bluuebunny/crossref_metadata_2025 huggingface dataset:
Theoretical-Practical Principles for the Design of Massive Open Online Courses (MOOCs) Applied to Continuous Teacher Education
Authors: Machiavelli Josiane Lemos , Cavalcante Patricia Smith
Published: February 2022

In populous countries with continental dimensions and a series of economic and infrastructure difficulties, such as Brazil, guaranteeing the quality of initial and continuing teacher education is a challenge. Therefore, researchers have been continually invited to think about new educational models. This chapter describes the theoretical and practical principles considered fundamental for teacher training that was carried out through massive open online courses (MOOCs) in a public higher education institution. Design-based research, a process that integrates design, quantitative, and qualitative methods to generate educational interventions, was the methodological path used to develop the MOOC. The principles are organized into five categories: human, pedagogical, structural and technological, regulatory, and analytical. Without pretending that they will function as protocols for planning, developing, offering, and evaluating MOOC-based courses, the authors hope that the results presented can be reconfigured, improved, and tried out in other educational offerings in varied contexts.
Epic Boss Battles
Authors: Kellinger Janna Jackson
Published: February 2022

This chapter begins with a self-exploration of the evolution of the author from using one-shot games as a high school English teacher to designing synchronous game-based courses as an assistant professor to creating asynchronous course-based games as an associate professor. The pros and cons of each are discussed with a focus on examining the pedagogical theories that support game-based teaching. Then, readers take a deep dive into ways to create asynchronous course-based games while avoiding common pitfalls. The chapter concludes with an exploration of how asynchronous course-based games can help create equity by providing students with the flexibility to learn at their own pace and on their own time and the ability for students to determine their own grades through the revision cycle.
An Integration of Virtual Reality Into the Design of Authentic Assessments for STEM Learning
Authors: Koh Kim , Chapman Olive , Lam Lanny
Published: February 2022

Creating equal learning opportunities for all students to develop STEM literacy and global competencies is an important educational initiative. Due to COVID-19 pandemic-related classroom disruptions, it is imperative to find new ways to engage and motivate students in STEM learning. This chapter looks at the potential integration of VR technology into the design and development of authentic STEM assessments to promote the STEM learning of elementary school students in both online and blended learning environments. The design principles of a VR-based authentic STEM assessment are guided by the following theoretical frameworks: VR technology, authentic assessment, criteria for authentic intellectual quality, patchwork text approach, and SOLO taxonomy. An example of the design of authentic STEM assessments is included. The chapter concludes with the authors' recommendations for building teachers' capacity in VR technology and authentic STEM assessments through preservice teacher preparation and inservice teacher professional development. Future research directions are also discussed.
Using Project-Based Learning Pedagogies in African Higher Education
Authors: Chakabwata William , Hategekimana Edward Kwiriha
Published: February 2022

For many, project-based learning (PBL) seems to be the emerging opportunity to restore the missing link and empower higher education with what it takes to assume its role in society. Specifically, it aims at establishing weaknesses in PBLs features in African higher education and how best these can be tackled. Furthermore, in a broader sense, this analysis aims at considering current imperative shifts in the structure of higher education to adjust to unprecedented changes in the world of work due to the already mentioned crisis. The chapter makes use of published materials to tap these weaknesses and show the way forward. The author recommends innovative pedagogical arrangements in higher education PBLs as the effective way in which higher education institutions in Africa can avert the mismatch between theoretical and practical knowledge.
Experiences and Perceptions of K-12 Teaching Online During COVID-19
Authors: Cardullo Victoria M. , Burton Megan , Wang Chih-hsuan
Published: February 2022

COVID-19 caused a significant shift in learning and teaching that impacted nearly every aspect of life. With the physical closure of classrooms, many school systems and teachers found themselves suddenly developing curriculum and instructional plans that could be delivered remotely, and most of these curriculum plans were administered online while students attended remotely from home. Technology is key and central to a distance learning environment. For this reason, it is vital to understand the teachers' perceptions about using technology. His/her attitude then influences the intention to use and this leads to the actual use of LMS and tools. The current study was a portion of a larger study investigating K-12 teachers' perceptions and attitudes during the pandemic of COVID-19. The authors explored responses that were gathered from open-ended questions. Examining teacher perceptions of advantages and disadvantages of online learning settings that emerged as a result in the shift to online instruction.
Surface Modification Techniques for Improving the Material Performance
Authors: Thanigaivelan R.  , Saravanan K. G.  , Makesh M.
Published: February 2022

Surface modification techniques are mainly considered to change the surface of the material based on the application. The surface modified materials possess excellent mechanical, tribological, and biological characteristics. In this chapter, the principle of various surface modification techniques including their outcomes, advantages, and limitations are reviewed. Among the various surface coating techniques, the most frequent techniques such as chemical vapor deposition (CVD), physical vapor deposition (PVD), micro-arc oxidation (MAO) coating, and electro-deposition coating were discussed in detail. The effect of surface modification on mechanical and tribological characteristics along with recent applications are described in detail. Finally, the major surface characterization techniques and their outcomes are elaborated in this chapter.
Recent Trends in Non-Traditional Machining of Alloys and Composites
Authors: Vinod Kumaar J. R.  , Mythili T.  , Suganya Priyadharshini G.
Published: February 2022

In the modern manufacturing era, machining alloys and composite materials enable proper machining methods to get the required shape and dimensions. The usage of alloys and composite materials is increasing in several industries including aerospace, automobile, MEMS, electronics, medical, biomedical, pharmaceutical industries, and so on because of less weight and more strength. Though various methods are available for machining of composites materials and alloys, only electrochemical micro-machining (ECMM) and wire electrical discharge machining (WEDM) are apt for micron-level machining of these materials by complex shapes with good surface quality. This chapter attempts to provide insight into the recent developments in machining of these alloys and composite materials by ECMM and WEDM.
Emergence of Advanced Manufacturing Techniques for Engineered Polymeric Systems in Cancer Treatment
Authors: Taleuzzaman Mohamad , Sartaz Ali , Alam Md. Jahangir , Javed Md. Noushad
Published: February 2022

Clinical performances of chemotherapeutic drugs which are used to manage different stages of cancers are usually facing numerous pharmacological challenges such as tumor microenvironment, high dose requirements, poor selectivity towards cancer cells, life-threatening cytotoxicity, and frequent drug resistance incidences, in addition to pharmacotechnical issues such as poor aqueous solubility, uncontrolled drug-release, low stability, non-specific bio-distribution, and erratic bioavailability profiles. The chapter aims to provide a brief account of advancements made in nanotechnology-enabled manufacturing engineering tools for manipulating polymeric materials as efficient carriers so that loaded anti-cancer drugs would exhibit better therapeutic applications and optimized clinical significance in cancers.
Flammability Index of Nigeria Agro Waste Processed With Polymer and Gum Arabic Hybridized Flame Retardants for Building Applications
Authors: Suoware Timine
Published: February 2022

Agro waste polymer composite (AWPC) comprising agro waste as reinforcement and polymer as the matrix is known to contribute additional fuel load when exposed to heat sources owing to their constituent make up. This has restricted their use in areas where strict compliance to fire regulations does exist. GA was mixed with flame retardants (FR) such as aluminium tri-hydroxide, ammonium polyphosphate, and carbon black at 0%, 12%, 15%, and 18% loading proportion, and these were then used to fabricate the AWPC using hand lay-up and compression moulding. The AWPC were tested for flammability properties in the cone calorimeter apparatus at 50kW/m2. Flammability properties such as time to ignition, heat released rates, mass loss rates, and smoke production rates obtained showed the AWPC processed with GA hybridized FR were greatly improved when compared to those without FR. Therefore, GA addition in AWPC proved to be a good FR that could be used in building applications to meet required fire safety standards.
Note from the Editor-in-Chief
Authors: Abeysekera Nalin
Published: February 2022

No abstract available
The Purinergic Receptor P2X4 Promotes Th17 Activation and the Development of Arthritis
Authors: Hamoudi Chakib , Zhao Chenqi , Abderrazak Amna , Salem Mabrouka , Fortin Paul R , Sévigny Jean , Aoudjit Fawzi
Published: February 2022

Purinergic signaling plays a major role in T cell activation leading to IL-2 production and proliferation. However, it is unclear whether purinergic signaling contributes to the differentiation and activation of effector T cells. In this study, we found that the purinergic receptor P2X4 was associated with human Th17 cells but not with Th1 cells. Inhibition of P2X4 receptor with the specific antagonist 5-BDBD and small interfering RNA inhibited the development of Th17 cells and the production of IL-17 by effector Th17 cells stimulated via the CD3/CD28 pathway. Our results showed that P2X4 was required for the expression of retinoic acid-related orphan receptor C, which is the master regulator of Th17 cells. In contrast, inhibition of P2X4 receptor had no effect on Th1 cells and on the production of IFN-γ and it did not affect the expression of the transcription factor T-bet (T-box transcription factor). Furthermore, inhibition of P2X4 receptor reduced the production of IL-17 but not of IFN-γ by effector/memory CD4+ T cells isolated from patients with rheumatoid arthritis. In contrast to P2X4, inhibition of P2X7 and P2Y11 receptors had no effects on Th17 and Th1 cell activation. Finally, treatment with the P2X4 receptor antagonist 5-BDBD reduced the severity of collagen-induced arthritis in mice by inhibiting Th17 cell expansion and activation. Our findings provide novel insights into the role of purinergic signaling in T cell activation and identify a critical role for the purinergic receptor P2X4 in Th17 activation and in autoimmune arthritis.
Continuing posterior tibial nerve stimulation after twelve weekly sessions: a randomized controlled trial
Authors: Zigman Jessica S. , Handler Stephanie J. , Amaya Stephanie , Zeno Aldene O. , Takashima Yoko , Navas John J. , Yazdany Tajnoos
Published: February 2022

Posterior Tibial Nerve Stimulation (PTNS) is a treatment option for refractory Overactive Bladder (OAB). There is currently no evidence to support which maintenance schedule is most effective. The objective of this study is to compare patientreported outcomes between monthly maintenance therapy and sessions scheduled Per patient request (PRN). We hypothesized that there is no difference in these measures between groups. After completing 12 sessions of PTNS, patients were randomized to monthly or PRN maintenance. Quality of life, patient satisfaction, and degree of symptom bother were assessed with validated questionnaires. Thirty six patients were randomized: 19 to monthly follow-up, and 17 to PRN follow-up. The PRN group demonstrated a significantly higher quality of life (p=0.04) with a large effect size (0.82). Over a three-month period, there was no significant difference in the average number of visits between the monthly and PRN groups, with an average of 1.79 (±1.18) and 1.24 (±1.35) visits, respectively (p=0.20). After six months of maintenance therapy, 42% of patients in the monthly group and 53% of patients in PRN group elected to continue therapy (p=0.27). There was no significant difference between the groups with regard to treatment satisfaction (p=0.62) or percent change in OAB symptoms (p=0.13). There is no difference between monthly and PRN follow-up in terms of patient satisfaction and symptom bother. However, the PRN group scored higher on the quality of life measure. PRN maintenance may optimize care for patients treating Overactive Bladder Syndrome with posterior tibial nerve stimulation.
Is pelvic organ prolapse correction with vaginal mesh suitable with a correct indication and protocolized follow-up?
Authors: Sarrio-Sanz Pau , Lopez-Lopez Ana Isabel , Martinez-Cayuelas Laura , Gomez-Perez Luis , Ortiz-Gorraiz Manuel Angel , Romero-Maroto Jesús
Published: February 2022

The use of vaginal mesh in order to correct Pelvic Organ Prolapse (POP) has been banned by the FDA due to the complications associated with them. The objective is to determine efficacy and safety in the short and long term in a sample of women undergoing transvaginal mesh surgery performed by properly trained surgeons, in a referral center and with a protocolized follow-up. We present a longitudinal, descriptive study of a cohort of 53 patients with POP who underwent transvaginal mesh surgery between 2001 and 2015. The efficacy of the treatment is evaluated quantifying both clinical changes and life quality, as well as the rate for prolapse recurrence and the short-and long-term treatment-related complications. A total of 53 patients with average follow-up of 87 months were included. All of them had their surgery performed by three properly-trained surgeons. Indication for mesh placement was assessed in 49.1% of cases due to previous surgery recurrence. Treatment improved urinary incontinence rates, constipation, voiding difficulty, dyspareunia and quality of life. Long-term complication rate was 9.6% (5.7% exposure, 1.9% urinary obstruction and 1.9% pain). None of the patients presented recurrence in the mesh-treated compartment and 6 patients (11.3%) needed surgery after recurrence in a different compartment at the end of follow-up. Vaginal placement of synthetic mesh for POP treatment is safe in the short-, medium- and long-term when performed in referral centers. The correct indication and long-term follow-up are essential to diagnose and treat possible complications.
Attitudes towards limited drug prescription rights: A survey of South African chiropractors
Authors: Huluman Thriya , Yelverton Christopher , Peterson Cynthia
Published: February 2022

Background: Several surveys that have been published show opinions regarding a change in the scope of chiropractic practice to include prescription rights. Currently, research into the attitudes of South African chiropractors towards having this right is non-existent.Aim: To ascertain the attitudes of South African chiropractors towards the inclusion of drug prescription rights in their scope of practice.Setting: The study was conducted on chiropractors registered with the Allied Health Professions Council of South Africa and members of the Chiropractic Association of South Africa.Method: A self-administrative online questionnaire was developed, and sent via email to all registered chiropractors in South Africa in February 2020. Descriptive statistics were used to analyse the data.Results: The response rate for this study was 15.9% (n = 138). 84% (n =105) were in favour of limited prescription rights for over-the-counter medication. However, 79.6% (n = 98) did not agree to full prescriptions rights for non-musculoskeletal drugs. A total of 33.6% (n = 42) rarely recommended OTC and prescription-based analgesics, muscle relaxants and non-steroidal anti-inflammatory drugs (NSAIDs) to their acute patients and 37.9% (n = 52) rarely recommended these drugs to chronic patients. 68.8% (n = 86) were confident in their knowledge of musculoskeletal drugs and 91.2% (n = 112) agreed on further education and training in pharmacology for those practitioners seeking limited medication prescription rights.Conclusion: The majority of South African chiropractor respondents indicated an interest in expanding their scope of practice to include limited prescription rights.Contribution: These findings could indicate a shift in the attitudes of chiropractors towards drug prescription rights within the profession.
Perceptions and knowledge of school management teams about non-communicable diseases and strategies to prevent them
Authors: Nomatshila Sibusiso C. , Apalata Teke R. , Mabunda Sikhumbuzo A.
Published: February 2022

Background: In 2016, non-communicable diseases (NCDs) were reported to be responsible for 41 million of the world’s 57 million deaths. These deaths were reported to be associated with modifiable lifestyle behaviours, such as tobacco smoking, poor physical activity and diets of poor nutritional value. There could be a knowledge gap on NCD risk factors amongst non-health professionals. Knowledge of NCDs is, therefore, important for the implementation of preventive measures to onset of NCDs.Aim: This study aimed at describing perceptions and knowledge of school management teams about NCDs and strategies to prevent them.Setting: This study was conducted in Mt Frere, South Africa.Methods: This explorative qualitative study using a phenomenological data collection approach was conducted amongst purposively selected school authorities in 2016–2017 to understand their perceptions and knowledge about NCDs and what can be performed to prevent them. Two focus group discussions (FGDs) were conducted using open-ended and unstructured questions guided by interview schedule. Tesch’s eight phases of thematic analysis approach was used to analyse narrative data resulting in two main themes and nine subthemes.Results: Two themes (understanding and prevention of NCDs, and control measures for NCDs) and nine sub-themes emerged from the data analysis. Inconsistent description of NCDs, its causes and controls were identified amongst school management teams in the FGD. Diet, poverty, societal factors, gaps between decision makers and communities, and poor policy implementation were identified by participants as major issues in the development of NCDs.Conclusion: There was no adequate knowledge on NCDs amongst the school management team participants. Improved visibility of health promotion personnel is needed to ensure community empowerment on NCDs prevention.Contribution: The findings in this study will help in closing the gaps in the implementation of preventive health services for NCDs within school health.
Incidence of candidemia and prevalence of azole-resistant candidemia at a tertiary South African hospital – A retrospective laboratory analysis 2016–2020
Authors: Chibabhai Vindana
Published: February 2022

Background: Candidemia is associated with high morbidity and mortality. The epidemiology of candidemia has changed globally over the past 20 years. South African surveillance demonstrated a shift in epidemiology from Candida albicans to non-albicans species including Candida parapsilosis and Candida auris. Hospital-level candidemia incidence from South Africa has not been reported previously.Methods: We performed a retrospective laboratory-based analysis of blood cultures with confirmed causative agents of candidemia. Ward type, department, gender and admission to critical care units were captured. Data were analysed in Microsoft Excel, Statistical Package for the Social Sciences (SPSS) and Epitools.Results: The incidence of candidemia during the study period was 2.87 per 1000 admissions. The total proportion of non-albicans species causing candidemia was 425/618 (69.7%). Overall, 65.4% of candidemia cases occurred in non-critical care units. There was a significant increase in the proportion of C. auris isolates between 2016 and 2020 (p  0.001). Isolation of C. auris was associated with admission to critical care units (p  0.001, odds ration [OR] 3.856, 95% confidence interval [CI]: 2.360–6.300). The proportion of azole-resistant candidemia cases increased from 21/53 (39.6%) in 2016 to 41/59 (69.5%) in 2020 (p = 0.002).Conclusion: The incidence of candidemia remained stable over the five-year study period. However, the proportion of C. auris isolates increased significantly during the study period as did the overall proportion of azole-resistant candidemia. Antifungal stewardship and continued hospital-level surveillance are imperative.
The wondrous world of biology
Authors: Moore Penny
Published: February 2022

No abstract available.
The times they are a changing
Authors: Devenish Lesley M.
Published: February 2022

No abstract avaialble.
Endless forms most beautiful
Authors: Nel Jeremy
Published: February 2022

No abstract available.
Comparison of Preoperative Nebulization with 4% Lignocaine and Ketamine in Reduction of Incidence of Postoperative Sore Throat
Authors: Prasant N. V. S. N. , Mohapatro Sudeep , Jena Jagadish , Moda Nupur
Published: February 2022

Background:

Postoperative sore throat (POST) is a common occurrence following general anesthesia with endotracheal intubation although clinicians often regard it as a minor complication. The incidence of POST is estimated to be 21%–65% in different studies. The administration of the drug through aerosol route gained popularity among anesthesiologists with good acceptance from the patients. Hence, we conducted the study with the aim to compare the efficacy of preoperative nebulization with 4% lignocaine and ketamine, in the prevention of POST.

Materials and Methods:

The study is a prospective, randomized double-blinded study comparing the effects of comparison between preoperative nebulization with ketamine and 4% lignocaine in preventing POST. Hemodynamic parameters, Ramsay sedation score, and visual analog scale (VAS) at 0, 6, and 24 h were observed in both groups.

Results:

Ketamine nebulization provides better prophylaxis against the occurrence of moderate-to-severe POST as compared to lignocaine. At 0 h, none of the patients had ST in both the groups; at 6 and 24 h, the ST was significantly higher in lignocaine group (28.9% and 8.9%) as compared to ketamine group (8.9% and 0%), with P = 0.04. Mild, moderate, and severe VAS was observed in 51%, 33%, and 16% of Group 1, respectively, while in Group 2, it was observed in 16%, 36%, and 49% of study population, respectively, and this difference was statistically significant.

Conclusion:

Patients undergoing surgery under general anesthesia with endotracheal intubation were benefitted from ketamine nebulization as prophylaxis against moderate-to-severe POST.
Serum Cortisol Levels with Etomidate Induction
Authors: Sarda Bhagyashree Gopal , Raipure Amrusha Mukesh , Ruparel Dipakkumar Hiralal
Published: February 2022

Context:

Hemodynamic stability during induction of anesthesia is always a concern for an anesthesiologist. Propofol remains the most popular induction agent with its favorable characteristics and few drawbacks like decrease in heart rate and blood pressure (BP). Although etomidate provides better hemodynamic stability, its use declined due to reports of adrenocortical suppression.

Aims:

We designed a study to compare the effect of anesthetic induction with etomidate versus propofol on serum cortisol levels and hemodynamics.

Settings and Design:

This was a prospective randomized double-blind comparative study.

Subjects and Methods:

Sixty ASA PS classes I and II patients scheduled for laparoscopic inguinal hernia repair under general anesthesia were included in the study. Thirty patients received propofol 2 mg.kg−1 and thirty, etomidate 0.3 mg.kg−1. Blood samples for serum cortisol were withdrawn preoperatively, immediate postoperatively, and 24 h after surgery. Vitals were monitored throughout.

Statistical Analysis Used:

All data are presented as mean ± standard deviation and proportions. Demographic data were analyzed by Student's t-test, and Chi-square test was used to analyze changes over time. The statistical software SPSS version 25.0 was used for data analysis.

Results:

Systolic blood pressure (BP), diastolic BP, and mean BP were more stable in the etomidate group compared to the propofol group. Serum cortisol levels before surgery in both the groups were within normal limits and comparable, followed by a significant decline in the etomidate group and rise in the propofol group in the immediate postoperative period. The levels in the third sample were comparable in both the groups.

Conclusion:

Etomidate offers superior hemodynamic compared to propofol. A decrease in serum cortisol level in the etomidate group was transient returning back to normal within 24 h.
Comparison of Spontaneous Ventilation, Pressure Control Ventilation and Pressure Support Ventilation in Pediatric Patients Undergoing Infraumbilical Surgery Using ProSeal Laryngeal Mask Airway
Authors: Dhar Rohini , Sofi Khalid , Mir Shafat Ahmad , Jehangir Majid , Wazir Mohsin
Published: February 2022

Background:

Pediatric infraumbilical surgeries are often performed under general anaesthesia using different modes of ventilation through Laryngeal Mask Airway .Although controlled ventilation has been successfully used, very less studies have been done to compare them with spontaneous ventilation for short duration surgeries.

Aims:

We tried to measure quantitave differences in haemodynamic and respiratory parameters and assess the recovery profile between controlled and spontaneous ventilation using Proseal LMA.

Settings and Design:

This was a prospective, randomized, double-blind study that comprised 90 American Society of Anaesthesiologist (ASA) classes I and II pediatric patients posted for infra umbilical surgery.

Materials and Methods:

90 paediatric patients undergoing infraumbilical surgeries were included. Three different ventilation strategies: spontaneous , pressure support and pressure-controlled ventilation were applied depending on attending anaesthesiologist's preference. Haemodynamic and respiratory parameters were recorded during the procedure. Post procedure parameters including need for supplementary oxygen, recovery time, complications were recorded.

Statistical Methods:

Analysis of variance (ANOVA) was employed for inter group analysis and for multiple comparisons, least significant difference (LSD) test was applied. Chi-square test or Fisher's exact test, whichever appropriate, was used for comparison of categorical variables.

Results:

The mean time interval between end of surgery and removal of LMA was significantly higher in PCV group in comparison to SV and PSV groups. In SV group lesser number of patients required oxygen supplementation and had shorter stay in recovery than PCV group.

Conclusion:

We conclude that spontaneous mode of ventilation can be used as safely as controlled /assist ventilation mode in short duration surgeries in high turn over settings.
A Comparative Study of Epidural Anesthesia with Dexmedetomidine Infusion versus General Anesthesia for Percutaneous Nephrolithotomy
Authors: Turki Sonali , Mir Shafat Ahmad , Sofi Khalid P. , Khan Nadeem , Khawaja Rouf , Wani Mohammad S
Published: February 2022

Background:

There has been considerable debate regarding the ideal anaesthetic technique for Percutaneous Nephrolithotomy (PCNL). PCNL is usually performed under general anaesthesia (GA) in prone position. The prone position under GA is associated with various complications. To address these complications, our study was carried out to determine whether epidural anaesthesia [EA] with dexmedetomidine sedation can be a better alternative to GA for PCNL.

Aims and Objectives:

To compare the efficacy and feasibility of performing PCNL under EA in combination with dexmedetomidine infusion.

Methods and Material:

Out of 225 patients observed in this study, 115 patients (group A) underwent PCNL under EA with dexmedetomidine infusion and 110 patients (group B) underwent PCNL under GA.

Results:

Mean time to the first dose of rescue analgesia was significantly increased in Epidural group (328.17 ± 63.74) compared to GA group (72.09 min, p < .0001) and the mean Visual analog scale [VAS] scores were significantly lower in epidural compared to GA group at different time intervals during the first 24 h after surgery (p<0.05). Patients in epidural group had significantly less post-operative nausea, vomiting (6.1 % vs 13.6 %), and significantly less shivering (12.2% vs 33.6%). Mean patient satisfaction score in epidural group was significantly higher (8.75 ± 1.29 vs 8.14 ± 1.39, p=0.001); however, the mean surgeon satisfaction score was comparable among the two groups (8.76 ± 1.39 in Group A and 8.61 ± 1.35 in Group B, p=0.421).

Conclusions:

Our study shows that EA is an equally effective alternative to GA for PCNL, with more patient satisfaction, less postoperative pain, early ambulation and postoperative recovery, less systemic analgesic requirements and less adverse effects.
A Randomized Comparative Study on Median and Paramedian Approaches for Subarachnoid Block using Sprotte Needle in the Cesarean Section
Authors: Kumari Reena , Kumar Tushar , Hembrom Boniface , Ram Barun , lakra Ladhu , Suwalka Usha
Published: February 2022

Background:

Since 1898 when August Bier, introduced spinal analgesia, there is lot of advancement made in the technique. There are various approaches and techniques for subarachnoid block.

Aim:

The aim of this study is to compare median and paramedian approach for spinal anesthesia for cesarean delivery using Sprotte needle in terms of number of attempts, success rate, adverse effects, and complications.

Materials and Methods:

One hundred patients were randomly divided into two equal groups and underwent subarachnoid block in median and paramedical block for elective cesarean section.

Results:

There is no significant difference between the two groups. Mean with standard deviation in the number of attempts for subarachnoid block through media and paramedian approach is 1.18 ± 0.48 and 1.06 ± 0.24, respectively (P = 0.51). The incidence of postdural puncture headache (PDPH) and lower backache was insignificant in both the groups (P = 0.218 and 0.646, respectively).

Conclusions:

Paramedian approach should not be considered as a reserve technique for spinal anesthesia and can be used as popularly as the median approach.
Comparing Duration of Analgesia after Intrathecal Administration of Opioids in Primary Paturients for Lower Segment Cesarean Section
Authors: Abbi Pooja , Gupta Ruchi , Kaur Harmandeep , Aggarwal Shivika
Published: February 2022

Background:

A pain free post operative period is a boon to mother for caring the neonate. We compared injection butorphanol and fentanyl as an adjuvant to bupivacaine in primary parturients for LSCS (Lower Segment Caesarean Section) with respect to duration of analgesia.

Aims and Objectives:

To study the effect of butorphanol vs fentanyl on duration of analgesia when added to bupivacaine for LSCS amongst primi parturients and to observe the block characteristics as secondary outcome.

Materials and Methods::

Study was carried out in 90 patients divided equally into three groups which included 12mg(2 mL) of 0.5% hyperbaric bupivacaine with 0.5 mL NS, 12mg (2 mL) of 0.5% hyperbaric bupivacaine 25 μg butorphanol made upto 2.5 mL with NS and 12mg(2 mL) of 0.5% hyperbaric bupivacaine with 25μg fentanyl made upto 2.5mL with normal saline. All patients were observed for duration of analgesia. Also Heart Rate (HR), Systolic and Diastolic Blood Pressure (SBP, DBP), two segment regression time of sensory block, motor block were assessed. The results were compiled and statistically analyzed using Chi-square test for nonparametric data and ANOVA for parametric data.

Results:

Two segment sensory regression is significantly prolonged in group with intrathecal administration of Bupivacaine with Butorphanol (190.33±15.86) than Bupivacaine with Fentanyl (170.67±20.83) and Bupivacaine with Normal saline (150.33±16.91). Duration of effective post operative analgesia was 349.67, 591.87 and 468.00 min in Group I, Group II and Group III respectively. There was no significant difference in onset of sensory and motor blockage in all three groups. HR, SBP and DBP were comparable among the groups.

Conclusions:

Intrathecal bupivacaine with 25 μg butorphanol mixture was clinically better as it provided longer duration of analgesia along with prolonged sensory block when compared to intrathecal bupivacaine with 25μg fentanyl mixture in primary parturients for LSCS.
Postcardiosurgical Pseudoaneurysm
Authors: Alsatli Raed A. , AlHalees Zohair , Kholaif Naji
Published: February 2022

Takayasu's arteritis is an autoimmune inflammatory disease of large arteries. We report a case of postcardiac surgery pseudoaneurysm. Anesthetic concerns, high risk related to surgery, necessary anesthetic preparations, and considerations will be mentioned here.
Clinicopathological factors associated with pathological upgrading from biopsy to prostatectomy in patients with ISUP grade group ≤2 prostate cancer
Authors: Li Xing , Wang Zhi-Xian , Zhu Yun-Peng , Wang Jing , Yin Yi-Sheng , Zeng Xiao-Yong
Published: February 2022

We performed this study to investigate pathological upgrading from biopsy to prostatectomy and clinicopathological factors associated with grade group (GG) upgrading in patients with International Society of Urological Pathology (ISUP) GG 1 and 2 prostate cancer (PCa) in a Chinese cohort. We included patients diagnosed with PCa with ISUP GG 1 and 2 at biopsy, who underwent RP at our institution. Pre- and postoperative clinical variables were examined. Univariate and multivariate logistic regression analyses were conducted to identify independent factors associated with GG upgrading. Patients in GG upgraded group had higher total prostate-specific antigen (tPSA; median: 14.43 ng ml−1
vs 10.52 ng ml−1, P = 0.001) and PSA density (PSAD; median: 0.45 ng ml−2
vs 0.27 ng ml−2, P < 0.001) than those in GG nonupgraded group. Patients in upgraded group had a higher ratio for Prostate Imaging-Reporting and Data System (PI-RADS) score >3 (86.4% vs 67.9%, P < 0.001). Those with GG 1 in biopsy were more likely to experience GG upgrading after RP than those with GG 2 (71 vs 54, P = 0.016). Independent preoperative factors predicting GG upgrading were PI-RADS score >3 (odds ratio [OR]: 2.471, 95% confidence interval [CI]: 1.132–5.393; P = 0.023), higher PSAD (P = 0.001), and GG in biopsy (OR: 0.241, 95% CI: 0.123–0.471; P < 0.001). The histopathological analyses of RP specimens revealed that perineural invasion (PNI; OR: 1.839, 95% CI: 1.027–3.490; P = 0.041) was identified as an independent factor associated with GG upgrading. Our results revealed that GG in the biopsy, PSAD, PI-RADS score >3, and PNI were independent factors of GG upgrading. These factors should be considered for patients with ISUP grade ≤2 PCa.
Translation and Linguistic Validation of the Chinese Version of Angle Labor Pain Questionnaire
Authors: Tan Chin Wen , Tan Hon Sen , Lim Lisa Lynn , Sultana Rehena , Sng Ban Leong
Published: February 2022

Background:

Despite having various choices of labor analgesia in modern obstetric practice, there are limited appropriate instruments to measure labor pain comprehensively. The Angle Labor Pain Questionnaire (A-LPQ) is a new, condition-specific instrument that measures the multidimensional characteristics of labor pain and experiences, yet little information is available on its use in other countries and languages. This study aimed at developing a Chinese version of the A-LPQ questionnaire.

Materials and Methods:

Two independent certified translators translated the English version of the A-LPQ questionnaire, and reconciliation was performed by discussing the discrepancies with a local coordinator. A third translator performed the backward translation, followed by a review by six clinicians on the reconciled version. A cognitive debriefing was done in five pregnant women during the early stage of labor to collect their feedback. After the proofreading, the final version was tested in 50 pregnant women during their labor.

Results:

The A-LPQ questionnaire was forward translated and was adjusted to expressive and clinical relevance in a local setting. Minor changes were done after backward translation and clinicians’ review to enable a better understanding. No changes were required during cognitive debriefing, and the subsequent finalization showed that the Chinese version of the A-LPQ questionnaire could be well understood (Difficulty level: 2.3 (SD 3.1); with 0 being fully understand, and 10 being extremely difficult to understand).

Conclusion:

We successfully performed linguistic validation on the Chinese version of the A-LPQ questionnaire, which is appropriate in measuring the dynamic nature of labor pain in a local Chinese setting.
Survey of Patients’ Perspectives on the Use of Acupuncture as a Complementary Treatment for Chronic Pain
Authors: Chow Yuen Mei , Tong Clara Kai Yi , Chutatape Thor Timothy Anuntapon , Seah Cheng Ngee , Cui Shu Li , Tan Kian Hian , Chan Diana Xin Hui
Published: February 2022

Background:

Acupuncture has been increasingly used as a complementary therapy in pain management. At Singapore General Hospital pain management center, approximately 40% of patients are referred for adjunctive onsite acupuncture. This number is increasing as acupuncture becomes a more readily accepted adjunct to conventional pain therapies.

Materials and Methods:

We conducted a two-part survey to look at patients’ perspectives before their acupuncture treatment regimen and the efficacy and effects of acupuncture after 5–10 sessions in the multidisciplinary management for their pain conditions.

Results:

A total of 80 people participated in the survey over 4 months. Sixty-one participants completed the two-part survey. 57.6% of participants had pain related to spine degeneration, of which 68.9% and 77% reported being affected in their sleep and mood, respectively. Follow-up survey after acupuncture sessions showed statistically significant improvement in pain scores. 79.5% reported improvements in mood and 90.9% in mobility. 93.2% said they would recommend acupuncture in the follow-up survey.

Conclusion:

Acupuncture was shown to have statistically significant effects on pain scores based on our pilot survey results. Majority of patients also reported improved mood and mobility which are part of the multidimensional effects of chronic pain that affect quality of life.
Acromioaxillo Suprasternal Notch Index as New Screening Test to Predict Difficult Laryngoscopy in Pediatric Population
Authors: Senapathi Tjokorda Gde Agung , Jobul Ivan Christianto , Widnyana I Made Gede , Sucandra I Made Agus Kresna , Ryalino Christopher , Raju Anu
Published: February 2022

Prediction of pediatric difficult endotracheal intubation is a challenge for anesthesiologists. Pediatric patient possess unique characteristics in relation with difficult intubation, especially their uncooperative nature which makes conventional anatomical criteria is not applicable. Acromioaxillo suprasternal notch index (AASI) is a new test that is more objective and does not require full cooperation from the patient. Twenty patients aged 1–6 years old underwent surgery under general anesthesia with endotracheal intubation were included in this case series. AASI seems positively correlated with Cormack–Lehane grade. It is a novel but useful examination to predict the difficulty of laryngoscopic visualization during tracheal intubation in children aged 1–6 years old. More samples and further study are needed to prove the correlation in this study.
Cancer patients’ satisfaction toward health services provided by non-governmental organizations
Authors: Ibrahim Samah M. , Shenouda Mona S. , Elsawy Manal M.
Published: February 2022

Background

Nongovernmental organizations (NGOs) play a significant role for cancer patients in Egypt and helping to build capacity for cancer prevention, treatment, and improve access to care. Patient satisfaction has long been considered as an important indicator when measuring health outcomes of care.

Aim

The aim of the study was to assess cancer patients’ satisfaction toward health services provided by non-governmental organizations.

Design

A descriptive exploratory research design was utilized in this study.

Setting

Three NGOs were selected randomly from all cancer organizations at Cairo governorate.

Sample

A purposive sample of 100 cancer patients chosen by specific inclusion criteria.

Tool for data collection

A structured interviewing questionnaire that consisted of three parts was used to collect data pertinent to the study. First part: personal data of patients. Second part: data about the level of social relationships (communication) regarding cancer patients. Third part: data about patient’s satisfaction toward service offers by NGOs.

Results

More than two-thirds of patients were satisfied with the overall services provided by NGO. Also, the majority of patients were satisfied with services in Bahia Foundation, then satisfied with Breast Cancer Foundation of Egypt, and the last one was Association of Friends of the National Cancer-free initiative. A highly statistical difference in patients’ satisfaction toward health services was provided by NGOs according to their sex.

Conclusion

The study concluded that more than two-thirds of patients were satisfied with the overall services provided by NGO services, the majority of cancer patients in Bahia Foundation have satisfaction about the services provided.

Recommendation

Based on the study results, it is recommended to develop a health-education program for cancer patients and their community to raise the awareness about nongovernmental services for cancer patients about how to involve them in organization’s services.
Risk factors for adolescents’ substance abuse
Authors: Basyoni Ahmed M. , Mohamed Afaf I. Abd El-Rehim , Ghazy Heba K. El-Said , Abdel-Daiem Nabila Abdel-Kader
Published: February 2022

Background

Substance abuse is a rising community health problem especially among adolescents throughout the world. Studies for substance abuse including risk factors need to be frequently updated, to refurbish the prevention and management treatments on a scientific basis.

Aim

To assess the risk factors for adolescents’ substance abuse.

Patients and methods

A descriptive research design was used.

Setting

The study was conducted at the outpatient clinic of Helwan Mental Health Hospital (Adolescent Addiction Clinic).

Sample

A convenience sample of adolescents (N=83) who attended the previously mentioned setting was included.

Tools

A questionnaire for adolescents about risk factors for substance abuse was used. It consists of 85 questions and includes two parts: part A − demographic characteristics and adolescents’ experiences with substances and part B − risk factors for substance abuse among adolescents.

Results

The current study revealed that 92.8% of the adolescents were males whereas 7.2% were females. Overall, 79.5% of adolescents were aged from 16 to 18 years, with a mean age±SD of 16.33±1.24 years. Regarding the age of starting substance abuse, 43.4 % of the adolescents started at 14 to less than 16 years, with a mean age±SD of 13.63±1.76. In addition, 71.1% of the adolescents had a smoker among their families, whereas 33.7% had a substance abuser among their families. Moreover, 100% of the adolescents had smoker friends, and 97.6% of their friends were substance abusers.

Conclusion

The study concluded that many factors can lead to substance abuse among adolescents. The most important factors were having substance abusers among family members and friends.

Recommendation

Educational programs about risk factors for substance abuse should be given to both parents and adolescents at schools, family health centers, and any family reunion places.
Laparoscopic Management of a Large Extragonadal Teratoma
Authors: Zahid Akmal Zulayla Mohd , Rahman Noorneza Abdul , Karim Zeti Rahayu , Omar Effat
Published: February 2022

Extragonadal teratoma of the omentum is a rare clinical entity. We report a case of a large omental teratoma in a postmenopausal woman who presented with 3 days history of right groin pain. She was previously diagnosed with right ovarian teratoma in 2013 but declined surgical intervention. Laparoscopy performed for suspected ovarian cyst torsion discovered a large omental teratoma measuring approximately 11 cm × 9 cm with the concurrent absence of the right fallopian tube and ovary. The mass was removed successfully via laparoscopic approach. The likely mechanism in this case is autoamputation of the adnexae due to chronic ovarian torsion. Establishing correct diagnosis preoperatively is difficult, however an extragonadal teratoma should be one of the differential diagnoses when a round, mobile mass is found in the abdomen. Laparoscopic management is feasible even in the presence of a large extragonadal teratoma.
Successful Management of a Noncommunicating Rudimentary Uterine Horn Pregnancy by Laparoscopic Surgery
Authors: Isono Wataru , Tsuchiya Akira , Honda Michiko , Saito Ako , Tsuchiya Hiroko , Matsuyama Reiko , Fujimoto Akihisa , Nishii Osamu
Published: February 2022

Pregnancy in a noncommunicating rudimentary horn is extremely rare but can cause serious clinical complications, such as uterine rupture. The standard treatment is excision of the rudimentary horn, and recently, in some cases, laparoscopic resection has been performed in the first trimester of gestation. Herein, we present a case of noncommunicating rudimentary horn pregnancy (NCRHP), which was diagnosed by magnetic resonance imaging at 6 weeks of gestation and treated by laparoscopic surgery. However, we have also found some rare cases in which patients could obtain live newborn babies. Since management is affected by the different levels of obstetric medical care and diagnostic tools, we also performed a review and analysis of NCRHP. A PubMed search yielded 103 cases reported in the English literature. Correct diagnosis and laparoscopic treatment were achieved more frequently in developed countries, especially in the first trimester of gestation. On the other hand, symptoms, including abdominal pain and hypovolemic shock, tended to occur in the second trimester of gestation. This period was also found to be a risk factor for uterine rupture. Among 18 patients at the third trimester of gestation, 13 obtained live neonatal infants. Therefore, detailed information about this disease is crucial for proper treatments.