Improve Patient Comfort Research Articles

Innovative Approaches in Fistula-In-Ano Management: Evaluating the Role of Fistula Brush - A Case Study

Introduction: Fistula in ano is one of the most common anorectal diseases. The prevalence is greater in men than women, with the rate of 12.3 cases per 100,000 and 5.6 cases per 100,000, respectively. In Ayurvedic Science Ksharasutra ligation is one of the most popular treatment modality for Bhagandara. Ksharasutra is indeed a well-known treatment in Ayurveda, particularly for managing conditions like pilonidal sinus and anal fistulas. However, it does have some limitations. Hence, an innovative technique is adopted by introducing a new Yantra i.e., Fistula brush in the field of Shalya Tantra for minimizing the unit cutting time in fistulous tract. Methodology: The fistulous tract was curetted using the fistula brush in 4-5 strokes followed by primary threading with barbour thread. Follow up thread change was done after curetting the tract using fistula brush until the tract was cut through. (under local anaesthesia). Result: The intervention results indicated a marked improvement in both subjective and objective parameters, demonstrating the intervention's effectiveness in enhancing patient outcomes. Discussion: The treatment of anal fistula through curettage of the tract using a fistula brush has been demonstrated to be a cost-effective and accessible method. This technique facilitates the removal of unhealthy granulation tissue while ensuring adequate drainage with the use of a drainage seton, thereby promoting the formation of healthy granulation tissue. Ultimately, this process encourages fibrosis of the tract and minimizes the risk of sphincter damage. Mechanical debridement plays a pivotal role throughout the stages of wound healing by promoting a clean, healthy wound environment. By alleviating symptoms associated with each stage - such as pain, burning sensation, discharge and local tenderness - it ultimately enhances the healing process and improves patient comfort.

PCSK9 inhibitors – new era of dyslipidemia treatment - effectiveness in reducing low-density lipoprotein (LDL-C) and cardiovascular risk

Introduction: Abnormal blood cholesterol levels in patients with increased cardiovascular risk have a worse prognosis for patient survival. Treating dyslipidemia is important because it can improve patient comfort and safety. It sometimes happens that currently used drugs to lower cholesterol are not effective - patients develop tolerance or experience serious side effects. For this reason, scientists are looking for new drugs with a different mechanism of action. An example of such a group of drugs are PCSK9 inhibitors used to treat dyslipidemia. In this paper, we will look at the effectiveness of currently used PCSK9 inhibitors, but also at the potential risks associated with their use. Material and methods: We searched for materials for this work in the Pubmed and Google Scholar databases using the keywords: "dyslipidemia", "cardiovascular disease", "PCSK9 inhibitors", "statins". Then we analyzed the selected materials. Aim of the study: Evaluation of the Conclusion: PCSK9 inhibitors are drugs that are very effective in lowering low-density lipoprotein (LDL-C), while reducing cardiovascular risk and potentially having long-lasting effects. Scientists are looking for new PCSK9 inhibitors with different mechanisms of action, which will be an even more effective therapy in lowering LDL-C.

Physiological impact of oral carbohydrate preload in healthy volunteers.

Oral carbohydrate loading has become a key component of Enhanced Recovery After Major Surgery (ERAS) pathways, with potential improvements in patient comfort, nausea and vomiting, ileus and length of stay. The contribution of each component of ERAS, including carbohydrate beverages, remains unclear. We aimed to determine the impact of standardized oral carbohydrate fluid loading on haemodynamics, stroke volume and gastric state in a group of healthy volunteers. Twenty-three volunteer participants free of known cardiovascular or gastrointestinal disease, consumed 400 mL of a proprietary carbohydrate solution. Heart rate (HR), blood pressure (BP), stroke volume (SV) and gastric cross-sectional area (CSA) were measured with bedside ultrasound at baseline, 30/60/120 min post-ingestion. There were small decreases in HR, BP (<10%) that were statistically significant. There were small increases (<10%) in SV at 30 and 60 min post-ingestion, but SV had returned to baseline by 120 min. There were no changes in SV variation. Gastric CSA increased immediately post-ingestion, then decreased in a linear fashion before returning to baseline by 120 min. In a standard 400 mL dose of a carbohydrate beverage, only small increases in SV could be demonstrated in the first-hour post-ingestion. All patients had largely returned to their baseline SV and gastric CSA state within 2 h post-fluid ingestion. A mild decrease in HR and BP was noted that persisted at 120 min. A 400 mL carbohydrate beverage does not appear to have favourable cardiovascular effects in a healthy population.

Comparison Of Post-Cesarean Section Pain Medication With Spinal Anesthesia Method Eracs And Without ERACS

This study focused on the observation of pregnant women after surgery to determine the comparison of drugs and pain scales after surgery with the ERACS method and the method without ERACS. This study aims to determine the comparison of drugs and pain scales in patients after Sectio Caesarea surgery using the ERACS method and without ERACS. Currently, the Enhanced Recovery After Caesarian Surgery (ERACS) method as a perioperative program is popular, because it is considered to have a faster healing time and minimize pain so as to provide comfort to patients. This quantitative study was designed using a Cross-Sectional approach. The research sample was 40 respondents whose Pain Scale was measured using the Visual Analog Scale (VAS) measured with an observation sheet. Based on the results of statistical analysis. In the results of the Univariate test analysis on drug administration and pain scales of both VAS variables after (24 hours). It can be concluded that there is a difference between the amount of pain medication given and the pain scale with the ERACS method and the method without ERACS. The ERACS method has been shown to be more effective in reducing pain after Sectio Caesarea surgery and accelerating patient recovery compared to the method without ERACS. These findings support the use of the ERACS method as a standard of care to improve patient comfort and clinical efficiency

Radial Access Approach to Peripheral Vascular Interventions: A Scientific Statement From the American Heart Association.

Transradial arterial access has transformed the field of coronary interventions, where it has several advantages over femoral access, such as reduced bleeding and access site complications, improved patient comfort, shorter time to ambulation after the procedure, reduced length of hospital stay, and potentially reduced mortality rates. Because of these benefits, as well as the concurrent expanding indications for various endovascular therapies, there is growing interest in adopting radial access for peripheral vascular interventions. However, radial access can present challenges, and specialized equipment for peripheral interventions through this route are under development. Nevertheless, a growing number of studies, largely comprising single-center and registry data, have broadly suggested that transradial arterial access is likely to be safe and associated with reduced bleeding and local access site complications for most peripheral interventions compared with transfemoral access. Large, prospective randomized trials are lacking, and the question of any effect on mortality rates has not been addressed. Whereas the field of transradial arterial access for peripheral vascular interventions is in development, it is clear that this approach, at least with available equipment, will not be suitable for all patients, and careful case selection is paramount. Furthermore, the remaining knowledge gaps must be addressed, and robust outcome data obtained, to allow full understanding of the factors that determine optimal patient, lesion, and equipment selection. Nevertheless, the use of transradial arterial access for peripheral vascular interventions holds great promise, particularly if the necessary technologic advances are rapid and favorable clinical trial data continue to emerge.

Cotton swabs for the measurement of NF-ĸB, IFN-γ, and FOXP3+Treg from lesions of anogenital wart patients

BACKGROUND Local tissue immunity plays a significant role in anogenital warts’ (AGW) pathomechanism and persistence. Assessing biomarkers from lesions instead of serum is recommended to evaluate therapeutic response. Since biopsy is invasive, it is necessary to find less invasive and more comfortable methods. This study aimed to assess the reliability of cotton swabs and tape stripping for evaluating AGW’s lesions biomarkers. METHODS We compared cotton swab versus tape stripping method to quantify nuclear factor-κappaB (NF-ĸB), interferon-gamma (IFN-γ), and FOXP3+regulatory T cell (FOXP3+Treg) from 3 patients with AGW in the preliminary study. The method was selected based on contamination possibility, side effects, and a simpler approach. The main study examined 48 patients with AGW for reliability and reproducibility using the best sampling method from preliminary result and Spearman’s Rho analysis, while considering the HIV status and CD4+ counts. RESULTS Both cotton swabs and tape stripping obtained adequate protein content for biomarkers examination. However, the tape stripping method was causing serum contamination and painful for patients due to the stripping. The total lesion volume in cotton swab method was positively correlated with all patients’ NF-ĸB (p = 0.001). IFN-γ had a negative correlation in all reactive HIV patients (p = 0.012). FOXP3+Treg and CD4+ counts were negatively correlated with total volume in reactive HIV patients (p = 0.046 and 0.017, respectively). CONCLUSIONS The cotton swab method was reliable in examining NF-ĸB, IFN-γ, and FOXP3+Treg due to its convenience and lack of serum contamination from AGW lesions, potentially improving patient comfort and practical benefits.

Impact of sweet drink on pituitary response and subject comfort during insulin tolerance test

The insulin tolerance test (ITT) is the gold standard for the diagnosis of cortisol and growth hormone (GH) deficiencies. Once hypoglycemia is detected whether patients should receive carbohydrates to recover faster from hypoglycemia is controversial. The aim of our study was to assess the impact of shortening the duration of hypoglycemia by providing a sugar drink on patient comfort and hormonal responses. This prospective, single-center, crossover, single-blind study enrolled 15 healthy participants. Each subject performed two ITT: one with normal Cola and the other with Cola Zero. Glucose and hormone levels were measured at baseline and after the induction of insulin-induced hypoglycemia. Patient tolerance to ITT was evaluated using reported hypoglycemia side effects, visual analog scale scores, and quality-of-life questionnaire. Normal Cola shortened the period of hypoglycemia (plasma glucose < 40 mg/dl) from 30 to 15 min (p = 0.005), allowing a higher proportion of participants to recover from potentially dangerous values after 45 min (12 vs. 5; p = 0.008). Cola also improved patient comfort, as evaluated using a visual analog scale (VAS score 2.6 vs 3.7, p = 0.016). Sugar did not significantly change the median cortisol and GH peaks. Body mass index was the only factor determining the cortisol peak, independent of the injected insulin dose. The time to reach hormone peaks was similar between the two protocols. Cortisol and GH values were significantly higher at 120 min in the Cola Zero group, suggesting the prolongation of hypothalamic-pituitary stress in the absence of sugar. Our study confirmed that rapid correction of hypoglycemia during ITT improves subject comfort, reduces the duration of hypoglycemia and associated symptoms, while guaranteeing unchanged cortisol and GH peaks.

Intrathecal baclofen pump for severe hypertonia in a patient with juvenile Huntington's disease: illustrative case.

While the symptoms of Huntington's disease (HD) typically first appear around the age of 40 years, 5%-10% of patients experience symptoms before the age of 21 years, in which case it is classified as juvenile Huntington's disease (JHD). JHD poses a unique clinical problem, as affected patients experience rapid deterioration in their quality of life as the motor manifestations of the disease become overwhelming. Medical treatment options for HD are sparse, and the only Food and Drug Administration-approved medication for the treatment of HD is the VMAT-2 inhibitor tetrabenazine. Unfortunately, treatments for JHD are even more limited, as investigational new drugs for HD oftentimes exclude patients with JHD from trials. Here, the authors present the case of a 15-year-old male with severe hypertonia and dystonic events secondary to JHD that was successfully treated with an intrathecal baclofen (ITB) pump. The patient experienced an improvement in hypertonia and a reduction in the frequency of dystonic events after ITB pump implantation, resulting in overall improved patient comfort. This case highlights the potential benefits of ITB therapy in managing debilitating hypertonia-type symptoms in patients with JHD. Given the limited treatment options for JHD, this intervention has the potential to profoundly enhance the quality of life for affected individuals. https://thejns.org/doi/10.3171/CASE24512.

Consensus Recommendations for the Reconstitution and Aesthetic Use of Poly-D,L-Lactic Acid Microspheres.

Poly-D,L-lactic acid (PDLLA) microspheres, marketed globally as Aesthefill® (Regen Biotech, Seoul, South Korea), are recognized for their biocompatible and biostimulatory properties, positioning them as a preferred option in aesthetic medicine. This article presents consensus recommendations from Brazilian experts on the reconstitution and clinical application of PDLLA for facial and non-facial treatments. Developed using a modified Delphi method with contributions from leading dermatologists and plastic surgeons, the consensus outlines protocols for reconstitution, injection techniques, and patient management. Key recommendations include reconstitution with 7-8 mL of sterile water for injection, the addition of lidocaine to improve patient comfort, and a preference for targeting the superficial subcutaneous layer. Dosing guidelines are specifically tailored to each treatment area and the desired degree of correction, underscoring the importance of personalized treatment plans. Maintenance treatments are advised at biennial intervals or at shorter intervals for patients exhibiting accelerated collagen degradation. The consensus also highlights the need for proper training and patient screening to minimize adverse effects, such as nodules and granulomas. This comprehensive guide aims to standardize the use of PDLLA, prioritizing patient safety and optimizing outcomes. While clinical trials evaluating PDLLA's aesthetic indications remain limited, these evidence-based guidelines bridge the gap by offering practical protocols grounded in clinical expertise. Further research is encouraged to validate these recommendations and explore new applications for PDLLA in aesthetic medicine.

Determination of effective half-life of 131I in thyroid cancer patients using remote dose-rate meter

BackgroundContinuously monitored external dose-rate signals from remote dose-rate meters (DRMs) were analyzed to determine the effective half-life (Teff) of 131I in differentiated thyroid cancer (DTC) patients. The aim is to gain novel understanding of the excretion of radioactive iodine (RAI) in DTC patients and to demonstrate that a remote DRM system can be reliably used for real-time monitoring of external dose-rates of DTC patients.Methods110 DTC patients who received postoperative RAI therapy between September 2018 and February 2023 in Turku University Hospital were studied retrospectively. The external dose-rates of the patients were continuously monitored during their hospitalization with a remote DRM fixed in the ceiling of the isolation room. Generalized linear mixed model (GLMM) was used to analyse the association between logarithmical Teff and patient characteristics.ResultsThe median Teff for all patients was 12.60 h (Q1: 10.35; Q3: 14.75 h). Longer Teffs were associated with higher BMI (p = 0.004), lower GFR (p < 0.001), and diabetes (p = 0.007). Our study also revealed that neither age nor subsequent RAI therapies have a significant impact on the whole body Teff (p = 0.522 and p = 0.414, respectively).ConclusionPatients with higher BMI, decreased GFR, or diabetes have a longer whole-body Teff of 131I. Ceiling-mounted remote DMRs can reliably be used to determine patient’s Teff. Since Teff values vary among patients, ceiling-mounted meters can be used to optimize the length of radiation isolation period at the hospital while improving patient comfort and staff efficiency.

Effectiveness of non-pharmacological interventions for pain reduction following chest tube removal: A systematic review and network meta-analysis

ObjectiveThis study aimed to determine the most effective non-pharmacological intervention for pain relief following chest tube removal in adult patients. MethodsWe performed a systematic review with network meta-analysis, searching electronic databases for randomized controlled trials up to January 20, 2024. Compared to control or placebo groups, the trials included adult patients receiving non-pharmacological interventions, such as cold therapy, relaxation exercises, music therapy, transcutaneous electrical nerve stimulation, or aromatherapy. Data analysis utilized a random-effects model, reporting standardized mean differences (SMD) with 95% confidence intervals (CI), and treatment ranking was determined through surface under the cumulative ranking analysis and forest plots. ResultsSixteen studies enrolling 1,342 patients were included, with moderate to high heterogeneity. Cold therapy and relaxation exercises effectively reduced pain after chest tube removal, with SMD of −1.84 (95 % CI: −2.81 to −0.87) and −2.04 (95 % CI: −3.43 to −0.65), respectively, from baseline to immediately post-removal. From baseline to ten to twenty minutes after removal, both therapies continued to show significant pain reduction, with SMD of −1.96 (95 % CI: −3.14 to −0.77) for cold therapy and −2.01 (95 % CI: −3.75 to −0.28) for relaxation exercises. Sensitivity analysis supported these findings, and cold therapy’s efficacy appeared unaffected by obesity. However, publication bias, possibly due to small study samples, was noted. ConclusionsCold therapy and relaxation exercises proved most effective for reducing pain immediately and up to ten to twenty minutes after chest tube removal. Given their cost-effectiveness, lack of side effects, and ease of use, we recommend relaxation exercises as a practical alternative to cold therapy. Nonetheless, further studies are needed to comprehensively assess non-pharmacological options for managing chest tube removal pain. Implications for clinical practiceIncorporate cold therapy and relaxation exercises into post-chest tube removal pain management to improve patient comfort and minimize reliance on pharmacological interventions.

To investigate endoscopic membranous nasolacrimal duct resection combined with retrograde lacrimal stent placement in the treatment of extremely inferior lacrimal duct obstruction

To investigate the efficacy of endoscopic membranous nasolacrimal duct resection combined with retrograde lacrimal stent in the treatment of extremely inferior lacrimal duct obstruction. Retrospective cohort study at Nanchang University’s Affiliated Eye Hospital. Experimental Group: Endoscopic membranous nasolacrimal duct resection combined with retrograde lacrimal stent implantation; Control group: Conventional endoscopic dacryocystorhinostomy combined with bicanalicular Silicone Stent implantation.The duration of the surgical procedure, postoperative comfort score, irrigation of the lacrimal passage after extubation, and Munk score of curative effect at six months post-operation were recorded. The data were quantified and analyzed using SPSS 26.0 statistical software. The symptoms of epiphora showed significant improvement following surgery. There were notable differences in operation time and postoperative comfort between the experimental group and the control group who underwent conventional endoscopic dacryocystorhinostomy (P < 0.05). However, there was no significant difference in efficacy and lacrimal duct irrigation after extubation or at six months post-operation (P > 0.05). The cure rate of the experimental group reached 70%, while the control group achieved a cure rate of 78%. Furthermore, the effective rate in the experimental group was found to be 81%, whereas it was 89% in the control group.No evident complications were observed in the experimental group. The combination of endoscopic membranous nasolacrimal duct resection and retrograde lacrimal stent reduces the invasiveness of the lacrimal duct structure, shortens the operation time, improves patient comfort, and achieves favorable therapeutic outcomes. This approach is recommended for patients with extremely Inferior lacrimal duct obstruction .

Ciprofol versus propofol for anesthesia induction in cardiac surgery: a randomized double-blind controlled clinical trial

BackgroundCiprofol, a novel intravenous general anesthetic with a chemical structure similar to propofol, exhibits significantly enhanced potency. It offers a rapid onset, reduced incidence of injection pain, and has comparable effects on heart rate and blood pressure to propofol. However, clinical data on its use for anesthesia induction in cardiac surgery remain limited.MethodsSeventy-eight patients undergoing coronary artery bypass grafting or valve replacement surgery were randomly assigned to receive either ciprofol (N = 40) or propofol (N = 38) for anesthesia induction. Variables recorded included changes in mean arterial pressure and heart rate during anesthesia, alterations in the oxygenation index and lactic acid concentration before and 10 min after anesthesia induction, and the incidence of adverse events such as bradycardia, hypotension, and injection pain.ResultsThe incidence of anesthesia-induced injection pain was significantly lower in the ciprofol group compared to the propofol group (3% vs. 18%, P < 0.05). The incidence of other adverse events was similar between the groups. No significant differences in hemodynamics or oxygenation index were observed during anesthesia induction between ciprofol and propofol.ConclusionsCiprofol demonstrated a significantly lower incidence of injection pain compared to propofol, potentially improving patient comfort during anesthesia induction. Additionally, ciprofol showed comparable circulatory stability to propofol during anesthesia induction in cardiac surgery, suggesting it may be a suitable alternative to propofol for this application.Trial registrationThe trial was registered at the ClinicalTrials.gov on 03/10/2024 (NCT06312345).

RADT-25. IMPACT OF SAME-DAY MASK CREATION ON GAMMA KNIFE TREATMENT

Abstract OBJECTIVE Technological advances have allowed stereotactic radiosurgery (SRS) to be administered using fixation with a noninvasive mask, rather than with a stereotactic frame. While the use of such masks offers advantages including the ability to hypofractionate SRS and improved patient comfort, there has been criticism that it eliminates the possibility of same-day, “wheels in to wheels out” SRS. Our study examines the feasibility of conducting mask fitting and SRS treatment on the same day versus the conventional different-day approach. METHODS Eligible participants had either underwent single-fraction-SRS (SF-SRS) or were in their initial session of hypofractionated-SRS (HF-SRS). 100 patients who underwent SRS from September 2020 to June 2021 were assessed. 52 patients underwent same-day fabrication and treatment, and 48 patients received treatment at least one day following mask fabrication. The Leksell Gamma Knife (LGK) console data was processed, and operator reports from each patient were extracted and analyzed. RESULTS The average number of pauses, pause time, and number of gates was greater for same-day patients. There was no significant difference in the number of positioning alarms between the groups. There were no significant differences in percent overestimation of treatment time or number of treatment alarms. Treatment gates occurred on average 19 minutes earlier for same-day patients then different-day patients, which likely corresponds to “mask fatigue,” due to spending 20 minutes longer on the treatment table, while the masks are being fabricated. CONCLUSION Mask-based SRS can be done safely and efficiently in a single day, mirroring the approach of frame-based treatments.

Os efeitos curativos do uso da pele de tilápia para curar queimaduras e feridas

Introdução: A pele de tilápia, um peixe de água doce, está sendo utilizada no tratamento de pacientes com queimaduras graves. Objetivos: O objetivo deste estudo foi identificar as evidências sobre o uso da pele de tilápia na cicatrização de queimaduras. Material e Métodos: A metodologia utilizada foi uma revisão de literatura. A pesquisa foi realizada por meio de busca eletrônica de artigos científicos publicados nos sites Scielo (Scientific Electronic Library Online) e Lilacs (Literatura Latino-Americana em Ciências da Saúde) e Pubmed. Foram utilizadas as terminologias de saúde consultadas nos descritores em Ciências da Saúde (DeCS/BIREME); evidências sobre o uso da pele de tilápia na cicatrização de queimaduras. Discussão: os bons resultados com pele de tilápia, solução salina, hidrofibra com prata e sulfadiazina de prata, porém a pele de tilápia e seus derivados apresentaram melhor delineamento das bordas da ferida, redução do exsudato, redução da formação de crostas, manutenção da umidade local. Isso resultou em tempos de cicatrização mais curtos, menos trocas de curativos e menos dor relacionada às trocas de curativos. Os testes histológicos mostram biocompatibilidade entre a pele humana e a pele de tilápia, sendo que nos testes microbiológicos não foi identificado crescimento bacteriano, e nas análises bioquímicas, a pele de tilápia apresentou maior porcentagem de colágeno tipo I do que o observado na pele humana, e mostrou-se resistente nos testes de tração. Conclusão: Os estudos incluídos nesta revisão mostraram que o uso da pele de tilápia como curativo biológico é eficaz no tratamento de queimaduras, pois adere bem ao leito da ferida, tem boa resistência à tração, não tem antigenicidade e reduz a dor. A assistência à saúde prestada ao paciente queimado é realizada diretamente pela equipe de enfermagem, que realiza todos os curativos e avalia o processo de cicatrização. O uso da pele de tilápia como curativo alternativo para esses pacientes permite que os enfermeiros prestem uma assistência de melhor qualidade e melhorem o conforto do paciente.

Exploring stereotactic radiosurgery for tremor using the Varian cone planning system

BackgroundStereotactic radiosurgery (SRS) is an effective treatment for essential tremor (ET) and Parkinsonian tremor (PT). However, current treatment methods can be time-consuming and expose patients to unnecessary radiation. This study investigates the use of the Varian TrueBeam system with FFF beam modes as a potential solution for these issues. MethodsWe recreated and evaluated treatment plans using the Varian TrueBeam and Eclipse Cone Planning system for ten patients previously treated for tremor cessation using a Novalis Tx linear accelerator with Brainlab planning system prescribed a maximum dose of 160 Gy. Analyses included beam-on delivery time, total MU, dose to brain and brainstem tissues, and confirmation of SRS cone accuracy. ResultsThe TrueBeam cone delivery system is highly accurate. Our results demonstrated a significant reduction in monitor units (MU) and treatment delivery time shortened to 17-26 min beam-on time for all-Varian plans compared to 39 min for non-Varian (iPlan) plans (p < 0.0001). Furthermore, the Varian plans showed improved or similar dose fall-off and radiation dose to brainstem normal tissue. ConclusionOur findings suggest that the Varian TrueBeam system offers a safe and effective option for SRS tremor treatment, providing similar or superior treatment parameters compared to other LINAC-based SRS treatments. The reduced treatment times and improved patient comfort offered by this system make it a promising solution for future tremor treatments.

Use of Transverse Abdominis block for Post Operative pain management in Patients undergoing Emergency Cesarean Sections : a prospective study

INTRODUCTION Postoperative pain management is an essential aspect of perioperative care for patients undergoing emergency Cesarean sections. Adequate pain control not only improves patient comfort and satisfaction but also facilitates early mobilization, reduces the risk of complications, and shortens hospital stays. Transverse abdominis plane (TAP) block is a well-established technique for providing analgesia to the anterior abdominal wall, which can significantly reduce postoperative pain. In recent years, ultrasound guidance has been increasingly used to improve the accuracy and safety of TAP block. This research article aims to review the use of ultrasound-guided TAP block for postoperative analgesia in patients undergoing emergency Cesarean Sections. Methodology : A total of 60 patients who underwent Emergency Cesarean Sections were included in the study. All received bilateral US-guided TAP blocks with either ropivacaine 0.5% 20 ml on each side i. e. 40 ml total or saline. All participants received a spinal anaesthetic with bupivacaine, followed by postoperative acetaminophen, non-steroidal anti-inflammatory drugs, and patient-controlled i.v. tramadol . Each patient was assessed 24 h after delivery for PCA Tramadol usage, average pain score, nausea, vomiting, itch and duration of hospital stay. Results and Conclusion Out of the total 60 patients , 30 were in the study group and 30 in placebo group. Total PCA Tramadol use in 24 h was reduced in the study group compared with the placebo group ( P&lt;0.05). The active group reported improved satisfaction with their pain relief measured by visual analogue scale as compared with the placebo group ( P=0.008). There were no local complications attributable to the TAP block. Transverse abdominis plane block was effective in providing analgesia with a substantial reduction in tramadol use during 24h after cesarean section when used as adjunctive to standard analgesia.

Characterizing T1 in the fetal brain and placenta over gestational age at 0.55T.

T1 mapping and T1-weighted contrasts have a complimentary but currently under utilized role in fetal MRI. Emerging clinical low field scanners are ideally suited for fetal T1 mapping. The advantages are lower T1 values which results in higher efficiency and reduced field inhomogeneities resulting in a decreased requirement for specialist tools. In addition the increased bore size associated with low field scanners provides improved patient comfort and accessibility. This study aims to demonstrate the feasibility of fetal brain T1 mapping at 0.55T. An efficient slice-shuffling inversion-recovery echo-planar imaging (EPI)-based T1-mapping and postprocessing was demonstrated for the fetal brain at 0.55T in a cohort of 38 fetal MRI scans. Robustness analysis was performed and placental measurements were taken for validation. High-quality T1 maps allowing the investigation of subregions in the brain were obtained and significant correlation with gestational age was demonstrated for fetal brain T1 maps ( ) as well as regions-of-interest in the deep gray matter and white matter. Efficient, quantitative T1 mapping in the fetal brain was demonstrated on a clinical 0.55T MRI scanner, providing foundations for both future research and clinical applications including low-field specific T1-weighted acquisitions.

CMOS Pulse Oximeter

Abstract: This paper presents the design and implementation of a non-invasive pulse oximeter based on Complementary MetalOxide-Semiconductor (CMOS) technology, aimed at enhancing the accuracy and accessibility of blood oxygen saturation measurements. Pulse oximetry is a critical tool in clinical and personal health monitoring, providing vital information about respiratory function. The integration of CMOS technology allows for miniaturization and energy efficiency, facilitating the development of compact, wearable devices capable of continuous monitoring. The proposed system utilizes advanced signal processing techniques, including lock-in detection and dual-wavelength illumination, to improve the reliability of photoplethysmographic (PPG) signal acquisition under various conditions. Experimental validation demonstrates the device's capability to deliver accurate SpO2 readings even in the presence of motion artifacts and ambient light interference. Furthermore, the calibration methods employed ensure that measurements are consistent and precise across different users. By leveraging the advantages of CMOS technology, this study not only highlights the potential for improved patient comfort and compliance but also opens new avenues for the application of pulse oximetry in diverse environments. The findings underscore the effectiveness of CMOS-based pulse oximeters in advancing non-invasive health monitoring solutions, ultimately contributing to enhanced patient care and outcomes.

Degree of pain in intravenous injection of propofol with intravenous lidocaine administration; A Literature Review Study

Intravenous propofol injection is widely used for anesthesia induction and sedation, though it often causes discomfort and pain at the injection site, leading to patient anxiety. Lidocaine, a local anesthetic, has been studied for its ability to reduce this pain by inhibiting sodium channels, thereby decreasing neuronal excitability and pain transmission. Research indicates that intravenous lidocaine effectively reduces the occurrence and intensity of pain during propofol injection. This study aims to assess the effectiveness of intravenous lidocaine in minimizing pain related to propofol injection. A literature review was conducted, analyzing studies from 2018 to 2024 obtained from databases such as Google Scholar, PubMed, and ScienceDirect. Twelve articles meeting the selection criteria were reviewed. The findings consistently show that intravenous lidocaine significantly lowers the pain associated with propofol injection. Additionally, lidocaine use reduced the required propofol dosage and improved patient satisfaction. The studies suggest that administering intravenous lidocaine before or during propofol injection is a practical approach to reducing injection pain. Future research should focus on optimizing the parameters that enhance lidocaine's analgesic effects, ultimately improving patient comfort and satisfaction in procedures involving sedation.