#iris publishers

[clinicalnursing]

Comparison of Pulse Oximetry and Capnography Monitoring with Arterial Blood Gases Parameters among Postoperative Pediatric Cardiac Surgeries at a University Hospital

Authored by  Nahla Shaaban Khalil*

Abstract

Background: Pediatric patients undergone mechanical ventilation after cardiac surgeries need rapid and reliable evaluation of their respiratory status. Monitoring of pulse oximetery and capnography as a surrogate, noninvasive measurement of arterial oxygen saturation (Sao2) and arterial carbon dioxide tension (PaCo2) became important respiratory monitoring.

The aim of the study: Was to compare pulse oximetery and capnography monitoring values with arterial blood gas parameters among postoperative pediatric cardiac surgeries.

Subjects and Methods: A descriptive correlational design was adopted utilizing a convenience sample of 88 pediatric patients with cardiac anomalies who undergoing total repair surgeries, intubated for mechanical ventilation and had an indwelling arterial catheter as part of their evaluation in postoperative period were included in the study. Patient’s demographic, clinical relevant data as well as invasive and noninvasive monitoring of arterial oxygen saturation and arterial carbon dioxide partial pressure were utilized in data collection

Results: Statistical analysis demonstrated mean differences between Sao2 and Spo2 (98.2 ±1.6% and 97.5±2.4% respectively; p=0.024)) as well as the mean difference between PaCo2 and PetCo2 (36.9±6.9mmHg and 33.1±7.7mmHg respectively; p <0.001). As well, a significant positive correlation was found between the mean Sao2 and Spo2 (r= 0.935, p<0.001) as well as, between the mean PaCo2 and PetCo2 (r= 0.930, p<0.001).

Conclusion It can be concluded that Spo2 and EtCo2 values are positively correlated with Sao2 and PaCo2 in mechanically ventilated pediatric patients after cardiac surgeries. Therefore Spo2 and EtCo2 monitoring can be used as a continuous, non-invasive predictor for Sao2 and PaCo2.

Keywords: Pulse oximetry; Capnography; Arterial blood gases; Congenital heart defects

Introduction

Pediatric patients on mechanical ventilation after cardiac surgeries are in a vulnerable period that requiring continuous and comprehensive monitoring and every single change in the patient’s physiological variables are taken into account [1]. Pediatric patients who undergo cardiac surgery are at risk for developing respiratory insufficiency after cardiac surgery as a result of the effects of general anesthesia, the surgical procedure and inflammatory response to cardiopulmonary bypass, therefore, they need careful management of mechanical ventilation for supporting oxygenation and ventilation [2]. Arterial blood gases is the gold standard for the assessment of oxygenation and ventilation [3]. However, there are several complications and limitations of arterial blood sampling which can arise from arterial puncture or presence of indwelling arterial catheter especially in pediatrics which includes local hematoma, artery vasospasm, infection at the puncture site, hemorrhage, arterial occlusion, air or thrombus embolism and local pain. Moreover, sampling is intermittent, timeconsuming and delay in obtaining results which can affect the clinical decision about patient management [4]. Pulse oximetry and capnography technology became monitoring standard in critical care units and commonly useful for accompanying mechanical ventilation management [5]. Pulse oximetry is an effective method for continuous and non-invasive monitoring of arterial oxygen saturation using a probe attached to different body sites which can lead to a more rapid treatment of serious hypoxemia, used for titration of inspired oxygen and wean mechanical ventilation [6]. Capnography is a useful noninvasive and continuous monitoring tool for arterial carbon dioxide tension. PetCo2 monitoring provides an assessment of the adequacy of ventilation also it can be used for confirming correct ETT placement, early warning for loss of the ventilator circuit integrity and changes in cardiopulmonary status [7]. Hence, the direction towards non-invasive methods for continuous monitoring of Sao2 and PaCo2values should be used followed to facilitate clinical diagnosis and treatment. In addition to avoiding complications related to invasive monitoring and helps in reducing medical cost [8].

For More Open Access Journals in Iris Publishers Please click on: https://irispublishers.com/ For More Articles in Iris Journal of Nursing & Care https://irispublishers.com/ijnc/

For more information: https://irispublishers.com/ijnc/fulltext/comparison-of-pulse-oximetry-and-capnography-monitoring-with-arterial-blood-gases-parameters.ID.000520.php

[irispublishersresearchandreviews]

Book Review ‘Sejarah Dan Kesan-Kesan Sejarah Kuala Selangor’ (Malay Version) - Iris Publishers

Scientific Journal of Research & Reviews (SJRR)

Written by Yusoff Hasan, the publication of this book is expected to benefit the people of Kuala Selangor especially and throughout Malaysia in general. The writer’s desire to write this book is at the insistence of some of his friends and his wife as to the extent of students, university student students, teachers in college practice coming to meet him. They came to ask the history of Kuala Selangor for a thesis in history studies. Every school break, they come to Kuala Selangorr to know their history. It can be said every week of every school holidays, as well as every general leave, some delegations come to see the historical places in Kuala Selangor, but none of them are specific. As the Secretary of the Malaysian Historical Society of Kuala Selangor, the writer feels it is the responsibility of the author to provide it. From this situation the writer tries to collect some materials, interviews, interviews from some of the elders as well as save documents about the history of Kuala Selangor since 1975 again.

To read more:  Full text

For More Open Access journals Iris Publishers

For More Articles in journal in Scientific Journal of Research & Reviews (SJRR)

[irispublishersfashion]

Iris Publishers_Journal of Textile Science & Fashion Technology

Authored by Ui-Jeen Yu*

Use of the contact dyeing method and natural mordants may have potential for reducing wastewater and developing a more sustainable method for natural dyeing. However, few studies have investigated colorfastness of naturally dyed fabrics using a contact dyeing method. Thus, the purpose of this study was to examine colorfastness to laundering of naturally dyed fabrics using contact dyeing and a natural mordant in relation to different mordant concentrations, mordanting procedures, and heating times. Mashed blueberries were sprayed on bleached cotton fabrics. Vinegar, a mordant, was applied in different concentrations: 25, 50, or 100% on the fabric. Mordanting treatment was applied in pre-, consecutive-, or postdyeing procedures. After dyeing, specimens were heated in a microwave for 10, 15, or 20 minutes and dried before colorfastness testing. AATCC 61 Colorfastness to laundering was conducted. Results indicated extended heat exposure, and pre-and post-mordanting procedures yielded better colorfastness to laundering. However, overall colorfastness to laundering of the contact-dyed cotton fabrics was poor to moderate, below acceptable performance standards for apparel products. Further research on different dye substances, natural mordants, heating methods, and heating times is needed to improve colorfastness of contact-dyed fabrics to laundering as well as to expand the use of sustainable contact-dyeing for consumers and the environment.

For More Open Access Journals in Iris Publishers Please click on: https://irispublishers.com/   For More Articles in Journal of Textile Science & Fashion Technology https://irispublishers.com/jtsft/

For More Information: https://irispublishers.com/jtsft/fulltext/examination-of-colorfastness-to-laundering-of-naturally-dyed-fabrics-using-contact-dyeing-method-with-blueberries.ID.000547.php

[irispublishersengineeringscience]

Iris Publishers - Global Journal of Engineering Sciences (GJES)

Design and Implementation of the Astable Multivibrator

Authorized by Edward Ong Yong Seng

This progress report covers the design and implementation of the Astable Multi-vibrator. An Astable Multi-vibrator consists of two amplifying stages connected in a positive feedback loop by two capacitive-resistive coupling networks. The amplifying elements may be junction or field-effect transistors, vacuum tubes, operational amplifiers, or other types of amplifier.

transistors, vacuum tubes, operational amplifiers, or other types of amplifier. The circuit is usually designed in a symmetric form as a cross-coupled pair. Two output terminals can be defined at the active devices, which will have complementary states; one will have high voltage while the other has low voltage, (except during the brief transitions from one state to the other).

Circuitry testing and troubleshooting were carried out in the Astable Multi-vibrator in both designs. The latter wasn’t implemented due to the big difference between the mark/space ratio of 1:100.

To read more about this article: Engineering Sciences

To know more about Journals: Iris Publishers

For more Information: https://irispublishers.com/gjes/fulltext/design-and-implementation-of-the-astable-multivibrator.ID.000554.php

[clinicalnursing]

Effect of Body Wash with Tea Tree Oil on the Prevention of Methicillin–Resistant Staphylococcus aureus in Critically Ill Patients at a university hospital in Egypt

Authored by Nahla Shaaban Khalil

Abstract

Background: Colonization with Methicillin-Resistant Staphylococcus aureus (MRSA) is independently is associated with mortality in critically ill adults. Tea tree has broad bactericidal activity. Clinical evidence supports its efficacy in eradicating MRSA, but there are no published data on its role in preventing MRSA colonization.

The aim of the study: To determine whether the daily use of 5% tea tree oil compared with standard care (soap and water) had a lower incidence of Methicillin-Resistant Staphylococcus aureus colonization.

Material and Methods: A quasi-experimental design was utilized and conducted at the neurological, intensive care units at Mansoura University Hospital including 120 adult critically ill patients participated in the study.

Results: There were highly statistically significant differences between the study and control groups on the seventh day. So, all the study group subjects’ swabs from nose and groin were free from MRSA, while all the control group subjects’ swabs showed positive for MRSA infection.

Conclusion and recommendations: Tea tree oil is effective in preventing MRSA infection. Therefore, the establishment of using tea tree oil in the prevention of MRSA infection and further researches are highly recommended on a larger probability sample in the different geographical hospitals in Egypt to ensure generalization of findings.

Keywords: Tea tree oil; Critically Ill patients; MRSA

Introduction

MRSA is a major nosocomial pathogen that causes severe morbidity and mortality rate in many hospitalized patients especially critically ill patients and considered one of the main causes of the death worldwide [1]. It is the leading cause of life threating problems such as bloodstream infection, pneumonia, surgical site infection, arthritis, osteomyelitis, and endocarditis if not treated quickly; MRSA can cause sepsis and death [2,3]. Moreover, MRSA infection leads to increased hospitalization length and health care costs [4]. Its prevalence in Egypt is high compared to other African countries. Its prevalence of HA-MRSA increased from 48.5% in 2005 to 69.1% in 2013 and CA-MRSA 23.3% to 60% [5]. Furthermore, about two billion people worldwide carry Staphylococcus aureus, between 2 million and 53 million people in the United States (USA) carry MRSA [6]. Mortality rate due to MRSA is 50 % and higher for patients infected with MRSA in intensive care unit [7]. According to centers for disease control and Prevention (CDC) approximately 2.3 million individuals in the USA diagnosed with MRSA, approximately 86% of persons diagnosed with MRSA associated nosocomial or health care infection and 14% were community infection, 94,000 cases are MRSA infection and 11,000 dies from MRSA infection in the USA each year [8]. Approximately 25-35 % of the populations carry Staphylococcus aureus bacteria on the skin or nose is generally harmless, the bacteria enter the body through a cut of the skin or another open wound [9]. MRSA infection symptoms generally begin as swollen, painful red bumps that may resemble pimples or spider bites. In addition, it has a wide range of symptoms depending on the infected part of the body. The affected area may be redness, warm to touch, abscess and fever [10]. Critically ill patients usually are exposed to a number of intrinsic and extrinsic factors in ICU increased risk of MRSA. Typically, the patients have multiple invasive procedures or devices as intravenous tubing, hemodialysis catheters, urinary catheters, mechanical ventilation and tracheotomy that may contribute to limitation of patients positioning and mobility, even so, increasing the risk of MRSA occurrence [11]. Moreover, length of ICU stay, antibiotic use, diminished immune response, old age, superficial wound, MRSA colonization adds to comorbidity as diabetes and chronic disease side by side with the patient underlying disease contribute to MRSA development [12]. Additionally, it has been noted that health care workers have an increased risk of colonization and contribute to the transmission of MRSA infections in hospitals [13]. Today, MRSA is not a response to antibiotics therapy; it becomes resistant to beta-lactam antibiotics and causes serious complications [14]. In recent years, natural products such as herbal medicine and essential oil spread increasingly owning to plant naturally derived oil like tea tree oil (TTO). it’s a safe and effective herbal source of therapeutic help in the health care system all over the world [15]. TTO has antimicrobial, antifungal and antiviral, and anti-inflammatory properties due to the presence of a compound that is known terpinene-4 [16,17]. In addition, TTO is safe and well tolerated by patients, and considered as an alternative therapy to prevent and treat MRSA infection [18].

Complementary therapy must be integrated into nursing practice to provide a high standard of holistic care and positive outcomes for the patients, their basic philosophies have been a part of the nursing profession since its beginnings .Critical care nurses should be aware of the legal and ethical obligation related to the use of that herbal therapy in order to promote a healing environment [19].

For More Open Access Journals in Iris Publishers Please click on: https://irispublishers.com/ For More Articles in Iris Journal of Nursing & Care https://irispublishers.com/ijnc/ For more information: https://irispublishers.com/ijnc/fulltext/effect-of-body-wash-with-tea-tree-oil-on-the-prevention-of-methicillin-resistant-staphylococcus-aureus-in-critically-ill-patients-at-a-university.ID.000519.php

[irispublishersengineeringscience]

Iris Publishers - Global Journal of Engineering Sciences (GJES)

Outside the Site Boundary

Authorized by Chan Kwan Fai Timothy

Site boundary is an important concern in the civil engineering field. Site boundary represents the extent of liability a person, group of people or even the whole society owed. Two issues may be resulted if our works have been implemented outside the site boundary. First, it may trespass to others and may damages their properties. Second, it may increase the cost of construction due to money spent on dispensable works. Owing to the extra cost and liability resulted, civil engineer used to consider the issue of site boundary.

To read more about this article: Engineering Sciences

To know more about Journals: Iris Publishers

For more Information: https://irispublishers.com/gjes/fulltext/outside-the-site-boundary.ID.000551.php

[clinicalnursing]

Evaluation of Adherence to the Guidelines of Clinical Practice of Vascular Lines by the Nursing Staff of the UMAE H.E. N.- 14 C.M.N. “A.R.C.” Veracruz Norte

For More Open Access Journals in Iris Publishers Please click on: https://irispublishers.com/ For More Articles in Iris Journal of Nursing & Carehttps://irispublishers.com/ijnc/ For more information: https://irispublishers.com/ijnc/fulltext/evaluation-of-adherence-to-the-guidelines-of-clinical-practice-of-vascular-lines-by-the-nursing-staff.ID.000518.php

Authored by  Jose Maria Domínguez Ruiz

Abstract

Introduction: Clinical practice guidelines are proposed to improve the quality of care. Its purpose is to establish a national reference to guide the making of clinical decisions based on recommendations based on the best available scientific evidence. The perspective of nursing in the 21st century is that all nurses look for evidence and apply it in their daily practice, in order to reflect on the assumptions considered as true and that guide the practice of day-to-day life, and which the impact and results of these interventions are routinely evaluated on patients.

Objective: To analyze the attachment to the prevention, diagnosis and treatment of infections related to vascular lines according to the recommendations of the clinical practice guide in the nursing staff of the intensive care unit in the High Specialty Medical Unit Number 14.

Material and methods: Observational, prospective and cross-sectional study, through review of 112 clinical files of patients with central venous catheters of the intensive care unit in the highly specialized medical unit number 14 Veracruz, Veracruz, Mexico, from August 2017 to November 2018. Incomplete files were excluded. To evaluate the adherence according to the recommendations of the clinical practice guideline, the single card of prevention, diagnosis and treatment of vascular-related infections was used, an adequate adherence was considered greater than 80%.

Results: It was discovered that 73% did not adhere to the recommendations of the clinical practice guide, while 18% had medium attachment and only 9% had attachment. Of this percentage, 7% corresponds to the night shift, with the evening shift being the one that does not show adherence to the recommendations. 9% attachment for seniority: less than 5 years (2.25%), 6-15 years (2.25%), 16-25 years (2.25%), more than 26 years (2.25%).

Conclusion: There is a need to continue with the continuous training and it is suggested to carry out an educational intervention to later evaluate in order to improve the results. It follows that no personal impulse has been shown in the research development on the subject.

Keywords: Attachment; Clinical Practice Guideline; Vascular line management; Evaluation of adherence

Introduction

The epidemiological profile that currently characterizes the national health system is dominated by diseases that are difficult to manage, as well as injuries generated by determinants of a complex nature related to both the living conditions of society and the abilities of people to make decisions. in favor of your own health and that of yours. As part of the use of high technology, the use of intravascular catheters is a fundamental tool in the monitoring and treatment of patients admitted to health institutions, regardless of the complexity of their condition; they are of vital importance especially in those that are in critical condition [1].The use of venous catheters is relatively recent, they appear in the literature in the year 1900 and in 1929, Werner Fossmann underwent central venous catheterization with cadavers, until 1957 Ross introduces the basic principles of intravenous therapy. However, in 1970, Swan The epidemiological profile that currently characterizes the national health system is dominated by diseases that are difficult to manage, as well as injuries generated by determinants of a complex nature related to both the living conditions of society and the abilities of people to make decisions. in favor of your own health and that of yours. As part of the use of high technology, the use of intravascular catheters is a fundamental tool in the monitoring and treatment of patients admitted to health institutions, regardless of the complexity of their condition; they are of vital importance especially in those that are in critical condition [1].The use of venous catheters is relatively recent, they appear in the literature in the year 1900 and in 1929, Werner Fossmann underwent central venous catheterization with cadavers, until 1957 Ross introduces the basic principles of intravenous therapy. However, in 1970, Swan

Historically, intravenous infusion therapy has contributed, in an important way, in the development of better treatments for health care. However, this procedure also poses serious risks for patients and for health service providers, since hospital stay (bed days) and spending due to adjacent complications are increased. The world literature has extensively described infectious complications and other problems such as extravasation, infiltration and occlusion, as a threat to the integrity of the patient because when they worsen, they are associated with considerable morbidity and an increased risk of death[4].Infections associated with a central catheter account for 10% of hospital infections; being the skin, the hematogenous route, the contamination of the connection system, the use of solutions and / or contaminated food, some of the routes by which they are produced. The incidence of infections associated with the vascular catheter varies depending on factors of the host, the catheter and its handling. There are specific factors described that correspond to the catheter, its location, the method of installation, the nature of placement in an emergency or elective situation, the number of lumens, the duration of catheterization and the characteristics of the host. Infections related to these vascular accesses increase morbidity, mortality, days of hospitalization and, consequently, costs for both the patient and the institutions. Therefore, they must be used under certain criteria, with infectious norms, assessing the particular benefit cost of each patient, since it is not a procedure free of other complications, risks and / or adverse events. The World Health Organization has shown that the prevention and protection of those risks that may endanger the well-being and life of the patient can be diminished through the implementation of checklists during the surgical act. In the same way, the consequences of those events that we must assume inevitably can be reduced. It is essential to have a prospective surveillance system for the assessment of infections and adverse events associated with vascular catheters. Thus, a checklist of patient safety with central venous catheter was implemented, which covers the procedure and follow-up of the patient with CVC; with the intention of improving the quality of care, providing patient safety, and reducing morbidity and mortality as well as hospital stay and health costs [5].

For More Open Access Journals in Iris Publishers Please click on: https://irispublishers.com/ For More Articles in Iris Journal of Nursing & Care https://irispublishers.com/ijnc/

For more information: https://irispublishers.com/ijnc/fulltext/evaluation-of-adherence-to-the-guidelines-of-clinical-practice-of-vascular-lines-by-the-nursing-staff.ID.000518.php 

[clinicalnursing]

Is complementary therapy (Vitamin D) effective among Psychiatric disorder? (Depression)?

Authored by  Qusai Mohammed Harahsheh

Literature Review

The relationship between vitamin D and depression was clarified in many studies, some of this studies shown that there is a strong relationship between vitamin D and depression and shown that positive effect of vitamin D among patient with depressive disorder such as decreasing depressive symptoms like worthless, hurt restless, hopeless and feeling empty and cost effective and other positive effects comparing with antidepressants medication. On the other hand few studies shown that there is no relationship between vitamin D and depressive disorder, and it’s just improve the bone tissue with calcium assistance. On this literature review the current author will clarify many articles related to the relationship between vitamin D and the depressive disorder. Studies found positive effect of vitamin D on Depressive disorder many studies shown positive effect of vitamin D on depressive disorder and many studies shown that there is a relationship between decreasing vitamin D and increasing depressive symptoms severity(Jisheng Zhane et al 2014) found that the people with low serum of vitamin D has a higher severity depressive symptoms compared with people with normal vitamin D level, on the same time in this experimental article the author use vitamin D supplementation for group of people with severe depressive symptoms within specific period of time and concluded that there is a positive effect in decreasing the severity of symptoms (JishengZhane., et al 2014) , moreover the smart point on this article was using the vitamin D supplementation just in winter to avoid important external factors like seasonal factors and sun light strength, on same time the author linked between the chronic diseases which prevent people spending time out door (under sun light) and vitamin D deficiency which may increase the severity of depressive symptoms which reflect the 2nd reason to choose winter season.

Furthermore, an experimental study done in summer 2009 for 44 healthy student given vitamin D supplementation for 5 days resulting on improving their mood in that period compared with pre supplementation status by using specific tool after and before the experiment [6].Moreover [6] conclude that the higher level of vitamin D in human body has strong relationship with preventing depression.

Moreover a study done in U.S. for 18875 young adults population to link between the concentration of serum vitamin D and depression, by using specific tool for assessment (Diagnostic interview schedule), the sample age was 15-39 years old, they estimate an odd ratio after analyzing the data for vitamin D deficiency and having depression, compared with persons which have normal vitamin D value [7]. On the same topic [7] shown many characteristic which considered as a higher provenance of vitamin D deficiency, this characteristic are below poverty people, female gender, persons which didn’t get supplements, non-Hispanic, black people higher BMI people, west regions and south regions European cities and people who have at least one depressive episode, all of characteristic have ≤ 50 mole/liter, vitamin D serum which mean vitamin D deficiency, this number looked very low compared with 75 mole/liter of serum vitamin D within other people.

The most important result of [7] articles that early diagnoses and actions for vitamin D deficiency and depression have important positive consequences amount people health. Moreover photo therapy may use for depression treatment, (shipowick et al 2009) make an experimental studies for six patient of depression by give vitamin D 5000 IE/day for three participant and the other three patient staying from 3-6 hours under the sum light in specific time of the day, all of them shown good consequences.

Studies shown that negative relationship between depression and vitamin D

Actually there is little studies found no relationship between vitamin D and depression, a study in UAE in 2013 for 141 employees from different majors in Abu Dhabi shown that the effect of sun exposure on depression may come from the life style and the routine daily activity then lead to depression which lead to isolation and staying at home which resulting on prevent exposure to sun light (Al-Anouti., et al 2013).

On the other hand, many studies didn’t mention vitamin D deficiency as a cause of depression or vitamin D may use as a type of complementary therapy for depressed patient , (Rashid and Heieder, 2008) study consider the childbirth, economical status, work issue, natural tragedies, menopause age, social dysfunction, religion, spiritual issues, all of them considered as depression causes, on the other hand they didn’t mentions anything related to vitamin D or vitamin D deficiency to be more specific.Moreover, the chines study for chines population in 2009 which focused in the elderly and middle age people to study the relationship between 25-hydroxyvitamin D and depressive symptoms conclude that there is no relationship between vitamin D and depression (pan et al 2009).Moreover, European study worked on the relationship between the neuropsychological function and the seven of 25-hydroxlvitamin D levels and parathyroid hormone in 206 shown that there is no relationship between vitamin D and depression.

For More Open Access Journals in Iris Publishers Please click on: https://irispublishers.com/ For More Articles in Iris Journal of Nursing & Care https://irispublishers.com/ijnc/

For more information: https://irispublishers.com/ijnc/fulltext/is-complementary-therapy-vitamin-d-effective-among-psychiatric-disorder-depression.ID.000517.php