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

Detection of Dengue Disease Empowered with Fused Machine Learning

Dengue fever is a life-threatening illness that affects both industrialized and poor nations, including Pakistan. It is necessary to forecast the illness at an early stage to avoid it. Machine Learning (ML) methods outperform other computer approaches in terms of illness prediction. The model utilized in this study to predict dengue fever is fused with machine learning. Artificial Neural Networks (ANN) and Support Vector Machine (SVM) provide the foundation of the conceptual framework. The datasets employed in these models have been collected from a government hospital in Lahore, Pakistan for diagnosing dengue fever (positive or negative). 70% of the statistics in the dataset are training data, whereas 30% are testing data. This fused model's membership functions explain whether a dengue diagnostic is positive or negative, which controls the model's output. A cloud storage system saves the fused model based on patients' real-time information for future use. The proposed model has a 96.19 % accuracy rate, which is much greater than earlier research

Proceedings of First Conference for Engineering Sciences and Technology: Vol. 1

This volume contains contributed articles of Track 1, Track 2 & Track 3, presented in the conference CEST-2018, organized by Faculty of Engineering Garaboulli, and Faculty of Engineering, Al-khoms, Elmergib University (Libya) on 25-27 September 2018. Track 1: Communication and Information Technology Track 2: Electrical and Electronics Engineering Track 3: Oil and Chemical Engineering Other articles of Track 4, 5 & 6 have been published in volume 2 of the proceedings at this lin

Energy Dependence of the Transverse Momentum Distributions of Charged Particles in pp Collisions Measured by ALICE

Differential cross sections of charged particles in inelastic pp collisions as a function of p_T have been measured at $\sqrt{s}$ = 0.9, 2.76 and 7 TeV at the LHC. The $p_T$ spectra are compared to NLO-pQCD calculations. Though the differential cross section for an individual $\sqrt{s}$ cannot be described by NLO-pQCD, the relative increase of cross section with sqrt(s) is in agreement with NLO-pQCD. Based on these measurements and observations, procedures are discussed to construct pp reference spectra at $\sqrt{s}$ = 2.76 and 5.02 TeV up to $p_T$ = 50 GeV/c as required for the calculation of the nuclear modification factor in nucleus-nucleus and proton-nucleus collisions