Differences of tensile strength in knot tying technique between orthopaedic surgical instructors and trainees

Background Knot tying technique is an extremely important basic skill for all surgeons. Clinically, knot slippage or suture breakage will lead to wound complications. Although some previous studies described the knot-tying technique of medical students or trainees, little information had been reported on the knot-tying technique of instructors. The objective of the preset study was to assess surgeons’ manual knot tying techniques and to investigate the differences of tensile strength in knot tying technique between surgical instructors and trainees. Methods A total of 48 orthopaedic surgeons (postgraduate year: PGY 2–18) participated. Surgeons were requested to tie surgical knots manually using same suture material. They were divided into two groups based on each career; instructors and trainees. Although four open conventional knots with four throws were chosen and done with self-selected methods, knot tying practice to have the appropriate square knots was done as education only for trainees before the actual trial. The knots were placed over a 30 cm long custom made smooth polished surface with two cylindrical rods. All knots were tested for tensile strength using a tensiometer. The surgical loops were loaded until the knot slipped or the suture broke. The tensile strength of each individual knot was defined as the force (N) required to result in knot failure. Simultaneously, knot failure was evaluated based on knot slippage or suture rupture. In terms of tensile strength or knot failure, statistical comparison was performed between groups using two-tailed Mann–Whitney U test or Fisher exact probability test, respectively. Results Twenty-four instructors (PGY6–PGY18) and 24 trainees (PGY2–PGY5) were enrolled. Tensile strength was significantly greater in trainees (83.0 ± 27.7 N) than in instructors (49.9 ± 34.4 N, P = 0.0246). The ratio of slippage was significantly larger in instructors than in trainees (P < 0.001). Knot slippage (31.8 ± 17.7 N) was significantly worse than suture rupture (89.9 ± 22.2 N, P < 0.001) in tensile strength. Conclusions Mean tensile strength of knots done by trainees after practice was judged to be greater than that done by instructors in the present study. Clinically, knot slippage can lead to wound dehiscence, compared to suture rupture.

Differences of tensile strength in knot tying technique between orthopaedic surgical instructors and trainees

Background: Knot tying technique is an extremely important basic skill for all surgeons. Clinically, knot slippage or suture breakage will lead to wound complications. Although some previous studies described the knot-tying technique of medical students or trainees, little information had been reported on the knot-tying technique of instructors. The objective of the preset study was to assess surgeons’ manual knot tying techniques and to investigate the differences of tensile strength in knot tying technique between surgical instructors and trainees.Methods: A total of 48 orthopaedic surgeons (postgraduate year: PGY 2-18) participated. Surgeons were requested to tie surgical knots manually using same suture material. They were divided into two groups based on each career; instructors and trainees. Although 4 open conventional knots with 4 throws were chosen and done with self-selected methods, knot tying practice to have the appropriate square knots was done as education only for trainees before the actual trial. The knots were placed over a 30 cm long custom made smooth polished surface with 2 cylindrical rods. All knots were tested for tensile strength using a tensiometer. The surgical loops were loaded until the knot slipped or the suture broke. The tensile strength of each individual knot was defined as the force (N) required to result in knot failure. Simultaneously, knot failure was evaluated based on knot slippage or suture rupture. In terms of tensile strength or knot failure, statistical comparison was performed between groups using two-tailed Mann-Whitney U test or Fisher exact probability test, respectively.Results: Twenty-four instructors (PGY6- PGY18) and 24 trainees (PGY2-PGY5) were enrolled. Tensile strength was significantly greater in trainees (83.0 ± 27.7N) than in instructors (49.9 ± 34.4N, P=0.0246). The ratio of slippage was significantly larger in instructors than in trainees (P<0.001). Knot slippage (31.8 ± 17.7N) was significantly worse than suture rupture (89.9 ± 22.2N, P<0.001) in tensile strength.Conclusions: Mean tensile strength of knots done by trainees after practice was judged to be greater than that done by instructors in the present study. Clinically, knot slippage can lead to wound dehiscence, compared to suture rupture.

The Effectiveness of Giving Cold Compress in Pain Reduction Intensity of Perineal Wound of Postpartum Mother

Perineal wound pain is very likely to cause problems for the postpartum mothers. In the process of childbirth often occurs perineal wound, for some cases, it will heal permanently, but if the wound is wide enough can be sutured to the perineum. Perineal repair not only giving some benefits, but also can cause pain. One way to deal is by applying non-pharmacological pain management, the way is by giving cold compresses in the form of ice bags, it will result smaller risk. The purpose of this study was to provide cold compress therapy in scars to reduce pain. Methods: Posttest only control group design. The population in this study was 30 postpartum mothers in Kanigoro Health Centers by using purposive sampling. The sample was 16 respondents. The independent variable was cold compress, while the dependent variable was pain in the perineal wound. The instrument used Standart Operating Prosedure. Results: Fisher Exact Probability Test shows p = 0.003 (a = 0.05). It could be concluded that giving cold compress could reduce the problem in perineal wound for postpartum mothers in the Kanigoro Health Center area. Along with this study, respondents are expected to actively ask questions, learn about problems during and after giving birth, especially not only learn about the technique of giving cold compresses to the perineum, but also about the provided comments.

Differences of tensile strength in knot tying technique between orthopaedic surgical instructors and trainees

Background: Knot tying technique is an extremely important basic skill for all surgeons. Clinically, knot slippage or suture breakage will lead to wound complications. Although some previous studies described the knot-tying technique of medical students or trainees, little information had been reported on the knot-tying technique of instructors. The objective of the preset study was to assess surgeons’ manual knot tying techniques and to investigate the differences of tensile strength in knot tying technique between surgical instructors and trainees. Methods: A total of 48 orthopaedic surgeons (postgraduate year: PGY 2-18) participated. Surgeons were requested to tie surgical knots manually using same suture material. They were divided into two groups based on each career; instructors and trainees. Although 4 open conventional knots with 4 throws were chosen and done with self-selected methods, knot tying practice to have the appropriate square knots was done as education only for trainees before the actual trial. The knots were placed over a 30 cm long custom made smooth polished surface with 2 cylindrical rods. All knots were tested for tensile strength using a tensiometer. The surgical loops were loaded until the knot slipped or the suture broke. The tensile strength of each individual knot was defined as the force (N) required to result in knot failure. Simultaneously, knot failure was evaluated based on knot slippage or suture rupture. In terms of tensile strength or knot failure, statistical comparison was performed between groups using two-tailed Mann-Whitney U test or Fisher exact probability test, respectively. Results: Twenty-four instructors (PGY6- PGY18) and 24 trainees (PGY2-PGY5) were enrolled. Tensile strength was significantly greater in trainees (83.0 ± 27.7N) than in instructors (49.9 ± 34.4N, P=0.0246). The ratio of slippage was significantly larger in instructors than in trainees (P<0.001). Knot slippage (31.8 ± 17.7N) was significantly worse than suture rupture (89.9 ± 22.2N, P<0.001) in tensile strength. Conclusions: Mean tensile strength of knots done by trainees after practice was judged to be greater than that done by instructors in the present study. Clinically, knot slippage can lead to wound dehiscence, compared to suture rupture.

Differences of tensile strength in knot tying technique between orthopaedic surgical instructors and trainees

Background: Knot tying technique is an extremely important basic skill for all surgeons. Clinically, knot slippage or suture breakage will lead to wound complications. Although some previous studies described the knot-tying technique of medical students or trainees, little information had been reported on the knot-tying technique of instructors. The objective of the preset study was to assess surgeons’ manual knot tying techniques and to investigate the differences of tensile strength in knot tying technique between surgical instructors and trainees.Methods: A total of 48 orthopaedic surgeons (postgraduate year: PGY 2-18) participated. Surgeons were requested to tie surgical knots manually using same suture material. They were divided into two groups based on each career; instructors and trainees. Although 4 open conventional knots with 4 throws were chosen and done with self-selected methods, knot tying practice to have the appropriate square knots was done as education only for trainees before the actual trial. The knots were placed over a 30 cm long custom made smooth polished surface with 2 cylindrical rods. All knots were tested for tensile strength using a tensiometer. The surgical loops were loaded until the knot slipped or the suture broke. The tensile strength of each individual knot was defined as the force (N) required to result in knot failure. Simultaneously, knot failure was evaluated based on knot slippage or suture rupture. In terms of tensile strength or knot failure, statistical comparison was performed between groups using two-tailed Mann-Whitney U test or Fisher exact probability test, respectively.Results: Twenty-four instructors (PGY6- PGY18) and 24 trainees (PGY2-PGY5) were enrolled. Tensile strength was significantly greater in trainees (83.0 ± 27.7N) than in instructors (49.9 ± 34.4N, P=0.0246). The ratio of slippage was significantly larger in instructors than in trainees (P<0.001). Knot slippage (31.8 ± 17.7N) was significantly worse than suture rupture (89.9 ± 22.2N, P<0.001) in tensile strength.Conclusions: Mean tensile strength of knots done by trainees after practice was judged to be greater than that done by instructors in the present study. Clinically, knot slippage can lead to wound dehiscence, compared to suture rupture.

Differences of tensile strength in knot tying technique between orthopaedic surgical instructors and trainees

Background: Knot tying technique is an extremely important basic skill for all surgeons. Clinically, knot slippage or suture breakage will lead to wound complications. Although some previous studies described the knot-tying technique of medical students or trainees, little information had been reported on the knot-tying technique of instructors. The objective of the preset study was to assess surgeons’ manual knot tying techniques and to investigate the differences of tensile strength in knot tying technique between surgical instructors and trainees.Methods: A total of 48 orthopaedic surgeons (postgraduate year: PGY 2-18) participated. Surgeons were requested to tie surgical knots using same suture material. They were divided into two groups based on each career; instructors and trainees. Although 4 knots with 4 throws were chosen and done with self-selected methods, knot tying practice was done as education only for trainees before the actual trial. The knots were placed over a 30 cm long custom made smooth polished surface with 2 cylindrical rods. All knots were tested for tensile strength using a tensiometer. The surgical loops were loaded until the knot slipped or the suture broke. The tensile strength of each individual knot was defined as the force (N) required to result in knot failure. Simultaneously, knot failure was evaluated based on knot slippage or suture rupture. In terms of tensile strength or knot failure, statistical comparison was performed between groups using two-tailed Mann-Whitney U test or Fisher exact probability test, respectively.Results: Twenty-four instructors (PGY6- PGY18) and 24 trainees (PGY2-PGY5) were enrolled. Tensile strength was significantly greater in trainees (83.0 ± 27.7N) than in instructors (49.9 ± 34.4N, P=0.0246). The ratio of slippage was significantly larger in instructors than in trainees (P<0.001). Knot slippage (31.8 ± 17.7N) was significantly worse than suture rupture (89.9 ± 22.2N, P<0.001) in tensile strength.Conclusions: Mean tensile strength of knots done by trainees after practice was judged to be greater than that done by instructors in the present study. Clinically, knot slippage can lead to wound dehiscence, compared to suture rupture.

PENGARUH PEMBERIAN KURMA TERHADAP KEMAJUAN PERSALINAN KALA II IBU BERSALIN DI RUMAH SAKIT AURA SYIFA KABUPATEN KEDIRI

Progress of labor depends on three factors: (power) is the efficiency of uterine contractions, passenger (fetal) and passage (uterus, cervix, pelvis). When there are any abnormalities in one or more of the factors above it can slow the progress of delivery process. Dates rich in carbohydrates as a source of energy, affect the progress of labor, spontaneity in labor and reduce postpartum hemorrhage. Carbohydrates as a booster are sugars that are absorbed and used by body cells not long after consumed. The purpose of this study was to determine the effect of dates on the progress of the second stage of labor in Aura Syifa Hospital Kediri Regency. The research design used was pre-experimental (pre experimental design) with a static group approach (the static group comparison). The samples were 32 respondents who were determined by accidental sampling technique. In this research the data analysis used was Fisher Exact Probability test. Based on the statistic test result that there was no influence of Providing Date Palm to the mother in labor at second progress of labor in Kediri Aura Syifa Hospital.

Predictive molecular tumor response through circulating DNA (cDNA) measurements and correlation with established prognostic markers in a series of solid tumors treated with multitargeted epigenetic therapy (MTET).

e13015 Background: Epigenetic dysregulation of certain genes contribute to the progression of cancers. Plasma ctDNA concentrations can reflect these altered genes and have been shown to correlate well with tumor burden. Methods: We planned to assess the correlation value of c DNA on known factors for prediction of overall survival (OS), recognized as surrogates for survival. Ten( 10) genes of interest, namely NOTCH1, FGF2, MYC, RB1, ATM, MET, BRCA1, BRCA2, ATM and, VHL, were selected as being highly influenced by epigenetic control. We included 54 patients with reported cDNA on the genes of interest for this study evaluating the predictive impact of early changes in cDNA in response to multitargeted epigenetic treatment and the patient survival. There were 12 cases with NOTCH1 mutations, 20 cases with MYC mutations, 5 cases with RB1, 15 cases with BRCA1 or BRCA2 mutations, 26 cases with FGF2 mutations, 18 cases with MET mutations, 2 with VHL mutations and 2 cases with ATM mutations, for a total of 100 data points. Tests for statistical significance were completed using the Fisher Exact probability test calculator found at vassarstats.net/tab2x2.html. Significance level was set at α = .05. Results: There was statistically significant (p-value: .046) correlation on the response of the allele frequency of the observed NOTCH1 alteration with similar response in the angiogenesis biomarkers (Plasma VEGF) and presence of circulating tumor cells. There was a significant correlation (p-value: .014) between a decrease in AF of the observed MYC alteration and biomarker/imaging response on follow-up. In the group of 26 identified with FGF2 mutations, 22 saw cDNA alteration fraction(AF) reduction post therapy. 16/26 of them had either c Myc or NOTCH1 alterations. Also 8 /18 cases with c Met alterations shared NOTCH1 or Myc alteration. This represents a statistically significant (p-value: .0001) correlation on the response of the allele frequency of the observed FGFR2 alteration with the response of other biomarkers. Conclusions: There were a number of significant correlations observed between early changes in cDNA allele fractions of specific genes and the later observations of established prognostic markers. We conclude that changes in cDNA mutated allele fractions observed in liquid biopsy may provide an early useful independent prognostic marker for tumors carrying epigenetically influenced targets and their alterations.

Pengaruh Pemberian Makanan Pendamping Asi ( MP – ASI) Dini Terhadap Kejadian Kekurangan Energi Protein (KEP) Pada Anak Umur 0 – 24 Bulan Di Wilayah Kota Kediri

Should we know that Mother’s Milk Complementary Foods is begin giving when someday after the baby was born. This is deficient think, because Mother’s Milk Complementary Foods present can make malnutrition consist or disturb child development (Energy-Protein Malnutrition). The destination of this research is to find out effect of giving too early Mother’s Milk complementary Foods with Energy-Protein Malnutrition incident to children on zero until twenty four months old. The methode of this research is the corelation with analitic case control characteristic that is eight child as case and eight others as control of fill up inclusion criteria . The samples will take by purposive sampling tehnis . The finishing data collection are using questionaire by weight and height measurement. The data analitic are using fisher exact probability test with 5% significancy. The result of this research is giving Mother’s Milk Complementary Foods to 87,5% Energy-Protein Malnutrition group and 25% non Energy-Protein Malnutrition is not timely. 100% Energy-Protein Malnutrition is nasty. There is an effect of giving too early Mother’s Food Complementary Foods in Energy-Protein Malnutrition accident on children at zero untill six months old. Be expected for the health personnel to give information and counseling about to give too early Mother’s Milk Complementary Foods about effect and the interval, at the same time for a children whio has Energy-Protein Malnutrition must give supplementary food that appropriate with the local program and integrated by Department of health.; Keywords = Giving too early Mother’s Milk Complementary Foods, Energy-Protein Malnutrition

The Preparation of Breastfeeding Lowers the Incidence of Nipple Blisters of Postpartum Mother in Sub-district Health Centers Gandusari Kec. Gandusari Kab. Blitar

Breastmilk has advantages and privilages as a source of nutrients compared to other nutrientsources. However, the breastfeeding process often fail. The main cause of the failure is a problem in thebreast. One of them are blisters on the nipples. Nipple blisters dominantly caused by breast feedingpreparationespecially on breast feeding techniques and breastcare. The purpose of this study was todetermine how is the preparation of breastfeeding lowers the incidence of nipple blisters of postpartummother in Sub-district Health CentersGandusari Kec.GandusariKab. Blitar. Methods: with posttestonly control group design. The population in this study was 50 postpartum mother in Health Centers.Thesample was 16 respondents by using purposive sampling. The independent variable was the preparationof breastfeeding, the dependent variable was the sore nipple blisters. The instrument used SOP.Result: the statistical Fisher Exact Probability Test showed p=0,003 (a=0,05). It could be concludedthat the preparation of brestfeeding could reduce the incidence of nipple blisters postpartum mother inSub-district Health Centers Gandusari. By this research, it was expected the respondents to activelyask, observing carefully about breasfeeding preparation especially breaastfeeding techniques andtreatments given. So, breastfeeding in infants couldbe succeed. As for the profession of midwifery resultsof this study could be used as the input in motivating postpartum mother, so that it could perform theappropriate techniques of breastfeeding and breastcareto avoid nipple blisters.