Ice Packs Research Articles

Cryotherapy in Postoperative Shoulder Surgery: A Systematic Review.

Cryotherapy, a therapeutic technique involving localized cooling of the body, has gained popularity for postsurgical rehabilitation. It induces a reduction in cellular metabolism, vasoconstriction, and pain relief, making it an attractive option for managing postoperative (PO) shoulder pain. This systematic review aimed to assess the effectiveness of cryotherapy in PO shoulder patients, focusing on pain, range of motion, functionality, and temperature changes. The review included six randomized clinical trials, involving a total of 233 patients who underwent various shoulder surgeries. Cryotherapy was applied using different methods, including Cryo/Cuff, Cryoton®, Polar Care 300, and ice packs. Results indicated that cryotherapy was generally effective in reducing PO shoulder pain. However, one study found no significant difference in pain outcomes between the cryotherapy group and control group. Furthermore, three studies demonstrated a decrease in intra-articular and skin temperatures with cryotherapy application. A risk of bias analysis revealed some concerns in the overall risk of bias for five studies, with one study considered to have a high risk of bias. Although publication bias assessment was not conducted due to the limited number of included studies, it was noted that the studies exhibited heterogeneity in terms of population, intervention methods, and outcome measures. In conclusion, cryotherapy appears to be a promising adjunctive treatment for PO shoulder pain, although the existing evidence has some limitations, including small sample sizes and methodological concerns. More high-quality studies are needed to establish the full extent of cryotherapy's effectiveness in PO shoulder rehabilitation, especially regarding its impact on functionality and range of motion.

First aid and pre-hospital practices in snakebite victims: The persistent use of harmful interventions

First aid intervention and pre-hospital (FAPH) practices are common in patients suffering from snakebite envenomation (SBE). In this study, we have reviewed the literature concerning the use of these practices in various regions of the world in the period 1947–2023 based on published prospective studies. A total of 71 publications fulfilled the inclusion criteria. In terms of the total number of patients in all studies that used each FAPH intervention, the most common practice was the application of tourniquets (45.8%). Other FAPH practices described include cuts/incisions (6.7%), the application of a variety of natural or synthetic substances at the bite site (5.6%), and ingestion of natural, usually herbal, remedies (2.9%). Washing the site of the bite was described in 9.1% of patients. There were other less frequent FAPH practices, including suction, splinting-immobilization, pressure-bandage, ice packs, application of a snake/black stone, and administration of alcoholic beverages. There were differences in the extent of application of FAPH interventions in different continents. Tourniquets were highest (55.7%) in Asia. Topical application of various products was common in South America, while pressure-bandage was only reported in Australia. We did not find any statistically significant variations in the frequency of the most frequent FAPH interventions at three-time intervals (before 2006, between 2006 and 2015, and after 2015). Our findings highlight the use of FAPH interventions in patients suffering SBE, some of which are known to be harmful. It is necessary to study these practices to a higher level of geographic granularity, using community-based surveys. Programs tailored to local contexts should be promoted, aimed at avoiding the use of harmful FAPH practices. It is also necessary to assess the efficacy and safety of some interventions through robust preclinical and clinical studies.

Epididimo-orhitis u 13-godišnjeg dječaka tokom varicella infekcije – ultrazvučno praćenje

Varicella is a highly contagious infectious disease that can cause various complications. One of them, epididymo-orchitis, is rare and poorly described in literature, and thus remains seldom thought of, under-diagnosed, and poorly treated. In this report we present the case of a 13-year-old boy initially examined by an infectologist and a pediatric surgeon under the diagnosis of a scrotal bacterial superinfection during a varicella infection. Wrongly treated with antibiotics, he was then examined by a pediatric endocrinologist, diagnosed with epididymoorchitis as a varicella complication, and treated with acetaminophen, ice packs and scrotum suspension, as the 24-hour window for antiviral therapy initiation was missed. Laboratory test showed no signs of infection, while ultrasonography showed enlargement of the right testicle and epididymis with thickening of tunica albuginea and paratesticular effusion. The ultrasound follow up then showed improvement with each examination and a year later a completely normal finding. The hormonal status was normal during the follow up, so was the sperm count. However, sperm mobility was reduced 5 years later and the patient was diagnosed with asthenozoospermia. Hence we must emphasize the role of a varicella infection and its ability to leave a long term consequence to reproductive health. Having in mind the diminished antiviral therapy and still doubtful complication prevention we have to point out the prevention measures, including vaccination and the development of new antiviral methods.

Coldpack Intervention to Alleviate Hematoma in Post-Percutaneous Coronary Intervention Patient: A Case Study

Introduction: Interventions necessary for patients experiencing Coronary Artery Disease (CAD) include revascularization through Coronary Artery Bypass or Percutaneous Coronary Intervention (PCI). Vascular complications resulting from PCI procedures include hematoma, microvascular aneurysm, bleeding, edema, incision site pain, ecchymosis, embolism, arterial occlusion, arterial spasm, arteriovenous fistula, and retroperitoneal hematoma. Objective: To describe the nursing intervention outcomes using cold packs to address hematoma in post-PCI patients with femoral sheath access. Method: A qualitative study employing a case study approach conducted from March 23-25, 2023, at the Heart and Vascular Hospital Tasikmalaya. Inclusion criteria for participants include a diagnosis of Coronary Artery Disease (CAD), prior PCI intervention, PCI access via femoral sheath, and willingness to provide informed consent. The intervention involves the application of a cold pack. Research instruments utilized in this study include semi-structured interviews (in-depth interviews) and observations using The Femoral Scale. Result: The use of cold packs to address hematoma in post-PCI patients with femoral sheath access is effective. This is evidenced by the absence of hematoma in post-PCI patients with femoral access after applying mechanical pressure with a cold pack. During the observation, patients did not express significant complaints; they reported greater comfort using a cold pack compared to the conventional sandbag approach. Conclusion: The utilization of cold packs in this case can be considered an alternative to sandbags to enhance patient comfort. However, it is imperative to conduct additional monitoring when removing the cold pack, especially during the 6-hour immobilization period, to ensure patient awareness and compliance with immobilization protocols.

Network meta-analysis of randomized controlled trials comparing the effectiveness of different treatments in reducing amniocentesis-associated pain and anxiety

ObjectiveThis network meta-analysis compared different methods to determine which is most efficient at lowering pain and anxiety in women undergoing amniocentesis.MethodWe looked through all published randomized controlled trials in the databases PubMed, Scopus, Web of Science, Cochrane, and EM base. Anxiety and pain were the predominant results. We used the R software version 4.2.1 to analyze the data.ResultsWe included a total of 20 studies, with sample sizes ranging from 60 to 570. Virtual reality was the most effective strategy for lowering pain during AC [MD = -1.30, 95% CI (-2.11, -0.49)]. In addition, paracetamol use was the most successful approach for lowering pain following AC [MD = -1.68, 95% CI (-1.99, -1.37)]. The use of H7 acupressure, however, was the strategy that significantly reduced anxiety following AC [SMD = -15.46, 95% CI (-17.77, -13.15)].ConclusionThe most effective method for reducing pain is the combination of virtual reality with paracetamol. Whereas, the most effective way to reduce anxiety is to combine an ice gel pack with H7 acupressure before applying AC.

The Predictive Value of Cold Pack Test for Pain After Third Molar Surgery

Early identification of patients who are prone to postoperative pain may provide individualization of postoperative analgesia strategies. The aim of the study was to investigate whether the cold pack test is associated with postoperative pain levels after mandibular third molar surgery. This prospective cohort study included healthy male patients admitted to Department of Oral and Maxillofacial Surgery of a tertiary health-care center between June 2022 and December 2022 and scheduled for lower third molar extraction. Those who had used any analgesic within the past 10days or had a history of intolerance/allergy to analgesics were excluded. The primary predictor variable was pain tolerance, measured using the endurance test score. Subjects were grouped into two categories, low tolerance test score (withdrew the hand from the cold pack in <240seconds) and high tolerance test score (maintained the hand on the cold pack for 240seconds). The primary outcome variable was pain measured by the patients from 0 to 10 with the visual analog scale, and the secondary outcome variables were the amount of ibuprofen and paracetamol consumed in the postoperative period. Pain measurements and ibuprofen consumption were recorded at 0-2, 8, 16, 24, 32, 40, 48, 56, 64, 72, 80, 88, and 96hours (0-2 interval of the first 2hours immediately after surgery). Age, classification and position of mandibular third molar were utilized as covariates. The relationship between pain tolerance and postoperative pain was analyzed using the Mann-Whitney U test and the Fisher exact test. Statistical analysis was performed using the SPSS version 28.0 software. A total of 30 male patients with a mean age of 22.5±4.8years were included in our study. In the group with low pain tolerance, the pain scores at the first 2hours, 32, and 48hours after the operation (4.55±3.59, 2.91±2.59, 2.91±2.43, respectively) were found to be significantly higher than the group with high pain tolerance (2.00±2.67, 0.95±1.68, 0.95±1.39, respectively) (P<.05). In the first 2hours after the operation, the amount of ibuprofen consumed was also significantly higher in the group with low pain tolerance compared to the other group, and 81.8% of this group felt the need to consume ibuprofen (P<.05). The cold pack test, a more practical version of quantitative sensory testing, is useful in identifying male patients at risk of developing greater pain after third molar surgery. It can be helpful to provide effective analgesia in male patients with different pain tolerance thresholds.

The effect of cold packs, lidocaine spray, and flashlights on cannulation pain in patients undergoing hemodialysis: a randomized controlled trial

BackgroundPain is a frequent and critical problem in daily hemodialysis practice. The pain experienced during arteriovenous fistula cannulation varies from 12% to even 80% in hemodialysis patients depending on the pain assessment tools used. Pain can lead to sleep problems, decreased compliance with hemodialysis therapy, frequent hospital hospitalizations, a decline in quality of life, and high death rates. Despite utilizing several methods as pain relief, it is still unknown in the literature and practice which method is the most effective. The purpose of the study was to compare the effect of lidocaine spray, cold packs, and flashlights on the pain induced by arteriovenous cannulation in hemodialysis patients. This was a prospective randomized open-label controlled trial. Hundred and eight adult patients on regular hemodialysis were recruited and simply randomized into one of four groups (lidocaine spray, cold packs, flashlights, and control) before cannulation.ResultsThe mean pain severity using visual analog scale was 4.3 (3.3–5.7) in lidocaine group, 4 (3–5.7) in cold packs group, 4.3 (3.3–5.3) in flashlight group, and 4.7 (3–6) in control group. There was a borderline significant difference between groups using Kruskal–Wallis test (p = 0.054). The post hoc Tukey test showed that only cold packs differ from control group with borderline significance (p = 0.051).ConclusionThe results showed that cold packs were safe and effective than lidocaine spray or flashlights in reducing cannulation pain. It is suggested to implement this method before cannulation in hemodialysis patients to reduce pain and improve quality of life. Future studies are needed to compare different application times of cold packs and its impact on pain scores to recommend the optimum time needed to achieve maximum analgesic effect.Trail registration: Clinical trials.gov NCT05822063, REC #194.Graphical abstract

PSII-19 Analysis of Vitamin A and E in Biological Samples After Prolonged Processing

Abstract The objective of this study was to assess vitamin A and E concentrations in liver and serum samples after extended transport to a diagnostic laboratory. This study was designed to quantify any vitamin A and E concentrations in liver or serum after samples were stored in a Styrofoam cooler with four ice packs for up to 2 days to simulate mailing samples to a diagnostic laboratory. Liver (entire right medial lobe, divided into three equal pieces) and blood (30 mL total, into three 10 mL serum tubes; BD Vacutainer, Franklin Lankes, NJ) samples were collected from six barrows (approximately 10 kg) post-euthanasia. All the samples (liver and serum) for two pigs were placed in one Styrofoam cooler with four ice packs (ThermoSafe PolarPack; 13.97 X 15.24 cm; Sonoco; Hartsville, SC, US) which was then placed onto a benchtop (room temperature, approximately 20°C) for the duration of the study. At the designated timepoints of 0, 1, or 2 days after collection, one sample of both tissue and serum were removed from the cooler, processed, and stored at -80°C until submission to the diagnostic laboratory. To process the samples, the blood was centrifuged (2,000 x g, 10 minutes, at 4°C) and the serum was isolated and placed into 1.5 ml microcentrifuge tubes (Fisher Scientific, Waltham, MA, CAT: 05-408-129). The liver was stored in whirl pack bags (15.24 cm X 22.86 cm). Samples were analyzed for vitamin A (retinol) and E (alpha-tocopherol) concentrations at the Iowa State University Veterinarian Diagnostic Laboratory (Ames, IA). Data were analyzed using the GLIMMIX procedure in SAS 9.4 (Statistical Analysis System, Cary, NC) with animal as the experimental unit and a fixed effect of time. No differences (P &amp;gt; 0.05) were found in serum vitamin A and E (Table 1; vitamin A: d 0 0.26 ppm, d 1 0.26 ppm, and d 2 0.27 ppm, vitamin E: d 0 2.20 ppm, d 1 2.36 ppm, and d 2 2.28) regardless of the sample being processed the day of, one day after, or two days after being collected from the pig. There were no differences (P &amp;gt; 0.05) in vitamin A or E concentrations (Table 1; vitamin A: d 0 12 ppm, d 1 11 ppm, and d 2 12 ppm, vitamin E: d 0 1.74 ppm, d1 2.32 ppm, and d 2 2.08) in the liver throughout the study. Based on these data, vitamin A and E concentrations in liver and serum samples are stable for up to 2 days after being stored in a cooler with ice packs at room temperature.

Application of dual-frequency ultrasound for reduction of perilesional edema and ecchymosis after rhinoseptoplasty.

Biological aspect and clinical research demonstrated that dual-frequency ultrasound (local dynamic micro-massage, LDM) waves of very high frequency can significantly modify cellular signaling providing anti-inflammatory and anti-fibrotic effects. During the recent past, these waves were successfully applied for the treatment of various inflammatory skin conditions, hypertrophic scars, and chronical wounds. Since the main complications after rhinoseptoplasty are caused by excessive inflammatory reactions and development of fibrosis along nasal implants which can lead to a revision rhinoseptoplasty, in this retrospective multicenter blinded study we have evaluated the efficacy of LDM ultrasound for the treatment of the postoperative perilesional ecchymosis and edema in patients after rhinoseptoplasty. Twenty-four patients received daily LDM treatment (study group) for 5 days starting from the first day postoperative, whereas 24 patients (control group) were treated with conventional ice packs. Dynamic reduction of the postoperative perilesional ecchymosis and edema was followed up, and the total duration of these side effects was determined within specific paranasal anatomical areas. Post-rhinoseptoplasty ecchymosis and edema were observed in the areas of anterior cheek, lower eyelids, and upper eyelids. Duration of the postoperative perilesional edema was significantly reduced in the group treated with LDM (1.9 ± 0.9 days) compared with control group (4.5 ± 2.1 days). Duration of the ecchymosis was also significantly reduced in LDM group (2.8 ± 1.4 days) compared with controls (7.4 ± 2.8 days). Postoperative patient satisfaction in LDM-treated and control groups was 3.1 ± 1.3 and 1.5 ± 0.7, respectively, demonstrating significantly higher satisfaction in LDM-treated group. This study proved that the post-rhinoseptoplasty group treated with LDM ultrasound showed a significantly shorter duration of the postsurgical perilesional ecchymosis and edema, with no substantial adverse effects other than those observed in the control group. It can be suggested that ultrasound treatment can serve as an alternative option for the noninvasive management of postoperative perilesional ecchymosis and edema.

Exploring the Effect of Trataka (A Yogic Cleansing Technique) and Cold Eye Pack on Eye Strain During COVID-19 Pandemic: A Randomized Three-Arm Trial.

Objective: Computer vision syndrome is a major global public health concern affecting >60 million individuals globally. Yoga and naturopathy practices can reduce visual fatigue and strain. The present study attempted to explore the effect of trataka that is, a yogic cleansing technique and cold eye pack on visual strain and fatigue. Subjects: Three hundred volunteers from an IT company were recruited following inclusion and exclusion criteria. Intervention: The subjects were randomly distributed in three groups, that is, trataka, cold eye pack, and waitlist control group with an allocation ratio of 1:1:1. Outcome measure: Visual Fatigue Scale and Visual symptoms checklist (VSC) was administered at baseline and end of 2 weeks. Repeated measures analysis of variance (RM-ANOVA) with Bonferroni corrections was used to test the difference across the groups. Results: All the variables were similar at the baseline among the groups. Significant changes in the within-group analysis occurred in both the trataka and cold eye pack groups. The RM-ANOVA revealed significant differences in the VAS and VSC (p = 0.001) and the post hoc analysis suggested that there were significant differences in both the trataka and cold eye pack group when compared with the control group (p = 0.001); however, there was no differences between the trataka and cold eye pack group in both the scales (p = 1). Conclusions: The results of the present study suggest that a trataka and cold eye pack for 14 days improves self-rated visual strain and fatigue among IT professionals with computer vision syndrome. Clinical Trial registration number: CTRI/2020/11/029003.

Speed of sound of ultrasonic pulses in fluids relevant to biomedical research

Tissue specimens are commonly stored in phosphate buffered saline (PBS) solution and formalin solution. Ultrasonic measurements of tissues may be performed in these same solutions. The goal of the present study was to measure the speed of sound in these fluids over a typical range of room temperature. An aluminum block with a 0.500-in. precision machined step was placed in a 1 L specimen tank containing the fluid of interest. The specimen tank was positioned in an 8 L tank of water with a thermostatically controlled heater and circulating pump, to which cold packs could also be added. A 7.5 MHz transducer was mechanically moved and scanned over the block to acquire echoes from either side of the step. The time difference between echoes received from either side of the step was measured to determine the speed of sound in the fluid. Measurements were performed in 0.5°C intervals from 15.0 to 25.0°C. The speed of sound was found to increase with temperature for both fluids, with ranges of 1484–1512 m/s for PBS and 1509–1532 m/s for formalin.

B-043 Thermal Evaluation and Field Study of Labcorp TrueThermTMpackaging System for Protecting Sub-Milliliter Blood Samples

Abstract Background Many diagnostic assays require temperature-controlled sample storage and shipment to ensure accuracy. Here we present, the Labcorp TrueTherm, designed for thermal-controlled shipment of small volume blood samples. The reusable TrueTherm combines a stainless steel vacuum bottle with a custom internal cold pack and insulating stopper. Users refrigerate the cold pack to protect against warm or cold temperature excursions. The whole system is relatively compact, measuring about 10in (25cm) in length, 3 inches (8cm) in diameter, and 2.5 pounds (1kg) in weight. Methods In order to evaluate thermal performance, the TrueTherm system was exposed to both ISTA-7D summer and winter conditions and internal temperature was recorded for 96hrs. Subsequently, venous blood samples were collected from n = 40 subjects, and immediately aliquoted into BD SST (Serum separator) Microtainers®. For each subject, sub-samples were subjected to centrifugal separation (provided by the Labcorp TrueSpinTM battery-powered centrifuge), serum removal, and 24hr insulated shipping on ice packs compared to a variety of 72hr cross-country shipping conditions with and without centrifugal separation and with and without insulated packaging (including TrueTherm) during August 2022. Results TrueTherm maintained temperature between 2 and 20C for 72hrs under simulated summer and winter conditions. Under actual cross-country summer commercial shipping conditions, both centrifugal separation and thermal control via TrueTherm expanded the number of valid analytes compared to unprotected whole blood (see Table 1). Conclusion The results suggest that TrueTherm is an effective system for protecting small blood samples from thermal extremes during extended shipping. Portable thermal moderation was complimentary with portable centrifugal separation to maximize stability of common analytes.

Emvolio - A battery operated portable refrigerator preserves biochemical and haematological integrity of biological samples in preclinical studies.

Background: Emvolio is a non-medical device, indigenously developed portable refrigeration for maintaining the internal temperature 2-8˚C. The Indian Patent Office has granted patent for applications such as preservation and transport of medicines, vaccines, food, beverages, dairy etc. Further, use of Emvolio can be utilized in transport and store biologicals to preserve their biochemical and cellular integrity. The objective of this study was to evaluate the biochemical and haematological integrity of biological samples such as rat blood, serum and liver. Methods: The steady temperature was maintained inside the Emvolio, and it was compared to that of thermocol and polypropylene boxes aided with frozen gel packs. The blood and liver samples were isolated from Wistar rats and kept in Emvolio, thermocol and polypropylene boxes for 10 hrs, and the temperature was monitored. The blood parameters, namely red blood cells (RBC), white blood cells (WBC), platelets, haematocrit, haemoglobin, mean corpuscular volume (MCV), mean corpuscular haemoglobin concentration (MCHC) and red cell distribution width (RDW), serum parameters like alanine transaminase, alkaline phosphatase, total protein, albumin, creatine kinase, blood urea nitrogen and liver parameters like superoxide dismutase (SOD), glutathione (GSH), catalase were estimated and compared. Results: Emvolio maintained a constant inner temperature range of 2-8˚C, whereas a significant temperature variation was seen in thermocol and polypropylene boxes. There was no significant deviation in the parameters tested when samples were kept in Emvolio for six hours compared to the zero hour readings. In contrast, there was a significant deviation among the parameters for the samples kept in thermocol and polypropylene boxes for six hours compared to zero hour parameters. Conclusions: Emvolio maintained constant temperature and preserved the biological integrity of rat blood, serum and liver. Thus, Emvolio can be efficiently used as a biological sample carrier, especially in preclinical studies.

Using new cold chain technologies to extend the vaccine cold chain in India: Equipment performance, acceptability, systems fit, and costs

This study evaluated the performance, acceptability, costs, and systems fit of three new cold chain devices in India: a second-generation ice-lined refrigerator (ILR), a solar direct drive (SDD) refrigerator, and a long-term passive device (LTPD). The evaluation was conducted over 15 months during 2016–2017. Sites were selected for their diversity in climate, terrain, and grid electrical supply, and 31 cold chain devices were deployed, 1 to each site. Results showed that all three technologies maintained correct temperatures. The SDD refrigerators had no malfunctions, whilst the ILRs had at least one malfunction, mostly due to the printed circuit board’s sensitivity to the erratic power supply. The LTPD temperature display panel caused challenges initially that required replacement of all solar panels with lithium batteries. Yet the devices’ long holdovers helped ensure vaccine potency. One challenge, particularly with the ILRs and SDD refrigerators, was condensation. The passively cooled LTPD was valued in settings with smaller populations and unreliable or no power; however, some its features, including the need to condition ice blocks, made it challenging to operate. In addition, the acceptable temperature range for the LTPD, as for all passively cooled devices (greater than 0 °C and less than + 10 °C),was confusing for some health workers due to the decades-long emphasis on maintaining temperatures at + 2 °C to + 8 °C. The greatest system-related benefit was establishment of new cold chain points (CCPs) at locations with intermittent or no grid electricity, bringing immunisation services closer to hard-to-reach areas. A key limitation of all three devices was the inability to freeze ice packs, which are required for vaccine carriers, somewhat restricting the potential of these technologies to reach underserved populations. Moreover, establishing new CCPs added costs to the health system. Results from this study, including costing data, can help guide decision-making.

550 CSF Leak or Ear Wax? Logical Thinking in Emergency Management of a Collapsed Patient with Heat Stroke

Abstract A man in his 60s presented to RESUS by ambulance on the hottest day of the year with suspected STEMI and collapse at home. The patient was intubated and unresponsive (GCS 5), with global rigors. Hospital ECG showed sinus tachycardia. Body temperature was in excess of 41°C, confirmed on central temperature monitoring. Bilateral clear fluid was noted to be discharging from both ear canals. Query CSF leak was indication for CT head, which was unremarkable. Considering this, efforts were focused on optimising body temperature. This was done with the use of ice packs and fans as well as continuous misting of cool water over the exposed patient. Improvement was shown with temperatures decreasing to 38°C. In questioning the cause of the “clear fluid,” a swab of it placed on an icepack swiftly returned the fluid to its natural consistency of ear wax. As a result of the extraordinarily high body temperatures, ear wax had melted in both ear canals and started to leak out, giving the impression of a CSF leak. This was simply identified at the bedside to refute the idea of a CSF leak. As CSF leak was the indication for a CT head, this could have been avoided with rapid cooling initiated earlier. Unfortunately, this patient later died due to heat stroke. Whilst avoiding the delay of a CT head most likely would not have changed the prognosis for this patient, it is useful to note the importance of logical thinking in an emergency setting.

The impact of thawing duration on leptin and adiponectin levels in frozen human milk samples.

Measurements of hormone concentrations in human milk from understudied populations across the world is of growing scientific interest. Due to limited access to suitable laboratory facilities at many research sites, human milk samples are often shipped frozen to distant laboratories for analysis. Shipping and handling exposes samples to the risk of thawing and degradation as the results of delays, mishandling, or other unforeseen circumstances. Similar degradation risk factors are well known in serum samples. However, the vulnerability of hormone degradation in human milk to thawing during transportation is largely unexplored. Leptin and adiponectin are of particular importance due to their roles in feeding behavior and metabolism in infants, hence our focus on these two hormones. In addition, leptin and adiponectin have been shown to be vulnerable to pasteurization temperature degradation in human milk samples. We tested the degradation of human milk metabolic hormones - leptin and adiponectin - in a controlled environment in response to a variety of freeze/thaw conditions that are reflective of potential temperature fluctuations during transportation. Human milk samples were experimentally subjected to thaw durations ranging from 4 to 16 h and assayed for hormonal levels to observe changes from baseline. Samples were also subjected to two additional experimental conditions, re-freezing after an extended period outside freezers or remaining thawed with additional ice packs, to investigate the impact of common transportation conditions. We found the assayed levels of leptin were not significantly impacted by an extended thaw cycle of 16 h. However, leptin levels were impacted by the extended period of 40 h outside of the freezer. Adiponectin showed a decrease in concentration percentage after the initial 16-h thaw period, but the increased degradation between 0-16 h and 16-40 h was not as severe as that seen in the leptin samples. The results of this experiment can be used to inform hormone measurement consistency given different thawing lengths or freezing conditions during transportation. Additionally, this research informs decisions regarding transportation, storage/handling, and data analysis in human milk research.

Red blood cell capacity of modern menstrual products: considerations for assessing heavy menstrual bleeding

BackgroundHeavy menstrual bleeding affects up to one third of menstruating individuals and has a negative impact on quality of life. The diagnosis of heavy menstrual bleeding is based primarily on...

Pemberian Kompres Dingin Terhadap Penurunan Nyeri Pada Asuhan Keperawatan Pasien Post Hemoroidektomi

Hemorrhoidectomy is a surgical removal of hemorrhoids by excision, which is removing tissue that has varicose veins (widening) that occurs in the anal canal area. This research design is analytical descriptive with case study method. The non-pharmacological implementation of post hemorrhoidectomy is the administration of cold compresses to reduce pain carried out at Bhayangkara M.Hasan Hospital, Palembang from June 15, 2022 to June 18, 2022. The subjects of this study were 2 post hemorrhoidectomy patients. Pain in Nursing Care of Post Hemorrhoidectomy Patients. The research instrument used in this study is the format of Nursing Care and Medical Records as a data collection tool. In this study, the instrument for measuring the pain scale was using the Wong Baker FACES Pain Rating Scale. As for cold compresses, the instruments used are ice packs, ice cribs, kom, perlak or blankets. Stationery and watches. After giving cold compresses for 3 days, both patients experienced a decrease in pain scale. Pain scale Mr. 'A' before giving cold compresses pain scale 4 after giving cold compresses pain scale 1. While the pain scale Mr. 'R' before giving cold compresses pain scale 5 after giving cold compresses pain scale 0. After giving cold compresses to post hemorrhoidectomy patients for 3 days, both patients experienced a decrease in pain scale.

Anesthetic Efficacy of Endo-Ice and Intrapulpal Ice Sticks After Inferior Alveolar Nerve Block in Symptomatic Irreversible Pulpitis: A Randomized Controlled Study.

There is a dearth of studies to assess the effectiveness of cryotherapy as a possible adjuvant in anesthesia. Therefore, this study aimed to compare the impact of pretreatment intraoral ice packs, application of Endo-ice, and a combination of Endo-ice and intrapulpal ice sticks use on the effectiveness of pulpal anesthesia as an adjunct in the management of pain and dental anxiety in mandibular second molars with symptomatic irreversible pulpitis (SIP) against traditional inferior alveolar nerve block (IANB) technique. The randomized controlled double-blind clinical study comprised of 200 subjects within the age group of 20-45 years with SIP involving mandibular second molars and divided into four groups of 50 each. Conventional IANB was administered in group 1. Intraoral compact ice packs, Endo-ice, and combined use of Endo-ice and intrapulpal ice sticks were employed following conventional IANB in groups 2, 3, and 4, respectively. The intensity of pain and anxiety before and after the intervention was documented using Heft-Parker visual analog scale (HP-VAS) and Corah's Dental Anxiety Scale-Revised (DAS-R). The average age of the overall study sample was 30.8±2.08 years, and the differences in age and gender distribution were found to be statistically insignificant. The mean HP-VAS scores on access opening and pulpectomy, using ANOVA paired with Tukey's post hoc multiple comparison tests were evaluated to be statistically highly significant (p<0.001). The greatest reduction in HP-VAS score was observed in group 4 receiving combined use of both Endo-ice and intrapulpal ice sticks. While the pretreatment DAS-R score was determined to be statistically insignificant between groups, group 1 subjects had the highest DAS-R score postoperatively (p<0.001). The effectiveness of pulpal anesthesia was found to be 84%, 96%, 92%, and 98% for groups 1 through 4, respectively, and demonstrated a statistically significant difference. The combined use of Endo-ice and intrapulpal ice sticks used as an adjuvant to local anesthesia (LA) was found to be significantly effective in lowering pain compared to the control groups in molars with SIP. Cold administration before and during the procedure was more effective than conventional LA in lowering intraoperative anxiety. Furthermore, the use of Endo-ice and intrapulpal cold after IANB significantly improves the effectiveness of pulpal anesthesia in mandibular second molars with SIP.

Effects of Peripheral Cooling on Upper Limb Tremor Severity and Functional Capacity in Persons with MS.

Upper limb intention tremor in persons with multiple sclerosis (pwMS) affects the ability to perform activities of daily life and is difficult to treat. The study investigated the effect of peripheral upper limb cooling on tremor severity and functional performance in MS patients with intention tremor. In experiment 1, 17 patients underwent two 15 min cooling conditions for the forearm (cold pack and cryomanchet) and one control condition. In experiment 2, 22 patients underwent whole arm cooling for 15 min using multiple cold packs. In both experiments, patients were tested at four time points (pre- and post-0, -25 and -50 min cooling) on unilateral tasks of the Test Evaluant les Membres supérieurs des Personnes Agées (TEMPA), Fahn's tremor rating scale (FTRS), Nine Hole Peg Test (NHPT). In experiment 1, the mean FTRS ranged from 13.2 to 14.1 across conditions. A two-way ANOVA showed mainly time effects, showing that cooling the forearm significantly reduced the FTRS, the performance on the NHPT, and three out of four items of the TEMPA, mostly independent of the cooling modality. In experiment 2, the mean FTRS was 13.1. A repeated measures ANOVA showed that cooling the whole arm reduced the FTRS and time needed to execute two out of four items of the TEMPA. These effects occurred immediately after cooling lasting at least 25 min. Cooling the whole upper limb led to a clinically noticeable effect on tremor severity and improved functional performance, which was pronounced during the first half-hour after cooling.