bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigating the Competitive Factors of Metal-Anion Coordination, Coordination by Water, and Hydrogen Bonding in Complexes of Cyanuric Acid with the Alkaline Earth Metals
Authors: Clegg William , Nichol Gary S.
Published: January 2024

A survey of the trends in metal-ligand coordination and hydrogen bonding has been carried out on complexes of singly deprotonated cyanuric acid CY− and alkaline earth metals, synthesised from aqueous solution and characterised by X-ray crystallography. Involvement of cyanurate in the metal coordination increases from Mg through Ca and Sr to Ba relative to coordination by water, in parallel with the increasing ionic radius and coordination number. The incidence of bridging of metal centres by both water and cyanurate also increases in this series. The Mg complex contains hexaaqua-coordinated cations, uncoordinated CY− anions, and additional water molecules. Ca and Sr complexes feature polymeric chains of coordinated metal ions, the Ca complex with uncoordinated anions and the Sr complex with all potential ligands coordinated. The Ba complex has a two-dimensional coordination network. Extensive hydrogen bonding plays a key role in generating a three-dimensional network in all four structures. The competition between cyanurate and water for coordination to the alkaline earth metal cations, and that between coordination and hydrogen bonding propensities of the cyanurate anion, appear to be finely balanced, with the structural outcomes depending on the relative sizes and degrees of hardness of the four cations of the group.
Precise Lightning Strike Detection in Overhead Lines Using KL-VMD and PE-SGMD Innovations
Authors: Xinsheng Dong , Jucheng Liu , Shan He , Lu Han , Zhongkai Dong , Minbo Cai
Published: January 2024

When overhead lines are impacted by lightning, the traveling wave of the fault contains a wealth of fault information. The accurate extraction of feature quantities from transient components and their classification is fundamental to the identification of lightning faults. The extraction process may involve modal aliasing, optimal wavelet base issues, and inconsistencies between the lightning strike distance and the fault point, which have the potential to impact the effectiveness of recognition. This paper presents a method for identifying lightning strike faults by utilizing Kullback-Leibler (KL) divergence enhanced Variational Mode Decomposition (VMD) and Symmetric Geometry Mode Decomposition (SGMD) improved with Permutation Entropy (PE) to address the aforementioned issues. A model of a 220 kV overhead line is constructed using real faults to replicate scenarios of winding strike, counterstrike, and short-circuit. The three-phase voltage is chosen and then sub-jected to Karenbaren decoupling in order to transform it into zero mode, line mode 1, and line mode 2. The zero mode voltage is decomposed using KL-VMD and PE-SGMD methods, and lightning identification criteria are developed based on various transient energy ratios. The research findings demonstrate that the criteria effectively differentiate between winding strike, counterstrike, and short-circuit faults, thus confirming the accuracy and efficacy of the lightning fault identification criteria utilizing KL-VMD and PE-SGMD.
Artificial Intelligence Sensing: Effective Flavor Blueprinting of Tea Infusions for a Quality Control Perspective
Authors: Caratti Andrea , Fina Angelica , Trapani Fulvia , Bicchi Carlo , Liberto Erica , Cordero Chiara , Magagna Federico
Published: January 2024

Tea infusions are the most consumed beverages in the world after water, their pleasant yet peculiar flavor profile drives consumer choice and acceptance and becomes a fundamental benchmark for industry. Any qualification method capable of objectifying the product's sensory features effectively supports industrial quality control laboratories guaranteeing high sample throughputs even without the human panel intervention. The current study presents an integrated analytical strategy acting as an Artificial Intelligence decision tool for black tea infusion aroma and taste blueprinting. Key markers validated by sensomics are accurately quantified in a wide dynamic range of concentrations. Thirteen key aromas are quantitatively assessed by standard addition with in-solution solid-phase microextraction sampling followed by GC-MS. On the other hand, nineteen key taste and quality markers are quantified by external standard calibration and LV-UV/DAD. The large dynamic range of concentration for sensory markers is reflected in the selection of seven high-quality teas from different geographical areas (Ceylon, Darjeeling Testa Valley and Castleton, Assam, Yunnan, Azores, and Kenya). The strategy acts as an AI smelling and taste machine predicting teas sensory features without the human panel intervention.
Aggressive Rhythm Control Strategy in Atrial Fibrillation Patients Presented at the Emergency Department. The HEROMEDICUS Study Design and Initial Results
Authors: Tsiachris Dimitrios , Argyriou Nikos , Tsioufis Panagiotis , Antoniou Christos Konstantinos , Laina Ageliki , Oikonomou George , Dourvas Panagiotis , Doundoulakis Ioannis , Kordalis Athanasios , Dimitriadis Kyriakos , Gatzoulis Konstantinos , Tsioufis Konstantinos
Published: January 2024

Atrial fibrillation has progressively become a more common reason for emergency de-partment visits, representing 0.5% of presenting reasons. Registry data have indicated that about 60% of atrial fibrillation patients who present to the emergency department are admitted, emphasizing the need for more-efficient management of atrial fibrillation in the acute phase. Management of atrial fibrillation in the setting of emergency department varies between countries and health care systems. The most plausible reason to justify a conservative rather than aggressive strategy in the management of atrial fibrillation is the absence of specific guidelines from diverse societies. Several trials of atrial fibrillation treatment strategies, including cardioversion, have demonstrated that atrial fibrillation in emergency department can be treated safely and effectively, avoiding admission. In the present study, we review the epidemiology and characteristics of atrial fibrillation pa-tients presenting to the emergency department will be reviewed, as well as the impact of diverse management strategies on atrial fibrillation-related hospital admissions. Lastly, the design and initial data of the HEROMEDICUS protocol, which constitutes an elec-trophysiology-based aggressive rhythm control strategy in patients with atrial fibrillation in the emergency department setting will be presented.
Night warming has mixed effects on development of the fall armyworm, Spodoptera frugiperda (Lepidoptera, Noctuidae) in southern China.
Authors: Xu Yang-Cheng , Chi Hai-Peng , Shi Ming-Yue , Lu Zhao-Zhi , Zalucki Myron P.
Published: January 2024

The fall armyworm, Spodoptera frugiperda (Lepidoptera, Noctuidae), is a notorious migratory pest. After invading China in 2019, the species has established as a year-round breeding population in most of the southern provinces. The area of winter corn in this region has been increasing due to the huge demand of fresh corn consumption which is potentially at risk from this invasive, although S. frugiperda growth and development under changing climate in this region is unclear, particularly the rising temperature during night period. Here we used highest daily temperatures of 27℃, 24℃, 20℃ and night temperatures that were 2℃, 4℃, 6℃ lower giving three daily temperature treatments reflective of winter conditions; GroupⅠ: 27-21℃, 27-23℃, 27-25℃, Group Ⅱ: 24-18℃, 24-20℃, 24-22℃, and Group Ⅲ: 20-14℃, 20-16℃, 20-18℃; to evaluate the effect of increasing night temperature on growth and development of S. frugiperda. Results show that the survival rate of larvae and pupae significantly declined with the daily temperature declining and the night temperature range increasing. Significant developmental effects were observed in all day-night temperature treatment, except for adults, with significant interaction effects for all stages except egg and generation time. Development rate accelerated along with the increasing daily temperature and night temperature, except for the intermediate treatments (Group Ⅱ). The uniformity of pupation and emergence times are higher in high daily temperatures and night temperature. Predictions of FAW development and warnings to local farmers need to be adjusted to take into account the more rapid development. These results will support decision makers to develop long-term management strategies for FAW in southern China.
Biosafety and Biosecurity in Africa: Challenges and Future Perspectives
Authors: Abdi Abas Mahammed , Abdiweli Saad Ahmed , Sheban Hamse , Abdale Abdirasaq , Sead Hamse , Hussein Muna , Mohamed Zamia , Dayib Mohamed , Kosar Hussien
Published: January 2024

Africa is a home to growing number of biosafety organisations that work to enhance public health in their nations by bringing attention to the significance of biosafety and biosecurity. Since many African countries are low-resource countries, they frequently confront a number of obstacles that seriously limit their ability to create or grow a sustainable capacity for managing biosafety and biosecurity. The goals of biosecurity and biosafety protocols are to reduce both intentional and unintentional biological risks that could have disastrous effects on a nation's health system, agriculture, security, political and economic stability. Regrettably, on a national, regional, and international level, biosecurity and biosafety are frequently given insufficient priority.Eventhough, Africa are home to a growing number of biosafety organisations that work to enhance public health in their nations by bringing attention to the significance of biosafety and biosecurity, Standard Biosafety and Biosecurity Measures to contain hazardous infections are missing across the African continent. In this paper the current state, challenges, and future prospects of biosafety and biosecurity status of African nations discussed.
Characterizing the 2019-2021 Drought in Southern and Southeastern Brazil Using S-TRACK Method
Authors: Bonfim Osmar Toledo , Ferreira Vanessa , Maroneze Rafael , Valdes Roilan Hernández , Mortarini Luca
Published: January 2024

The period from 2019 to 2021 witnessed an enduring and severe drought that impacted southeast South America. Initially characterized as a meteorological drought, its influence later extended across the entire hydrological cycle. This paper explores the application of the S-TRACK method to monitor and characterize the 2019/21 drought in Southern Brazil (SB) and Southeast Brazil (SEB). Monthly precipitation data from reanalyses and satellites, alongside the Standardized Precipitation Index (SPI) for drought quantification, are utilized. Precipitation datasets, validated against rain gauge records, highlight ERA-5 and CHIRPS as having the highest correlation in both SB and SEB, with PERSIANN exhibiting a moderate correlation. The utilization of the S-TRACK method for spatial drought tracking revealed the temporal dynamics of the drought events, with three significant episodes occurring in 2020/2021. Initially, the onset of the drought was observed in the SB region, characterized by intensities ranging from moderate to extreme. Subsequently, the drought extended northward, reaching its maximum intensity at lower latitudes within the SEB region before either dissipating or experiencing a reduction in both its spatial extent and intensity. The prolonged presence of drought-affected areas in the same region over an extended period contributed significantly to the exacerbation of drought severity, particularly during the March to May trimester.
Existential Wellbeing in Palliative Care: A Paradigm of Existential Positive Psychology
Authors: Wong Paul T. P. , Cowden Richard G. , Yu Timothy T. F. , Arslan Gökmen
Published: January 2024

This article introduces existential wellbeing (EWB) as one of the most ignored but also the most important kind of wellbeing, especially for people who experience life-limiting diseases and need palliative care (Wong & Yu, 2021). This article will not only review the literature regarding the nature and practice of existential wellbeing in palliative care, but also propose a preliminary Existential Wellbeing Scale.

EWB is defined as the quality-of-life characterized by living well and dying well in spite of pain, obstacles, and the shadow of death; wellbeing within the context of human suffering can only be fully understood from the perspective of existential positive psychology (EPP), dedicated to the study of sustainable wellbeing based on the foundation of transcending suffering. The basic tenets of EPP are (1) redefining positivity or wellbeing in terms of seeing and being the light in the darkness; (2) focusing on the dialectical process of navigating an adaptive balance; and (3) re-orienting one’s life attitude from egotism to self-transcendence (Wong, 2023a).

More specifically, EWB depends on some combination of the following experiences: (1) Prior experience of overcoming adversity; (2) Existential intelligence (Gardner, 2020) in addressing existential concerns; (3) Existential wisdom of the soul (Wong 2022a; Wong, Ho, et al, 2023a) to achieve existential wellbeing and sustainable flourishing; (4) Spiritual wellbeing based on spiritual values such as faith, hope, and love (Wong, 2023); (5) Knowledge of meaning-focused coping (Eisenbeck et al., 2021); and (6) The new paradigm of self-transcendence (Reed & Haugan, 2021; Wong, Arslan et al., 2021; Wong, Ho et al., 2023b) to transcend and transform suffering into wellbeing and triumph.
Study of the Multi-Critical Parameters Characterizing the Instability Behavior of Translational Rockslides Considering the Excavation
Authors: Liu ShenHai , Yang Liang , Wang Mengyao , Shen Ming , Sheng Yifan
Published: January 2024

Translational rockslides caused by toe excavation are one of the commonly seen geohazards in mountainous regions due to line traffic construction. Quantifying their failure extension length (FEL) and travel distance are of significant interest as well as huge challenges in landslide hazard assessment. In this paper, a simple criterion is proposed for predicting these two factors based on the principles of rigid body limit equilibrium and kinetic energy theorem. Further, the proposed criterion is validated against the field observations and numerical results with a practical case of the Xinjianan landslide, a medium-sized translational rockslide that occurred in 2013 in Nanchuan District, Chongqing. The findings indicate that a tiny discrepancy can be found in FEL between the field observations and the proposed criteria, while this discrepancy could be considerable in travel distance between different methods. However, the relative discrepancies all fall within 20%, deemed acceptable.
Comprehensive Insights Into Modrna Vaccines: persistent Pp-spike Recombinant Protein, Hyperimmune/inflammatory Reactions, Thrombotic Vasculopathy, Chronic Organ Complications, And Excess Deaths.
Authors: palacios castrillo Ronald
Published: January 2024

A recent study revealed a persistent presence of the PP-Spike recombinant protein in 50% of individuals who received ModRNA injections, contrasting with unvaccinated controls, whether SARSCoV-2 infected or not, up to 187 days post-injection. The implications of these findings are discussed in the context of PP-Spike recombinant protein-induced hyperimmune/inflammatory reactions and thrombotic vasculitis as mechanisms to elucidate the serious side effects, long-term organ complications, and excess deaths observed after administering Covid ModRNA products. These results underscore the urgent need for a comprehensive reassessment of the risk-benefit profile of ModRNA injections, including an immediate halt in their use for any person, and a renewed emphasis on understanding and addressing their long-term effects on human health
Conceptual understanding and analysis conceptual difficulties of nervous system: from the perspective of pre-service biology teachers
Authors: Laelasari Iseu , Wakhidah Nur
Published: January 2024

The aims of this study were to describe level of conceptual understanding and conceptual difficulties on the nervous system from the perspective of pre-service biology teachers. This research was used cross-sectional research design with a sample of 30 participants was selected randomly. The six essays that were created using the conceptual understanding indicator, and twelve multiple-choice questions that were created in the form of three-tier examinations, and the open questionnaires developed to detect challenging concepts in the nervous system make up the instrument. Data has been analysed using descriptive statistics. Data analysis indicates that the average score of conceptual understanding of pre-service biology teachers is 67.33 belongs to the medium category. For the highest percentage of conceptual understanding indicator is ability to exemplify concepts (86.67%) and the other hand, lower percentage is indicators of ability to connect various concepts (46.67%). The best concept for conceptual understanding especially about sub-matter of structure and function of neurons, central and autonomy nerves. Conversely, for the nervous system concepts that are recognized as challenging, particularly the concepts of physiology, impulse transmission mechanism, and somatic nerve inertia. The lack of conceptual understanding caused by complexity of subject, abundance of terminology, and intangible things. The study is expected to be used mainly for development of various learning methods or media that viewed as suitable for improving conceptual understanding of and reducing conceptual difficulties.
Development and validation of an instrument to access elementary school preservice teachers’ understanding towards STEM education
Authors: Shidiq Galih Albarra , Widiyan Agung Purwa , Nishikawa Saori , Tae Lidwina Felisima
Published: January 2024

The instrument could be an important tool to measure the current situation of preservice teachers’ understanding of STEM education at the elementary school level. The study aimed to develop and validation of the scale of instrument test of elementary school preservice teachers’ understanding of integrated STEM. The scale of the instrument was developed based on the items results of theoretical background review and the experts’ suggestions with the total number of participants in this study is 124 Indonesian elementary school preservice teachers’ understanding from the university at the central regions of Indonesia were voluntarily selected to fill out the test. The primary component analysis generated by the components and sub-components of each item could be measured by the Cronbach’s alpha of .940 value and the finding indicated that the scale is valid and reliable to interpretation as a vehicle for evaluating the elementary school preservice teachers’ understanding of STEM education. The implication of this study was about the possibility to implementation STEM into the classroom which is related to improve 21st century skills.
Identify the Writing Ability of 5-6 Years Old
Authors: Redinanti Dian Putri
Published: January 2024

This descriptive quantitative research is intended to observe the stimulation used and identify writing skills in children aged (5-6) years, then analyze according to the stages of writing development in children in PAUD Mentari Jaya, OKU Regency. With a total sample of 9 children. Data was collected through observation, interview and documentation techniques. Referring to previous research, data collection in this study used more complex instruments. The results showed that the children's writing ability was at a very well-developed stage, indicated by a score of 3.8 for holding a tripod grasp writing instrument. The ability to copy the cross marks a score of 3.7. The ability to copy triangular shapes gets a score of 3.6. A score of 3.3 for the ability to recognize between large and small curve lines. The ability to make scribbles such as shapes, marks, and directed lines gets a score of 3.4. A score of 3.3 for being able to write letters randomly to form a word. A score of 3.3 for the ability to distinguish similar letters. A score of 3.8 for the ability to trace simple writing. A score of 3.7 on the ability to copy simple text. And a 3.4 in the ability to write his name correctly. It was concluded that the writing ability based on the average score of each child and based on the ability of each indicator varied. Some indicators have developed well, and some still need further stimulation.
Family Transformation as a Source of Early Childhood Character Education (Bandura's Social Cognitive Theory Perspective)
Authors: Sakti Syahria Anggita
Published: January 2024

The purpose of this research is to describe the shift of the family in its function as the main pillar in instilling character values in early childhood. The method used in this research is a focused interview method with a qualitative approach. The stages of instilling children's character in the family today are (1) knowledge (knowing), where children are given an understanding of the values, norms, and principles expected in the family. (2) acting, where children need to practice these values in real actions, and (3) habit, where the expected positive characters have been internalized in children so that they automatically and unconsciously act in accordance with these values. Later, this development can be integrated and directed in every school activity. Thus, character education can be well integrated into the school curriculum and extracurricular activities. Through this approach, it is hoped that the goal of character development in children can be achieved more effectively and sustainably. 
Building Political Awareness of Gender for The Young Learners
Authors: Yulianti Enny , Sally Novian Uticha , Risdiana Alfu Rohmah
Published: January 2024

The development of early childhood political and gender learning is based on various comprehensive rational considerations, children are a quality asset of the nation. Its success will determine the sustainability of the nation's life so that every nation in the world develops as well as possible. The purpose of this study was to determine the planning, methods, media, children's learning behavior, inhibiting factors, teacher efforts in overcoming obstacles, as well as evaluations carried out by teachers in introducing politics and gender in children aged 5-6 years in RA Ya Salam, Pati Regency. This study uses a descriptive research method with a qualitative approach. The samples of this study were 2 teachers and 21 children in grade B. The teacher's lesson plans were prepared quite well. There are 4 methods used, namely, habituation, storytelling, conversing and sociodrama. The media used are pictures, books, videos and dolls. The changing learning behavior of children includes children who are able to classify themselves and children understand how to look the right way as a boy and a girl, children become aware of gender equality and are passionate about achieving their goals. The inhibiting factors faced by teachers are the stereotyped behavior of gender roles that have been entrenched, as well as the limited time and learning media. The results of this study indicate that political and gender learning in overall learning has been implemented well.
OPTIMIZING MEDICAL CARE FOR PATIENTS WITH STROKE IN A MULTIDISCIPLINARY HOSPITAL
Authors:   City Clinical Hospital named after M.P. Konchalovsky of the Moscow Healthcare Department, Moscow, Russia, Gritsanchuk Alexander , Bezlepko Alexander ,   City Clinical Hospital named after M.P. Konchalovsky of the Moscow Healthcare Department, Moscow, Russia, Tatarinova Tatiana ,   First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia, Yushkovа Anastasia ,   City Clinical Hospital named after M.P. Konchalovsky of the Moscow Healthcare Department, Moscow, Russia, Pchelnikova Diana ,   City Clinical Hospital named after M.P. Konchalovsky of the Moscow Healthcare Department, Moscow, Russia
Published: January 2024

Significance. Acute cerebrovascular accident also known as stroke is one of the most common causes of morbidity, mortality and disability in Russia and abroad. In this regard, constant efforts are being undertaken to improve and optimize the diagnosis and provision of emergency specialized medical care to patients with this condition. The purpose of the study is to demonstrate experience of a multidisciplinary team at the regional vascular center, set up at a multidisciplinary medical institution that also operates in an ambulance mode, City Clinical Hospital named after M.P. Konchalovsky of the Moscow Healthcare Department. Material and methods. The material of the study was performance evaluation of a multidisciplinary team at the City Clinical Hospital named after M.P. Konchalovsky for the period from 2019 to 2022 to optimize the diagnosis and choice of treatment for patients with stroke. Results. Optimizing routing of patients with suspected stroke upon admission made it possible to save time and reduce the timespan before the thrombolytic therapy or thromboextraction is initiated. The introduction of a multidisciplinary team made it possible to reduce time for making the right decisions related to the treatment of patients with stroke. The change in the concept of diagnosing and treating patients with stroke from “sequence” to “parallelism” has significantly reduced the time spent on making a diagnosis, initiating thrombolytic therapy, thromboextraction if necessary, and reducing disability and mortality in patients with stroke. Conclusion. Specialized vascular centers and departments have proven to be effective in improving the diagnosis, treatment and functional performance of patients with stroke. However, the lack of regulatory documents requires further development of algorithms of the work of multidisciplinary teams. The introduction of multidisciplinary teams at the Regional Vascular Center of the "stroke network" made it possible to: achieve medical efficiency by reducing the "door-to-needle" time, mortality and severity of disability indicators; attain cost effectiveness by reducing length of hospital stay and cost of inpatient treatment of patients with stroke. Scope of application. Public health and health organization
PRINCIPLES AND APPROACHES TO ZONING THE NORTH TERRITORIES ACCORDING TO MEDICAL AND BIOLOGICAL INDICATORS. ANALYTICAL REVIEW
Authors:   ", Lugovaya Elena ,   Arktika",   Scientific Research Center, Far Eastern Branch of the Russian Academy of Sciences, Magadan, Russia, Averyanova Inessa ,   "Arktika" Scientific Research Center, Far Eastern Branch of the Russian Academy of Sciences, Magadan, Russia, Vdovenko Sergei ,   "Arktika" Scientific Research Center, Far Eastern Branch of the Russian Academy of Sciences, Magadan, Russia
Published: January 2024

Significance. Studies on the Russian north territories describe them as zones of discomfort owing to natural and climatic conditions that increasingly stress out the human body functional systems. In addition, the quality of life in such regions is also influenced by socio-economic, environmental, ethnic and biomedical factors. An important priority of the state is to develop a scientifically grounded comprehensive approach to zoning the North and Arctic territories to realize activities aimed at implementing the health-saving strategy in the North regions. The purpose of the study was to analyze scientific literature to systematize principles and approaches to zoning the North and Arctic regions based on biomedical indicators, and identify informative criteria for assessing the degree of tension experienced by physiological systems with a subsequent development of functional health indices. Material and Methods. Scientific publications (n = 32) were searched for in eLibrary and PubMed database and then selected given they are open-access and meet the inclusion criteria (compliance with the research topic, full-text is available, free access). The selected works are presented by Meta-Analysis (4 in total); Review (17 in total), Systematic Review (11 in total). All papers were published between April 1st, 2001 – May 1st, 2022. Results. The study presents approaches to zoning the North and Arctic territories of the Russian Federation based on natural-geographical, medical-biological and socio-economic principles. Conclusion. Scientific postulates of the developed analytical review will serve basis for the author’s approach to the medical and biological grounds for zoning the North and Arctic territories using informative indices to evaluate functional reserves of the human body.
Comparison of Post Operative Sedation between Ultrasound Guided TAP Block with the Standard Post-Operative Analgesic Regimen
Authors:   Senior Resident, Department of Anaesthesiology, Chamarajanagar Institute of Medical Sciences, Yadapura, Karnataka 571313, India., S P Samarth , P K Shreecharan ,   Registrar, Department of Anaesthesiology, Manipal Hospital, Bangalore, Karnataka 560017, India., Mohan Sarala ,   Senior Consultant, Department of Anaesthesiology, St. Martha’s Hospital, Bengaluru, Karnataka 560001, India.
Published: January 2024

Introduction: From its humble beginnings, ultrasound guided regional anaesthesia has evolved over the years, with the development of newer blocks and alternative approaches to existing peripheral nerve blocks. Therefore it finds application in not only the anaesthesia set-up but also in critical care and trauma triages, as a modality to provide anaesthesia and analgesia to patients. It is currently the standard of care for administering regional anaesthesia. Methodology: The patients were selected by convenience sampling and those who matched the selection criterion, were briefed about the nature of the study and the procedures involved, in a language understood by them and written informed consent was taken. Descriptive data of the patient such as name, age, sex and detailed medical history, was collected. Results: In our study it was observed that some patients in both Groups S and T experienced mild sedation (Ramsay Sedation Score 3) when assessed for the same at the 2 hour and 4 hour interval. The number of patients experiencing mild sedation at these intervals, were more in Group T as compared to Group S. Conclusion: But this difference in Sedation scores between the two groups was not found to be statistically significant (p value> 0.05). At the subsequent intervals of 6, 12 and 24 hours, there was no difference in the incidence of sedation between the two groups.
Efficacy of Magnesium Sulphate as an Adjunct to Ropivacaine in Local Subcutaneous Infiltration for Postoperative Analgesia Following Lower Segmental Ceasfrean Section in Parturents under Spinal Anesthesia
Authors:   Assistant Professor, Department of Anesthesiology, Raichur Institute of Medical Sciences, Raichur, Karnataka 584102, India., Siddartha Myakala , Raghavendra P G ,   Assistant Professor, Department of Anesthesiology, Raichur Institute of Medical Sciences, Raichur, Karnataka 584102, India.
Published: January 2024

Introduction: Magnesium is an antagonist of NMDA receptors and associated ion channels. It is found in very small concentrations in the plasma and is chiefly an intracellular ion. It is suggested that magnesium has many important roles to play in nociception. An inverse relationship has been documented between the severity of pain with different painful medical and surgical conditions and the serum magnesium levels. Methodology: Patients were monitored for postoperative pain and any analgesic requirement for a period of 24 hours. Any patient complaining of pain or reporting VAS ≥ at any time was administered In tramadol 100 mg IV slowly over 2-3 minutes. If pain was not relieved after 30 minutes and patients still complained of pain, additional doses of Inj tramadol 50mg IV was given and this dose could be repeated every 30 minutes upto a total dose of 250 mg in 6 hourly and maximum of 400mg of Inj tramadol over 24 hours. Results: The number of patients who were administered 2nd, 3rd and 4th doses of rescue analgesics was significantly greater in group A as compared to group B. None of the patients in group B needed more than 4 doses of rescue analgesia while in group A, 5 patients were administered a rescue analgesic for 5th time. The study suggests that local infiltration of local anaesthetic agent alone or in conjunction with magnesium is safe. Conclusion: The addition of magnesium to local anaesthetics potentiates the effect of local anaesthetics and reduces the postoperative opioid requirement.
Comparison of Ondansetron 4mg, Dexamethasone 8mg and Ondansetron 4 mg with Dexamethasone 8mg in Preventing Nausea and Vomiting PostLaparoscopic Cholecystectomy
Authors:   Professor, Department of Anaesthesia, Jagadguru Jayadeva Murugarajendra Medical College, Davangere, Karnataka 577002, India., Bentur Priyadarshini M , R Ashwini ,   Senior Resident, Department of Anaesthesia, Jagadguru Jayadeva Murugarajendra Medical College, Davangere, Karnataka 577002, India.
Published: January 2024

Introduction: The most common distressing symptom following surgery and anaesthesia are nausea and vomiting with an incidence of up to 20 to 30% despite newer medications like Ondansetron and steroids in our armamentarium. Aims: To determine the efficacy of combination therapy with Ondansetron and Dexamethasone and each drug alone in prevention of Postoperative nausea and vomiting (PONV) post laparoscopic cholecystectomy.Also to assess adverse effects if any. Methods: 105 patients aged between 18 and 55 years belonging to ASA status 1 and 2, electively posted for lap cholecystectomy were randomly divided into three groups of 35 each. Gp A received 4mg Inj Ondansetron, Gp B received Inj Dexamethasone 8mg and Gp C received both drugs together. Similar anaesthesia and surgery techniques were used. Upto 24 h period was assessed for incidence of nausea and vomiting and need for rescue antiemetic. Statistical analysis: Chi square test and Student t test were used. Results and Discussion: Overall cumulative incidence of PONV was 54.2% in A Gp, 25.7% in B Gp and 14.2% in Gp C. Complete response, that is no nausea and vomiting was seen in 85.7%in Gp C, 74.2% in Gp B and 45.82%in Gp A which was statistically significant. Ondansetron, a selective 5HT3 receptor antagonist is a good drug for PONV in gynaecological laparoscopy. Dexamethasone is effective against onco and chemotherapy related nausea and vomiting. Combination therapy of the 2 showed good results and reduction in incidence of PONV in lapchole cystectomy.
Comparative Assessment of Bupivacaine and Levobupivacaine in Elective Cesarian Section Cases
Authors:   Assistant Professor, Department of Anesthesia, Pacific Institute of Medical Sciences, Udaipur 313015, India., Goda Vineeta , Sharma Venus ,   Assistant Professor, Department of Anesthesia, Pacific Institute of Medical Sciences, Udaipur 313015, India., Goda Mamta ,   Senior Resident, Department of Anesthesia, Government Medical College, Dungarpur, Rajasthan 314001, India.
Published: January 2024

The anesthetist is held responsible for ensuring a stable and safe operative and post-operative environment so as to aid in the faster and uneventful recovery of the patient. Spinal anesthesia in obstetric surgeries has been gaining rapid acceptance as a choice method but the agent of choice for anesthesia must be such that it can provide a stable state for both the mother and child. The present study was done to ascertain the comparative efficacy of two agents levobupivacaine and bupivacaine in elective cesarian surgery cases. The results showed that levobupivacaine had a shorter duration of sensory and motor block as well as statistically significant lower levels of side effects as compared to bupivacaine. The authors concluded that levobupivacaine may be a more feasible alternative in such surgeries as compared to bupivacaine.
Comparitive Study of the Effect of IV Magnesium Sulfate and IV Lignocaine on Hemodynamic Response to Laryngoscopy and Endotracheal Intubation
Authors:   Pg resident, Department of Anaesthesiology, M.G.M Medical College, Kamothe, Navi Mumbai 400102, Maharastra, India., Sharma Siddharth , Sathe Vishwas ,   Professor and guide, Department of Anaesthesiology, M.G.M Medical College, Kamothe, Navi Mumbai 400102, Maharastra, India., Dsouza Olvyna ,   Professor and HOD, Department of Anaesthesiology, M.G.M Medical College, Kamothe, Navi Mumbai 400102, Maharastra, India.
Published: January 2024

To compare the efficacy of IV Lignocaine(preservative free) (1.5mg/kg body weight) and IV Magnesium sulphate(20 mg/kg body weight) in elective surgery under general anesthesia for controlling the hemodynamic response to laryngoscopy and endotracheal intubation. It can be observed from the present study, the two groups were comparable for age, sex, weight and ASA status of the patients. Magnesium sulphate at 20 mg/kg bodyweight produced significant decrease in heart rate and blood pressure than lignocaine group. The mean heart rate was 92.16 + 10.98 and 123.84 + 8.78 per minute(p=0.0001) at one minute post intubation in Magnesium sulphate group and Lignocaine group respectively. The mean systolic pressure was 130.92 + 8.17 mm of Hg and 158.20 + 4.76 mm of Hg (p=0.0001) and the mean diastolic pressure was 87.64 + 5.7 mm Hg and 99.28 + 4.3 mm of Hg (p=0.0001) at one minute post intubation in Magnesium sulphate group and Lignocaine group respectively. It can be observed from the above result that Magnesium sulphate (in a dose of 20 mg/kg body weight) 3 minutes prior to laryngoscopy when compared to lignocaine (in a dose of 1.5 mg/kg body weight) 3 minutes prior to laryngoscopy causes greater attenuation of stress response to laryngoscopy and endotracheal intubation resulting in greater reduction of heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure and rate pressure product thus causing better hemodynamic stability and thus proving beneficial in patients with hypertension or history or coronary artery disease making it a desirable choice for such patients. Keywords: Magnesium sulphate; Lignocaine; Intubating and Anaesthesia.
Comparative Study between Local Anaesthetics alone and Dexamethasone as an Adjuvant to Local Anaesthetics in Usg Guided Supraclavicular Brachial Plexus Block in Orthopedic Surgeries at and below Elbow
Authors:   Assistant Professor, Department of Anaesthesiology, Lt.brkm Govt.medical College, Dimrapal, Jagdalpur, Chhattisgarh 494001, India., Naik Suchismita , Kashi Gulab Singh ,   Assistant Professor, Department of Anaesthesiology, Lt.brkm Govt.medical College, Dimrapal, Jagdalpur, Chhattisgarh 494001, India.
Published: January 2024

Background: Addition of adjuvants to local anaesthetic drugs improves onset, duration and quality of brachial plexus block in terms of intraoperative anaesthesia as well as postoperative analgesia very effectively. USG guided block ensures safety ,allowing operators to perform block with greater accuracy under direct visualization. Objective: The study was carried to compare the block characteristics between bupivacaine and lignocaine with adrenaline alone and dexamethasone as an adjuvant to mixture of bupivacaine and lignocaine with adrenaline in ultrasound guided supraclavicular brachial plexus block for orthopedic surgeries at and below elbow. Materials and Methods: After obtaining the approval from the Institutional Ethics committee and written informed consent 60 ASA I and ASA II patients between age 18 to 60 years were divided into two groups. Group N(n=30),received 10ml of Lignocaine 2% with Adrenaline plus 18ml of Bupivacaine 0.5% plus Normal saline 2ml.Group D received 10ml of Lignocaine 2% with Adrenaline plus 18ml of Bupivacaine 0.5% plus Dexamethasone 2ml (8mg).Onset of sensory and motor block, duration of sensory and motor block and duration of analgesia were compared among two groups.Results:Our study revealed that onset of both sensory and motor block was earlier in Group D ,duration of sensory and motor block and duration of analgesia was longer in Group D than Group N. Conclusion: Dexamethasone prolongs the duration of sensory and motor block and duration of analgesia when used as an adjuvant to mixture of Bupivacaine and Lignocaine with Adrenaline as compare to mixture of Bupivacaine and Lignocaine with Adrenaline alonein USG guided supraclavicular brachial plexusblock. Keywords: Adrenaline; Bupivacaine; Dexamethasone; Supraclavicular brachial plexus block; USG.
The Efficacy of Transdermal Diclofenac Patch for Postoperative Analgesia in Comparison with Intramuscular Diclofenac in Patients Undergoing Lower Abdominal and Perineal Surgeries Under Sub-Arachnoid Block A Randomised Comparative
Authors:   Senior resident, Department of Anaesthesiology, BLDE (Deemed to be university) Shri B.M.Patil Medical college and Hospital, Vijayapura, Karnataka 586103, India., Rao Varsha , Patil Vidya ,   Professor and HOD, Department of Anaesthesiology, BLDE (Deemed to be university) Shri B.M.Patil Medical college and Hospital, Vijayapura, Karnataka 586103, India., Suntan Anusha ,   Assistant professor, Department of Anaesthesiology, BLDE (Deemed to be university) Shri B.M.Patil Medical college and Hospital, Vijayapura, Karnataka 586103, India., LK Shivanand ,   Associate Professor, Department of Anaesthesiology, BLDE (Deemed to be university) Shri B.M.Patil Medical college and Hospital, Vijayapura, Karnataka 586103, India.
Published: January 2024

Background: Although, postoperative pain is a distinctive and most common form of pain, it remains poorly treated. Aim: To evaluate the efficacy of Transdermal diclofenac patch versus IM diclofen patients undergoing lower abdominal and perineal surgeries under Subarachnoid during postoperative period. Methodology: This randomised comparative study included 90 ASA I and II patien either sex aged 18 – 60 years. Patients were randomly divided by computer generated into two groups of 45 patients each. Group A was applied with a Transdermal Diclofenac (100mg) at the beginning of surgery after subarachnoid block. In groupB 75mg of Diclofenac sodium was given intramuscularly half an hour befo end of surgery. Data was analysed using Chi-square test and Mann Whitney U test Results: The mean difference in the time of administration of rescue analgesia in grou 8hr 37 mins ± 1 hr 4.2 mins and group B is 6hrs 19 mins ±58.6 mins ( P value is < 0.0001 ) effects in group A were very minimal. Conclusion: Thus transdermal diclofenac patch is effective, non- invasive and safer w treating postoperative pain. Keywords: Transdermal Diclofenac Patch, Im Diclofenac, Postoperative Analgesia.
Comparison of Peng Block versus Ficb in Hip Surgeries, A Randomised Control Study
Authors:   Assistant Professor, Department of Anesthesiology, Sanjay Gandhi Institute of Trauma and Orthopedics, Bangalore, Karnataka 560011., Kumar Malathi Anil , HR Madhumala ,   Assistant professor,  Department of Anesthesiology, Bangalore Medical College and Research Institute, Bangalore, Karnataka 560034, India., Shetty Ashna ,   Post Graduate Student, Department of Anesthesiology, Bangalore Medical College and Research Institute, Bangalore, Karnataka 560034, India.
Published: January 2024

Background: Hip surgeries are among the common surgeries performed in orthopaedics especially in geriatric age group. A recent anatomical study on hip innervation led to the identification of relevant landmarks to target the hip articular branches of femoral nerve and accessory obturator nerve making Pericapsular nerve group (PENG) block popular. However there are other commonly performed blocks for hip surgeries including Fascia Iliaca block, 3 in 1 block, Femoral nerve block. This study is aimed at comparing the efficacy of Pericapsular nerve group (PENG) block and Fascia Iliaca Block (FICB) in terms of post operative analgesia. Aims and objectives: To compare the efficacy of post- operative analgesia in Pericapsular nerve group (PENG) block and Fascia Iliaca block in hip surgeries. Material and Methods: Total 90 patients scheduled for hip surgeries under combined spinal epidural anesthesia were selected for the study. In 30 patients ,ultrasound guided PENG block was given, in other 30 ultrasound guided Suprainguinal Fascia Iliaca block was given and other 30 patients were used as control group in the post operative period and duration of analgesia was assessed by numeric rating scale (NRS) and visual analogue scores ( VAS ) Results: In our study of 90 patients posted for hip surgeries, PENG block showed better results in terms of reduction in pain scores, time of first analgesia requirement and quantity of rescue analgesics used in the post operative period. Conclusion: The newer PENG block is better than Fascia Iliaca block in hip surgeries in delaying post opioid consumption, its associated side effects and delirium especially in geriatric patients.
Multimodality Approach in Management of Pressure Sore: A Systemic Review
Authors:   Senior resident, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Pondicherry, India-605006., C. Vinayak , R.K. Chittoria ,   Professor, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Pondicherry, India-605006., M.S. Kumaran ,   Senior resident, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Pondicherry, India-605006., B. Preethitha ,   Senior resident, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Pondicherry, India-605006., H.K. Sudhanva ,   Senior resident, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Pondicherry, India-605006., S. Elankumar ,   Senior resident, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Pondicherry, India-605006., K.R. Sireesha ,   Senior resident, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Pondicherry, India-605006., A. Agarwal ,   Senior resident, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Pondicherry, India-605006., S. Gupta ,   Senior resident, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Pondicherry, India-605006.
Published: January 2024

Pressure sores are unyielding wounds proving a nightmare to treating physician and adding to financial burden and psychological distress of the patient and the care giver. Systemic multidisciplinary approach and multimodal intervention to treat the wound is essential to achieve favourable results. In our case report we highlight the various modalities of treatment that can be used for the treatment of such pressure sore and review other modalities that can be used to accelerate the wound healing process.