Effectiveness of normal saline flush and heparinised flush upon intravenous line patency among patients receiving intravenous medication

An Experimental Study to Assess the Effectiveness of Normal Saline Flush and Heparinized Flush in Maintaining the Patency of Intravenous Lines Among Patients Receiving Intravenous Medication at Selected Hospitals, Chennai. OBJECTIVES: 1. To assess the level of patency before and after normal saline flush in experimental group I and heparinized flush in experimental group II among patients receiving intravenous medication. 2. To determine the effectiveness of normal saline flush in experimental group I and heparinized flush in experimental group II among patients receiving intravenous medication. 3. To assess the level of satisfaction of nurses regarding normal saline flush in experimental group I and heparinized flush II in experimental group II among patients receiving intravenous medication. 4. To find out the association between the selected demographic variables upon the intravenous line patency before and after normal saline flush in experimental group I and heparinized flush in experimental group II among patients receiving intravenous medication. 5. To find out the association between the selected clinical variables upon the intravenous line patency before and after normal saline flush experimental group I and heparinized flush in experimental group II among patients receiving intravenous medication. The conceptual framework for the study was developed on the basis of King’s Goal Attainment Theory. An intensive review of literature and experts guidance laid the foundation to the development of tools such as demographic variable proforma, clinical variable proforma, observation checklist and patient satisfaction rating scale. In this study, true experimental research design was adopted. The present study was conducted at Apollo Speciality Hospital, Chennai among patients receiving intravenous medication. The sample size for the present study was 60 patients who receiving intravenous medication, among 60 which 30 patients were assigned to experimental group I and 30 patients in experimental group II who satisfied the inclusion criteria. The investigator used the demographic variable proforma and clinical variable proforma of patients to obtain the baseline data. Observation checklist was used to assess the level of intravenous line patency before and after normal saline flush and heparinized flush and rating scale to assess the level of satisfaction of patient about normal saline flush in experimental group I and heparinized flush in experimental group II. The data collection tools were validated and reliability was established. After the pilot study, the data collection of main study was conducted for period of 4 weeks. The collected information was tabulated and analyzed by using appropriate descriptive and inferential statistics. MAJOR FINDINGS OF THE STUDY: • Significant percentage of the patients were in the age group of 41-50 years (40%, 36.6%), males (70%, 73.3%), were living in urban region (70%, 80%), graduates (26.7%, 53.3%), non professional (73.3%, 60%), got married (86.7%, 70%), most of the patients were not having the history of previous hospitalization (66.7%, 73.3%), stayed in the hospital at the duration of 4-8 days (43.3%, 46.7%) in the experimental group I and experimental group II respectively. • Significant percentage of the patients got admitted with various diagnosis (43.3%, 50%), received medical treatment (73.3%, 73.3%), had median cephalic intravenous line (40%, 36.7%), had 20 G cannula (43.3%, 50%), received drugs through intravenous line (63.3%, 63.3%), infused at rate of 40 to 60 drops/min (46.7%, 43.3%), received more than 2000ml of fluid (40%, 46.7%) and all of them were received intravenous therapy more than 48 hours (100%, 100%) in the experimental group I and experimental group II respectively. • Majority of patients in experimental group I and experimental group II had no intravenous blockage (90%, 96.7%) in pre test respectively. However after normal saline flush and heparinized flush, no patients had intravenous blockage (100%, 100%) in experimental group I and experimental group II of patients receiving intravenous medication. • The mean and standard deviation for the scores of intravenous line patency (M=25.4,SD=3.06), (M=26, SD=2.75) among patients before normal saline flush and heparinised flush in experimental group I and experimental group II is significant at p<0.001***. On the other hand after administration of normal saline flush in experimental group I and heparinised flush in experimental group II, the mean and standard deviation (M=17.3,SD=1.37), (M=17.1,SD=1.14) were low when compared with pre test intravenous line patency score. The difference was found statistically significant at p<0.001. Hence the null hypothesis H01 was rejected. • Majority of the patients (93.33%) were highly satisfied with normal saline flush for maintaining intravenous line patency in experimental group I. • Majority of the patients (93.3%) were highly satisfied with heparinized flush for maintaining intravenous line patency in experimental group II. • There was a significant association between intravenous line patency and demographic variables of sex (χ2=6.00, df=1), (p < 0.05*) in pre test and sex (χ2=4.35, df=1), (p < 0.05*), residence (χ2=9.66, df=1), (p < 0.05*) of post test in experimental group I and marital status (χ2=9.30, df=1), (p < 0.01**) of pre test in experimental group II. Hence there was no association between other demographic variables like age, educational status, income per month, occupation, previous history of hospitalization, duration of hospitalization and intravenous line patency in experimental group I and experimental group II of patients. Hence the null hypothesis H02 was rejected with sex, residence, marital status and retained with other demographic variables. • There was a significant association between intravenous line patency and other clinical variables of reason for admission (χ2=6.30, df=1), (p < 0.05*), size of cannula (χ2=4.23, df=1), (p < 0.05*) in pre test of experimental group I and diagnosis (χ2=6.29, df=1), (p < 0.05*) in post test of experimental group II. However there was no significant association between other clinical variables like site of intravenous line, type of fluid, rate of fluid flow, total volume of fluid, duration of therapy and patency of intravenous line. Hence the null hypothesis Ho3 was rejected with diagnosis, reason for admission, size of cannula and retained with other clinical variables. RECOMMENDATIONS: 1. A similar study could be undertaken on larger scale for more valid generalization. 2. Present study could be replicated in different settings. 3. The intervention can be applied in practice for maintaining the patency for central venous catheter and arterial catheter. 4. The study could be conducted to analyze the relationship between the use of intravenous flush and maintaining catheter patency

Insulin Resistance in psoriasis patients versus normal persos in a tertiary care hospital; A comparative study

BACKGROUND: Psoriasis is a chronic T-cell mediated inflammatory skin disease characterized by complex alterations in epidermal growth and differentiation together with multiple biochemical, vascular and immunological changes. OBJECTIVES: This study was carried out in psoriasis patients to estimate their level of insulin resistance and to study the other associated biochemical parameters like fasting plasma glucose, serum high density lipoproteins and serum triglycerides in psoriasis patients. MATERIALS AND METHODS: This cross-sectional study included 100 psoriasis patients and 100 age matched healthy controls attending outpatient department of Dermatology, Sree Mookambika Institute of Medical Sciences. Fasting blood samples were collected. FPG, insulin, HDL and triglycerides were assessed using Beckmann Coulter kit. IR was calculated using HOMA-IR adopting the value ≥2.5. Independent sample “t” tests were done for comparison of variables in two groups. Statistical analysis was done by SPSS 20. RESULTS: IR was observed in the study group. FPG and fasting insulin levels were significantly high in the cases compared to the controls. Triglyceride levels were significantly higher and HDLwas significantly lower in psoriasis patients. CONCLUSION: The results reveal IR was seen in psoriasis patients when compared to the controls. There was also a strong association of biochemical parameters like hyperinsulinemia, hyperglycemia, high triglycerides and low HDL levels in the study group. This may elevate the risk of atherosclerosis, particularly cardiovascular diseases. Therefore periodic screening of psoriatic patients is recommended which may help in appropriate management

Radial flow of kaon mesons in heavy ion reactions

This work investigates the collective motion of kaons in heavy ion reactions at SIS energies (about 1-2 GeV/nucleon). A radial collective flow of $K^+$ mesons is predicted to exist in central Au + Au collisions, which manifests in a characteristic "shoulder-arm" shape of the transverse mass spectrum of the midrapidity $K^+$ mesons. The $K^+$ radial flow arises from the repulsive $K^+$ mean field in nuclear matter. In spite of a strong reabsorption and rescattering the attractive $K^-$ mean field leads as well to a collective radial flow of $K^-$ mesons. The $K^-$ radial flow, however, is different from that of $K^+$ mesons and can be observed by a characteristic "concave" structure of the transverse mass spectrum of the $K^-$ mesons emitted at midrapidity. The kaon radial flows can therefore serve as a novel tool for the investigation of kaon properties in dense nuclear matter.Comment: 30 pages RevTex, 5 PS figures, accepted for publication in Phys. Rev.

Design of Compact Baugh-Wooley Multiplier Using Reversible Logic

In today&apos;s digital era, developing digital circuits is bounded by the research towards investigating various nano devices. This paper provides the design of compact Baugh-Wooley multiplier using reversible logic. Even though various researches have been done for designing reversible multiplier, this work is the first in the literature to use Baugh-Wooley algorithm using reversible logic. In this work, a new 5 × 5 reversible multiplier cell is proposed which will be useful in designing Baugh-Wooley multiplier. The proposed single multiplier cell is able to perform addition of a 1 × 1 product with the sum and carry from the previous cell. This reversible multiplier cell is useful in building up regularity in the array multipliers. The Toffoli gate synthesis of the proposed reversible multiplier cell is also given

In-medium dependence and Coulomb effects of the pion production in heavy ion collisions

The properties of the high energy pions observed in heavy ion collisions, in particular in the system Au on Au at 1 GeV/nucleon are investigated. The reaction dynamics is described within the Quantum Molecular Dynamics (QMD) approach. It is shown that high energy pions freeze out early and originate from the hot, compressed matter. $N^*$--resonances are found to give an important contribution toward the high energy tail of the pion. Further the role of in-medium effects in the description of charged pion yields and spectra is investigated using a microscopic potential derived from the Brueckner G-matrix which is obtained with the Reid soft-core potential. It is seen that the high energy part of the spectra is relatively more suppressed due to in-medium effects as compared to the low energy part. A comparision to experiments further demonstrates that the present calculations describe reasonably well the neutral (TAPS) and charged (FOPI) pion spectra. The observed energy dependence of the $\pi^-/\pi^+$ ratio, i.e. deviations from the isobar model prediction, is due to Coulomb effects and again indicate that high energy pions probe the hot and dense phase of the reaction. These findings are confirmed independently by a simple phase space analysis.Comment: 28 pages Latex, prepared with elsevier-style, 13 PS-figure

Surgical glue- a promising technology for wound healing

Wound closure is one of the important steps of surgical dressing and suturing is the most commonly used method of wound closure. The process of suturing takes very long time for surgery and increases the patient’s risk of anesthesia awareness. Skin glues are a safe and effective method to close selected wounds. They are also cost-effective and help prevent infection. Ideally, wounds should be less than 4 cm, not contaminated or infected and have skin edges that are not under tension. Wounds should be closed within 12 hours. Novel methods of wound closure have been introduced to address these issues, most notably cyanoacrylate tissue glues. The evidence would suggest that the use of cyanoacrylate tissue glue is associated with a reduction in closure time and costs. On a daily basis, dermasurgeons are facing different kinds of wounds that have to be closed. With a plethora of skin closure materials currently available, choosing a solution that combines excellent and rapid cosmetic results with practicality and cost-effectiveness is preferred

Reliable Computing Under Resources Constraints Policy 1

Abstract Hardware-based trusted computing platforms are intended to overcome many of the problems of trust that are prominent in computing systems. In this paper, a result of the Software Engineering Institute&apos;s Independent Research and Development Project &quot;Trusted Computing in Extreme Adversarial Environments: Using Trusted Hardware as a Foundation for Cyber Security,&quot; we discuss the capabilities and limitations of the Trusted Platform Module (TPM). We describe credential storage, device identity, chains of trust, and other techniques for extending hardwarebased trust to higher levels of software-based infrastructure. We then examine the character of trust and identify strategies for increasing trust. We show why acceptance of TPM-based trust has been limited to date and suggest that broader acceptance will require more focus on traditional trust issues and on end-to-end services.