scholarly journals Investigating the partial pressure of carbon dioxide (CO2) in the respiratory gases in Laparoscopic Gallbladder Surgery and comparing it with Arterial Partial Pressure of Carbon Dioxide

2019 ◽  
Vol 5 (6) ◽  
Keyword(s):  
Carbon Dioxide ◽  
Laparoscopic Surgery ◽  
Partial Pressure ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Carbon Dioxide Pressure ◽  
Gallbladder Surgery ◽  
The Mean ◽  
Carbon Dioxide Co2 ◽  
Respiratory Gases

Objectives: The aim of this paper is determining the end-expiratory dioxide pressure in gallbladder laparoscopic surgery and compares it with the arterial carbon dioxide pressure. Methods: This cross-sectional study was performed on 30 patients undergoing laparoscopic cholecystectomy. At the beginning of operation, ABG sample was taken from the patient's radial artery before CO2 was injected into the abdomen. At the same time, CO2 was measured by a capnography device. At the end of surgery, ABG sample was prepared for the second time before CO2 was removed from the abdomen and CO2 was recorded simultaneously by capnography device. After collecting data from ABG samples, arterial PaCO2 was compared with those obtained from capnography device results and SPSS 16 software was used for data analysis. Results: The mean preoperative PaCO2 for laparoscopic (PaCO2-1) was 34.343 and the mean preoperative ETCO2 for laparoscopic (ETCO2-1) was 31.37. These values after laparoscopic surgery were 34.813 for PaCO2, 34.813 (PaCO2-2) and 33.13 (ETCO2-2). There was also a correlation between PaCO2-1 and ETCO2-1 results between PaCO2-2 and ETCO2-2, which was stronger between PaCO2-2 and ETCO2-2. Conclusion: There was a strong correlation between ETCO2 results from capnography and PaCO2 from ABG and to monitor carbon dioxide retention, capnography can be used as an alternative to ABG for laparoscopic gallbladder surgery patients.

The effect of Substituting blood sampling through routine direct venipuncture with intravenous cannulation on the accuracy of hematologic results in children

2021 ◽  
Author(s):  
Manijeh Tabrizi ◽  
Hamidreza Badeli ◽  
Parmoon Parvari ◽  
Afagh Hassanzadeh Rad
Keyword(s):  
Partial Pressure ◽  
Cross Sectional Study ◽  
Blood Sampling ◽  
Pediatric Care ◽  
Significant Similarity ◽  
Cross Sectional ◽  
Paired Samples ◽  
Significant Difference ◽  
The Mean ◽  
Collection Methods

Background: In pediatric care settings, intravenous cannulation (IVC) is usually needed for diverse purposes. Considering the painfulness and invasiveness of sampling by direct venipuncture (DVP), using a painless and less invasive method would be promising. Therefore, this study aimed to compare the effect of substitution of routine DVP with direct blood sampling through IVC on the accuracy of hematologic results. Materials and Methods: This was a cross-sectional study conducted on 5-14-year-old children admitted to the emergency ward of 17th Shahrivar Pediatric Hospital in Rasht, north of Iran. After discarding only one ml of blood, paired-samples were taken from IVC and DVP and analyzed for 30 most frequently requested electrolytes, hematologic, and blood gas tests. The similarity of the obtained results by the two methods indicated the probability of substituting DVP with IVC and was defined by the absence of significant statistical difference (P>0.05). Results: The comparison between the mean of hematologic factors by two methods showed significant similarity between groups regarding all parameters (P>0.05) except the mean of red blood cell count in the two groups (P<0.05). Assessing the level of electrolytes by two collection methods showed that there was a significant similarity between the mean of all parameters (P>0.05) except for phosphorus (P=.002). Furthermore, assessing the level of electrolytes showed a significant similarity between the potential of hydrogen, partial pressure of carbon dioxide, bicarbonate, and buffer base in the two groups (P>0.05). However, there was a significant difference between partial pressure of oxygen, base excess, and O2 saturation in the two collection methods (P<0.05). Conclusion: Based on the promising results obtained in this study, it seems that these methods could be interchangeably used, and IVC can be an alternative method for DVP by discarding the minimum amount of blood and less invasiveness in children.

scholarly journals Bradycardia during laparoscopic surgeries: A cross-sectional study

2020 ◽  
Vol 9 (1) ◽  
pp. 5-12
Author(s):  
Binod Gautam ◽  
Ashmita Maharjan ◽  
Suson Ghimire
Keyword(s):  
Cardiac Arrest ◽  
Laparoscopic Surgery ◽  
Management Strategies ◽  
Cross Sectional Study ◽  
Adverse Outcomes ◽  
Sectional Study ◽  
Cross Sectional ◽  
Co Morbidity ◽  
Vagal Reflex ◽  
The Mean

Background: Bradycardia occurring during laparoscopic surgery potentially leads to cardiac arrest and adverse outcomes. Apart from the vagal reflex for its genesis, the knowledge on frequency and risk factors is limited.  Objectives: To identify the bradycardia frequency and time points for its occurrence during laparoscopic surgeries. Methodology: In this hospital-based cross-sectional study, anaesthesia-related incident reports on bradycardia were collected from January to December 2019. Bradycardias (heart rate less than 60/minute) that occurred during laparoscopic surgeries were analyzed to characterize patient factors, the time point for occurrence, circumstantial events, management strategies, and outcomes. Results: Among 801 laparoscopic surgeries, 28 (3.4%) bradycardic incidents were identified, with one progressing to cardiac arrest. All bradycardias occurred in 26 patients undergoing laparoscopic cholecystectomy under general anaesthesia, with two patients each experiencing two bradycardic episodes. The mean patient age was 45 (±16.3) years and 17 (65.3%) were women. Fifteen (57.6%) patients had no co-morbidity. Controlled hypertension and hypothyroidism co-existed in seven (26.9%) and three (11.5%) cases respectively. Bradycardia occurred once each (3.5%) during laryngoscopy and endotracheal intubation. Six (21.4%) and twenty (71.4%) bradycardias respectively occurred before and during pneumoperitoneum. The mean of minimum heart rates was 43 (±8.8) per minute. Anticholinergics were administered in 25 (89.2%) incidents. Stopping surgery and pneumoperitoneum deflation included other major management strategies. The cardiac arrest case received chest compressions and adrenaline. Surgery resumed in all cases without adversity. Conclusion: Bradycardia occurs during laparoscopic surgery, more frequently during pneumoperitoneum and in healthy and younger females. Immediate cessation of surgical stimuli and atropine administration possibly prevent bradycardia from progressing to cardiac arrest.

Brief Overview and Experience of Visual Evoked Potential of First 67 cases at Referral Neuroscience Hospital in Bangladesh

2020 ◽  
Vol 6 (2) ◽  
pp. 74-77
Author(s):  
Mohammad Enayet Hussain ◽  
Bithi Debnath ◽  
AFM Al Masum Khan ◽  
Md Ferdous Mian ◽  
Md Nahidul Islam ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Optic Neuritis ◽  
Clinical Diagnosis ◽  
Optic Neuropathy ◽  
Cross Sectional Study ◽  
P Value ◽  
Pattern Reversal ◽  
Cross Sectional ◽  
The Mean ◽  
Visual Evoked

Background: The visual evoked potentials (VEP) is a valuable tool to document occult lesions of the central visual channels especially within the optic nerve. Objectives: The purpose of the present study was to observe the findings of first few cases of VEP done in the neurophysiology department of the National Institute of Neurosciences (NINS), Dhaka, Bangladesh. Methodology: This cross-sectional study was conducted in the Department of Neurophysiology at the National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from September 2017 to March 2020. All patients referred to the Neurophysiology Department of NINS for VEP were included. Pattern reversal VEPs were done using standard protocol set by International Federation of Clinical Neurophysiology (IFCN). Results: The mean age of the study population was 30.70 (±12.11) years (6-68 years) with 31 (46.3%) male and 36 (53.7%) female patients. The mean duration of illness was 8.71 (±1.78) months (3 days- 120 months). Most common presenting symptom was blurring of vision (37.3%) and dimness of vision (32.8%). Patterned VEP revealed mixed type (both demyelinating and axonal) of abnormality in most cases [29(43.35)]. The most common clinical diagnosis was multiple sclerosis (29.85%) and optic neuropathy (26.87%). In the clinically suspected cases of multiple sclerosis, optic neuropathy and optic neuritis most of the cases of VEP were abnormal and the p value is 0.04 in optic neuropathy and optic neuritis. Conclusion: The commonest presentation of the patients in this series were blurring of vision and dimness of vision. The most common clinical diagnosis for which VEP was asked for, was optic neuritis and multiple sclerosis. Most abnormalities were of mixed pattern (demyelinating and axonal). Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 74-77

Sonographic Assessment of Amniotic Fluid Volume using Single Deepest Pocket (SDP) among Igbo Women with Uncomplicated Singleton Pregnancies.

2019 ◽  
Vol 2 (1) ◽  
pp. 1-18
Author(s):  
Chijioke Okeudo ◽  
B.U. Ezem
Keyword(s):  
Amniotic Fluid ◽  
Gestational Age ◽  
Cross Sectional Study ◽  
Fluid Volume ◽  
Singleton Pregnancy ◽  
Cross Sectional ◽  
South Eastern ◽  
Amniotic Fluid Volume ◽  
The Mean ◽  
Singleton Pregnancies

Background: The amniotic fluid is fundamental for proper fetal development and growth. Ultrasound visualization of the amniotic fluid permits both subjective and objective estimates of the amniotic fluid. Objective: The objective of this study was to determine the reference values of normal single deepest pocket (SDP) – upper and lower limits, mean SDP and variation of the SDP with gestational age among Igbo women of South-Eastern Nigeria extraction carrying uncomplicated singleton pregnancy. Methodology: This was a prospective cross sectional study involving 400 women carrying uncomplicated singleton pregnancies and who were sure of the date of the first day of their last menstrual period. The single deepest pocket / maximum vertical pool were determined once at presentation at the hospital.. The study was conducted from January 1st to December 31st 2015. The second author carried out all the scanning. The SDP was obtained. Results: The womens’ mean and median ages were the same at 28 years. The gestational age range of the pregnancies was 14-41 weeks. The mean SDP was 5.8cm, while the 5th and 95th percentiles were 3.3cm and 8.5cm respectively. There was no difference in the mean SDP in both term and preterm. There was irregular but continuous rise of mean SDP to a peak of 6.8cm at gestational age of 39 weeks. In conclusion, the participants had a mean SDP of 5.8cm. There was also a positive correlation between SDP and Gestational age. We therefore recommend a longitudinal study to assess perinatal outcome and abnormal amniotic fluid volume among Igbo women of South-Eastern Nigeria. Key words: Single Deepest Pocket, Uncomplicated Singleton Pregnancy, Igbo Women.

Advantages and limitations of the endoscopic tympanoscopy a prospective study

2020 ◽  
Vol 1 (1) ◽  
pp. 012-017
Author(s):  
Najib Zouhair ◽  
Anass Chaouki ◽  
Amine M’khatri ◽  
Youssef Oukessou ◽  
Sami Rouadi ◽  
...  
Keyword(s):  
Middle Ear ◽  
Operating Time ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Invasive Approach ◽  
Intraoperative Bleeding ◽  
Advantages And Disadvantages ◽  
Early Return ◽  
The Mean ◽  
Endoscopic Tympanoplasty

Tympanoplasty is one of the most performed procedures in ENT. The aggressiveness of its microscopic approach has led otologists to adopt the endoscopic approach as a less invasive alternative. The purpose of this work is to appreciate the advantages and disadvantages of this surgical technique. We conducted a prospective descriptive cross-sectional study on 20 interventions within the ENT department of August the 20th 1953 Hospital of Casablanca from April 2019 to June 2019. The average age of operated patients was 36.3 years. Perforations were unilateral in (71%) of the cases with a predominance of the anterior (29%) and subtotal (36%) locations. The tympanoplasties were performed by 3 different senior otologic surgeons, and were left in (57%). The mean operating time was (59.5 min) and the mean anesthesia duration was 75.1 min. Intraoperative vision allowed us to fully visualize the margins of all perforations (100%) and anatomical structures of the middle ear in almost all interventions. The first procedures carried out were filled with difficulties whose management of intraoperative bleeding was the main one in (42.8%) of the cases. (57%) procedures were described as easy. No complication was detected intraoperatively or immediately postoperatively. Endoscopic tympanoplasty has several advantages, including: Minimally invasive approach to the middle ear; panoramic perioperative vision; Gain of operating time; decrease in the duration of anesthesia; Valuable educational tool; postoperative comfort; Decrease in hospital stay and early return to daily activities; Better aesthetic rendering; cost and transportability. However, we also note a number of disadvantages of endoscopic tympanoplasty, particularly: performing the procedure with one hand; difficulty passing through the EAC; 2D vision that alters the perception of depth; management of intraoperative bleeding; fogging; learning curve.

Comparison of Heffner Criteria and Light Criteria in Differentiating Exudative and Transudative Pleural Effusion

2020 ◽  
Vol 22 (3) ◽  
pp. 141-145
Author(s):  
Krishna Chandra Devkota ◽  
S Hamal ◽  
PP Panta
Keyword(s):  
Pleural Effusion ◽  
Cross Sectional Study ◽  
Pleural Space ◽  
Sectional Study ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Medical College ◽  
The Common ◽  
The Mean ◽  
Exudative Pleural Effusion

Pleural effusion is present when there is >15ml of fluid is accumulated in the pleural space. It can be divided into two types; exudative and transudative pleural effusion. Tuberculosis and parapneumonic effusion are the common cause of exudative pleural effusion whereas heart failure accounts for most of the cases of transudative pleural effusion. This study was a hospital based cross sectional study performed at Nepal Medical College during the period of January 2016-December 2016. A total of 50 patients who fulfilled the inclusion criteria were enrolled. Pleural effusion was confirmed by clinical examination and radiology. After confirmation of pleural effusion, pleural fluid was aspirated and was analysed for protein, LDH, cholesterol. The Heffner criteria was compared with Light criteria to classify exudative or transudative pleural effusion. Among 50 patients, 30 were male and 20 were female. The mean age of patient was 45.4±21.85 years. The sensitivity and specificity of using Light criteria to detect the two type of pleural effusion was 100% and 90.9%, whereas using Heffner criteria was 94.87%, 100% respectively(P<0.01). There are variety of causes for development of pleural effusion and no one criteria is definite to differentiate between exudative or transudative effusion. In this study Light criteria was more sensitive whereas Heffner criteria was more specific to classify exudative pleural effusion. Hence a combination of criteria might be useful in case where there is difficulty to identify the cause of pleural effusion.

scholarly journals High Adherence to the Mediterranean Diet Is Associated with a Reduced Risk of Obesity among Adults in Gulf Countries

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 995
Author(s):  
Israa M. Shatwan ◽  
Eiman A. Alhinai ◽  
Balqees Alawadhi ◽  
Shelini Surendran ◽  
Najlaa M. Aljefree ◽  
...  
Keyword(s):  
Mediterranean Diet ◽  
Total Sample ◽  
Cross Sectional Study ◽  
Inverse Association ◽  
Protective Effects ◽  
Hip Circumference ◽  
Cross Sectional ◽  
Gulf Countries ◽  
The Mean ◽  
The Mediterranean

The Mediterranean diet (MedDiet) is considered as a good example of a healthy dietary pattern that has protective effects on obesity. The aim of the present study was to assess the adherence of adults from three Gulf countries (Saudi Arabia, Oman, and Kuwait) to the MedDiet and its association with obesity risk. A cross-sectional study was conducted on 961 men and women (75.7%) aged 20–55 years old. Waist circumference (WC), and hip circumference (HC) were measured waist/hip ratio (WHR) and body mass index (BMI) were calculated. A validated 14-item Questionnaire was used to measure adherence to MedDiet. The mean of the adherence to MedDiet score was 5.9 ± 2.03 for the total sample. An inverse association was observed between the adherence to MedDiet and BMI after adjusting for potential confounders (p = 0.0003 in total participants, and p = 0.001 in women only). A protective effect was seen with a higher adherence to the MedDiet on HC, suggesting that a greater adherence to the MedDiet was associated with a decreased HC (p = 0.04 in total participants, and p = 0.01 in women only). In conclusion, low adherence to the MedDiet among participants from three gulf countries was associated with increased obesity indicators, BMI, and HC.

Altered retinal oxygen metabolism in patients with combined ocular and central nervous system sarcoidosis

Rheumatology ◽  
2020 ◽  
Author(s):  
Astrid Kindt ◽  
Keld-Erik Byg ◽  
Jimmi Wied ◽  
Torkell Ellingsen ◽  
Jesper Rømhild Davidsen ◽  
...  
Keyword(s):  
Oxygen Metabolism ◽  
Cross Sectional Study ◽  
Screening Methods ◽  
Cross Sectional ◽  
Corrected Visual Acuity ◽  
Multi Linear Regression ◽  
The Mean ◽  
Arteriovenous Difference ◽  
Retinal Arteriolar ◽  
Retinal Oximetry

Abstract Objective To evaluate retinal oxygen metabolism by retinal oximetry for ocular and CNS diseases in a cross-sectional study of sarcoidosis. Methods Overall 201 eyes from 103 biopsy-verified sarcoidosis patients were included and divided into four groups depending on the organ affection: (i) sarcoidosis without ocular or CNS affection, (ii) ocular sarcoidosis, (iii) CNS sarcoidosis, and (iv) combined ocular and CNS sarcoidosis. Retinal oximetry was obtained and analysed, with the mean retinal arteriolar and venular saturation as well as arteriovenous difference as principal outcomes. Comparison between groups was done in a multi linear regression model adjusted for age, sex, duration of sarcoidosis, best corrected visual acuity and retinal oximetry quality. Results Mean (s.d.) age was 50.5 (13.4) (95% CI: 47.9, 53.1) years and 52.2% were males. Eyes of the combined Ocular/CNS group had a higher retinal arteriovenous difference than eyes of the Non-ocular/no-CNS group (42.1% vs 37.7%, P = 0.012) but did not differ between other groups. Eyes in the four groups (Non-ocular/no-CNS, Ocular, CNS and Ocular/CNS) did not differ according to retinal arterial (94.5%, 93.5%, 93.5% and 94.5%, respectively) or venular (57.5%, 56.4%, 55.0% and 52.5%, respectively) oxygen saturation. Conclusions The results of this study suggest that eyes of sarcoidosis patients with combined ocular and CNS affection have an altered oxygen metabolism indicating a subclinical eye affection that is not recognized by conventional screening methods.

Effect of Medialization of the Trochlear Groove and Lateralization of the Tibial Tubercle on TT-TG Distance: A Cross-sectional Study of Dysplastic and Nondysplastic Knees

2021 ◽  
pp. 036354652098781
Author(s):  
Mathias Paiva ◽  
Lars Blønd ◽  
Per Hölmich ◽  
Kristoffer Weisskirchner Barfod
Keyword(s):  
Trochlear Dysplasia ◽  
Cross Sectional Study ◽  
Magnetic Resonance Images ◽  
Tibial Tubercle ◽  
Control Group ◽  
Trochlear Groove ◽  
Sectional Study ◽  
Cross Sectional ◽  
Mean Values ◽  
The Mean

Background: Tibial tubercle–trochlear groove (TT-TG) distance is often used as a measure of lateralization of the TT and is important for surgical planning. Purpose: To investigate if increased TT-TG distance measured on axial magnetic resonance images is due to lateralization of the TT or medialization of the TG. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 84 knees (28 normal [NK], 28 with trochlear dysplasia [TD], and 28 with patellar dislocation without TD [PD]) were examined. The medial border of the posterior cruciate ligament (PCL) was chosen as the central anatomic landmark. The distance from the TT to PCL (TT-PCL) was measured to examine the lateralization of the TT. The distance from the TG to the PCL (TG-PCL) was measured to examine the medialization of the TG. Between-group differences were investigated by use of 1-way analysis of variance. Results: The mean values for TT-TG distance were 8.7 ± 3.6 mm for NK, 12.1 ± 6.0 mm for PD, and 16.7 ± 4.3 mm in the TD group ( P < .01). The mean values for TT-PCL distance were 18.5 ± 3.6 mm for NK, 18.5 ± 4.5 mm for PD, and 21.2 ± 4.2 mm in the TD group ( P = .03). The mean values for TG-PCL distance were 9.6 ± 3.0 mm for NK, 7.1 ± 3.4 mm for PD, and 5.1 ± 3.3 mm in the dysplastic group ( P < .01). Conclusion: The present results indicate that increased TT-TG distance is due to medialization of the TG and not lateralization of the TT. Knees with TD had increased TT-TG distance compared with the knees of the control group and the knees with PD. The TT-PCL distance did not differ significantly between groups, whereas the TG-PCL distance declined with increased TT-TG.

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