scholarly journals Intra-Arterial Labetalol and Nitroglycerin in Preventing Radial Artery Spasm Following Transradial Angiography: A New Approach

2020 ◽  
Vol 26 (2) ◽  
pp. 142-149
Author(s):  
Gohar Eslami ◽  
Samad Golshani ◽  
Mahmood Moosazadeh ◽  
Faezeh Shadfar
Keyword(s):  
Blood Flow ◽  
Clinical Practice ◽  
Pain Intensity ◽  
Radial Artery ◽  
P Value ◽  
Analog Scale ◽  
New Approach ◽  
Vasomotor System ◽  
End Of Treatment ◽  
Significant Difference

Background: Radial artery spasm (RAS) resulted from decreasing blood flow and activation of vasomotor system leads to a decrease in artery diameter, perfusion and patency, and increase the risk of procedure failure. In this study, we investigated the effects of intra-arterial administration of nitroglycerin and labetalol on radial artery diameter, RAS, and pain intensity in patients undergoing diagnostic radial angiography. Methods: Sixty-four patients randomly enrolled into one of the nitroglycerin (150 μg) or labetalol (500 μg) groups. The radial artery size, and the incidence of RAS were measured before, immediately after puncture, and at the end of treatment. Pain intensity was evaluated using a visual-analog-scale (VAS) at the end of the procedure. Hemodynamic status before, and during the procedure was also recorded. Results: Labetalol causes a significantly larger increase in radial diameter than nitroglycerin immediately after intra-arterial injection (2.24±0.58 mm vs. 1.65±0.39 mm, P-value<0.001). The rate of RAS immediately after vasodilator administration in the labetalol group was 3.1% vs. 12.5% in the nitroglycerin group (P-value=0.355), but the overall incidence (immediately after administration+ at the end of procedure) did not show a statistically significant difference (53.125% vs 31.25% respectively, P-value=0.076). The VAS score did not show a significant difference between two groups (1.15±0.44 in nitroglycerin vs. 1.50±0.91, P-value=0.063). Conclusion: Labetalol increases radial artery diameter more than nitroglycerin. However, the efficacy of labetalol in terms of RAS incidence, and patients’ pain was similar to nitroglycerin. Therefore, intra-arterial labetalol could be considered as one of the therapeutic options in clinical practice in order to reduce RAS and procedure failure.

scholarly journals Nitric oxide is not obligatory for radial artery flow-mediated dilation following release of 5 or 10 min distal occlusion

2010 ◽  
Vol 298 (1) ◽  
pp. H119-H126 ◽  
Author(s):  
Kyra Pyke ◽  
Daniel J. Green ◽  
Cara Weisbrod ◽  
Matthew Best ◽  
Lawrence Dembo ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Blood Flow ◽  
Shear Rate ◽  
Flow Velocity ◽  
Radial Artery ◽  
Blood Flow Velocity ◽  
Reactive Hyperemia ◽  
Area Under The Curve ◽  
Flow Mediated Dilation ◽  
Significant Difference

This study investigated the nitric oxide (NO) dependence of radial artery (RA) flow-mediated dilation (FMD) in response to three different reactive hyperemia (RH) shear stimulus profiles. Ten healthy males underwent the following three RH trials: 1) 5 min occlusion (5 trial), 2) 10 min occlusion (10 trial), and 3) 10 min occlusion with cuff reinflation at 30 s (10–30 trial). Trials were performed during saline infusion and repeated during NG-monomethyl-l-arginine (l-NMMA) infusion in the brachial artery. RA blood flow velocity was measured with Doppler ultrasound, and B-mode RA images were analyzed using automated edge detection software. Shear rate estimation of shear stress was calculated as the blood flow velocity/vessel diameter. l-NMMA decreased baseline vascular conductance by 35%. l-NMMA infusion did not affect the peak shear rate stimulus ( P = 0.681) or the area under the curve (AUC) of shear rate to peak FMD ( P = 0.088). The AUC was significantly larger in the 10 trial vs. the 10–30 or 5 trial ( P < 0.001). Although percent FMD (%change in diameter) in the 10 trial was larger than that in the 5 trial ( P = 0.035), there was no significant difference in %FMD between the saline and l-NMMA conditions in any trial: 5 trial, 5.62 ± 1.48 vs. 5.63 ± 1.27%; 10 trial, 9.07 ± 1.16 vs. 11.22 ± 2.21%; 10–30 trial, 6.52 ± 1.43 vs. 7.98 ± 1.51% for saline and l-NMMA, respectively ( P = 0.158). We conclude the following: 1) RH following 10 min of occlusion results in an enhanced stimulus and %FMD compared with 5 min of occlusion. 2) When the occlusion cuff is reinflated 30 s postrelease of a 10 min occlusion, it does not result in an enhanced %FMD compared with that which results from RH following 5 min of occlusion. 3) The lack of effect of l-NMMA on FMD suggests that NO may not be obligatory for radial artery FMD in response to either 5 or 10 min of occlusion in healthy volunteers.

scholarly journals Knowledge, Attitude and Practice of Primary Care Physicians in Dealing with Acute Stroke in Indonesia

2021 ◽  
Author(s):  
Putu Jaya Kusuma ◽  
Lilik Djuari ◽  
Abdulloh Machin ◽  
Asra Al Fauzi
Keyword(s):  
Primary Care ◽  
Clinical Practice ◽  
Thrombolytic Therapy ◽  
Acute Stroke ◽  
Primary Care Physicians ◽  
P Value ◽  
Stroke Management ◽  
Significant Difference ◽  
Level Of Knowledge ◽  
Stroke Knowledge

Objective: There are still many things that interfere with the practice of effective acute stroke management, with one of them being the failure of health workers providing appropriate management. Hence, this study was conducted to evaluate the level of knowledge, attitude and practices of primary care physicians (PCPs) in acute stroke management in Indonesia.Material and Methods: This cross-sectional face-to-face survey was conducted among all PCPs, from 63 primary health care centres; from October, 2019 to January, 2020 in Surabaya, Indonesia. A self-designed questionnaire, consisting of 25 questions, based on several guidelines, was used as the instrument of this survey.Results: In total, 134 PCPs participated. The majority of their level of knowledge obtained was in the moderate category (51.5%), while the majority of their attitude and practices towards stroke were in the good category (67.9% and 75.2%). Nearly 75.0% of PCPs also knew about thrombolytic therapy, but only <50.0% knew the ‘golden period’ of thrombolytic therapy. A significant correlation was found between PCPs knowledge-attitude (p-value<0.001), knowledge-practices (p-value=0.002) and attitude-practices (p-value<0.001). There was also a significant difference in the level of stroke knowledge between PCPs, with different clinical practice experience (p-value=0.015). Better stroke knowledge tended to be obtained by PCPs with younger clinical practice experience.Conclusion: The level of knowledge, attitude and practices of PCPs in acute stroke management in Indonesia is good, but should still be improved; especially knowledge about the use of thrombolytic therapy and its ‘golden period.’

scholarly journals Dor no pós-operatório em crianças submetidas a procedimentos cirúrgicos

2019 ◽  
Vol 87 (25) ◽  
Author(s):  
Amanda Francielle Santos ◽  
Rafaela Ribeiro Machado ◽  
Caíque Jordan Nunes Ribeiro ◽  
José Marden Mendes Neto ◽  
Maria do Carmo de Oliveira Ribeiro ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Child Health ◽  
Pain Intensity ◽  
Exploratory Study ◽  
P Value ◽  
Health Profile ◽  
Chi Square ◽  
Post Surgery ◽  
Significant Difference ◽  
The Face

O objetivo deste estudo foi avaliar os fatores sociodemográficos, clínicos e cirúrgicos relacionados com a intensidade dador no pós-operatório de crianças. Estudo descritivo e exploratório com abordagem quantitativa, realizado com 31 crianças de cinco a 12 anos nas primeiras 72 horas de pós-operatório utilizou-se um questionário com perguntas clínicas, sociodemográficas e as escalas de faces e numérica de dor. Foram realizados os testes Qui-quadrado e Exato de Fisher paraa análise dos resultados. Evidenciou-se que o tipo de cirurgia realizada influencia significativamente (p-valor= 0,036) napresença de dor nas 24h, após a cirurgia. A intensidade da dor com o tipo de cirurgia nos dois primeiros dias de pós-operatório apresentou valor significativo (p-valor=0,044) no primeiro dia e (p-valor=0,021) no segundo. No 2º dia de internação,a variável sexo (feminino) mostrou diferença significativa com relação à média de intensidade de dor (p-valor=0,032) eno 3º dia, a característica clínica que se fez significativa foram os antecedentes patológicos (p-valor=0,031) quando relacionado à intensidade da dor. Conclui-se que as variáveis sociodemográficas, clínica e cirúrgica interferem na presença eintensidade de dor em crianças no pós-operatório, principalmente tipo de cirurgia, sexo e antecedentes patológicos.Palavras-chave: Criança; Dor; Dor pós-operatória; Perfil de saúde.ABSTRACTThe aim of this study is evaluating the socio-demographic, clinical and surgical factors related to the pain intensity inthe children´s post-surgery. Descriptive and exploratory study with a quantitative approach conducted with 31 five totwelve-year-old children in the first 72 hours of the post-surgery, where it was applied a questionnaire with clinical andsocio- demographic questions, and the face and numerical scales of pain. The Chi-square and the Fischer Exact tests wereused for the analysis of the results. It was observed that the kind of surgery performed influences significantly (p-value=0.036) in the presence of pain in the first 24 hours, after the surgery. The intensity of pain with the kind of surgery in thefirst two post-surgery days presented a significant value (p-value=0.044) in the first day and (p-value=0.021) in the secondday. In the 2nd day of admission the variable sex (female) showed a significant difference in relation to the intensity of painaverage (p-value=0.032), and in the 3rd day the significant characteristic was the pathological background (p-value=0.031)when related to the intensity of pain. It is concluded that socio-demographic, clinical and surgical variables interfere in thepresence and intensity of pain in children in post-surgery, especially kind of surgery and pathological background.Keywords: Child; Health profile; Pain; Postoperative pain.

scholarly journals A cooling cuff compared to a moist ice pack on radial artery blood flow and lumen diameter in healthy participants

2018 ◽  
Vol 23 ◽  
Author(s):  
Joshua Gernetzky ◽  
Laura O'Connor ◽  
Desiree Varatharajullu ◽  
Zombuso C. Dludla
Keyword(s):  
Blood Flow ◽  
Radial Artery ◽  
Repeated Measures ◽  
Acute Stage ◽  
Lumen Diameter ◽  
P Value ◽  
Artery Blood Flow ◽  
Post Intervention ◽  
Post Test ◽  
Ice Pack

Background: Cryotherapy is a favourable treatment for post-traumatic injuries in the acute stage because of its effect on inflammation and pain. A novel cooling cuff, which can be easily used and can be wrapped around the injured area that does not require freezing, has been developed. Its efficacy compared to traditional ice therapy has not been established.Aim: To establish the effect of a cooling cuff on radial artery blood flow and lumen diameter compared to moist ice.Setting: Chiropractic clinic and radiographic laboratory.Method: A controlled laboratory pre-test post-test investigation assessed asymptomatic participants who were randomly allocated into a moist ice pack (n = 22) or the cooling cuff (n = 21) group. The intervention was placed on the participants forearm over the radial artery for 15 min. Data was collected by a qualified diagnostic radiographer using Doppler ultrasound. Data was analysed, using repeated measures analysis of variance to assess changes in blood flow and lumen diameter pre- and post-intervention. A p-value of less than 0.05 was considered significant.Results: Both groups showed a significant decrease in radial artery blood flow (p < 0.001) after 15 min with no significant changes being observed in diameter size. No significant differences were observed between the groups for radial artery blood flow or diameter.Conclusion: The cooling cuff resulted in a similar effect on radial artery blood flow and lumen diameter as moist ice, indicating that patients and practitioners may utilise the cooling cuff in the acute phases of an injury to alter blood flow.

Comparison of Renal Segmental Artery Blood Flow on Doppler in Young Obese & Non Obese Individuals

2021 ◽  
Vol 15 (10) ◽  
pp. 3036-3038
Keyword(s):  
Blood Flow ◽  
Sampling Technique ◽  
P Value ◽  
Diabetic Patients ◽  
Artery Blood Flow ◽  
Segmental Artery ◽  
Significant Difference ◽  
History Of ◽  
Renal Parenchymal Disease ◽  
Parenchymal Disease

Aim: To compare renal segmental artery blood flow on Doppler in young obese & non-obese individuals. Methodology: In University Ultrasound Clinic Green Town, Lahore, Pakistan, a comparative study was conducted. 180 patients of age group 16 to 25 were enrolled in this study with convenient sampling technique. All the obese & non-obese patients having no history of renal disease were included in this study. Hypertensive and diabetic patients were also included. Pregnant females having any renal parenchymal disease were excluded. Results: In 90 non-obese individuals the average mean of PI was .989±.249 while in 90 obese individuals the average mean of PI was .985±.338. No statistical difference between the two averages as p-value 0.928> α=0.05. Conclusion: Study concluded that no statistically significant difference between the average PI in non-obese individuals compared to the average of PI in obese individuals. Keywords: Obese, Renal segmental artery, Pulsatility Index (PI), Ultrasonography

scholarly journals The Effect of Cold Compress on Pain Intensity in Fractured Patients at RSUP H. Adam Malik Medan

2021 ◽  
Vol 16 (2) ◽  
Author(s):  
Citra Amelia Lubis ◽  
Dudut Dudut Tanjung ◽  
Asrizal Asrizal Asrizal
Keyword(s):  
Pain Intensity ◽  
T Test ◽  
Control Group ◽  
P Value ◽  
Nursing Interventions ◽  
Significant Difference ◽  
Before And After ◽  
Quasi Experimental ◽  
Equivalent Control ◽  
And Function

<em><span lang="EN-US">Fracture occurs due to the damage of the shape and function of the bone, and the fractured patients generally experience pain. One of the interventions to reduce pain intensity in fracture patients is cold compress. This study aims to identify the effectiveness of cold compress on pain intensity in fracture patients in H. Adam Malik Hospital Medan. This is a quantitative study with a quasi-experimental design approach with an equivalent control group pretest-posttest design. The number of samples is 70 respondents consisting of 35 people for each intervention and control group, respectively, which was collated by consecutive sampling. Data analysis used paired t-test and independent t-test. The results showed that there was a significant influence before and after cold compress intervention on pain intensity (p value 0.001 (p = &lt;0.05)). There is a significant difference between the intervention with cold compresses and the hospital standard intervention on pain intensity in fracture patients (p value 0.001 (p = &lt;0.05)). It can be concluded that cold compress has a significant effect on the pain intensity in fracture patients. Cold compress is one of the nursing interventions that can help to reduce the intensity of fracture pain.</span></em>

scholarly journals EFFECTIVENESS OF ISOTONIC EXERCISES ON QUADRICEPS - HAMSTRING STRENGTH RATIO IN OSTEOARTHRITIC FEMALES

2013 ◽  
Vol 2 (2) ◽  
pp. 15-20
Author(s):  
Nazish Rafique ◽  
Ghazala Noor Nizami ◽  
Anum Rafique
Keyword(s):  
Experimental Design ◽  
P Value ◽  
Strength Ratio ◽  
Analog Scale ◽  
Repetition Maximum ◽  
Functional Activities ◽  
Hamstring Muscles ◽  
Significant Difference ◽  
Before And After ◽  
Quasi Experimental

To evaluate the Q/H strength ratio, before and after the isotonic exercises. The Quasi experimental design was selected in this study. 50 female patients with knee osteoarthritis and disturbed Quadriceps – Hamstring (Q/H) ratio were assessed through Visual Analog Scale (VAS), Range Of Motion, Kellgren-Lawrence Scale and Repetition Maximum (RM). All of the patients were assessed at 1st visit, and then 15 sessions of isotonic exercises were given. They were examined again at 15th day to assess the effects of isotonic exercises on Q/H ratio. There was a significant difference in Q/H ratio before and after isotonic exercises. The average Q/H ratio before an exercise was less (0.8712 ± 0.1174) as compared to the ratio taken after exercises (0.9832 ± 0.1127). The P-value was less than 0.05 that was significant. The strength of quadriceps and hamstring muscles were increased, hence reduced the intensity of pain. The isotonic exercises were found to be effective for strengthening of quadriceps and hamstring muscles. There was a significant increase in Q/H ratio after isotonic exercises, with improvement in pain and ROM. This may improve their daily functional activities.

THE EFFECT OF CUPPING THERAPY ON THE SCALE OF PAIN IN ADVANCED AGE WHO EXPERIENCED JOINT PAIN IN JEMBER

2020 ◽  
Vol 1 (1) ◽  
pp. 21-29
Author(s):  
Istiadhatul Magfiroh ◽  
Wahyudi Widada ◽  
Sofia Rhosma Dewi
Keyword(s):  
Pain Intensity ◽  
Joint Pain ◽  
Cupping Therapy ◽  
The Body ◽  
Wilcoxon Test ◽  
Control Group ◽  
P Value ◽  
Test Results ◽  
Significant Difference ◽  
Before And After

ABSTRACT   Joint inflammation characterized by swelling of the joints, redness, heat, pain and movement disorders. Arthralgia causes the elderly to have difficulty in carrying out activities that are burdening the joints of the body. Wet cupping therapy is a complementary therapy that has a working principle of vacuum, injury and blood-sucking in certain areas so it can cure the disease. This study was to identify the effect of cupping therapy on pain intensity in elderly patients with arthralgia in Bangsalsari Jember. It was a quasy experiment research with pretest-posttest with control group approach. The sample in this study was 30 elderly then divided into two groups, i.e. 15 elderly in the wet cupping therapy group and 15 elderly in the warm compress group. It used purposive sampling. The average pain intensity before moist cupping therapy was 7.47, and after wet cupping therapy 5.53. While the moderate pain intensity before warm compress was 7.00 and after warm compress 5.73. Wilcoxon test results moist cupping therapy obtained P-value 0.001 means there are significant differences before and after the wet cupping therapy. While Wilcoxon test results, warm compress got P-value 0.001 means there are substantial differences before and after the warm compress. Mann Whitney test result obtained P-value 0.383 means there is no significant difference of effect between the treatment group and the control group. There is an effect of cupping therapy and warm compress on pain intensity. Elderly can use wet cupping therapy as an alternative treatment to decrease joint pain intensity arthralgia.

scholarly journals Carotid Sound Signal Artifact Detection based on Discrete Wavelet Transform Decomposition

2021 ◽  
Vol 7 (2) ◽  
pp. 299-302
Author(s):  
Patricio Fuentealba ◽  
Rutuja Salvi ◽  
Jasmin Henze ◽  
Anja Burmann ◽  
Axel Boese ◽  
...  
Keyword(s):  
Blood Flow ◽  
Wavelet Transform ◽  
Discrete Wavelet Transform ◽  
Objective Assessment ◽  
P Value ◽  
Discrete Wavelet ◽  
Artifact Detection ◽  
Significant Difference ◽  
Automated Data Processing ◽  
Processing Techniques

Abstract Auscultation methods allow a non-invasive diagnosis of cardiovascular diseases like atherosclerosis based on blood flow sounds of the carotid arteries. Since this process is highly dependent on the clinician’s experience, it is of great interest to develop automated data processing techniques for objective assessment. We have recently proposed a computerassisted auscultation system that we use to acquire carotid blood flow sounds. In this work, we present an approach for detecting artifacts within the blood flow sound caused by swallowing or coughing events. For this purpose, we first decompose the signal using a discrete wavelet transform (DTW). Then, we compute an energy ratio between the DWT scales associated with the signal information with and without artifacts using a sliding window of 1 s length. Evaluation based on Kruskal-Wallis and Wilcoxon rank-sum tests shows a statistically significant difference (p-value<.0001) between the signal with and without artifact. Therefore, the proposed method allows the identification of the studied signal artifacts.

scholarly journals Assessment of pain experience in adults and children after bracket bonding and initial archwire insertion

2013 ◽  
Vol 18 (5) ◽  
pp. 32-37 ◽  
Author(s):  
Marcio José da Silva Campos ◽  
Marcelo Reis Fraga ◽  
Nádia Rezende Barbosa Raposo ◽  
Ana Paula Ferreira ◽  
Robert Willer Farinazzo Vitral
Keyword(s):  
Pain Intensity ◽  
Periodontal Ligament ◽  
Soft Tissues ◽  
Analog Scale ◽  
Pain Experience ◽  
Low Intensity ◽  
Assessment Period ◽  
Significant Difference ◽  
Orthodontic Patients ◽  
Adults And Children

INTRODUCTION: Ninety five percent of orthodontic patients routinely report pain, due to alterations in the periodontal ligament and surrounding soft tissues, with intensity and prevalence varying according to age. OBJECTIVE: This study aimed to assess toothache and buccal mucosal pain in adults and children during two initial phases of the orthodontic treatment. METHODS: The intensity of toothache and buccal mucosal pain reported by 20 patients, 10 children (11-13 years) and 10 adults (18-37 years) was recorded with the aid of a Visual Analog Scale (VAS), during 14 days - 7 days with bonded brackets only and 7 days with the initial archwire inserted. RESULTS: There was no significant difference in pain intensity among adults and children. After bracket bonding, 50% of the children and 70% of the adults reported pain. 70% of both groups reported pain after initial archwire insertion. While adults reported constant, low intensity, buccal mucosal pain, the children showed great variation of pain intensity, but with a trend towards decreasing pain during the assessment period. After initial archwire insertion the peaks of toothache intensity and prevalence occurred 24 hours in children and 48 hours in adults. CONCLUSIONS: In general, children reported pain less frequently than adults did, though with greater intensity.

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