5th Minute Research Articles

Ophthalmic Artery Doppler as a Predictor of Adverse Neonatal Outcomes in Women With Preeclampsia.

This study aimed to evaluate the association between ophthalmic artery (OA) Doppler indices and adverse neonatal outcomes in women with pregnancies complicated by preeclampsia (PE). A prospective cross-sectional study involving 110 pregnant women who were diagnosed with PE in the first 24 h of hospitalization was conducted at three hospitals in southeastern Brazil from April 2020 to December 2022. The ophthalmic parameters analyzed were the resistance index (RI), pulsatility index (PI), first peak systolic velocity (PSV1), second peak systolic velocity (PSV2), ratio of PSV2 to PSV1 (PSV ratio or the peak ratio [PR]), and end-diastolic velocity (EDV). The outcome measures were neonatal death (during hospitalization), neonatal intensive care unit (ICU) admission, gestational age at delivery < 32 weeks, birth weight < 1500 g, birth weight < 10th percentile, the presence of comorbidities associated with prematurity, the use of invasive mechanical ventilation, an Apgar score at the 5th minute < 7.0, and signs of neurological impairment. Pregnant women with severe features of PE showed higher values of systolic (152.8 ± 20.7 vs. 136.3 ± 11.9, p = 0.000) and diastolic (98.1 ± 12.8 vs. 88.1 ± 10.8, p = 0.000) blood pressure values and lower gestational age at admission (31.5 ± 3.8 vs. 33.7 ± 4.3, p = 0.009) than PE without severe features. No significant differences were found between the mean values of the OA Doppler indices when comparing the presence or absence of neonatal outcomes in the women with PE. OA Doppler, while valuable for the prediction, diagnosis, and evaluation of adverse maternal outcomes, does not independently predict adverse neonatal outcomes in women with severe features of PE.

Fire Resilience of Load-Bearing Wall Made of Hollow Timber Elements

During a fire load, a charred layer forms on the timber elements, which is a natural protection against fire, so that a certain level of fire resistance could be achieved by using elements with a larger cross-section. However, this modus of fire protection is not always suitable. One of the most commonly used fire protection systems are fire protection boards. In this work, a large-scale fire test was carried out on a protected load-bearing wall made of hollow elements under the effect of sustained mechanical loads and fire exposure. Different stages of charring were observed. The test was aborted at the 91st minute due to a decrease in the load-bearing capacity and integrity criteria. The allowable average temperature rise on the non-exposed side of the specimen (140 K) was not exceeded until the 91st minute of the test, and the allowable maximum temperature rise on the non-exposed side of the specimen (180 K) was not exceeded until the 90th minute of the test. The loss of specimen integrity occurred at the 90th minute of the test. For surfaces protected by fire-resistant panels, it should be considered that the onset of charring is delayed until a certain time. According to EN 1995-1-2, charring can start before the fire protection is removed, but at a lower charring rate than the rates up to the time of failure of the fire protection. The expression proposed in EN 1995-1-2 shows relatively accurate results for certain systems and thicknesses of fire protection linings. However, it does not consider the presence of more than one lining layer or the full range of lining thicknesses themselves. For the wall described in this paper, the predicted failure time of the fire boards would therefore be 41.5 min, which is not consistent with the results of the experiment (51 min). The results of the calculation model according to EN 1995-1-2 did not fully agree with the results of the fire test on the protected load-bearing wall.

Changes in ultrasonic elastometry parameters of the liver parenchyma during its radiofrequency ablation (experimental study)

Objective. To determine in the experiment the changes in the elasticity of the liver parenchyma during its radiofrequency ablation at different distances from the electrode and their correspondence to the zones of irreversible thermal damage of the tissue. Materials and methods. The elasticity of the parenchyma of six samples of isolated porcine liver during radiofrequency ablation in automatic mode for 12 min with an initial applicator power of 50 W and its subsequent automatic increase by 10 W/min until critical impedance values were reached was evaluated by ultrasonic elastometry with the determination of the Young's modulus. The elasticity of the liver in kilopascals was determined before the start of radiofrequency ablation, during its implementation every minute for 12 minutes and 15, 30 and 60 minutes after the procedure in three zones located at a distance of 1.0, 1.8 and 3.0 cm from the applicator. Results. Before radiofrequency ablation, the elasticity of the liver parenchyma ranged from 4.1 to 9.3 kPa and averaged (6.64 ± 1.55) kPa. At the maximum power of the applicator – (109.67 ± 4.97) W – the transverse size of the hyperechogenic “cloud” at the 12th minute of the procedure was (18.0 ± 1.41) mm. The value of Young's modulus in the first zone of elastometry statistically significantly increased from the 1st minute of radiofrequency ablation and by the 11th minute reached the level of (46.38 ± 5.43) kPa and did not change significantly thereafter. In the second zone, a statistically significant increase in the value of Young's modulus to (44.22 ± 6.55) kPa was observed throughout the procedure, and after its termination it changed statistically insignificantly. In the third zone, changes in the value of Young's modulus occurred 3 minutes after the start of the procedure and continued until its completion, but its maximum value – (15.63 ± 1.57) kPa – exceeded the baseline level only about 2 times, and an hour after the completion of radiofrequency ablation, the value of Young's modulus decreased statistically significantly. Conclusions. The stiffness of the parenchyma of isolated porcine liver increases significantly during radiofrequency ablation under conditions of its sufficient duration, and depending on the distance to the electrode, these changes have different phase character. In loci corresponding to the zone of irreversible tissue necrosis, the initial slow approximately twofold increase in Young's modulus during the first 3 to 4 minutes is followed by a rapid exponential increase in the next 5 to 6 minutes and the formation of a plateau with 6 to 8 times the initial level, after which the index does not change significantly. To determine the edge of liver parenchyma ablation by elastometry, in addition to the absolute value of Young's modulus at the end of radiofrequency ablation and the multiplicity of its increase relative to the baseline value, such criteria as the three–phase nature of the increase in this indicator and the absence of its decrease within an hour after the procedure are equally important.

Fe-doped SrZrO3 nanostructures as photocatalyst: Solid-state synthesis and UV-light driven eradication of thymol blue dye

In this study, pristine and Fe-doped Strontium Zirconate (SZF0 and SZF10) nanophosphors were synthesized using a simple solid-state method. The structural and optical properties of the synthesized materials were extensively characterized using Powder X-ray Diffraction (PXRD), UV–visible spectroscopy, Raman spectroscopy, Field Emission Scanning Electron Microscopy (FESEM), and Transmission Electron Microscopy (TEM). The PXRD analysis confirmed the multiple phase purity and crystallinity with #96–900–0228 (orthorhombic) and #96–153–8368 (cubic) of the samples, having calculated crystallite size of 22.2 nm for SZF0 and 21.4 nm for SZF10. UV-visible spectroscopy revealed the quenching of bandgap energies from 3.24 eV to 1.65 eV for effective UV-light absorption. Raman spectroscopy provided insights into the prominent vibrational modes (Ag, B2g, and B3g) and structural integrity of the doped and undoped samples. Morphological analysis through FESEM and EDAX affirmed the agglomerated cluster clubbed morphology and stated elements of the SZF10 sample with particle size distribution averaging at 22.11 nm which was well aligned with PXRD results. Meanwhile, the TEM analysis confirms the same with high crystallinity. The photocatalytic activity of the synthesized SZF10 sample was evaluated by degrading TB dye under various experimental conditions. The results show a prominent degradation rate of 81.04 % at the 90th minute. The same results were utilized in studying the kinetics of the degradation process which align with the 1st-order kinetics with k and R2 values of 0.00737 and 0.98034, respectively. The influence of different parameters such as pH, catalyst dosage, and dye concentration on the degradation efficiency was systematically studied to obtain the optimum values.

Does Cold Vapor Prevent Postoperative Nausea and Vomiting After Laparoscopic Cholecystectomy? A Randomized Controlled Trial

PurposeThe aim of this study was to examine the effect of cold vapor on nausea and vomiting in the early postoperative period after laparoscopic cholecystectomy. DesignRandomized controlled study. MethodsThis study was carried out with 44 intervention and 44 control group patients who underwent laparoscopic cholecystectomy between May 2022 and December 2022. Cold vapor was applied to the experimental group for 15 minutes in the postanesthesia care unit (PACU). The patients were evaluated in terms of nausea and vomiting at the 0th minute and 30th minute in the PACU, and at the 2nd, 6th, 12th, and 24th hours in service after surgery. FindingsThere was a significant difference between the groups in terms of nausea at the postoperative 30th minute, 2nd hour, and 6th hour. The postoperative nausea incidence and scores in the experimental group were significantly lower. There was no significant difference between the groups in terms of vomiting at all times after surgery. ConclusionsPostoperative cold vapor helps to reduce the severity of nausea but does not affect vomiting. Thus, it can be used in the control of nausea after cholecystectomy.

Maximum extension and regression rate of cutaneous sensory block obtained with the external oblique intercostal block or the modified thoracoabdominal nerves block through perichondrial approach in patients undergoing laparoscopic cholecystectomy.

Several studies demonstrate that both external oblique ıntercostal block (EOIB) and modified thoracoabdominal nerves block through perichondrial approach (M-TAPA) contribute to analgesia in the anterior abdomen by targeting the thoracoabdominal nerves through distinct pathways. However, the sensory assessment and dermatomal analysis remain poorly understood. This prospective observational study aimed to determine the sensory assessment and dermatomal regression rate of EOIB and M-TAPA in patients undergoing laparoscopic cholecystectomy. The study included a total of 24 patients, with 12 patients in each group. Blocks were performed bilaterally, administering 25 mL of bupivacaine 0.25% for each side, resulting in a total volume of 50 mL. The anterior abdominal wall was vertically partitioned into the midabdomen, left-lateral abdomen, and right-lateral abdomen, and horizontally divided into the epigastric, umbilical, and hypogastric regions. Sensory block was assessed at the 45th minute with cold stimulus and pinprick. Subsequent evaluations were at intervals of 6, 10, 14, 18, 22, and 24 hours. The blocked area percentile with cold sensation in the anterior abdomen was 43.07% (36.67-55.74) with EOIB, 40.49% (34.05-43.67) with M-TAPA (P=0.3219). When the region above the intertubercular plane was examined with cold sensation, EOIB covered 55.92% (46.75-62.07), and M-TAPA covered 49.60% (40.39-54.03) of the epigastric and umbilical areas. Assessment of the midabdominal portion of the anterior abdomen revealed that the blocked area percentile was statistically significantly higher in the M-TAPA group with both cold sensation and pinprick. At 45 minutes, the percentage of blocked dermatomes was 100% between T7-T8 in the EOIB group and between T7-T10 in the M-TAPA group. Both groups exhibited lower success rates in dermatomes T5 and T12, with no sensory block within the L1 dermatome, and cutaneous dermatomal block status either absent or negligible after 24 hours. All trocar entries were located within the cutaneous sensory block for both blocks, except for trocar C, which was located most laterally. Bilateral EOIB and M-TAPA produce a comparable sensory cutaneous block in the anterior abdomen, particularly in the umbilical and epigastric regions. Additionally, the midabdominal cutaneous blocked area was greater in patients undergoing M-TAPA, suggesting a more consistent distribution along the anterior cutaneous branches of the thoracoabdominal nerves.

Antiinflamation Activity Test of Keji Beling (Strobilanthes crispa (L.) Blume) Leaves Extraction on White Mencites (Mus musculus)

Background: Inflammation often occurs in According to data from WHO, 2004) the number of people with bone inflammation worldwide reached around 11.9 million people. In high-income countries, around 1.3 million people experience bone pain, while in low to middle-income countries, the prevalence reached 5.9 million. In Southeast Asia, there are 4.4 million people with arthritis. In North Sumatra, the prevalence of arthritis according to the diagnosis of health workers is 8.4%, while based on diagnosis or symptoms it reaches 19.2%. In Medan City, the prevalence based on the diagnosis of health workers is 5.1%, and based on diagnosis and symptoms it is 17.2%. The method used in this study is the formation of artificial edema on the soles of the feet of male white mice with 1% carrageenan induction. Testing the anti-inflammatory activity of keji beling leaf extract was carried out with 25 test animals divided into 5 treatment groups. The groups consisted of positive controls given sodium diclofenac at a dose of 6.5 mg/kgBW, negative controls given Na-CMC 0.5%, and three extract groups at doses of 100 mg/kgBW, 200 mg/kgBW, and 300 mg/kgBW. The results showed that the percentage of inflammation in the five test groups decreased consistently from the 60th minute to the 360th minute after carrageenan induction. The highest percentage of inflammation was recorded at the 120th minute for the Na-CMC group, followed by the 100 mg/kgBW, 200 mg/kgBW, 300 mg/kgBW, and sodium diclofenac groups. The highest percentage of inflammation inhibition was obtained from the sodium diclofenac portion, followed by 300 mg/kgBW, 200 mg/kgBW, and 100 mg/kgBW. This shows that the good inhibition percentage is owned by EDKB 300 mg/kgBW continued sodium diclofenac, and EDKB 200 mg/kgBW and 100 mg/kgBW. This indicates that the sodium diclofenac portion and extract with doses of 100, 200, and 300 mg/kgBW have the power to function as anti-inflammatory agents, compared to the Na-CMC group which showed no effect.

Reducing E. coli and Coliform in clean water using chlorine diffuser combined with white sand

Background: Water intended for hygiene, sanitation, and drinking must be free of physical, chemical, and microbiological pollutants. The most frequent microbiological contaminants in water are E. coli and Coliform bacteria. Chlorination, which uses chlorine compounds, is a widely used technique to eliminate germs from water. This process is regarded as effective and safe for sanitation, disinfection, and consumption. Purpose: To analyze differences in the reduction of E. coli and Coliform bacteria in water using the chlorine diffuser method combined with white sand. Method: A quasi-experimental method and a pretest posttest design, carried out at a boarding house x in Gonilan Kartasura village. The research sample was taken by purposive sampling. The sample criteria are water at the research location, namely Gonilan village which classified as densely populated. Research data was collected using observation techniques using observation sheets with three folds and three divisions of time span, namely 30 minutes, 45 minutes and 60 minutes. The data collected was then analyzed using the anova method to determine the average differences in group samples. Results: The application of a chlorine diffuser combined with white sand can reduce levels of E. coli bacteria. In the Anova test, the p-value scores were obtained at 0.045 and 0.031, thus the alternative hypothesis was accepted, namely that there was a decrease in E. coli and Coliform bacteria using the chlorine diffuser method combined with white sand. The research results in the 60th minute of the experiment went from 1 to 0. Meanwhile, there was no significant decrease in Coliform bacteria. Initially the Coliform level was 68.3, then after 60 minutes of experimentation it only decreased to 63.6. Conclusion: Based on the research carried out, it was concluded that there was a significant reduction in the levels of E. coli and Coliform bacteria using the chlorine diffuser combined with white sand with a higher dose of chlorine used.

Three-Dimensional (3D) Flood Simulation Aids Informed Decision Making: A Case of a Two-Story Underground Parking Lot in Beijing

Flooding in underground spaces, such as subway stations, underground malls, and garages, has increased due to intensified rainfall, urbanization, and population growth. Traditional 2D simulations often overlook crucial vertical flow variations, especially in steep transitions like stairs and ramps. The current study aims to investigate the flood dynamics in large underground geometries by taking a parking lot in Beijing, China, as a study case. The model overcomes the limitations of previous simulations by adapting a full 3D mesh-based simulation with reasonable computational cost. Unlike earlier studies, this model employs a high temporal resolution transient inflow at the inlet to the underground space. Simulation scenarios consider different return periods (5, 20, and 100 years) and inlet water depths, providing an analysis of their impact on flood status in the underground structure. The model generates high spatial–temporal results, enabling precise detection of flood-prone locations, evacuation times, and suggested mitigation techniques. The results recommend evacuating from hazard areas before the 10th minute during extreme flood events. Additionally, the study estimates a 40% increase in flood hazards for scenarios with direct connections between levels. Overall, the study highlights the importance of 3D simulations for accurate risk assessment.

Efficacy of different warming methods for perioperative hypothermia prevention on body temperature and shivering among transurethral resection patients: A systematic review and meta-analysis study

PurposeThe present study attempts to assess the impacts of distinct warming strategies employed to avert perioperative hypothermia on core body temperature and shivering among transurethral resection patients. MethodsWe performed a comprehensive search of Turkish and English keywords across a range of databases, including PUBMED, Web of Science, Cochrane Library, SCOPUS, Ovid, EBSCOhost, Yöktez, DergiPark, and TR Index, to identify studies on the subject published between January 1, 2001–2024. The search procedure yielded 11 studies to be recruited for meta-analysis. We analyzed the data using the trial version of Comprehensive Meta-Analysis Software (CMA). The degree of heterogeneity was quantified using Higgins I2 tests, while we assessed publication bias through Kendall's Tau and Egger's regression analyses. ResultsThis meta-analysis focuses exclusively on the effects of forced air warming and irrigation fluid warming, as only these methods provided sufficient data to calculate effect size. Our findings demonstrated that while forced air warming significantly affected preoperative (g = 0.279), intraoperative (15th minute, T4) (g = 0.845), postoperative (g = 0.647) body temperature and postoperative shivering (g = −2.279), irrigation fluid warming had a significant impact on postoperative body temperature (g = 1.007) and intraoperative shivering (g = 0.188). ConclusionOverall, our results indicated that forced air warming and irrigation fluid warming can serve as a preventive measure against hypothermia and shivering among transurethral resection patients. Given that other forms of warming could not be included in this research, further studies are recommended to explore scholarly evidence on the efficacy of these methods.

Inclusion Transfer Phenomenon under Unsteady Multiphase Flow during Rheinstahl–Heraeus Vacuum Treatment Process

Inclusion particles are extremely harmful to the quality of steel products, and Rheinstahl–Heraeus (RH) vacuum treatment is the key process to remove the inclusions from molten steel. By coupling analyzing the unsteady gas–liquid flow and decarbonization reaction, the inclusion mass/population conservation model is developed to explore the inclusion particles transfer phenomenon during RH vacuum treatment process. The coupling mathematical models are validated by the metallurgical experimental data. The results show that the predicted inclusion mass concentration in unsteady CO–Ar–molten steel multiphase system has significantly smaller relative error than that in steady Ar–molten steel flow. CO bubble plays a key role in the inclusion transfer phenomenon, which prompts the inclusion transport, the collision‐aggregation, and the removal process. At the 4th minute of vacuum treatment, the average inclusion volume concentration and the average inclusion number density in CO–Ar–molten steel are 72.75% and 64.62% of those in Ar–molten steel, respectively. The average inclusion characteristic radius in CO–Ar–molten steel is 7.33% larger than that in Ar–molten steel.

Research on the effect of post-activation potentiation under different velocity loss thresholds on boxer's punching ability.

This study was conducted in accordance with the principles of velocity-based training theory, with the objective of investigating the effects of post-activation potentiation (PAP) induced by different velocity loss (VL) thresholds (10% vs. 20%) on the punching ability of boxers. In addition, the aim was to determine the velocity loss thresholds and time nodes that produced the optimal activation effect. Twenty-four male elite boxers were randomly assigned to three groups: CON, 10 VL, and 20 VL. All subjects in the three groups underwent an activation intervention involving an 85% of the one-repetition maximum (1RM) squat, with 6-8 repetitions performed in the CON. The number of repetitions in the 20%VL and 10 VL was determined based on the velocity loss monitored by the GymAware PowerTool system. Four time points were selected for observation: the 4th, 8th, 12th and 16th minutes. These were chosen to test the subjects' punching ability. The results demonstrated that activation training at different VL induced a post-activation potentiation in boxers, improving punching ability bilaterally and to a greater extent than in the CON. The dominant side demonstrated the greatest efficacy at the 12th minute under the 20% velocity loss threshold, while the non-dominant side exhibited the greatest efficacy at the 8th minute under the 10% velocity loss threshold.

COMPARATIVE EVALUATION OF CARDIOVASCULAR PARAMETERS OF PROPOFOL / ETOMIDATE FOR ABDOMINAL SURGERIES IN CALVES

The calves presented with abdominal affections requiring surgical interventions were randomly divided into group I and group II with seven animals in each group. All the animals were premedicated with dexmedetomidine at 2 µg/kg body weight, pentazocine at 1 mg/kg body weight and midazolam at 0.2 mg/kg body weight intravenously. In group I and group II, anaesthetic induction was carried out with propofol at 2 mg/kg body weight and etomidate at 0.25 mg/kg body weight intravenously, respectively. Both the groups were maintained in Isoflurane anaesthesia with modified oro-endotracheal tube. The cardiovascular parameters such as heart rate, mean arterial blood pressure, systolic and diastolic blood pressure were monitored during different stages of anaesthesia in both the groups. In both the groups, a significant decrease in heart rate was noticed after premedication and anaesthetic induction. A Significant increase was noticed in systolic blood pressure values after anaesthetic induction and 10th minute of anaesthesia in group I and a highly significant increase was noticed after induction up to 10 minutes in group II. A highly significant increase in diastolic blood pressure was noticed after induction and 10th minute in group I, whereas significant increase was noticed in mean arterial pressure after induction and 15th minute of anaesthesia in group II animals. The cardiovascular parameters recorded in the present study concluded etomidate produced better cardiovascular stability and minimal respiratory depression compared to propofol throughout the anaesthetic period.

7550 Case Report On Concurrent Metastases To The Pituitary And Adrenal From A Primary Breast Cancer

Abstract Disclosure: M.V. David-santos: None. M.C. Isidro: None. Background: Metastatic Cancer to the pituitary gland is a rare condition accounting for 0.5% of all pituitary tumors. It rarely manifests clinically and is often found incidentally. Endocrine dysfunction usually arise, with 38.4% of cases presenting with Diabetes Insipidus, while 37.7% as Panhypopituitarism. On the other hand, prevalence of adrenal metastases is at 0.5 to 3.8% with 43% occurring bilaterally. Primary adrenal insufficiency occurs at 12.4% among those with bilateral metastases. Case: A 32-year old Chinese woman was diagnosed with Stage 4 breast adenocarcinoma ER PR Her2 Neu positive with metastases to the axillary lymph nodes, bone and right adrenal in July 2021. She underwent chemotherapy with Paclitaxel and Trastuzumab then radical mastectomy of the left breast in April 2022.5 months post op, PET scan was done which showed a 11 x 18 x 21 mm pituitary mass. In light of the primary malignancy, lesion was considered a metastatic focus. At that time, patient did not exhibit any neurologic symptoms such as blurring of vision or headaches. No polyuria, polydipsia, nocturia, easy fatigability, nausea or vomiting. Physical examination findings were normal. A hormonal panel showed the following: elevated Prolactin at 150 ng/ml (NV 3-20), normal plasma ACTH IRMA 10 pg/ml (NV &amp;lt; 50 pg/ml), low 8AM plasma cortisol at 1.55 ug/dL (Ref 5- 25 ug/dL), TSH was low at 0.15iIU/ml (0.27-3.75) while FT4 was normal at 0.87 ng/dl (NV 0.68 - 2.56).ACTH stimulation showed low cortisol at the 30th minute and 1st hour post ACTH infusion. Serum sodium and urine Osmolality were both normal. The hyperprolactinemia was attributed to Stalk effect, while the decreased cortisol was considered as central adrenal insufficiency. She was then started on Prednisone 5mg tab daily. Repeat TSH and FT4 5 months after showed normal TSH at 1.209, low FT4 at 5.97 pmol/L (NV 9.01-19.05). She was started on Levothyroxine 50mcg daily for the central hypothyroidism.Repeat Cranial MRI 4 months post diagnosis of the pituitary mass showed increased in its size. An endoscopic transsphenoidal resection and biopsy of the pituitary mass showed metastatic carcinoma of the pituitary gland. Staining of the sellar tumor were compatible with a metastatic carcinoma of breast origin. Intensity-modulated radiation therapy (IMRT) at 400 gray was done for 5 fractions and Trastuzumab was continued. Cranial MRI done 6 months post IMRT showed decreasing size of the pituitary mass to its latest size of 6 x 9 x 13 mm as of November 2023. Latest Whole abdominal CT scan of the adrenals showed clearing of the right adrenal Nodule. Conclusion: Breast cancer may also metastasize to endocrine organs causing hormonal dysfunction. Although curative treatment is no longer the goal for Metastatic breast cancer, prolongation of the quality of life is an important aspect to consider. Hormonal work up, surveillance and hormonal replacement can help in attaining this goal. Presentation: 6/3/2024

Appropriate dose of tranexamic acid in the topical treatment of anterior epistaxis, 500 mg vs 1000 mg: A double-blind randomized controlled trial.

Patients with epistaxis typically visit the emergency department for initial treatment. According to recent studies, tranexamic acid (TXA) is effective in the treatment of epistaxis. This study compared the therapeutic superiority of saline to that of 500 and 1000 mg doses of topical TXA for the treatment of anterior epistaxis. Materials and methods: This phase 4 clinical trial was a randomized, controlled, and double-blind trial. A total of 152 patients were divided into three groups. Group 1 was treated with 1000 mg TXA, Group 2 with 500 mg TXA, and Group 3 with saline. Results: Based on multinomial logistic regression analysis, the bleeding frequency at the 5th minute was 2.9 times and rebleeding status was 4.3 times less in Group 1 (1000 mg TXA) than in Group 3 (saline). There were no differences between the three groups in terms of side effects or salvage therapy. Conclusion: In addition to its superiority in treatment, 1000 mg of TXA is recommended because of the decreased rate of recurrent bleeding and low incidence of side effects.

Findings of Hypotension in Spinal Anesthesia Patients with Lumbar 3-4 And Lumbar 4-5

Background: Hypotension is a common complication associated with spinal anesthesia, often resulting from sympathetic nerve block. Factors such as the type of drug, patient positioning, injection site, dosage, and age influence the incidence of hypotension. Purpose: This study aimed to evaluate the incidence of hypotension in patients receiving spinal anesthesia at the lumbar 3-4 (L3-L4) and lumbar 4-5 (L4-L5) injection sites. Methods: A quantitative descriptive study with a cross-sectional approach was conducted, involving 190 respondents selected via purposive sampling. Univariate data analysis was performed. Findings: Findings indicated that patients receiving spinal anesthesia at the L3-L4 site experienced an average systolic blood pressure decrease of 24.69% and a diastolic decrease of 16.17%. In contrast, patients with L4-L5 injections showed a lesser reduction, with systolic pressure dropping by 15.51% and diastolic pressure by 12.31%. Additionally, the pulse rate decreased progressively within the first 20 minutes following induction. The average pulse rate at the 20th minute was 75.06 for patients with L3-L4 injections and 75.65 for those with L4-L5 injections. Conclusion: The study highlights that the incidence of hypotension varies based on the spinal injection site, with more significant decreases in blood pressure observed in patients receiving injections at L3-L4 compared to L4-L5. These findings have important implications for anesthesia management in clinical practice.

Effectiveness and safety of an inexpensive infant chemical warmer: a pilot study

Introduction. Hypothermia has been widely regarded as a major contributor to neonatal mortality and morbidity. Chemical warming packs used during delivery room resuscitation are associated with decreased rates of hypothermia. The ideal thermal mattress should be inexpensive, electricity-free, reusable, and safe for use in low-resource settings. In this pilot study, we describe the characteristics of a novel, inexpensive chemical warmer developed by the authors. Methods. The novel neonatal chemical warmer consists of two main components. The first component is the chemical warmer bag which is designed for single use, while the other is the container in which the chemical warmer is placed upon activation is reusable. A total of 5 chemical heaters were activated and tested. The goal was to determine whether the temperatures measured on the surface of the warmer were in the optimal range of the chemical heaters available so far. The temperature was measured every 5 minutes at 5 places (corners of the heater and in the middle of the heater), and the maximum measured temperature will be recorded. Temperatures were recorded every 5 minutes as long as the surface temperature measured above 35.9 ºC. Results. By the 5 minutes after activation two and at the 10th minute, all five chemical warmers achieved the desired surface temperature &gt; 36.0 °C (range 38.4 – 40.4 °C.). The length in which the chemical warmer provided the temperatures in the desired range (36.0 – 42.0 °C) varied between 35 to 60 minutes, and we observed that this is highly dependent on starting surface temperatures. Regarding the safety of the surface temperatures produced, no recorded temperatures were above 42.0 °C. The maximum recorded temperature was 40.4 °C in the warmer, with the highest starting temperature in the 10th minute. Conclusion. The novel neonatal chemical warmer performed well when the starting surface temperatures were higher, with the best-performing one being the one with the highest starting temperature of 33.0 °C.

DIAGNOSTIK PAPER ANALYTICAL DEVICE (PAD) MENGGUNAKAN EKSTRAK UBI JALAR UNGU UNTUK DETEKSI BORAKS DALAM MAKANAN

Consuming foods containing borax (tetraborate) will cause health problems. However, in reality, borax is often added to foods such as crackers, meatballs, wet noodles, dumplings. These foods are usually produced by unregistered public members, so their quality is less controlled, so routine monitoring of borax levels in food is needed so that the food quality circulating in the community is maintained and safe for consumption. This research aimed to develop simple method that does not use special instruments to diagnose borax using a Paper Analytical Device (PAD) based on digital imaging using natural reagents from purple sweet potato extract. The research design was laboratory research and development (RnD). The research was conducted at Poltekkes Kemenkes Bandung in January-June 2022. The samples used were borax samples at concentrations of 100, 300, and 500 ppm. The research method was PAD based on digital imaging using Image J. This research was carried out by extracting anthocyanins from purple sweet potatoes, then optimizing the anthocyanin concentration extract; pH; measurement time, determining measurement linearity, and validation by determining % recovery. The research results include that the optimum pH is 9. Optimized measurement time is 3 minutes and is stable until the 5th minute, the linear concentration range of tetraborate is 100-500 ppm tetraborate. In the validation test of the PAD method, a recovery percentage of 87.58-87.95% was obtained for 200 and 300 ppm tetraborate samples. The research result will be able to diagnose and monitor borax in food.

Effect Of Cerclage Suture Type On Pregnancy And Newborn Results: Mersylene Suture Versus Prolene Suture

Purpose: The aim of this study is to compare pregnancy and neonatal outcomes according to the type of the suture material used in the transvaginal cerclage operation. Materials and Methods: Patients who underwent transvaginal cervical cerclage due to cervical insufficiency in a tertiary health center between 2020 and 2024 were evaluated retrospectively. Demographic data regarding cerclage indications (ultrasound-based, prophylactic or physical examination-based), number of weeks of gestation in cerclage, cerclage suture type (prolene, mersilen), gestational week at cerclage insertion and delivery, routes of delivery were recorded. In addition, birth weight, 1st and 5th minute APGAR scores, and neonatal intensive care unit (NICU) requirements were recorded as neonatal parameters. Patients were divided into two groups according to cerclage suture type (mersilene or prolene) and maternal, newborn and pregnancy outcomes were compared between these groups. Results: Comparison of the groups in terms of age, gravidity, parity, number of miscarriages and BMI revealed significantly higher mean gravidity in group 1 compared to group 2 (P0.05). No difference was determined with regard to gestational week at cerclage application, cervical length, cervical dilatation just before cerclage insertion, gestational age at cerclage removal and delivery and birth weight (p&gt;0.05). Groups were comparable in terms of subgroups established according to their numbr number of previous deliveries (p&gt;0.05). Groups were comparable in terms of indications for cerclage insertion (p&gt;0.05). Cesarean delivery rate was 40 % in group 1 while it was 43.6 % in groups 2, no statistical difference was determined in terms of rate of cesarean delivery (p&gt;0.05). Similar number of newborns needed NICU admission between the two groups following delivery (17.5% versus 17.9 %p&gt;0.05). Mean APGAR scores at 1st (6.8 versus 7.4) and 5 th (7.8 versus 8.3) min were comparable between the groups (p&gt;0.05) Conclusion: Although mersilen stitch is commonly preferred, data analysis revealed similar results with prolene stitch in terms of maternal and neonatal outcomes.

Video analysis of music therapy interaction for children experiencing neurodevelopment delay

Children experiencing neurodevelopmental delay have motor, linguistic, and cognitive problems that affect their skills in various domains, especially interpersonal ones. Since music therapy is based on musical exchange, these three case studies explore how child–music therapists’ interactions change within and between sessions. Moreover, we evaluated whether the children’s and parents’ musical interaction changed in everyday life. Three children experiencing neurodevelopmental delay participated in 70 psychodynamic music therapy sessions, relying primarily on musical improvisation techniques. The initial (i.e. pre-test) and final sessions (i.e. post-test) were video recorded and codified with the Kategoriensystem Musik Therapie (KAMUTHE) in the 10th and 30th minutes. Videos were analyzed using the Behavioral Observation Research Interactive Software (BORIS). In addition, parents completed the Music in Everyday Life (MEL) Scale to evaluate how they experienced musical activities with their children. Reliable Change Indexes (RCIs) were calculated to assess significant changes in everyday musical activities. Based on video analysis, three children were more active at the 30th minute and the post-test, while Music Therapists stimulated them less. In addition, therapists adapted the activities and stimuli based on the children’s responses. Based on RCIs, parents reported an increased musical engagement with two children. Music therapy might help children experiencing neurodevelopmental delays modify their interaction style and improve motor and interpersonal skills.