Learning curve of ultrasound-guided surgeon-administered transversus abdominis plane (UGSA-TAP) block on a porcine model.

Background: Surgeons commonly perform ultrasound-guided Transversus Abdominis Plane blocks to manage acute pain following abdominal surgeries. There is no consensus on whether surgeons should undergo basic hands-on training to perform TAP blocks or if video-based learning is sufficient. We theorized that simulation-based learning is superior to video-based learning. In the present study, we present the analysis of technical skills of UGSA-TAP block performance on a live porcine model by general surgery trainees after undergoing video or simulation-based learning. Methods: We performed a prospective, double-blinded, randomized study. Ten surgery residents and two surgery critical-care fellows (n = 12) without prior experience in performing the TAP block were recruited. The participants were randomized either into a video-based or simulation-based training group. After that, all participants performed a TAP block on a live anesthetized pig, which was recorded and scored by three blinded anesthesiologists. All participants completed a post-performance survey to assess their confidence in gaining competency in the UGSA-TAP block. Statistical analyses were performed to assess the differences between the two groups. P < 0.05 was considered statistically significant. Results: All simulation-based learning participants successfully performed a survey scan, identified the three muscular layers of the abdominal wall, and identified the transversus abdominis plane compared to 50 %, 50 %, and 33 % video-based learning group participants for the respective parameters (p < 0.05). While some performance metrics showed no statistically significant differences between the groups, substantial effect sizes (Cohen's ℎ up to 1.07) highlighted notable differences in participants' performance. Both groups exhibited confidence in core competencies, with varied rates of satisfactory skill execution. Performance assessed using a global rating scale revealed a higher passing rate for the simulation group (83 % vs. 33 %). Participant feedback via the Likert scale reflected confidence post-training. Inter-rater reliability (0.83-1) confirmed the robustness of study evaluations. Conclusion: The UGSA-TAP block curriculum should be introduced into the surgical residency programs with an emphasis on simulation-based learning to enhance the procedural skills of the trainees before transitioning to surgical patients.

Nematicidal natural products from the aerial parts of Lantana camara Linn.

Lantanilic acid, camaric acid and oleanolic acid possessing nematicidal activity were isolated from the methanolic extract of the aerial parts of Lantana camara Linn. through bio-assay guided fractionation. These compounds exhibited 98%, 95% and 70% mortality respectively against root-knot nematode Meloidogyne incognita at 0.5% concentration. Conventional nematicide furadan showed 100% mortality at this concentration.

Nematicidal constituents of the aerial parts of Lantana camara.

Two new constituents, lantanoside (1) and lantanone (2), and the known compounds linaroside (3) and camarinic acid (4) were isolated from the aerial parts of Lantana camara. Compounds 1, 3, and 4 were tested for nematicidal activity against root-knot nematode Meloidogyne incognita and showed 90, 85, and 100% mortality, respectively, at 1.0% concentration. The results were comparable to those obtained with the conventional nematicide furadan (100% mortality at 1.0% concentration). Structures of the new compounds were elucidated by spectroscopic and chemical techniques.