In this study, examining pain, comfortandanxiety levels of surgical patients with drains, it was detected that patients’ pain level was moderate, general comfort level was high andanxiety level was moderate. It is stated that in the literature that %26-33 of the patients experience moderate pain at rest in postoperative period (Cocelli et al, 2008). Puntillo & Ley (2004) and Mueller et al. (2000), in their studies onpatientsundergone cardiac surgeryand with underwater chest drains, pain levels at the first three postoperative days were similar to our study. Similarly to our study, Ustundag (2009) in her studies onpatientsundergone coronary artery bypass graft surgery, indicates that comfort level of the patients was high. Although it is addressed in the literature that discomfort andpain are common after cardiac surgery, in Owen & Gould’s (1997) study, investigating experiences ofpatients with underwater chest drains, most of the patients reported that their comfort did not compromised, unless they were coughing and bending towards the drain. In Closs & Briggs’s (2002) study, it was stated that drains were reported as a cause of discomfort by the patientsundergone orthopedic surgery. It is mentioned in the literature that, patientsundergone surgical procedures may not only face a physical trauma such as surgery, but they may also live in fear andanxiety (Pritchard, 2010). It was determined in our study that the patients experienced anxietyin a moderate level. In their studies, Binns- Turner et al. (2011) working on the patientsundergone mastectomy and Ustundag (2009) working onpatientsundergone cardiac surgery
mented screening tests during the first and second trimesters, respectively, only 5 sub- jects benefited from both (integrated test). Chi-square test showed significant correla- tions between the implementation of screening methods and age, education level, in- come, and the location of prenatal care (p < 0.05). Conclusion: The findings of the present study showed women to poorly implement Down syndrome screening methods. Therefore, the necessity of providing appropriate educational programs for health staff and mothers seems undeniable. Moreover, paying attention to the related factors such as income, educational level, and adequate training of mothers during pregnancy is essential. Article History:
In a recent study, Tonella et al. , using transcutaneous electrical stimulation have shown pain relief in postoperative abdominal surgery, on which the patientsin the study group had lower pain scores during forced coughing and respiratory incentives. This type of therapy may also be used for patientsin the postoperative of heart surgery with the benefit of reduced use of sedatives and their side effects.
Dexmedetomidine is a highly selective presynaptic α-2 adrenergic agonist that may block norepinephrine release and enhance sympathetic inhibition to maintain the balance of the unregulated sympathetic feedback loop. Two cases of dexmedetomidine being used to diminish PSH symptoms have been reported (Goddeau, Silverman & Sims, 2007; Kern et al., 2016), which may support the disconnection theory. Unlike a traditional sedative such as propofol, which acts on GABA receptors in the cortex, dexmedetomidine displays the ac- tions of analgesia, sedation, andanxiety treatment by acting on the α2 adrenergic receptors in the locus coeruleus (LC) (Nelson et al., 2003). Patients sedated using dexmedetomidine can be awakened at any time to judge changes in their conscious state. It has also been re- ported that dexmedetomidine has a neuroprotective effect because it inhibits the apoptosis of nerve cells, protecting against local ischemia and slowing the progression of infarction (Cai et al., 2014; Cosar et al., 2009; Dahmani et al., 2005). These features make dexmedeto- midine a commonly prescribed sedative in NICUs.
Recently, Cho et al 25 designed a randomized clinical trial to evaluate the effectsof physiotherapy combined with manual lymphatic drainage on shoulder function, painand lymphedema compared with isolated physical therapy in breast cancer patients with AWS. The 48 participants re- cruited for the study had painin the arm area and presented palpable or visible cords on the arm for at least four weeks after surgery. They were submitted to three weekly sessions of a physiotherapy program for four weeks, which consisted of stretching and strengthening exercises for upper limb tissue mobilization, scapular mobilization and shoulder ROM exercises, and a speciﬁc program for AWS. The partic- ipants were divided into two groups: the ﬁrst group only performed the exercise program, and the second underwent the exercise program and 30 minutes of manual lymphatic drainage daily 5 times for 1 week, with instructions to perform it at home themselves for the other two to four weeks of the program. There was a signiﬁcant improvement inpainand arm volume in the group that performed manual lymphatic drainage. In addition, both groups showed im- provements in quality of life, strength and shoulder function after the interventions. There was no signiﬁcant difference related to visible cording between the groups, and it was present in 28.5% of the patients who underwent exercises combined with manual lymphatic drainage, andin 35% of the patients who only performed exercises.
Results: We observed a significant impact of strabismus on the quality of life of the interviewed individuals. Feelings of sadness and inferiority because of stra- bismus were reported by 74.2% and 58.4% respondents, respectively. In terms of functionality, 12.1% reported difficulty in reading, 14% said they had difficulty in depth perception (stereopsis), and 17.8% frequently or always associated pain or burning sensation in the eyes to strabismus. A significant difference was detected in the quality of life scores for the psychosocial aspect among patients who had and had not undergonesurgery (Wilcoxon test, 158; p<0.001). Individuals who had undergonesurgery had a better quality of life from the psychosocial perspective. Conclusions: In this evaluation, we found a significant negative interference of strabismus on quality of life from both the functional and psychosocial perspecti- ves. This demonstrated the importance of treatment for strabismus, regardless of age, because it can interfere with the functional well-being of the individual.
However, there are divergent results between studies, Gregorini et al.  showed that TENS is effective in controlling painin the postoperative period of cardiac surgeryand provides improvement in respiratory muscle strength and increased lung volumes and capacities. On the other hand, Stubbing & Jellicoe  showed that TENS did not change the painofpatients after thoracic surgery, creating the need for systematization of existing information. Thus, the existence of several randomized controlled trials (RCTs) concerning the application of TENS with or without the use of drugs in the postoperative period of thoracic surgery approach with thoracotomy and sternotomy, the absence of systematic review studies encompassing approach sternotomy and the absence of meta-analysis justify the conduct of a recent systematic review on the subject . The objective of this study was to evaluate the effectsof TENS onpainand pulmonary function in the postoperative period of thoracic surgery (heart or pulmonary approach with posterolateral thoracotomy or median sternotomy) by means of systematic review and meta-analysis of RCTs.
To conclude, topical anesthesia associated with sedation is easy to apply, practical, fast, effective and accessible to any health professional or institution involved in the treatment of cataracts, but patients should be carefully selected and it should be performed and followed by an anesthesiologist. Sedation had an important contribution, especially in an- xious, apprehensive patients, since it tranquilized the patient allowing better cooperation. Good patient acceptance and low incidence of perioperative complications indicate that this technique can be disseminated and widely used, respecting the learning curve and abilities of each surgeon.
After approval of the study by the Research Ethical Board of our institute, we enrolled 120 patients with idiopathic frozen shoulder in our cross-sectional study. Adult patients with phase-II frozen shoulder, diagnosed upon their prior medical history, physical examination, and imaging (MRI and radiographs), were enrolled in our referral hospital. The minimum duration of shoulder pain was 3 months for all included individuals. Our exclusion criteria were: history of rotator cuff tear, previous shoulder surgery or fracture and, psychosis. Informed consent was obtained from all patients.
During trocar insertion, 27 of the 36 patients (75%) in the topical group scored grade 2, seven (19%) grade 3, and two (6%) grade 1 pain; in contrast, only 3 of the 33 patients (9%) in the retrobulbar group scored grade 1 pain. The mean pain scores during trocar entry differed significantly between the groups (p<0.001). However, there was no statistically significant difference between the groups during the passive removal of silicone oil, cannula removal, or the sclerotomy suturing steps of the surgery (p=1.000, p=0.173, and p=0.06, respectively). The mean ( ± SD) comfort score of the surgeon was 0.11 ± 0.40 for the topical group. With the retrobulbar group, the surgeon performed all the procedures with extreme comfort (Grade 0). There was no significant difference in the overall painand discomfort scores (for anesthesia administration andsurgery) or the surgeon’s comfort scores between the groups (p=0.448 and p=0.092; respectively). In both groups, the postoperative mean BCVA increased or remained the same when com pared with the preoperative BCVA. Postoperative BCVA was not changed in seven eyes (19%) in the topical group andin six eyes (18%) in the retrobulbar group.
Objective: to analyze the perception of nurses about their experience in palliative care. Method: a descriptive and exploratory study with a qualitative approach conducted in a referral hospital in palliative care. The sample consisted of 12 care nurses. For data collection an interview was conducted with a semi-structured script covering sociodemographic data and four questions to meet the objectives of the study. Data were transcribed and evaluated by content analysis. Results: the nurses emphasized that palliative care should not only contemplate patients, but the family, revealing feelings and important measures such as affection, affection, comfortandpain management. Conclusion: there is a process of implementation about the principles that permeate this type of care and it is worth noting that it is a new service that is in the process of continuous formation and training, which has contributed to the results.
These 9 models are shaped by considering Plan irregularities i.e. the plan area for each structure is same only there is difference of geometry. For all types of structure total numbers of storeys are 12.The elevation is same for all the 9 models. Distribution of each storey height is shown below,
Despite the robustness of the effect of EP onpain judgements, can we expect it to be the same for male and female painpatients? In the absence of EP, is a female’s pain equally undervalued as compared to a male’s pain? Although the aforemen- tioned studies do not allow us to give an answer to such questions, we have reasons to believe that the effect of EP onpain judgements might depend on a patient’s sex. Evidence suggests that peoples’ cognitive representations of somatisation, by being clearly more associated with the female than the male stereotype (Bernstein & Kane, 1981; Martin & Lemos, 2002), are more often applied to the interpretation of a female’s symptoms (e.g. chest pain; Chiaramonte & Friend, 2006; Martin & Lemos, 2002). Also, mounting evidence on what Healy (1991) termed the ‘Yentl syndrome’ indirectly supports this contention. Several studies show that while in the absence of diagnostic evidence of cardiac pathology, a woman’s chest pain is more often underdiagnosed and undertreated as compared to a man’s chest pain, when EP is present no sex-related biases inpain treatment seem to persist (e.g. Chang et al., 2007; Johnson et al., 1996; Maynard, Bershansky, Griffith, & Selker, 1996; Schulman et al., 1999). In sum, these findings point to the moderator role of EP on sex-related biases inpain judgements. However, because most of these studies have focused exclusively on chest painand have only presented indirect evidence of this effect, we aimed to directly test the moderating role of EP on sex-related biases in CLBP. Based on the reviewed literature, we expected:
caine infusion in major abdominal surgeries and found that, inpatients who had received lidocaine infusion at a rate of 1.5 mg/kg/h following a loading dose of 1.5 mg/kg 30 min before surgical incision up to the end ofsurgery demanded fewer numbers of PCA and less morphine administered via PCA, and the total consumption of morphine was relatively lower compared with the control group. In our study, we found no difference between groups in the time to the first requirement for an analgesic, the number of demands for PCA, and the amount of fentanyl delivered by PCA. In both groups, even though the total amount of postoperative opioid consumption was nearly equal, we detected lower requirements for additional analgesics inpatients who had received lidocaine infusion. Early postoperative resting and dynamic VAS scores in the esmolol group were comparatively lower, but in the long term, the VAS scores determined in all measurement periods did not differ between the esmolol and lidocaine groups. It has been recognized that the intra- venous administration of sodium channel blockers such as lidocaine has antinociceptive effects via its impact on dorsal spinal horn neurons. 22 However, some studies have revealed
Molecular studies on HCV have contributed to various epidemiological studies, andin an attempt to study HCV dissemination in dialysis centers, several researchers have used genotyping techniques for the characterization of circulating viral strains. Allander et al.  were the first to determine the similarity of the nucleotide sequence among hemodialysis patients, to characterize HCV dissemination among them. They observed that 5 out of 14 patients with positive serology for HCV had been contaminated with the same viral strain, and that two other patients had been infected with two strains from different genotypes. These patients did not receive blood transfusions and did not share the same dialysis machine, however they shared the same room. They used sequencing of the E2/NS1 region to characterize the nosocomial transmission of HCV in a dialysis unit. De Lamballerie  characterized nosocomial transmission by the identification of the circulating HCV genotypes in a dialysis center, through characterization of the viral envelope region.
RESULTS: he predominant age group was 40 to 60 years. 72% of the patients showed some bone changes and the major- ity interviewed did not have formal jobs at the time of interview. here was a noticeable increase in the intensity ofpainin pa- tients with bone alterations when compared to those without, as well as an increased ambulation impairment. he Hospital Anxietyand Depression Scale showed a slight increase in both parameters in those with bone pain. Regarding the quality of life, physical function and work status were the most afected. here was the absence of alexithymia in most of the interviewees, a positive correlation between pain intensity versus physical func- tion (r=-0.14, p=0.03), physical function x work status (r=-0.28, p=0.04) and a negative correlation between alexithymia versus anxiety (r=0.03, p=0.62) and moderate pain versus overall health (r=0.06, p=0.40).
weekly sessions conducted by a physical thera- pist, another group attended monthly sessions and a third group attended no sessions at all. Although, at the end of the treatment, the two first groups demonstrated a statistically significant difference in physical performance and quality of life, only the group monitored monthly managed to maintain the improvement in quality of life for 18 months. None of the groups maintained the improvement in exercise tolerance. A study with a post-PRP one-year follow-up period found significant improve- ments in quality of life and exercise tolerance, as well as a reduction in the length of hospital stays, but no impact onanxiety or depression variables, (29) differing from the findings of the
stage, the content of manganese was made up with an addition of ferromanganese and the melt was held for 3 minutes. During holding of the melt and before tapping, the temperature of liquid iron was measured with a thermocouple. The melt was transferred to a ladle, which was next transported to the casting stand and molten metal was poured into the previously prepared moulds. Test bars with a φ 15 mm diameter and castings were made following the production regime adopted by HARDKOP Foundry at Trzebinia. As a next step, specimens were prepared for metallographic examinations. Chemical composition of the cast iron phase constituents was examined using a JEOL 500LV scanning electron microscope with attachment for X-ray microanalysis (EDS).
The development of fisheries sector was expected to keep the economy growth stable, to absorb more labor forces, to produce high foreign exchange, and the most important thing is to increase the income per capita as well as to give a muliplier effects to the society. The effect of economy from an economy activity is usually performed with input-output analysis approach (I-O) and Computable Geberal Equlibrium (CGE) to know the direct, indirect and induced impacts . The impact of economy in a productive activity, for example fisheries can be grouped into three catergories, i.e. direct advantage, indirect advantage, and induced advantage . Direct advantage is triggered from the fishing activity that needs input like labor force/ ship’s crew, fuel, Ice, clean water, supplies/ ration etc. That input can be obtained from other sector. This can cause indirect advantage. If ship’s crew is from local area, the expense of the crew can create induced benefit in that area. Not all the benefits or the impact can be felt by local society. Does the input come from the other area or imported one, the rotation of money can cause indirect benefit then. This is a leakage of benefit. The flow of the money from the fisheries activity to the local society at last creates the impact of economy and economy leakage. Even though it is a little, the empirical studies that try to count the downstream and upstream linkage in small scale fishing in a developing country tend to show that the number of added work is created through the downstream and upstream linkage that is significant enought . Downstream and upstream linkage is stated in Table 1. Generally, the international value chain for economic commodities is important for sellers, such as, tuna, salmon, skipjack tuna, shrimp and tilapia, which consist of some nodal with a product that passes over longer to achieve consumers. Whereas some species that is not economically important is important to the sustainability for local food which is part of the shorter value chain . Small scale fishing is very important as a source of livelihood, earning, production and world fish supply. Besides that, small scale fishing provides fish that directly gives contribution to increase the food and nutrition sustainability .
Objective: The purpose of this study was to evaluate the patients’ life adjustment after epilepsy surgery, through instruments of quality of life (QoL), anxiety, depression, preoperative expectations and postoperative life changing. Methods: Thirty-six adults who underwent temporal lobe epilepsy surgery were interviewed before surgery, and 6 and 12 months after surgery. Results: For all patients, epilepsy surgery gave rise to an evolving process of postoperative adjustment, what means that they were satisfied with surgery results, and that their expectations were reached. The improvement was seen in their QoL (p=0.004), anxiety (p=0.019) and depression (p=0.001), which was associated to their perception of positive life changing. The inexistence of depressive andanxiety symptoms and the good QoL after surgery predicted the perception of positive life changing. This study could predict a total of 56.5% of aspects involved in the perception of positive life changing after epilepsy surgery, what seems that other variables may be involved in this process. The patients’ status before surgery (expectations, QoL, anxiety, depression and seizures frequency) did not predict the life satisfaction after surgery, what means that when patients evaluate their actual lives they do it looking for daily aspects and do not tend to compare to their lives before surgery. Conclusion: The findings of the present study have implications for the evaluation of life adjustment postsurgery, calling attention to measures of preoperative expectations, anxiety, depression and QoL. The strength of these contributions highlights the importance of registering the patients’ feelings and opinions during the presurgical evaluation and may help the health providers to understand the aspects necessary to improve the patients’ quality of life.