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COMPARATIVE STUDY ULTRASOUND GUIDED ABDOMINAL FIELD BLOCKS VERSUS PORT INFILTRATION IN LAPAROSCOPIC CHOLECYSTECTOMIES FOR POST-OPERATIVE PAIN RELIEF

Research article of Global Journal of Anesthesia and Clinical Research Comparative study ultrasound guided abdominal field blocks versus port infiltration in laparoscopic cholecystectomies for post-operative pain relief Shazia Shafi1, *Nusrat Jehan2,  Kouser  Benazir 3 1Senior Resident, Department of Anesthesiology & Critical Care, Govt. Medical College, Srinagar, India.2Associate professor, Department of Anesthesiology & Critical Care, Govt. Medical College, Srinagar, India.3Consultant, Department of Anesthesiology & Critical Care, Govt. Medical College, Srinagar, India. Background and Aims: Effective post‑operative analgesia after laparoscopic cholecystectomy is important because it facilitates early amelioration, ambulation and short hospital stay. Aim: To compare the postoperative analgesic efficacy of ultrasound guided abdominal field blocks with port site infiltration with ropivacaine in laparoscopic cholecystectomy. Methods: An observational study was conducted in the Postgraduate Department of Anaesthesiology and Critical Care Medicine in collaboration with the Department of General Surgery, Government Medical College, Srinagar from October 2017 – December 2018. Patients were randomised into two groups to receive either local anaesthetic infiltration of the laparoscopy port sites (n = 40, Group A/standard group) and  USAFBs (n = 40, Group B/study group) using a total dose of 30 ml of ropivacaine 0.2% with sterile technique. Randomisation was done by flipping of coin method. The primary objective was to measure magnitude of pain in first 24 hours using numeric rating scores (NRS). To estimate opioid consumption in first 24 hours postoperatively. To assess the quality of pain relief and patient satisfaction on a four point Patient satisfaction scale.  Statistical analysis was done using SPSS version 21. Data were compared using the Chi‑square test and students’ t‑test. Results: Duration of analgesia was significantly longer in Group B than group A. Upon inter group comparison of A vs. B the results were statistically significant (p value <0.001). At all time in 24 hrs. Postoperative period (1, 2, ...

MOTION AND ITS EFFECTS ON THE CEMENT MANTLE – A BIOMECHANICAL ANALYSIS OF FEMORAL STEM DISPLACEMENT DURING IMPLANT CEMENTATION

Research Article of American Journal of Orthopedic Research and Reviews Motion and its Effects on the Cement Mantle - A Biomechanical Analysis of Femoral Stem Displacement during Implant Cementation Michael P. Ast, MD1; Adam Gitlin, MD2; Nadeen O. Chahine, PhD3; Daniel Grande, PhD4; Peter Lementowski, MD5 1Hospital of Special Surgery, New York, NY; 2University of Florida College of Medicine, Jacksonville, FL; 3Department of Biomechanics, Columbia Uni-versity, New York, NY; 4Feinstein Institute for Medical Research, Manhasset, NY; 5Westchester Medical Center, Valhalla, NY Background: It is a common notion that motion of a femoral component during cementation should be avoided as it may weaken the cement mantle. We created an in vitro model of cemented femoral components and subjected them to varying  rotational motion during the cement curing process, to measure the effect on the pullout strength of the stem. Methods:  21 sawbones femurs were separated into four groups.  The first group served as control and was cemented in a standard fashion. The remainder of the stems were divided into groups and subjected to angular rotational displacement within the cement mantle during curing .  Anteroposterior and lateral radiographs were obtained of each model to evaluate for cement defects. Pullout strength testing was performed. Results: Despite rotational displacement, no cement defects were noted on imaging.  The control stems showed an average pullout strength of 3735.79N. The experimental groups showed a trend for lower failure loads but it was not statistically significant (P=0.063). Of the 21 stems tested, three encountered cement mantle failure and associated stem pullout and the remainder failed by peripros-thetic fracture. Conclusion: Despite conventional thinking that rotational displacement during the cementing process leading to disruption of the cement mantle integrity, this was not borne out in our study.  This should give surgeons confidence that in the set-ting of unintended rotational displacement ...

Acute cholecystitis with intraluminal gallbladder bleeding: Case report and literature review

Case Report of International Journal of Case Reports Acute cholecystitis with intraluminal gallbladder bleeding: Case report and literature review Jerica Novak, MD, PhD, Aleksander Göntér, MD, Jurij Janež, MD, PhD Department of Abdominal Surgery, University Medical Centre Ljubljana, Zaloška cesta 7, 1000 Ljubljana, Slovenia, University of Ljubljana, Faculty of Medicine, Vrazov trg 2, 1000 Ljubljana, Slovenia. Background: Hemorrhagic cholecystitis is an infrequent complication of acute cholecystitis associated with high mortality rate. Recognition of this acute abdominal condition is often challenging. Authors present a case of acute intraluminal gallbladder bleeding with a consequential gallbladder wall perforation and hematoperitoneum requiring emergency surgery in a patient on anticoagulant therapy. Case Presentation: An 80-year old woman with atrial fibrillation on warfarin was presented to abdominal surgeon due to acute abdominal pain with hemodynamic instability and active intraluminal gallbladder bleeding on CT-scan. An emergency laparotomy with cholecystectomy was performed. Despite intensive treatment patient died on the third postoperative day. Conclusions: Hemorrhagic cholecystitis is a potentially life-threatening condition. Patients on anticoagulant therapy with clinical signs of acute cholecystitis are more prone to develop bleeding into the gallbladder. Contrast-enhanced CT of the abdomen is the diagnostic modality of choice and cholecystectomy definitive therapy in patients with hemorrhagic cholecystitis. Keywords: hemorrhagic cholecystitis, anticoagulant therapy, hematoperitoneum, abdominal CT, emergency surgery ...

STUDY OF PLACENTAS OF HYPERTENSIVE MOTHERS ASSISTED IN TWO PUBLIC MATERNITIES OF RECIFE-PE

Research Article of International Research Journal of Obstetrics and Gynecology STUDY OF PLACENTAS OF HYPERTENSIVE MOTHERS ASSISTED IN TWO PUBLIC MATERNITIES OF RECIFE-PE Karinne Gomes Mendonça1*, Evandro Valentim da Silva2, Fálba Bernadete Ramos dos Anjos3 1UFPE, 2Pathology Laboratory of Hospital das ClínicasHC/UFPE, 3Professor / Researcher at the Department of Histology and Embryology – UFPE Objective: Perform the histomorphometric study of the following regions: areas of perivillous fibrin deposition; thickness of the endothelial layer of the vessels; analysis of Tenney-Parker changes. Analyze the Placental Index (IP). Results: It was seen that the weight of the placentas increased according to the weight of the newborn, however, when the variable PI was analyzed as being decisive for the development of a risk-free pregnancy, it was found that this parameter was not significant between the groups studied. (p <0.05). It was found that there is a significant difference in relation to the areas of fibrin deposition (P <0.05) between the groups and that it possibly converges with the data found in the literature in which it could be established that in the GrH there is a different relationship in this pattern. The findings of the thickness of the middle layer were significant in the GrH when compared to the GrN (p <0.05), when this parameter is compared between the Hypertensive Disorders of Pregnancy (HDP) groups, microscopically the PE cases showed prominent changes. I n the present study, Tenney-Parker changes were prominent and discreet in 75% of the GrH placentas versus 20% in the GrN. However, there are contradictions in the literature regarding the consideration of this finding seen only in Hematoxylin-Eosin staining. Conclusion: Given the above, the presence of syncytial knots, the difference between vessel thickness and areas of fibrin deposition are possibly involved in the pathogenesis of Hypertensive Syndromes, regardless of age and ...

PROFILE OF PREGNANT WOMEN COLONIZED BY GROUP B Streptococcus SERVED BY THE UNIQUE HEALTH SYSTEM IN A LABORATORY OF MEDIANEIRA / PARANÁ

Research Article of International Research Journal of Obstetrics and Gynecology PROFILE OF PREGNANT WOMEN COLONIZED BY GROUP B Streptococcus SERVED BY THE UNIQUE HEALTH SYSTEM IN A LABORATORY OF MEDIANEIRA / PARANÁ Solange Matias Heinzen*, Isabel Fernandes de Souza, Sheila Caroline Vendrame Maikot, Aline Preve da Silva, Paola Fernanda Fedatto, Ana Carolina Martins Gomes Higher Education Institute of Foz do Iguaçu (IESFI), Foz do Iguaçu, PR. Objective: The objective of this study was to determine the prevalence of pregnant colonization by group B Streptococcus (GBS) and to verify whether socioeconomic and demographic conditions are risk factors for colonization by this bacterium. Method: This cross-sectional study included the collection of sociodemographic data through a questionnaire and authorization to access the result of the cultivation of vaginal swabs for the investigation of GBS of 50 women treated at the Unified Health System (SUS) in a laboratory in the municipality of Medianeira, PR, between august and september 2020. Results: The population studied showed a 14% prevalence of colonization by GBS, within national and world standards. Among the factors analyzed, the only significant and protective association was living with fewer people in the same house, up to two people, reducing the risk of developing a positive culture for GBS by more than 5 times (5.54) when compared to pregnant women who live with more than 3 people in the same residence (p <0.1; RR = 0.181, CI 90% 0.04-0.82). There was no association between colonization by GBS with age, skin color, school education, occupation and type of housing, income, fixed partner, parity and gestational symptoms. Conclusion: This study requires greater sampling for statistical strengthening, however it indicates basic data for the creation of GBS disease prevention protocols based on the applied community. Keywords: Streptococcus agalactiae. Group B Streptococcus (GBS). Vaginal swabs. Maternal colonization. Maternal-fetal ...

PREGNANCY IN ADOLESCENCE AND HEALTH EDUCATION FOR THE EXERCISE OF RESPONSIBLE SEXUALITY: AN INTEGRATIVE REVIEW

Review Article of International Research Journal of Obstetrics and Gynecology Pregnancy in Adolescence and Health Education for the Exercise of Responsible Sexuality: an Integrative Review Vanessa Carla dos Santos Neco1*, Carlos Henrique Souza Andrade2, Danielle Patrícia Mendonça da Silva3. 1UNICAP. 2UNISÃOMIGUEL; 3UNISÃOMIGUEL Objective: This review aims to investigate the scientific production aboute the health education in adolescence for the responsible sexual practice. Methods: This is an integrative review, using scientific articles indexed in the Virtual Health Library (VHL). We searched for articles in the databases LILACS, SCIELO and BDENF and the following descriptors were used: Pregnancy in Adolescence; Nurse; Health Education. In the search, 20 articles were found, of which, only 14 met the objective of the study. Inclusion criteria: full text available, original article, publication between 2014 and 2019 available in Portuguese and included in the proposed theme. Results: Adolescent pregnancy is considered a relevant public health problem, due the high prevalence across the country. The profile of pregnant adolescents is between 12 and 19 years, most of them single, low education, mixed race, housewives. The literature shows that early pregnancy impairs the female emancipation, results the school dropout, early entry into the labor market, disqualification, violence, decreased opportunities and also being associated with the spread of IST’s. Due to this situation and the future repercussions, unplanned pregnancy among adolescents requires holistic approaches to promote health and prevention measures. Conclusion: The nurse is essential in the development of preventive and educational skills with adolescents, establishing a strategy aimed at preventing teenage pregnancy, creating groups with purposes in the promotion of health and prevention of IST’s/early pregnancy, with the objective of making young people aware of the importance of active participation in health education actions. Keywords: Pregnancy, Nursing, Health Education ...