Background: Emergence agitation (EA) is a common phenomenon observed in pediatric patients following general anesthesia. This study aimed to assess the efficacy of propofol and fentanyl in preventing EA and to compare...Background: Emergence agitation (EA) is a common phenomenon observed in pediatric patients following general anesthesia. This study aimed to assess the efficacy of propofol and fentanyl in preventing EA and to compare their associated complications or side effects. Methods: This prospective randomized observational comparative study was conducted at Dhaka Medical College Hospital from July 2013 to June 2014. The study aimed to evaluate the effects of propofol and fentanyl on EA in children aged 18 to 72 months undergoing circumcision, herniotomy, and polypectomy operations. Ninety children were included in the study, with 45 in each group. Patients with psychological or neurological disorders were excluded. Various parameters including age, sex, weight, American Society of Anesthesiologists (ASA) class, duration of anesthesia, Saturation of Peripheral Oxygen (SPO2), heart rate (HR), respiratory rate (RR), Pediatric Anesthesia Emergence Delirium (PAED) score, duration of post-anesthesia care unit (PACU) stay, incidence of laryngospasm, nausea, vomiting, and rescue drug requirement were compared between the two groups. Results: Age, sex, weight, ASA class, and duration of anesthesia were comparable between the two groups. Perioperative SpO2 and HR were similar in both groups. However, the PAED score was significantly higher in the fentanyl group during all follow-ups except at 30 minutes postoperatively. The mean duration of PACU stay was significantly longer in the fentanyl group. Although the incidence of laryngospasm was higher in the fentanyl group, it was not statistically significant. Conversely, nausea or vomiting was significantly higher in the fentanyl group. The requirement for rescue drugs was significantly higher in the fentanyl group compared to the propofol group. Conclusion: Both propofol and fentanyl were effective in preventing emergence agitation in pediatric patients undergoing various surgical procedures under sevoflurane anesthesia. However, propofol demonstrated a better safety profile with fewer incidences of nausea, vomiting, and rescue drug requirements compared to fentanyl.展开更多
The United States is in the throes of a severe opioid overdose epidemic,primarily fueled by the pervasive use of fentanyl and the emerging threat of xylazine,a veterinary sedative often mixed with fentanyl.The high po...The United States is in the throes of a severe opioid overdose epidemic,primarily fueled by the pervasive use of fentanyl and the emerging threat of xylazine,a veterinary sedative often mixed with fentanyl.The high potency and long duration of fentanyl is compounded by the added risks from xylazine,heightening the lethal danger faced by opioid users.Measures such as enhanced surveillance,public awareness campaigns,and the distribution of fentanylxylazine test kits,and naloxone have been undertaken to mitigate this crisis.Fentanyl-related overdose deaths persist despite these efforts,partly due to inconsistent policies across states and resistance towards adopting harm reduction strategies.A multifaceted approach is imperative in effectively combating the opioid overdose epidemic.This approach should include expansion of treatment access,broadening the availability of medications for opioid use disorder,implementation of harm reduction strategies,and enaction of legislative reforms and diminishing stigma associated with opioid use disorder.展开更多
Wireless Ad Hoc Networks consist of devices that are wirelessly connected.Mobile Ad Hoc Networks(MANETs),Internet of Things(IoT),and Vehicular Ad Hoc Networks(VANETs)are the main domains of wireless ad hoc network.Int...Wireless Ad Hoc Networks consist of devices that are wirelessly connected.Mobile Ad Hoc Networks(MANETs),Internet of Things(IoT),and Vehicular Ad Hoc Networks(VANETs)are the main domains of wireless ad hoc network.Internet is used in wireless ad hoc network.Internet is based on Transmission Control Protocol(TCP)/Internet Protocol(IP)network where clients and servers interact with each other with the help of IP in a pre-defined environment.Internet fetches data from a fixed location.Data redundancy,mobility,and location dependency are the main issues of the IP network paradigm.All these factors result in poor performance of wireless ad hoc networks.The main disadvantage of IP is that,it does not provide in-network caching.Therefore,there is a need to move towards a new network that overcomes these limitations.Named Data Network(NDN)is a network that overcomes these limitations.NDN is a project of Information-centric Network(ICN).NDN provides in-network caching which helps in fast response to user queries.Implementing NDN in wireless ad hoc network provides many benefits such as caching,mobility,scalability,security,and privacy.By considering the certainty,in this survey paper,we present a comprehensive survey on Caching Strategies in NDN-based Wireless AdHocNetwork.Various cachingmechanism-based results are also described.In the last,we also shed light on the challenges and future directions of this promising field to provide a clear understanding of what caching-related problems exist in NDN-based wireless ad hoc networks.展开更多
文摘Background: Emergence agitation (EA) is a common phenomenon observed in pediatric patients following general anesthesia. This study aimed to assess the efficacy of propofol and fentanyl in preventing EA and to compare their associated complications or side effects. Methods: This prospective randomized observational comparative study was conducted at Dhaka Medical College Hospital from July 2013 to June 2014. The study aimed to evaluate the effects of propofol and fentanyl on EA in children aged 18 to 72 months undergoing circumcision, herniotomy, and polypectomy operations. Ninety children were included in the study, with 45 in each group. Patients with psychological or neurological disorders were excluded. Various parameters including age, sex, weight, American Society of Anesthesiologists (ASA) class, duration of anesthesia, Saturation of Peripheral Oxygen (SPO2), heart rate (HR), respiratory rate (RR), Pediatric Anesthesia Emergence Delirium (PAED) score, duration of post-anesthesia care unit (PACU) stay, incidence of laryngospasm, nausea, vomiting, and rescue drug requirement were compared between the two groups. Results: Age, sex, weight, ASA class, and duration of anesthesia were comparable between the two groups. Perioperative SpO2 and HR were similar in both groups. However, the PAED score was significantly higher in the fentanyl group during all follow-ups except at 30 minutes postoperatively. The mean duration of PACU stay was significantly longer in the fentanyl group. Although the incidence of laryngospasm was higher in the fentanyl group, it was not statistically significant. Conversely, nausea or vomiting was significantly higher in the fentanyl group. The requirement for rescue drugs was significantly higher in the fentanyl group compared to the propofol group. Conclusion: Both propofol and fentanyl were effective in preventing emergence agitation in pediatric patients undergoing various surgical procedures under sevoflurane anesthesia. However, propofol demonstrated a better safety profile with fewer incidences of nausea, vomiting, and rescue drug requirements compared to fentanyl.
文摘The United States is in the throes of a severe opioid overdose epidemic,primarily fueled by the pervasive use of fentanyl and the emerging threat of xylazine,a veterinary sedative often mixed with fentanyl.The high potency and long duration of fentanyl is compounded by the added risks from xylazine,heightening the lethal danger faced by opioid users.Measures such as enhanced surveillance,public awareness campaigns,and the distribution of fentanylxylazine test kits,and naloxone have been undertaken to mitigate this crisis.Fentanyl-related overdose deaths persist despite these efforts,partly due to inconsistent policies across states and resistance towards adopting harm reduction strategies.A multifaceted approach is imperative in effectively combating the opioid overdose epidemic.This approach should include expansion of treatment access,broadening the availability of medications for opioid use disorder,implementation of harm reduction strategies,and enaction of legislative reforms and diminishing stigma associated with opioid use disorder.
基金supported by the National Research Foundation of Korea(NRF)grant funded by the Korea government(MSIT)(No.2022R1A2C1003549).
文摘Wireless Ad Hoc Networks consist of devices that are wirelessly connected.Mobile Ad Hoc Networks(MANETs),Internet of Things(IoT),and Vehicular Ad Hoc Networks(VANETs)are the main domains of wireless ad hoc network.Internet is used in wireless ad hoc network.Internet is based on Transmission Control Protocol(TCP)/Internet Protocol(IP)network where clients and servers interact with each other with the help of IP in a pre-defined environment.Internet fetches data from a fixed location.Data redundancy,mobility,and location dependency are the main issues of the IP network paradigm.All these factors result in poor performance of wireless ad hoc networks.The main disadvantage of IP is that,it does not provide in-network caching.Therefore,there is a need to move towards a new network that overcomes these limitations.Named Data Network(NDN)is a network that overcomes these limitations.NDN is a project of Information-centric Network(ICN).NDN provides in-network caching which helps in fast response to user queries.Implementing NDN in wireless ad hoc network provides many benefits such as caching,mobility,scalability,security,and privacy.By considering the certainty,in this survey paper,we present a comprehensive survey on Caching Strategies in NDN-based Wireless AdHocNetwork.Various cachingmechanism-based results are also described.In the last,we also shed light on the challenges and future directions of this promising field to provide a clear understanding of what caching-related problems exist in NDN-based wireless ad hoc networks.
