A COMPARISON OF EFFECT OF NEBULISED KETAMINE AND NEBULISED MAGNESIUM SULPHATE IN REDUCTION OF INCIDENCE AND SEVERITY OF POSTOPERATIVE SORE THROAT - A PROSPECTIVE RANDOMIZED DOUBLE BLINDED STUDY

Introduction: Postoperative sore throat (POST) is a common occurrence following general anesthesia with endotracheal intubation. The incidence of POST is estimated to be 21%-65% in various studies. Irritation and inammation of the air way are considered to be the cause of POST. Although considered a minor and self limiting complication, it may cause a signicant patient morbidity, dissatisfaction and increased the length of duration of hospital stay. Various pharmacological and non pharmacological methods have been tried to decrease POST with varying success rates. Among the interventions, the use of ketamine gargle or lozenges has highest success rates, but the problem with this is the bitter taste of the drug and the risk of aspiration, so aerosol route of drug administration gained popularity among the anesthesiologists with good acceptance from the patients. It is known that N-methyl-D-aspartate (NMDA) receptors have a role in nociception and inammation. Hence, this study is aimed at using the aerosol route of magnesium sulphate and ketamine and to nd it effectiveness in preventing POST. Aim Of The Study: To evaluate the effect of nebulized ketamine and nebulized magnesium sulphate for attenuation of postoperative sore throat in patients undergoing surgeries under general anesthesia with tracheal intubation. Materials And Methods: This study was done in the Department of Anesthesiology in collaboration with the Department of Surgery in Kanyakumari Government Medical College from January 2019 to December 2019. Patient planned for surgery under general anesthesia except head, neck & ENT surgeries were selected and randomized into two groups (35 each). Each group received nebulisation for 15 min before induction of general anaesthesia. Group M: Nebulization with 500mg magnesium sulphate in 5ml NS. Group K: Nebulization with 50mg ketamine in 5ml NS. The Parameters related to the study such as duration of laryngoscopy, time taken to intubate, duration of surgery, number of attempts to intubate were recorded. Incidence and severity of sore throat were assessed by four point scale. Incidence of sore throat is assessed for 24 hours. Complication were recorded. Results: We found that the demographic parameters were comparable and statistically insignicant. The mean duration of laryngoscopy difference between the two groups Group M - 24.54± 1.12 seconds and Group K - 24.49 ±1.15 seconds was not statistically signicant P= 0.834 (P>0.05). The mean time taken to intubate in Group M - 27.54± 1.12 seconds and Group K - 27.54± 1.12 seconds was not statistically signicant with P=1.000 respectively (P>0.05). The mean duration of surgery in Group M - 90.71±15.67 minutes and the Group K - 88.20 ±16.53 minutes between the two groups was not statistically signicant P= 0.516 (P>0.05). The mean difference of number of attempts taken to intubate between the two groups was statistically insignicant P=0.771 (P>0.05). The overall incidence of sore throat in Group M was 91% and in Group B was 34%. The severity of sore throat between Group M and Group K is statistically signicant at 2, 4, 6 hrs at grade 1 and grade 2. Conclusion: On the basis of our result, we can suggest that the use of perioperative ketamine nebulization when compared magnesium sulphate nebulization reduces the incidence and severity of post-operative sore throat at 4th and 6th hour during postoperative period in patients who had received general anesthesia with tracheal intubation.

DEVELOPMENT OF AN ALGORITHM FOR THE APPOINTMENT OF BIOFEED-BACK THERAPY AND CYTOFLAVIN FOR THE TREATMENT OF OSTEOCHONDROSIS IN ELDERLY PATIENTS

Непрерывное совершенствование протоколов лечения различных недугов, в частности неврологических осложнений остеохондроза, одна из важных задач оказания медицинской помощи пожилым пациентам. Дополнительное курсовое лечение с применением Цитофлавина и БОС-терапии представляется перспективным решением, однако необходима разработка алгоритма прогнозирования его эффективности у пациентов, основываясь на их исходном клинико-психофизиологическом статусе. В результате проведенного исследования выявлены предикторы эффективности применения Цитофлавина и БОС-терапии и разработан алгоритм их назначения. Continuous improvement of protocols for the treatment of various ailments, in particular, osteochondrosis, is one of the important tasks of providing medical care to elderly patients. Supplementation of treatment with Cytoflavin and biofeed-back therapy seems to be a promising solution, however, it is necessary to develop an algorithm to predict it effectiveness in patients taking into account their initial clinical and psychophysiological status. As a result of the treatment, predictors of the effectiveness of the use of Cytoflavin and biofeed-back therapy have been identified and an algorithm for their administration has been developed.

Pandemic COVID-19 and measures to limit its spreading in Bulgaria: aftermaths and conclusions

Since the beginning of 2020, the world has suddenly found itself in a unique situation - the spreading of the coronavirus has caused serious consequences in all areas and at all levels of society and required a radical change in peoples lives. The purpose of this article is, after presenting and analyzing the economic and social consequences of the spreading of COVID-19 and the measures taken by the government, to show that they have had an impact on all areas of the social system and that they will have a further reflection over time. The analysis used a sociological approach that interprets society as an integral system of interrelated and interdependent elements.The analysis showed that, especially in spring, instead of looking for options that balance safety and the ability to work, introducing fewer measures, but more carefully thought out, and strictly monitor their compliance, in fact, too many measures were taken. As the result, the control over their observance was weak. It is difficult to deny the lack of a systematic approach and thinking in perspective. The focus was exclusively on the results characterizing the spread of the coronavirus, ignoring the effects in other areas of public life, as well as in relation to diseases other than coronavirus. The epidemic highlighted problems and gaps in the countrys health care system and showed that there is a need to rethink the universality of market principles, whether they are applicable to health care system, and whether cost-effectiveness is the most important indicator for it, or the criteria for it effectiveness are different.

Knowledge management in the context of academic libraries: the state of the art in brazilian studies

The objective is to identify and analyze, based on the state of the art, how Knowledge Management (KM) has been approached in university libraries. This is a bibliographic search, based on theses, dissertations and papers available in the Digital Library of Theses and Dissertations of the Higher Education Personnel Improvement Coordination, as well as in the Journal Portal, from 2009-2018. We found 13 papers (dissertations and theses), of which 6 were selected due to their proximity to the research theme. In the Journal Portal were recovered 584 papers that, after a “floating reading”, were selected 9. The results show that Knowledge Management has been approached through comparative study, instrument proposition to diagnose or manage information and knowledge in an integrated way, experience reports on Knowledge Management practices, among others. However, in most of the investigated institutions, KM is adopted in a non-systematic way, decreasing it effectiveness.

تطوير كتاب القواعد العربية لطلاب قسم تعليم اللغة العربية بجامعة مولانا مالك إبراهيم الإسلامية الحكومية مالانج

This study aims to determine the development of textbooks for nahwu 2 and it effectiveness in the class. This study uses R&D research methods with the Dick and Carey model. The results of this study indicate that the use of the 'Qowaid book Nahwu 2 Material' in Nahwu 2 learning in class E, 3rd semester of the Department of Arabic Language Education, Faculty of Tarbiyah and Teacher Training, UIN Maulana Malik Ibrahim, Malang runs effectively. This is due to the evidence that the statistical results of (t) between the two classes (3,567) are more than the ttable level at the 5% level (1,740) and from the ttable level at the 1% level (2,567). The researcher concludes that the previous hypothesis is acceptable, and this shows that the use of the book 'Qowaid Nahwu 2 Material' in teaching Nahwu 2 is so effective

AUTOMATED SEARCH OF SOFTWARE ERRORS BY FAZZING METHOD

The paper considers fuzzing as a promising method of testing and error detection in software using the input of incorrect data to programs. Classification of the automated systems of errors search in the software with indication of their shortcomings is made. The substantiation of errors search advantages under the name Driller is given. The stages of Driller cyclic operation are considered including test data input, actual fuzzing, mixed execution and fuzzing repetition. It is emphasized that the Driller is an open source project. In addition, attention is drawn to the possibility of the specified program to eliminate the «exponential explosion» of considered execution paths number, and it effectiveness at a multiplicity of crossings between the paths of the program under test. It was shown that the Driller allows to effectively solve the problems of information security.

Effects of Information Technology (IT) on Internal Audit in Southwest Nigeria Universities

This study examined the effects of information technology on internal audit in Southwest Nigeria Universities. Primary data were employed and questionnaires were distributed to the selected Universities. Out of 180 questionnaires, 152 questionnaires were filled and returned by the respondents. The study employed factor analysis and binary logit regression analysis as estimation techniques. The findings from factor analysis showed that Kaiser-Meyer-Olkin and Bartlett’s tests value was 0.786(78.6%) implying that the variables have a 78.6% variation in the data. The value of components variance revealed 62.750 on component 4 indicating that at component 4 there was 62.8% factor variation in the data. Nonetheless, the logit regression equation revealed that fraud discovery of IT (FD) has a positive and insignificant effect on internal audit. Also, IT effectiveness (ITE) revealed that ITE has a negative and significant effect on internal audit. Equally, asset recovery (AR) exhibited a negative and insignificant effect on internal audit. Furthermore, the external audit (EA) has a positive and insignificant effect on internal audit. This study concluded that a significant relationship exists between information technology and internal audit in Southwest Universities. It was recommended that Universities in Southwest should promote and encourage information technology in the internal audit department and also encourage the external users.