Comparison of carcasses and meat quality of chicken kept under different conditions

The aim of this work is to evaluate whether the quality and growth of the carcass of broiler chickens is affected by different living conditions and how the pH, total fat, protein and nitrogen content of the chicken differs from the quality of the chicken sold in the shop. The study was conducted in two farms where slow-growing broiler chickens were kept under different conditions: on farm X 6 broilers grew under closed conditions and on farm Y 6 broilers under free-range conditions. After 4 months of growth, a visual inspection of internal organs was taken and taken 200g of breast and was sampled for quality testing. 3 broiler chicken breast samples were purchased from market for control. The pH of meat, percentage of total fat, percentage of nitrogen and percentage of protein were analyzed. Determination of pH of active acidity The meat was analyzed using a Sartorius Professional PP-15 pH meter using three measurements and averaging them. Total fat percentage calculated using LST ISO 1443: 2000 standard. Percentage of nitrogen calculated using LST ISO 937: 2000 standard. The protein content calculated from the obtained amount of nitrogen and multiplied by a factor of 6.25 (European Parliament and Council Regulation (EU) no. 1169/2011, Annex 1, p. 10). Data processed by Microsoft Office Exel 2016. Statistical data analysis was performed on SPSS Statistical Package no. Version 13. (Arithmetic mean, minimum and maximum values were analyzed of total fats, nitrogen, protein and pH) No pathological organ or developmental abnormalities were detected during the study. The control group had a higher pH and a higher total fat content in the meat than broiler chickens on the farm. The proc. nitrogen content was highest in Y and the highest of protein in X. No organ changes were observed in the post-mortem broiler chickens at 4 months post-mortem. Slow and steady growing of chickens prevents rapid weight gain and possible bone or visceral damage

Cesarean Delivery in Severe Pulmonary Hypertension: A Case Report

Pregnancy in a woman with pulmonary hypertension carries a prohibitively high risk of maternal mortality, and pregnancy is contraindicated in such patients. Some women decide to continue with their pregnancy despite being aware of possible fatal maternal outcome. The management of pulmonary hypertension in pregnancy is a challenge and requires a multiprofessional approach. We report the case of a patient with severe pulmonary hypertension, who successfully underwent elective cesarean section under epidural anesthesia at 38 weeks of gestation and discuss major issues associated with the obstetric and anesthetic management of pregnant patients with pulmonary hypertension

Labor epidural analgesia and the incidence of instrumental assisted delivery

Objective: To assess the influence of labor epidural analgesia on the course of labor and to determine its association with instrumental assisted delivery rate. Materials and methods: A retrospective case–control study was performed during 2007–2011 aiming to identify the relation between epidural analgesia (EA) and instrumental assisted delivery (IAD) rate. All patients in whom instrumental assistance for delivery was applied were allocated into either case (parturients who received EA and had IAD) or control (parturients who did not receive EA but had IAD) groups. Maternal demographic data, pregnancy and delivery characteristics as well as neonatal short-term outcome were studied. Results: A total of 7675 vaginal deliveries occurred during the study period and 187 (2.43%) patients had IAD. Vacuum extraction was applied to 67 (2.16%) parturients who received EA, and to 120 (2.61%) who did not. The median duration of the first stage of labor was 510 min in the EA group as compared to 390 min in the control group (P = 0.001). The median duration of the second stage of labor among cases and controls was 60 and 40 min, respectively (P < 0.0005). Cases more often had their labor induced by oxytocin 80.3% as compared to 58.3% among controls (P = 0.003). There was no significant association between the use of EA and increased IAD rate (OR = 0.81; 95% CI, 0.60–1.09). Conclusions: Labor EA did not increase the incidence of IAD and the risk of adverse neonatal outcomes, but was associated with prolonged first and second stages of labor

The influence of dexamethasone and ketolgan on postoperative nausea and vomiting and estimation of risk factors in women undergoing gynecologic laparoscopic surgeries

The aim of this study was to determine the effect of dexamethasone and ketolgan on postoperative nausea and vomiting and to evaluate risk factors for postoperative nausea and vomiting. Material and methods. A prospective, double-blind, randomized clinical study was carried out. One hundred fi fty-three ASA I–II women undergoing laparoscopic gynecologic operations were randomized into three groups: dexamethasone group (n=51), ketolgan group (n=51), and control group (n=51). Patients in the dexamethasone group were given 4 mg of dexamethasone intravenously before the induction of general anesthesia, the ketolgan group received 30-mg ketolgan intravenously, and control group did not receive any medication. The incidence and severity of postoperative nausea and vomiting were registered 24 hours after the surgery. Results. The incidence of postoperative nausea and vomiting in the dexamethasone group was 13.8%; in the ketolgan group, 37.3%, and in the control group, 58.9% (P=0.026). Patients with a history of migraine suffered from postoperative nausea and vomiting in 70.3% of cases and migraine- free patients in 25.8% of cases (P=0.015). Opioids for postoperative analgesia increased the incidence of postoperative nausea and vomiting as compared with nonsteroidal anti-infl ammatory drugs (P=0.00002). Conclusions. Preoperative medication with dexamethasone signifi cantly reduces the incidence of postoperative nausea and vomiting. Avoidance of opioids for postoperative analgesia reduces the incidence of postoperative nausea and vomiting. Migraine and motion sickness are independent risk factors for postoperative nausea and vomiting

Labour analgesia: knowledge, acquired information and choice of parturient

Background and Goal of Study: Changing social values and medical technology have influenced birth-related pain management options and choices. It is recomended that the method used for analgesia should be individualised to each woman’s wishes, needs and circumstances. A woman’s lack of knowledge about the risks and benefits of the various methods of pain relief can heighten anxiety. Midwive is a reliable source of information about labour analgesia. Materials and methods: A prospective cohort study was carried at 2015 08- 09 in a teaching hospital.The qestionnaires were given to all parturients af ter delivery. Results and discussion: 110 questionnaires were given, returned - 104, the response rate was 96%. Parturients knowledge about labour analgesia (selfassessment): suf ficient - 73.1% (n=72), insuf ficient - 15.4% (n=16), didn’t know anything 11.5% (n=12) (χ2=0.233, p=0.248). Known natural pain relieving methods were: breathing exercises for 89.4% (n = 93) of parturients, physical activity for 72.1%, massage - 68.3% (n=71), hidrotherapy - 28.8% (n=30), acupuncture - 11.5% (n=12), acupressure - 10.6% (n=11), application of hot and cold compresses to the perineum - 8.7% (n=9). Known pharmacological labour analgesia methods were epidural analgesia for 90.4% (n = 94) of parturients,and 80.8% (n=84) consider it as most ef fective, spinal analgesia for 49.0% (n=51) and nitrous oxide for 42.3% (n=44) of parturients. Possible pain relief methods Advantages and disadvantages Natural analgesia Pharmacological analgesia Suf ficient information 36.5% 22.1% 36.6% Partial information 20.2% 22.4% 57.7% Not provided 43.3% 53.8% 8.7% p 0.248 0.007 0.007 χ2 0.233 0.533 0.146 [Information provided by midwives for parturients] Choise of parturients: 54.8% (n=57) pharmacological labour analgesia, 45.2% (n=47) natural methods. Most of the parturients - 95.2% (n=99) - will chose the same method during next delivery. The choice of labour analgesia method is determined

Comparison of two different methods of analgesia. Postoperative course after colorectal cancer surgery

Background. The purpose of our study is to compare two methods of postoperative analgesia in colorectal cancer patients after resectional operations, and to evaluate advantages and limitations of each method on the postoperative course of these patients. Methods. One hundred patients scheduled to undergo elective colorectal cancer surgery were randomized into two groups; after general anesthesia, one group received epidural analgesia (n=50) and the second one \u96 intramuscular pethidine analgesia (n=50). Visual analogue scale at rest and on coughing was used to compare intensiveness of pain between the two groups during the day of surgery and first three postoperative days. Patients\u92 mood and self-satisfaction were evaluated using self-assessment manikin scale. Side effects of both analgesia techniques were registered. All complications and postoperative hospital stay were also evaluated. Results. Visual analogue scale pain scores at rest and on coughing were significantly better in epidural analgesia group as compared to systemic intramuscular pethidine analgesia group (p<0.05). Additional analgesics were needed for 10 (20%) and 28 (56%) patients respectively to keep visual analogue scale pain scores below 5. Adverse effects such as profound sedation, nausea and vomiting were more frequent in systemic intramuscular pethidine group, but pruritus \u96 very uncommon to compare with epidural analgesia group (p<0.05). There were no significant differences between the two groups in respect to complications and postoperative hospital stay. Conclusions. Epidural analgesia has demonstrated significantly better effectiveness than intramuscular pethidine analgesia after colorectal cancer surgery with fewer adverse events. Self-assessment manikin scores showed better self-satisfaction in patients of epidural analgesia group as compared to patients in systemic pethidine group

Infusion solutions of gelatin derivates

Besides crystalloids, colloids are used for the treatment of hypovolemia and shock. They are high-molecular-weight proteins of bovine origin with properties of more rapid replacement of circulating blood volume. Iso-oncotic character provides the volume effect (»100%) close to the volume intravenously infused with the duration of action for 2–4 hours. Gelatin solutions are excreted with urine and feces in unchanged form without prolonged fixation in organism. Even in case of acute renal failure, gelatin peptides do not accumulate due to increased activity of proteolytic enzymes; therefore, they are the first-choice colloids. Gelatin solutions do not change coagulation as other colloids; just they may cause hemodilution as crystalloids do, so they are safe in case of hemorrhage and thrombocytopenia. There is a decreased risk of bleeding when gelatin solutions are used in surgery as compared with other colloids; in addition, they protect from hypotension due to vasodilatation in epidural or spinal analgesia. Gelatin solutions may cause compensatory hyperemia and increase of cardiac output, cardiac index, myocardial contractility, mean arterial blood pressure, and diuresis; in addition, oxygen delivery to the tissues improves. The dosage depends on clinical condition of a patient, and it is suggested to be 100–2000 mL and even more, for isovolemic hemodilution – 20 mL/kg of body weight. Adverse reactions such as anaphylactoid or anaphylactic to gelatin derivates are rare and similar to other colloids

Sight related complaints after prolonged laparoscopic oncogynecologic surgery

Background and Goal of Study: Minimally invasive surgery is used in order to reduce surgical aggression and to minimize morbidity. Recently the safety of prolonged laparoscopic surgery has been called into question due to the possibility of increase in intracranial pressure caused by pneumoperitoneum and Trendelenburg position. One of the complications is thought to be related to sight. The goal of the study was to evaluate the rate of sight related complaints among women who underwent prolonged laparoscopic oncogynecologic surgery and to assess the impact of surgery duration on the rate of complaints. Materials and methods: A retrospective cohort study was carried out in a teaching hospital. Medical records were analyzed of women who underwent laparoscopic oncogynecologic surgery lasting three hours or longer in the Trendelenburg position in 2013-2014. Subsequently all these women were contacted by phone in order to obtain the information regarding their sight following the surgery. Results and discussion: Of 82 patients who fit the inclusion criteria, 57 (69,5 %) were successfully contacted and included in the study. The average age of patients was 61,1 (±8,6) years. The average duration of surgery reached 217,8 (± 58,2) minutes, ranging from 3 to 8 hours. During the interviews via phone 40,4% (n= 23) of patients expressed complaints related to sight following the surgery. The rate of those complaints statistically significantly depended on the duration of surgery (p=0,011). Overall 29,7% (n=17) of patients complained of decreased eyesight making up 73,9% of all cases of visual disturbances. Seven (12,3%) patients reported shimmering or black dots in the field of vision (30,4% of all complaints). Feeling of pain or tension in the eyes was the main complaint in four (7,0%) cases. In 30,4% (n=7) of cases related to sight complaints the visual disturbances occurred immediately af ter the surgery, the remaining cases manifested a few weeks or months later.

Relation between labour pain relief methods, postpartum depression, satisfaction with labour and labour analgesia for primiparous parturients

Background and Goal of Study: Childbirth is associated with severe pain and intensive stress for most women. Women underestimate the pain of childbirth, especially primiparas. Unsatisf ying birth experiences are associated with the occurrence of postpartum depression. Pain relieving during childbirth is not as significant in ensuring a positive birth experience, but labour analgesia may decrease postpartum depression by af fecting the feeling of powerlessness. Our primary objective was to assess the relation between labour analgesia, satisfaction with labour and labour analgesia and the postpartum depression. Materials and methods: An observational prospective cohort study was carried at 2014 11 - 2015 09 in a teaching hospital. To evaluate the satisfaction the New Mother Quality of Care questionnaire (NEMOQC) was used. To estimate postpartum depression level Edinburgh Postnatal Depression Scale (EPDS) was used at <72 h and 4 weeks (contacted by phone) af ter birth. Results and discussion: 264 primiparas af ter vaginal delivery fit the inclusion criteria. 245 were included, 19 didn’t answer all questionnaires. The response rate was 92.8%. Epidural analgesia was used for 100 (40.8%) of parturients, 50 (20.4%) used nitrous oxide and 95 (38.8%) didn’t use analgesia. Postpartum depression was in 10.2% (N=25) cases within 72 hours, and in 12.1% (N=29) 4 weeks af ter delivery.184 Obstetric Anaesthesiology N2O vs without analgesia Epidural vs without analgesia OR 95% CI p OR 95% CI p Satisfaction with labour analgesia 3,467 1,706-7,045 0,001 3,424 1,896-6,183 <0,001 Satisfaction with labour 0,547 0,250-1,199 0,132 0,414 0,215-0,795 0,008 Postpartum depression <72 h 1,000 0,323-3,101 1,000 1,071 0,425-2,704 0,884 Postpartum depression after 4 weeks 1,272 0,644-2,512 0,489 0,155 0,052-0,253 <0,001 [The effect of labour analgesia methods on satisfac] There is no statistically significant association between satisfaction with labor and post-partum depression withi