ABSTRACT
Objective
The objective of the study was to assess the efficacy of immediate skin-to-skin care (SSC) versus swaddling in pain response to intramuscular injection of vitamin K at 30 min of ...birth in neonates.
Methods
Healthy full-term newborns were enrolled immediately after normal vaginal delivery and randomized in two groups, SSC and swaddling. Neonatal Infant Pain Scale (NIPS) was measured before, immediately after and at 2 min after the injection.
Results
Total 100 newborns were enrolled in the study (50 in each group). The mean (SD) birth weight of newborns in the SSC and swaddling group was 2668 (256) and 2730 (348) g, respectively. NIPS was comparable between the SSC and swaddling at before 1.78 (0.58) vs. 1.96 (0.83), p = 0.21, and immediately after the injection 4.82 (0.72) vs. 5.08 (0.75), p = 0.08. NIPS at 2 min after the injection was significantly low in the SSC group compared to the swaddling group 1.38 (0.70) vs. 2.88 (1.00), p < 0.001. At 2 min after injection, the NIPS score was significantly lower than baseline in the SSC group (p = 0.002), while it was significantly higher in the swaddling group (p < 0.001). A significantly higher proportion of newborns had a NIPS score of more than three at 2 min after injection in the swaddling group as compared to the SSC group (22% vs. 2%, p < 0.001).
Conclusion
Immediate SSC was more efficacious as compared to swaddling as a pain control intervention while giving vitamin K injection.
Clinical Trial Registration
The trial is registered with the Clinical Trial Registry of India with Registration number: CTRI/2020/01/022984.
Lay Summary
Skin-to-skin care and swaddling are commonly used non-pharmacological measures to reduce pain perception in neonates for invasive procedures like heel prick, venipuncture and vaccination. We did this randomized control trial to compare the efficacy of immediate skin-to-skin care after birth vs. swaddling for reducing neonatal pain associated with intramuscular injection of vitamin K at 30 min after birth. We observed that the immediate skin-to-skin care, a standard of care, is more efficacious in controlling pain compared to swaddling for giving routine intramuscular vitamin K injection within one hour of birth.
Ameloblastoma is an odontogenic tumor that is locally invasive and epithelial in origin and accounts for 1% of all jaw tumors and cysts. The body and ramus region of the mandible is where it is most ...commonly found in the third and fourth decades of life usually. Multicystic ameloblastoma is thought to be the most aggressive kind of ameloblastoma with a high recurrence rate. Surgical treatments are aggressive in nature like marginal or segmental resection have been practiced but conservative managements such as decompression, enucleation, or curettage are also being employed. This case report aimed to demonstrate the conservative management of multicystic ameloblastoma presented in the second decade of life and analyze the treatment outcomes for the same.
The ring structure has an inherent symmetry that can be used to focus light to a single in‐plane spot for near‐field plasmonic applications. However, when excited with a linearly polarized light, it ...yields split focal spot at the center due to destructive interference of surface plasmon polaritons (SPPs). Here, twin configurations of a slit‐based plasmonic lens for in‐plane focusing of a linearly polarized light are proposed. Lenses are designed based on the ring geometry in order to exploit symmetric nature of the ring structure. Either a metallic or a dielectric semicircular protrusion is introduced in the symmetric ring structure for compensating the phase mismatch between SPPs counter‐propagating from two sides of the ring. The focusing properties of the lenses are analyzed using finite‐difference time‐domain simulations. A single focal spot with full width at half maxima of 0.27λ0 and 0.28λ0 is obtained for plasmonic lenses with metallic and dielectric protrusions, respectively. Thus the diffraction limit is beaten by focusing the light to a subwavelength region of approximately quarter its wavelength. The lenses have potential applications in nanosensing, nanoimaging, and nanolithography, wherein closely populated focused spots are desired using linearly polarized excitation.
Twin configurations of a slit‐based plasmonic lens are proposed for in‐plane focusing of a linearly polarized light to a single spot. To analyze the focusing properties of lenses, finite‐difference time‐domain simulations are performed. The proposed lenses beat the diffraction limit by focusing light to a subwavelength region of approximately quarter its wavelength. These lenses have potential applications in nanosensing, nanoimaging, and nanolithography.
In this investigation, numerical analysis of square butt, butt with V-groove and T-weld joint configurations have been performed to estimate transient temperature distributions and residual stresses. ...A computational welding simulation based on a prescribed temperature approach was used that works on thermal load input derived from temperature analysis. In the thermal analysis, welding heat source or torch temperature was considered as the prescribed value of temperature, which helps in simulating real welding conditions. The inclusion of filler metal in the numerical analysis replicates the real welding phenomenon, which provides temperature distribution along the true distance of the joints. The maximum temperature was observed at the weld pool area and decreased in parabolic shape toward the base metal. Residual stresses were measured along the selected path (in the mid of plates) that comprises node-to-node variation of stresses in both longitudinal and transverse directions. von Mises and Tresca stress criterion was adopted to show accumulated stresses in the weld joints. It was observed that stresses accumulated in the different configurations of weld joints were below the yield strength 210 MPa of SUS304 steel. Peak values of stresses were observed at weld beads and in the nearby regions.
PurposeThe key purpose of conducting this review is to identify the issues that affect the structural integrity of pipeline structures. Heat affected zone (HAZ) has been identified as the weak zone ...in pipeline welds which is prone to have immature failuresDesign/methodology/approachIn the present work, literature review is conducted on key issues related to the structural integrity of pipeline steel welds. Mechanical and microstructural transformations that take place during welding have been systematically reviewed in the present review paper.FindingsKey findings of the present review underline the role of brittle microstructure phases, and hard secondary particles present in the matrix are responsible for intergranular and intragranular cracks.Research limitations/implicationsThe research limitations of the present review are new material characterization techniques that are not available in developing countries.Practical implicationsThe practical limitations are new test methodologies and associated cost.Social implicationsThe fracture of pipelines significantly affects the surrounding ecology. The continuous spillage of oil pollutes the land and water of the surroundings.Originality/valueThe present review contains recent and past studies conducted on welded pipeline steel structures. The systematic analysis of studies conducted so far highlights various bottlenecks of the welding methods.
Background: Maize (Zea mays L.) is one of the important cereal crop and its demand is increasing due to its versatile use but the productivity in India is still low. The basic requirement for ...improving the crop productivity is soil fertility and it is highly related with soil organic matter. Due to unavailability of organic manure and their higher cost, cheaper the organic source available at farm should be explored to meet the requirement.Methods: A field experiment was conducted at College Agronomy Farm, B.A. College of Agriculture, AAU, Anand during summer-kharif seasons of years 2017 and 2018 to examine the impact of legume crop residue and nitrogen levels on maize crop. Experiment comprised of three legume crops grown in summer season viz., green gram, groundnut and cluster bean, two residue management treatments viz., residue removal and incorporation and three nitrogen levels in kharif maize viz., 100%, 75% and 50% recommended dose of nitrogen.Result: Results indicated that cluster bean-maize sequence provided the highest leaf area and leaf area index at 60 days after sowing, chlorophyll content and dry matter production at 30 and 60 days after sowing and crop growth rate for of maize crop. Incorporation of legume residues also had significant effect on plant height, dry matter production and chlorophyll content; leaf area and leaf area index at 60 days after sowing and crop growth rate and absolute growth rate of maize crop. Application of 100% RDN beneficially affected all the growth parameter and indices. Overall, summer legume cropping with their residue incorporation and higher nitrogen levels favourably impacts on various growth parameters and growth indices of maize crop.
Partial splenic artery embolization (PSAE) is an alternative treatment modality for managing hypersplenism secondary to portal hypertension. We are presenting a case series of patients with portal ...hypertension who underwent PSAE for symptomatic hypersplenism.
We included patients with portal hypertension who underwent PSAE from January 2022 to December 2022. Patients' characteristics and procedure related complications were noted. Data were analyzed for improvement in the hematological parameters.
A total of 11 (7 women, median age 34 18–56 years) patients were included. Three patients were cirrhotic (hepatitis B-2, metabolic dysfunction–associated steatotic liver disease −1) and 8 were non-cirrhotic (extra-hepatic portal vein obstruction-5, Non cirrhotic portal fibrosis-3). Splenic artery aneurysm was concomitantly present in 5 cases. Technical success was achieved in all cases. Post embolization, hemoglobin, white blood cells and platelet counts improved at 4 weeks, 12 weeks and 24 weeks along with symptomatic improvement. All patients had post-embolization syndrome. One patient developed transient ascites and secondary bacterial peritonitis which was managed conservatively. One patient died due to splenic abscess and septicemia.
Although, hematological parameters and symptoms improve post procedure, PSAE is associated with major complications and should be performed judiciously in selected cases only. Graphical abstract is presented in Figure 1.
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