bluuebunny/crossref_metadata_2025 huggingface dataset:
An Insight into the Factors Controlling Delta Flood Events: The Case of the Evros River Deltaic Plain (NE Aegean Sea)
Authors: Poulos Serafeim , Karditsa Aikaterini , Hatzaki Maria , Tsapanou Athina , Papapostolou Christos , Chouvardas Konstantinos
Published: February 2022

The present contribution aims to give an insight into the main terrestrial and marine processes leading to delta flooding in the case of the transboundary Evros delta, located at the microtidal NE Aegean Sea, on the basis of recorded flood events in the Evros deltaic plain. The prevailing weather conditions at the onset of the event, along with sea-level rise above the mean state, portray the mechanism for the development of compound flood events and subsequent riparian flooding. This system blocks the riverine water’s seaward exit, resulting in the flooding of the lower deltaic plain. The river discharge is recognized as a secondary factor acting mainly toward the persistence of the events. Several limitations restrict the quantification potential of the relative contribution of the key factors to the development, onset, and duration of a flood. Mitigation of the impacts of such flood events requires intercountry cooperation and a management plan based on a network of environmental monitoring.
Modern approaches for postoperative care patients of urological profile
Authors:   SBHI SR «Togliatti City Clinical Hospital No. 1», Spiridonova Tatyana Viktorovna
Published: February 2022

The article presents the experience of nursing specialists in the urological department, based on modern approaches to the care of postoperative patients.
Experience in implementing information technologies in healthcare
Authors:   FSBI «Volga Federal Medical Research Center» of the Ministry of Healthcare of Russia, Smirnova Elena Valerievna
Published: February 2022

The authors pay special attention to one of the main parts of the information system — an automated workstation for a medical worker.
Modern trends in changing methodological approaches to the organization of remuneration
Authors:   Basic Department of the Chamber of Commerce and Industry of the Russian Federation ", Gudkov A.O. ,   Development of human capital",   , Plekhanov Russian University of Economics, Moscow
Published: February 2022

The article analyzes modern approaches and tendencies to the organization of remuneration, emphasizes the importance of state regulation, the approaches of private enterprises to this issue.
The Political Dialogue and Cooperation Agreement and relations between European Union and Cuba
Authors: Romero Antonio
Published: February 2022

This document makes an assessment of the Political Dialogue and Cooperation Agreement (PDCA) between Cuba and the European Union (EU) in its four years of validity, and of the evolution of political and economic relations between both parties. The analysis is structured in five headings that address the background, determinants and significance of the PDCA between Cuba and the EU; the main elements discussed in the political dialogue —and in thematic dialogue— between the two parties since 2018, and the central aspects of trade, investment and cooperation relations between Cuba and the EU. The report concludes that, unlike the United States, the EU is able to support the complex process of economic and institutional transformations underway in Cuba, in four fundamental areas: i) technical assistance and advice for the design and implementation of public policies, macroeconomic management, decentralisation and local development; ii) cooperation to fight climate change and transform Cuba’s productive and technological structure; iii) the promotion and encouragement of foreign investment flows from Europe, targeting key productive sectors; and iv) the exploration of financial opportunities for Cuba through the European Investment Bank (EIB) under the current PDCA.
Корекція кінематографічної реальності в умовах актуалізації спеціальних ефектів
Authors: Безуглий Андрій
Published: February 2022

Cтоліття існування кінематографа не могло відбуватися без розвитку його унікальної мови, яка набирала силу для втілення смислів на екрані та надавала певний досвід перебування у світі. Один з важливих елементів, який забезпечує реальність того, що відбувається на екрані – це спецефект. Він здійснює функцію легітимізації того,що відбувається з точки зору реального. Іншими словами, спецефект допомагає глядачеві повірити в те, що відбувається на екрані, щоб здійснилося "занурення" у кінематографічну реальність. Стаття є філософським міркуванням на тему спеціальних ефектів у кінематографі. У ній були зроблені спроби відповісти на такі питання: "Яку функцію виконує спецефект?", "Яку реальність він допомагає створювати та яким чином?". Також була зроблена спроба осмислити природу цього явища, зрозуміти його зв'язок з іншими елементами фільмів, позначити роль "спецефекту".
Філософсько-богословське вчення про "внутрішню людину" св. Луки (Войно-Ясенецького)
Authors: Величко Олена
Published: February 2022

В статті аналізується філософського-богословське вчення св. Луки Войно-Ясенецького про людину як триєдиний психосоматичний організм, що складає органічне ціле у вертикалі підпорядкування: тіла (цілісніості, що включає у себе усі органи, системи) – душі (як сукупності органічних та чуттєвих сприйняттів, слідів спогадів, думок, почуттів, вольових актів) - духу (як розумного, вольового, життєдайного початку) у її внутрішньому трансцендентально-кордоцентричному і зовнішньо-тілесному єстві. Термін "внутрішня людина" визначається через протиставлення "людині зовнішній" як плотській, гріховній, дезорієнтованій і відвернутій від розуму та духу. Поняття "внутрішня людина" розглядається у праксисі протистояння гріху як деяка цілісність у її розумі, серці і духу, що панує над плоттю.
Поняття “генетичного образу” та екзистенціального підгрунтя феномену ідентичності
Authors: Райда Костянтин
Published: February 2022

В численних дослідженнях ідентичності, що здійснюються в межах раціоналістичної традиції, почасти остаточно втрачається відповідність первинним формам та змісту самого процесу виникнення і формування цього феномену. А роздуми щодо її виявів та конституалізацій починають більше нагадувати гесівську "гру у бісер", аніж адекватне філософське мислення. В статті досліджується генетичний образ та екзистенціальне підгрунтя ідентичності у якості процесів самоідентифікації та визначення суспільної значимості людської істоти, де її екзистенціальність (психоемоційний комплекс) у всіх можливих перетурбаціях відіграє надзвичайно вагому роль. Замість безплідно-логічного виявлення тотожності як головної сутності досліджуваного феномену у даному випадку на авансцені розмірковувань з’являються і процеси одночасного відтворення, і процеси спостереження, які відбуваються й зачіпають усі рівні психічної та психоемоційної діяльності індивіда, за допомогою яких він намагається оцінити себе з огляду на те, як саме інші люди сприймають його у порівнянні зі своїм самоуявленням та уявленнями інших людей у межах значимої для них типології. Адже, коли людині треба конче відчути, або ж створити зв’язок з тією або іншою людською спільнотою, вона з необхідністю повинна звертатися й до тих своїх атрибутів, які поділяє з іншими людьми. І лише у тому випадку, коли такі атрибути, не порушуючи її особистої гідності, складають й частину того, що людина називає "бути самим собою", вони можуть бути підставою для формування її ідентичності.
Deep CNN Model for Non-Screen Content and Screen Content Image Quality Assessment
Authors: Chaudhary Dilip , Venkatesh Venkatesh
Published: February 2022

In the current world, user experience in various platforms matters a lot for different organizations. But providing a better experience can be challenging if the multimedia content on online platforms is having different kinds of distortions which impact the overall experience of the user. There can be various reasons behind distortions such as compression or minimal lighting condition while taking photos. In this work, a deep CNN-based Non-Screen Content and Screen Content NR-IQA framework is proposed which solves this issue in a more effective way. The framework is known as DNSSCIQ. Two different architectures are proposed based upon the input image type whether the input is a screen content or non-screen content image. This work attempts to solve this by evaluating the quality of such images.
Analysis of the Growth of the Axial Length of the Eye in Children with Progressive Myopia using Combined Design Orthokeratological Lenses
Authors: Бездетко П.А. , Пархомец Р.А.
Published: February 2022

Цель. Провести анализ роста аксиальной длины глаза у детей с прогрессирующей миопией на фоне использования ортокератологических линз (ОКЛ) комбинированного дизайна. Материалы и методы. В исследовании приняли участие 120 детей с миопией, I группа - 60 детей, которым назначались ортокератологические линзы, II группа - 60 детей, которым были назначены очки. Определялась рефракция до назначения коррекции и через 24 месяца после. Измерялась аксиальная длина глаза до начала коррекции и каждые 6 месяцев. Результаты. Дети, которые использовали ортокератологические линзы, имели прирост длины глазного яблока значительно меньше, чем дети в группе сравнения. В I группе прирост аксиальной длины может соответствовать прогрессированию миопии на 0,24 дптр/год, а в группе сравнения на 1,02 дптр/год. Выводы. Использование ОКЛ комбинированного дизайна является эффективным методом контроля прогрессирования миопии у детей.

Purpose. To analyze the growth of the axial length of the eye in children with progressive myopia while using combined design orthokeratological lenses Materials and methods. 120 children with myopia took part, group I - 60 children who were prescribed orthokeratological lenses, group II - 60 children who were assigned glasses. Refraction was determined before correction was prescribed and 24 months later. The axial length of the eye was measured before the start of the correction and each 6 months later. Results. Children who used orthokeratological lenses had an increase in the length of the eyeball significantly less than children in the comparison group. In group I, the increase in axial size of the eyes can correspond to the progression of myopia by 0.24 diopters/year, and in the comparison group by 1.02 diopters/year. Conclusion. The use of a combined design OKL is an effective method for controlling the progression of myopia in children.
Fixed Combination in the Treatment of Patients with Primary Open-Angle Glaucoma
Authors: Джумова М.Ф. , Марченко Л.Н. , Чекина А.Ю. , Далидович А.А. , Джумова А.А.
Published: February 2022

Эффективной и доказанной стратегией для сохранения зрительных функций и качества жизни пациента является воздействие на внутриглазное давление (ВГД), которое должно быть снижено до целевого уровня. В ряде случаев достижение целевого уровня возможно при одновременном применении нескольких топических гипотензивных средств. Предпочтительно применение фиксированных комбинированных препаратов. За последние десятилетия были разработаны и внедрены в практику несколько оригинальных гипотензивных препаратов различного принципа действия и их дженериков, применяемых для лечения пациентов с глаукомой. Возможность взаимозаменяемости оригинального препарата аналогом является актуальной для каждого офтальмолога. В данном обзоре обобщены данные о простагландиновых и непростагландиновых фиксированных комбинированных препаратах, их дженериках, преимуществах бесконсервантных препаратов, гипотензивном эффекте, безопасности и переносимости в сравнении с другими гипотензивными средствами и их комбинациями.

Reduction of intraocular pressure (IOP) is an effective strategy for preserving visual functions and quality of life in patients with primary open-angle glaucoma (POAG). In some cases, achieving the target level of IOP is possible with the use of several topical antihypertensive agents. The use of fixed combinations of drugs is preferable. Over the past decades, several original antihypertensive drugs and their generics used to treat patients with glaucoma have been developed and put into practice. In this review, we will try to summarize the data on fixed prostaglandin and non-prostaglandin combined drugs, generics, the advantages of preservative-free drugs, their hypotensive effect in comparison with other antihypertensive agents and their combinations.
Features of the Course of Bipolar Affective Disorder in Patients with Alcohol Addiction
Authors: Демьянов И.А. , Бойко Е.О. , Ложникова Л.Е. , Зайцева О.Г. , Демьянов А.В. , Мельник Е.Ю.
Published: February 2022

За время проведения клинического исследования выполнена оценка коморбидности биполярного аффективного расстройства с зависимостью от алкоголя, развившейся на фоне биполярного расстройства и предшествовавшей биполярному расстройству, с целью определения особенностей течения заболевания. В исследование вошли 120 пациентов в возрасте от 18 до 65 лет (75 мужчин, 45 женщин) с биполярным аффективным расстройством первого типа, которые проходили стационарное лечение в ГБУЗ «СКПБ № 1» (Краснодар) в период с 2013 по 2018 г.

During the course of the clinical study, the comorbidity of bipolar disorder (BD) with alcohol addiction following BD (BD-A) and preceding BD was assessed in order to determine the features of the course of the disorder. The study involved 120 patients aged from 18 to 65 years (75 men, 45 women) with bipolar disorder of the first type, who underwent inpatient treatment at State budgetary institution of health care “Specialized Clinical Psychiatric Hospital No. 1” (Krasnodar) in the period from 2013 to 2018.
Сonjuntivities in Children and Adolescents in the Conditions of Pandemic COVID-19: What Should the First Contact Doctor Know? Questions and Answers
Authors: Бекетова Г.В. , Витовская О.П.
Published: February 2022

В педиатрии существует много вопросов, касающихся дифференциации и диагностики офтальмологических заболеваний врачом первого контакта. В статье в форме вопросов и ответов представлена мультидисциплинарная дискуссия педиатра и офтальмолога в отношении анатомо-физиологических подходов к формированию диагнозов, тех состояний, которые сопровождаются симптомом «красного глаза». Авторы обсуждают алгоритмы диагностики, постановки диагноза и современных подходов к лечению синдрома «красного глаза». Представлены клинические критерии острого конъюнктивита различной этиологии. Рассмотрены современные подходы к диагностике и лечению поражений глаза с использованием местных антибактериальных средств в различных формах выпуска, с разными комбинациями действующих веществ, в том числе препаратов Флоксанекст, Тоброцим-Некст комби и Тоброцим-Некст.

There are a lot of questions regarding the differentiation and diagnosis of ophthalmic diseases by a doctor of first contact. The article in the form of questions and answers presents a multidisciplinary discussion of a pediatrician and an ophthalmologist in relation to anatomical and physiological approaches to the formation of diagnoses, those conditions that are accompanied by the symptom of "red eye". The authors discuss algorithms for diagnosis, and modern approaches to the treatment of red eye syndrome. Clinical criteria for acute conjunctivitis of various etiology are presented. Considered modern approaches to the diagnosis and treatment of eye lesions using local antibacterial agents in various forms of releases, different combinations of active substances, including the drugs Floxanext, Tobrotsim-Next-Сombi and Tobrotsim-Next.
Pendidikan Ekonomi Menurut Perspektif Al-Quran
Authors: Yasmansyah
Published: February 2022

Tujuan penelitian ini adalah untuk menemukan konsep pemberdayaan ekonomi umat Islam dalam al-Qur’an dan mengetahui kontribusi pemberdayaan ekonomi ummat Islam untuk kehidupan. Bahaya kemiskinan dan ketidakberdayaan bisa merusak akidah, merusak akhlak, merusak stabilitas keamanan, dan menciptakan kecemburuan sosial. Maka dari itu melalui ayat-ayat al-Qur’an ini peneliti akan mengangkat judul pemberdayaan ekonomi ummat Islam dalam perspektif al-Qur’an. Jenis penelitian yang dilakukan metodologi, tafsir maudlu’i mengenai ekonomi dalam al-Qur’an ini mempunyai tahapan kerja sebagai berikut: pertama, menginventarisasi ayat-ayat yang terkait dengan permasalahan ekonomi yang akan dibahas, baik berdasar pada kata kunci maupun pada kandungan ayat secara umum maupun khusus. Kedua, menafsirkan ayat-ayat tersebut baik berdasar urutan ayat dalam mushaf atau berdasar urutan turunnya surat. Ketiga, model penafsiran yang digunakan adalah maudlu’i dengan melakukan konstektualisasi dalam realitas perekonomian. Dalam penelitian ini peneliti akan meneliti data-data yang terungkap dalam al-Qur'an, kitab tafsir, hadits, dan buku-buku yang relevan atau jurnal dan makalah yang memiliki hubungan dengan makna pemberdayaan ekonomi ummat Islam. Konsep pemberdayaan ekonomi ummat Islam dalam perspektif al-Qur’an adalah membebaskan manusia dari ketidakadilan, memperdayakan potensi diri manusia, menyadarkan manusia untuk peduli terhadap sesama, memuntuk manusia menuju kebahagiaan dunia dan akhirat. Kontribusi pemberdayaan ekonomi ummat Islam dalam kehidupan adalah: Ikut berperan serta memberantas praktek riba, perdagangan manusia, momopoli kekayaan, kekuasaan yang menyebabkan kemiskinan, kelaparan, ketakutan, ikut memotivasi pada pribadi muslim agar kuat, tangguh dan pantang menyerah serta berusaha bersungguh-sungguh dan tidak putus asa
İçme Suyu İsale Hatlarındaki Basınç Kırıcı Yapılarda Enerji Üretiminin Yapısal Tasarımı ve Analizi Kahramanmaraş Örneği
Authors: TAHİROĞLU Ahmet Fatih , DİŞ Muhammet Ömer
Published: February 2022

Şehirlere içme suyu sağlayan isale hatlarının önemli bir kısmı daha yüksek rakımlı kaynak noktalarından şehir merkezlerine ulaşmaktadır. Onlarca kilometre uzunluğa sahip olabilen bu hatlarda düşü farkından oluşan suyun yüksek basıncı tasarım aşamasında konumlandırılan maslaklarda ve depolarda kırılmaktadır. Bu çalışma ile tasarım aşamasında enerji üretimi düşünülmeden projelendirilen ve inşa edilen mevcut içme suyu isale hatlarındaki potansiyelin, hat üzerinde değişikliğe gidilmeden değerlendirilmesi araştırılmıştır. Bu bağlamda Kahramanmaraş özelinde il merkezine içme suyu sağlayan hatlar üzerinde potansiyel incelenmiştir. Yapılan ön fizibilite neticesinde savunulan hipotezin geçerli olduğu ve örnek projenin Kahramanmaraş Su ve Kanalizasyon İdaresi için verimli olacağı sonucuna ulaşılmıştır. Bu sonuçtan yola çıkarak, ayrıca, Türkiye genelindeki potansiyelin tespiti ve hayata geçirilmesine yönelik nasıl çalışmalar yapılabileceği hususunda değerlendirmeler yapılmıştır.
El reconocimiento indígena a partir de las experiencias con medios de comunicación en el Cabildo Nasa ubicado en la ciudad de Bogotá D. C., Colombia
Authors:   , Gómez Bastidas Adriam
Published: February 2022

La presente investigación explora los modos de reconocimiento existentes en el cabildo indígena Nasa de Bogotá y su vínculo con la producción discursiva de los medios de comunicación tradicionales y masivos para la comprensión de tres relatos de vida de hombres y mujeres pertenecientes a esta comunidad. Para ello, se realiza una indagación frente al estado actual del movimiento social indígena con énfasis en el grupo étnico Nasa de Bogotá que busca caracterizar y comprender las percepciones y experiencias que hombres y mujeres poseen en torno a sus procesos de interacción con recursos audiovisuales. Lo anterior con miras al desarrollo y divulgación de un portafolio fotográfico que, como producción estética, problematiza en torno a las significaciones propias del devenir indígena a partir de las prácticas de reconocimiento ancestral.
CLINICAL AND LABORATORY EVALUATION OF A NOVEL DENTAL GEL FOR TREATMENT OF CHRONIC CATARRHAL GINGIVITIS
Authors: Averyanov Sergey , Khayrzamanova Ksenia , Iskhakov Ilgiz , Afanasyeva Julia , Startseva Ludmila
Published: February 2022

This article presents the study of a dental gel developed by us, containing, as an active ingredient, sanguitrithrin and oil extract from calendula flowers and yarrow grass. As a result of our studies of the dental gel on 1,844 children and adolescents, we revealed that it has antiinflammatory and wound-healing activities and produces anti-inflammatory, reparative, hemostatic and trophic effects. The results of the study make it possible to use the dental gel in clinical practice for treatment of inflammatory periodontal diseases in children. We substantiated the prospects of using the phytocomplex in the form of a dental gel and proved it as effective and safe. Besides, its dosage form is convenient for use in dental practice and even provides advantages over known domestic analogues.
Tratamiento definitivo en traumatismo avulsivo de la región cérvico-facial. Presentación de caso clínico
Authors: Suarez Pupo Amilkar , Arias Pla Carlos Antonio , Vargas Baños Marcelo Jorge , Yagual Jiménez Karol Magdalena
Published: February 2022

Introducción: Las lesiones autoinfligidas por armas de fuego con cañón largo en la zona cérvico-facial no siempre logran consumar el suicidio y pueden ocasionar una herida avulsiva de esta región anatómica.  Objetivo: Socializar los beneficios del tratamiento multidisciplinario inmediato en la atención al paciente con traumatismo facial complejo. Caso clínico. Paciente masculino de 60 años de edad con intento autolítico por arma de fuego, con pérdida importante de tejido a nivel mandibular y compromiso de la vía aérea. Resultados: Las distintas etapas de accionar quirúrgico se lograron en las primeras cuatro horas desde que sucedió el incidente. El paciente no presentó complicaciones postoperatorias ni necesidad de una nueva operación. Discusión: En la actualidad existe la tendencia a realizar tratamiento definitivo en un solo tiempo quirúrgico inicial. Conclusión: La intervención inmediata y protocolizada de las especialidades Cirugía General, Maxilofacial y Cirugía Plástica–Reconstructiva en pacientes con heridas avulsivas de la región cérvico facial pueden lograr un tratamiento definitivo en un único tiempo quirúrgico y con resultados favorables.
A double blind randomized clinical trial to compare the efficacy of bupivacaine and ropivacaine for painless delivery
Authors: Kamali Alireza , Anousheh Narges , Shokrpour Maryam , Pazouki Shirin
Published: February 2022

Background & objective: Childbirth is an important phenomenon in the life of the mother and although this experience is the wish of every mother, it also concerns her due to the labor pain and the possible dangers that threaten her. There are several medications for painless delivery, such as epidural analgesia with the help of bupivacaine and ropivacaine. The aim of this study was to compare the efficacy of painless delivery with epidural method by bupivacaine and ropivacaine in women candidates for painless delivery.

Methodology: This study is a double blind randomized clinical trial. In this study, patients were randomly divided into two equal groups of bupivacaine and ropivacaine using cubic random method. The demographic data, incidence of cesarean section and mean birth phases were evaluated. Finally, data were analyzed using SPSS 22 software, ANOVA and T-test.

Results: A total of 112 patients were enrolled in the study. There was no significant difference between the two groups in terms of mean active phase of labor, mean Apgar score of min 1 and 5, incidence of cesarean section and mothers motor block score, but the mean of the second phase of labor and mean use of delivery helping instruments (such as forceps and vacuum) were lower in the ropivacaine group. Also, the mean score of patients' satisfaction was higher in ropivacaine group.

Conclusion: It could be concluded that the combination of ropivacaine and fentanyl versus the combination of bupivacaine and fentanyl was a very suitable combination for controlling labor pain by epidural method, while it did not increase the rate of cesarean section and did not have a negative effect on neonatal Apgar scores of min 1 and 5, it had a significant effect on decreasing the mean of second stage of labor, decreasing the use of delivery helping instruments and increasing patient satisfaction score.

Key words: Bupivacaine; Ropivacaine; Epidural analgesia; Painless delivery

Citation: Anousheh N, Shokrpour M, Pazouki S, Kamali A. A double blind randomized clinical trial to compare the efficacy of bupivacaine and ropivacaine for painless delivery. Anaesth. pain intensive care 2021;25(3): 274–279.  DOI: doi.org/10.35975/apic.v25i3.1146

Received: November 2, 2020, Reviewed: February 22, 2021, Accepted: March 26, 2021
Tourniquet palsy in upper limb; a case report
Authors: Perveen Wajida , Amin Ijaz , Hashmi Riaz , Anwar Sahreen , Ali Misbah Amanat
Published: February 2022

Corrective surgical procedures especially on the limbs take much time to finish and need intense vigilance. During these surgeries tourniquet application is common to prevent excessive blood loss and to perform the procedure in a bloodless field. However, tourniquets have been known to cause some complications due to nerve compression needing immediate attention. We present a case of tourniquet palsy in upper limb with involvement of radial, ulnar and median nerve. The patient received physiotherapy treatment which lead towards his speedy recovery and prevented him from disabilities.
Key words: Tourniquet palsy; Nerve injury; Physiotherapy; Neurodynamics
Citation: Perveen W, Amin I, Hashmi R, Anwar S, Ali MA. Tourniquet palsy in upper limb; a case report. Anaesth. pain intensive care 2021;25(4):535–538. DOI: 10.35975/apic.v25i4.1585
Received: March 4, 2021, Reviewed: March 2, 2021, Accepted: June 23, 2021
Ultrasound–guided serratus anterior plane block versus thoracic epidural analgesia for acute post–thoracotomy pain: a prospective randomized controlled study
Authors: Mostafa Mamdouh M. , Bakeer Ahmed H. , Gamal Reham M.
Published: February 2022

Background: Post–thoracotomy pain can result not only in discomfort to the patient but also in pulmonary complications, due to ineffective coughing, which leads to retention of secretions. It can result into chronic post–thoracotomy pain in the long term. Many analgesic techniques are in use to control it, including continuous serratus anterior plane block (SAPB) and thoracic epidural analgesia (TEA). We compared the efficacy and safety of SAPB with continuous TEA in patients undergoing open lung resection.
Methodology: This randomized, open–labeled, parallel–controlled trial was done in 60 patients aged 20 to 60 y with American Society of Anesthesiologists physical status II–III, who underwent elective thoracotomy for lung cancer surgery. Patients were randomly allocated according to analgesia either via a thoracic epidural catheter (10 ml levobupivacaine 0.25%, followed by 5 ml/h of 0.125%) or an ultrasound–guided SAPB (30 ml levobupivacaine 0.25% followed by 5 ml/h of 0.125%). Mean arterial pressure and heart rate were recorded during and after the surgery. Inj. fentanyl was used as rescue analgesia. Postoperatively VAS at rest and on coughing was used to assess the pain. Any complications were noted.
Results: After excluding five patients, 27 and 28 patients were allocated to the TEA and SAPB groups, respectively. Intraoperatively and until 24 h after the end of surgery, the mean arterial pressure and heart rate were higher in the SAPB group than in the TEA group. Intraoperatively, the requirement for fentanyl was more in the SAPB group. Postoperatively, VAS at rest and cough were significantly higher in the SAPB group. The occurrence of nausea and vomiting, hypotension, and bradycardia were similar in the groups.
Conclusions: In patients undergoing open lung resection for cancer, continuous serratus anterior plane block was less effective than thoracic epidural analgesia in controlling postoperative pain and presented similar adverse events.
Key words: Serratus anterior plane block; Thoracic epidural, Continuous; Thoracotomy pain, Acute
Abbreviations: PTP – Post–thoracotomy pain; TEA – Thoracic epidural analgesia; VAS – Visual analog scale; SAPB – Serratus anterior plane block; MAP – Mean arterial blood pressure; LA – Local anesthetics
Preregistration: The study was registered in the institutional board ethical committee (201617026) and on www.clinicaltrials.gov (NCT03933592)
Citation: Mostafa MM, Bakeer AH, Gamal RM. Ultrasound–guided serratus anterior plane block versus thoracic epidural analgesia for acute post–thoracotomy pain: a prospective randomized controlled study. Anaesth. pain intensive care 2021;25(6):733–740 ;
DOI: 10.35975/apic.v25i6.1692
Received: July 09, 2021, Reviewed: October 06, 2021, Accepted: October 09, 2021
The intensity of extremely low frequency electromagnetic field by target temperature of MEGAWARMERⓇ patient temperature management system
Authors: Kim Se Hun , Park Yei Heum , Lee Hyunseong , Lee Sang Eun , Park Jae Hong , Lee Ki Hwa , Kim Yong Han
Published: February 2022

Background: Extremely low frequency electromagnetic field (ELF-EMF) emitted by electronic devices is associated with various biological effects on the human body. MEGAWARMERⓇ patient temperature management system (PTMS) is widely used for the patient temperature management in anesthesia and critical care. We investigated the intensity of ELF-EMF according to the distance and target temperature of MEGAWARMERⓇ PTMS to find the distance allowing minimized exposure to ELF-EMF.
Methodology: This study was a prospective experimental study. Target temperature was set at 31℃, 36℃ and 41℃. After setting each target temperature, the intensity of ELF-EMF was measured 300 times during 10 min at interval of 2 sec, at distances of 15, 30, and 45 cm from the MEGAWARMERⓇ PTMS, respectively. Nine measurement groups from 3 different target temperatures and 3 different distances resulted in 2700 data. Including background EMF intensity with the MEGAWARMERⓇ PTMS also turned off, total 3000 data in 10 groups were collected.
Results: At the distance of 15 cm from the MEGAWARMERⓇ PTMS, mean values of ELF-EMF were 4.6721 milligauss (mG), where 1 G is equivalent to 10⁻⁴ Tesla (T) (or 1 mG = 0.1 μT) at 31℃, 4.2852 mG at 36℃, and 3.9935 mG at 41℃. At the distance of 30 cm, mean values of ELF-EMF were 2.0948 mG at 31℃, 2.0790 mG at 36℃, and 2.0633 mG at 41℃. At the distances of 15 cm and 30 cm, the lower target temperature showed statistically significantly higher mean values of ELF-EMF (p < 0.05). In all three target temperatures, longer distance made statistically significantly lower mean value of ELF-EMF (p < 0.05).
Conclusions: The mean intensity of ELF-EMF from the MEGAWARMERⓇ Patient Temperature Management at the distance of 15 cm and 30 cm exceeded 2 mG recommended by Swedish Confederation of Professional Employees guideline.
Key words: Extremely low frequency electromagnetic field; Temperature management; Intensive care unit
Abbreviations: ELF-EMF– Extremely Low Frequency ElectroMagnetic Field; PRMS – Patient Temperature Management System; mG – milligauss
Citation: Kim SH, Park YH, Lee H, Lee SE, Park JH, Lee KH, Kim YH. The intensity of extremely low frequency electromagnetic field by target temperature of MEGAWARMERⓇ patient temperature management system. Anaesth. pain intensive care 2021;25(6):741-745;
DOI: 10.35975/apic.v25i6.1693
Received: August 11, 2021, Reviewed: September 30, 2021, Accepted: October 6, 2021
Dr. Muhammad Jamil Akhtar
Authors: Akhtar Dr. Muhammad Jamil
Published: February 2022

Dr. Muhammad Jamil Akhtar was born on November 2, 1959, in East Pakistan (now Bangladesh). He received his early education there, then migrated to Pakistan when he was merely 13 years old.
Anesthesia without opioids
Authors: Butt Mohsin Nazir , Faraz Asma , Fazal Maheen
Published: February 2022

Summary

Opium was the first opioids with sedative and analgesic effects, so was readily adopted by the surgical doctors to be used during surgeries. Later on its natural alkaloid, morphine, was extensively used, till synthetic alkaloids were introduced in the clinical practice. Now many non-narcotic analgesic drugs have been synthesized and proven to be devoid of serious side effects, commonly associated with the opioid use. There have been some staunch advocates of non-narcotic based anesthesia, who claim that the side effects of the opioids outweigh their benefits in the anesthesia. This editorial throws some light on the current and the future trends in analgesic use in anesthesia.

Key words: Opioids; Analgesics; Non-opioid analgesics; Perioperative pain; Side effects

Citation: Butt MN, Faraz A, Fazal M. Anesthesia without opioids (Editorial). Anaesth. pain intensive care 2021;26(1):4–7;

DOI: 10.35975/apic.v26i1.1758

Received: January 10, 2022, Accepted: January 12, 2022
Stimulation of acupoint P6 before induction of anesthesia to prevent postoperative nausea and vomiting; a randomized control trial
Authors: Hamid Saman , Butt Mohsin Nazir , Rehman Azhar , Afshan Gauhar
Published: February 2022

Background & Aims: Laparoscopic surgery has been associated with troublesome postoperative nausea and vomiting (PONV) in patients. Various regimens have been tried by the anesthesiologist to prevent PONV in laparoscopic cholecystectomy (LapChole). The primary objective of this study was to determine the role of stimulation of acupoint P6 for this purpose in patients undergoing LapChole at our institution. 

Methodology: A randomized clinical trial was conducted at the Aga Khan University Hospital, Karachi, Pakistan. The research setting took place at the Post Anesthesia Care Unit (PACU) of the hospital. A total of 84 participants undergoing LapChole, ASA Status I or II, were enrolled and randomly allocated into two groups: 41 in control and 43 in the intervention group. In the intervention group, a commercially available band – PressureRight™ was applied at the wrist and the beads were placed exactly at P6 point. In the control group, the band was applied at the wrist with the beads placed on the dorsal surface. In both groups, acupressure band was applied before the induction of anesthesia in the waiting area of the operating room and continued during the intraoperative period and six hours postoperatively.

Measurements: Postoperatively, patients were monitored for postoperative nausea and vomiting at the time of arrival in post anesthesia care unit [PACU], after half hour, three hour and six hours postoperatively using numerical pain scale [NPS] from 1-10 [1=none, 2-5=mild, 6-7=moderate, 8-10=severe] for PONV separately.

Main Results: The results of PONV in PACU, at 30 minutes, three hours and six hours postoperatively showed an insignificant difference in intervention and control group. The frequencies of mild to moderate PONV were gradually reduced in both groups but the reduction was more pronounced in the control group than in the intervention group. There were no reported events of severe PONV at three hours and six hours postoperatively in both groups. The use of rescue antiemetics was statistically insignificant between the two groups [P = 0.744].

Conclusions: Our study reports that acupressure at Neiguan P6 point starting before the induction of anesthesia till 6 hours postoperative has no significant role in preventing PONV in patients undergoing laparoscopic cholecystectomy. Rescue antiemetics were required in both groups with a similar frequency.

Key words: Acupoint P6; Acupressure; PONV; Laparoscopic cholecystectomy; Antiemetics; Randomized Clinical Trial

Ethical approval: AKU No. 5365-ane-ERC-18, dated July 17, 2018

Citation: Hamid S, Butt MN, Rehman A, Afshan G. Stimulation of acupoint P6 before induction of anesthesia to prevent postoperative nausea and vomiting; a randomized control trial. Anaesth. pain intensive care 2022;26(1):96-101.

DOI: 10.35975/apic.v26i1.1774

Received: August 6, 2021, Reviewed: October 22, 2012, Accepted: December 15, 2021
Difficult airway management in Apert syndrome for maxillofacial reconstruction: a case report
Authors: Purwoko Purwoko , Azhar Andre , Permana Septian Adi
Published: February 2022

Apert syndrome (AS) is an autosomal dominant disease associated with several craniofacial and limb deformities. Craniofacial deformities in AS patients requiring surgery are usually associated with difficult airway management. We report a case of a 21-year-old male patient, ASA III, with AS, who had a mandibular fracture and reconstruction was planned. The patient had all the features of AS. He had no comorbidities such as hypertension and diabetes mellitus. Awake intubation with fiberoptic bronchoscope was planned. In these patients with AS, intravenous access might also be difficult due to limb deformities. Some surgical procedures make intravenous access even more difficult. Rarely, if intravenous access is judged to be mandatory in an emergency, intraosseous or intramuscular access may be an alternative.

Abbreviations: AS - Apert syndrome; ED - emergency department; MSCT - Multislice Computerized Tomography

Key words: Apert syndrome; Acrocephalosyndactylia / diagnostic imaging; Acrocephalosyndactylia / pathology; Syndactyly / pathology; Maxillofacial reconstruction, Airway management

Citation: Purwoko P, Azhar A, Permana SA. Difficult airway management in Apert syndrome for maxillofacial reconstruction: a case report. Anaesth. pain intensive care 2021;26(1):119-122.

DOI: 10.35975/apic.v26i1.1781

Received: October 27, 2021, Reviewed: November 11, 2021, Accepted: November 14, 2021
Utilising Epidemiological Dynamics of SARS-CoV-2 Cases in Nigeria to Predict the Dissemination Pattern in Different States and Local Government Areas
Authors:   Medical Research Council Unit, the Gambia at the London School of Hygiene and Tropical Medicine, Oboh Mary A. , Agbanah-Owa Seun O. , Fagbohun Ifeoluwa K. , Ajibola Olumide
Published: February 2022

Background: More than a year following the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the effect on health, economics, travel, and social aspects of life remains evident. With the deployment of the coronavirus disease 2019 (Covid-19) vaccine to various countries, it is believed that the impact of Covid-19 on populations will be mitigated. However, due to vaccine short-age and uncertainty about the duration of protection, individuals must adhere to effective preventive measures that could reduce the spread of the virus. This is important as countries begin to open their borders. Using the susceptible, exposed, infected, and recovered model, we set out to estimate the incidence rate and spread of COVID-19 to the different Local Government Areas (LGAs). Methods: In this study, we collected SARS-CoV-2 incidence data generated by the Nigerian Centre for Disease Control (NCDC) from the onset of the pandemic until October 2020 to retrospectively predict the incidence at the beginning of the pandemic in Nigeria. Results: We observed discrepancies in incidence between our model and the NCDC COVID-19 cases at different time points resulting in a weak positive correlation. Unfortunately, it was observed from our model that SARS-CoV-2 will still be in circulation even in 2022. Conclusion: While the government of Nigeria must open up the borders, appropriate preventive measures and massive vaccine campaigns to increase vaccine coverage should be in place.
Larval Habitat Characterization and Molecular Identification of Anopheles gambiae Complex in three Local Government Areas (LGAs) of Ekiti State, Nigeria
Authors:   Department of Animal and Environmental Biology, Faculty of Science, Federal University Oye-Ekiti, Ekiti State, Nigeria, Nwana Aaron O. , Okoh Hilary I. , Oyeniyi Amos T. , Adeogun Adedapo O.
Published: February 2022

Background: Mosquito-borne diseases have remained a serious problem in many parts of the world despite several control efforts to manage the vector abundance. Mosquitoes transmit such diseases like malaria, dengue, lymphatic filariasis and yellow fever. Malaria parasites, transmitted through the bite of an infected female Anopheles mosquitoes still result in many morbidity and mortality in Nigeria. In this study, larval breeding site characterization and molecular identification of Anopheles mosquitoes were carried out in Ado, Oye and Ikole LGAs of Ekiti State, Nigeria . Methods: Mosquito larvae were collected from the study sites at different times during the mosquito breeding season from April to July 2019. Habitat characteristics were observed after which larvae collection was carried out. Identification of Anopheles adult mosquitoes was done using taxonomic keys and multiplex Polymerase Chain Reaction (PCR) and the results were analysed using the chi-squared test Results: A total of 2,011 Anopheles mosquitoes larvae were collected from the various habitats in the three LGAs. Larvae breeding sites characteristics and the respective abundance of larvae caught include: Sunlight 1,509(75.04), Shade 502(24.96); Presence of algae 1,152(57.28), Absence of algae 859(42.72); Presence of vegetation 1,426(70.91), Absence of vegetation 585(29.09); Turbid 617(30.68), Clear 1,394(69.32); Temporary 1,909(94.93), Permanent 102(5.07); Stagnant 2,011(100), Flowing 0(0.00); Natural 1,851(92.04), Manmade 160(7.96); Presence of settlement 1,978(98.36) and Absence of settlement 33(1.64). The difference between each compared group was significant (p<0.05). Significant difference (p<0.05) also exist for the Anopheles mosquitoes collected; An. gambiae s.l (91.5%), An. funestus (7.96%) and An. maculipalpis (0.6%). Molecular identification of An. gambiae s.l. showed that products were formed in 83.61%, 76.61% and 84.47% of the samples from Ado, Oye and Ikole LGAs respectively and only two members of the An gambiae complex were identified in the entire LGAs; An. gambiae s.s. (59.22%) and An. arabiensis (21.89%). Conclusion: This study identified the An. gambiae as the main Anopheles species in the study sites. This finding is similar to results from other parts of South-western Nigeria where An. gambiae was the predominant vector. There is therefore a need to intensify control efforts in the three LGAs .
Parasitic Contamination on Raw Vegetables Sold in Selected Open Markets in Ekiti, Southwest Nigeria
Authors:   Department of Animal and Environmental Biology, Federal University Oye-Ekiti, Ekiti State, Nigeria, Mogaji Hammed O. , Ishola Ashiat Y. , Adekunle Oladunni N. , Adekoya Modinat A. , Oluwafemi Funmilayo S. , Ajayi Oluwafemi A. , Odoh Ikenna M. , Ekpo Uwem F.
Published: February 2022

Background: Infections arising from the consumption of parasite-contaminated vegetables are a major concern in public health. This study assessed the parasitic contamination of vegetables sold across open markets in Ekiti, Nigeria Methods: A total of 88 samples of 6 different vegetables: African spinach (Amaranthus hybridus), pumpkin (Telfairia occidentalis), Jute leaf (Corchorus olitorus), Sierra Leone bologi leaf (Solanecio biafrae), Yoruba bologi leaf (Crassocephalum ruben), and Waterleaf (Talinum triangulare) were purchased from 42 vendors selected using a snow-ball sampling approach. About 200g of each sample was processed using sedimentation technique and observed for parasites eggs/ova under the microscope. Data obtained were analyzed using SPSS version 20. Results: A total of 9 parasites were recovered, with an overall prevalence of 53.4% (n=45). Nematodes were the most predominant (45, 51.1%). By species, the recovered eggs/larvae of hookworms were more (27, 30.7%), compared to Ascaris spp. (22, 25.0%) and Strongyloides spp (17, 19.3%) (p=0.00). Amaranthus hybridus was the most contaminated (15, 75%), followed by Crassocephalum ruben (10, 62.5%) (p=0.05). The majority of the contaminated vegetables were from Ifaki market (15, 75%). Conclusion: This study, therefore, highlights the need to intensify efforts at improving hygienic practices among farmers and consumers in these areas.
Emerging Characteristic Profile of Patients on Multi-Drug Resistant Tuberculosis Treatment in Oyo State Drug-Resistant Tuberculosis Treatment Centres
Authors:   Department of Community Medicine, Osun State University, Osogbo, Akinleye Callistus A. , Adekunle Adekola O. , Onabule Abiodun , Olowe Olugbenga A. , Daniel Olusoji J.
Published: February 2022

Background: The global pandemic of tuberculosis has left everlasting scars on people’s lives. Drug-resistant tuberculosis is becoming an increasingly serious hazard to public health. With over 240,000 fatalities due to drug-resistant tuberculosis (DR-TB) worldwide, and Nigeria is one of the 14 nations with a significant multi-drug resistant TB burden, increased focus on dis-ease control is needed. Methods: The study was a retrospective cohort study. A total of 149 patients diagnosed using the gene Xpert machine and referred to the DR-TB treatment centers in University College Hospital and Government Chest Hospital were recruited. Data were collected from the patients’ case files and analyzed using Statistical Package for Social Sciences (SPSS) version 25. Results: One hundred and forty-nine MDR-TB patients were enrolled in the study, of which 12.75% were new cases while 130 (87.2%) were on retreatment. The prevalence of MDR TB mortality was 4%. However, 30.9% had normal PCV at baseline while 68.5% of those enrolled had abnormal PCV. A total of 22(14.8 %) were reactive to the HIV test, while 125(83.9%) were not. At baseline, Body Mass Index (BMI) showed that 16.1% had a healthy weight, 18.1% were underweight, 2.7% were over-weight, and 59.7% were obese. At four months of treatment, BMI shows that 59.1% had healthy or normal weight, 12.8% were underweight, 6.0% were overweight, and 0.6% were obese. At four months, a significant association was observed between the baseline PCV, HIV status, hypertensive state, and the MDR-TB patient’s treatment outcome (p < 0.05). Conclusion: The category of MDR TB patients had a significant outcome in the patient’s survival. New patients on treatment had better survival outcomes than retreatment cases. The baseline PCV and HIV status had a significant impact on the treatment outcome of the MDR-TB patients at four months of treatment TB. Also, good care needs to be intensified in MDR-TB patients that have HIV so as to improve the treatment outcome of such patients.
Rood rood mannetje
Authors: Schipper Jeroen
Published: February 2022

Nieuwe, tijdloze liedjes voor de onderbouw, midden- en bovenbouw die ook zonder begeleiding (op kamp, onderweg, maar ook gewoon lekker thuis) goed gezongen kunnen worden. Het is een boek met muzieknotatie inclusief akkoordsymbolen, lessuggesties en illustraties met een los verkrijgbare CD met meezingversie. Door afwisseling in stijl, vorm, melodie en ritme zijn de liedjes een kleurrijke aanvulling op het bestaande basisschoolrepertoire en een ondersteuning en inspiratiebron voor het muziekonderwijs.
Effect of hot rolling parameters on recovery mechanism in 436 (17%Cr, Nb-Mo) ferritic stainless steel
Authors: Salojee M , Annan KA , Siyayisa CW , Moema J
Published: February 2022

Ferritic stainless steel (FSS) grades are widely used for applications that require high strength and corrosion resistance. Their cost and versatility in the steel market have attracted a lot of interest from both industry and academic research. Despite their desirable properties, these steels grades experience surface defects as a result of microstructural evolution that evolves due to softening mechanism. The current study simulated the roughing hot rolling processes of AISI 436 (17%Cr, Nb-Mo) FSS to study the effects of inter-pass time and strain on the precipitation behaviour and the softening mechanisms in 436 FSS. The softening mechanisms and the resulting microstructures were investigated using SEM-EBSD technique. The results revealed Particle Stimulated Nucleation of new grains during the simulated roughing rolling which promoted recrystallisation due to strain accumulation. Stored deformation energy was found to increase with an increase in interpass time and strain.