scholarly journals Accuracy of Ultrasound-Guided Pudendal Nerve Block in the Ischial Spine and Alcock’s Canal Levels: A Cadaveric Study

Pain Medicine ◽  
2020 ◽  
Vol 21 (11) ◽  
pp. 2692-2698
Author(s):  
Béatrice Soucy ◽  
Dien Hung Luong ◽  
Johan Michaud ◽  
Mathieu Boudier-Revéret ◽  
Stéphane Sobczak
Keyword(s):  
Pudendal Nerve ◽  
Ischial Spine ◽  
Ultrasound Guided ◽  
Us Guidance ◽  
Significant Difference ◽  
Alcock’S Canal ◽  
The Difference ◽  
One Year ◽  
Musculoskeletal Us ◽  
Different Levels

Abstract Background Blockade of the pudendal nerve (PN) using ultrasound (US) guidance has been described at the levels of the ischial spine and Alcock’s canal. However, no study has been conducted to compare anatomical accuracy between different approaches in targeting the PN. Objective To investigate the accuracy of US-guided injection of the PN at the ischial spine and Alcock’s canal levels. This study also compared the accuracy of the infiltrations by three sonographers with different levels of experience. Subjects Eight Thiel-embalmed cadavers (16 hemipelvises). Methods Three physiatrists trained in musculoskeletal US imaging with 12 years, five years, and one year of experience performed the injections. Each injected a 0.1-mL bolus of colored dye in both hemipelvises of each cadaver at the ischial spine and Alcock’s canal levels under US guidance. Each cadaver received three injections per hemipelvis. The accuracy of the injection was determined following hemipelvis dissection by an anatomist. Results The injections were accurate 33 times out of the total 42 attempts, resulting in 78% accuracy. Sixteen out of 21 injections at the ischial spine level were on target (76% accuracy), while the approach at Alcock’s canal level yielded 17 successful injections (81% accuracy). The difference between the approaches was not statistically significant. There was also no significant difference in accuracy between the operators. Conclusions US-guided injection of the PN can be performed accurately at both the ischial spine and Alcock’s canal levels. The difference between the approaches was not statistically significant.

scholarly journals The difference in outcome of patients with open inguinal hernia repair by using delayed absorbable sutures instead of non-absorbable sutures for mesh fixation

2020 ◽  
Vol 8 (1) ◽  
pp. 24
Author(s):  
Ali G. Mohammed Redha ◽  
Adil A. Jaber ◽  
Aqeel M. Nasser
Keyword(s):  
Hernia Repair ◽  
Mesh Fixation ◽  
Good Alternative ◽  
P Value ◽  
Absorbable Sutures ◽  
Significant Difference ◽  
The Difference ◽  
Group 2 ◽  
One Year ◽  
Group 1

Background: Different methods are found for mesh fixation in inguinal hernioplasty both open and laparoscopic. In open technique, sutures have been the method of choice for their reduced costs and surgeons’ habits. Whether absorbable instead of non-absorbable sutures can be used still a matter of debate in view of hernia recurrence and post-operative complications.Methods: This is a prospective done on 158 male patients with uncomplicated unilateral inguinal hernias. Two groups of 69 patients were evaluated after periods up to 1 year after open hernioplasty by using delayed absorbable sutures in one group (group 1) and non-absorbable sutures in the other group (group 2) for fixation of mesh.Results: In spite of a noticeable reduction in complication in the group 1 in term of number and percentage when compared with group 2 mainly chronic pain, there is no significant difference (p value>0.05). However, these results are associated with zero recurrence in both groups during a period of one year follow up.Conclusions: Delayed absorbable sutures are good alternative of non-absorbable sutures in open mesh hernia repair associated with less complications and almost no increase in chance of recurrence.  

scholarly journals Students’ Motivation to Learn English as a Foreign Language in the Context of Saudi Arabian Learners

2021 ◽  
Vol 12 (3) ◽  
pp. 242-256
Author(s):  
Hind Aljuaid
Keyword(s):  
Foreign Language ◽  
English Language ◽  
Saudi Arabian ◽  
Motivation To Learn ◽  
Mean Values ◽  
Significant Difference ◽  
Integrative Effort ◽  
Motivation Scale ◽  
The Difference ◽  
Different Levels

Motivation is the major contributor to the students’ learning English as a second language. However, varying reasons have been suggested by different researchers and theorists to explain the reasons and dimensions of this motivation. Therefore, the study aimed to evaluate the motivation to learn English as a foreign language (EFL) among 157 Saudi Arabian university students. The instrument used for the analysis was a modified version of the motivation scale developed by Wen (1997), which measures motivation based on six subscales: integrative, instrumental, effort, valence, expectation, and ability. In addition, students’ motivation was compared among students with different English language levels using multivariate analysis of variance (MANOVA) on six motivation subscales. The results of the MANOVA revealed that there was no significant difference among students of different levels of English knowledge when each level was compared separately. Nevertheless, when comparing a merged group of students with English level knowledge of 1st to 3rd with the group of 4th level, the motivation of the latter group was statistically significantly higher. Furthermore, the difference in mean values was significant for integrative, effort, valence, and ability subscales. Thus, the findings of this research depicted that instrumental and integrative motivations could be the main contributor to students’ motivation to learn English as a foreign language.

scholarly journals Qualitative Diagnosis of Liver Tumors Based on Ultrasound-Guided Automatic Biopsy

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
Bin Peng
Keyword(s):  
Liver Tumors ◽  
Liver Parenchyma ◽  
Lesion Size ◽  
Control Group ◽  
Ultrasound Images ◽  
Ultrasound Guided ◽  
Significant Difference ◽  
Conventional Ultrasound ◽  
The Difference ◽  
And Control

The goal of this study was to see if automatic biopsy guided by ultrasound could be used to provide a qualitative diagnosis of a liver tumor. Methods. A total of 40 patients (101 focuses) were treated with automatic liver parenchyma biopsy under ultrasound guidance, and the correlation between pathological outcomes and ultrasound images was investigated. The lesion size in the observation group was compared to that in the control group using conventional ultrasound ( P  > 0.05), and there was no significant difference. Under contrast-enhanced ultrasound (CEUS), there was no statistically significant difference in lesion size between the observation and control groups ( P  > 0.05). The difference in lesion size between the conventional ultrasonography and CEUS observation groups was statistically significant ( P 0.05). Conclusion. Ultrasound-guided automated biopsy of the liver parenchyma is a simple and effective procedure with fewer problems and a high diagnostic rate, and it deserves to be promoted clinically.

scholarly journals OR18-07 Laser Ablation Versus Radiofrequency Ablation for Benign Non-Functioning Thyroid Nodules: Six-Month Results of a Randomised, Parallel, Open-Label, Trial (Lara Trial)

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Roberto Cesareo ◽  
Claudio Maurizio Pacella ◽  
Valerio Pasqualini ◽  
Giuseppe Campagna ◽  
Mario Iozzino ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Thyroid Nodules ◽  
Volume Reduction ◽  
High Rate ◽  
Open Label ◽  
Significant Difference ◽  
Nodule Volume ◽  
The Difference ◽  
Receive Treatment ◽  
One Year

Abstract ABSTRACT Background: Up to now, there are no direct prospective studies comparing Laser (LA) and radiofrequency ablation (RFA). We aimed to compare, in a head- to-head clinical trial, the efficacy and safety of both techniques in a population affected by solid or predominantly solid benign non-functioning thyroid nodules (BNTN). Methods. LARA is a six-month, single-use, randomized, superiority, open-label, parallel trial. We enrolled subjects with a solitary BNTN or dominant nodule characterized by pressure symptoms/cosmetic problems or patients without symptoms who experienced a volume increase >20% in one year. Nodules underwent core needle biopsy (CNB) to evaluate the histological architecture. Patients were randomly assigned (1:1) to receive treatment with either LA or RFA. The primary endpoint was to evaluate the difference in nodule volume reduction between the RF and the LA group at six months. Moreover, we aimed to assess the differences between groups in the rate of nodules with greater than 50% base volume reduction (successful rate) at six months after treatment. ClinicalTrials.gov: number NCT02714946. Findings: From January 2016 to November 2018, 60 patients were randomly assigned (30 participants per group). In the whole study population, the average volume of nodules was 25 ml. The two groups were similar in terms of basal nodule volume, thyroid function, histology, symptoms/cosmetic score and procedure time. At six months, participants in the RFA group showed a reduction volume of 64·3% (95% CI: 57·5% - 71·2%) compared to 53·2% (95% CI: 47·2% - 59·2%) in the LA group (p= 0·015) and this difference was also confirmed in a linear regression model adjusted for age, baseline volume and proportion of cellular component (Laser vs. RFA percent change Delta= -12·8, P=0·018).We have not recorded any significant difference in terms of successful rate at six months after treatment between the two groups (86·7% in the RFA vs 66·7% in the LA, p=0·127). At six months, both symptoms and cosmetic scores improved (compressive symptom score: 2·13 vs 3·9 for RFA, p < 0·001; 2·4 vs. 3·87 for LA, p < 0·001; cosmetic score: 1·65 vs 2·2 for RFA p <0·001, 1·85 vs 2·2 for LA p <0·001) without any statistically significant difference between the two groups. No statistical difference between the two groups was detected at six months as regards the TSH level. High rate of cellularity negatively affects the volume reduction in RFA group (r coefficient -0·41, p=0·034) while histological features did not affect the efficacy of the LA. The adverse event rates were 37% and 43% for RFA and LA, respectively, with no requirement for hospitalization. Interpretation: Both techniques are very effective in reducing the volume of thyroid nodules. RFA appears to be more effective than LA, but both techniques showed no difference in terms of success rate six months after treatment. The safety of the two techniques is very satisfactory.

scholarly journals Internet Addiction, Locus of Control and Resilience

2020 ◽  
Vol 19 (1) ◽  
pp. 27-45
Author(s):  
Juslin Jacob
Keyword(s):  
Locus Of Control ◽  
Gender Difference ◽  
Emerging Adults ◽  
Internet Addiction ◽  
Resilience Scale ◽  
Significant Difference ◽  
Research Findings ◽  
The Difference ◽  
One Way Anova ◽  
Different Levels

The study investigates the difference in the Locus of Control and Resilience with respect to different levels of Internet Addiction as well as their impact on Internet Addiction among emerging adults. It assesses Internet Addiction levels, investigates the association between Internet Addiction, Locus of Control and Resilience and analyses gender difference. Internet Addiction Test by Young, Locus of Control (LOC-Scale) Scale developed by Rotter (1966) and The Brief Resilience Scale were used. Pearson’s product-moment correlation analysis was used to evaluate the association between Internet Addiction, Locus of Control and Resilience. An independent t-test was used to test whether there is a statistical difference between gender and internet addiction at different levels. One-way ANOVA was used to investigate the gender difference in Internet Addiction, Locus of Control and Resilience respectively. The research findings show that there is a significant relationship between Internet Addiction, Locus of Control and Resilience as well as significant gender difference in Internet Addiction. A significant difference in Resilience among the different levels of Internet Addiction was also found in the study.

A Comparison of the Postoperative Analgesic Effectiveness of Ultrasound-Guided Dorsal Penile Nerve Block and Ultrasound-Guided Pudendal Nerve Block in Circumcision

2020 ◽  
Vol 104 (11-12) ◽  
pp. 871-877
Author(s):  
Volkan Ozen ◽  
Dogakan Yigit
Keyword(s):  
Postoperative Complications ◽  
Nerve Block ◽  
Postoperative Analgesia ◽  
Pudendal Nerve ◽  
Pain Scale ◽  
Ultrasound Guided ◽  
Pudendal Nerve Block ◽  
Dorsal Penile Nerve Block ◽  
Significant Difference ◽  
Dorsal Penile Nerve

<b><i>Aim:</i></b> The aim of this study was to compare the postoperative analgesic effectiveness of the 2 block types. We also aimed to evaluate the effect of these block types on the postoperative complications and parental satisfaction. <b><i>Materials and Methods:</i></b> This prospective observational study was conducted between April and July 2019 at a training and research hospital. Patients aged between 5 and 12 years in the ASA I-II group, who were scheduled for circumcision, were included in the study. The primary outcome was the pain measured using the Children’s Hospital Eastern Ontario Pain Scale and the Faces Pain Scale-Revised. The secondary outcomes were the postoperative complications and parenteral satisfactions. <b><i>Results:</i></b> The number of patients receiving a pudendal block (<i>n</i> = 40) and dorsal penile nerve block (DPNB) block (<i>n</i> = 40) was equal. No statistically significant difference was found between the groups that were administered a DPNB and pudendal block in terms of pain scores (<i>p</i> &#x3e; 0.05). We did not observe any postoperative block-related complications or side effects. Parents reported excellent satisfaction in both groups. <b><i>Discussion:</i></b> Ultrasound (US)-guided pudendal nerve block and US-guided DPNB provided effective and long-lasting postoperative analgesia for circumcision surgery. <b><i>Conclusions:</i></b> This study has shown that both blocks provide postoperative analgesia with similar effectiveness and ensured a very comfortable period at the circumcision surgery. Clinicians can use either of these techniques depending on their clinical circumstances and experience.

scholarly journals A Simple Surgical Approach for the Management of Acquired Severe Lower Punctal Stenosis

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Sameh S. Mandour ◽  
Khaled E. Said-Ahmed ◽  
Hany A. Khairy ◽  
Moataz F. Elsawy ◽  
Marwa A. Zaky
Keyword(s):  
Nasolacrimal Duct ◽  
Ophthalmological Examination ◽  
Slit Lamp ◽  
University Hospitals ◽  
Silicone Tube ◽  
Significant Difference ◽  
Fluorescein Dye ◽  
The Difference ◽  
One Year ◽  
Punctal Stenosis

Purpose. Evaluation of using pigtail probe to detect and open severely stenosed lower lacrimal punctum followed by self-retaining bicanalicular intubation. Study design. A prospective nonrandomized clinical study. Methods. The study included 24 patients with severe lower punctal stenosis (grade 0 according to Kashkouli scale) attending at Menoufia University Hospitals. The upper punctum and canaliculus were patent. All patients were complaining of epiphora and had a thorough ophthalmological examination including dye disappearance test and slit-lamp examination. Pigtail probe was used from patent upper punctum to detect the lower stenosed punctum which was opened with a scalpel. Syringing of the lower lacrimal passages was done to confirm its patency, and self-retaining silicone bicanalicular stent was inserted. The silicone tube was left in place for 6 months before it was removed. Patients were then followed-up for 1 year after the surgery. Results. One year after surgery, epiphora was absent (grade 0) in 16 eyes (66.7%) and was present only occasionally (grade 1) in 4 eyes (16.7%). The difference from preoperative epiphora was statistically significant. One year after surgery, fluorescein dye disappearance time was grade 1 (<3 minutes) in 20 cases (83.3%), and grade 2 (3–5 minutes) in 4 cases (16.7%). There was a statistically significant difference compared with preoperative results. Conclusion. Using the pigtail probe is effective in treatment of severe punctal stenosis. Maintaining the punctal opening and prevention of restenosis can be achieved by using self-retaining bicanalicular stent after confirmation of nasolacrimal duct patency. This trial is registered with NCT03731143.

scholarly journals Learning process of ultrasound-guided Ilio-fascial compartment block on a simulator: a feasibility study

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Julien Celi ◽  
Christophe A. Fehlmann ◽  
Olivier T. Rutschmann ◽  
Iris Pelieu-Lamps ◽  
Roxane Fournier ◽  
...  
Keyword(s):  
Medical Students ◽  
Feasibility Study ◽  
Median Number ◽  
Emergency Physicians ◽  
Ultrasound Guided ◽  
Learning Path ◽  
Significant Difference ◽  
The Us ◽  
The Difference ◽  
The Stability

Abstract Background Ultrasound-guided fascia iliaca compartment block (US-FICB) is not part of the learning curriculum of the emergency physicians (EP) and is usually performed by anesthesiologists. However, several studies promote EP to use this procedure. The goal of this study was to assess the feasibility of a training concept for non-anesthesiologists for the US-FICB on a simulator based on a validating learning path. Method This was a feasibility study. Emergency physicians and medical students received a 1-day training with a learning phase (theoretical and practical skills), followed by an assessment phase. The primary outcome at the assessment phase was the number of attempts before successfully completing the procedure. The secondary outcomes were the success rate at first attempt, the length of procedure (LOP), and the stability of the probe, corresponding to the visualization of the needle tip (and its tracking) throughout the procedure, evaluated on a Likert scale. Results A total of 25 participants were included. The median number of attempts was 2.0 for emergency physicians and 2.5 for medical students, and this difference was not significant (p = 0.140). Seven participants (28%) succeeded at the first attempt of the procedure; the difference between emergency physicians and medical students was not significant (37% versus 21%; p = 0.409). The average LOP was 19.7 min with a significant difference between emergency physicians and medical students (p = 0.001). There was no significant difference regarding the stability of the probe between the two groups. Conclusion Our 1-day training for non-anesthesiologists with or without previous skills in ultrasound seems to be feasible for learning the US-FICB procedure on a simulator.

scholarly journals Study on the Effect of Different Doses of Hydromorphone on the Time Response and Postoperative Analgesia of Ropivacaine in Ultrasound-Guided Suprailiac Fascia Inguinal Block

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Baiyun Wang ◽  
Bingbing Hu ◽  
Huanhui Zhong ◽  
Chengda Zhao
Keyword(s):  
Postoperative Analgesia ◽  
Adverse Reactions ◽  
Incidence Rates ◽  
Time Effect ◽  
Ultrasound Guided ◽  
Analgesic Effects ◽  
Vas Score ◽  
Significant Difference ◽  
The Difference ◽  
Different Doses

Objective. To investigate the effects of different doses of hydromorphone under the guidance of ultrasound on ropivacaine blocking the superior inguinal iliac fascia and postoperative analgesia. Methods. From January 2020 to June 2021, 90 American Society of Anesthesiologists (ASA) I-II patients undergoing elective total hip arthroplasty (THA) were selected and randomly divided into 3 groups, 30 patients in each one. Ultrasound-guided superior inguinal iliac fascia block was performed in the patients of the 3 groups before operation. The L group: 0.3% ropivacaine 30 ml; the H1 group: 0.3% ropivacaine + 25 μg/kg hydromorphone 30 ml; the H2 group: 0.3% ropivacaine + 50 μg/kg hydromorphone 30 ml. The time until the occurrence of pain, pain intensity, sufentanil remedial dose, the number of PCIA presses, and effective times were compared among the 3 groups. The VAS and Ramsay scores of 3 groups were recorded at 12 h, 24 h, 36 h, and 48 h after operation. Results. The time from the end of surgery to the appearance of pain in the H2 group was higher than that in the H1 group and the L group, and the time in the H1 group was higher than that in the L group ( P < 0.05 ). The VAS score in the H2 group was lower than that in the H1 group and the L group, and the VAS score in the H1 group was lower than that in the L group ( P < 0.05 ). The VAS scores of 12 h, 24 h, 36 h, and 48 h after operation in the H2 group were lower than those of the H1 group and the L group, and the H1 group was lower than the L group ( P < 0.05 ). The Ramsay scores at 12 h, 24 h, 36 h, and 48 h after operation in the H2 group and the H1 group were higher than those in the L group ( P < 0.05 ), and the difference was not statistically significant in the H2 group and the H1 group ( P > 0.05 ). The remedial dosage of sufentanil, times of PCIA compression, and effective times in the H2 group were lower than those in the H1 group and the L group, and the level in the H1 group was lower than that in the L group ( P < 0.05 ). The incidence rates of adverse reactions in the L group, the H1 group, and the H2 group were 13.33%, 23.33%, and 30.00%, respectively. There was no significant difference in the incidence rate of adverse reactions among the 3 groups ( P > 0.05 ). Conclusion. 25 μg/kg and 50 μg/kg hydromorphone used in the ultrasound-guided superior inguinal iliac fascia block can enhance the time effect of ropivacaine and improve analgesic effects, with good safety. In addition, time effect and analgesic effect of 50 μg/kg hydromorphone in enhancing ropivacaine were more obvious.

scholarly journals Comparison of ropivacaine alone or with dexamethasone as an adjuvant for reducing pain during positioning for neuraxial blockade with ultrasound-guided fascia iliaca compartment block

2020 ◽  
Vol 8 (6) ◽  
pp. 2270
Author(s):  
Suvir Dubey ◽  
Uday Ambi ◽  
Priya Taank ◽  
Shalendra Singh ◽  
Vikas Marwah
Keyword(s):  
Blood Pressure ◽  
Hip Fracture ◽  
Ultrasound Guided ◽  
Rescue Analgesia ◽  
Gradual Improvement ◽  
Neuraxial Blockade ◽  
Significant Difference ◽  
Group A ◽  
The Difference ◽  
Group B

Background: Comparison of ropivacaine alone or with dexamethasone as an adjuvant for reducing pain during positioning for neuraxial blockade with ultrasound-guided fascia iliaca compartment block.Methods: In this double-blinded study, a total of 60 patients between 18 to 80 years of age, undergoing surgery for hip fracture were enrolled. Patients in Group A received 40 ml of 0.25% ropivacaine +2 ml saline and patients in Group B received 40 ml of 0.25% ropivacaine +8 mg dexamethasone. USG guided FICB and postoperative monitoring was done by the chief investigator who was unaware of group allotted and drug administered.Results: There is no significant difference in the heart rate between the two groups after 30 min of the block. The variation of systolic blood pressure of both the group for the first 30 min after giving FICB block was not significant (p>0.05). The absolute value of diastolic blood pressure (DBP) was significantly lower in Group B compared to group A just before the block, a variation of DBP with time was not significant. There was a gradual improvement of pain score from mean 6.7 in Group A and 6.6 in Group B at 0 min to score of 2 at the end of 30 min in both the group. This improvement was achieved earlier in Group B compared to Group A, although the difference was not significant (p>0.05). Vital parameters like HR, SBP, DBP, SpO2 values were similar in both the groups. No patients in either group required any interventions both pre-operatively and pos-operatively. Time of rescue analgesia was noted with the VAS score was significantly more in Group B (p≤0.004). The incidence of hematoma, accidental intravascular injection, convulsion, and paresthesia were nil in both groups.Conclusions: Although both the groups had comfortable and pain-free positioning for administering spinal anaesthesia before surgery. USG guided FICB is easy to perform block and give excellent analgesia for positioning and mobilization of hip fracture patients pre and post-operatively both, and dexamethasone as an adjuvant to 0.25%ropivavaine prolong its local anesthetic effect significantly.

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