Patients’ satisfaction with sedoanalgesia versus subarachnoid analgesia in endourology

AbstractObjectiveIn this study the effectiveness and safety of sedoanalgesia technique compared to spinal anesthesia in endourology procedure as well as patients’ satisfaction was assessed.Patients and methodsA prospective randomized study was performed in 80 adult patients, ASA I, II, and III who underwent various endoscopic procedures randomly allocated into two groups 40 patients each: Sedoanalgesia group, received local anesthesia (2% lignocaine gel), i.v. midazolam incremental doses 0.015mg/kg on demand, and i.v. fentanyl 2μg/kg, and 0.5μg/kg on demand interaoperative, and Spinal anesthesia group received 2.5ml heavy bupivacaine 0.5% to achieve around T10 level. We recorded vital parameters, and the number of cases with hemodynamic, respiratory complications, nausea and vomiting, and conversion to general anesthesia (failure). Postoperatively the intensity of pain (VAS 0-100mm), time to first analgesic request (VAS ⩾30), patient satisfaction (complete, partial or not satisfied) and time to readiness for discharge were assessed.ResultsThere was no significant difference in intra, postoperative hemodynamic changes and complications between groups but hypotension was more frequent in Spinal group. Immediate postoperative, there was no significant difference in pain score between groups, but 1 and 2h postoperatively there were higher pain scores in Sedoanalgesia group. Time to first analgesic request and readiness for discharge were significantly less in Sedoanalgesia group, but the difference was not significant as regard satisfaction scores.ConclusionSedoanalgesia is an effective, safe and simple alternative to Spinal anesthesia for endourology, with good patients’ satisfaction and less time to discharge

Thermophysical properties of graphene-based nanofluids

Heat transfer operations are very common in the process industry to transfer a huge amount of thermal energy, i.e., heat, from one fluid to another for different purposes. Many fluids are used as heat transfer fluid (HTF), in which water is the most common HTF due to its high specific heat, availability, and affordability. However, conventional HTFs, including water, have a lower thermal conductivity, which is the most critical thermophysical property, hence decreased heat transfer efficiency. The addition of solid particles of highly thermally conductive material, specifically at nano-size, i.e., nanoparticles NPs, result in nanofluid NF, which has evolved over the last two decades as efficient HTF and have been investigated in a wide range of applications. Among NPs, graphene (Gr) based materials have shown very high potential as NF due to the very high thermal conductivity up to 5,000 W/m.K, hence higher thermal conductivity NF. This work aims to thoroughly discuss the thermophysical properties of Gr-based NFs, including thermal conductivity, heat capacity, density, and viscosity. The discussion focus on the thermophysical properties as it is the ultimate determinator of the heat transfer characteristics of the HTF, such as the convective and the overall heat transfer coefficient as well as the heat transfer capacity of the NF. The discussion expands to the relative enhancement in such thermophysical properties reaching up to a 40% increase in thermal conductivity, as the most critical thermophysical property. The discussion shows that Gr-based NF has a much higher thermal conductivity relative to widely studied metal oxide NF and at much lower content, and lower density and viscosity increase, which is critical for determining the pumping power requirements. Critical challenges facing the application of Gr-based NFs such as cost, stability, increased density and viscosity, and environmental impacts are thoroughly discussed with mitigation recommendations given

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

Contains fulltext : 172380.pdf (publisher's version ) (Open Access

Synthesis and physicochemical studies of perovskite manganite La0.8Ca0.2Nn1 xCoxO3(0?x?0.3)

The physicochemical properties of La0.8Ca0.2Mn1xCoxO nanopowders as a function of Co content (x) have been investigated. La0.8Ca0.2Mn1xCoxO nanopowders were synthesized by sol-gel method and morphologically and structurally well characterized by Scanning electron microscopic (SEM), Infrared spectroscopic (IR) and Raman spectroscopic techniques. IR spectra shows peak at around 600 cm1 attributed to the stretching mode of MnO6 octahedral and peak at 700 cm1 assigned to La-Ca-O-Mn bending vibrations. Raman spectra indicate peaks at around 512 and 652 cm?1 related to the Jahn-Teller octahedral distortions. The intensity of these peaks increases with increasing Co doping. The UV-visible spectra were measured in the frequency range of 200-800 nm and two energy gaps were found at 1.63 eV and 3.294 eV for x = 0, 0.1 and 0.3.Scopu

Development of canagliflozin nanocrystals sublingual tablets in the presence of sodium caprate permeability enhancer: formulation optimization, characterization, in-vitro, in silico, and in-vivo study

AbstractCanagliflozin (CFZ) is a sodium-glucose cotransporter-2 inhibitor (SGLT2) that lowers albuminuria in type-2 diabetic patients, cardiovascular, kidney, and liver disease. CFZ is classified as class IV in the Biopharmaceutical Classification System (BCS) and is characterized by low permeability, solubility, and bioavailability, most likely attributed to hepatic first-pass metabolism. Nanocrystal-based sublingual formulations were developed in the presence of sodium caprate, as a wetting agent, and as a permeability enhancer. This formulation is suitable for children and adults and could enhance solubility, permeability, and avoid enterohepatic circulation due to absorption through the sublingual mucosa. In the present study, formulations containing various surfactants (P237, P338, PVA, and PVP K30) were prepared by the Sono-homo-assisted precipitation ion technique. The optimized formula prepared with PVP-K30 showed the smallest particle size (157 ± 0.32 nm), Zeta-potential (−18 ± 0.01), and morphology by TEM analysis. The optimized formula was subsequently formulated into a sublingual tablet containing Pharma burst-V® with a shorter disintegration time (51s) for the in-vivo study. The selected sublingual tablet improved histological and biochemical markers (blood glucose, liver, and kidney function), AMP-activated protein kinase (AMPK), and protein kinase B (AKT) pathway compared to the market formula, increased CFZ’s antidiabetic potency in diabetic rabbits, boosted bioavailability by five-fold, and produced faster onset of action. These findings suggest successful treatment of diabetes with CFZ nanocrystal-sublingual tablets

Impact of Adjuvant Radiotherapy in Patients with Central Neurocytoma: A Multicentric International Analysis

Background: Central neurocytoma (CN) is a rare tumor accounting for <0.5% of all intracranial tumors. Surgery ± radiotherapy is the mainstay treatment. This international multicentric study aims to evaluate the outcomes of CNs patients after multimodal therapies and identify predictive factors. Patients and methods: We retrospectively identified 33 patients with CN treated between 2005 and 2019. Treatment characteristics and outcomes were assessed. Results: All patients with CN underwent surgical resection. Radiotherapy was delivered in 19 patients. The median radiation dose was 54 Gy (range, 50–60 Gy). The median follow-up time was 56 months. The 5-year OS and 5-year PFS were 90% and 76%, respectively. Patients who received radiotherapy had a significantly longer PFS than patients without RT (p = 0.004) and a trend towards longer OS. In addition, complete response after treatments was associated with longer PFS (p = 0.07). Conclusions: Using RT seems to be associated with longer survival rates with an acceptable toxicity profile