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@#PURPOSE: This study was done to explore the experiences of young adult males with below-knee amputation at surgical wards and clinics in Teaching Hospital, Kurunegala, Sri Lanka. DESIGN: The study used the phenomenology design of qualitative research. METHODS: Face-to-face interviews were conducted for data collection using a theme list with a saturation point reached at 16 participants. The duration of an interview was 30-45 minutes and was recorded on audiotape and transcribed later. Phases of familiarization with the data, coding, searching for themes, reviewing themes, defining and naming themes, and writing up were conducted accordingly to thematic analysis. FINDINGS: The young adult male below-knee amputees showed changes in lifestyle with dependence on others, supporting aids, and experiencing discomfort. They showed mental distress with dissatisfaction with life and suffering of life. Additionally, they lacked power with identity changes and encounter economic problems in their lives. CONCLUSIONS AND RECOMMENDATIONS: It is essential to give special education to the staff caring for the below-knee amputees to minimize their unpleasant and challenging experiences. Health staff can motivate family members and friends for individuals' mental adjustment to their new life. Additionally, the social attitude of the community should be changed positively regarding amputated patients.
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Masculino , Sri Lanka , Desarticulação , Sistema MusculoesqueléticoRESUMO
Ventral hernia is a fascial defect located on the abdominal wall. Primary ventral hernias are named as umbilical, epigastric, spigelian and lumbar hernias. A lumbar hernia is a parietal wall defect that may occur anywhere in the lumbar region between the 12th rib and the iliac crest. A 47-year-old female, came with complaints of mass in left lower abdomen since 2 months. On clinical examination a defect of 8 × 8 cm was felt in the left lumbar region with positive cough impulse. CECT abdomen and pelvis was done to confirm lumbar hernia. Patient underwent mesh repair for the same. Lumbar and flank hernias are uncommon and are a challenge to treat for any general surgeon. Surgery is considered gold standard either an open mesh repair or laparoscopically.
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@#PURPOSE OF THE STUDY: This study aimed to investigate the knowledge, attitudes, and practices regarding post-operative pain management among nurses working in the surgical units in Kandy, Sri Lanka. DESIGN: The study was based on quantitative method, specifically descriptive design. Samples were selected using the probability sampling technique of simple random sampling. The sample size obtained was 200 nurses using 95% confidence level and a 4% margin of error for a population of 300 nurses in the research setting. METHODS: A self-administered questionnaire was chosen as a data collection method, and this questionnaire contained 36 questions under four sub-topics. A box was kept in the matron office in the surgical section to collect the questionnaire. The data were analyzed using descriptive analysis with percentages. FINDINGS: According to the research findings, 66% (132) were knowledgeable about the meaning of post-operative pain management. Post-operative pain management was identified by 74% (148) of the respondents, and 26% (52) correctly indicated that the most accurate judge of post-operative pain is the patients' self-report. When considering the attitudes, 66% (132) of the participants agreed that post-operative patients show discomfort before receiving the next analgesics. Among the participants, 60% (120) of nurses worried that patients would become addicted to analgesics that they give, while 20% (40) disagreed, and 2% strongly disagreed. 54% (108) of the nurses stated that patients were kept under close observation and the pain was monitored regularly, while 46% (92) expressed that patient is kept in a comfortable position. To manage post-operative pain, 80% (160) used non-pharmacological methods while 20% (40) did not. CONSLUSIONS: The findings of this study identified problems such as inadequate knowledge, and inappropriate attitudes and practices regarding postoperative pain management.
Assuntos
Dor Pós-Operatória , ConhecimentoRESUMO
Background: Respiratory distress syndrome (RDS) is one of the most common causes of neonatal respiratory failure and neonatal death. It is more common in preterm neonates but also been found in term and late preterm neonates. This study aims at studying the risk' factors for developing RDS in term neonates. Objectives was to study the maternal and perinatal risk factors for RDS in term neonates.Methods: This is a retrospective case control study conducted in neonatal intensive care unit of tertiary care centre. A total of 100 term neonates with RDS were taken as cases and 150 normal term neonates were taken as control. Data were collected from the hospital NICU records, maternal and neonatal history was taken. The ?2 tests or Fisher's exact text were used for one-way risk factor analysis. The effects of multiple factors on term neonatal RDS were analyzed using logistic regression analysis.Results: In our study RDS in term neonates' was significantly associated with following risk factors like selective cesarean section, male sex, SGA, oligohydramnios, MSAF, severe fetal distress, birth asphyxia, PROM, and maternal-fetal infection. Among the significant risk factors severe birth asphyxia, maternal-fetal infection, PROM, MSAF were showing positive association with RDS in full-term neonates.Conclusions: Several high-risk factors such as severe birth asphyxia, maternal-fetal infection, PROM, and MSAF were closely correlated with full-term neonatal RDS. Hence these could provide a significant reference for the diagnosis and treatment of term neonatal RDS.
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Background: Respiratory distress syndrome (RDS) occurs in about 50% of preterm infants born at less than 30 weeks of gestational age. Surfactant therapy and mechanical ventilation have been the standard of care in the management of RDS. Objective of this study to compare the time required to achieve successful extubation criteria in Volume guarantee mode of ventilation to that with Time cycled pressure-limited mode of ventilation and the duration of mechanical ventilation between them in preterm neonates ventilated for respiratory distress syndrome.Method: The study was done at Neonatal intensive care unit, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala over a period of 2 years. Total of 37 inborn preterm neonates between 26 weeks to 32weeks with RDS requiring mechanical ventilation were included in 2-year study period with 18 babies in 1st year study period ventilated with SIPPV mode and 19 babies in 2nd year study period on SIPPV'VG mode of ventilation. Analysis was done using SPSS v. 16 software.Results: In the present study the neonates receiving SIPPV-VG ventilation had stable and equivalent gas exchange at significantly lower MAP and PIP compared to neonates receiving SIPPV -TCPL. Also, neonates receiving SIPPV-VG had achieved significantly faster extubation criteria than SIPPV-TCPL and hence lesser duration of ventilation.Conclusion: Our study concludes that Volume Guarantee ventilation achieves near stable tidal volume delivery by auto-weaning peak inspiratory pressures thereby promoting early extubation and hence reducing volutrauma and barotrauma in contrast to TCPL mode.
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Objective: To detect Hemoglobin variants D and S in dried blood spot collected on Guthrie card
Materials and Methods: This study was conducted in Gulf Medical University Ajman on known positive samples for hemoglobin S and hemoglobin D. Known EDTA blood sample was spotted on Guthrie card, the hemolysate of a punched disc collected from blood spot was eluted and the elute examined by Tosoh G7 using HPLC method1
Results: HPLC analysis of the eluate could correctly identify the hemoglobin's subtypes with 100% concordance in detection for hemoglobin D and hemoglobin S
Conclusion: HPLC analyzed the eluate from blood spot on card can correctly detect hemoglobin D and hemoglobin S. Dried blood spot card could be used to screen newborn for presence of hemoglobin S and hemoglobin D