Group Standard Deviation Research Articles

A Comparative Study to Evaluate the Effectiveness of Crushed Ice Pack Application and Sitz Bath on Episiotomy Pain and Wound Healing Among Postnatal Mothers

An episiotomy is an incision made in the perineum- the tissue between the vaginal opening and the anus during child birth. Pain at the episiotomy site is more distressing for the mother during postnatal period. An ice pack application or warm shallow bath (sitz bath) may increase comfort and promotes healing. The main aim of this present study was to compare the effect of Crushed ice pack application and Sitz bath on episiotomy pain and wound healing among postnatal mothers. A Matched group design was adopted in this study. By using Non probability purposive sampling technique 22 postnatal mothers with episiotomy were selected as samples at Ramakrishna Hospital, Coimbatore and 11mothers were assigned randomly to each group I and group II. Episiotomy pain was assessed by using Numerical Pain Intensity scale and Wound healing was assessed by using Davidson REEDA scale. Group I received crushed ice pack application and Group II received sitz bath. Intervention was given for 10 minutes twice a day for three consecutive days from first postnatal day. Data were analysed by using descriptive and inferential statistical methods. The statistical analysis revealed that the calculated mean scores of episiotomy pain in the group I and group II was1.72 and 2.9 respectively and the mean difference is 1.2 with the standard deviation of group I and group II was 0.64 and 0.53 respectively. The calculated ‘t’ value 11.3 was greater than the table value of 2.086 at 0.05 level of significance. The calculated mean scores of episiotomy wound healing in the group I and group II was 1.54 and 1.81 respectively and the mean difference is 0.27 with the standard deviation of group I and group II was 0.5 and 0.6 respectively. The calculated‘t’ value 2.6 was greater than the table value of 2.086 at 0.05 level of significance. Finally, the study concluded that the crushed ice pack application was more effective than sitz bath in reducing the level of episiotomy pain and promotes wound healing among postnatal mothers.

A PROSPECTIVE STUDY TO COMPARE COMBINED USE OF INTRAVAGINAL MISOPROSTOL AND INTRACERVICAL FOLEY CATHETER VERSUS INTRAVAGINAL MISOPROSTOL ALONE FOR TERMINATION OF MID-TRIMESTER PREGNANCY IN DEPARTMENT OF OBSTETRICS AND GYNAECOLOGY SMS MEDICAL COLLEGE, JAIPUR

Aims and Objectives: The aims and objectives of the study are to compare the mean induction to abortion interval and efficacy of intra-vaginal misoprostol alone versus combined use of intravaginal misoprostol and intracervical Foley catheter in termination of mid-trimester pregnancy. Methods: This was prospective, comparative study conducted during March 2021 to April 2022 at Department of Obstetrics and Gynaecology, SMS Medical College, Jaipur. The study included sample size of 60 cases (30 cases in each group). 60 cases were randomly allocated to either intravaginal misoprostol alone (Group A) or combined use of intravaginal misoprostol and Foley catheter (Group B) for termination of mid-trimester pregnancy. The study included all pregnant females between 14 and 20 weeks of gestation who were admitted for termination of pregnancy. Results: Mean induction to abortion interval±standard deviation for Group A was 20.79±2.01 h and for Group B, it was 17.29±3.58 h. Mean dose of tablet misoprostol required for Group A±standard deviation was 1453.3±267.47 mcg and for Group B, it was 1053.33±267.47 mcg. Conclusion: In this study, we found that with the combined use of intravaginal misoprostol and intracervical Foley catheter, there was a significant reduction in duration of induction to abortion, total dose misoprostol required, and hospital stay than in intravagnial misoprostol alone in termination of mid-trimester pregnancy.

Improving English Vocabulary Through Quizizz in Practice Tests for Gamification and Google Forms with AutoProctor in Assessment tests for the Preclusion of Malpractice

Research on Vocabulary is prominent, and it helps learners find many diverse ways to learn vocabulary to a greater extent. However, the research on vocabulary in recent years gradually diminishes as students age and get to higher education [1]. Many researchers recommend the effective use of digital tools to motivate students to participate actively in learning [9], and digital gamification makes quite an impact by creating student interest in word learning [1] [12]. At this juncture, our research serves the need for improving the vocabulary of Engineering students through digital gamification using 'Quizizz' in their Practice tests and Google Forms with 'AutoProctor' to preclude their malpractice during their assessment test-taking. This study was carried out based on quantitative research by collecting and analyzing numerical data of a couple of research groups, the control group (n1=45) and experimental group (n2=69), and also through a closed-ended questionnaire using a Likert Scale. The findings demonstrate how this research culminated in the results that brought a subtle difference in the two groups; the control and experimental groups that pursued the traditional and blended methods. The Pooled Standard Deviation (Spooled) (Weighted average of Standard Deviations from both the groups) statistically demonstrated that it had deviated from the control group's Standard Deviation (s1) by 0.286 and from the experimental group's Standard Deviation (s2) by 0.2. This weighted average vindicated the study that the experimental group could perform better than the control group in the post-test.

Effect of Nebulized Heparin on Mechanically Ventilated Patients

Background: Previous clinical studies have shown that nebulized heparin can shorten the duration of mechanical ventilation in people with acute respiratory distress syndrome (ARDS). The current study examines whether nebulization with heparin provides similar benefits compared to normal saline. Method: A six-month randomized controlled trial was conducted in a tertiary care hospital. The study included patients who were intubated during their stay in the intensive care unit (ICU) and required mechanical ventilation for more than 48 hours. Both groups of patients had a PaO2/FiO2 ratio of less than 300. Enrolled patients were randomly assigned to two groups using a lottery method: Group A received nebulized heparin, while Group B received nebulized normal saline. The researchers measured the PaO2/FiO2 ratio in both groups at baseline, day 3 and day 7. They also recorded the number of days without ventilator support and mortality during the first 28 days for both groups. Results: A total of 108 subjects between the ages of 18 and 60 years, regardless of gender, admitted to the intensive care unit (ICU) and requiring mechanical ventilation were included in the study. The results of our study showed that in group A the mean PaO2/FiO2 ratio was 222.7 ± 65.51 standard deviation (SD), while in group B on the third day it was 200.6 ± 60.8 SD (p = 0, 07). On day 7, the mean PaO2/FiO2 ratio was 227.4-218.3 SD in group B and 218.3-49.1 SD in group A (p=0.41). In terms of ventilator-free days, the mean duration (composite) was 16.9 x 9.1 standard deviations in group A and 12.6 x 7.9 standard deviations in group B for the 28-day period (p=0.01) . Conclusions: No significant differences in the mean PaO2/FiO2 ratio between the two groups on day 3 and day 7 were observed. However, looking at both survivors and non-survivors, as well as survivors alone, patients who received aerosolized heparin had significantly more ventilation-free days compared to those who received placebo. No significant differences were found between the two groups in terms of mortality over the 28-day period.

Effect of different irrigants on the push-out bond strength of biodentine and TheraCal LC when used for perforation repair in simulated condition.

Perforation repair materials should have excellent sealing ability and dislodgement resistance. While several materials have been employed for perforation repair, newer calcium-silicate materials, such as Biodentine and TheraCal LC, have shown promising outcomes. This study aimed to evaluate the effect of different irrigants on the dislodgement resistance of Biodentine and TheraCal LC when used for perforation repair in simulated conditions. 3% sodium hypochlorite, 2% chlorhexidine gluconate, and 17% EDTA were evaluated for their effect on the dislodgement resistance of Biodentine and TheraCal LC. 48 permanent mandibular molars were selected for the study. The samples were divided into two groups: Group I - Biodentine and Group II - TheraCal LC, with 24 samples each. The mean dislodgement resistance and standard deviation of Group I (Biodentine) and Group II (TheraCal LC) were compared and Failure pattern analysis was done. Biodentine showed a significant decrease in push-out bond strength after contact with 3% NaOCl, 2% CHX, and 17% EDTA whereas, TheraCal LC showed no significant decrease in push-out bond strength after exposure to 3% NaOCl, 2% CHX, and 17% EDTA. Overall, TheraCal LC can be considered good perforation repair material with excellent physical and biological properties.

Posterior wall substrate modification using optimized and contiguous lesions in patients with atrial fibrillation.

Radiofrequency (RF) linear ablation at the left atrial (LA) roof and bottom to isolate the LA posterior wall using contiguous and optimized RF lesions was evaluated. Achieving isolation of the LA posterior wall is challenging as two continuous linear lesion sets are necessary. Forty consecutive patients with symptomatic atrial fibrillation (AF) and arrhythmia substrates affecting the LA posterior wall underwent posterior wall isolation by linear lesions across the roof and bottom. The cohort was divided into two groups: group 1 (20 patients) linear ablation guided by contact force (CF) only; group 2 (20 patients) guided by ablation index (AI) and interlesion distance. Bidirectional block across the LA roof and bottom was achieved in 40/40 patients. Additional endocardial RF applications in 5 patients from group 1 vs. 3 patients from group 2 resulted in posterior wall isolation in all patients. Procedure duration was almost equal in both groups. CF and AI were significantly higher in group 2 for the roof line, whereas no statistical difference was found for the bottom line. AI-guided LA posterior wall isolation led to a significantly lower maximum temperature increase. The mean AI value as well as the mean value for catheter-to-tissue CF for the roof line were significantly higher when AI-guided ablation was performed. Standard deviation in group 2 showed a remarkably lower dispersion. Ablation index guided posterior wall isolation for substrate modification is safe and effective. AI guided application of the posterior box lesion allows improved lesion formation.

Evaluation of Overactive Bladder Symptoms in Patients Recovering from Post-Acute COVID-19 Syndrome.

PurposeCoronavirus disease (COVID-19) is a multi-organ viral infection with many manifestations. However, its impact on the genitourinary system is nowadays under investigation. This study aimed to evaluate the consequences on bladder function in patients suffering from post-acute COVID-19 syndrome (PACS) transferred to inpatient rehabilitation for long-term care after initial treatment for COVID-19 pathophysiology.Materials and MethodsAll the patients were initially asked the question (after having recovered from the acute stage of COVID-19 disease): “Have you noticed a sudden, uncontrolled need to urinate and sometimes a urine leakage accompanying the voiding desire?” Sixty-six out of 147 patients responded positively to this question and were assessed with the AUA Urology Care Foundation Overactive Bladder Assessment Tool (AUA-OAB-tool). All included men were evaluated with the IPSS score.ResultsThe median age of patients was 59.5 (range 44–72). We identified 44 patients with newly diagnosed OAB (Group A; post-COVID assessment) and 22 with worsening OAB symptoms (Group B). The mean symptom score ± standard deviation in Group A patients was 18.25 ± 2.11 (using the above AUA OAB tool). In the patients of Group B, there was an increase in the above score from 10.43 ± 1.52 (pre-COVID condition) to 17.87 ± 1.89 (post-COVID assessment). In patients of Group A, the total quality of life (QOL) score was 17.74 ± 2.34. Patients in Group B presented an escalation in total QOL score from 9.04 ± 1.41 (pre-COVID) to 18.84 ± 1.96 (post-COVID condition). There was no statistically significant difference in symptoms and QOL scores between men and women in groups A and B. There were 11 men in Group A and 5 in Group B with an IPSS score >20.ConclusionOAB symptoms may be essential to PACS syndrome and influence quality of life, delaying full recovery.

Multimedia sensor image detection based on constrained underdetermined equation

Abstract In order to study the image detection of multimedia sensor based on constrained under determined equation, this paper proposes the improvement of image sensor quality detection method based on image recognition algorithm. Firstly, the principle and steps of the under determined method are explained, and the complexity of the algorithm is analyzed. The image sensor is the most important part of the mobile camera, which determines the performance of the mobile camera, and its assembly quality largely determines the quality of the whole mobile camera. The case studied in this paper is model h mobile phone camera, and the first pass rate of good products is only 80%. In order to meet the 95% pass rate of good products required by customers, it is necessary to comprehensively improve the processes that have a great impact on product quality, so as to improve the first pass rate of products, achieve quality objectives and reduce manufacturing failure costs. In order to find out the threshold value of the height information measured by the improved method, to determine whether the product is good, and to find out the process that has a great impact on the surface flatness of the image sensor, the product measurement experiment is specially set. The improved war page test method was used to measure the products of each experimental group. Among them, No. 22, No. 39 and No. 40 products are poor due to changes in physical properties in subsequent production, and cannot flow to the next process for production. Therefore, the data of No. 22, No. 39 and No. 40 are missing in the test data. A total of 133 groups of experimental data were obtained in this experimental test. The results showed that the standard deviations of group 1, group 2, group 3 and group 4 were 0.172, 0.125 and 0.304 respectively. That is, after the same product is treated by false hardening, heating hardening and base installation processes, the false hardening and heating hardening processes have relatively little impact on the surface flatness of the image sensor. After the base opening and installation process, the surface flatness of the image sensor begins to change. The standard deviations of the measurement results of group 1 and groups 4, 5, 6 and 7 were 0.304, 0.381, 0.391 and 0.514 respectively. That is, after the base installation, calibration, bonding, soldering and testing of the product, the surface flatness of the image sensor and the initial surface flatness have changed greatly. Therefore, production technicians can focus on the process that starts to change, that is, the base installation process. The improved method has the advantages of automatic operation, low error, low error rate and so on.

COMPARSION OF LIPID PROFILE IN DIABETIC HYPERTENSIVES VS DIABETIC NORMOTENSIVES

Background: Lipid abnormalities are linked to a higher risk of cardiovascular disease and other morbidity in people with diabetes. Dyslipidemia may signal the onset of Type 2 diabetes in the future. A trio of diminished high density lipoprotein (HDL), increased triglycerides (TG), and increased low density lipoprotein (LDL) is known as diabetic dyslipidemia. As a result, diabetic dyslipidemia serves as a separate risk factor and predictor for coronary artery disease (CAD). Aim: To compare Serum lipid profile levels in type-2 diabetics with hypertension (Group 1) and type-2 diabetics without hypertension (Group 2). Methods: Prospective observational study was undertaken on 200 subjects aged 40-60 years from November 2019 to October 2020 with patients of Type-2 diabetes mellitus (both old and new cases) with hypertension (Group 1) and Type-2 diabetes mellitus without hypertension (Group 2) having any of the complications associated with diabetes and on age and sex matched diabetics without hypertension. Results: Mean value of total cholesterol ± standard deviation of Group 1 was 188.92 ± 34.66 mg/dl and that of Group 2 was 190 ± 46.54, the difference between the two groups being statistically not significant (p=0.853). Mean value of triglycerides ± standard deviation of Group 1 was 214.81 ± 78.35 mg/dl and that of Group 2 was 184.04 ± 62.69 mg/dl, the difference between the two groups being statistically highly significant (p=0.003). Mean value of LDL ± standard deviation of Group 1 was 104.42 ± 31.26 mg/dl and that of Group 2 was 109.57 ± 39.78 mg/dl, the difference between the two groups being statistically not significant (p=0.309). Mean value of HDL ± standard deviation of Group 1 was 42.98 ± 6.20 mg/dl and that of Group 2 was 43.80 ± 6.47 mg/dl, the difference between the two groups being statistically not significant (p=0.361). Mean systolic and diastolic blood pressure in Group 1 was 127.64 ± 13.41 and 86.20 ± 7.06 mmHg and that of Group 2 was 118 ± 10.80 and 77.52 ± 7.87 mmHg, the difference between the two groups being statistically highly significant (p<0.0001). Mean Fasting Blood sugar of Group 1 was 197.80 ± 74.75 mg/dl and that of Group 2 was 177.91 ± 62.52mg/dl the difference being highly statistically significant (p= 0.043). Conclusion: The findings of this study concluded that there is a positive relationship between type-2 diabetes mellitus and lipid profile. Mean values of total cholesterol, LDL, triglycerides were significantly raised in type-2 diabetics, supporting the hypothesis that dyslipidemia is a significant complication of type-2 diabetes mellitus, which further contributes to the increased risk of multiple organ morbidities in diabetes. A significant difference in mean triglyceride level was found in both groups. There were no significant differences in mean HDL, LDL and cholesterol levels among the two groups as the levels of these parameters were raised to an almost equal extent in both the groups.

The Effectiveness of Task Based Intruction (TBI) toward Students’ Interest in Learning English Vocabulary at SMPN 1 Sambelia

This research was aimed at find out whether or not using Task Based Intructionhas positive effect toward students’ interest in learning English vocabulary. Thisresearch was an experimental research.The population the second year students of SMPN 1 Sambelia in academic year 2021/2022 was 209 students. The sample of the research was 54 students. The sample was taken by cluster random sampling technique. The instrument that was used test (20 items) and questionnaire. The score were analyzed by used descriptive and inferential analysis. Descriptive analysis was used to describe mean, mode, median, and standard deviation of group according to AnasSudijono:2007, and inferential analysis was used to describe the value of t-test for comparison between t-table. It was showed that the value of-test = 2.575 was higher than the value of t-table = 1.675. So, using Task Based Intruction approach has positive effect toward students’ interest in learning English vocabulary at SMPN 1 Sambelia.

Susceptibility of repigmentation of enamel surface to red wine and brandy staining after 35% hydrogen peroxide bleaching

Aim and objectives: To investigate the susceptibility of enamel surface for repigmentation by red wine and brandy stains after 35% hydrogen peroxide bleaching. Methodology: 40 freshly extracted human permanent maxillary central incisor teeth were collected for the study. Incisors were stored in 0.1% thymol solution and were used within 1 month of extraction. The teeth were cleaned with ultrasonic scaler, polished with pumice paste. The samples were than divided into two groups of 20 incisors teeth each. Both groups of 20 teeth each were than bleached using 35% hydrogen Peroxide as per the manufacturer’s instructions, i.e. 15 minutes three times a day, every alternate day for four days. Group 1 were than immersed in 200 ml of red wine and group 2 were immersed in 200 ml of brandy for 15 minutes, 6 hours, 1 week and 1 month each. Advance spectrophotometer was used to measure the color shade of the teeth pre bleaching, after 15 minutes, after 6 hours, after 1 week and after 1 month of red wine and brandy immersion. The colour differences (ΔE) at each time interval were calculated accordingly. Results: Spectrometer analysis showed mean ΔE values ± standard deviation of group 1 and group 2 at different time intervals. Color change due to repigmentation was lowest for group 1 teeth from baseline to 15 minutes time interval. Mean ΔE value ± standard deviation was 4.04045±1.308029. However color change value was highest in group 2 teeth at 1 week to 1 month time interval and was 13.45717±1.098210. Group 2 teeth had higher ΔE value than group 1 at any point of time interval. Conclusions: It was concluded that low pH values causes more repigmentation of bleached enamel surface as it was found more with brandy in comparison to red wine. The bleaching treatment with 35% hydrogen peroxide enabled the teeth to become clearer; nevertheless, the intake of food and beverages containing colorants or an acidic pH can negatively affect the effectiveness of bleaching.

Comparison of Clinical and Angiographic Profiles of Patients with or without Left Main Coronary Artery Disease

Background: Left main coronary artery disease constitutes highest risk lesion subset of CAD population. Flow dynamics and pathophysiology in the left main coronary artery are different from that of the other coronary arteries. So traditional risk factors might interact differently with left main artery resulting in different clinical and angiographic characteristics compared to others. Anatomic pattern evaluation in left main coronary artery disease is important in deciding best management options. However, their pattern and profiles were variably shown in different studies with discrepant Results suggesting geographic variation and lead to evaluation of characteristics in our own population. Better understanding this specific problem might lead to further improvement in its management. Methods: It was an observational cross-sectional study. Ninety-one adult coronary artery disease patients over the period of one year who underwent invasive coronary angiogram were studied. Study subjects were divided into two groups after coronary angiogram: Left main (Group 1) and Non-left main (Group 2) CAD. Demographic data, risk factor profiles and angiographic patterns of both groups were compared to see if any statistically significant difference present or not. Results: The mean age and standard deviation in group 1 is 55.2±9.4 and in group 2 is 55.5±12.9; the comparative analysis showed no statistically significant difference. Most of the patients were male 69 (76%) and the comparative study showed statistically significant differences (p=0.046) which showed left main disease tended to be higher in male. Majority (64%) had BMI in normal range with no significant difference. Among the risk factors comparison, diabetes and family history of CAD showed significant association with the left main cohort (p<0.05). Non-ST elevated ACS was the most common presentation and significantly associated with the left main group (p<0.05). On coronary angiogram, there were 80 patients (87.92%) who had no left main artery involvement while 11 patients (12.08%) had left main disease. The comparative study of coronary artery involvement among the two groups reveals no statistically significant differences (p>0.05) but triple vessel disease was found more commonly than single and double vessel disease. Distal lesions (64%) were found more frequently than other types of left main stenosis followed by ostio-proximal lesion (36%). Conclusion: In the patients with left main coronary artery disease, male gender, diabetes mellitus, positive family history and presentation with non-ST elevation ACS were found to be significantly associated. Distal left main lesion and triple vessel disease were commonly found. University Heart Journal 2022; 18(1): 3-9

THE EFFECT OF QUESTION ANSWER RELATIONSHIP (QAR) STRATEGY ON STUDENTS' ACHIEVEMENT IN READING COMPREHENSION

The focus of this research is to demonstrate the influence of question-and-answer learning on students' reading interest in narrative texts. Is there an effect of question answer relationship strategy on students' reading skills in reading narrative texts? Class Vlll SMP Methodist 9 Medan is the problem in this research. This form of research is a quasi-experimental study that includes an experimental and a control group, as well as pre- and post-tests. The post-test results showed that 22 pupils (88 percent) received very high scores and 3 students (12 percent) received high scores. The experimental group's mean score was likewise raised. Prior to using the QAR technique, the mean was 67.04. The mean after learning using the QAR technique was 83.36. The median in the pre-test was 76, but after learning with the QAR approach, it was 82. Prior to treatment, the experimental group's standard deviation was 1.676. After learning by applying QAR strategy, the standard deviation in the experimental group was 2.084. Students are more engaged in reading after employing the question-and-answer learning paradigm to improve their interest. This demonstrates that the question-and-answer interaction strategy's learning effect has a significant impact on students' success in reading narrative texts

Effect of Task Oriented Training on Spasticity in Post Stroke Individuals

<p dir="ltr"><strong>Purpose:</strong> Post-stroke spasticity may be maladaptive and interfere with an individual’s ability to perform functionally useful movement. However studies investigating how the spasticity relates to motor recovery are rare. Reducing the limb spasticity will help post stroke individuals function better at the activities of daily living. There is a paucity of literature showing the effect of task oriented approach on spasticity when compared to the standard conventional approach. Hence, there is a need to find out the effect of task oriented training on spasticity in post stroke individuals. <strong>Methods:</strong> A comparative study with a study design of Randomised Clinical Trial (RCT) was conducted among 60 post stroke individuals (30 post stroke individuals in group A and Group B respectively). Group A was given a task oriented approach for managing the spasticity and group B was given conventional treatment along with a task oriented approach to manage the spasticity. The treatment protocol for both the groups lasted for 6 weeks (4 days a week). <strong>Results:</strong> The mean and standard deviation on the Modified Ashworth Scale of Group A and Group B at baseline is 3.46 ± 0.68 and 3.56 ± 0.72 respectively which shows no significance (p value = 0.2925 and t value = 0.5493). The mean and standard deviation of Group A and Group B at 6 weeks is 2.4 ± 1.04 and 1.33 ± 1.1 respectively which is significant (p value = 0.0003, t value = 3.877.) <strong>Conclusion:</strong> It can be concluded that task oriented training alone is effective in acute stroke survivors, but in chronic stroke survivors it is not remarkably efficacious and requires a combined approach of task oriented training along with conventional management for finer outcomes.</p>

The Effect of Picture Word Inductive Model (PWIM) on Students’ Vocabulary Mastery

This research is aimed at finding out whether using Picture Word Inductive Model has positive effect on students’ vocabulary mastery or not. The research was pre-experimental with pre-test post-test design. The population and sample of the study was second grade students of MTs NW Lingsar which consisted of one class (26 students). The instrument that was used objective test (20 items). The score was analyzed by used descriptive and inferential analysis. Descriptive analysis was used to describe mean; mode, median, and standard deviation of group, and inferential analysis was used to describe the value of t-test for comparison between t-table. It was showed that the value of-test = 4.708 was higher than the value of t-table = 1.708. So, using Picture Word Inductive Model has positive effect on students’ vocabulary mastery at MTs NW Lingsar.

Compare the Clinical Severity and Length of Hospital Stay in Children with Bronchiolitis Treated with the 3% Hypertonic Saline Nebulization Versus Normal Saline and Salbutamol

Background: Acute bronchiolitis, a lower respiratory tract infection, is the most common reason for hospitalizing infants and children for breathing issues. Salbutamol dissolved in sterile saline solution was commonly used to treat hospitalized infants with acute bronchiolitis. This study was conducted with the hypothesis that giving bronchiolitis-affected infants 3 % hypertonic saline solution to inhale instead of 0.9% NS+salbutamol would reduce their clinical severity ratings and length of hospitalization. Objective: To compare the clinical severity and length of hospital stay in children with bronchiolitis treated with the 3% hypertonic saline nebulization versus Normal saline and salbutamol Study Design: A randomized controlled trial Place and Duration: This study was conducted at Indus Medical College The University of Modern Sciences, Tando Muhammad Khan from June 2021 to June 2022 Methodology: A total of 120 individuals with acute bronchiolitis were included in this research after exclusions and inclusions. Both the 0.9% normal saline with salbutamol nebulization and the 3% hypertonic saline nebulization (n = 60) were randomly assigned to the two groups. The data was obtained regarding, age, gender, the pattern of presentation, clinical severity at different time intervals, duration of oxygen therapy, length of hospital stay, and rapid or gradual improvement and discharge of the patient from the hospital. Chi-square and unpaired t-tests were employed as test statistics to analyse the categorical data numerical data. The level of significance was set at 5%, with p0.05 (at the 95% confidence interval) being regarded as significant. Results: A total of 32 (53.3%) females made up group I, while 34 (56.67%) males made up group II. In groups I and II, the mean hospital stays were respectively 61.7±14.5 hours and 81.4±18.2 hours. The mean and standard deviation for group I oxygen therapy time was 13.5± 4.2, while group II was 23.8±4.9 hours. Amongst the hypertonic saline group, out of total 60 patients, 55 (91.67%)patients were recovered and discharged rapidly. Meanwhile, in group II, 32 (53.3%) patients were recovered and discharged rapidly. Conclusion: Yet, in terms of symptom relief, oxygenation improvement, and length of hospital stay for a baby with acute bronchiolitis, the 3% hypertonic saline group outperformed the 0.9% normal saline group. Clear clinical improvements and an increase in oxygen saturation were seen in both therapy groups. Keywords: Acute Bronchiolitis, Hypertonic Saline, Normal Saline, Salbutamol

End-to-Side Versus End-to-End Venous Anastomosis Using Couplers in Mandibular Reconstruction: A Comparative Study.

This study compares the advantages of end-to-side technique over end-to-end technique for venous anastomosis using couplers. Patients were divided into group I and group II based on end-to-side and end-to-end techniques, respectively. Intraoperative anastomotic time, flap ischemic time, and postoperatively flap vitality were the parameters evaluated. Thirty-eight patients were randomly allocated to two groups with 19 patients in each group. The mean anastomotic time with standard deviation in group I was 391.84 ± 49.052s and in group II was354.47 ± 46.365s with p value 0.021. The mean flap ischemic time with standard deviation in group I was 180.68 ± 35.773min and in group II was 161.21 ± 32.418min with p value 0.087. All the flaps in group I were vital, whereas 78.9% of flap vitality was observed in group II with p value 0.105. Based on this study, end-to-side venous anastomosis using couplers is a better technique over end-to-end venous anastomosis.

The Effect of Student Team Work Learning (STWL) towards Students’ Reading Comprehension

This research was aimed at finding out whether or not Student Team Work Learning Strategy (STWL) has positive effect on students’ reading comprehension. The research was pre experimental with one pre-test post-test design. The sample of the study was second grade students of MA Nurul Muhsini Jomang Batu Jai Lombok Tengah which consisted of one class 30 students. The instrument used was reading test inthe form of multile chose test and objective test which were consited of 25 items. The score was analyzed by using descriptive and inferential analysis. Descriptive analysis was used to describe mean, mode, median, and standard deviation of group, and inferential analysis was used to describe the value of t-test for comparison between t-table. It was showed that the value of t-test = 5.411 was higher than the value of t-table = 1.692. Alternatively, using Student Team Work Learning Strategy has positive effect on students’ reading comprehension at second grade students of MA Nurul Muhsini Jomang Batu Jai Lombok Tengah.

Fenestrated versus debranching thoracic endovascular aortic repair for endovascular treatment of distal aortic arch and descending aortic lesions

BackgroundCervical debranching, followed by thoracic endovascular aortic repair (TEVAR), is well-established for treating aortic arch lesions. However, total endovascular repair with fenestrated endografts has not been adequately studied. Thus, we performed a comparison of the two techniques. MethodsThe present study was a single-center, retrospective study comparing the treatment of thoracic aortic lesions with custom-made fenestrated stent-grafts (fenestrated TEVAR [fTEVAR]) with a single fenestration for the left subclavian artery (LSA), a scallop for the left carotid artery, and hybrid repair with a thoracic stent-graft and cervical debranching of the LSA. Emergency cases were excluded. ResultsFrom 2012 to 2018, 19 patients (58% male) underwent elective fTEVAR (group A) and 17 patients (82% male) underwent debranching TEVAR (dTEVAR; group B). The mean age ± standard deviation in group A was 65.8 ± 2 years and 68 ± 3 years in group B. Left carotid–subclavian bypass was performed in 15 of 17 patients (88%) and transposition of the LSA in 2 of 17 patients (12%) in group B. The two groups were comparable regarding comorbidities, except for peripheral arterial disease: 5 of 19 patients in group A (26%) and none in group B had had peripheral arterial disease (P = .049). Dissection or post-dissection aneurysm was the indication for treatment in 6 of 19 patients in the fTEVAR group (group A) and in 12 of 17 patients in the dTEVAR group (group B; 31.6% vs 70.6%; P = .04). The indication for the remaining patients was a degenerative aortic aneurysm. Technical success was achieved in all cases, except for one case of dTEVAR owing to a type Ia endoleak. The mean endovascular operative time was 191 ± 120 minutes for fTEVAR and 130 ± 75 minutes for dTEVAR (P = NS). The mean operative time for the debranching procedure was 181 ± 97 minutes. No deaths or major strokes had occurred in the early postoperative period (30 days). Of the 17 patients in group B, 5 (29.4%) had experienced a local complication related to the debranching procedure. The mean follow-up was 14.6 ± 2 months for group A and 17 ± 2 months for group B. Of the 19 patients in group A and 17 patients in group B, 2 (10.5%) and 6 (35.3%) had required an unplanned reintervention related to the thoracic stent-graft during the follow-up period, respectively (P = NS). The estimated freedom from unplanned reintervention at 12 months was 86% for group A and 81% for group B. Primary patency of the LSA stent-graft or the carotid–subclavian bypass/transposition was 100% in both groups. ConclusionsBoth techniques showed excellent midterm patency rates for the target vessel and high technical success rate. The operation times were shorter for the fTEVAR group and complications related to the debranching procedure were avoided.

Effects of Combined Exercise Program on Body Composition, Lipid and Cortisol Levels in Blood among Middle School Students with Intellectual Disability

The purpose of this study was to identify physiological responses through combined exercddise for intellectually disabled people who view obesity as one of their physical characteristics. To achieve the purpose of this study, an eight-week compound exercise was conducted on 28 intellectually disabled middle school students residing in K city and the average and standard deviation for groups (normal BMI groups, obese BMI groups) were calculated. In addition, data processing was performed using two way repeated measured ANOVA using SPSS 18.0, and post-verification was performed if there were significant differences. The results are as follows: First, there was no change in weight for middle school students with intellectual disabilities through eight weeks of combined exercise. However, the lean body mass increased in the standard population, body fat mass and BMI decreased in the standard population, and the bone density factor increased in both the standard population and the obese population. Second, neutral fat decreased in the standard group, and the low-density cholesterol factor decreased in the obesity group. Third, cortisol factors have been shown to decrease in standard groups. In conclusion, the eight-week compound exercise has been shown to have an effect of improvement in the physical composition and blood lipid variables of middle school students with intellectual disabilities.