Descriptive Intervention Study Research Articles

Web-based standardized patient simulation for taking anamnesis: an approach in nursing education during the pandemic

BackgroundTo address the challenges in nursing education brought about by the pandemic, this study aimed to evaluate the use of a web-based standardized patient practice in the development of nursing students’ anamnesis taking skills and their views about its application.MethodWe conducted a descriptive intervention study with 39 s-year nursing students. The students completed anamnesis using the standardized patient practice in line with a scenario with real standardized patients in a web-based environment with audio and video.ResultsThe total scores of students’ anamnesis skills were low. The agreement between the total scores, scores obtained from the health patterns, and each item in the control list was statistically significant (p < 0.05).ConclusionWeb-based standardized patient practice is an alternative for clinical practice facilitating the gaining of competencies in making holistic nursing diagnoses under conditions that limit face-to-face interactions, such as pandemics.

COVID-19: Establishing, implementing and assessment safety strategy, descriptive interventional study.

The increase in severe acute respiratory syndrome SARS-CoV-2 has invariably affected medical professionals in their training, academic and professional development. The present study was an interventional descriptive study aimed at reducing the risk of exposure to COVID-19 and enabling physical attendance to the practical session for applied medical students by establishing and implementing a safety strategy. The adopted safety strategy has eight conditions and 50 requirements. Compliance with the safety strategy along with the serological diagnosis of COVID-19 was used as a key performance indicator for assessing the efficiency of the safety strategy. A total of 197 students were enrolled at the beginning of the study. The overall results showed that 78.1% of the respondents strictly followed the protocol, 14.5% of the individuals partially responded to the protocol and 7.4% of the individuals did not respond to the protocol. Twenty-two (12.6%) out of the 175 participants who completed the study had positive COVID-19 during the study period, whereas the remaining 153 participants (87.4%) appeared to be healthy. The serological results showed that 68 (38.9%) and 66 (37.7%) individuals of the study population had positive IgM+IgA and IgG of COVID-19, respectively; the majority of the participants who developed antibodies did not show symptoms and appeared to be healthy during the study. The physical distancing condition was the only condition that displayed a significant relationship with seropositive IgM+IgA. The compiling of standardized protocols along with serological diagnoses can be an effective tool in measuring the effectiveness of safety protocol and reducing the risk of exposure to COVID-19.

The association between weight loss and long term development in quality-of-life among children living with obesity: a pragmatic descriptive intervention study

BackgroundChildhood obesity is associated with impaired Quality-of-Life (QoL), increased stigmatization and higher risk of development of depression compared to their peers. This report describes the long-term development in QoL for cohort of children with obesity after a sustainable weight reduction.MethodsThis pragmatic descriptive intervention study enrolled 120 children with obesity, age 5–17 years, in a multifactorial lifestyle intervention. The intervention was an across sectors collaboration between a department of pediatrics and community health care workers. QoL was assessed yearly throughout the intervention and evaluated by a 6-item Visual Analogue Scale (VAS). For analyzing changes in VAS, as function BMI-SDS, regression models were used, while ANOVA and Wilcoxon test were applied for normal and not-normal distributed data. 95% confidence interval not containing 0 and p-value < 0.05 was considered statistically significant.ResultsAfter 26.4 months (13.9 SD) an overall decrease in bullying (0.6 vs. 0.0 median) and motivation (10.0 vs. 9.6) was observed. QoL increased in children with a BMI-SDS reduction (0.65 (2.49 SD)) opposite children with no-change or increasing BMI-SDS who reported reduced QoL (-0.36 (1.55 SD) and -0.96 (2.27 SD)). A significant inverse relationship was observed for Joy of Life, QoL and body perception as a function of BMI-SDS per year.ConclusionWeight reduction causes improvement in QoL for children with obesity and an inverse relationship for QoL and changing BMI-SDS / year was establish.

Effect of Ultrasound-Guided Genicular Nerve Block in Knee Osteoarthritis with Neuropathic Pain

Introduction: Osteoarthritis(OA) remains one of the most common musculoskeletal disorders. It was thought to be a non-inflammatory, wear and tear disorder, but recent studies have suggested the presence of a neuropathic pain component. Genicular nerve block has emerged as a new intervention to manage the neuropathic component of pain in knee OA. Materials and Methods: We conducted a prospective, hospital-based descriptive interventional study. Persons having OA with neuropathic pain component were identified using PainDETECT scale. We randomised the participants meeting the inclusion criteria into two groups. In the study group with thirty participants, we performed an ultrasound-guided triple-site genicular nerve block. The control group of equal size underwent conservative management. Participants were assessed using PainDETECT scale, Visual analogue scale (VAS) and Western Ontario McMaster Universities Arthritis Index (WOMAC) at baseline, 2 weeks and 4 weeks. Results: In the study group, PainDETECT score decreased from 24.93±1.99 at baseline to 8.07±2.97 at 2weeks and 7.9±2.87 at 4weeks. WOMAC significantly improved in the study group from 94.27±8.35 to 48.43±10.14 at 4weeks. VAS score also decreased in the study group from 9.2±0.71 to 4.73±1.44 at 2weeks and 4.53±1.28 at 4weeks. The control group also showed a significant decrease in PainDETECT score from 24.13±1.17 to 12.07±1.36 at 4weeks. However, a decrease in VAS score(from 9.13±0.68 to 7.67±0.67 at 4weeks) and WOMAC(from 97±4.49 to 88.5±4.93 at 4weeks) was less significant. Conclusion: Genicular nerve block provides significant pain relief and improved functional outcome in OA knee with neuropathic pain component. Furthermore, it is more effective than conservative management.

A Descriptive Study on Visual Outcome and Intraocular Pressure Control after Trabeculectomy with Manual Small Incision Cataract Surgery in Patients with Glaucoma and Cataract.

Context:Glaucoma is a optic neuropathy having multifactorial causes. Both cataract and glaucoma condition can influence management of the one another.Aims:To know the visual outcome and intraocular pressure control after combined trabeculectomy in patients with glaucoma and cataract.Settings and Design:It was a descriptive interventional study done for two years. All patients diagnosed to have significant cataract and diagnosed glaucoma were included in study.Methods and Material:After taking consent, combined surgery was performed and post-op follow up was done on 1st postoperative day and then on 1st week, 2weeks, 4weeks, 6weeks, 8weeks and 6 months. All parameters assessed and tabulated for statistical analysis.Results:Mean age of subjects was 59 years. 46.7% were males. Most of the patients (73.4%) were diagnosed as POAG. 26.7% were having PACG. Pre-operatively, 7 patients had vision better than 6/36. 13 patients had 6/36 and 10 patients had less than 6/36. At 6 weeks postoperatively, 76.7% had vision 6/9 or better, 16.7% had between 6/12 to 6/18, 6.7% less than 6/18. Mean IOP, Preoperatively among POAG and PACG was 19.90 and 33.25mmHg. Among POAG, Postoperatively at 6weeks, 8week, and 6months, IOP was 13.81, 13.91 and 12.72mmHg respectively. Postoperatively at 6weeks, 8week, and 6months, IOP was 19.75, 18.00 and 17.25mmHg in case of PACG.Conclusions:The study has showed the postoperative visual outcome and control of intraocular pressure is better with combined trabeculectomy with cataract surgery but still patients should be individualised according to their presentation.

Progesterone supplementation for prevention of preterm birth.

Objective: To study the efficacy of Progesterone supplementation for prevention of preterm birth. Study Design: Descriptive Interventional Study. Setting: Department of Obstetrics and Gynecology at Independent University Hospital, Faisalabad. Period: January 2018 to December 2020. Material &amp; Methods: Data collected by using Non probability consecutive sampling techniques. Total 156 patients were included in study. Data was collected after informed consent, on pre designed proforma. Patient presented in 1st trimester and having previous history spontaneous preterm labour and recurrent miscarriages. We included patient presenting after 24 weeks of pregnancy and patient having threatened or actual preterm labour. Results: Among 156 patients, more than 82% of patient were delivered after 34 weeks of gestation and 18% were delivered before 34 weeks of gestation. Fetal outcome was very good in those patients who were delivered after 34 weeks of gestation with the use of Prophylactic progesterone therapy. Conclusion: Prophylactic use of progesterone helps in prolongation of pregnancy beyond 36 weeks and also help in decreasing the morbidity associated with premature delivery.

Impact of brief educational intervention on knowledge of cancer among community pharmacists.

Community pharmacists may play a vital role in early detection and prevention of cancer. Findings from our pre-assessment studies showed that the Ghanaian community have inadequate knowledge of cancer. We assessed the impact of a brief educational intervention on knowledge level of cancer among Ghanaian community pharmacists. The study was a descriptive interventional study. Knowledge of cancer, signs and symptoms, risk factors and cancer screening tests were assessed before in a pre-assessment study and after a brief online education in our current study. A total of 435 community pharmacists were recruited in both studies. The mean ± SD total knowledge score of cancer increased from 9.03 ± 2.65 to 12.97 ± 1.43 out of a maximum score of 15 points. The mean ± SD total knowledge score of signs and symptoms of cancer increased from 4.15 ± 2.14 to 6.86 ± 0.76 out of a maximum score of 7 points. For the total knowledge score of causes and risk factors of cancer, the mean ± SD score increased from 8.13 ± 3.31 to 11.59 ± 0.87 out of a maximum score of 12 points. Lastly, the mean ± SD total knowledge score of cancer screening tests increased from 9.04 ± 5.01 to 16.39 ± 0.86 out of a maximum score of 18 points. There were overall statistically significant improvements of participants knowledge in all aspects of cancer in this study compared to the pre-assessment study. Our study presents evidence of the effectiveness of a brief educational intervention tailor-made for Ghanaian community pharmacists.

Inclusion of case-based learning within gross anatomy practical sessions

Background The introduction of clinical scenarios or case-based learning within the practical gross anatomy sessions is one way of vertically integrating anatomy into medical curricula. This study presents the overall outcome of including case-based learning within the practical classes of gross anatomy to undergraduate final anatomy students (semester four), in the Faculty of Medicine, University of Khartoum. Methods This descriptive interventional study was implemented during gross anatomy practical sessions for final anatomy students (semester four) at the Faculty of Medicine, University of Khartoum. Case-based learning was added to traditional prosection-based stations. Data concerning the responses of participants to different items of Likert scale questions were collected through a self-administered questionnaire. The questionnaire covered aspects of gross anatomy teaching and learning. In addition, final anatomy examination scores (students who were exposed to case-based learning) were compared to scores of the previous year (not exposed to case-based learning). Data were analyzed using statistical package for social sciences version 20. Results Participants who responded to the questionnaire were 216 (78 males, 136 females and 2 were missing) out of 313, generating a response rate of 69%. The mean age of the participants in the study was 18.9 ± 0.84 years. Students reported increased satisfaction in all sessions where clinical scenarios casebased learning were included. The percentage of students who chose the options ‘strongly agree’ or ‘agree’ in the different questionnaire items were as follows:84.9 % for ‘’help in formulation of intended learning outcomes’, 76.8% for ‘gain of deep knowledge versus superficial knowledge’, 71.3% for ‘increased retention of anatomical facts’, 62.5% for ‘increased interest in anatomy course’, 74.4% for ‘increased understanding of gross anatomy course’, 76.4% for ‘enjoying gross anatomy’ and 72.9% expressed overall student satisfaction. Most of the students (89.7%) recommended continuation of the integrated casebased learning sessions. There was a significant improvement in students` scores in gross anatomy final examination when compared to previous year’s scores of students who were not exposed to case-based learning. The mean scores were 69.7 ± 16.6 and 64.2 ± 17.9, respectively (d=0.317, P&lt;0.001). Conclusion Introduction of case-based learning within prosection-based gross anatomy sessions resulted in better levels of students’ satisfaction and improved students’ performance in the final gross anatomy examination.

Status Penglihatan Pasien Makroadenoma Hipofisis Pasca Bedah Transphenoid

AIM: The main aim of surgery in pituitary macroadenoma are restoration of visual acuity and visual field defects by decompression of the optic chiasm. Pituitary macroadenoma has slow growth pattern. This study describes the visual status of patients with pituitary macroadenoma and the post operative results.&#x0D; METHODS: Retrospective, descriptive interventional study of patients with pituitary adenoma underwent transphenoid surgery at Dr Sardjito General Hospital, Yogyakarta.&#x0D; RESULTS: There were 7 patients age 29-65 years old, mean age was 42 years old, consist of 3 male and 4 female and were followed-up varies between 1 until 6 months. There was history of previous transphenoid surgery in 1 patients. Duration of patient’s complaint varies between 1 until 36 months and the mean duration was 12 months. In 6 patients there were bitemporal hemianopia and 1 patients had general depression visual field defect. Visual acuity pre operative was between 0,003 until 1,0 , and the mean visual acuity was 0,1 (right eye) and 0,18 (left eye). Visual acuity post operative was between no light preception until 1,0 , and the mean visual acuity was 0,27 (right eye) and 0,19 (left eye) but there were no statistically significant differences. Fundus examination reveal optic atrophy in all patients.&#x0D; CONCLUSION: Transphenoidal surgery is the treatment of choice in patients with pituitary macroadenoma. Prolonged duration of symptoms and delay of surgery may impact the visual status&#x0D; KEYWORDS: Visual status, visual field defect, pituitary macroadenoma, transphenoid surgery, post operative

Progression of renal function in patients with chronic kidney disease on a low-protein diet supplemented with aminoacids and ketoanalogues

chronic kidney disease (CKD) is a public health problem. Low-protein diets supplemented with ketoacids and essential aminoacids have proved effective at different CKD stages. to assess the progression of renal failure in adult patients with CKD stages 3b and 4 receiving a protein-controlled diet supplemented with aminoacids and ketoanalogues. retrospective, descriptive intervention study. The nutritional intervention consisted of a protein/calorie intake of 0.4-0.6 g/kg/day and 30-35 kcal/kg/day plus a tablet of ketoanalogues (Ketosteril®)/5 kg weight. We assessed nutritional condition, glomerular filtration (GF) and creatinine, urea and albumin levels at 0, 3, 6, 9 and 12 months. SPSS version 18 was used for data statistical analysis. thirty-three patients were studied (67% male; mean age 59.7 years, r: 24-87). Protein/calorie intake was 0.55 ± 0.20 g/kg/day and 34 ± 4.51 kcal/kg/day. Ketosteril® intake was 11.87 tablets/day (r: 9-14). Initial GF was 24.97 ± 6.64 ml/min/1.73 m2, showing a significant increase between three and 12 months (25.51 ± 8.57 and 29.26 ± 10.33 ml/min/1.73 m2; p = 0.006). Urea nitrogen decreased significantly at six months compared with the initial level (p < 0.005). Body mass index did not change significantly (initial, 26. 63 ± 4.08 kg/m2; after a year, 26.78 ± 3.98 kg/m2). Initial and final albumin levels were 3.53 ± 0.64 g/l and 4.00 ± 0.53 g/l, respectively (p = 0.79). a low-protein diet supplemented with ketoanalogues administered to patients with CKD stages 3b and 4 preserved nutritional condition and mineral balance, improved GF significantly and decreased urea levels.

Pharmacist-led interventions improve quality of medicine-related healthcare service at hospital discharge

ObjectivesThis study aims to investigate the effects on quality of the medicine-related healthcare service provided at hospital discharge after implementing a pharmacist-led patient-centred discharge service.MethodsMedical in-patients ready for discharge and...

EP02.05: Bilateral hypogastric artery ligation before hysterectomy with placenta in situ in cases of placenta precreta: can it reduce maternal morbidity?

Evaluate the role of hypogastric artery ligation in cases placenta accrete before hysterectomy with placenta in situ to reduce the amount of blood loss and decrease the maternal morbidities. Retrospective descriptive interventional study of women (< span style = “line-height:20.7999992370605px” > 10 cases reported in the period from Jan 2013–Jan 2015). In our few cases, antepartum ultrasound diagnosed placenta percreta with suspicion of invasion to bladder using colour Doppler US and 3D power Doppler techniques, planned Peripartum hysterectomy preceded by bilateral hypogastric arteries ligation, intraoperative time; amount of blood transfused intraoperatively. Need for additional vaginal hemostatic, sutures ureteric injury or ligation, duration of ICU stay, incidence of DIC and need for additional surgical interference all are decreased dramatically. Prenatal diagnosed placenta percreta using ultrasound with bladder invasion and new surgical technique of bilateral hypogateric arteries ligation is considered an effective method before hysterectomy especially in cases of placenta percreta aiming to decrease all maternal morbidities of such cases.

Impact of Health Education on Knowledge, Attitude and Practice of Cervical Cancer Screening Among Secondary School Teachers in Enugu State

A cross sectional, descriptive interventional study directed by four research questions and three hypotheses was used to determine the impact of health education on knowledge, attitude and practice of cervical cancer screening among secondary school teachers. Population was secondary school teachers in Enugu State. Sample size of 380 teachers in 14 schools in Enugu North Local Government Area was drawn as sample using multi-stage sampling technique. Instrument used was questionnaire. Data were presented in tables and analyzed using measures of central tendencies and percentages. Hypotheses were tested using chi-square. Findings revealed relative good knowledge, positive attitudes, poor practice and significant impact of health education on their knowledge, attitude and practice. Recommendations were made as well as suggestions for further studies.

Extended safety and support systems for people with dementia living at home

Purpose – The purpose of this paper is to highlight the complexity surrounding the implementation of advanced electronic tracking, communication and emergency response technologies, namely, an extended safety and support (ESS) system for people with dementia (pwd) living at home. Results are presented from a Swedish demonstration study (2011-2012) conducted in 24 municipalities. Design/methodology/approach – It is a descriptive intervention study with a pre-post test design. Questionnaires were administered to pwd, carers and professionals at the outset and eight months later. ESS logging data were analyzed. Findings – ESS usage rates varied widely. A total of 650 alerts were triggered, mainly when the pwd was outdoors. Activities were reduced amongst pwd, most likely due to a progression of their disease. Carers noted that pwd were more independent than previously on those occasions when they engaged in outdoor activities. Staff considered that nearly half of pwd could remain living at home due to the ESS, compared with a third amongst carers. In total, 50 per cent of carers felt it was justified to equip their relative with an ESS without their explicit consent, compared to one in eight staff. Research limitations/implications – A limitation is the amount of missing data and high drop- out rates. Researchers should recruit pwd earlier in their illness trajectory. A mixed-methods approach to data collection is advisable. Practical implications – Carers played a crucial role in the adoption of ESS. Staff training/supervision about assistive devices and services is recommended. Social implications – Overall, use of ESS for pwd living at home was not an ethical problem. Originality/value – The study included key stakeholder groups and a detailed ethical analysis was conducted.

488P - Implementation of a Pharmaceutical Care Programme for Patients Treated with Investigational Oral Drugs in a Clinical Trials Unit

ABSTRACT Background: Oral agents provide an attractive approach to chemotherapy and its use is increasing. However, it is necessary to educate the patient to achieve a correct adherence, avoid interactions and get a correct management of adverse effects. When considering an investigational drug, the complexity increases: difficult drugs' identification because of their presentation (packaging and labeling) which leads to an increased number of medication-related problems. Purpose: Implementing a pharmaceutical care (PC) program for oral investigational drugs in the Oncology Clinical Trials Unit of a tertiary hospital. Methods: Prospective and descriptive intervention study conducted in cancer patients receiving oral investigational chemotherapy. The PC program was structured in interviews. Demographic data, level of patient's knowledge about the prescribed treatment and usual medication review to identify drug interactions were collected in the first visit. Subsequent follow-up interviews were aimed to assess adherence and conduct a survey of patient satisfaction. Results: The process of implementation of a PC program was conducted properly. Eighty-three patients were included (median age 58 years (31-80); 42 males). The 47.0% of patients admitted having doubts about the treatment. The 56.6% did not know how to take the medication in relation with food and the 77.10% what to do if they forget or vomit a dose. The overall adherence rate was 98.9%. Six interactions were detected and 23 interventions were made (13 related to drug interactions information). The reasons for non-adherence were missed doses (4 cases), voluntary decision (3 cases) and misinterpretation of the dosing regimen (2 cases). The 78.6% of patients learned something new about their treatment after the interview and 92.9% are in favor of receiving PC. Conclusions: Patient's information about their investigational treatment is often incomplete. Due to the good results of adherence and patient satisfaction, individualized PC should be performed in these patients to ensure effectiveness and safety. Disclosure: All authors have declared no conflicts of interest.

PS-081 Implementation of a pharmaceutical care programme for patients treated with investigational oral drugs in a clinical trials unit

BackgroundOral agents provide an attractive approach to chemotherapy and their use is increasing. However, it is necessary to educate the patient to achieve adherence, avoid interactions and manage adverse effects...

Effect of a health education program on cancer awareness among college students: Responding to the challenges of cancer control in India

Background: Cancer is a major public health problem worldwide. One of the most cost effective strategies identified for better cancer control is emphasis on health education. Aims & Objective: This study was undertaken to explore knowledge and awareness of the students of degree colleges about cancer and also to assess the impact of health education on improving awareness about cancer on these students. Material and Methods: The study is a descriptive interventional study with pre and post intervention evaluation. Knowledge about cancer was assessed before and after a short lecture with the help of predesigned, pre tested, semi structured proforma. A total of 563 students were included in the study. Results: Knowledge about cancer was found to be lacking among students as assessed in various spheres such as epidemiology (59.86%), clinical features (22.75%), diagnosis (41.0%)), treatment (41.39%) and preventive measures (63.94%). Statistically significant improvement in knowledge was found after health education. The percentage of students with poor knowledge was reduced from 43.16% to only 18.47% following health education. Conclusion: The method of health education through group approach should be applied at community level because health education is an effective tool to increase the knowledge and awareness regarding cancer.

Evidence of Effectiveness of Health Care Professionals Using Handheld Computers: A Scoping Review of Systematic Reviews

BackgroundHandheld computers and mobile devices provide instant access to vast amounts and types of useful information for health care professionals. Their reduced size and increased processing speed has led to rapid adoption in health care. Thus, it is important to identify whether handheld computers are actually effective in clinical practice.ObjectiveA scoping review of systematic reviews was designed to provide a quick overview of the documented evidence of effectiveness for health care professionals using handheld computers in their clinical work.MethodsA detailed search, sensitive for systematic reviews was applied for Cochrane, Medline, EMBASE, PsycINFO, Allied and Complementary Medicine Database (AMED), Global Health, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. All outcomes that demonstrated effectiveness in clinical practice were included. Classroom learning and patient use of handheld computers were excluded. Quality was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR) tool. A previously published conceptual framework was used as the basis for dual data extraction. Reported outcomes were summarized according to the primary function of the handheld computer.ResultsFive systematic reviews met the inclusion and quality criteria. Together, they reviewed 138 unique primary studies. Most reviewed descriptive intervention studies, where physicians, pharmacists, or medical students used personal digital assistants. Effectiveness was demonstrated across four distinct functions of handheld computers: patient documentation, patient care, information seeking, and professional work patterns. Within each of these functions, a range of positive outcomes were reported using both objective and self-report measures. The use of handheld computers improved patient documentation through more complete recording, fewer documentation errors, and increased efficiency. Handheld computers provided easy access to clinical decision support systems and patient management systems, which improved decision making for patient care. Handheld computers saved time and gave earlier access to new information. There were also reports that handheld computers enhanced work patterns and efficiency.ConclusionsThis scoping review summarizes the secondary evidence for effectiveness of handheld computers and mhealth. It provides a snapshot of effective use by health care professionals across four key functions. We identified evidence to suggest that handheld computers provide easy and timely access to information and enable accurate and complete documentation. Further, they can give health care professionals instant access to evidence-based decision support and patient management systems to improve clinical decision making. Finally, there is evidence that handheld computers allow health professionals to be more efficient in their work practices. It is anticipated that this evidence will guide clinicians and managers in implementing handheld computers in clinical practice and in designing future research.

An assessment of changes in the magnesium level during gynecological abdominal surgeries

Background: Magnesium (Mg) is the fourth most common cation in the human body and the second most intracellular cation after potassium. It has a fundamental role in several vital functions. As this essential ion is not measured in routine chemistry panels, little is known about its alterations during intraoperative time. Aim: The present study was designed to determine the negative eff ects of postoperative hypomagnesemia during and after surgeries. Subject and Methods: This study was a descriptive interventional study involving 74 patients. All patients underwent gynecological abdominal surgeries, and anesthesia protocols were standardized to comprise general and spinal anesthesia. All the patients were aged between 25 and 45 years, with ASA class I and II. Their total serum Mg level was measured 1 h before and 2 h after the surgery. The total serum Mg, calcium, and albumin level were measured by photometric methods. Data were analyzed using SPSS version 16.0 (Chicago Illinois, (USA). Inferential statistic was done using Vilksonnon-parametric and Pearson’s correlation test. P<0.05 were considered as significant. Results: The mean serum Mg levels were 1.87 (0.32) mg/dl before and 1.55 (0.34) mg/dl after the surgeries (The normal range: = 1.7-2.5 mg/dl). Results illustrated a significant hypomagnesemia after operations. Conclusion: Clinical impact of hypomagnesemia during surgeries needs to be studied further. Moreover, surgeons should be warned about the severity of probable electrolyte imbalances induced by perioperative events to decrease associated morbidities. Keywords: ASA, cation, gynecologic surgeries, magnesium, magnesium level, photometric method, standardized anesthesia, surgeries

Ultrasonography and color Doppler in juvenile idiopathic arthritis: diagnosis and follow-up of ultrasound-guided steroid injection in the wrist region. A descriptive interventional study

BackgroundThe wrist region is one of the most complex joints of the human body. It is prone to deformity and functional impairment in juvenile idiopathic arthritis (JIA), and is difficult to examine clinically. The aim of this study was to evaluate the role of ultrasonography (US) with Doppler in diagnosis of synovitis, guidance of steroid injections, and follow-up examinations of the wrist in JIA.MethodsIn 11 patients (median age 12.5 years, range 2-16), 15 wrists with clinically active arthritis were assessed clinically by US and color Doppler (Logiq 9, GE, 16-4 MHz linear transducer) prior to and 1 and 4 weeks after US-guided steroid injection.ResultsUS detected synovitis in the radio-carpal joints, the midcarpal joints, and the tendon sheaths in 87%, 53% and 33% of the wrists, respectively. Multiple compartments were involved in 67%. US-guidance allowed accurate placement of steroid in all 21 injected compartments, with a low rate of subcutaneous atrophy. Synovial hypertrophy was normalized in 86% of the wrists, hyperemia in 91%, and clinically active arthritis in 80%.ConclusionsUS enabled detection of synovial inflammation in compartments that are difficult to evaluate clinically and exact guidance of injections, and it was valuable for follow-up examinations. Normalization of synovitis was achieved in most cases, which supports the notion that US is an important tool in management of wrist involvement in JIA.