)]; an average 24 min reduction in the time to fluids [RE mean difference = − 24.11(95% CI − 14.09 to − 34.14 min, p value < 0.01)], and patients receiving an additional 575 mL fluids [RE mean difference = 575.40 (95% CI 202.28–1353.08, p value < 0.01)]. The compliance rate of early fluid administration reported in the studies included in the narrative synthesis is 48% [RR = 0.48 (95% CI 0.24–0.72)]. Conclusion Performance improvement interventions improve compliance and time and volume of fluids administered to patients with sepsis in the emergency department. While patient-related factors such as advanced age, co-morbidities, cryptic shock were associated with poor compliance, important organisational factors such as inexperience of clinicians, overcrowding and inter-hospital transfers were also identified. A comprehensive understanding of the facilitators and barriers to early fluid administration is essential to design quality improvement projects. PROSPERO Registration ID CRD42021225417.

Healthcare ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 132
Luca Pontone Gravaldi ◽  
Francesca Bonetti ◽  
Simona Lezzerini ◽  
Fernando De Maio

This study aimed to evaluate the safety and effectiveness of non-pharmacological interventions supervised by a physiotherapist in patients with Ankylosing Spondylitis, PROSPERO Protocol number CRD42020209453. Five databases (PubMed, PEDro, Scopus, Web of Science Core, and EMBASE) and reference lists with relevant articles were searched. Randomised controlled trials (RCTs) on the effectiveness of non-pharmacological interventions supervised by a physiotherapist were compared with usual care or home-based exercise programmes. Two investigators independently screened eligible studies. A total of 12 RCTs satisfied eligible criteria. The risk of bias ranged between medium and high. The meta-analysis results indicated that between supervised physiotherapy and usual care, the former was significantly associated with improvement in disease activity (standardised mean difference = −0.37, 95% CI, −0.64; −0.11; p < 0.001, I2 = 71.25%, n = 629), and functional capacity (standardised mean difference = −0.36, 95% CI, −0.61; −0.12, p < 0.05; n = 629). No statistically significant differences emerged when interventions were compared with home-based exercise programmes. Supervised physiotherapy is more effective than usual care in improving disease activity, functional capacity, and pain in patients with ankylosing spondylitis. No significant improvements emerged when supervised physiotherapy and home-based exercise programmes were compared. Further investigation and RCTs with larger samples are needed.

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