bluuebunny/crossref_metadata_2025_split huggingface dataset:
Topical vs. intravenous administration of tranexamic acid to minimize blood loss in abdominal hysterectomy perioperatively: A randomized controlled study
Authors: Mitra Sukanya , Jain Kompal , Singh Jasveer , Jindal Swati , Mehra Reeti , Singh Swati 
Published: July 2022

Background and Aims:
Topical application of tranexamic acid (TXA) to bleeding wound surfaces is rapidly gaining recognition and currently a topic of further research in patients undergoing abdominal hysterectomy.The aim of the study was to compare the efficacy of topical vs. intravenous (i.v.) administration of TXA in reducing perioperative blood loss in patients undergoing abdominal hysterectomy.

Material and Methods:
A double-blinded parallel-group randomized controlled study was conducted in a tertiary teaching institute. Group 1 (n = 25) received 10 mg.kg-1 i.v. bolus of TXA after induction followed by infusion of 1 mg.kg-1.h-1 of TXA, in 50 ml of normal saline (NS), till the completion of surgery and just before closure of peritoneum 100 ml of NS was applied topically over the raw surface. Group 2 (n = 25) received 50 ml of NS over 10 min after induction, followed by infusion of 50 ml of NS, till the completion of surgery and just before closure of peritoneum, 1.5 g of TXA mixed in 100 ml of NS was applied topically over the raw surface. The primary outcome was total perioperative blood loss (intraoperative plus 24 h postoperative). The secondary outcomes included change in hemoglobin concentration postoperatively at 12 h, 24 h; need for blood/blood product transfusion; amount of blood/blood product transfused and side effects of TXA.

Results:
Total perioperative blood loss was 312 ± 106.65 ml in group 1 and 325 ± 89.90 ml in group 2 (p = 0.659). It was found that the mean reduction in hemoglobin was 0.7 g.dl-1 and 0.54 g.dl-1 in group 1 and 0.67 g.dl-1 and 0.44 g.dl-1 in group 2 at 12 h and 24 h respectively, with no significant intergroup difference.

Conclusion:
Administration of TXA topically is as efficacious as TXA administered i.v. to minimize perioperative blood loss in patients undergoing abdominal hysterectomy.
A prospective observational study on changes in endo-tracheal tube cuff pressure and its correlation with airway pressures during various stages of robotic pelvic surgeries
Authors: Gupta Priyanka , Tandon Shipra , Dhar Mridul , Agarwal Ankit , Pathak Sharmishtha , Prabakaran P. 
Published: July 2022

Background and Aims:
Robotic surgeries often require a relatively long duration of pneumo-peritoneum and trendelenburg position which may accentuate changes in endo-tracheal tube (ETT) cuff pressure leading to pressure related complications. The aim of this study was to analyze changes in ETT cuff pressures during various stages of pneumo-peritoneum and surgical positioning and its correlation with airway pressure changes.

Material and Methods:
A prospective observational study was planned after approval of institutional review board on 60 patients undergoing elective robotic pelvic surgery requiring head down position. Baseline cuff pressure was adjusted to 25 cm H2O. ETT cuff pressure, peak airway pressure and end tidal CO2 (ETCO2) was measured at various time intervals before and after pneumo-peritoneum and head down. Ventilatory parameters were kept fixed after baseline setting. Those requiring any change were excluded. Pearson’s coefficient was used for correlation and ANOVA for trend of parameters at different time intervals (P value <0.05 was considered significant).

Results:
Baseline cuff pressure after manual inflation was 46.2 ± 17.4 cm H2O. Significant correlation was observed between change in cuff pressure and increase in peak airway pressure at the end of the surgery (r = 0.4, P < 0.05). Serial measurements of ETT cuff pressure, peak airway pressure and ETCO2 were significantly increased compared to baseline (P < 0.05).

Conclusion:
Significant increases in ETT cuff pressure may be seen in robotic surgeries, with a positive correlation between change in cuff pressure and increase in airway pressures. Objective adjusted measurement of cuff pressure and airway pressures is recommended for such surgeries.
Changing trends in assessment: Effectiveness of Direct observation of procedural skills (DOPS) as an assessment tool in anesthesiology postgraduate students
Authors: Kamat Chaitanya , Todakar Mahantesh , Patil Madhumati , Teli Anita 
Published: July 2022

Background and Aims:
National Medical commission of India (NMC) has introduced Competency based Medical Education (CBME) following the international trend. Competency based assessment differs from traditional assessment and we need to adopt to newer work place-based assessments (WPBA). Direct Observation of Procedural Skills (DOPS) is one such assessment tool, which assesses procedural skills of a student. Hence this study was conducted to evaluate the effectiveness of DOPS among Anesthesiology postgraduate students.

Material and Methods:
A prospective interventional study was conducted, where in 55 postgraduate students underwent DOPS assessment while performing three routine core skills of Anesthesiology. Observations were documented (Pre-DOPS-Score) and immediate verbal feedback was given. Students were educated through demonstration of all three procedures on actual patients by three faculty members using the DOPS checklist. The students were finally assessed again with proforma and DOPS scores were documented (Post-DOPS Score). Mean Pre-DOPS and Post-DOPS assessment Scores were compared. Student and faculty Perceptions were taken regarding the DOPS assessment.

Results:
There was significant improvement in the procedural skill performance after DOPS with a statistically significant difference. Average time taken for DOPS test was 11 min. Average time taken for giving feedback was 13 min. Students and faculty members gave positive feedback about DOPS.

Conclusion:
DOPS is very feasible and effective assessment tool, improves procedural skills of Anaesthesiology postgraduate students, helps to develop good clinical skills which finally brings good clinical care.
Comparison of landmark guided and ultrasound guided percutaneous dilatational tracheostomy: Efficiency, efficacy and accuracy in critically ill patients
Authors: Dugg Kavita , Kathuria Suneet , Gupta Shikha , Gautam P. L. , Singh Tanveer , Bansal Hanish 
Published: July 2022

Background and Aims:
To overcome the procedure-related complications associated with landmark-guided percutaneous dilatational tracheostomy (PDT) ultrasound is emerging as a promising tool. Present study was designed to compare landmark-guided PDT and ultrasound-guided PDT in terms of efficiency, efficacy, and accuracy.

Material and Methods:
Hundred intensive care unit patients requiring prolonged mechanical ventilation were prospectively randomized into 2 groups of 50 patients each. In land mark guided (LMG) group, patients underwent landmark-guided PDT, whereas in ultrasound guided (USG) group, patients underwent ultrasound-guided PDT.

Results:
Both the groups were comparable in terms of demographic data, sequential organ failure assessment score, ventilator settings, and mean days on mechanical ventilation prior to PDT. The mean assessment time in the ultrasound-guided group (1.56 ± 1 min) was significantly more (P-value = 0.000) than in the landmark-guided group (0.84 ± 0.72 min). The mean total procedure time for the USG group (5.98 ± 10.23 min) was more than that for the LMG group (4.86 ± 8.03 min) (P-value 0.542). Deviation of puncture site from the midline was seen in two patients in group A as compared to none in the USG group (P-value = 0.153). The number of patients requiring more than one attempt for successful needle insertion was more (P-value = 0.148) in the LMG group (20%) as compared to USG group (8%). Incidence of complications, like bleeding and desaturation was more in the LMG group as compared to the USG group.

Conclusion:
Ultrasound-guided PDT is associated with reduction in periprocedural complications as compared to landmark technique, although it takes slightly longer time.
Effect of add-on Gabapentin premedication on hemodynamic response to skull pin insertion
Authors: Kundra Sandeep , Luthra Neeru , Dureja Mehak , Gupta Rekha , Bansal Hanish , Singh Mirley R. 
Published: July 2022

Background and Aims:
Effectiveness of oral gabapentin premedication in suppressing response to laryngoscopy and tracheal intubation suggests its potential for attenuating skull pin insertion response. The present study was therefore planned to evaluate the effect of add-on oral gabapentin premedication to local anesthetic injection at pin insertion site in obtunding hemodynamic response.

Material and Methods:
Sixty adult patients posted for elective craniotomy were enrolled for a prospective, randomized and double-blinded study. Group I patients received gabapentin 900 mg orally as premedication whereas Group II patients received oral placebo. Both groups were administered subcutaneous (s.c.) injection (Inj) 2% lignocaine 2 mL at all four pin insertion sites. Mean arterial pressure (MAP) and heart rate (HR) were measured every 30 s for the initial 10 min. Increases in HR beyond 20% and MAP 30% above baseline were treated with bolus intravenous (IV) Inj propofol 30 mg. Quantitative data was compared using Student’s t-test and Mann Whitney U test, while categorical data was compared using Chi-square (χ2) test.

Results:
The increase in HR and MAP from baseline was significantly greater and it remained above baseline levels longer in Group II as compared to Group I. Twenty-one patients (70%) received rescue boluses of propofol with a mean dose of 45.00 ± 39.98 mg in Group II as compared to nine (30%) patients receiving mean of 18.20 ± 29.04 mg in Group I. (P = 0.015). The mean emergence time and sedation scores in both the groups were statistically similar (P = 0.060).The incidence of adverse effects like hypotension, bradycardia, nausea/vomiting, sedation or dry mouth were similar in both the groups.

Conclusion:
Add-on oral gabapentin premedication potentiates the effect of s.c. lignocaine Inj for suppression of skull pin insertion response.
A randomized comparative study of three supraglottic airway devices for controlled ventilation in anesthetized patients
Authors: Sharma Manoj , Sharma Bimla , Gupta Manish , Panday Bhuwan Chand , Sahai Chand , Sood Jayashree 
Published: July 2022

Background and Aims:
The LMA® ProSeal™, LMA® Supreme™ and Ambu® AuraGain™ are second-generation supraglottic airway devices (SADs) with integrated gastric access. In this study, we compared the clinical performance of these three devices in adults for controlled ventilation in anesthetized paralysed patients.

Material and Methods:
Two hundred and seventy adults, American Society of Anesthesiologists (ASA) Physical Status I-III, undergoing elective surgical procedures, were randomized into three groups with 90 patients in each: Group 1: LMA® ProSeal™, Group 2: LMA® Supreme™ and Group 3: Ambu® AuraGain™. All the three devices were evaluated for oropharyngeal seal pressure (OSP) and other parameters: ease and the number of attempts at device placement, fibreoptic laryngeal view and intraoperative and postoperative complications.

Results:
In the present study, the mean OSP was 38.9 ± 3.050 cm H2O in the LMA ProSeal™ group, 37.41 ± 4.097 cm H2O in LMA® Supreme™ group and 37.32 ± 3.740 cm H2O in Ambu® AuraGain™ group. The difference was found to be statistically significant (P = 0.006). The three groups were comparable for the ease of device insertion, number of attempts at device placement, fibreoptic laryngeal view, intraoperative and postoperative complications.

Conclusion:
In this study, we found that the LMA® ProSeal™ provided the highest OSP in comparison to the other two devices, even though this difference is not clinically relevant. The use of Ambu® AuraGain™ was associated with difficult and lowest first-time insertion success rate (P < 0.001) along with an increased incidence of airway trauma as compared to the other two SADs.
Pre-shaped supraglottic airway devices offer an alternative to endotracheal intubation for airway management of postburn neck contracture: A case series
Authors: Kumar Rakesh , Kumar Sunil , Kumar Neera G. , Bhandari Padam S. 
Published: July 2022

Background and Aims:
Moderate to severe postburn contractures (PBCs) of the neck lead to multiple areas of difficulty in airway management. Awake flexible fiberscope guided intubation with cuffed endotracheal tube (ETT) is considered the “gold standard” for securing the airway in these cases. Supraglottic airway devices (SADs), if at all used, are used either as rescue devices or as conduits for ETT. This case series looks at the possibility of using SADs as a planned airway securing device in these cases.

Material and Methods:
We managed 24 cases of moderate to severe PBC neck using six types of pre shaped SADs as the first choice airway device. These SADs were placed after either airway topicalization (19 cases) or general anesthesia (GA) (5 cases). Once SAD placement was confirmed, all the patients received GA and muscle relaxant. Tests for proper placement and function and fiberscopy (conducted in four cases) were performed at various times during the procedure. The SADs were removed once the patients were fully awake.

Results:
SADs could be placed in one attempt in all the cases. The time taken to hand over the patients to surgeons was 12–20 min. SADs maintained their proper placement and function in spite of changing airway dimensions during contracture release. The patients tolerated the SADs well right until the time they were fully awake. The SADs could be successfully removed on the operation table in all the cases.

Conclusion:
Pre shaped SADs secure the airway quickly and are free from the risk of intraoperative displacements and allow uneventful emergence in moderate and severe PBC neck cases and need to be considered as the first choice in these cases.
Comparative Evaluation of the Accuracy and Efficiency of Silicone-Based Bite-Registration Record Using Handheld Conventional Versus Recently Introduced Powered Mixing Gun – An in Vitro study
Authors: Sayed Mohammed E. , Ahmad Manawar , Abdul Hina Naim , Ageeli Osama Abdu , AlShafie Talal , Alrefaei Ali Mohammed 
Published: July 2022

Purpose:
An accurate and functional interocclusal record is very important in restorative dentistry, and any inaccuracies may lead to extensive intraoral adjustments, which can compromise the esthetics and/or mechanical strength of the restorations. The current literature lacks a direct comparison of dimensional accuracy and time efficiency between conventional and powered mixing techniques. The present study compared the accuracy and efficiency of recently introduced powered mixing gun with the conventional handheld gun that was used to mix two silicone-based bite-registration materials.

Materials and Methods:
A total of 100 bite registrations were recorded on maxillary and mandibular typodont models mounted on a semi-adjustable articulator. Of these, 50 bite registrations were recorded using a handheld conventional mixing gun technique and the other 50 using a handheld powered mixing gun technique. Both types of bite registrations were performed using fast and superfast set bite-registration materials. The dimensional accuracy and time efficiency of both techniques were analyzed and compared.

Results:
The accuracy and time efficiency of the handheld powered gun mixing technique were significant (P < 0.05) than the conventional mixing technique for fast set bite registration material in vertical distances A1A2 (P = 0.01), B1B2 (P = 0.015), and C1C2 (P = 0.001). However, for horizontal distances AB (P = 0.008) and AC (P = 0.001), accuracy was more significant (P < 0.05) for the superfast set bite registration material compared to the fast set material using the powered mixer.

Conclusion:
The powered mixing gun technique was more accurate and efficient than the conventional mixing gun technique for recording the bite registration using fast and superfast set materials.
Diagnostic and therapeutic roles of iron oxide nanoparticles in biomedicine
Authors: Lu Chia-Hung , Hsiao Jong-Kai 
Published: July 2022

Abstract
Nanotechnology changed our understanding of physics and chemics and influenced the biomedical field. Iron oxide nanoparticles (IONs) are one of the first emerging biomedical applications of nanotechnology. The IONs are composed of iron oxide core exhibiting magnetism and coated with biocompatible molecules. The small size, strong magnetism, and biocompatibility of IONs facilitate the application of IONs in the medical imaging field. We listed several clinical available IONs including Resovist (Bayer Schering Pharma, Berlin, Germany) and Feridex intravenous (I.V.)/Endorem as magnetic resonance (MR) contrast agents for liver tumor detection. We also illustrated GastroMARK as a gastrointestinal contrast agent for MR imaging. Recently, IONs named Feraheme for treating iron-deficiency anemia have been approved by the Food and Drug Administration. Moreover, tumor ablation by IONs named NanoTherm has also been discussed. In addition to the clinical application, several potential biomedical applications of IONs including cancer-targeting capability by conjugating IONs with cancer-specific ligands, cell trafficking tools, or tumor ablation agents have also been discussed. With the growing awareness of nanotechnology, further application of IONs is still on the horizon that would shed light on biomedicine.
Affective Bodies: Intimate Design Practices to Reinvent the Everyday
Authors: Paez Roger , Valtchanova Manuela 
Published: July 2022

This article investigates some of the implications of intimate design practices by presenting two academic projects carried out within the context of an uncertain present. It argues that design practices have the capacity to foster intimacy and affect through the lens of the politics of care. Drawing on the notion of affective bodies, the authors claim that design can explore new paths to reinvent the everyday, focusing on recent crisis-ridden contexts. The article examines how intimate practices that reformulate everyday politics can reclaim temporality, active citizenship and radical affectivity as infrastructural needs in contemporary urban habitats.
The two case studies date from March 2020 through December 2021 under the climate of crisis brought about by the sudden outbreak of the COVID-19 pandemic in Western Europe and the ongoing Mediterranean refugee crisis. Given the escalation of the blurring between the private and public spheres, the personal and the political, it is especially relevant to explore intimacy as a means of enacting politically empowered action through design. Both case studies aim to temporarily interrupt conventional uses of collective urban spaces in order to generate pockets of resistance that explore the subliminal potentials of urban spaces and allow us to imagine, and even experience, different ways of living through an updated lens of care. These irruptions of intersubjective appropriations of urban spaces not only have an emblematic impact, but also a cumulative effect by generating a growing network of affective bodies in action. This emergent affective network offers relevant opportunities for the transformation of crisis-ridden urban contexts through dynamic interactions between sociality and spatiality.
Impacto socioeconómico en estudiantes de la Universidad Técnica de Manabí por el Covid-19
Authors: Sardi Gustavo Adolfo Santana , Morales Kleber Rafael Ferrin , Mera Laura Isabel López , Macías Elena Paola Pico , Bravo Karina Luzdelia Mendoza 
Published: July 2022

La pandemia provocada por la Covid-19 ha dejado consecuencias de alto impacto en todos los campos de la sociedad y la educación no está exenta de dicho impacto. Por lo tanto, los gestores y líderes educativos han tenido que redefinir sus prácticas y modelos haciéndola virtual y utilizando la tecnología mediante las diferentes plataformas de la comunicación. Las universidades y las instituciones superiores son un elemento fundamental del desarrollo de la sociedad y se han visto amenazadas significativamente por la pandemia del Covid-19, produciendo impactos en el avance de la educación con el cierre de las instituciones educativas y la recesión económica que se produce a partir de las medidas para controlar la pandemia, a todo esto sino se realizan esfuerzos importantes para contrarrestar sus efectos, el cierre de escuelas provocará una pérdida de aprendizajes, un aumento en la deserción escolar y una mayor inequidad. Este articulo tiene como objetivo determinar con claridad los impactos a nivel económico y social en las en los estudiantes universitarios, para utilizar diferentes recursos idóneos y promover la adaptación al nuevo sistema educativo y lograr mejor aprovechamiento de la educación en estos sectores más vulnerables de la sociedad. Se expone una revisión bibliográfica de experiencias competitivas de aprendizaje y se describen las opiniones de cada autor investigado. Se utilizaron varios métodos de nivel teórico, entre los que se encuentran análisis-síntesis e inducción-deducción. Se recopiló la información a través del empleo del motor de búsqueda Google Académico, seleccionando los artículos que tuvieran en algún campo de la investigación. La conclusión más destacada de este estudio exploratorio consiste en constatar el fuerte impacto que el confinamiento ha tenido para la situación vital del estudiantado universitario en el ámbito socioeconómico y académico, principalmente, y la relación existente con la satisfacción vital y la resiliencia, fundamentalmente.
Active teaching & learning practices and students’ academic performance in secondary schools in Arua District
Authors: Bileti Acidri Emmanuel 
Published: July 2022

The purpose of this paper was to evaluate the degree to which Active Teaching and Learning (ATL) practices influence students’ academic performance in secondary schools in Arua district. The specific objectives of the study were to (1) analyse the levels at which ATL methods, techniques and instructional materials are used in secondary schools in Arua district (2) examine the level of students’ academic performance in secondary schools in Arua district (3) evaluate the influence of ATL on students’ academic performance in secondary schools in Arua district. The paper hypothesized that there was no significant influence of ATL practices on students’ academic performance in secondary schools in Arua district. A sample of 120 was drawn comprising of head teachers, deputy head teachers, directors of study, subject teachers and students from four Enabel partner secondary schools in Arua district. A mixed method research design was used. Data was collected through use of questionnaire survey, observation guide and focus group discussions. The study revealed that the level to which ATL methods were used at Secondary schools in Arua district was moderate at mean of 3.10 (62%), ATL techniques was very high at Mean 4.39 (88%) and ATL Instructional resources was high at Mean 3.84 (77%). Level of students’ performance was high at mean 3.72 (75%). The influence of ATL practices on students’ academic performance was positive with r – value .634 and Coefficient of Determination (r2) at .401 meaning that ATL practices had influenced students’ academic performance by 40.1% by the study period leaving 59.9% influenced by other factors. The null hypothesis which stated that there was no significant influence of ATL practices on students’ academic performance in secondary schools in Arua district was rejected because the P-value of 0.000 was found to be less than the significance level of 0.01. Teachers and other stakeholders should always be innovative in the use of ATL methods, instructional resources and techniques to enhance students’ academic performance.