Amit Sharma;GD Puri;Rajeev Chauhan;Ankur Luthra;Gauri Khurana;Amarjyoti Hazarika;Shyam Charan Meena
Journal of Dental Anesthesia and Pain Medicine
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v.24
no.1
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pp.67-73
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2024
Background: Nitrous oxide has been an integral part of surgical anesthesia for many years in the developed world and is still used in developing countries such as India. The other main concerns in low-resource countries are the lack of an advanced anesthesia gas-scavenging system and modular surgical theatres. As a greenhouse gas that has been present in the atmosphere for more than 100 years and damages the ozone layer, nitrous oxide is three times worse than sevoflurane. Here, we conducted an observational study to quantify the annual nitrous oxide consumption and its environmental impact in terms of carbon dioxide equivalence in one of busiest tertiary health care and research centers in Northern India. Methods: Data related to nitrous oxide expenditure' from the operation theatre and manifold complex of our tertiary care hospital and research center from 2018 to 2021 were collected monthly and analyzed. The outcomes were extracted from our observational study, which was approved by our institutional ethics board (INT/IEC/2017/1372 Dated 25.11.2017) and registered prospectively under the Central Registry (CTRI/2018/07/014745 Dated 05.07.2018). Results: The annual nitrous oxide consumption in our tertiary care hospital was 22,081.00, 22,904.00, 17,456.00, and 18,392.00 m3 (cubic meters) in 2018, 2019, 2020, and 2021, respectively. This indicates that the environmental impact of nitrous oxide (in terms of CO2 equivalents) from our hospital in 2018, 2019, 2020, and 2021 was 13,016.64, 13,287.82, 10,289.94, and 10,841.24 tons, respectively. Conclusion: This huge amount of nitrous oxide splurge is no longer a matter of laughter, and serious efforts should be made at every central and peripheral health center level to reduce it.
Purpose: Children with cerebral palsy (CP) and their parents experience various problems that can affect their quality of life. This study examined factors affecting the quality of life of children with CP. Methods: A cross-sectional study was conducted in Yogyakarta, Indonesia, from January to August 2019. The participants were consecutively recruited children with CP aged 2 to 18 years and their parents. Ninety-eight children with CP and their parents, specifically their mothers, were recruited. Children's health-related quality of life (HRQoL) was measured using the Pediatrics Quality of Life Cerebral Palsy. Parental HRQoL and stress were measured using the WHOQOL-BREF and Parenting Stress Index (PSI). Results: Functional level V was the most common category for both Gross Motor Function Classification System (GMFCS) and Bimanual Fine Motor Function (BFMF) (35% and 28%, respectively). Children's mean HRQoL was medium (49.81±20.35). The mean total PSI score was high (94.93±17.02), and 64% of parents experienced severe stress. Bivariate analysis showed that GMFCS, BFMF, number of comorbidities, presence of pain, and parental stress were significantly correlated with the total score for children's HRQoL (p<.05). Multiple linear regression analysis (p<.05) demonstrated that more severe GMFCS and parental stress were associated with lower mean HRQoL scores in children. Conclusion: Factors including the level of GMFCS and parental stress affected the HRQoL of children with CP. Parental stress management should be included in the comprehensive management of these children.
Purpose: Recently, the prevalence of eosinophilic gastrointestinal disease (EGID) has shown an increasing trend worldwide. As the diagnosis of EGID requires invasive endoscopy with biopsy, noninvasive markers for detecting EGID in suspected patients, particularly children, are urgently needed. Therefore, this study aimed to evaluate the diagnostic accuracy of serum eosinophil cationic protein (ECP) beyond peripheral eosinophil counts in pediatric patients with EGID. Methods: Overall, 156 children diagnosed with EGID were enrolled and 150 children with functional abdominal pain disorder (FAPD) were recruited as controls. All participants underwent endoscopic biopsy in each segment of the gastrointestinal (GI) tract and serum ECP measurement, as well as peripheral eosinophil percent and absolute eosinophil count. Results: Comparing EGID (n=156) with FAPD (n=150) patients, serum ECP levels were significantly higher in pediatric patients with EGID than in those with FAPD (25.8±28.6 ㎍/L vs. 19.5±21.0 ㎍/L, p=0.007), while there was no significant difference in peripheral eosinophil percent and absolute eosinophil counts between the two groups. Serum ECP levels were correlated with peripheral eosinophil percent (r=0.593, p<0.001) and the absolute eosinophil count (r=0.660, p<0.001). The optimal cutoff value of serum ECP for pediatric EGID was 10.5 ㎍/mL, with a sensitivity of 69.9% and a specificity of 43.4% with an area under the receiver operating characteristic curve of 0.562. Conclusion: The combination of serum ECP levels and peripheral eosinophil counts, when employed with appropriated thresholds, could serve as a valuable noninvasive biomarker to distinguish between EGID and FAPD in pediatric patients manifesting GI symptoms.
Kang Kwon;Eun-na Heo;Mi-rae Jeong;Ma-eum Lee;Hyung-sik Seo
The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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v.37
no.1
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pp.69-85
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2024
Objectives : By analyzing articles on xerostomia and burning mouth syndrome, two representative diseases that cause various symptoms in oral cavity. Methods : We analyzed articles by dividing them into review articles, original articles, case reports. The subjects were 11 articles on xerostomia and 13 articles on burning mouth syndrome published in Korean medical journals. Results : 1. The subjects were 11 articles on xerostomia and 13 articles on burning mouth syndrome published in Korean medical journals. 2. The first article was published in 2007 and the most published articles were three each in 2013, 2018 and 2022. 3. Classification by type of article was as follows: 2 review articles(8.3%), 16 original articles(66.7%) and 6 case reports(25.0%). 4. The journal with the most published articles was journal of internal Korean medicine and the topics were xerostomia(72.7%), burning mouth syndrome(76.9%). 5. For both diseases, the number of female patients was higher than that of male patients. 6. The main symptom of xerostomia is dryness in the mouth and the main symptom of burning mouth syndrome is pain in the oral cavity. 7. Questionnaires, diagnosis based on dialectics and diagnostic devices were used to diagnose xerostomia and burning mouth syndrome. Conclusion : Diagnosis of xerostomia and burning mouth syndrome require overall consideration the entire hum an body along with the oral cavity. Since there are many different diagnostic methods, appropriate methods must be carefully selected and used.
A 3-year-old, 20.6 kg, neutered male German Shepherd dog was referred to Kyungpook National University Veterinary Medicine Teaching Hospital. Clinical examination revealed chronic diarrhea for 6 weeks and a non-tender, distended abdomen without lethargy, anorexia, and vomiting. Diarrhea was watery and had a waxing and waning course despite symptomatic treatment. A complete blood count identified mild leukocytosis and mild anemia. Serum biochemistry analysis showed elevated alanine aminotransferase and aspartate aminotransferase levels, and mild hypoalbuminemia. Abdominal ultrasound examination revealed mixed echogenicity with absent blood flow at the caudate process of the caudate liver lobe and a small amount of ascites. Computed tomography revealed torsion of the caudate process of the caudate liver lobe and spleen and gas dilatation of the intestine. After establishing a diagnosis of organ torsion on imaging, we deemed the condition an emergency and immediately performed surgery. Given that laparotomy confirmed organ torsion, liver lobectomy, total splenectomy, and prophylactic gastropexy were conducted. The patient was discharged 11 days after surgery without complications. In general, liver lobe torsion and splenic torsion are uncommon in dogs and present with nonspecific clinical signs, such as abdominal pain, lethargy, anorexia, and vomiting. In the current case, torsion of the caudate liver lobe and spleen occurred without other clinical signs except for a distended abdomen. Moreover, no reports in dogs have demonstrated the simultaneous occurrence of both diseases.
Eun Jeong Jang;Jung Sun Kim;Kitai Kim;Hye Sun Gwak;Ji Min Han
Korean Journal of Clinical Pharmacy
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v.34
no.1
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pp.21-29
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2024
Background: Daytime sleepiness, a common phenomenon among adolescents focused on academics, has negative effects on aspects such as growth and overall learning. However, research on various drugs and diseases affecting daytime sleepiness is lacking in the reality. Therefore, this study aims to investigate the factors influencing daytime sleepiness in adolescents with daytime sleepiness. Methods: This study was conducted through a survey of 2,432 middle and high school students, aged 14 to 19. The questionnaire consisted of information on socio-demographic characteristics, overall health status, and sleep patterns. The Pediatric Daytime Sleepiness Scale (PDSS), translated into Korean, was used to assess daytime sleepiness. Daytime sleepiness was measured by calculating the total score for each item of the PDSS, and divided into two groups based on the cutoff value of 19, which was the upper quartile. Results: We analyzed a total of 1,770 students including 799 boys and 971 girls. Students with a PDSS score of 19 or higher made up 33.3% of boys and 66.7% of girls. In multivariate analyses, females, smoking, poor self-reported health level, sleep after 12 am, not feeling refreshed in the morning, headache, muscle pain, and scoliosis increased the risk of daytime sleepiness significantly. The AUROC of PDSS, including significant factors in multivariate analyses, was 0.751 (95% CI 0.725~0.776). Conclusions: Daytime sleepiness in adolescents affects growth, academic performance, and emotional stability. Therefore, it is important to manage medications, diseases, and other factors that affect daytime sleepiness on a social level.
Background: This study was conducted to apply active release techniques to male youth basketball players to help improve physical development and damage prevention and improve performance through improved balance and functional movement. Design: Randomized control trial. Methods: The subjects included 33 youth basketball players who were randomly assigned to the experimental group (n=17) and the control group (n=16). For the experimental group, the active release technique was applied to the hip muscles, calf muscles, posterior thigh muscles based on the distribution of injuries surveyed in youth basketball players in the Korean Basksetball League. The Y-balance test and the functional reach test (FRT) were used to assess balance and the Functional Movement Screen (FMS) was used to assess functional movement. Interventions were conducted twice a week for 4 weeks at 40 minutes per session. The experimental group was the active release technique group, and static stretching, a common exercise therapy technique, and self-myofascial release using a foam roller were applied for 20 minutes. The control group received general exercise therapy and placebo active release technique. The placebo active release technique applies pressure only. results:The experimental group showed a greater improvement in balance, as evidenced by the FRT, compared to the control group, which received general exercise treatment. However, there was no statistically significant difference in improvement between the 2 groups. In the case of the experimental group, the difference in the Y balance test before and after the intervention was larger than that of the control group, but there was no statistically significant difference. Significant improvement was found in functional movement, as evidence by the FMS, for the trunk stability test (p < 0.05), in-line lunge test (p < 0.05), rotational stability test (p < 0.05), total score (p < 0.05). Conclusion: In this study, the active release technique improved the balance and functional movement of young basketball players more than general exercise therapy. The application of the active release technique is therefore expected to assist in physical development, prevent damage, and improve the performance of youth basketball players.
Purpose: No evidence exists regarding the advantages of periodontal regeneration treatment for furcation defects using soft block bone substitutes. Therefore, this randomized controlled trial aimed to assess the clinical and radiographic outcomes of regenerative therapy using porcine-derived soft block bone substitutes (DPBM-C, test group) compared with porcine-derived particulate bone substitutes (DPBM, control group) for the treatment of severe class II furcation defects in the mandibular molar regions. Methods: Thirty-five enrolled patients (test group, n=17; control group, n=18) were available for a 12-month follow-up assessment. Clinical (probing pocket depth [PPD] and clinical attachment level [CAL]) and radiographic (vertical furcation defect; VFD) parameters were evaluated at baseline and 6 and 12 months after regenerative treatment. Early postoperative discomfort (severity and duration of pain and swelling) and wound healing outcomes (dehiscence, suppuration, abscess formation, and swelling) were also assessed 2 weeks after surgery. Results: For both treatment modalities, significant improvements in PPD, CAL, and VFD were found in the test group (PPD reduction of 4.1±3.0 mm, CAL gain of 4.4±2.9 mm, and VFD reduction of 4.1±2.5 mm) and control group (PPD reduction of 2.7±2.0 mm, CAL gain of 2.0±2.8 mm, and VFD reduction of 2.4±2.5 mm) 12 months after the regenerative treatment of furcation defects (P<0.05). However, no statistically significant differences were found in any of the measured clinical and radiographic parameters, and no significant differences were observed in any early postoperative discomfort and wound healing outcomes between the 2 groups. Conclusions: Similar to DPBM, DPBM-C showed favorable clinical and radiographic outcomes for periodontal regeneration of severe class II furcation defects in a 12-month follow-up period.
Purpose: Authors suggest a new alternative of preparedness capabilities for health care institutes to react to the new types of communicable diseases and the pandemic situations through the quality improvement and advancement of Negative Pressure Isolation Stretcher (NPIS). Methods: We employed FOCUS-PDCA, a representative quality improvement model. First, we identified and materialized necessary components of existing NPIS to be improved. Second, we fabricated an advanced NPIS prototype. Third, we carried out a performance test by the accreditation institute and an empirical evaluation at the communicable diseases trauma center, to locate the improvement pain points of the prototype. Finally, we draw a conclusion on quality improvement points to be considered during the production stage. Results: The suggested, NPIS outperforms the existing one in terms of communicable disease controls, patient treatments and the safety during the patient transfer, and the ease of use. Additionally, the suggested NPIS turns out to be a proper alternative to satisfy the requirements of long range transfer of patients with communicable disease. Conclusion: Authors developed a quality improved, NPIS prototype. There are several points that still remain to be improved. Additionally, we expect that the concurrent use of the suggested NPIS with the existing one will fortify the preparedness capabilities on reacting to the communicable diseases.
Concomitant chemoradiotherapy (CCRT) treated patients experience various complications. We present a rare case of post-CCRT Bell's palsy and describe its various possible causes, so as to increase awareness among clinicians about Bell's palsy being a CCRT-associated adverse effect. The patient was a 48-year-old man diagnosed with squamous cell carcinoma who presented with post-CCRT Bell's palsy. After radiotherapy for 6 weeks (overall 67.5 Gy) and four rounds of cisplatin chemotherapy, he complained of paralysis of the entire left face. A test was performed 33 days after the last CCRT session to differentiate Bell's palsy from other causative factors. Based on magnetic resonance imaging findings, facial nerve invasion due to tumor size increase was determined to not cause Bell's palsy. Inflammation of the left Eustachian tube was observed. Hence, steroids and famciclovir were administered, which markedly improved the facial paralysis symptoms within 56 days after facial paralysis development. In conclusion, patients can develop Bell's palsy owing to complex effects of various CCRT mechanisms. Although the exact cause of Bell's palsy has not been identified and the effectiveness of drug treatment was questionable in this case, unlikely causative factors should be excluded through various tests and appropriate and timely measures must be adopted.
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