BACKGROUND Head fixation is necessary to maintain the desired head position. Application of skull pins in neurosurgery leads to hemodynamic changes and this sudden change can be prevented by combining general anaesthesia with scalp block which blocks supraorbital nerve, supratrochlear nerve, zygomaticotemporal nerve, auriculotemporal nerve, lesser occipital nerve and greater occipital nerve which are present in superficial and deep layers of the scalp. Several studies have been done to study the efficacy of Injection levobupivacaine and injection bupivacaine in 0.5 % concentrations for scalp block. However, the comparative efficacy of 0.25% injection levobupivacaine and injection bupivacaine for scalp block has not been determined by any study previously. We wanted to compare the efficacy of 0.25% injection levobupivacaine and 0.25% injection bupivacaine in scalp block on the haemodynamic response to head pinning, incision and during craniotomy. METHODS This prospective randomised study included 60 patients of ASA status I or II between age 18–60 years and of either sex who underwent supratentorial craniotomy under general anaesthesia followed by scalp block. Patients were randomly allocated into two groups of 30 each and before application of the Mayfield skull pin head holder, scalp block was given as per group distribution (Group A: 20 ml 0.25% injection bupivacaine and Group B: 20 ml of 0.25% injection levobupivacaine). The hemodynamic responses were recorded at baseline, during scalp block and after head pin insertion, incision and at craniotomy. The total analgesic requirement during intraoperative and post operative period was noted. RESULTS There were no clinically and statistically significant differences in values of heart rate and blood pressure after head pin insertion, skin incision and craniotomy in both the groups. CONCLUSIONS The study revealed that 0.25% injection levobupivacaine when used for scalp block was as efficacious as 0.25% injection bupivacaine. Both the drugs in low concentration of 0.25% were effective in minimizing pressor response to skull pin insertion, incision and craniotomy with less incidence of complication and reduced intraoperative requirement of analgesia.
{"title":"Evaluation of Clinical Efficacy of Scalp Block with 0.25% Injection Bupivacaine and 0.25% Injection Levobupivacaine to Blunt the Hemodynamic Response to Skull Pin Insertion during Supratentorial Craniotomies - A Prospective Study","authors":"Veena Arvind Ganeriwal, Anjali Gupta, Shrinidhi Kulkarni, Juilee Ajit Salvi","doi":"10.14260/jemds.v12i6.427","DOIUrl":"https://doi.org/10.14260/jemds.v12i6.427","url":null,"abstract":"BACKGROUND \u0000Head fixation is necessary to maintain the desired head position. Application of skull pins in neurosurgery leads to hemodynamic changes and this sudden change can be prevented by combining general anaesthesia with scalp block which blocks supraorbital nerve, supratrochlear nerve, zygomaticotemporal nerve, auriculotemporal nerve, lesser occipital nerve and greater occipital nerve which are present in superficial and deep layers of the scalp. Several studies have been done to study the efficacy of Injection levobupivacaine and injection bupivacaine in 0.5 % concentrations for scalp block. However, the comparative efficacy of 0.25% injection levobupivacaine and injection bupivacaine for scalp block has not been determined by any study previously. We wanted to compare the efficacy of 0.25% injection levobupivacaine and 0.25% injection bupivacaine in scalp block on the haemodynamic response to head pinning, incision and during craniotomy. \u0000METHODS \u0000This prospective randomised study included 60 patients of ASA status I or II between age 18–60 years and of either sex who underwent supratentorial craniotomy under general anaesthesia followed by scalp block. Patients were randomly allocated into two groups of 30 each and before application of the Mayfield skull pin head holder, scalp block was given as per group distribution (Group A: 20 ml 0.25% injection bupivacaine and Group B: 20 ml of 0.25% injection levobupivacaine). The hemodynamic responses were recorded at baseline, during scalp block and after head pin insertion, incision and at craniotomy. The total analgesic requirement during intraoperative and post operative period was noted. \u0000RESULTS \u0000There were no clinically and statistically significant differences in values of heart rate and blood pressure after head pin insertion, skin incision and craniotomy in both the groups. \u0000CONCLUSIONS \u0000The study revealed that 0.25% injection levobupivacaine when used for scalp block was as efficacious as 0.25% injection bupivacaine. Both the drugs in low concentration of 0.25% were effective in minimizing pressor response to skull pin insertion, incision and craniotomy with less incidence of complication and reduced intraoperative requirement of analgesia.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44691126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND The purpose of the present study was to evaluate patellar height and trochlear groove angle in individuals with and without medial patellofemoral ligament rupture for surgical reconstruction and possible clinical use. METHODS The study had a retrospective design, and included 149 people (53 females, 96 men) who were between the ages of 18 and 36 admitted to the Orthopedic Clinic of Bartın State Hospital with various complaints in knee joints and different preliminary diagnoses between January 2005 and December 2020. The study population was examined as two groups, those with and without medial patellofemoral rupture. The study included 61 patients with medial patellofemoral ligament rupture and 88 patients without medial patellofemoral ligament rupture. Patellar morphology, patellar height, trochlear morphology, and patellar alignment were measured from digital MRI images. RESULTS As a result of the study, while significant differences were detected in trochlear groove angle, there wasn’t significant differences in patella elevation (patellar height) between the groups (with and without medial patellofemoral ligament rupture). CONCLUSIONS Our study has versatile evaluation parameters, it will make a significant contribution to the literature.
{"title":"Morphometric Findings in Medial Patellofemoral Ligament Rupture Compared to Individually-Matched Controls","authors":"Ayşe Gül Kabakci, Emre Öğüt, Volkan Tolga Tekbaş, Memduha Gülhal Bozkir","doi":"10.14260/jemds.v12i6.424","DOIUrl":"https://doi.org/10.14260/jemds.v12i6.424","url":null,"abstract":"BACKGROUND \u0000The purpose of the present study was to evaluate patellar height and trochlear groove angle in individuals with and without medial patellofemoral ligament rupture for surgical reconstruction and possible clinical use. \u0000METHODS \u0000The study had a retrospective design, and included 149 people (53 females, 96 men) who were between the ages of 18 and 36 admitted to the Orthopedic Clinic of Bartın State Hospital with various complaints in knee joints and different preliminary diagnoses between January 2005 and December 2020. The study population was examined as two groups, those with and without medial patellofemoral rupture. The study included 61 patients with medial patellofemoral ligament rupture and 88 patients without medial patellofemoral ligament rupture. Patellar morphology, patellar height, trochlear morphology, and patellar alignment were measured from digital MRI images. \u0000RESULTS \u0000As a result of the study, while significant differences were detected in trochlear groove angle, there wasn’t significant differences in patella elevation (patellar height) between the groups (with and without medial patellofemoral ligament rupture). \u0000CONCLUSIONS \u0000Our study has versatile evaluation parameters, it will make a significant contribution to the literature.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46390358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-30DOI: 10.14260/jemds.v12i6.430
Surya Rao Rao Venkata Mahipathy, James Solomon Jesudasan, Ajay Chandrasekar V.S., Alagar Raja Durairaj, Manoj Ananthappan
A 62-year-old male patient had reported to our department with a history of pterygoid implant placement in the right maxillary region. The referring dentist had updated us about the possibility of a misplaced implant. The patient was anxious but showed no clinical signs of discomfort or pain. A CT scan with contrast was done to check for the location of the implant and also visualize the proximity to any vital structures. The CT study revealed an implant seen in the right parapharyngeal space closely abutting the internal carotid artery. The screw of the implant was sharp and since it was closely abutting the internal carotid artery it warranted removal at the earliest. An endoscopic approach was discussed with the ENT surgeons but due to the size of the implant and limited access through the antrum we had to look for an alternative method. The technique of performing an access osteotomy of the maxilla would give better visualization and access to the implant but would require the maxilla to be plated and the patient who was 62 years old was not too keen on the thought of this procedure. Finally, an extraoral submandibular approach was finalized and used. Under general anaesthesia, a submandibular incision was marked and dissection was done, the carotid was first identified and taken control off in case we encountered any bleeding or injury to the internal maxillary artery while removing the implant. Dissection continued towards the mandible and the masseter was split to give access to the pterygoid region. An intraoperative C- arm showed that the implant was in close vicinity. The implant was removed intraorally via the buccal vestibule and the wound sites were closed without any complications.
{"title":"Misplaced Pterygoid Implant removed following Surgical Exploration","authors":"Surya Rao Rao Venkata Mahipathy, James Solomon Jesudasan, Ajay Chandrasekar V.S., Alagar Raja Durairaj, Manoj Ananthappan","doi":"10.14260/jemds.v12i6.430","DOIUrl":"https://doi.org/10.14260/jemds.v12i6.430","url":null,"abstract":"A 62-year-old male patient had reported to our department with a history of pterygoid implant placement in the right maxillary region. The referring dentist had updated us about the possibility of a misplaced implant. The patient was anxious but showed no clinical signs of discomfort or pain. A CT scan with contrast was done to check for the location of the implant and also visualize the proximity to any vital structures. The CT study revealed an implant seen in the right parapharyngeal space closely abutting the internal carotid artery. The screw of the implant was sharp and since it was closely abutting the internal carotid artery it warranted removal at the earliest. An endoscopic approach was discussed with the ENT surgeons but due to the size of the implant and limited access through the antrum we had to look for an alternative method. The technique of performing an access osteotomy of the maxilla would give better visualization and access to the implant but would require the maxilla to be plated and the patient who was 62 years old was not too keen on the thought of this procedure. Finally, an extraoral submandibular approach was finalized and used. Under general anaesthesia, a submandibular incision was marked and dissection was done, the carotid was first identified and taken control off in case we encountered any bleeding or injury to the internal maxillary artery while removing the implant. Dissection continued towards the mandible and the masseter was split to give access to the pterygoid region. An intraoperative C- arm showed that the implant was in close vicinity. The implant was removed intraorally via the buccal vestibule and the wound sites were closed without any complications.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42281229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-30DOI: 10.14260/jemds.v12i6.425
Mohd Altaf Dar, Mudasir Maqbool, Irfat Ara
BACKGROUND Geriatrics is a specialty of medicine that focuses on the health and well-being of the elderly. The elderly in India make up 12.8% of the world's total population. Elderly people sometimes have a wide range of health issues that necessitate the use of prescription medications to treat and avoid consequences. All other age groups use fewer drugs than the elderly do. The current study was done to determine the drug use patterns of elderly patients at a tertiary care teaching hospital in Jammu and Kashmir. METHODS This was a four-month-long study in a tertiary care hospital in Jammu and Kashmir that used a prospective and observational approach. The patient case records, patient/patient caretaker interview at the bedside, prescription charts, and lab results were used to gather pertinent patient data for the study. After getting the patient's/patient caretaker's permission, patients who met the eligibility requirements were enrolled. RESULTS For a total of four months, 120 patients were included in the research. Patients in this study ranged in the age groups of 60 to 70 years (55.73%), 71 to 80 years (25.83%), 81 to 90 years (10.83%), and more than 90 years (7.51 percent ). In this study, individuals with a wide range of illnesses were enrolled, including COPD (21 patients), hypertension (19 patients), diabetes (13 patients), IHD (9 patients), acute exacerbation of bronchial asthma (7 patients), jaundice (4 patients), and pulmonary tuberculosis (6 patients). CONCLUSIONS It was found that poly-pharmacy is linked to a variety of side effects and interactions with medications, including an increase in adverse drug reactions (ADRs). Drug interactions can be minimized if the prescribing physician receives assistance from a clinical pharmacist when designing a treatment plan.
{"title":"Patterns of Drug Use in Geriatric Patients at a Tertiary Care Teaching Hospital in Jammu and Kashmir","authors":"Mohd Altaf Dar, Mudasir Maqbool, Irfat Ara","doi":"10.14260/jemds.v12i6.425","DOIUrl":"https://doi.org/10.14260/jemds.v12i6.425","url":null,"abstract":"BACKGROUND \u0000Geriatrics is a specialty of medicine that focuses on the health and well-being of the elderly. The elderly in India make up 12.8% of the world's total population. Elderly people sometimes have a wide range of health issues that necessitate the use of prescription medications to treat and avoid consequences. All other age groups use fewer drugs than the elderly do. The current study was done to determine the drug use patterns of elderly patients at a tertiary care teaching hospital in Jammu and Kashmir. \u0000METHODS \u0000This was a four-month-long study in a tertiary care hospital in Jammu and Kashmir that used a prospective and observational approach. The patient case records, patient/patient caretaker interview at the bedside, prescription charts, and lab results were used to gather pertinent patient data for the study. After getting the patient's/patient caretaker's permission, patients who met the eligibility requirements were enrolled. \u0000RESULTS \u0000For a total of four months, 120 patients were included in the research. Patients in this study ranged in the age groups of 60 to 70 years (55.73%), 71 to 80 years (25.83%), 81 to 90 years (10.83%), and more than 90 years (7.51 percent ). In this study, individuals with a wide range of illnesses were enrolled, including COPD (21 patients), hypertension (19 patients), diabetes (13 patients), IHD (9 patients), acute exacerbation of bronchial asthma (7 patients), jaundice (4 patients), and pulmonary tuberculosis (6 patients). \u0000CONCLUSIONS \u0000It was found that poly-pharmacy is linked to a variety of side effects and interactions with medications, including an increase in adverse drug reactions (ADRs). Drug interactions can be minimized if the prescribing physician receives assistance from a clinical pharmacist when designing a treatment plan.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44835225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-30DOI: 10.14260/jemds.v12i6.429
Kumaran Chinnappa, Saumya Gaur
A 2 year old boy presented with swelling in the right side of the neck (upper cervical lymph node) since 6 months measuring 3 x 4 cm. The swelling was small in size initially (0.5 x 1cm) and gradually progressed to the present size. It was not associated with pain, fever, cough or loss of weight. Also no associated systemic symptoms. No other lymphadenopathy and organomegaly noted.
2岁男孩，6个月以来出现颈部右侧(上颈淋巴结)肿胀，尺寸为3 × 4 cm。肿胀最初很小(0.5 x 1cm)，逐渐发展到现在的大小。它与疼痛、发烧、咳嗽或体重减轻无关。也没有相关的全身症状未见其他淋巴结病变和器官肿大。
{"title":"Kimura’s Disease in a Young Boy - A Rare Cause of Lymphadenopathy","authors":"Kumaran Chinnappa, Saumya Gaur","doi":"10.14260/jemds.v12i6.429","DOIUrl":"https://doi.org/10.14260/jemds.v12i6.429","url":null,"abstract":"A 2 year old boy presented with swelling in the right side of the neck (upper cervical lymph node) since 6 months measuring 3 x 4 cm. The swelling was small in size initially (0.5 x 1cm) and gradually progressed to the present size. It was not associated with pain, fever, cough or loss of weight. Also no associated systemic symptoms. No other lymphadenopathy and organomegaly noted.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47351574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-30DOI: 10.14260/jemds.v12i6.426
Hussein Talib Mohsin, Mustafa Mohammed Salih, Ali Ridha Hassoon
BACKGROUND Following general anaesthesia, up to 62% of patients experience postoperative sore throat. Despite the fact that it resolves on its own, efforts must be made to reduce it. We wanted to evaluate the difference between conventional method and instrumental measurement of cuff pressure in incidence and severity of postoperative sore throat in this study. METHODS A prospective observational study that included 150 adult patients aged < 50 years scheduled for elective surgical operation requiring general anaesthesia and endotracheal intubation. They were divided randomly into two groups: Group A included 75 patients and the adequacy of cuff inflation was generally assessed clinically and group B included 75 patients and the adequacy of cuff inflation was generally assessed by using a cuff manometer. RESULTS Incidence of postoperative sore throat in all times was significantly lower in Group B than in Group A. Prevalence of mild postoperative sore throat after one hr. was significantly higher in group B than that in group A (94.1% versus 61.4%, P= 0.001). CONCLUSIONS Impaired tracheal mucosal blood flow was an important factor in the incidence of postoperative sore throat associated with tracheal intubation and recommended that a cuff inflation pressure of 30 cmH2O should not be exceeded.
{"title":"Evaluation of the Effect of the Endotracheal Tube Cuff Pressure Measurement on Postoperative Sore Throat","authors":"Hussein Talib Mohsin, Mustafa Mohammed Salih, Ali Ridha Hassoon","doi":"10.14260/jemds.v12i6.426","DOIUrl":"https://doi.org/10.14260/jemds.v12i6.426","url":null,"abstract":"BACKGROUND \u0000Following general anaesthesia, up to 62% of patients experience postoperative sore throat. Despite the fact that it resolves on its own, efforts must be made to reduce it. We wanted to evaluate the difference between conventional method and instrumental measurement of cuff pressure in incidence and severity of postoperative sore throat in this study. \u0000METHODS \u0000A prospective observational study that included 150 adult patients aged < 50 years scheduled for elective surgical operation requiring general anaesthesia and endotracheal intubation. They were divided randomly into two groups: Group A included 75 patients and the adequacy of cuff inflation was generally assessed clinically and group B included 75 patients and the adequacy of cuff inflation was generally assessed by using a cuff manometer. \u0000RESULTS \u0000Incidence of postoperative sore throat in all times was significantly lower in Group B than in Group A. Prevalence of mild postoperative sore throat after one hr. was significantly higher in group B than that in group A (94.1% versus 61.4%, P= 0.001). \u0000CONCLUSIONS \u0000Impaired tracheal mucosal blood flow was an important factor in the incidence of postoperative sore throat associated with tracheal intubation and recommended that a cuff inflation pressure of 30 cmH2O should not be exceeded.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42491328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BACKGROUND Laboratory and clinical data suggest that 70% of laboratory errors take place in the preanalytical phase and it is the most neglected part of the laboratory process. Needle phobia and hemolysis are the major problems in the preanalytical process. Complications during venipuncture due to pain-related needle phobia may lead to puncture of artery instead of the vein and in certain cases nerve damage, pain, numbness and thus resulting in unhappy patient experience and anxiety. Hence, the current evaluation focused on pain perception during venipuncture and the incidence of hemolysis. Objectives The current study intended to find out that the BD Vacutainer® UltraTouch™ push button blood collection set (25G) a) can improve the experience of blood draw in terms of pain perception, b) had insignificant effect on hemolysis in terms of potassium value, c) had insignificant impact on result variation for lactate dehydrogenase, aspirate aminotransferase, iron, cholesterol, creatinine, RBC (Red Blood Cell), haemoglobin (Hb), and platelet count compared to the current blood collection practice. METHODS The study was divided into three phases: Phase 1 – determining pain perception during blood collection with BD Vacutainer® UltraTouch™ push button blood collection set (UTPBBCS), Phase 2 – comparing potassium value between the blood samples taken with UTPBBCS and those using BD Vacutainer® Flashback Needle (FBN), Phase 3 – comparing lactate dehydrogenase, aspirate aminotransferase, iron, cholesterol, creatinine, RBC (Red Blood Cell), haemoglobin (Hb), and platelet count. RESULTS This study found that 91.67% of participants responded with nil to negligible pain and there was no evidence of hemolysis and the evaluated parameters (K+ - Potassium, lactate dehydrogenase, aspirate aminotransferase, iron, cholesterol, creatinine, RBC, haemoglobin, platelet count) were found to be consistent. CONCLUSIONS Phlebotomists found UTPBBCS to be a reliable device and well-received by the volunteers as it minimized pain. Also, there was no hemolysis due to the 25G needle. Therefore, UTPBBCS (25G) can be considered as less painful blood collection device due to a significantly better blood collection experience without compromising sample quality.
{"title":"Effect of BD Vacutainer® UltraTouch™ Push Button Blood Collection Set (25G) on Pain Perception and Hemolysis - The First of Its Kind Evaluation in a Reference Laboratory Setup in India","authors":"Nilesh Shah, Puneet Nigam, Medha Jadhav, Glen Menezes","doi":"10.14260/jemds.v12i5.404","DOIUrl":"https://doi.org/10.14260/jemds.v12i5.404","url":null,"abstract":"BACKGROUND \u0000Laboratory and clinical data suggest that 70% of laboratory errors take place in the preanalytical phase and it is the most neglected part of the laboratory process. Needle phobia and hemolysis are the major problems in the preanalytical process. Complications during venipuncture due to pain-related needle phobia may lead to puncture of artery instead of the vein and in certain cases nerve damage, pain, numbness and thus resulting in unhappy patient experience and anxiety. Hence, the current evaluation focused on pain perception during venipuncture and the incidence of hemolysis. \u0000Objectives \u0000The current study intended to find out that the BD Vacutainer® UltraTouch™ push button blood collection set (25G) a) can improve the experience of blood draw in terms of pain perception, b) had insignificant effect on hemolysis in terms of potassium value, c) had insignificant impact on result variation for lactate dehydrogenase, aspirate aminotransferase, iron, cholesterol, creatinine, RBC (Red Blood Cell), haemoglobin (Hb), and platelet count compared to the current blood collection practice. \u0000METHODS \u0000The study was divided into three phases: Phase 1 – determining pain perception during blood collection with BD Vacutainer® UltraTouch™ push button blood collection set (UTPBBCS), Phase 2 – comparing potassium value between the blood samples taken with UTPBBCS and those using BD Vacutainer® Flashback Needle (FBN), Phase 3 – comparing lactate dehydrogenase, aspirate aminotransferase, iron, cholesterol, creatinine, RBC (Red Blood Cell), haemoglobin (Hb), and platelet count. \u0000RESULTS \u0000This study found that 91.67% of participants responded with nil to negligible pain and there was no evidence of hemolysis and the evaluated parameters (K+ - Potassium, lactate dehydrogenase, aspirate aminotransferase, iron, cholesterol, creatinine, RBC, haemoglobin, platelet count) were found to be consistent. \u0000CONCLUSIONS \u0000Phlebotomists found UTPBBCS to be a reliable device and well-received by the volunteers as it minimized pain. Also, there was no hemolysis due to the 25G needle. Therefore, UTPBBCS (25G) can be considered as less painful blood collection device due to a significantly better blood collection experience without compromising sample quality.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45886150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-30DOI: 10.14260/jemds.v12i5.401
Reenu Elizabeth Thomas, Nitin Batra, Rupali Chopra, Amandeep Bedi
BACKGROUND Myopia is becoming one of the major public health problems globally. Various structural changes are seen in the fundus of myopic patients. Hence there is a need to understand the normal macular thickness in myopes. With the advent of Optical Coherence Tomography (OCT), foveal and macular thickness can be measured with micrometer resolution. However, there have been hardly any studies that have compared the central foveal and macular thickness among low, moderate and high myopes. We wanted to assess foveal and macular thickness in low, moderate and high myopic patients and study the association between foveal and macular thickness with axial length and spherical equivalent. METHODS A total of 150 eyes of 150 subjects with varying degrees of myopia who presented to the Department of Ophthalmology, Christian Medical College and Hospital, Ludhiana formed the study group. Comprehensive ophthalmic examination was performed which included visual acuity, refraction by autorefractometer, axial length by NIDEK AL-SCAN, foveal and macular thickness measurements by Optical Coherence Tomography. RESULTS A total of 150 patients of different grades of myopia were analyzed. The central foveal thickness increased from mild to high myopia. The average macular thickness, and the thickness of the various quadrants in inner and outer macula ring decreased with progression of myopia. CONCLUSIONS It was observed from our study that with increasing grades of myopia, there is increase in central foveal thickness and decrease in the average macular thickness which should be considered mainly in high myopes in retinal disorders.
{"title":"Foveal and Macular Thickness Measurements in Myopes as Determined by Optical Coherence Tomography","authors":"Reenu Elizabeth Thomas, Nitin Batra, Rupali Chopra, Amandeep Bedi","doi":"10.14260/jemds.v12i5.401","DOIUrl":"https://doi.org/10.14260/jemds.v12i5.401","url":null,"abstract":"BACKGROUND \u0000Myopia is becoming one of the major public health problems globally. Various structural changes are seen in the fundus of myopic patients. Hence there is a need to understand the normal macular thickness in myopes. With the advent of Optical Coherence Tomography (OCT), foveal and macular thickness can be measured with micrometer resolution. However, there have been hardly any studies that have compared the central foveal and macular thickness among low, moderate and high myopes. We wanted to assess foveal and macular thickness in low, moderate and high myopic patients and study the association between foveal and macular thickness with axial length and spherical equivalent. \u0000METHODS \u0000A total of 150 eyes of 150 subjects with varying degrees of myopia who presented to the Department of Ophthalmology, Christian Medical College and Hospital, Ludhiana formed the study group. Comprehensive ophthalmic examination was performed which included visual acuity, refraction by autorefractometer, axial length by NIDEK AL-SCAN, foveal and macular thickness measurements by Optical Coherence Tomography. \u0000RESULTS \u0000A total of 150 patients of different grades of myopia were analyzed. The central foveal thickness increased from mild to high myopia. The average macular thickness, and the thickness of the various quadrants in inner and outer macula ring decreased with progression of myopia. \u0000CONCLUSIONS \u0000It was observed from our study that with increasing grades of myopia, there is increase in central foveal thickness and decrease in the average macular thickness which should be considered mainly in high myopes in retinal disorders.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42054468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-30DOI: 10.14260/jemds.v12i5.405
Muhammed Furkan Gedik, Raif Alan
BACKGROUND Negative effects of third molars (3Ms) on the periodontal conditions of adjacent second molars (2Ms) depending on the level of impaction are quite common. Radiographic evaluation is of great importance in such cases. Therefore, the purpose of this study was to compare the efficacy of panoramic radiography (PR) and cone-beam CT (CBCT) images to determine the amount of bone loss on the distal side of 2Ms in relation to mandibular 3Ms. METHODS Radiographic data of 491 patients selected consecutively from the database were scanned. After applying the exclusion criteria, PR and CBCT images of a total of 97 patients were analyzed. The chi-square test was used to determine whether there was a relationship between the independent variables. The measurement of the agreement between PRs and CBCTs was calculated using Cohen's kappa coefficient. RESULTS 97 patients (47 females and 50 males) aged between 18-67 years (33.79±12.23 years) were included in this study. Most of the patients were in their 20s (41.2%). Moderate agreement was found between measurements made using PR and CBCT to determine bone loss in the distal side of the 2M. While bone loss was recorded in 53.7% of the teeth as a result of measurements made with PRs, this prevalence was determined as 61.5% in measurements made with CBCTs. (κ=0.448; P<0.001). There was no difference in terms of bone loss according to gender and location, while the highest rate of bone loss was observed in individuals aged 50 and over. In addition, a maximum bone loss was detected when 3M's position was horizontal and Class III / Level C according to Winter and Pell & Gregory classifications, respectively. CONCLUSIONS In individuals with 3M teeth, it is critical to use radiographs at regular intervals to monitor the periodontal status of 2M teeth, even in the absence of symptoms. In cases where severe bone loss is observed or suspected to be severe, CBCT provides detailed information and facilitates the clinician in planning any intervention.
{"title":"Evaluation of the Relationship between Mandibular Third Molars and Adjacent Second Molars - Panoramic Radiography vs. CBCT","authors":"Muhammed Furkan Gedik, Raif Alan","doi":"10.14260/jemds.v12i5.405","DOIUrl":"https://doi.org/10.14260/jemds.v12i5.405","url":null,"abstract":"BACKGROUND \u0000Negative effects of third molars (3Ms) on the periodontal conditions of adjacent second molars (2Ms) depending on the level of impaction are quite common. Radiographic evaluation is of great importance in such cases. Therefore, the purpose of this study was to compare the efficacy of panoramic radiography (PR) and cone-beam CT (CBCT) images to determine the amount of bone loss on the distal side of 2Ms in relation to mandibular 3Ms. \u0000METHODS \u0000Radiographic data of 491 patients selected consecutively from the database were scanned. After applying the exclusion criteria, PR and CBCT images of a total of 97 patients were analyzed. The chi-square test was used to determine whether there was a relationship between the independent variables. The measurement of the agreement between PRs and CBCTs was calculated using Cohen's kappa coefficient. \u0000RESULTS \u000097 patients (47 females and 50 males) aged between 18-67 years (33.79±12.23 years) were included in this study. Most of the patients were in their 20s (41.2%). Moderate agreement was found between measurements made using PR and CBCT to determine bone loss in the distal side of the 2M. While bone loss was recorded in 53.7% of the teeth as a result of measurements made with PRs, this prevalence was determined as 61.5% in measurements made with CBCTs. (κ=0.448; P<0.001). There was no difference in terms of bone loss according to gender and location, while the highest rate of bone loss was observed in individuals aged 50 and over. In addition, a maximum bone loss was detected when 3M's position was horizontal and Class III / Level C according to Winter and Pell & Gregory classifications, respectively. \u0000CONCLUSIONS \u0000In individuals with 3M teeth, it is critical to use radiographs at regular intervals to monitor the periodontal status of 2M teeth, even in the absence of symptoms. In cases where severe bone loss is observed or suspected to be severe, CBCT provides detailed information and facilitates the clinician in planning any intervention.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45837821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-30DOI: 10.14260/jemds.v12i5.400
Rubble Mangla, Nitin Batra, Gurvinder Kaur, Tanisha Mittal, Reenu Thomas
BACKGROUND Precise central corneal thickness (CCT) measurement is of utmost importance in various corneal diseases and refractive procedures. Various methods are available to measure CCT. But studies comparing CCT measurements with different devices have shown variable results. This study compares the CCT measurements by different devices and Ultrasound Pachymetry (USP). METHODS This prospective study that was conducted from October 2017 to June 2019 included 100 subjects aged more than 18 years and CCT was measured by non-contact specular microscopy (NCSM), spectral domain optical coherence tomography (SD-OCT), optical biometry (OB) and USP in normal eyes. For every patient and with each device, three readings were taken and an average was recorded. The data recorded per protocol was analyzed using Intraclass correlation coefficient and Bland-Altman analysis. RESULTS The mean value of CCT with NCSM, SD-OCT, OB, USP was 528.98±32.18µm, 532.64±30.49µm, 517.47±31.89µm and 533.39±33.44µm, respectively. The intraclass correlation was found to be maximum between NCSM and USP (0.953, p<0.001). The mean paired difference of CCT values with SD-OCT and USP was statistically insignificant (-0.75±14.73, p=1.00) whereas the difference obtained with all other devices was statistically significant. CONCLUSIONS A statistically significant positive correlation (p<0.001) was observed on comparing all the four devices with each other for measurement of CCT. The OCT had the best agreement and also positively correlated with USP. Hence, we conclude that OCT can be an effective alternative to USP for measuring CCT.
{"title":"Comparison of Central Corneal Thickness Measurement by Specular Microscopy, Optical Coherence Tomography, Optical Biometry and Ultrasound Pachymetry in Normal Eyes","authors":"Rubble Mangla, Nitin Batra, Gurvinder Kaur, Tanisha Mittal, Reenu Thomas","doi":"10.14260/jemds.v12i5.400","DOIUrl":"https://doi.org/10.14260/jemds.v12i5.400","url":null,"abstract":"BACKGROUND \u0000Precise central corneal thickness (CCT) measurement is of utmost importance in various corneal diseases and refractive procedures. Various methods are available to measure CCT. But studies comparing CCT measurements with different devices have shown variable results. This study compares the CCT measurements by different devices and Ultrasound Pachymetry (USP). \u0000METHODS \u0000This prospective study that was conducted from October 2017 to June 2019 included 100 subjects aged more than 18 years and CCT was measured by non-contact specular microscopy (NCSM), spectral domain optical coherence tomography (SD-OCT), optical biometry (OB) and USP in normal eyes. For every patient and with each device, three readings were taken and an average was recorded. The data recorded per protocol was analyzed using Intraclass correlation coefficient and Bland-Altman analysis. \u0000RESULTS \u0000The mean value of CCT with NCSM, SD-OCT, OB, USP was 528.98±32.18µm, 532.64±30.49µm, 517.47±31.89µm and 533.39±33.44µm, respectively. The intraclass correlation was found to be maximum between NCSM and USP (0.953, p<0.001). The mean paired difference of CCT values with SD-OCT and USP was statistically insignificant (-0.75±14.73, p=1.00) whereas the difference obtained with all other devices was statistically significant. \u0000CONCLUSIONS \u0000A statistically significant positive correlation (p<0.001) was observed on comparing all the four devices with each other for measurement of CCT. The OCT had the best agreement and also positively correlated with USP. Hence, we conclude that OCT can be an effective alternative to USP for measuring CCT.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44745362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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