Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Production And Chemical Analysis Of Weaning Food From Maize, Soybean And Fluted Pumpkin Seed Flour

The use of maize (ogi), soybean and fluted pumpkin seed flours in weaning food formulation was investigated. Three samples were made from the three flours: sample A 100% maize ogi; sample B 50:50 maize-soybean and sample C 60:30:10 maize-soybean-fluted pumpkin seed flour. The chemical composition of the formulations were as follows, for samples A, B and C respectively: protein 2.6%, 21.5% and 16.18%; fat 2.2%, 5.1% and 3.5%, ash 0.6%, 1.3% and 2.0%; moisture content 9.0%, 7.8% and 5.0%, carbohydrate 85.62%, 64.35% and 71.35%, energy 372.4%, 389.3% and 384.1%. The microbial count of the formulations after 3 weeks of storage at room temperature showed that sample A had the range between 3 x 102 to 12 x 104 cfug-1, sample B: 8 x 102 to 16 x 104 cfug-1, sample C: 6 x 102 to 19 x 104 cfug-1. Key words: Weaning food, Maize, Soybean, Fluted pumpkin seed Nigerian Food Journal Vol.22 2004: 171-17

Production And Chemical Analysis Of Weaning Food From Maize, Soybean And Fluted Pumpkin Seed Flour

The use of maize (ogi), soybean and fluted pumpkin seed flours in weaning food formulation was investigated. Three samples were made from the three flours: sample A 100% maize ogi; sample B 50:50 maize-soybean and sample C 60:30:10 maize-soybean-fluted pumpkin seed flour. The chemical composition of the formulations were as follows, for samples A, B and C respectively: protein 2.6%, 21.5% and 16.18%; fat 2.2%, 5.1% and 3.5%, ash 0.6%, 1.3% and 2.0%; moisture content 9.0%, 7.8% and 5.0%, carbohydrate 85.62%, 64.35% and 71.35%, energy 372.4%, 389.3% and 384.1%. The microbial count of the formulations after 3 weeks of storage at room temperature showed that sample A had the range between 3 x 102 to 12 x 104 cfug-1, sample B: 8 x 102 to 16 x 104 cfug-1, sample C: 6 x 102 to 19 x 104 cfug-1. Key words: Weaning food, Maize, Soybean, Fluted pumpkin seed Nigerian Food Journal Vol.22 2004: 171-17

Effect of smoking time on keeping quality of smoked mackerel (Scomboromorus scombrus)

Experiments were carried out to study the effects of smoking time on keeping quality of smoked mackerel (Scomboromorus scombrus). Frozen fish was thawed, eviscerated, clean, brined and smoked at 7580°C for 2, 2½, 3 and 3½ hr and stored in the smoking kiln for 20 days. Proximate composition, phenol content, rancidity test and microbiological evaluation were carried out using the smoked samples on the 1st, 4th, 7th, 10th, 16th and 20th day of storage. Increased steam volatile phenol and nonvolatile phenol deposition that ranged from 0.001 to 0.026 and from 0.48 to 1.35 respectively was observed with increased smoking time and decreased with storage days. Thiobarbituric acid value and peroxide values increased from 4.29 to 13.66 and 8.7 to 30.0 respectively with storage days and increased with smoking time while moisture content and water activity decreased from 51.0 to 12.3 and 0.960 to 0.650 respectively with storage days and as well as smoking time. Keywords: smoking, time, keeping quality, mackerel Nigerian Food Journal Vol. 23 2005: 114-12

Optimization of Soaking Duration and Temperature for Two Nigerian Rice Cultivars

Optimization of soaking duration and temperature for two Nigerian rice cultivars were evaluated. Temperatures of 50oC, 70oC and 90oC were used for both long and short grain rice paddy. Each treatment had three replicates of 12, 18 and 24 h of soaking durations. The physical analysis of the long/short rice paddies were 1000 kernel volume 24.3/22.3 cm3, 1000 kernel weight 24.2/24.3 g, density 1.3/1.1 gcm3, length, 9.9/8.2 mm, width, 2.95/3.3 mm, water absorption rate of 34/11% and moisture content of 14/11% respectively. Sensory evaluation of the long/short grainrice yield based on colour and general acceptability showed that significant differences existed among the samples with colour 8.05/7.85, general acceptability 8.10/7.80 respectively. The long/short grain percentage breakages were 2.7/1.2% and total yield 70/67%, respectively. At 70oC long grain rice yield increased as soaking duration increased, and at 90oC, short grain rice yield increased as soaking duration increased. The best quality was achieved by soaking the long grain at 70oC for 24 h and short grain at 90oC for 24 h.Keywords: Temperature, soaking duration, processing, rice cultivar

A survey on existing practices adopted in Dambu production and utilization in some northern states of Nigeria

A survey was conducted in relation to the production process of dambu. Dambu is a staple food for the Fulanis and Hausas. A majority of the dambu dealers (42.7%) were less than 25 years old. A proportion of 78.7% of processors of dambu were females. The processors/consumers (37.4%) indicated that millet was the major raw material for dambu production. A significant difference (p = 0.01) existed among respondents on the variety of millet chosen for dambu production. The study reveals that ‘gero’ is the variety in common use. Spices are indispensable as an ingredient in dambu production with ginger being the single most important spice (p = 0.07). The traditional pounding method for processing millet into flour is still very much used. The processors (58.9%) and retailers (41.0%) generally agreed that the method of marketing dambu is by hawking in transparent low density polyethylene package. Sun drying as indicated by 35.3% of the respondents was the most common method of storing left-over dambu. Total percentage of 27.4, 39.2 and 33.4% were deduced for the poor, the middle and the rich class consumption of dambu, respectively. With increasing influence of advertising upon customers, small food processing enterprises making dambu will have to improve the packaging and preservation of their products as to survive the competition. The implications of these are highlighted and a possible solution of optimizing the dambu production process is recommended