1
|
Subedi A, Thapa P, Prajapati R, Schyns-van den Berg AMJV. Effect of height versus height/weight-based spinal bupivacaine on maternal hemodynamics for elective cesarean in short stature patients: a randomized clinical trial. J Anesth 2023; 37:905-913. [PMID: 37709952 DOI: 10.1007/s00540-023-03252-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 08/27/2023] [Indexed: 09/16/2023]
Abstract
PURPOSE Doses of spinal bupivacaine adjusted to patient height or height/weight have been shown to provide hemodynamic stability during cesarean section. However, their effects in short stature parturients are unknown. METHODS In this double-blind, randomized clinical trial, we randomly assigned short parturients (height < 150 cm) undergoing elective cesarean section, to receive doses of intrathecal hyperbaric bupivacaine either height or height/weight-adjusted, in a 1:1 ratio. The primary outcome was post-spinal hypotension (defined as systolic blood pressure [SBP] < 90% of baseline between spinal administration and delivery of the baby). Secondary outcomes included severe post-spinal hypotension (SBP < 80% of baseline), post-delivery hypotension (SBP < 90% and < 80% of baseline), intraoperative bradycardia, nausea and vomiting, shivering, rescue analgesic needed, and spinal block characteristics. RESULTS A total of 112 patients underwent randomization. Post-spinal hypotension (SBP < 90% of baseline) occurred in 52% of the patients in the height/weight group and in 55% in the height group (difference - 3.5%: 95% confidence interval [CI] - 22 to 14.8, P = 0.705). There was no significant difference between the two groups in the occurrences of post-spinal severe hypotension (SBP < 80% of baseline), post-delivery hypotension, and spinal block characteristics. Six patients (11%) in the height/weight group needed intraoperative rescue analgesic compared to none in the height group (P = 0.027). CONCLUSION We found that height-based dosing in short parturients provides the optimal trade-off between intraoperative hemodynamic instability and provision of pain-free anesthesia. TRIAL REGISTRATION clinicaltrial.gov-NCT04082676. https://clinicaltrials.gov/ct2/show/NCT04082676 .
Collapse
Affiliation(s)
- Asish Subedi
- Department of Anesthesiology and Critical Care, BP Koirala Institute of Health Sciences, Dharan, Nepal.
| | - Parineeta Thapa
- Department of Anesthesiology and Critical Care, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | | | | |
Collapse
|
2
|
Fernandes NL, Lilaonitkul M, Subedi A, Owen MD. Global obstetric anaesthesia: bridging the gap in maternal health care inequities through partnership in education. Int J Obstet Anesth 2023; 55:103646. [PMID: 37211512 DOI: 10.1016/j.ijoa.2023.103646] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 02/20/2023] [Indexed: 05/23/2023]
Abstract
Maternal mortality rates are unacceptably high globally. Low- and middle-income countries (LMICs) face challenges of an inadequate anaesthesia workforce, under-resourced healthcare systems and sub-optimal access to labour and delivery care, all of which negatively impact maternal and neonatal outcomes. In order to effect the changes in surgical-obstetric-anaesthesia workforce numbers advocated by the Lancet Commission on Global Surgery to support the UN sustainable development goals, mass training and upskilling of both physician and non-physician anaesthetists is imperative. The implementation of outreach programmes and partnerships across organisations and countries has already been shown to improve the provision of safe care to mothers and their babies, and these efforts should be continued. Short subspecialty courses and simulation training are two cornerstones of modern obstetric anaesthesia training in poorly resourced environments. This review discusses the challenges to accessing quality maternal healthcare in LMICs and the use of education, outreach, partnership and research to protect the most vulnerable women from coming to harm in the peripartum period.
Collapse
Affiliation(s)
- N L Fernandes
- Department of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
| | - M Lilaonitkul
- Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, CA, USA
| | - A Subedi
- Department of Anesthesiology and Critical Care, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - M D Owen
- Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| |
Collapse
|
3
|
Subedi A. Postsurgical events and persistent pain after breast cancer surgery. Anaesthesia 2023. [PMID: 36809675 DOI: 10.1111/anae.15993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2023] [Indexed: 02/23/2023]
Affiliation(s)
- A Subedi
- BP Koirala Institute of Health Sciences, Dharan, Nepal
| |
Collapse
|
4
|
Mahato VK, Dongol A, Acharya P, Yadav AK, Subedi A, Jaisani MR. “Can Perioperative Intravenous Lidocaine Decrease Postoperative Pain After Oral and Maxillofacial Surgeries?”: A Randomized Clinical Trial. J Maxillofac Oral Surg 2022. [DOI: 10.1007/s12663-022-01831-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
|
5
|
Deshar R, Subedi A, Pokharel K, Sah BP, Prasad JN. Effect of glycopyrrolate on vasopressor requirements for non-elective cesarean section under spinal anesthesia: a randomized, double-blind, placebo-controlled trial. BMC Anesthesiol 2022; 22:327. [PMID: 36284288 PMCID: PMC9594911 DOI: 10.1186/s12871-022-01882-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 10/21/2022] [Indexed: 11/20/2022] Open
Abstract
Background The study aimed to investigate whether prophylactic use of glycopyrrolate decreases the vasopressor requirements to prevent hypotension following spinal anesthesia during non-elective cesarean section. Method In this double-blind randomized clinical trial, 258 patients undergoing non-elective cesarean section were randomly assigned (1:1) to receive intravenous 0.2 mg glycopyrrolate or normal saline (placebo) before spinal anesthesia. The primary outcome was phenylephrine equivalent needed intraoperatively. Secondary outcomes included incidences of maternal hypotension, reactive hypertension, bradycardia, need for atropine, tachycardia, intraoperative nausea/vomiting, shivering, pruritus, dry mouth, dizziness; neonatal APGAR score at 1 min and 5 min, neonatal resuscitation needed, NICU admission and neonatal death. Results Three patients withdrew from the study due to failed spinal anesthesia. 128 patients in the glycopyrrolate group and 127 patients in the placebo group were analyzed. The mean phenylephrine equivalent needed was 1108.96 μg in the glycopyrrolate group and 1103.64 μg in the placebo group (mean difference, 5.32 μg [95% CI − 67.97 to 78.62]; P = 0.88). Hypotension occurred in 38 patients (30%) in the glycopyrrolate group as compared with 49 patients (39%) in the placebo group (P = 0.13). Tachycardia was reported in 70% of the participants in the glycopyrrolate group and 57% of those in the placebo group (P = 0.04). No statistically significant difference was noted in hypotensive episodes > 1, reactive hypertension, bradycardia, need for atropine, nausea, vomiting, shivering, and dry mouth between the two groups. Neonatal outcomes were similar in the two groups. Conclusion Prophylactic use of glycopyrrolate does not decrease the requirements of vasopressor to prevent hypotension in non-elective cesarean section under spinal anesthesia. Trial registration Registration number: NCT04401345. Date of registration: 26/05/2020. Website: https://clinicaltrials.gov
Collapse
Affiliation(s)
- Rajesh Deshar
- Department of Anesthesiology & Critical Care Medicine, Bheri Hospital, Nepalgunj, Nepal
| | - Asish Subedi
- grid.414128.a0000 0004 1794 1501Department of Anesthesiology & Critical Care Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Krishna Pokharel
- grid.414128.a0000 0004 1794 1501Department of Anesthesiology & Critical Care Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Birendra Prasad Sah
- grid.414128.a0000 0004 1794 1501Department of Anesthesiology & Critical Care Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Jagat Narayan Prasad
- grid.414128.a0000 0004 1794 1501Department of Anesthesiology & Critical Care Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| |
Collapse
|
6
|
Prasad JN, Adhikari S, Singh SN, Subedi A, Thapa P, Guddy KM, Sarraf DP. Study of Two Different Volumes of 0.75% Ropivacaine for Ultrasound Guided Supraclavicular Brachial Plexus Block on Successful Blockade and Diaphragmatic Motility. Kathmandu Univ Med J (KUMJ) 2022; 20:406-411. [PMID: 37795713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
Background Use of ultrasound guidance during supraclavicular brachial plexus block allows the usage of a lower anesthetics dose and minimizing unwanted effects of the anesthesia. Objective To compare the success of sensory blockade and the incidence of hemidiaphragmatic dysfunction in patients receiving two different volume of 0.75% Ropivacaine for ultrasound guided supraclavicular brachial plexus block. Method A prospective randomized double-blinded comparative study was conducted. Group A patients (n=30) received 20 ml and Group B (n=30) received 25 ml of 0.75% Ropivacaine for ultrasound guided supraclavicular brachial plexus block. Hemodynamic parameters, oxygen saturation, diaphragmatic excursion, onset of sensory blockade and time for completion of blockade were measured. Independent t-test, Chi-square test and Mann-Whitney U test were used to analyze the data at p value of less than 0.05 using Statistical Package for Social sciences (version 11.5). Result At 30 minutes, 29 (96.67%) patients in group B and 27 (90.0%) patients in group A had no sensation in median, radial, ulnar, musculocutaneous and medial cutaneous nerves teritories; however, it was not significant statistically (p value > 0.05). At 30 minutes in Group A, 25 (83.33%) patients had no diaphragmatic hemiparesis and five (16.67%) patients had partial diaphragmatic hemiparesis. However, three (10%) patients had no diaphragmatic hemiparesis in Group B, 25 (83.33%) patients had partial and two (6.67%) patients had complete diaphragmatic hemiparesis and it was statistically significant (p < 0.05). Age and sex had no effect on diaphragmatic hemiparesis in both groups (p value > 0.05). Conclusion The patients receiving lower volume of Ropivacaine had less incidence of hemidiaphragmatic dysfunction with similar sensory blockade as compared to the patients receiving higher volume of Ropivacaine.
Collapse
Affiliation(s)
- J N Prasad
- Department of Anaesthesiology and Critical Care, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - S Adhikari
- Department of Anaesthesiology and Critical Care, Mechi Zonal Hospital, Biratnagar, Nepal
| | - S N Singh
- Department of Anaesthesiology and Critical Care, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - A Subedi
- Department of Anaesthesiology and Critical Care, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - P Thapa
- Department of Anaesthesiology and Critical Care, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - K M Guddy
- Department of Obstetrics and Gynecology, Golden Hospital, Biratnagar, Nepal
| | - D P Sarraf
- Department of Clinical Pharmacology and Therapeutics, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| |
Collapse
|
7
|
Georges F, Rashad MNH, Stefanko A, Dlamini M, Karki B, Ali SF, Lin PJ, Ko HS, Israel N, Adikaram D, Ahmed Z, Albataineh H, Aljawrneh B, Allada K, Allison S, Alsalmi S, Androic D, Aniol K, Annand J, Atac H, Averett T, Ayerbe Gayoso C, Bai X, Bane J, Barcus S, Bartlett K, Bellini V, Beminiwattha R, Bericic J, Biswas D, Brash E, Bulumulla D, Campbell J, Camsonne A, Carmignotto M, Castellano J, Chen C, Chen JP, Chetry T, Christy ME, Cisbani E, Clary B, Cohen E, Compton N, Cornejo JC, Covrig Dusa S, Crowe B, Danagoulian S, Danley T, De Persio F, Deconinck W, Defurne M, Desnault C, Di D, Duer M, Duran B, Ent R, Fanelli C, Franklin G, Fuchey E, Gal C, Gaskell D, Gautam T, Glamazdin O, Gnanvo K, Gray VM, Gu C, Hague T, Hamad G, Hamilton D, Hamilton K, Hansen O, Hauenstein F, Henry W, Higinbotham DW, Holmstrom T, Horn T, Huang Y, Huber GM, Hyde CE, Ibrahim H, Jen CM, Jin K, Jones M, Kabir A, Keppel C, Khachatryan V, King PM, Li S, Li WB, Liu J, Liu H, Liyanage A, Magee J, Malace S, Mammei J, Markowitz P, McClellan E, Mazouz M, Meddi F, Meekins D, Mesik K, Michaels R, Mkrtchyan A, Montgomery R, Muñoz Camacho C, Myers LS, Nadel-Turonski P, Nazeer SJ, Nelyubin V, Nguyen D, Nuruzzaman N, Nycz M, Obretch OF, Ou L, Palatchi C, Pandey B, Park S, Park K, Peng C, Pomatsalyuk R, Pooser E, Puckett AJR, Punjabi V, Quinn B, Rahman S, Reimer PE, Roche J, Sapkota I, Sarty A, Sawatzky B, Saylor NH, Schmookler B, Shabestari MH, Shahinyan A, Sirca S, Smith GR, Sooriyaarachchilage S, Sparveris N, Spies R, Su T, Subedi A, Sulkosky V, Sun A, Thorne L, Tian Y, Ton N, Tortorici F, Trotta R, Urciuoli GM, Voutier E, Waidyawansa B, Wang Y, Wojtsekhowski B, Wood S, Yan X, Ye L, Ye Z, Yero C, Zhang J, Zhao Y, Zhu P. Deeply Virtual Compton Scattering Cross Section at High Bjorken x_{B}. Phys Rev Lett 2022; 128:252002. [PMID: 35802440 DOI: 10.1103/physrevlett.128.252002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 03/28/2022] [Accepted: 04/18/2022] [Indexed: 06/15/2023]
Abstract
We report high-precision measurements of the deeply virtual Compton scattering (DVCS) cross section at high values of the Bjorken variable x_{B}. DVCS is sensitive to the generalized parton distributions of the nucleon, which provide a three-dimensional description of its internal constituents. Using the exact analytic expression of the DVCS cross section for all possible polarization states of the initial and final electron and nucleon, and final state photon, we present the first experimental extraction of all four helicity-conserving Compton form factors (CFFs) of the nucleon as a function of x_{B}, while systematically including helicity flip amplitudes. In particular, the high accuracy of the present data demonstrates sensitivity to some very poorly known CFFs.
Collapse
Affiliation(s)
- F Georges
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - M N H Rashad
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - A Stefanko
- Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - M Dlamini
- Ohio University, Athens, Ohio 45701, USA
| | - B Karki
- Ohio University, Athens, Ohio 45701, USA
| | - S F Ali
- Catholic University of America, Washington, DC 20064, USA
| | - P-J Lin
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - H-S Ko
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
- Seoul National University, 1 Gwanak-ro, Gwanak-gu, 08826 Seoul, Korea
| | - N Israel
- Ohio University, Athens, Ohio 45701, USA
| | - D Adikaram
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - Z Ahmed
- University of Regina, Regina, Saskatchewan, S4S 0A2 Canada
| | - H Albataineh
- Texas A&M University-Kingsville, Kingsville, Texas 78363, USA
| | - B Aljawrneh
- North Carolina Agricultural and Technical State University, Greensboro, North Carolina 27411, USA
| | - K Allada
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - S Allison
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - S Alsalmi
- Kent State University, Kent, Ohio 44240, USA
| | - D Androic
- University of Zagreb, Trg Republike Hrvatske 14, 10000 Zagreb, Croatia
| | - K Aniol
- California State University, Los Angeles, Los Angeles, California 90032, USA
| | - J Annand
- SUPA School of Physics and Astronomy, University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - H Atac
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - T Averett
- The College of William and Mary, Williamsburg, Virginia 23185, USA
| | - C Ayerbe Gayoso
- The College of William and Mary, Williamsburg, Virginia 23185, USA
| | - X Bai
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - J Bane
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - S Barcus
- The College of William and Mary, Williamsburg, Virginia 23185, USA
| | - K Bartlett
- The College of William and Mary, Williamsburg, Virginia 23185, USA
| | - V Bellini
- Istituto Nazionale di Fisica Nucleare, Dipartimento di Fisica delle Università degli di Catania, I-95123 Catania, Italy
| | | | - J Bericic
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - D Biswas
- Hampton University, Hampton, Virginia 23669, USA
| | - E Brash
- Christopher Newport University, Newport News, Virginia 23606, USA
| | - D Bulumulla
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - J Campbell
- Dalhousie University, Nova Scotia, NS B3H 4R2, Canada
| | - A Camsonne
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - M Carmignotto
- Catholic University of America, Washington, DC 20064, USA
| | - J Castellano
- Florida International University, Miami, Florida 33199, USA
| | - C Chen
- Hampton University, Hampton, Virginia 23669, USA
| | - J-P Chen
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - T Chetry
- Ohio University, Athens, Ohio 45701, USA
| | - M E Christy
- Hampton University, Hampton, Virginia 23669, USA
| | - E Cisbani
- Istituto Nazionale di Fisica Nucleare-Sezione di Roma, Piazzale Aldo Moro, 2-00185 Roma, Italy
| | - B Clary
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - E Cohen
- Tel Aviv University, Tel Aviv-Yafo 6997801, Israel
| | - N Compton
- Ohio University, Athens, Ohio 45701, USA
| | - J C Cornejo
- Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
- The College of William and Mary, Williamsburg, Virginia 23185, USA
| | - S Covrig Dusa
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - B Crowe
- North Carolina Central University, Durham, North Carolina 27707, USA
| | - S Danagoulian
- North Carolina Agricultural and Technical State University, Greensboro, North Carolina 27411, USA
| | - T Danley
- Ohio University, Athens, Ohio 45701, USA
| | - F De Persio
- Istituto Nazionale di Fisica Nucleare-Sezione di Roma, Piazzale Aldo Moro, 2-00185 Roma, Italy
| | - W Deconinck
- The College of William and Mary, Williamsburg, Virginia 23185, USA
| | - M Defurne
- CEA Saclay, 91191 Gif-sur-Yvette, France
| | - C Desnault
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - D Di
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - M Duer
- Tel Aviv University, Tel Aviv-Yafo 6997801, Israel
| | - B Duran
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - R Ent
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - C Fanelli
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - G Franklin
- Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - E Fuchey
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - C Gal
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - D Gaskell
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - T Gautam
- Hampton University, Hampton, Virginia 23669, USA
| | - O Glamazdin
- Kharkov Institute of Physics and Technology, Kharkov 61108, Ukraine
| | - K Gnanvo
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - V M Gray
- The College of William and Mary, Williamsburg, Virginia 23185, USA
| | - C Gu
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - T Hague
- Kent State University, Kent, Ohio 44240, USA
| | - G Hamad
- Ohio University, Athens, Ohio 45701, USA
| | - D Hamilton
- SUPA School of Physics and Astronomy, University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - K Hamilton
- SUPA School of Physics and Astronomy, University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - O Hansen
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - F Hauenstein
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - W Henry
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - D W Higinbotham
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - T Holmstrom
- Longwood University, Farmville, Virginia 23901, USA
| | - T Horn
- Catholic University of America, Washington, DC 20064, USA
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - Y Huang
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - G M Huber
- University of Regina, Regina, Saskatchewan, S4S 0A2 Canada
| | - C E Hyde
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - H Ibrahim
- Cairo University, Cairo 121613, Egypt
| | - C-M Jen
- Virginia Polytechnic Institute & State University, Blacksburg, Virginia 234061, USA
| | - K Jin
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - M Jones
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - A Kabir
- Kent State University, Kent, Ohio 44240, USA
| | - C Keppel
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - V Khachatryan
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
- Stony Brook, State University of New York, New York 11794, USA
- Cornell University, Ithaca, New York 14853, USA
| | - P M King
- Ohio University, Athens, Ohio 45701, USA
| | - S Li
- University of New Hampshire, Durham, New Hampshire 03824, USA
| | - W B Li
- University of Regina, Regina, Saskatchewan, S4S 0A2 Canada
| | - J Liu
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - H Liu
- Columbia University, New York, New York 10027, USA
| | - A Liyanage
- Hampton University, Hampton, Virginia 23669, USA
| | - J Magee
- The College of William and Mary, Williamsburg, Virginia 23185, USA
| | - S Malace
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - J Mammei
- University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - P Markowitz
- Florida International University, Miami, Florida 33199, USA
| | - E McClellan
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - M Mazouz
- Faculté des Sciences de Monastir, Monastir 5019, Tunisia
| | - F Meddi
- Istituto Nazionale di Fisica Nucleare-Sezione di Roma, Piazzale Aldo Moro, 2-00185 Roma, Italy
| | - D Meekins
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - K Mesik
- Rutgers University, New Brunswick, New Jersey 08854, USA
| | - R Michaels
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - A Mkrtchyan
- Catholic University of America, Washington, DC 20064, USA
| | - R Montgomery
- SUPA School of Physics and Astronomy, University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - C Muñoz Camacho
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - L S Myers
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - P Nadel-Turonski
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S J Nazeer
- Hampton University, Hampton, Virginia 23669, USA
| | - V Nelyubin
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - D Nguyen
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - N Nuruzzaman
- Hampton University, Hampton, Virginia 23669, USA
| | - M Nycz
- Kent State University, Kent, Ohio 44240, USA
| | - O F Obretch
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - L Ou
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - C Palatchi
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - B Pandey
- Hampton University, Hampton, Virginia 23669, USA
| | - S Park
- Stony Brook, State University of New York, New York 11794, USA
| | - K Park
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - C Peng
- Duke University, Durham, North Carolina 27708, USA
| | - R Pomatsalyuk
- Kharkov Institute of Physics and Technology, Kharkov 61108, Ukraine
| | - E Pooser
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - A J R Puckett
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - V Punjabi
- Norfolk State University, Norfolk, Virginia 23504, USA
| | - B Quinn
- Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - S Rahman
- University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - P E Reimer
- Physics Division, Argonne National Laboratory, Lemont, Illinois 60439, USA
| | - J Roche
- Ohio University, Athens, Ohio 45701, USA
| | - I Sapkota
- Catholic University of America, Washington, DC 20064, USA
| | - A Sarty
- Saint Mary's University, Halifax, Nova Scotia B3H 3C3, Canada
| | - B Sawatzky
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - N H Saylor
- Rensselaer Polytechnic Institute, Troy, New York 12180, USA
| | - B Schmookler
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - M H Shabestari
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - A Shahinyan
- AANL, 2 Alikhanian Brothers Street, 0036 Yerevan, Armenia
| | - S Sirca
- Faculty of Mathematics and Physics, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - G R Smith
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | | | - N Sparveris
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - R Spies
- University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - T Su
- Kent State University, Kent, Ohio 44240, USA
| | - A Subedi
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - V Sulkosky
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - A Sun
- Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - L Thorne
- Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - Y Tian
- Shandong University, Jinan 250100, China
| | - N Ton
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - F Tortorici
- Istituto Nazionale di Fisica Nucleare, Dipartimento di Fisica delle Università degli di Catania, I-95123 Catania, Italy
| | - R Trotta
- Duquesne University, 600 Forbes Avenue, Pittsburgh, Pennsylvania 15282, USA
| | - G M Urciuoli
- Istituto Nazionale di Fisica Nucleare-Sezione di Roma, Piazzale Aldo Moro, 2-00185 Roma, Italy
| | - E Voutier
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - B Waidyawansa
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - Y Wang
- The College of William and Mary, Williamsburg, Virginia 23185, USA
| | - B Wojtsekhowski
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Wood
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - X Yan
- Huangshan University, Tunxi, Daizhen Road 245041, China
| | - L Ye
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - Z Ye
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - C Yero
- Florida International University, Miami, Florida 33199, USA
| | - J Zhang
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - Y Zhao
- Stony Brook, State University of New York, New York 11794, USA
| | - P Zhu
- University of Science and Technology of China, Hefei, Anhui 230026, China
| |
Collapse
|
8
|
Androić D, Armstrong DS, Bartlett K, Beminiwattha RS, Benesch J, Benmokhtar F, Birchall J, Carlini RD, Cornejo JC, Covrig Dusa S, Dalton MM, Davis CA, Deconinck W, Dowd JF, Dunne JA, Dutta D, Duvall WS, Elaasar M, Falk WR, Finn JM, Forest T, Gal C, Gaskell D, Gericke MTW, Gray VM, Grimm K, Guo F, Hoskins JR, Jones DC, Jones MK, Kargiantoulakis M, King PM, Korkmaz E, Kowalski S, Leacock J, Leckey J, Lee AR, Lee JH, Lee L, MacEwan S, Mack D, Magee JA, Mahurin R, Mammei J, Martin JW, McHugh MJ, Meekins D, Mesick KE, Michaels R, Micherdzinska A, Mkrtchyan A, Mkrtchyan H, Narayan A, Ndukum LZ, Nelyubin V, van Oers WTH, Owen VF, Page SA, Pan J, Paschke KD, Phillips SK, Pitt ML, Radloff RW, Rajotte JF, Ramsay WD, Roche J, Sawatzky B, Seva T, Shabestari MH, Silwal R, Simicevic N, Smith GR, Solvignon P, Spayde DT, Subedi A, Suleiman R, Tadevosyan V, Tobias WA, Tvaskis V, Waidyawansa B, Wang P, Wells SP, Wood SA, Yang S, Zang P, Zhamkochyan S, Christy ME, Horowitz CJ, Fattoyev FJ, Lin Z. Determination of the ^{27}Al Neutron Distribution Radius from a Parity-Violating Electron Scattering Measurement. Phys Rev Lett 2022; 128:132501. [PMID: 35426696 DOI: 10.1103/physrevlett.128.132501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/02/2022] [Indexed: 06/14/2023]
Abstract
We report the first measurement of the parity-violating elastic electron scattering asymmetry on ^{27}Al. The ^{27}Al elastic asymmetry is A_{PV}=2.16±0.11(stat)±0.16(syst) ppm, and was measured at ⟨Q^{2}⟩=0.02357±0.00010 GeV^{2}, ⟨θ_{lab}⟩=7.61°±0.02°, and ⟨E_{lab}⟩=1.157 GeV with the Q_{weak} apparatus at Jefferson Lab. Predictions using a simple Born approximation as well as more sophisticated distorted-wave calculations are in good agreement with this result. From this asymmetry the ^{27}Al neutron radius R_{n}=2.89±0.12 fm was determined using a many-models correlation technique. The corresponding neutron skin thickness R_{n}-R_{p}=-0.04±0.12 fm is small, as expected for a light nucleus with a neutron excess of only 1. This result thus serves as a successful benchmark for electroweak determinations of neutron radii on heavier nuclei. A tree-level approach was used to extract the ^{27}Al weak radius R_{w}=3.00±0.15 fm, and the weak skin thickness R_{wk}-R_{ch}=-0.04±0.15 fm. The weak form factor at this Q^{2} is F_{wk}=0.39±0.04.
Collapse
Affiliation(s)
- D Androić
- University of Zagreb, Zagreb, HR 10002, Croatia
| | | | - K Bartlett
- William & Mary, Williamsburg, Virginia 23185, USA
| | | | - J Benesch
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - F Benmokhtar
- Christopher Newport University, Newport News, Virginia 23606, USA
| | - J Birchall
- University of Manitoba, Winnipeg, Manitoba R3T2N2, Canada
| | - R D Carlini
- William & Mary, Williamsburg, Virginia 23185, USA
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - J C Cornejo
- William & Mary, Williamsburg, Virginia 23185, USA
| | - S Covrig Dusa
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - M M Dalton
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - C A Davis
- TRIUMF, Vancouver, British Columbia V6T2A3, Canada
| | - W Deconinck
- William & Mary, Williamsburg, Virginia 23185, USA
| | - J F Dowd
- William & Mary, Williamsburg, Virginia 23185, USA
| | - J A Dunne
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - D Dutta
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - W S Duvall
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA
| | - M Elaasar
- Southern University at New Orleans, New Orleans, Louisiana 70126, USA
| | - W R Falk
- University of Manitoba, Winnipeg, Manitoba R3T2N2, Canada
| | - J M Finn
- William & Mary, Williamsburg, Virginia 23185, USA
| | - T Forest
- Idaho State University, Pocatello, Idaho 83209, USA
- Louisiana Tech University, Ruston, Louisiana 71272, USA
| | - C Gal
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - D Gaskell
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - M T W Gericke
- University of Manitoba, Winnipeg, Manitoba R3T2N2, Canada
| | - V M Gray
- William & Mary, Williamsburg, Virginia 23185, USA
| | - K Grimm
- William & Mary, Williamsburg, Virginia 23185, USA
- Louisiana Tech University, Ruston, Louisiana 71272, USA
| | - F Guo
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - J R Hoskins
- William & Mary, Williamsburg, Virginia 23185, USA
| | - D C Jones
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - M K Jones
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | | | - P M King
- Ohio University, Athens, Ohio 45701, USA
| | - E Korkmaz
- University of Northern British Columbia, Prince George, British Columbia V2N4Z9, Canada
| | - S Kowalski
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - J Leacock
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA
| | - J Leckey
- William & Mary, Williamsburg, Virginia 23185, USA
| | - A R Lee
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA
| | - J H Lee
- William & Mary, Williamsburg, Virginia 23185, USA
- Ohio University, Athens, Ohio 45701, USA
| | - L Lee
- University of Manitoba, Winnipeg, Manitoba R3T2N2, Canada
- TRIUMF, Vancouver, British Columbia V6T2A3, Canada
| | - S MacEwan
- University of Manitoba, Winnipeg, Manitoba R3T2N2, Canada
| | - D Mack
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - J A Magee
- William & Mary, Williamsburg, Virginia 23185, USA
| | - R Mahurin
- University of Manitoba, Winnipeg, Manitoba R3T2N2, Canada
| | - J Mammei
- University of Manitoba, Winnipeg, Manitoba R3T2N2, Canada
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA
| | - J W Martin
- University of Winnipeg, Winnipeg, Manitoba R3B2E9, Canada
| | - M J McHugh
- George Washington University, Washington, DC 20052, USA
| | - D Meekins
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - K E Mesick
- George Washington University, Washington, DC 20052, USA
- Rutgers, The State University of New Jersey, Piscataway, New Jersey 08854, USA
| | - R Michaels
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | | | - A Mkrtchyan
- A. I. Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan 0036, Armenia
| | - H Mkrtchyan
- A. I. Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan 0036, Armenia
| | - A Narayan
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - L Z Ndukum
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - V Nelyubin
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - W T H van Oers
- University of Manitoba, Winnipeg, Manitoba R3T2N2, Canada
- TRIUMF, Vancouver, British Columbia V6T2A3, Canada
| | - V F Owen
- William & Mary, Williamsburg, Virginia 23185, USA
| | - S A Page
- University of Manitoba, Winnipeg, Manitoba R3T2N2, Canada
| | - J Pan
- University of Manitoba, Winnipeg, Manitoba R3T2N2, Canada
| | - K D Paschke
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - S K Phillips
- University of New Hampshire, Durham, New Hampshire 03824, USA
| | - M L Pitt
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061, USA
| | | | - J F Rajotte
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - W D Ramsay
- University of Manitoba, Winnipeg, Manitoba R3T2N2, Canada
- TRIUMF, Vancouver, British Columbia V6T2A3, Canada
| | - J Roche
- Ohio University, Athens, Ohio 45701, USA
| | - B Sawatzky
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - T Seva
- University of Zagreb, Zagreb, HR 10002, Croatia
| | - M H Shabestari
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - R Silwal
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - N Simicevic
- Louisiana Tech University, Ruston, Louisiana 71272, USA
| | - G R Smith
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - P Solvignon
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - D T Spayde
- Hendrix College, Conway, Arkansas 72032, USA
| | - A Subedi
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - R Suleiman
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - V Tadevosyan
- A. I. Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan 0036, Armenia
| | - W A Tobias
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - V Tvaskis
- University of Manitoba, Winnipeg, Manitoba R3T2N2, Canada
- University of Winnipeg, Winnipeg, Manitoba R3B2E9, Canada
| | | | - P Wang
- University of Manitoba, Winnipeg, Manitoba R3T2N2, Canada
| | - S P Wells
- Louisiana Tech University, Ruston, Louisiana 71272, USA
| | - S A Wood
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Yang
- William & Mary, Williamsburg, Virginia 23185, USA
| | - P Zang
- Syracuse University, Syracuse, New York 13244, USA
| | - S Zhamkochyan
- A. I. Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan 0036, Armenia
| | - M E Christy
- Hampton University, Hampton, Virginia 23668, USA
| | - C J Horowitz
- Indiana University, Bloomington, Indiana 47405, USA
| | - F J Fattoyev
- Indiana University, Bloomington, Indiana 47405, USA
| | - Z Lin
- Indiana University, Bloomington, Indiana 47405, USA
| |
Collapse
|
9
|
Christy ME, Gautam T, Ou L, Schmookler B, Wang Y, Adikaram D, Ahmed Z, Albataineh H, Ali SF, Aljawrneh B, Allada K, Allison SL, Alsalmi S, Androic D, Aniol K, Annand J, Arrington J, Atac H, Averett T, Ayerbe Gayoso C, Bai X, Bane J, Barcus S, Bartlett K, Bellini V, Beminiwattha R, Bericic J, Bhatt H, Bhetuwal D, Biswas D, Brash E, Bulumulla D, Camacho CM, Campbell J, Camsonne A, Carmignotto M, Castellanos J, Chen C, Chen JP, Chetry T, Cisbani E, Clary B, Cohen E, Compton N, Cornejo JC, Covrig Dusa S, Crowe B, Danagoulian S, Danley T, Deconinck W, Defurne M, Desnault C, Di D, Dlamini M, Duer M, Duran B, Ent R, Fanelli C, Fuchey E, Gal C, Gaskell D, Georges F, Gilad S, Glamazdin O, Gnanvo K, Gramolin AV, Gray VM, Gu C, Habarakada A, Hague T, Hamad G, Hamilton D, Hamilton K, Hansen O, Hauenstein F, Hernandez AV, Henry W, Higinbotham DW, Holmstrom T, Horn T, Huang Y, Huber GM, Hyde C, Ibrahim H, Israel N, Jen CM, Jin K, Jones M, Kabir A, Karki B, Keppel C, Khachatryan V, King PM, Li S, Li W, Liu H, Liu J, Liyanage AH, Mack D, Magee J, Malace S, Mammei J, Markowitz P, Mayilyan S, McClellan E, Meddi F, Meekins D, Mesick K, Michaels R, Mkrtchyan A, Moffit B, Montgomery R, Myers LS, Nadel-Turonski P, Nazeer SJ, Nelyubin V, Nguyen D, Nuruzzaman N, Nycz M, Obrecht RF, Ohanyan K, Palatchi C, Pandey B, Park K, Park S, Peng C, Persio FD, Pomatsalyuk R, Pooser E, Puckett AJR, Punjabi V, Quinn B, Rahman S, Rashad MNH, Reimer PE, Riordan S, Roche J, Sapkota I, Sarty A, Sawatzky B, Saylor NH, Shabestari MH, Shahinyan A, Širca S, Smith GR, Sooriyaarachchilage S, Sparveris N, Spies R, Stefanko A, Su T, Subedi A, Sulkosky V, Sun A, Tan Y, Thorne L, Ton N, Tortorici F, Trotta R, Uniyal R, Urciuoli GM, Voutier E, Waidyawansa B, Wojtsekhowski B, Wood S, Yan X, Ye L, Ye ZH, Yero C, Zhang J, Zhao YX, Zhu P. Form Factors and Two-Photon Exchange in High-Energy Elastic Electron-Proton Scattering. Phys Rev Lett 2022; 128:102002. [PMID: 35333083 DOI: 10.1103/physrevlett.128.102002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 11/06/2021] [Accepted: 01/31/2022] [Indexed: 06/14/2023]
Abstract
We present new precision measurements of the elastic electron-proton scattering cross section for momentum transfer (Q^{2}) up to 15.75 (GeV/c)^{2}. Combined with existing data, these provide an improved extraction of the proton magnetic form factor at high Q^{2} and double the range over which a longitudinal or transverse separation of the cross section can be performed. The difference between our results and polarization data agrees with that observed at lower Q^{2} and attributed to hard two-photon exchange (TPE) effects, extending to 8 (GeV/c)^{2} the range of Q^{2} for which a discrepancy is established at >95% confidence. We use the discrepancy to quantify the size of TPE contributions needed to explain the cross section at high Q^{2}.
Collapse
Affiliation(s)
- M E Christy
- Hampton University, Hampton, Virginia 23669, USA
| | - T Gautam
- Hampton University, Hampton, Virginia 23669, USA
| | - L Ou
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - B Schmookler
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - Y Wang
- William and Mary, Williamsburg, Virginia 23185, USA
| | - D Adikaram
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - Z Ahmed
- University of Regina, Regina, Saskatchewan S4S 0A2 Canada
| | - H Albataineh
- Texas A & M University, Kingsville, Texas 77843, USA
| | - S F Ali
- Catholic University of America, Washington, District of Columbia 20064, USA
| | - B Aljawrneh
- North Carolina A&T State University, Greensboro, North Carolina 27411, USA
- Al Zaytoonah University of Jordan, Amman 11733, Jordan
| | - K Allada
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - S L Allison
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - S Alsalmi
- Kent State University, Kent, Ohio 44240, USA
| | - D Androic
- University of Zagreb, Trg Republike Hrvatske 14, 10000, Zagreb, Croatia
| | - K Aniol
- California State University, Los Angeles, Los Angeles, California 90032, USA
| | - J Annand
- SUPA School of Physics and Astronomy, University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - J Arrington
- Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Argonne National Laboratory, Lemont, Illinois 60439, USA
| | - H Atac
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - T Averett
- William and Mary, Williamsburg, Virginia 23185, USA
| | | | - X Bai
- University of Virginia, Charlottesville, Virginia 232904, USA
| | - J Bane
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - S Barcus
- William and Mary, Williamsburg, Virginia 23185, USA
| | - K Bartlett
- William and Mary, Williamsburg, Virginia 23185, USA
| | - V Bellini
- Istituto Nazionale di Fisica Nucleare, Department of Physics and Astronomy, I-95123 Catania, Italy
| | | | - J Bericic
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - H Bhatt
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - D Bhetuwal
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - D Biswas
- Hampton University, Hampton, Virginia 23669, USA
| | - E Brash
- Christopher Newport University, Newport News, Virginia 23606, USA
| | - D Bulumulla
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - C M Camacho
- Institut de Physique Nucleaire, 15 Rue Georges Clemenceau, 91400 Orsay, France
| | - J Campbell
- Dalhousie University, Nova Scotia NS B3H 4R2, Canada
| | - A Camsonne
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - M Carmignotto
- Catholic University of America, Washington, DC 20064, USA
| | - J Castellanos
- Florida International University, Miami, Florida 33199, USA
| | - C Chen
- Hampton University, Hampton, Virginia 23669, USA
| | - J-P Chen
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - T Chetry
- Ohio University, Athens, Ohio 45701, USA
| | - E Cisbani
- Istituto Nazionale di Fisica Nucleare - Sezione di Roma, P.le Aldo Moro, 2 - 00185 Roma, Italy
| | - B Clary
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - E Cohen
- Tel Aviv University, Tel Aviv-Yafo 69978, Israel
| | - N Compton
- Ohio University, Athens, Ohio 45701, USA
| | - J C Cornejo
- William and Mary, Williamsburg, Virginia 23185, USA
- Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - S Covrig Dusa
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - B Crowe
- North Carolina Central University, Durham, North Carolina 27707, USA
| | - S Danagoulian
- North Carolina A&T State University, Greensboro, North Carolina 27411, USA
| | - T Danley
- Ohio University, Athens, Ohio 45701, USA
| | - W Deconinck
- William and Mary, Williamsburg, Virginia 23185, USA
| | - M Defurne
- CEA Saclay, 91191 Gif-sur-Yvette, France
| | - C Desnault
- Institut de Physique Nucleaire, 15 Rue Georges Clemenceau, 91400 Orsay, France
| | - D Di
- University of Virginia, Charlottesville, Virginia 232904, USA
| | - M Dlamini
- Ohio University, Athens, Ohio 45701, USA
| | - M Duer
- Tel Aviv University, Tel Aviv-Yafo 69978, Israel
| | - B Duran
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - R Ent
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - C Fanelli
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - E Fuchey
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - C Gal
- University of Virginia, Charlottesville, Virginia 232904, USA
| | - D Gaskell
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - F Georges
- Ecole Centrale Paris, 3 Rue Joliot Curie, 91190 Gif-sur-Yvette, France
| | - S Gilad
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - O Glamazdin
- Kharkov Institute of Physics and Technology, Kharkov 61108, Ukraine
| | - K Gnanvo
- University of Virginia, Charlottesville, Virginia 232904, USA
| | - A V Gramolin
- Boston University, Boston, Massachusetts 02215, USA
| | - V M Gray
- William and Mary, Williamsburg, Virginia 23185, USA
| | - C Gu
- University of Virginia, Charlottesville, Virginia 232904, USA
| | - A Habarakada
- Hampton University, Hampton, Virginia 23669, USA
| | - T Hague
- Kent State University, Kent, Ohio 44240, USA
| | - G Hamad
- Ohio University, Athens, Ohio 45701, USA
| | - D Hamilton
- SUPA School of Physics and Astronomy, University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - K Hamilton
- SUPA School of Physics and Astronomy, University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - O Hansen
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - F Hauenstein
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - A V Hernandez
- Catholic University of America, Washington, DC 20064, USA
| | - W Henry
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - D W Higinbotham
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - T Holmstrom
- Randolph Macon College, Ashland, Virginia 23005, USA
| | - T Horn
- Catholic University of America, Washington, DC 20064, USA
| | - Y Huang
- University of Virginia, Charlottesville, Virginia 232904, USA
| | - G M Huber
- University of Regina, Regina, Saskatchewan S4S 0A2 Canada
| | - C Hyde
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - H Ibrahim
- Cairo University, Cairo, 12613, Egypt
| | - N Israel
- Ohio University, Athens, Ohio 45701, USA
| | - C-M Jen
- Virginia Polytechnic Institute and State University, Blacksburg, Virginia 234061, USA
| | - K Jin
- University of Virginia, Charlottesville, Virginia 232904, USA
| | - M Jones
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - A Kabir
- Kent State University, Kent, Ohio 44240, USA
| | - B Karki
- Ohio University, Athens, Ohio 45701, USA
| | - C Keppel
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - V Khachatryan
- Stony Brook, State University of New York, New York 11794, USA
- Cornell University, Ithaca, New York 14853, USA
| | - P M King
- Ohio University, Athens, Ohio 45701, USA
| | - S Li
- University of New Hampshire, Durham, New Hampshire 03824, USA
| | - W Li
- University of Regina, Regina, Saskatchewan S4S 0A2 Canada
| | - H Liu
- Columbia University, New York, New York 10027, USA
| | - J Liu
- University of Virginia, Charlottesville, Virginia 232904, USA
| | - A H Liyanage
- Hampton University, Hampton, Virginia 23669, USA
| | - D Mack
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - J Magee
- William and Mary, Williamsburg, Virginia 23185, USA
| | - S Malace
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - J Mammei
- University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - P Markowitz
- Florida International University, Miami, Florida 33199, USA
| | - S Mayilyan
- AANL, 2 Alikhanian Brothers Street, 0036 Yerevan, Armenia
| | - E McClellan
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - F Meddi
- Istituto Nazionale di Fisica Nucleare - Sezione di Roma, P.le Aldo Moro, 2 - 00185 Roma, Italy
| | - D Meekins
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - K Mesick
- Rutgers University, New Brunswick, New Jersey 08854, USA
| | - R Michaels
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - A Mkrtchyan
- Catholic University of America, Washington, DC 20064, USA
| | - B Moffit
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - R Montgomery
- SUPA School of Physics and Astronomy, University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - L S Myers
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - P Nadel-Turonski
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S J Nazeer
- Hampton University, Hampton, Virginia 23669, USA
| | - V Nelyubin
- University of Virginia, Charlottesville, Virginia 232904, USA
| | - D Nguyen
- University of Virginia, Charlottesville, Virginia 232904, USA
| | - N Nuruzzaman
- Hampton University, Hampton, Virginia 23669, USA
| | - M Nycz
- Kent State University, Kent, Ohio 44240, USA
| | - R F Obrecht
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - K Ohanyan
- AANL, 2 Alikhanian Brothers Street, 0036 Yerevan, Armenia
| | - C Palatchi
- University of Virginia, Charlottesville, Virginia 232904, USA
| | - B Pandey
- Hampton University, Hampton, Virginia 23669, USA
| | - K Park
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - S Park
- Stony Brook, State University of New York, New York 11794, USA
| | - C Peng
- Duke University, Durham, North Carolina 27708, USA
| | - F D Persio
- Istituto Nazionale di Fisica Nucleare - Sezione di Roma, P.le Aldo Moro, 2 - 00185 Roma, Italy
| | - R Pomatsalyuk
- Kharkov Institute of Physics and Technology, Kharkov 61108, Ukraine
| | - E Pooser
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - A J R Puckett
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - V Punjabi
- Norfolk State University, Norfolk, Virginia 23504, USA
| | - B Quinn
- Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - S Rahman
- University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - M N H Rashad
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - P E Reimer
- Argonne National Laboratory, Lemont, Illinois 60439, USA
| | - S Riordan
- Stony Brook, State University of New York, New York 11794, USA
| | - J Roche
- Ohio University, Athens, Ohio 45701, USA
| | - I Sapkota
- Catholic University of America, Washington, DC 20064, USA
| | - A Sarty
- Saint Mary's University, Halifax, Nova Scotia B3H 3C3, Canada
| | - B Sawatzky
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - N H Saylor
- Rensselaer Polytechnic Institute, Troy, New York 12180, USA
| | - M H Shabestari
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - A Shahinyan
- AANL, 2 Alikhanian Brothers Street, 0036 Yerevan, Armenia
| | - S Širca
- Faculty of Mathematics and Physics, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - G R Smith
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | | | - N Sparveris
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - R Spies
- University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - A Stefanko
- Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - T Su
- Kent State University, Kent, Ohio 44240, USA
| | - A Subedi
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - V Sulkosky
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - A Sun
- Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - Y Tan
- Shandong University, Shandong, Jinan 250100, China
| | - L Thorne
- Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - N Ton
- University of Virginia, Charlottesville, Virginia 232904, USA
| | - F Tortorici
- Istituto Nazionale di Fisica Nucleare, Department of Physics and Astronomy, I-95123 Catania, Italy
| | - R Trotta
- Duquesne University, Pittsburgh, Pennsylvania 15282, USA
| | - R Uniyal
- Catholic University of America, Washington, DC 20064, USA
| | - G M Urciuoli
- Istituto Nazionale di Fisica Nucleare - Sezione di Roma, P.le Aldo Moro, 2 - 00185 Roma, Italy
| | - E Voutier
- Institut de Physique Nucleaire, 15 Rue Georges Clemenceau, 91400 Orsay, France
| | - B Waidyawansa
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - B Wojtsekhowski
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Wood
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - X Yan
- Huangshan University, 44 Daizhen Road, Tunxi District, Huangshan, Anhui Province, China
| | - L Ye
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - Z H Ye
- University of Virginia, Charlottesville, Virginia 232904, USA
- Tsinghua University, 30 Shuangqing Rd, Haidian District, Beijing 100190, China
| | - C Yero
- Florida International University, Miami, Florida 33199, USA
| | - J Zhang
- University of Virginia, Charlottesville, Virginia 232904, USA
| | - Y X Zhao
- Stony Brook, State University of New York, New York 11794, USA
| | - P Zhu
- University of Science and Technology of China, Hefei, Anhui 230026, China
| |
Collapse
|
10
|
Subedi A, Schyns-van den Berg AM, Thapa P, Limbu PM, Trikhatri Y, Poudel A, Dhakal Y, Bhandari S. Intrathecal morphine does not prevent chronic postsurgical pain after elective Caesarean delivery: a randomised controlled trial. Br J Anaesth 2022; 128:700-707. [DOI: 10.1016/j.bja.2021.11.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/19/2021] [Accepted: 11/10/2021] [Indexed: 11/26/2022] Open
|
11
|
Dlamini M, Karki B, Ali SF, Lin PJ, Georges F, Ko HS, Israel N, Rashad MNH, Stefanko A, Adikaram D, Ahmed Z, Albataineh H, Aljawrneh B, Allada K, Allison S, Alsalmi S, Androic D, Aniol K, Annand J, Atac H, Averett T, Ayerbe Gayoso C, Bai X, Bane J, Barcus S, Bartlett K, Bellini V, Beminiwattha R, Bericic J, Biswas D, Brash E, Bulumulla D, Campbell J, Camsonne A, Carmignotto M, Castellano J, Chen C, Chen JP, Chetry T, Christy ME, Cisbani E, Clary B, Cohen E, Compton N, Cornejo JC, Covrig Dusa S, Crowe B, Danagoulian S, Danley T, De Persio F, Deconinck W, Defurne M, Desnault C, Di D, Duer M, Duran B, Ent R, Fanelli C, Franklin G, Fuchey E, Gal C, Gaskell D, Gautam T, Glamazdin O, Gnanvo K, Gray VM, Gu C, Hague T, Hamad G, Hamilton D, Hamilton K, Hansen O, Hauenstein F, Henry W, Higinbotham DW, Holmstrom T, Horn T, Huang Y, Huber GM, Hyde C, Ibrahim H, Jen CM, Jin K, Jones M, Kabir A, Keppel C, Khachatryan V, King PM, Li S, Li W, Liu J, Liu H, Liyanage A, Magee J, Malace S, Mammei J, Markowitz P, McClellan E, Meddi F, Meekins D, Mesik K, Michaels R, Mkrtchyan A, Montgomery R, Muñoz Camacho C, Myers LS, Nadel-Turonski P, Nazeer SJ, Nelyubin V, Nguyen D, Nuruzzaman N, Nycz M, Obretch OF, Ou L, Palatchi C, Pandey B, Park S, Park K, Peng C, Pomatsalyuk R, Pooser E, Puckett AJR, Punjabi V, Quinn B, Rahman S, Reimer PE, Roche J, Sapkota I, Sarty A, Sawatzky B, Saylor NH, Schmookler B, Shabestari MH, Shahinyan A, Sirca S, Smith GR, Sooriyaarachchilage S, Sparveris N, Spies R, Su T, Subedi A, Sulkosky V, Sun A, Thorne L, Tian Y, Ton N, Tortorici F, Trotta R, Urciuoli GM, Voutier E, Waidyawansa B, Wang Y, Wojtsekhowski B, Wood S, Yan X, Ye L, Ye Z, Yero C, Zhang J, Zhao Y, Zhu P. Deep Exclusive Electroproduction of π^{0} at High Q^{2} in the Quark Valence Regime. Phys Rev Lett 2021; 127:152301. [PMID: 34678020 DOI: 10.1103/physrevlett.127.152301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 06/07/2021] [Accepted: 08/17/2021] [Indexed: 06/13/2023]
Abstract
We report measurements of the exclusive neutral pion electroproduction cross section off protons at large values of x_{B} (0.36, 0.48, and 0.60) and Q^{2} (3.1 to 8.4 GeV^{2}) obtained from Jefferson Lab Hall A experiment E12-06-014. The corresponding structure functions dσ_{T}/dt+εdσ_{L}/dt, dσ_{TT}/dt, dσ_{LT}/dt, and dσ_{LT^{'}}/dt are extracted as a function of the proton momentum transfer t-t_{min}. The results suggest the amplitude for transversely polarized virtual photons continues to dominate the cross section throughout this kinematic range. The data are well described by calculations based on transversity generalized parton distributions coupled to a helicity flip distribution amplitude of the pion, thus providing a unique way to probe the structure of the nucleon.
Collapse
Affiliation(s)
- M Dlamini
- Ohio University, Athens, Ohio 45701, USA
| | - B Karki
- Ohio University, Athens, Ohio 45701, USA
| | - S F Ali
- Catholic University of America, Washington, DC 20064, USA
| | - P-J Lin
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - F Georges
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - H-S Ko
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
- Seoul National University, 1 Gwanak-ro, Gwanak-gu, 08826 Seoul, Korea
| | - N Israel
- Ohio University, Athens, Ohio 45701, USA
| | - M N H Rashad
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - A Stefanko
- Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - D Adikaram
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - Z Ahmed
- University of Regina, Regina, Saskatchewan S4S 0A2 Canada
| | - H Albataineh
- Texas A&M University-Kingsville, Kingsville, Texas 78363, USA
| | - B Aljawrneh
- North Carolina Ag. and Tech. State University, Greensboro, North Carolina 27411, USA
| | - K Allada
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - S Allison
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - S Alsalmi
- Kent State University, Kent, Ohio 44240, USA
| | - D Androic
- University of Zagreb, Trg Republike Hrvatske 14, 10000 Zagreb, Croatia
| | - K Aniol
- California State University, Los Angeles, Los Angeles, California 90032, USA
| | - J Annand
- SUPA School of Physics and Astronomy, University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - H Atac
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - T Averett
- The College of William and Mary, Williamsburg, Virginia 23185, USA
| | - C Ayerbe Gayoso
- The College of William and Mary, Williamsburg, Virginia 23185, USA
| | - X Bai
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - J Bane
- University of Tennessee, Knoxville, Tennessee 37996, USA
| | - S Barcus
- The College of William and Mary, Williamsburg, Virginia 23185, USA
| | - K Bartlett
- The College of William and Mary, Williamsburg, Virginia 23185, USA
| | - V Bellini
- Istituto Nazionale di Fisica Nucleare, Dipt. Di Fisica delle Uni. di Catania, I-95123 Catania, Italy
| | | | - J Bericic
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - D Biswas
- Hampton University, Hampton, Virginia 23669, USA
| | - E Brash
- Christopher Newport University, Newport News, Virginia 23606, USA
| | - D Bulumulla
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - J Campbell
- Dalhousie University, Nova Scotia B3H 4R2, Canada
| | - A Camsonne
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - M Carmignotto
- Catholic University of America, Washington, DC 20064, USA
| | - J Castellano
- Florida International University, Miami, Florida 33199, USA
| | - C Chen
- Hampton University, Hampton, Virginia 23669, USA
| | - J-P Chen
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - T Chetry
- Ohio University, Athens, Ohio 45701, USA
| | - M E Christy
- Hampton University, Hampton, Virginia 23669, USA
| | - E Cisbani
- Istituto Nazionale di Fisica Nucleare-Sezione di Roma, P.le Aldo Moro, 2-00185 Roma, Italy
| | - B Clary
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - E Cohen
- Tel Aviv University, Tel Aviv 699780 1, Israel
| | - N Compton
- Ohio University, Athens, Ohio 45701, USA
| | - J C Cornejo
- Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
- The College of William and Mary, Williamsburg, Virginia 23185, USA
| | - S Covrig Dusa
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - B Crowe
- North Carolina Central University, Durham, North Carolina 27707, USA
| | - S Danagoulian
- North Carolina Ag. and Tech. State University, Greensboro, North Carolina 27411, USA
| | - T Danley
- Ohio University, Athens, Ohio 45701, USA
| | - F De Persio
- Istituto Nazionale di Fisica Nucleare-Sezione di Roma, P.le Aldo Moro, 2-00185 Roma, Italy
| | - W Deconinck
- The College of William and Mary, Williamsburg, Virginia 23185, USA
| | - M Defurne
- CEA Saclay, 91191 Gif-sur-Yvette, France
| | - C Desnault
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - D Di
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - M Duer
- Tel Aviv University, Tel Aviv 699780 1, Israel
| | - B Duran
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - R Ent
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - C Fanelli
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - G Franklin
- Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - E Fuchey
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - C Gal
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - D Gaskell
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - T Gautam
- Hampton University, Hampton, Virginia 23669, USA
| | - O Glamazdin
- Kharkov Institute of Physics and Technology, Kharkov 61108, Ukraine
| | - K Gnanvo
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - V M Gray
- The College of William and Mary, Williamsburg, Virginia 23185, USA
| | - C Gu
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - T Hague
- Kent State University, Kent, Ohio 44240, USA
| | - G Hamad
- Ohio University, Athens, Ohio 45701, USA
| | - D Hamilton
- SUPA School of Physics and Astronomy, University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - K Hamilton
- SUPA School of Physics and Astronomy, University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - O Hansen
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - F Hauenstein
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - W Henry
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - D W Higinbotham
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - T Holmstrom
- Randolph Macon College, Ashlan, Virginia 23005, USA
| | - T Horn
- Catholic University of America, Washington, DC 20064, USA
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - Y Huang
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - G M Huber
- University of Regina, Regina, Saskatchewan S4S 0A2 Canada
| | - C Hyde
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - H Ibrahim
- Cairo University, Cairo 121613, Egypt
| | - C-M Jen
- Virginia Polytechnic Institute & State University, Blacksburg, Virginia 234061, USA
| | - K Jin
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - M Jones
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - A Kabir
- Kent State University, Kent, Ohio 44240, USA
| | - C Keppel
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - V Khachatryan
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
- Stony Brook, State University of New York, New York 11794, USA
- Cornell University, Ithaca, New York 14853, USA
| | - P M King
- Ohio University, Athens, Ohio 45701, USA
| | - S Li
- University of New Hampshire, Durham, New Hampshire 03824, USA
| | - W Li
- University of Regina, Regina, Saskatchewan S4S 0A2 Canada
| | - J Liu
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - H Liu
- Columbia University, New York, New York 10027, USA
| | - A Liyanage
- Hampton University, Hampton, Virginia 23669, USA
| | - J Magee
- The College of William and Mary, Williamsburg, Virginia 23185, USA
| | - S Malace
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - J Mammei
- University of Manitoba, Winnipeg, Manitoba R3T 2N2, Canada
| | - P Markowitz
- Florida International University, Miami, Florida 33199, USA
| | - E McClellan
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - F Meddi
- Istituto Nazionale di Fisica Nucleare-Sezione di Roma, P.le Aldo Moro, 2-00185 Roma, Italy
| | - D Meekins
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - K Mesik
- Rutgers University, New Brunswick, New Jersey 08854, USA
| | - R Michaels
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - A Mkrtchyan
- Catholic University of America, Washington, DC 20064, USA
| | - R Montgomery
- SUPA School of Physics and Astronomy, University of Glasgow, Glasgow G12 8QQ, United Kingdom
| | - C Muñoz Camacho
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - L S Myers
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - P Nadel-Turonski
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S J Nazeer
- Hampton University, Hampton, Virginia 23669, USA
| | - V Nelyubin
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - D Nguyen
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - N Nuruzzaman
- Hampton University, Hampton, Virginia 23669, USA
| | - M Nycz
- Kent State University, Kent, Ohio 44240, USA
| | - O F Obretch
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - L Ou
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - C Palatchi
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - B Pandey
- Hampton University, Hampton, Virginia 23669, USA
| | - S Park
- Stony Brook, State University of New York, New York 11794, USA
| | - K Park
- Old Dominion University, Norfolk, Virginia 23529, USA
| | - C Peng
- Duke University, Durham, North Carolina 27708, USA
| | - R Pomatsalyuk
- Kharkov Institute of Physics and Technology, Kharkov 61108, Ukraine
| | - E Pooser
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - A J R Puckett
- University of Connecticut, Storrs, Connecticut 06269, USA
| | - V Punjabi
- Norfolk State University, Norfolk, Virginia 23504, USA
| | - B Quinn
- Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - S Rahman
- University of Manitoba, Winnipeg, Manitoba R3T 2N2, Canada
| | - P E Reimer
- Physics Division, Argonne National Laboratory, Lemont, Illinois 60439, USA
| | - J Roche
- Ohio University, Athens, Ohio 45701, USA
| | - I Sapkota
- Catholic University of America, Washington, DC 20064, USA
| | - A Sarty
- Saint Mary's University, Halifax, Nova Scotia B3H 3C3, Canada
| | - B Sawatzky
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - N H Saylor
- Rensselaer Polytechnic Institute, Troy, New York 12180, USA
| | - B Schmookler
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - M H Shabestari
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - A Shahinyan
- AANL, 2 Alikhanian Brothers Street, 0036 Yerevan, Armenia
| | - S Sirca
- Faculty of Mathematics and Physics, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - G R Smith
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | | | - N Sparveris
- Temple University, Philadelphia, Pennsylvania 19122, USA
| | - R Spies
- University of Manitoba, Winnipeg, Manitoba R3T 2N2, Canada
| | - T Su
- Kent State University, Kent, Ohio 44240, USA
| | - A Subedi
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - V Sulkosky
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - A Sun
- Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - L Thorne
- Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, USA
| | - Y Tian
- Shandong University, Jinan, Shandong, 250100, China
| | - N Ton
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - F Tortorici
- Istituto Nazionale di Fisica Nucleare, Dipt. Di Fisica delle Uni. di Catania, I-95123 Catania, Italy
| | - R Trotta
- Duquesne University, 600 Forbes Avenue, Pittsburgh, Pennsylvania 15282, USA
| | - G M Urciuoli
- Istituto Nazionale di Fisica Nucleare-Sezione di Roma, P.le Aldo Moro, 2-00185 Roma, Italy
| | - E Voutier
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, 91405 Orsay, France
| | - B Waidyawansa
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - Y Wang
- The College of William and Mary, Williamsburg, Virginia 23185, USA
| | - B Wojtsekhowski
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Wood
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - X Yan
- Huangshan University, Huangshan, Anhui, 245041, China
| | - L Ye
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - Z Ye
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - C Yero
- Florida International University, Miami, Florida 33199, USA
| | - J Zhang
- University of Virginia, Charlottesville, Virginia 22904, USA
| | - Y Zhao
- Stony Brook, State University of New York, New York 11794, USA
| | - P Zhu
- University of Science and Technology of China, Hefei, Anhui 230026, China
| |
Collapse
|
12
|
Subedi A, Pokharel K, Sah BP, Chaudhary P. Association of preoperative pain catastrophizing with postoperative pain after lower limb trauma surgery. J Psychosom Res 2021; 149:110575. [PMID: 34371257 DOI: 10.1016/j.jpsychores.2021.110575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 07/12/2021] [Accepted: 07/19/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate an association between preoperative Nepali pain catastrophizing scale (N-PCS) scores and postoperative pain intensity and total opioid consumption. METHODS In this prospective cohort study we enrolled 135 patients with an American Society of Anaesthesiologists physical status I or II, aged between 18 and 65 years, and scheduled for surgery for lower-extremity fracture under spinal anaesthesia. Maximum postoperative pain reported during the 24 h was classified into two groups, no-mild pain group (Numeric rating scale [NRS] scores 1-3) and a moderate-severe pain group (NRS 4-10). The Pearson's correlation coefficient was used to compare the association between the baseline N-PCS scores and outcome variables, i.e., the maximum NRS pain score and the total tramadol consumption within the first 24 h after surgery. Logistic regression models were used to identify the predictors for the intensity of postoperative pain. RESULTS As four patients violated the protocol, the data of 131 patients were analyzed. Mean N-PCS scores reported by the moderate-severe pain group was 27.39 ± 9.50 compared to 18.64 ± 10 mean N-PCS scores by the no-mild pain group (p < 0.001). Preoperative PCS scores correlated positively with postoperative pain intensity (r = 0.43, [95% CI 0.28-0.56], p < 0.001) and total tramadol consumption (r = 0.36, [95% CI 0.20-0.50], p < 0.001). Preoperative pain catastrophizing was associated with postoperative moderate-severe pain (odds ratio, 1.08 [95% confidence interval, 1.02-1.15], p = 0.006) after adjusting for gender, ethnicity and preoperative anxiety. CONCLUSION Patients who reported higher pain catastrophizing preoperatively were at increased risk of experiencing moderate-severe postoperative pain. CLINICAL TRIAL REGISTRATION www.clinicaltrials.gov Identifier: NCT03758560.
Collapse
Affiliation(s)
- Asish Subedi
- BP Koirala Institute of Health Sciences, Dharan, Nepal.
| | | | | | | |
Collapse
|
13
|
Amatya R, Barakoti A, Rai JR, Subedi A. Colistin Resistance among Human Clinical Isolates from a Tertiary Care Hospital in Nepal. Kathmandu Univ Med J (KUMJ) 2021; 19:294-300. [PMID: 36254412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Background Colistin is increasingly being used for treatment of multidrug resistant (MDR) bacterial infections in human. The plasmid mediated mcr-1 gene was detected recently among the poultry in Nepal. Plasmid mediated colistin resistance among human isolates would severely compromise the treatment of MDR bacterial infections. Objective To find out the prevalence of colistin resistance among the gram-negative bacteria isolated from clinical specimen. Method A descriptive cross-sectional study was conducted in a tertiary care hospital in Kathmandu. Colistin resistance among all the gram negative bacilli (GNB), isolated in a year, from all clinical specimen subjected for aerobic bacterial isolation, was detected by disc diffusion and agar dilution methods. Those with a minimum inhibitory concentration (MIC) > 2 mcg/ml were subjected to polymerase chain reaction for detection of mcr-1 gene. Result A total of 1993 aerobic GNB were isolated from clinical samples received from February 2018 to January 2019. By the agar dilution screening method, 2.1% of the GNBs isolated had MIC of colistin > 2 mcg/ml. None of these possessed the mcr-1 gene. Conclusion Given the occurrence of increased MIC of colistin in the clinical isolates in our set up, nationwide active surveillance would generate data for Nepal. The study for the presence of other genes (chromosomal or plasmid mediated) responsible for the increased MIC of colistin would further guide the control measures.
Collapse
Affiliation(s)
- R Amatya
- Department of Microbiology, Nepal Medical College Teaching Hospital, Gokarneshwor -08, Kathamndu, Nepal
| | - A Barakoti
- Department of Microbiology, Nepal Medical College Teaching Hospital, Gokarneshwor -08, Kathamndu, Nepal
| | - J R Rai
- Department of Microbiology, Nepal Medical College Teaching Hospital, Gokarneshwor -08, Kathamndu, Nepal
| | - A Subedi
- Department of Microbiology, Nepal Medical College Teaching Hospital, Gokarneshwor -08, Kathamndu, Nepal
| |
Collapse
|
14
|
Adhikari P, Subedi A, Sah BP, Pokharel K. Analgesic effects of intravenous ketamine after spinal anaesthesia for non-elective caesarean delivery: a randomised controlled trial. BMJ Open 2021; 11:e044168. [PMID: 34193480 PMCID: PMC8246353 DOI: 10.1136/bmjopen-2020-044168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES This study aimed to determine if low dose intravenous ketamine is effective in reducing opioid use and pain after non-elective caesarean delivery. DESIGN Prospective, randomised, double-blind. SETTING Tertiary hospital, Bisheshwar Prasad Koirala Institute of Health Sciences, Dharan, Nepal PARTICIPANTS: 80 patients undergoing non-elective caesarean section with spinal anaesthesia. INTERVENTIONS Patients were allocated in 1:1 ratio to receive either intravenous ketamine 0.25 mg/kg or normal saline before the skin incision. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was the total amount of morphine equivalents needed up to postoperative 24 hours. Secondary outcome measures were postoperative pain scores, time to the first perception of pain, maternal adverse effects (nausea, vomiting, hypotension, shivering, diplopia, nystagmus, hallucination) and neonatal Apgar score at 1 and 5 min, neonatal respiratory depression and neonatal intensive-care referral. RESULTS The median (range) cumulative morphine consumption during the first 24 hours of surgery was 0 (0-4.67) mg in ketamine group and 1 (0-6) mg in saline group (p=0.003). The median (range) time to the first perception of pain was 6 (1-12) hours and 2 (0.5-6) hours in ketamine and saline group, respectively (p<0.001). A significant reduction in postoperative pain scores was observed only at 2 hours and 6 hours in the ketamine group compared with placebo group (p<0.05). Maternal adverse effects and neonatal outcomes were comparable between the two groups. CONCLUSIONS Intravenous administration of low dose ketamine before surgical incision significantly reduced the opioid requirement in the first 24 hours in patients undergoing non-elective caesarean delivery. TRIAL REGISTRATION NUMBER NCT03450499.
Collapse
Affiliation(s)
| | - Asish Subedi
- Anesthesiology & Critical Care, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Birendra Prasad Sah
- Anesthesiology & Critical Care, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Krishna Pokharel
- Anesthesiology & Critical Care, BP Koirala Institute of Health Sciences, Dharan, Nepal
| |
Collapse
|
15
|
Kurmi S, Pandit N, Sah S, Subedi A, Adhikary S. Safety and Feasibility of Enhanced Recovery after Surgery (ERAS) Protocol in Patients Undergoing Stoma Closure. Indian J Surg 2021. [DOI: 10.1007/s12262-020-02320-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
|
16
|
Dhakal Y, Subedi A. Iatrogenic pneumomediastinum followed by bilateral pneumothoraces: A case report. Anaesth Intensive Care 2021; 49:222-226. [PMID: 33934617 DOI: 10.1177/0310057x21996375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Major respiratory catastrophe associated with iatrogenic airway injury during the Sistrunk operation is a rare event. A three-year-old patient underwent thyroglossal duct cyst removal under general anaesthesia. An iatrogenic thyroid cartilage injury occurred in the intraoperative period, and it was repaired primarily. Later, in the post-anaesthesia care unit, the patient developed subcutaneous emphysema in the neck and face, and then pneumomediastinum and bilateral pneumothoraces. The patient was managed with bilateral chest drains and endotracheal intubation, and he required mechanical ventilation for three days. So, even after repair of a recognised iatrogenic airway injury associated with the Sistrunk operation, it may be necessary to continue positive pressure ventilation in the postoperative period to avoid serious respiratory complications.
Collapse
Affiliation(s)
- Yogesh Dhakal
- Department of Anaesthesiology and Critical Care, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Asish Subedi
- Department of Anaesthesiology and Critical Care, BP Koirala Institute of Health Sciences, Dharan, Nepal
| |
Collapse
|
17
|
Pokharel K, Subedi A, Tripathi M, Biswas BK. Effect of amino acid infusion during cesarean delivery on newborn temperature: a randomized controlled trial. BMC Pregnancy Childbirth 2021; 21:267. [PMID: 33789610 PMCID: PMC8011173 DOI: 10.1186/s12884-021-03734-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 03/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The effect of maternal amino acid (AA) infusion before and during cesarean delivery on neonatal temperature remains unknown. We hypothesized that thermogenic effects of AA metabolism would help maintain body temperature of newborn babies and their mothers. METHODS Seventy-six parturients scheduled for elective singleton term cesarean delivery were equally randomized to receive intravenous 200 ml of AA or placebo approximately 1 h before subarachnoid block (infusion rate:100 ml/h). The primary outcome was the newborn rectal temperature at 0, 5 and 10 min after birth. The secondary outcomes included the maternal rectal temperature at six time-points: T0 = before starting study solution infusion, T1 = 30 min after starting infusion, T2 = one hour after starting infusion, T3 = during spinal block, T4 = half an hour after spinal block, T5 = at the time of birth and T6 = at the end of infusion, as well as maternal thermal discomfort and shivering episodes. RESULTS There were no differences in newborn temperature between the two groups at any of the time-points (intervention-time-interaction effect, P = 0.206). The newborn temperature (mean [95%CI] °C) at birth was 37.5 [37.43-37.66] in the AA and 37.4 [37.34-37.55] in the placebo group. It showed a significant (P < 0.001) downward trend at 5 and 10 min after birth (time effect) in both groups. One neonate in the AA and five in the placebo group were hypothermic (temperature < 36.5 °C) (P = 0.20). There was a significant difference in the maternal temperature at all time points between the two groups (Intervention-time interaction effect, P < 0.001). However, after adjustment for multiplicity, the difference was significant only at T6 (P = 0.001). The mean difference [95%CI] in temperature decline from baseline (T0) till the end of infusion (T6) between the two groups was - 0.39 [- 0.55;- 0.22] °C (P < 0.0001). Six mothers receiving placebo and none receiving AA developed hypothermia (temperature < 36 °C) (P = 0.025). Maternal thermal discomfort and shivering episodes were unaffected by AA therapy. CONCLUSIONS Under the conditions of this study, maternal AA infusion before and during spinal anesthesia for cesarean delivery did not influence the neonatal temperature within 10 min after birth. In addition, the maternal temperature was only maintained at two hours of AA infusion. TRIAL REGISTRATION ClinicalTrials.government, Identifier NCT02575170 . Registered on 10th April, 2015 - Retrospectively registered.
Collapse
Affiliation(s)
- Krishna Pokharel
- Department of Anesthesiology and Critical Care, BP Koirala Institute of Health Sciences, Dharan, Nepal.
| | - Asish Subedi
- Department of Anesthesiology and Critical Care, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Mukesh Tripathi
- Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Rishikesh, India
| | - Binay Kumar Biswas
- Department of Anesthesiology, ESI-Post Graduate Institute of Medical Science & Research, Kolkata, India
| |
Collapse
|
18
|
Affiliation(s)
- Asish Subedi
- Department of Anesthesiology & Critical Care, BP Koirala Institute of Health Sciences, Dharan, Nepal,
| | | |
Collapse
|
19
|
Androić D, Armstrong DS, Asaturyan A, Bartlett K, Beaufait J, Beminiwattha RS, Benesch J, Benmokhtar F, Birchall J, Carlini RD, Cornejo JC, Dusa SC, Dalton MM, Davis CA, Deconinck W, Dowd JF, Dunne JA, Dutta D, Duvall WS, Elaasar M, Falk WR, Finn JM, Forest T, Gal C, Gaskell D, Gericke MTW, Grames J, Gray VM, Grimm K, Guo F, Hoskins JR, Jones D, Jones MK, Jones RT, Kargiantoulakis M, King PM, Korkmaz E, Kowalski S, Leacock J, Leckey JP, Lee AR, Lee JH, Lee L, MacEwan S, Mack D, Magee JA, Mahurin R, Mammei J, Martin JW, McHugh MJ, Meekins D, Mei J, Mesick KE, Michaels R, Micherdzinska A, Mkrtchyan A, Mkrtchyan H, Morgan N, Narayan A, Ndukum LZ, Nelyubin V, van Oers WTH, Owen VF, Page SA, Pan J, Paschke KD, Phillips SK, Pitt ML, Radloff RW, Rajotte JF, Ramsay WD, Roche J, Sawatzky B, Seva T, Shabestari MH, Silwal R, Simicevic N, Smith GR, Solvignon P, Spayde DT, Subedi A, Subedi R, Suleiman R, Tadevosyan V, Tobias WA, Tvaskis V, Waidyawansa B, Wang P, Wells SP, Wood SA, Yang S, Zang P, Zhamkochyan S. Precision Measurement of the Beam-Normal Single-Spin Asymmetry in Forward-Angle Elastic Electron-Proton Scattering. Phys Rev Lett 2020; 125:112502. [PMID: 32976004 DOI: 10.1103/physrevlett.125.112502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 08/07/2020] [Accepted: 08/11/2020] [Indexed: 06/11/2023]
Abstract
A beam-normal single-spin asymmetry generated in the scattering of transversely polarized electrons from unpolarized nucleons is an observable related to the imaginary part of the two-photon exchange process. We report a 2% precision measurement of the beam-normal single-spin asymmetry in elastic electron-proton scattering with a mean scattering angle of θ_{lab}=7.9° and a mean energy of 1.149 GeV. The asymmetry result is B_{n}=-5.194±0.067(stat)±0.082 (syst) ppm. This is the most precise measurement of this quantity available to date and therefore provides a stringent test of two-photon exchange models at far-forward scattering angles (θ_{lab}→0) where they should be most reliable.
Collapse
Affiliation(s)
- D Androić
- University of Zagreb, Zagreb, HR 10002, Croatia
| | | | - A Asaturyan
- A. I. Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan 0036, Armenia
| | - K Bartlett
- William & Mary, Williamsburg, Virginia 23185, USA
| | - J Beaufait
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - R S Beminiwattha
- Ohio University, Athens, Ohio 45701, USA
- Louisiana Tech University, Ruston, Louisiana 71272, USA
| | - J Benesch
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - F Benmokhtar
- Duquesne University, Pittburgh, Pennsylvania 15282, USA
| | - J Birchall
- University of Manitoba, Winnipeg, Manitoba R3T2N2, Canada
| | - R D Carlini
- William & Mary, Williamsburg, Virginia 23185, USA
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - J C Cornejo
- William & Mary, Williamsburg, Virginia 23185, USA
| | - S Covrig Dusa
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - M M Dalton
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - C A Davis
- TRIUMF, Vancouver, British Columbia V6T2A3, Canada
| | - W Deconinck
- William & Mary, Williamsburg, Virginia 23185, USA
| | - J F Dowd
- William & Mary, Williamsburg, Virginia 23185, USA
| | - J A Dunne
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - D Dutta
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - W S Duvall
- Virginia Polytechnic Institute & State University, Blacksburg, Virginia 24061, USA
| | - M Elaasar
- Southern University at New Orleans, New Orleans, Louisiana 70126, USA
| | - W R Falk
- University of Manitoba, Winnipeg, Manitoba R3T2N2, Canada
| | - J M Finn
- William & Mary, Williamsburg, Virginia 23185, USA
| | - T Forest
- Louisiana Tech University, Ruston, Louisiana 71272, USA
- Idaho State University, Pocatello, Idaho 83209, USA
| | - C Gal
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - D Gaskell
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - M T W Gericke
- University of Manitoba, Winnipeg, Manitoba R3T2N2, Canada
| | - J Grames
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - V M Gray
- William & Mary, Williamsburg, Virginia 23185, USA
| | - K Grimm
- William & Mary, Williamsburg, Virginia 23185, USA
- Louisiana Tech University, Ruston, Louisiana 71272, USA
| | - F Guo
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - J R Hoskins
- William & Mary, Williamsburg, Virginia 23185, USA
| | - D Jones
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - M K Jones
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - R T Jones
- University of Connecticut, Storrs-Mansfield, Connecticut 06269, USA
| | | | - P M King
- Ohio University, Athens, Ohio 45701, USA
| | - E Korkmaz
- University of Northern British Columbia, Prince George, British Columbia V2N4Z9, Canada
| | - S Kowalski
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - J Leacock
- Virginia Polytechnic Institute & State University, Blacksburg, Virginia 24061, USA
| | - J P Leckey
- William & Mary, Williamsburg, Virginia 23185, USA
| | - A R Lee
- Virginia Polytechnic Institute & State University, Blacksburg, Virginia 24061, USA
| | - J H Lee
- William & Mary, Williamsburg, Virginia 23185, USA
- Ohio University, Athens, Ohio 45701, USA
| | - L Lee
- University of Manitoba, Winnipeg, Manitoba R3T2N2, Canada
- TRIUMF, Vancouver, British Columbia V6T2A3, Canada
| | - S MacEwan
- University of Manitoba, Winnipeg, Manitoba R3T2N2, Canada
| | - D Mack
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - J A Magee
- William & Mary, Williamsburg, Virginia 23185, USA
| | - R Mahurin
- University of Manitoba, Winnipeg, Manitoba R3T2N2, Canada
| | - J Mammei
- University of Manitoba, Winnipeg, Manitoba R3T2N2, Canada
- Virginia Polytechnic Institute & State University, Blacksburg, Virginia 24061, USA
| | - J W Martin
- University of Winnipeg, Winnipeg, Manitoba R3B2E9, Canada
| | - M J McHugh
- George Washington University, Washington, DC 20052, USA
| | - D Meekins
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - J Mei
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - K E Mesick
- George Washington University, Washington, DC 20052, USA
- Rutgers, The State University of New Jersey, Piscataway, New Jersey 088754, USA
| | - R Michaels
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | | | - A Mkrtchyan
- A. I. Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan 0036, Armenia
| | - H Mkrtchyan
- A. I. Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan 0036, Armenia
| | - N Morgan
- Virginia Polytechnic Institute & State University, Blacksburg, Virginia 24061, USA
| | - A Narayan
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - L Z Ndukum
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - V Nelyubin
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - W T H van Oers
- University of Manitoba, Winnipeg, Manitoba R3T2N2, Canada
- TRIUMF, Vancouver, British Columbia V6T2A3, Canada
| | - V F Owen
- William & Mary, Williamsburg, Virginia 23185, USA
| | - S A Page
- University of Manitoba, Winnipeg, Manitoba R3T2N2, Canada
| | - J Pan
- University of Manitoba, Winnipeg, Manitoba R3T2N2, Canada
| | - K D Paschke
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - S K Phillips
- University of New Hampshire, Durham, New Hampshire 03824, USA
| | - M L Pitt
- Virginia Polytechnic Institute & State University, Blacksburg, Virginia 24061, USA
| | | | - J F Rajotte
- Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA
| | - W D Ramsay
- University of Manitoba, Winnipeg, Manitoba R3T2N2, Canada
- TRIUMF, Vancouver, British Columbia V6T2A3, Canada
| | - J Roche
- Ohio University, Athens, Ohio 45701, USA
| | - B Sawatzky
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - T Seva
- University of Zagreb, Zagreb, HR 10002, Croatia
| | - M H Shabestari
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - R Silwal
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - N Simicevic
- Louisiana Tech University, Ruston, Louisiana 71272, USA
| | - G R Smith
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - P Solvignon
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - D T Spayde
- Hendrix College, Conway, Arkansas 72032, USA
| | - A Subedi
- Mississippi State University, Mississippi State, Mississippi 39762, USA
| | - R Subedi
- George Washington University, Washington, DC 20052, USA
| | - R Suleiman
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - V Tadevosyan
- A. I. Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan 0036, Armenia
| | - W A Tobias
- University of Virginia, Charlottesville, Virginia 22903, USA
| | - V Tvaskis
- University of Winnipeg, Winnipeg, Manitoba R3B2E9, Canada
| | - B Waidyawansa
- Ohio University, Athens, Ohio 45701, USA
- Louisiana Tech University, Ruston, Louisiana 71272, USA
| | - P Wang
- University of Manitoba, Winnipeg, Manitoba R3T2N2, Canada
| | - S P Wells
- Louisiana Tech University, Ruston, Louisiana 71272, USA
| | - S A Wood
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - S Yang
- William & Mary, Williamsburg, Virginia 23185, USA
| | - P Zang
- Syracuse University, Syracuse, New York 13244, USA
| | - S Zhamkochyan
- A. I. Alikhanyan National Science Laboratory (Yerevan Physics Institute), Yerevan 0036, Armenia
| |
Collapse
|
20
|
Khatiwada S, Pokharel K, Subedi A. Intraoperative Infusion of Magnesium Sulphate does not Reduce Laryngospasm and Agitation during Emergence from Anaesthesia in Children. Kathmandu Univ Med J (KUMJ) 2020; 18:223-227. [PMID: 34158427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Background Laryngospasm and agitation during emergence from general anaesthesia are frequent in children. Magnesium sulphate may have the potential of reducing both of these adverse events. In addition, magnesium has analgesic and anaesthetic properties. Objective To find out the effectiveness of magnesium sulphate in reducing the occurrence of emergence laryngospasm and agitation and other adverse events if any in children. Method Randomized, placebo controlled study was conducted at a tertiary care hospital in 132 children, aged 3-12 years undergoing general anaesthesia for hernia and hydrocele surgery. Children with American Society of Anaesthesiologist Physical Status > II were excluded. After insertion of laryngeal mask airway, 20 ml of either magnesium sulphate 15 mg/kg (Group M) or normal saline (Group N) was infused at the rate of 1 ml/min. The severity of laryngospasm and agitation was assessed. We also noted other adverse events, if occurred. Result Laryngospasm occurred in 7(10.6%) patients of group M and in 10(15.1%) patients of group N(p=0.40). While 14(10.6%) patients developed laryngospasm immediately after removal of LMA, only 3(2.2%) patients developed it in the post anaesthetic care unit. Two (3.0%) patients of group M and four patients (6.0%) of group N were agitated (p=0.40). Three (4.5%) patients of group M and 14(21.2%) patients of group N coughed during emergence (p=0.004). Conclusion Intraoperative infusion of 15 mg/kg magnesium sulphate, does not reduce the occurrence of emergence laryngospasm and agitation in children. However, it significantly reduce emergence cough.
Collapse
Affiliation(s)
- S Khatiwada
- Department of Anaesthesiology and Critical Care, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - K Pokharel
- Department of Anaesthesiology and Critical Care, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - A Subedi
- Department of Anaesthesiology and Critical Care, BP Koirala Institute of Health Sciences, Dharan, Nepal
| |
Collapse
|
21
|
Subedi A. Is difficult or failed intubation a confounder or an effect modifier for hypoxaemia? Comment on Br J Anaesth; 125: e81-7. Br J Anaesth 2020; 125:e348-e349. [PMID: 32611525 DOI: 10.1016/j.bja.2020.05.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 05/07/2020] [Indexed: 11/19/2022] Open
|
22
|
Ghimire A, Subedi A, Bhattarai B, Sah BP. The effect of intraoperative lidocaine infusion on opioid consumption and pain after totally extraperitoneal laparoscopic inguinal hernioplasty: a randomized controlled trial. BMC Anesthesiol 2020; 20:137. [PMID: 32493276 PMCID: PMC7268281 DOI: 10.1186/s12871-020-01054-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 05/25/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND As a component of multimodal analgesia, the administration of systemic lidocaine is a well-known technique. We aimed to evaluate the efficacy of lidocaine infusion on postoperative pain-related outcomes in patients undergoing totally extraperitoneal (TEP) laparoscopies inguinal hernioplasty. METHODS In this randomized controlled double-blind study, we recruited 64 patients to receive either lidocaine 2% (intravenous bolus 1.5 mg. kg - 1 followed by an infusion of 2 mg. kg- 1. h- 1), or an equal volume of normal saline. The infusion was initiated just before the induction of anesthesia and discontinued after tracheal extubation. The primary outcome of the study was postoperative morphine equivalent consumption up to 24 h after surgery. Secondary outcomes included postoperative pain scores, nausea/vomiting (PONV), sedation, quality of recovery (scores based on QoR-40 questionnaire), patient satisfaction, and the incidence of chronic pain. RESULTS The median (IQR) cumulative postoperative morphine equivalent consumption in the first 24 h was 0 (0-1) mg in the lidocaine group and 4 [1-8] mg in the saline group (p < 0.001). Postoperative pain intensity at rest and during movement at various time points in the first 24 h were significantly lower in the lidocaine group compared with the saline group (p < 0.05). Fewer patients reported PONV in the lidocaine group than in the saline group (p < 0.05). Median QoR scores at 24 h after surgery were significantly better in the lidocaine group (194 (194-196) than saline group 184 (183-186) (p < 0.001). Patients receiving lidocaine were more satisfied with postoperative analgesia than those receiving saline (p = 0.02). No difference was detected in terms of postoperative sedation and chronic pain after surgery. CONCLUSIONS Intraoperative lidocaine infusion for laparoscopic TEP inguinal hernioplasty reduces opioid consumption, pain intensity, PONV and improves the quality of recovery and patient satisfaction. TRIAL REGISTRATION ClinicalTrials.gov- NCT02601651. Date of registration: November 10, 2015.
Collapse
Affiliation(s)
- Anup Ghimire
- Department of Anesthesiology, Nepal Mediciti Hospital, Lalitpur, Nepal
| | - Asish Subedi
- Department of Anesthesiology & Critical Care Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal.
| | - Balkrishna Bhattarai
- Department of Anesthesiology & Critical Care Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Birendra Prasad Sah
- Department of Anesthesiology & Critical Care Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal
| |
Collapse
|
23
|
Dhakal Y, Bhattarai B, Khatiwada S, Subedi A. Effect of Positive Airway Pressure During Preoxygenation on Safe Apnea Period: a comparison of the supine and 25° head up position. Kathmandu Univ Med J (KUMJ) 2020; 18:165-170. [PMID: 33594024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Background Preoxygenation is performed before induction of anaesthesia which increases oxygen reserve and provides delayed onset of hypoxia during period of apnea. Several techniques such as positive airway pressure and head-up tilt during preoxygenation have shown to prolong safe apnea period compared to conventional technique. However, uniform recommendations have not yet been made. Objective To find out the effect of combination of 5 cmH2 O continuous positive airway pressure (CPAP) and 25° head up position during preoxygenation on safe apnea period. Method In this comparative study 60 non-obese adult patients were divided into three equal groups; Group C receiving preoxygenation in conventional technique, Group S receiving preoxygenation with 5 cmH2 O continuous positive airway pressure in supine position and Group H receiving preoxygenation in 25° head-up position with 5 cmH2 O continuous positive airway pressure. After 3 min of preoxygenation, intubation was performed after induction of anaesthesia with propofol, fentanyl and succinylcholine. After confirming the tracheal intubation by direct visualization, all patients were administered vecuronium to maintain neuromuscular blockade. Postintubation, patients in all groups were left in same position with the tracheal tube exposed to atmosphere and without being ventilated till the SpO2 dropped to 92%. The primary outcome compared between the groups was the safe apnea period (time from loss of consciousness to fall of SpO2 to 92%). Result The duration of safe apnea period was longer (p < 0.05) in Group H patients (405.9 ± 106.69 s) as compared to the Group C (296.9 ± 99.01s) and Group S (319.65 ± 71.54s). Although the duration of safe apnea period was longer in the Group S as compared to Group C the difference was not statistically significant. Conclusion Preoxygenation in 25° head-up position with 5 cm H2O continuous positive airway pressure significantly prolongs safe apnea period in non-obese adults compared to supine position, with or without 5 cmH2O continuous positive airway pressure.
Collapse
Affiliation(s)
- Y Dhakal
- Department of Anaesthesiology and Critical Care, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - B Bhattarai
- Department of Anaesthesiology and Critical Care, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - S Khatiwada
- Department of Anaesthesiology and Critical Care, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - A Subedi
- Department of Anaesthesiology and Critical Care, BP Koirala Institute of Health Sciences, Dharan, Nepal
| |
Collapse
|
24
|
Subedi A, Tripathi M, Pokharel K, Khatiwada S. Effect of Intravenous Lidocaine, Dexamethasone, and Their Combination on Postoperative Sore Throat: A Randomized Controlled Trial. Anesth Analg 2020; 129:220-225. [PMID: 30320641 DOI: 10.1213/ane.0000000000003842] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Postoperative sore throat (POST), hoarseness, and cough after tracheal intubation are not uncommon. Although both lidocaine and dexamethasone have been used independently to reduce these events, there is no study assessing the combined effects of lidocaine and dexamethasone. METHODS This prospective, double-blind, randomized controlled study enrolled 180 patients requiring general anesthesia with endotracheal intubation for >90 minutes. They received 1 of the 4 intravenous agents just before induction of anesthesia: lidocaine (1.5 mg/kg) in group L, dexamethasone (8 mg) in group D, lidocaine (1.5 mg/kg) with dexamethasone (8 mg) in group DL, and placebo as normal saline in group NS. Standard anesthesia protocol was followed. Incidence and severity of a sore throat, cough, and hoarseness of voice were assessed up to 24 hours postoperatively. The primary outcome was the incidence of POST, and the main effects of dexamethasone and lidocaine were the primary interest. RESULTS Data of 45 patients in D, 44 in L, 44 in DL, and 43 in NS groups were analyzed. The incidence of a sore throat was 36%, 43%, 25%, and 56% in group D, L, DL, and NS, respectively (P = .02). Dexamethasone with or without lidocaine reduced the incidence of the POST (odds ratio, 0.44; 95% confidence interval, 0.24-0.82; P < .01). However, lidocaine was not effective in reducing POST (odds ratio, 0.62; 95% confidence interval, 0.33-1.14; P = .12). No difference was observed in the severity of a sore throat, incidence and severity of a cough, and hoarseness among the groups. CONCLUSIONS Dexamethasone, with or without lidocaine, was effective in reducing the incidence of POST in patients requiring prolonged tracheal intubation.
Collapse
Affiliation(s)
- Asish Subedi
- From the Department of Anesthesiology and Critical Care, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Mukesh Tripathi
- Department of Anesthesiology, All India Institute of Medical Sciences, Rishikesh, India
| | - Krishna Pokharel
- From the Department of Anesthesiology and Critical Care, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Sindhu Khatiwada
- From the Department of Anesthesiology and Critical Care, BP Koirala Institute of Health Sciences, Dharan, Nepal
| |
Collapse
|
25
|
Xiong W, Gasparian A, Gao H, Dutta D, Khandaker M, Liyanage N, Pasyuk E, Peng C, Bai X, Ye L, Gnanvo K, Gu C, Levillain M, Yan X, Higinbotham DW, Meziane M, Ye Z, Adhikari K, Aljawrneh B, Bhatt H, Bhetuwal D, Brock J, Burkert V, Carlin C, Deur A, Di D, Dunne J, Ekanayaka P, El-Fassi L, Emmich B, Gan L, Glamazdin O, Kabir ML, Karki A, Keith C, Kowalski S, Lagerquist V, Larin I, Liu T, Liyanage A, Maxwell J, Meekins D, Nazeer SJ, Nelyubin V, Nguyen H, Pedroni R, Perdrisat C, Pierce J, Punjabi V, Shabestari M, Shahinyan A, Silwal R, Stepanyan S, Subedi A, Tarasov VV, Ton N, Zhang Y, Zhao ZW. A small proton charge radius from an electron-proton scattering experiment. Nature 2019; 575:147-150. [PMID: 31695211 DOI: 10.1038/s41586-019-1721-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 09/19/2019] [Indexed: 11/09/2022]
Abstract
Elastic electron-proton scattering (e-p) and the spectroscopy of hydrogen atoms are the two methods traditionally used to determine the proton charge radius, rp. In 2010, a new method using muonic hydrogen atoms1 found a substantial discrepancy compared with previous results2, which became known as the 'proton radius puzzle'. Despite experimental and theoretical efforts, the puzzle remains unresolved. In fact, there is a discrepancy between the two most recent spectroscopic measurements conducted on ordinary hydrogen3,4. Here we report on the proton charge radius experiment at Jefferson Laboratory (PRad), a high-precision e-p experiment that was established after the discrepancy was identified. We used a magnetic-spectrometer-free method along with a windowless hydrogen gas target, which overcame several limitations of previous e-p experiments and enabled measurements at very small forward-scattering angles. Our result, rp = 0.831 ± 0.007stat ± 0.012syst femtometres, is smaller than the most recent high-precision e-p measurement5 and 2.7 standard deviations smaller than the average of all e-p experimental results6. The smaller rp we have now measured supports the value found by two previous muonic hydrogen experiments1,7. In addition, our finding agrees with the revised value (announced in 2019) for the Rydberg constant8-one of the most accurately evaluated fundamental constants in physics.
Collapse
Affiliation(s)
- W Xiong
- Duke University and Triangle Universities Nuclear Laboratory, Durham, NC, USA
| | - A Gasparian
- North Carolina A&T State University, Greensboro, NC, USA.
| | - H Gao
- Duke University and Triangle Universities Nuclear Laboratory, Durham, NC, USA
| | - D Dutta
- Mississippi State University, Mississippi State, MS, USA.
| | | | - N Liyanage
- University of Virginia, Charlottesville, VA, USA
| | - E Pasyuk
- Thomas Jefferson National Accelerator Facility, Newport News, VA, USA
| | - C Peng
- Duke University and Triangle Universities Nuclear Laboratory, Durham, NC, USA
| | - X Bai
- University of Virginia, Charlottesville, VA, USA
| | - L Ye
- Mississippi State University, Mississippi State, MS, USA
| | - K Gnanvo
- University of Virginia, Charlottesville, VA, USA
| | - C Gu
- Duke University and Triangle Universities Nuclear Laboratory, Durham, NC, USA
| | - M Levillain
- North Carolina A&T State University, Greensboro, NC, USA
| | - X Yan
- Duke University and Triangle Universities Nuclear Laboratory, Durham, NC, USA
| | - D W Higinbotham
- Thomas Jefferson National Accelerator Facility, Newport News, VA, USA
| | - M Meziane
- Duke University and Triangle Universities Nuclear Laboratory, Durham, NC, USA
| | - Z Ye
- Duke University and Triangle Universities Nuclear Laboratory, Durham, NC, USA.,Argonne National Laboratory, Lemont, IL, USA
| | - K Adhikari
- Mississippi State University, Mississippi State, MS, USA
| | - B Aljawrneh
- North Carolina A&T State University, Greensboro, NC, USA
| | - H Bhatt
- Mississippi State University, Mississippi State, MS, USA
| | - D Bhetuwal
- Mississippi State University, Mississippi State, MS, USA
| | - J Brock
- Thomas Jefferson National Accelerator Facility, Newport News, VA, USA
| | - V Burkert
- Thomas Jefferson National Accelerator Facility, Newport News, VA, USA
| | - C Carlin
- Thomas Jefferson National Accelerator Facility, Newport News, VA, USA
| | - A Deur
- Thomas Jefferson National Accelerator Facility, Newport News, VA, USA
| | - D Di
- University of Virginia, Charlottesville, VA, USA
| | - J Dunne
- Mississippi State University, Mississippi State, MS, USA
| | - P Ekanayaka
- Mississippi State University, Mississippi State, MS, USA
| | - L El-Fassi
- Mississippi State University, Mississippi State, MS, USA
| | - B Emmich
- Mississippi State University, Mississippi State, MS, USA
| | - L Gan
- University of North Carolina, Wilmington, NC, USA
| | - O Glamazdin
- Kharkov Institute of Physics and Technology, Kharkov, Ukraine
| | - M L Kabir
- Mississippi State University, Mississippi State, MS, USA
| | - A Karki
- Mississippi State University, Mississippi State, MS, USA
| | - C Keith
- Thomas Jefferson National Accelerator Facility, Newport News, VA, USA
| | - S Kowalski
- Massachusetts Institute of Technology, Cambridge, MA, USA
| | | | - I Larin
- Alikhanov Institute for Theoretical and Experimental Physics NRC "Kurchatov Institute", Moscow, Russia.,University of Massachusetts, Amherst, MA, USA
| | - T Liu
- Duke University and Triangle Universities Nuclear Laboratory, Durham, NC, USA
| | | | - J Maxwell
- Thomas Jefferson National Accelerator Facility, Newport News, VA, USA
| | - D Meekins
- Thomas Jefferson National Accelerator Facility, Newport News, VA, USA
| | | | - V Nelyubin
- University of Virginia, Charlottesville, VA, USA
| | - H Nguyen
- University of Virginia, Charlottesville, VA, USA
| | - R Pedroni
- North Carolina A&T State University, Greensboro, NC, USA
| | - C Perdrisat
- College of William and Mary, Williamsburg, VA, USA
| | - J Pierce
- Thomas Jefferson National Accelerator Facility, Newport News, VA, USA
| | - V Punjabi
- Norfolk State University, Norfolk, VA, USA
| | - M Shabestari
- Mississippi State University, Mississippi State, MS, USA
| | | | - R Silwal
- Massachusetts Institute of Technology, Cambridge, MA, USA
| | - S Stepanyan
- Thomas Jefferson National Accelerator Facility, Newport News, VA, USA
| | - A Subedi
- Mississippi State University, Mississippi State, MS, USA
| | - V V Tarasov
- Alikhanov Institute for Theoretical and Experimental Physics NRC "Kurchatov Institute", Moscow, Russia
| | - N Ton
- University of Virginia, Charlottesville, VA, USA
| | - Y Zhang
- Duke University and Triangle Universities Nuclear Laboratory, Durham, NC, USA
| | - Z W Zhao
- Duke University and Triangle Universities Nuclear Laboratory, Durham, NC, USA
| |
Collapse
|
26
|
Bajracharya JL, Subedi A, Pokharel K, Bhattarai B. The effect of intraoperative lidocaine versus esmolol infusion on postoperative analgesia in laparoscopic cholecystectomy: a randomized clinical trial. BMC Anesthesiol 2019; 19:198. [PMID: 31684867 PMCID: PMC6829809 DOI: 10.1186/s12871-019-0874-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 10/23/2019] [Indexed: 01/08/2023] Open
Abstract
Background As a part of multimodal analgesia for laparoscopic cholecystectomy, both intraoperative lidocaine and esmolol facilitate postoperative analgesia. Our objective was to compare these two emerging strategies that challenge the use of intraoperative opioids. We aimed to assess if intraoperative esmolol infusion is not inferior to lidocaine infusion for opioid consumption after laparoscopic cholecystectomy. Methods In this prospective, randomized, double-blind, non-inferiority clinical trial, 90 female patients scheduled for elective laparoscopic cholecystectomy received either intravenous (IV) lidocaine bolus 1.5 mg/kg at induction followed by an infusion (1.5 mg/ kg/h) or IV bolus of esmolol 0.5 mg/kg at induction followed by an infusion (5–15 μg/kg/min) till the end of surgery. Remaining aspect of anesthesia followed a standard protocol apart from no intraoperative opioid supplementation. Postoperatively, patients received either morphine or tramadol IV to maintain visual analogue scale (VAS) scores ≤3. The primary outcome was opioid consumption (in morphine equivalents) during the first 24 postoperative hours. Pain and sedation scores, time to first perception of pain and void, and occurrence of nausea/vomiting were secondary outcomes measured up to 24 h postoperatively. Results Two patients in each group were excluded from the analysis. The postoperative median (IQR) morphine equivalent consumption in patients receiving esmolol was 1 (0–1.5) mg compared to 1.5 (1–2) mg in lidocaine group (p = 0.27). The median pain scores at various time points were similar between the two groups (p > 0.05). More patients receiving lidocaine were sedated in the post-anesthesia care unit (PACU) than those receiving esmolol (p < 0.05); however, no difference was detected later. Conclusion Infusion of esmolol is not inferior to lidocaine in terms of opioid requirement and pain severity in the first 24 h after surgery. Patients receiving lidocaine were more sedated during their stay in PACU than those receiving esmolol. Trial registration ClinicalTrials.gov- NCT02327923. Date of registration: December 31, 2014.
Collapse
Affiliation(s)
| | - Asish Subedi
- Department of Anesthesiology & Critical Care Medicine, BP Koirala Institute of Health Sciences, BPKIHS, Dharan, Nepal.
| | - Krishna Pokharel
- Department of Anesthesiology & Critical Care Medicine, BPKIHS, Dharan, Nepal
| | | |
Collapse
|
27
|
Khattri JB, Godar ST, Subedi A. A Study of Vitamin D among Patients Presenting in the Psychiatric OPD of Manipal Teaching Hospital, Pokhara. Kathmandu Univ Med J (KUMJ) 2019; 17:293-297. [PMID: 33311038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Background There have been growing interests in the association between vitamin D and depression in recent years. Objective The objective of this study was to find the prevalence of low vitamin D level in the patients suffering from depressive episodes. The next objective was to determine whether there are any statistically significant differences between the mean vitamin D levels of different sociodemographic variables and also to find the sociodemographic variables predicting the vitamin D level. Method The patients diagnosed as depressive episodes were selected from the out-patient unit of Department of Psychiatry of Manipal Teaching Hospital, Pokhara. The proforma was used to collect the sociodemographic profile of the patient. The diagnosis of depressive episode was made according to the International Classification of Disease-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research. The serum vitamin D level of less than 30 ng/ml was considered as low level in this study. Result The prevalence of low vitamin level was found in 81.8%. The mean difference of vitamin D level was statistically significant in gender and marital status of the patients. The low mean vitamin level was found in the socio-demographic variables like in age above 60 years, Newar caste, female gender, separated from the spouse patients and in the patients living in the urban area as compared to other group of patients. The gender of the patients predicted vitamin D level in the depressed patients. Conclusion There is high prevalence of low vitamin D level in the depressed patients. The correction of low vitamin D level would be helpful in the holistic management of patient with depressive episodes.
Collapse
Affiliation(s)
- J B Khattri
- Department of Psychiatry, Manipal College of Medical Sciences, Pokhara, Nepal
| | - S T Godar
- Department of Ophthalmology, Manipal College of Medical Sciences, Pokhara, Nepal
| | - A Subedi
- Department of Psychiatry, Manipal College of Medical Sciences, Pokhara, Nepal
| |
Collapse
|
28
|
Abstract
Background Respiratory adverse events are not uncommon in the post-anesthesia care unit (PACU) following general anesthesia. In this regard, hyperventilation leading to apnea and desaturation is a rare entity. Here we have reported a case of a 15-year-old girl who, following an uneventful general anesthesia, developed severe hyperventilation leading to apnea and desaturation in the PACU. Case presentation The 15-year-old girl underwent cortical mastoidectomy under general anesthesia. After a smooth anesthesia and an uneventful early recovery, she developed hyperventilation after about 15 min in the PACU. The symptom was severe enough to lead to apnea, desaturation and severe respiratory alkalosis. She required bag and mask ventilation and the symptoms resolved only transiently with propofol sedation. Finally, she responded to intravenous haloperidol and did not have any further episode after receiving haloperidol. Conclusion Hyperventilation after a smooth recovery from anesthesia is not a common presentation. In this article we have tried to discuss the possible cause of such symptom in our patient and how we successfully managed this case. We have also proposed an algorithmic approach to diagnose and manage such cases in the PACU.
Collapse
Affiliation(s)
- Parineeta Thapa
- Department of Anaesthesiology and Critical Care, B. P. Koirala Institute of Health Sciences, Dharan, Koshi, Nepal.
| | - Asish Subedi
- Department of Anaesthesiology and Critical Care, B. P. Koirala Institute of Health Sciences, Dharan, Koshi, Nepal
| | - Anjali Poudel
- Department of Anaesthesiology and Critical Care, B. P. Koirala Institute of Health Sciences, Dharan, Koshi, Nepal
| | - Pankaj Baral
- Department of Anaesthesiology and Critical Care, B. P. Koirala Institute of Health Sciences, Dharan, Koshi, Nepal
| |
Collapse
|
29
|
Subedi A, Pokharel K. Is a Single Dose of Propofol Good Enough to Prevent Respiratory Complications beyond the Induction Phase? Anesthesiology 2019; 130:509-510. [DOI: 10.1097/aln.0000000000002576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
30
|
Pokharel K, Rijal R, Bhattarai B, Subedi A, Khatiwada S. Implications of Subarchnoid Block in Senile Kyphosis. Kathmandu Univ Med J (KUMJ) 2018; 16:351-353. [PMID: 31729353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Since the literature related to safety or efficacy of placing spinal blocks in patients with kyphosis is lacking, we aim to discuss about the anaesthesia implications of spinal anaesthesia in senile kyphosis. We successfully administered spinal anesthesia in three elderly patients with predominant kyphotic deformity with absent or mild scoliosis. The needle insertion attempts did not exceed two and a smaller dose of anesthetic was sufficient. While choosing spinal anaesthesia in patients with kyphosis, a risk benefit analysis needs to be performed based on the co-presence of scoliosis and its severity, desired level of anesthesia, and associated or coexisting systemic illness.
Collapse
Affiliation(s)
- K Pokharel
- Department of Anaesthesiology and Critical Care, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - R Rijal
- Department of Orthopaedics, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - B Bhattarai
- Department of Anaesthesiology and Critical Care, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - A Subedi
- Department of Anaesthesiology and Critical Care, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - S Khatiwada
- Department of Anaesthesiology and Critical Care, BP Koirala Institute of Health Sciences, Dharan, Nepal
| |
Collapse
|
31
|
Siwakoti S, Subedi A, Sharma A, Baral R, Bhattarai NR, Khanal B. Incidence and outcomes of multidrug-resistant gram-negative bacteria infections in intensive care unit from Nepal- a prospective cohort study. Antimicrob Resist Infect Control 2018; 7:114. [PMID: 30275945 PMCID: PMC6158849 DOI: 10.1186/s13756-018-0404-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 09/10/2018] [Indexed: 11/29/2022] Open
Abstract
Background Infections caused by multi-drug resistant gram-negative bacterial infections are the principle threats to the critically ill patients of intensive care units. Increasing reports of these infections from the Nepalese intensive care unit underline the clinical importance of these pathogens. However, the impact of these infections on the patient’s clinical outcome has not yet been clearly evaluated. The objective of our study was to determine the incidence and associated clinical outcome of multi-drug resistant gram-negative bacterial infections in intensive care unit from a tertiary care center of Nepal. Methods A prospective cohort study was conducted among adult patients admitted in intensive care unit of B. P Koirala Institute of Health Sciences from July to December 2017. Patients infected with multi-drug resistant gram-negative bacteria, non-multi-drug resistant gram-negative bacteria and those without infection were included. Identification of gram-negative bacteria and their antibiotic susceptibility pattern was performed with standard microbiological methods. Demographic, clinical profiles and outcomes (in-hospital-mortality, intensive care unit and hospital length of stay) were documented. Results The incidence rate of multi-drug resistant gram-negative bacteria infections was 47 per 100 admitted patients (64/137) with 128 episodes. Acinetobacter species (41%, 52/128) was the commonest followed by Klebsiella pneumoniae (28%, 36/128) and Pseudomonas spp (21%, 27/128). Patients with multi-drug resistant gram-negative bacteria in comparison to non-multi-drug resistant gram-negative bacteria had high healthcare-associated infections (95%, 61/64 versus 20%, 2/10; p = < 0.001). In-hospital-mortality was 38% (24/64), 20% (2/10) and 10% (4/41) in multi-drug resistant, non-multi-drug resistant and uninfected group respectively (p = 0.007). After adjustment for independent risk factors, compared to uninfected patients, the odds ratio (CI) for in-hospital-mortality in multi-drug resistant and non-multi-drug resistant group was (4.7[1.4–15.5], p = 0.01) and 2.60 [0.38–17.8], p = 0.32) respectively. Multi-drug resistant patients also had longer intensive care unit and hospital stay, however, it was statistically insignificant. Conclusion The incidence of multi-drug resistant gram-negative bacterial infections was remarkably high in our intensive care unit and showed a significant association with healthcare-associated infections and in-hospital-mortality.
Collapse
Affiliation(s)
- Shraddha Siwakoti
- 1Department of Microbiology, B. P. Koirala Institute of Health Sciences, Dharan, 56700 Nepal
| | - Asish Subedi
- 2Department of Anaesthesiology and Critical care, B. P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Abhilasha Sharma
- 1Department of Microbiology, B. P. Koirala Institute of Health Sciences, Dharan, 56700 Nepal
| | - Ratna Baral
- 1Department of Microbiology, B. P. Koirala Institute of Health Sciences, Dharan, 56700 Nepal
| | - Narayan Raj Bhattarai
- 1Department of Microbiology, B. P. Koirala Institute of Health Sciences, Dharan, 56700 Nepal
| | - Basudha Khanal
- 1Department of Microbiology, B. P. Koirala Institute of Health Sciences, Dharan, 56700 Nepal
| |
Collapse
|
32
|
Panday DR, Amar A, Subedi A, Hussain MS, Gupta M, Rauniar GP. Antibiotic Usage and its Culture Sensitivity Pattern in Urinary Tract Infections at Tertiary Hospital in Eastern Nepal. Kathmandu Univ Med J (KUMJ) 2017; 15:332-335. [PMID: 30580352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Background The presence of microbial pathogen in the urinary tract is Urinary Tract Infection (UTI). In BP Koirala Institute of Health Sciences (BPKIHS), each year there are around 1000 cases of UTIs. Antibiotic is empirically started after sending culture/sensitivity (c/s) with intention to change antibiotic if c/s demands. Objective To see the antimicrobial prescribing pattern and c/s pattern of UTI inpatients of BPKIHS together with their socio-demographic and laboratory profile. Method It was a Record-Based Retrospective Descriptive Study of past one-year. All available inpatient-records from Medical-Record Section were extensively searched for the keyword "UTI" diagnosis. The relevant data were entered in Microsoft Excel-sheet and analyzed with IBM SPSS 21. Ethical clearance was obtained from the IRC before study. Result There were 86 cases from four different wards. There was slight female preponderance (51.16%). Fifty-five (63.95%) cases were complicated. Fever (75.51%) was the most common symptom. Only 20% were tachycardic but 90% were tachypnic. Leucocytosis (59.26%), urine albumin within 30-100 mg/dl (33.85%) and >5 Urine WBC/hpf (80.26%) were seen. Ceftiaxone (53.16%) was the most commonly prescribed empirical antibiotic, followed by Cefixime (6.32%). Fourteen (16.27%) cases were culture positive. E. coli was the most (78.57%) common pathogen grown. In culture sensitivity study, Amikacin (42.85%) was the most sensitive antibiotic. Conclusion Eighty-six UTI inpatients were identified last year. Fever and Tachypnoea were very common. Leucocytosis, 1+ proteinuria and urine WBC>5/hpf were frequently seen. Ceftriaxone was the most common antibiotic prescribed. E. coli was the most common pathogen grown and Amikacin was the most sensitive antibiotic.
Collapse
Affiliation(s)
- D R Panday
- Department of Clinical Pharmacology and Therapeutics, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - A Amar
- Department of Clinical Pharmacology and Therapeutics, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - A Subedi
- Department of Clinical Pharmacology and Therapeutics, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Md S Hussain
- Department of Clinical Pharmacology and Therapeutics, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - M Gupta
- Department of Clinical Pharmacology and Therapeutics, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - G P Rauniar
- Department of Clinical Pharmacology and Therapeutics, BP Koirala Institute of Health Sciences, Dharan, Nepal
| |
Collapse
|
33
|
Ghimire A, Bhattarai B, Prasad JN, Subedi A, Thapa P, Limbu PM, Adhikari S. Postoperative Analgesic Effect of Morphine Added to Bupivacaine for Transversus Abdominis Plane (TAP) Block in Appendectomy. Kathmandu Univ Med J (KUMJ) 2017; 17:137-141. [PMID: 34547845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Background Transversus abdominis plane (TAP) block with local anaesthetics produces effective pain relief following lower abdominal surgeries. Although opioids have been found to have effects through peripheral receptors also, reports on their effect when used as additive to local anaesthetics for TAP block are lacking. Objective To assess the analgesic effect of peripherally administered morphine with bupivacaine for ipsilateral TAP block in patients undergoing emergency appendectomy under general anaesthesia. Method Sixty patients undergoing appendectomy were randomized to undergo ipsilateral TAP with 20 ml of 0.5% bupivacaine plus 2 ml of NS (total 22 ml) and 2 ml of intravenous (IV) saline (Group TB) or with 20ml of 0.5% bupivacaine plus 2 mg (2 ml) of morphine (total 22 ml) and 2 ml of NS IV (Group TBM) or with 20 ml of 0.5% bupivacaine plus 2 ml of NS (total 22 ml) and 2 mg (2 ml) IV morphine (Group TB-IVM). Pain severity was measured using Visual Analogue Scale (VAS) preoperatively (Baseline) and at 30 min, 6h, 12 h and 24 h postoperatively. Inj. tramadol 50 mg IV was used as rescue analgesic when postoperative VAS was 4 or more. The duration of analgesia (time to first analgesic) and the postoperative 24 h tramadol requirement was recorded. Result The mean duration of analgesia in Group TBM was significantly longer (801.50 ± 74.92 min, p=0.002) than in Group TB (720.00 ± 42.17 min) and Group TB-IVM (712.70 ± 40.94 min). The mean postoperative 24 h tramadol requirement was also less in Group TBM (69.23 ± 25.31mg) than in Groups TB (100.00 ± 38.34 mg) and TB-IVM (95.00 ± 39.40 mg) but did not reach the level of statistical significance (p=0.057). Significantly less ondansetron was required in Group TBM (3.80 ± 2.04 mg) than in Group TB (6.80 ± 2.93 mg) and TB-IVM (6.00 ± 2.75 mg) (p=0.002). Conclusion Morphine added to bupivacaine effectively prolongs the analgesic duration of TAP block in appendectomy.
Collapse
Affiliation(s)
- A Ghimire
- Department of Anaesthesiology and Critical Care, B P Koirala Institute of Health Sciences, Dharan, Nepal
| | - B Bhattarai
- Department of Anaesthesiology and Critical Care, B P Koirala Institute of Health Sciences, Dharan, Nepal
| | - J N Prasad
- Department of Anaesthesiology and Critical Care, B P Koirala Institute of Health Sciences, Dharan, Nepal
| | - A Subedi
- Department of Anaesthesiology and Critical Care, B P Koirala Institute of Health Sciences, Dharan, Nepal
| | - P Thapa
- Department of Anaesthesiology and Critical Care, B P Koirala Institute of Health Sciences, Dharan, Nepal
| | - P M Limbu
- Department of Anaesthesiology and Critical Care, B P Koirala Institute of Health Sciences, Dharan, Nepal
| | - S Adhikari
- Department of General Surgery, B P Koirala Institute of Health Sciences, Dharan, Nepal
| |
Collapse
|
34
|
Karn D, Subedi A, Kc S. Clinico-etiological Profile of Melasma among Female Health Workers in a Tertiary Care Center of Central Nepal - A Cross Sectional Study. Kathmandu Univ Med J (KUMJ) 2017; 17:160-163. [PMID: 34547850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Background Melasma is an acquired symmetrical dyschromia with profound psychosocial impacts. It is a common pigmentary disorder with less clear etiology and limited management options. There are limited data regarding melasma in our scenario. Objective To evaluate the clinico-etiological profile of melasma, among the female health workers (FHW) in a tertiary health center. Method This is a single center, cross-sectional, descriptive study involving female health workers with or without melasma. A total of 198 female health workers were evaluated at Dhulikhel hospital Kathmandu university hospital for clinic-etiological profile of melasma in January 2017. Video-dermatoscopy was used for the clinical diagnosis of melasma. A structured, self-administered questionnaire was used for assessment. Risk factor assessment of etiological agents as sun exposure, hormonal medication, photo aggravating drugs, stressors as night duty were evaluated. Result The point prevalence of melasma among female health workers 20.7% (n=41). The mean age of respondents was 26.2 ± 3.23 years with duration of disease process 3.6 ± 2.5 years. Centro-facial pattern was the commonest clinical type (53.7%) and video-dermatoscopy revealed mixed pattern as the commonest (56.1%) pigment deposition pattern. Among 132 female health workers doing night duty on regular basis, 23 had melasma while 66 female health workers not doing night duty, 18 had melasma (p = 0.10). Whereas while comparing hours of night duty per week among respondents with melasma (n=23) and without melasma (n=18) were 23.72±10.08 hours and 17.8±4.77 hours respectively (p=0.02). Conclusion The present study reveals higher prevalence of melasma among female health workers having more stressors as night duty.
Collapse
Affiliation(s)
- D Karn
- Department of Dermatology, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | - A Subedi
- Department of Dermatology, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | - S Kc
- Department of Dermatology, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| |
Collapse
|
35
|
Androic D, Armstrong D, Asaturyan A, Averett T, Balewski J, Bartlett K, Beaufait J, Beminiwattha R, Benesch J, Benmokhtar F, Birchall J, Carlini R, Cates G, Cornejo J, Covrig S, Dalton M, Davis C, Deconinck W, Diefenbach J, Dowd J, Dunne J, Dutta D, Duvall W, Elaasar M, Falk W, Finn J, Forest T, Gal C, Gaskell D, Gericke M, Grames J, Gray V, Grimm K, Guo F, Hoskins J, Johnston K, Jones D, Jones M, Jones R, Kargiantoulakis M, King P, Korkmaz E, Kowalski S, Leacock J, Leckey J, Lee A, Lee J, Lee L, MacEwan S, Mack D, Magee J, Mahurin R, Mammei J, Martin J, McHugh M, Meekins D, Mei J, Michaels R, Micherdzinska A, Mkrtchyan A, Mkrtchyan H, Morgan N, Myers K, Narayan A, Ndukum L, Nelyubin V, Nuhait H, Nuruzzaman, van Oers W, Opper A, Page S, Pan J, Paschke K, Phillips S, Pitt M, Poelker M, Rajotte J, Ramsay W, Roche J, Sawatzky B, Seva T, Shabestari M, Silwal R, Simicevic N, Smith G, Solvignon P, Spayde D, Subedi A, Subedi R, Suleiman R, Tadevosyan V, Tobias W, Tvaskis V, Waidyawansa B, Wang P, Wells S, Wood S, Yang S, Young R, Zang P, Zhamkochyan S. Qweak: First Direct Measurement of the Proton’s Weak Charge. EPJ Web Conf 2017. [DOI: 10.1051/epjconf/201713708005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
36
|
Subedi A, Dhakal Y, Bhattarai B, Khatiwada S. Abstract PR576. Anesth Analg 2016. [DOI: 10.1213/01.ane.0000492957.47139.b5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
37
|
Ghimire A, Bhattarai B, Koirala S, Subedi A. Analgesia before Performing Subarachnoid Block in the Sitting Position in Patients with Proximal Femoral Fracture: A Comparison between Fascia Iliaca Block and Femoral Nerve Block. Kathmandu Univ Med J (KUMJ) 2016; 13:152-5. [PMID: 26643833 DOI: 10.3126/kumj.v13i2.16789] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Positioning for subarachnoid block (SAB) in patients with femoral fracture is painful and may remain suboptimal requiring use of large doses of opioids. These patients generally being elderly with multiple comorbidities and frailty are likely to have many undesirable effects of opioids including respiratory depression and confusion. OBJECTIVE The objective was to compare the feasibility and effectiveness of fascia iliaca compartment block (FICB) and femoral nerve block (FNB) in reducing pain associated with positioning for subarachnoid block in patients undergoing proximal femoral fracture fixation procedures. METHOD Group FICB patients (n=15) received fascia iliaca block with 30 ml of 1.5% lignocaine with adrenaline and group FNB patients (n=15) received femoral nerve block with 15 ml of 1.5% lignocaine with adrenaline. After the study blocks, patients were kept on supine position for at least 20 minutes before shifting them to the operation theatre. Pain was assessed by using visual analog scale values before the block and during the position for subarachnoid block. Time to perform subarachnoid block, quality of positioning and acceptance was recorded. RESULT Visual analog scale values during positioning for SAB were lower in FIB group than in FNB (1.0±1.1 versus 2.1±0.8; P< 0.05). Time to perform SAB was shorter in FIB than in FNB (109.6±28.2 seconds versus 134.8±31.9 seconds; P< 0.05). Quality of patient positioning for SAB was comparable between the groups. Patient acceptance was less in group FNB (P< 0.05). CONCLUSION Fascia iliaca compartment block provides better analgesia than femoral nerve block in terms of facilitating optimal positioning for subarachnoid block in patients undergoing proximal femoral fracture fixation procedure.
Collapse
Affiliation(s)
- A Ghimire
- Department of Anaesthesiology and Critical Care, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - B Bhattarai
- Department of Anaesthesiology and Critical Care, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - S Koirala
- Department of Anaesthesiology and Critical Care, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - A Subedi
- Department of Anaesthesiology and Critical Care, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| |
Collapse
|
38
|
Subedi A, Chaudakshetrin P, Chotisukarat H, Mandee S. Effect of Co-Morbid Conditions on Persistent Neuropathic Pain after Brachial Plexus Injury in Adult Patients. J Clin Neurol 2016; 12:489-494. [PMID: 27819420 PMCID: PMC5063877 DOI: 10.3988/jcn.2016.12.4.489] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 05/05/2016] [Accepted: 05/09/2016] [Indexed: 02/06/2023] Open
Abstract
Background and Purpose Neuropathic pain (NeuP) associated with traumatic brachial plexus injury (BPI) can be severe, persistent, and resistant to treatment. Moreover, comorbidity associated with NeuP may worsen the pain and quality of life. This study compared persistent NeuP after BPI between patients with and without co-morbid conditions (psychiatric dysfunction and other painful conditions) and tramadol usage as a second-line agent in combination with an antiepileptic and/or antidepressant during a 2-year follow-up. Methods The medical records of patients diagnosed with BPI referred to a pain center between 2006 and 2010 were reviewed for 2 years retrospectively. Data regarding patient demographics, injury and surgical profiles, characteristics of NeuP and its severity, and treatment received were compared between patients with and without manifesting co-morbid conditions. The NeuP and pain intensity assessments were based on the DN4 questionnaire and a numerical rating scale, respectively. Results Of the 45 patients studied, 24 patients presented with one of the following co-morbid conditions: myofascial pain (21%), psychiatric disorder (17%), phantom limb pain (4%), complex regional pain syndrome (21%), and insomnia (37%). Tramadol was required by 20 patients with co-morbidity and, 9 patients without co-morbidity (p<0.001). The mean pain score after 2 years was higher in patients with co-morbidity than in those without co-morbidity (p<0.05). Conclusions Persistent pain following BPI was more common in patients manifesting other painful conditions or psychiatric co-morbidity. A higher proportion of the patients in the co-morbid group required tramadol as a second-line of agent for pain relief.
Collapse
Affiliation(s)
- Asish Subedi
- Department of Anesthesiology, BPKIHS, Dharan, Nepal.
| | | | | | - Sahatsa Mandee
- Department of Anesthesiology, Siriraj Hospital, Bangkok, Thailand
| |
Collapse
|
39
|
Khatiwada S, Bhattarai B, Pokharel K, Subedi A. Adverse Events in Children Receiving General Anaesthesia with Laryngeal Mask Airway Insertion. JNMA J Nepal Med Assoc 2015. [DOI: 10.31729/jnma.2766] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Introduction: Perioperative adverse events are more common in children compared to adult population. Reporting an adverse event proves effective in identifying problems and helps in prevention and early management. Our objective was to identify the types, incidence, and the time of occurrence of perioperative adverse event. We also aimed to find out whether the occurrence of the types of adverse events differs in children below and above five years.
Methods: This was a prospective study in 242, ASA Physical Status I and II children aged day one to 14 years, receiving general anesthesia with laryngeal mask airway for various elective surgeries. Adverse events observed in the perioperative period were recorded.
Results: Adverse events related to respiratory system (n=26, 55%) were the most common followed by cardiovascular system (n= 14, 30%). Adverse events were observed in 24(10%) children in the operating room and in 20 (8%) children in the post anaesthesia care unit. In the operating room, majority (14 of 27, 52%) of the events occurred immediately after removal of laryngeal mask airway. Respiratory events were more common in children below five years (p=0.007), whereas cardiac events were more common in children above five years (p=0.02).
Conclusions: The commonest adverse event in children is related to respiratory system. Adverse events occur more frequently in the operating room, mostly immediately after removal of laryngeal mask airway. Respiratory events are more frequent in children below five years whereas cardiac events are more frequent in children above five years.
Keywords: adverse events; children; laryngeal mask airway; laryngospasm; perioperative.
Collapse
|
40
|
Khatiwada S, Bhattarai B, Pokharel K, Subedi A. Adverse Events in Children Receiving General Anaesthesia with Laryngeal Mask Airway Insertion. JNMA J Nepal Med Assoc 2015; 53:77-82. [PMID: 26994025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
INTRODUCTION Perioperative adverse events are more common in children compared to adult population. Reporting an adverse event proves effective in identifying problems and helps in prevention and early management. Our objective was to identify the types, incidence, and the time of occurrence of perioperative adverse event. We also aimed to find out whether the occurrence of the types of adverse events differ in children below and above five years. METHODS This was a prospective study in 242, ASA Physical Status I and II children aged day one to 14 years, receiving general anesthesia with laryngeal mask airway for various elective surgeries. Adverse events observed in the perioperative period were recorded. RESULTS Adverse events related to respiratory system (n=26, 55%) were the most common followed by cardiovascular system (n= 14, 30%). Adverse events were observed in 24(10%) children in the operating room and in 20 (8%) children in the post anaesthesia care unit. In the operating room, majority (14 of 27, 52%) of the events occurred immediately after removal of laryngeal mask airway. Respiratory events were more common in children below five years (p=0.007), whereas cardiac events were more common in children above five years (p=0.02). CONCLUSIONS The commonest adverse event in children is related to respiratory system. Adverse events occur more frequently in the operating room, mostly immediately after removal of laryngeal mask airway. Respiratory events are more frequent in children below five years whereas cardiac events are more frequent in children above five years.
Collapse
Affiliation(s)
- S Khatiwada
- Department of Anesthesiology and Critical Care, BPKIHS, Dharan, Nepal
| | - B Bhattarai
- Department of Anesthesiology and Critical Care, BPKIHS, Dharan, Nepal
| | - K Pokharel
- Department of Anesthesiology and Critical Care, BPKIHS, Dharan, Nepal
| | - A Subedi
- Department of Anesthesiology and Critical Care, BPKIHS, Dharan, Nepal
| |
Collapse
|
41
|
Mankowsky R, Subedi A, Först M, Mariager SO, Chollet M, Lemke HT, Robinson JS, Glownia JM, Minitti MP, Frano A, Fechner M, Spaldin NA, Loew T, Keimer B, Georges A, Cavalleri A. Nonlinear lattice dynamics as a basis for enhanced superconductivity in YBa2Cu3O6.5. Nature 2015; 516:71-3. [PMID: 25471882 DOI: 10.1038/nature13875] [Citation(s) in RCA: 114] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 09/19/2014] [Indexed: 11/09/2022]
Abstract
Terahertz-frequency optical pulses can resonantly drive selected vibrational modes in solids and deform their crystal structures. In complex oxides, this method has been used to melt electronic order, drive insulator-to-metal transitions and induce superconductivity. Strikingly, coherent interlayer transport strongly reminiscent of superconductivity can be transiently induced up to room temperature (300 kelvin) in YBa2Cu3O6+x (refs 9, 10). Here we report the crystal structure of this exotic non-equilibrium state, determined by femtosecond X-ray diffraction and ab initio density functional theory calculations. We find that nonlinear lattice excitation in normal-state YBa2Cu3O6+x at above the transition temperature of 52 kelvin causes a simultaneous increase and decrease in the Cu-O2 intra-bilayer and, respectively, inter-bilayer distances, accompanied by anisotropic changes in the in-plane O-Cu-O bond buckling. Density functional theory calculations indicate that these motions cause drastic changes in the electronic structure. Among these, the enhancement in the character of the in-plane electronic structure is likely to favour superconductivity.
Collapse
Affiliation(s)
- R Mankowsky
- 1] Max Planck Institute for the Structure and Dynamics of Matter, 22761 Hamburg, Germany [2] University of Hamburg, 22761 Hamburg, Germany [3] Center for Free-Electron Laser Science (CFEL), 22761 Hamburg, Germany
| | - A Subedi
- Centre de Physique Théorique, École Polytechnique, CNRS, 91128 Palaiseau Cedex, France
| | - M Först
- 1] Max Planck Institute for the Structure and Dynamics of Matter, 22761 Hamburg, Germany [2] Center for Free-Electron Laser Science (CFEL), 22761 Hamburg, Germany
| | - S O Mariager
- Swiss Light Source, Paul Scherrer Institut, 5232 Villigen, Switzerland
| | - M Chollet
- Linac Coherent Light Source, SLAC National Accelerator Laboratory, Menlo Park 94025, California, USA
| | - H T Lemke
- Linac Coherent Light Source, SLAC National Accelerator Laboratory, Menlo Park 94025, California, USA
| | - J S Robinson
- Linac Coherent Light Source, SLAC National Accelerator Laboratory, Menlo Park 94025, California, USA
| | - J M Glownia
- Linac Coherent Light Source, SLAC National Accelerator Laboratory, Menlo Park 94025, California, USA
| | - M P Minitti
- Linac Coherent Light Source, SLAC National Accelerator Laboratory, Menlo Park 94025, California, USA
| | - A Frano
- Max Planck Institute for Solid State Research, 70569 Stuttgart, Germany
| | - M Fechner
- Materials Theory, Eidgenössische Technische Hochschule Zürich, 8093 Zürich, Switzerland
| | - N A Spaldin
- Materials Theory, Eidgenössische Technische Hochschule Zürich, 8093 Zürich, Switzerland
| | - T Loew
- Max Planck Institute for Solid State Research, 70569 Stuttgart, Germany
| | - B Keimer
- Max Planck Institute for Solid State Research, 70569 Stuttgart, Germany
| | - A Georges
- 1] Centre de Physique Théorique, École Polytechnique, CNRS, 91128 Palaiseau Cedex, France [2] Collège de France, 11 place Marcelin Berthelot, 75005 Paris, France [3] Département de Physique de la Matière Condensée (MaNEP), Université de Genève, 1211 Genève, Switzerland
| | - A Cavalleri
- 1] Max Planck Institute for the Structure and Dynamics of Matter, 22761 Hamburg, Germany [2] University of Hamburg, 22761 Hamburg, Germany [3] Center for Free-Electron Laser Science (CFEL), 22761 Hamburg, Germany [4] Department of Physics, University of Oxford, Clarendon Laboratory, Oxford OX1 3PU, UK
| |
Collapse
|
42
|
de la Torre A, Hunter EC, Subedi A, McKeown Walker S, Tamai A, Kim TK, Hoesch M, Perry RS, Georges A, Baumberger F. Coherent quasiparticles with a small fermi surface in lightly doped Sr(3)Ir(2)O(7). Phys Rev Lett 2014; 113:256402. [PMID: 25554897 DOI: 10.1103/physrevlett.113.256402] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Indexed: 06/04/2023]
Abstract
We characterize the electron doping evolution of (Sr_{1-x}La_{x})_{3}Ir_{2}O_{7} by means of angle-resolved photoemission. Concomitant with the metal insulator transition around x≈0.05 we find the emergence of coherent quasiparticle states forming a closed small Fermi surface of volume 3x/2, where x is the independently measured La concentration. The quasiparticle weight Z remains large along the entire Fermi surface, consistent with the moderate renormalization of the low-energy dispersion, and no pseudogap is observed. This indicates a conventional, weakly correlated Fermi liquid state with a momentum independent residue Z≈0.5 in lightly doped Sr_{3}Ir_{2}O_{7}.
Collapse
Affiliation(s)
- A de la Torre
- Department of Quantum Matter Physics, University of Geneva, 24 Quai Ernest-Ansermet, 1211 Geneva 4, Switzerland
| | - E C Hunter
- School of Physics and Astronomy, The University of Edinburgh, James Clerk Maxwell Building, Mayfield Road, Edinburgh EH9 2TT, United Kingdom
| | - A Subedi
- Centre de Physique Théorique, École Polytechnique, CNRS, 91128 Palaiseau Cedex, France
| | - S McKeown Walker
- Department of Quantum Matter Physics, University of Geneva, 24 Quai Ernest-Ansermet, 1211 Geneva 4, Switzerland
| | - A Tamai
- Department of Quantum Matter Physics, University of Geneva, 24 Quai Ernest-Ansermet, 1211 Geneva 4, Switzerland
| | - T K Kim
- Diamond Light Source, Harwell Campus, Didcot OX11 0DE, United Kingdom
| | - M Hoesch
- Diamond Light Source, Harwell Campus, Didcot OX11 0DE, United Kingdom
| | - R S Perry
- London Centre for Nanotechnology and UCL Centre for Materials Discovery, University College London, London WC1E 6BT, United Kingdom
| | - A Georges
- Department of Quantum Matter Physics, University of Geneva, 24 Quai Ernest-Ansermet, 1211 Geneva 4, Switzerland and Centre de Physique Théorique, École Polytechnique, CNRS, 91128 Palaiseau Cedex, France and Collège de France, 11 place Marcelin Berthelot, 75005 Paris, France
| | - F Baumberger
- Department of Quantum Matter Physics, University of Geneva, 24 Quai Ernest-Ansermet, 1211 Geneva 4, Switzerland and Swiss Light Source, Paul Scherrer Institut, CH-5232 Villigen PSI, Switzerland and SUPA, School of Physics and Astronomy, University of St Andrews, St Andrews, Fife KY16 9SS, United Kingdom
| |
Collapse
|
43
|
Tripathi M, Subedi A, Raimajhi A, Pokharel K, Pandey M. Preinduction incentive spirometry versus deep breathing to improve apnea tolerance during induction of anesthesia in patients of abdominal sepsis: A randomized trial. J Postgrad Med 2014; 59:275-80. [PMID: 24346384 DOI: 10.4103/0022-3859.123154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Abdominal sepsis is associated with varied degree of hypoxemia and atelactasis in the lung and can enhance the onset of desaturation of arterial blood during apnea. AIMS This study looked at methods to improve safety margin of apnea during induction of anesthesia in these high-risk patients. SETTINGS AND DESIGN It was a randomized, single blind study on adult patients presenting for emergency laparotomy due to peritonitis in a university teaching hospital setting. MATERIALS AND METHODS In group 1 (IS) (n = 32), three sessions of incentive spirometry (IS) were performed within one hour before induction of anesthesia. In group 2 (DB) (n = 34), patients were subjected to deep breathing sessions in a similar manner. All patients received preoxygenation (100%) by mask for 3 min, followed by rapid-sequence induction of anesthesia using fentanyl, thiopental, and suxamethonium and endotracheal intubation. Patients were subjected to a period of apnea by keeping the end of the endotracheal tube open to air till they developed 95% hemoglobin saturation (SpO 2) by pulse oxymetry. Positive pressure ventilation was resumed at the end. We observed for hemodynamic changes, apnea time, and SpO 2 (100%) recovery time on resuming ventilation. Arterial blood gas samples were taken before intervention, after IS or DB, after preoxygenation, and at the end of apnea. STATISTICAL ANALYSIS USED One-way analysis of variance (ANOVA), X 2 test, Kaplan-Meier graph, and log-rank tests were applied to compare the two study groups. RESULTS Oxygenation level in group 1 (265 ± 76.7 mmHg) patients was significantly (P < 0.001) higher than in group 2 (221 ± 61.8 mmHg)at the end of preoxygenation. The apnea time (median: lower bound - upper bound Confidence Interval apnea time) (272:240-279 s) in group 1 (IS) patients was significantly higher P < 0.05) than in group 2 (180:163-209 s) patients. Saturation recovery time (35:34-46 s) in group 1 (IS) patients was also quicker than in group 2 patients (48:44-58 s). CONCLUSIONS IS in the preoperative period is superior to deep breathing sessions for improving apnea tolerance during induction of anesthesia in abdominal sepsis patients.
Collapse
Affiliation(s)
- M Tripathi
- Department of Anaesthesiology and Critical Care, BP Koirala Institute of Health Sciences, Dharan, Nepal; Department of Anaesthesiology, SGPG Institute of Medical Sciences, Lucknow, Uttar Pradesh, India,
| | | | | | | | | |
Collapse
|
44
|
Pokharel K, Tripathi M, Bhattarai B, Subedi A, Sah BP. Large versus Small Dose Magnesium Sulfate Infusion in Tetanus. JNMA J Nepal Med Assoc 2014. [DOI: 10.31729/jnma.2555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Introduction: Evidence based guidelines regarding the use of magnesium sulfate in tetanus is lacking. Hence, our objective was to compare two infusion doses of magnesium sulfate to control the tetanic spasms. Methods: Data of 14 adult male patients admitted in the intensive care unit were retrieved. Twelve adult ventilated patients received magnesium infusion as an adjunct to diazepam therapy to control tetanic spasms. We retrospectively divided them into two groups for comparison. Group 1 patients (n=7) received a smaller dose (<1 g.h-1) than group 2 (n=5) (1.5 to 2 g.h-1). Results: The duration of symptoms before arrival to hospital was significantly longer in group 1 than group 2. The Ablett severity grade was II in three patients in group 1 and III in all patients of group 2. In Ablett severity grade III patients, the diazepam dose used was significantly higher in group 1 (n=4) (292±48 mg.d-1) than group 2 (n=3) (106±9 mg.d-1) as magnesium infusion dose was restricted due to hypotension in group 1. Amongst the patients who received MgSO4 for ≥10 days, the requirement of diazepam was significantly reduced in the second week (174.1±59.2 mg/d) than the first week (325.4±105.9 mg.d-1) of infusion in group 2 (n=4) but not in group 1 patients (n=4). Conclusions: The larger dose of MgSO4 infusion was titrated to control tetanic spasms as an adjunct to diazepam in select group of patients without hypotension. Uncontrolled hypotension, cardiac arrhythmia and renal failure were the factors to limit its infusion dose.Keywords: MgSO4; magnesium sulphate; tetanus.
Collapse
|
45
|
Pokharel K, Tripathi M, Bhattarai B, Subedi A, Sah BP. Large versus Small Dose Magnesium Sulfate Infusion in Tetanus. JNMA J Nepal Med Assoc 2014; 52:796-801. [PMID: 26905707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
INTRODUCTION Evidence based guidelines regarding the use of magnesium sulfate in tetanus is lacking. Hence, our objective was to compare two infusion doses of magnesium sulfate to control the tetanic spasms. METHODS Data of 14 adult male patients admitted in the intensive care unit were retrieved. Twelve adult ventilated patients received magnesium infusion as an adjunct to diazepam therapy to control tetanic spasms. We retrospectively divided them into two groups for comparison. Group 1 patients (n=7) received a smaller dose (<1 g.h(-1)) than group 2 (n=5) (1.5 to 2 g.h(-1)). RESULTS The duration of symptoms before arrival to hospital was significantly longer in group 1 than group 2. The Ablett severity grade was II in three patients in group 1 and III in all patients of group 2. In Ablett severity grade III patients, the diazepam dose used was significantly higher in group 1 (n=4) (292±48 mg.d(-1)) than group 2 (n=3) (106±9 mg.d(-1)) as magnesium infusion dose was restricted due to hypotension in group 1. Amongst the patients who received MgSO(4) for ≥10 days, the requirement of diazepam was significantly reduced in the second week (174.1±59.2 mg/d) than the first week (325.4±105.9 mg.d(-1)) of infusion in group 2 (n=4) but not in group 1 patients (n=4). CONCLUSIONS The larger dose of MgSO(4) infusion was titrated to control tetanic spasms as an adjunct to diazepam in select group of patients without hypotension. Uncontrolled hypotension, cardiac arrhythmia and renal failure were the factors to limit its infusion dose.
Collapse
Affiliation(s)
- K Pokharel
- Department of Anaesthesiology and Critical Care, B. P. Koirala Institute of Health Science, Dharan, Nepal
| | - M Tripathi
- Department of Anaesthesiology and Critical Care, B. P. Koirala Institute of Health Science, Dharan, Nepal, Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Rishikesh, UK, India
| | - B Bhattarai
- Department of Anaesthesiology and Critical Care, B. P. Koirala Institute of Health Science, Dharan, Nepal
| | - A Subedi
- Department of Anaesthesiology and Critical Care, B. P. Koirala Institute of Health Science, Dharan, Nepal
| | - B P Sah
- Department of Anaesthesiology and Critical Care, B. P. Koirala Institute of Health Science, Dharan, Nepal
| |
Collapse
|
46
|
Androic D, Armstrong D, Asaturyan A, Averett T, Balewski J, Beaufait J, Beminiwattha R, Benesch J, Benmokhtar F, Birchall J, Carlini R, Cates G, Cornejo J, Covrig S, Dalton M, Davis C, Deconinck W, Diefenbach J, Dowd J, Dunne J, Dutta D, Duvall W, Elaasar M, Falk W, Finn J, Forest T, Gaskell D, Gericke M, Grames J, Gray V, Grimm K, Guo F, Hoskins J, Johnston K, Jones D, Jones M, Jones R, Kargiantoulakis M, King P, Korkmaz E, Kowalski S, Leacock J, Leckey J, Lee A, Lee J, Lee L, MacEwan S, Mack D, Magee J, Mahurin R, Mammei J, Martin J, McHugh M, Meekins D, Mei J, Michaels R, Micherdzinska A, Mkrtchyan A, Mkrtchyan H, Morgan N, Myers K, Narayan A, Ndukum L, Nelyubin V, Nuruzzaman, van Oers W, Opper A, Page S, Pan J, Paschke K, Phillips S, Pitt M, Poelker M, Rajotte J, Ramsay W, Roche J, Sawatzky B, Seva T, Shabestari M, Silwal R, Simicevic N, Smith G, Solvignon P, Spayde D, Subedi A, Subedi R, Suleiman R, Tadevosyan V, Tobias W, Tvaskis V, Waidyawansa B, Wang P, Wells S, Wood S, Yang S, Young R, Zhamkochyan S. Early Results from the QweakExperiment. EPJ Web of Conferences 2014. [DOI: 10.1051/epjconf/20146605002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
47
|
Subedi A, Tripathi M, Bhattarai B, Pokharel K, Dhital D. Successful intubation with McCoy laryngoscope in a patient with ankylosing spondylitis. J Nepal Health Res Counc 2014; 12:70-72. [PMID: 25574990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Involvement of cervical spine in ankylosing spondylitis limits neck movement resulting in difficult intubation. We report a case of 45-yr-old lady of ankylosing spondylitis with restricted neck movement planned for emergency laparotomy. Grade 3 Cormack and Lehane laryngoscopic view was observed with Macintosh laryngoscope and gum elastic bougie could not be negotiated. At second attempt with McCoy blade, the posterior commissure of the vocal cord could be visualized and intubation was successful. Thus, in absence of flexible laryngoscopes and when awake intubation is not feasible, McCoy blade should be considered an alternative than Macintosh blade to attempt intubation in patients of ankylosing spondylitis with restricted neck movement.
Collapse
Affiliation(s)
- A Subedi
- Department of Anaesthesiology, BPKIHS, Dharan, Nepal
| | - M Tripathi
- Department of Anaesthesiology, SGPGI, Lucknow, India
| | - B Bhattarai
- Department of Anaesthesiology, BPKIHS, Dharan, Nepal
| | - K Pokharel
- Department of Anaesthesiology, BPKIHS, Dharan, Nepal
| | - D Dhital
- Department of Anaesthesiology, BPKIHS, Dharan, Nepal
| |
Collapse
|
48
|
Androic D, Armstrong DS, Asaturyan A, Averett T, Balewski J, Beaufait J, Beminiwattha RS, Benesch J, Benmokhtar F, Birchall J, Carlini RD, Cates GD, Cornejo JC, Covrig S, Dalton MM, Davis CA, Deconinck W, Diefenbach J, Dowd JF, Dunne JA, Dutta D, Duvall WS, Elaasar M, Falk WR, Finn JM, Forest T, Gaskell D, Gericke MTW, Grames J, Gray VM, Grimm K, Guo F, Hoskins JR, Johnston K, Jones D, Jones M, Jones R, Kargiantoulakis M, King PM, Korkmaz E, Kowalski S, Leacock J, Leckey J, Lee AR, Lee JH, Lee L, MacEwan S, Mack D, Magee JA, Mahurin R, Mammei J, Martin JW, McHugh MJ, Meekins D, Mei J, Michaels R, Micherdzinska A, Mkrtchyan A, Mkrtchyan H, Morgan N, Myers KE, Narayan A, Ndukum LZ, Nelyubin V, van Oers WTH, Opper AK, Page SA, Pan J, Paschke KD, Phillips SK, Pitt ML, Poelker M, Rajotte JF, Ramsay WD, Roche J, Sawatzky B, Seva T, Shabestari MH, Silwal R, Simicevic N, Smith GR, Solvignon P, Spayde DT, Subedi A, Subedi R, Suleiman R, Tadevosyan V, Tobias WA, Tvaskis V, Waidyawansa B, Wang P, Wells SP, Wood SA, Yang S, Young RD, Zhamkochyan S. First determination of the weak charge of the proton. Phys Rev Lett 2013; 111:141803. [PMID: 24152148 DOI: 10.1103/physrevlett.111.141803] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Indexed: 06/02/2023]
Abstract
The Q(weak) experiment has measured the parity-violating asymmetry in ep elastic scattering at Q(2)=0.025(GeV/c)(2), employing 145 μA of 89% longitudinally polarized electrons on a 34.4 cm long liquid hydrogen target at Jefferson Lab. The results of the experiment's commissioning run, constituting approximately 4% of the data collected in the experiment, are reported here. From these initial results, the measured asymmetry is A(ep)=-279±35 (stat) ± 31 (syst) ppb, which is the smallest and most precise asymmetry ever measured in ep scattering. The small Q(2) of this experiment has made possible the first determination of the weak charge of the proton Q(W)(p) by incorporating earlier parity-violating electron scattering (PVES) data at higher Q(2) to constrain hadronic corrections. The value of Q(W)(p) obtained in this way is Q(W)(p)(PVES)=0.064±0.012, which is in good agreement with the standard model prediction of Q(W)(p)(SM)=0.0710±0.0007. When this result is further combined with the Cs atomic parity violation (APV) measurement, significant constraints on the weak charges of the up and down quarks can also be extracted. That PVES+APV analysis reveals the neutron's weak charge to be Q(W)(n)(PVES+APV)=-0.975±0.010.
Collapse
Affiliation(s)
- D Androic
- University of Zagreb, Zagreb HR-10002, Croatia
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Khatiwada S, Tripathi M, Pokharel K, Acharya R, Subedi A. Ambiguous Phorate Granules for Sesame Seeds Linked to Accidental Organophosphate Fatal Poisoning. JNMA J Nepal Med Assoc 2012. [DOI: 10.31729/jnma.67] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Ingestion of organophosphate compound for suicidal attempt is a major health problem in developing countries. However, unintentional ingestion by an adult is rare. An 80-year-old lady and her 30-year-old granddaughter consumed phorate (organophosphate) granules thinking it to be the seeds of sesame. After grinding the granules and mixing with pickle, they consumed the preparation with rice. The granddaughter was brought dead at emergency department and the older lady after resuscitation shifted to intensive care unit. She was extubated on 17th day and discharged on 23rd day. Pesticide formulation resembling any edible items must be withdrawn from the market at the earliest. Stringent regulation on vendors, apparent formulation or packaging and education about the hazards of these compounds can prevent this type of unintentional poisoning.
Keywords: Ambiguous, organophosphate, phorate, sesame seeds, unintentional poisoning.
Collapse
|
50
|
Khatiwada S, Tripathi M, Pokharel K, Acharya R, Subedi A. Ambiguous phorate granules for sesame seeds linked to accidental organophosphate fatal poisoning. JNMA J Nepal Med Assoc 2012; 52:49-51. [PMID: 23279775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
UNLABELLED Ingestion of organophosphate compound for suicidal attempt is a major health problem in developing countries. However, unintentional ingestion by an adult is rare. An 80-year-old lady and her 30-year-old granddaughter consumed phorate (organophosphate) granules thinking it to be the seeds of sesame. After grinding the granules and mixing with pickle, they consumed the preparation with rice. The granddaughter was brought dead at emergency department and the older lady after resuscitation shifted to intensive care unit. She was extubated on 17th day and discharged on 23rd day. Pesticide formulation resembling any edible items must be withdrawn from the market at the earliest. Stringent regulation on vendors, apparent formulation or packaging and education about the hazards of these compounds can prevent this type of unintentional poisoning. KEYWORDS Ambiguous, organophosphate, phorate, sesame seeds, unintentional poisoning.
Collapse
Affiliation(s)
- S Khatiwada
- Department of Anaesthesiology and Critical Care, BPKIHS, Dharan, Nepal.
| | | | | | | | | |
Collapse
|