bluuebunny/crossref_metadata_2025 huggingface dataset:
PENGARUH PROMOSI MEDIA SOSIAL INSTAGRAM TERHADAP KEPUTUSAN PEMBELIAN KONSUMEN DI OUTLET MAKAN BEKACAK CABANG PANDAN ARUM KABUPATEN TABALONG
Authors: Fitry Sugiarti  , Saroyo
Published: October 2024

Persaingan di bidang Food And Beverage (F&B) yang semakin ketat membuat banyak pelaku usaha atau perusahaan mengalami penurunan jumlah pembelian konsumen. Akibat dari terjadinya penurunan jumlah pembelian ini menjadi masalah yang cukup serius bagi keberlangsunan hidup suatu usaha atau perusahaan. Tujuan penelitian ini untuk mengetahui Pengaruh Promosi Media Sosial Instagram Terhadap Keputusan Pembelian Konsumen Di Outlet Makan Bekacak Cabang Pandan Arum Kabupaten Tabalong.Penelitian ini menggunakan metode pendekatan kuantitatif dengan desain survei. Populasi dalam penelitian ini sebanyak 250 yang terdiri dari konsumen yang membeli produk di outlet Makan Bekacak cabang Pandan Arum. Jumlah sampel yang diambil sebanyak 71 responden dengan Teknik Accidental Sampling. Teknik pengumpulan data menggunakan kuesioner. Data primer diperoleh dari penyebaran kuesioner dilapangan. Teknik analisis data yang dilakukan adalah uji validitas, uji reliabilitas, uji normalitas, uji regresi linier sederhana, uji hipotesis (uji-t) dan uji koefisien determinasi untuk pengujian dari hasil kuesioner. Hasil penelitian menyimpulkan bahwa Ada Pengaruh Promosi Media Sosial Instagram Terhadap Keputusan Pembelian Konsumen Di Outlet Makan Bekacak Cabang Pandan Arum Kabupaten Tabalong, dan Besarnya Pengaruh Promosi Media Sosial Instagram 31,9% Terhadap Keputusan Pembelian Konsumen Di Outlet Makan Bekacak Cabang Pandan Arum Kabupaten Tabalong. Sedangkan sisanya sebesar 68,1% dipengaruhi oleh variabel lainnya yang tidak dimasukkan atau ditelitian dalam penelitian ini.
Kata Kunci : Promosi Media Sosial Instagram, Keputusan Pembelian, Makan Bekacak
IMPLEMENTASI APLIKASI ELEKTRONIK OFFICE (E-OFFICE) PADA SEKRETARIAT DPRD KABUPATEN TABALONG
Authors: Muhammad Fikri Hatamami  , Jamaludin
Published: October 2024

E-Office (Elektronik Office) atau elektronik perkantoran merupakan salah satu bagian dari Digitalisasi administrasi. Digitalisasi administrasi merupakan metode penulisan data administrasi yang dulunya masih menggunakan sistem manual seperti penggunaan tulis tangan (buku, dan pena), dan dengan perkembangan zaman menjadi berbentuk digital, menggunakan perangkat komputer yang serba canggih, semakin tinggi spesifikasi komputer yang digunakan maka akan semakin banyak pekerjaan yang akan di selesaikan. Tujuan penelitian ini adalah untuk mengetahui dan menganalisis Implementasi Aplikasi Elektronik (E-Office) Pada Sekretariat Kabupaten Tabalong. Penelitian ini menggunakan metode penelitian Deskriptif Kualitatif, Kemudian dengan metode pengumpulan data menggunakan observasi, wawancara, dan dokumentasi. Sumber data primer diperoleh dari observasi wawancara dengan informan berjumlah 5 (Lima) orang sedangkan data sekunder diperoleh dari dokumen dan laporan-laporan data terkait. Analisa data menggunakan model interaktif yang dikembangkan oleh Miles, dan Saldana (2014) yaitu Pengumpulan data, Penyajian data, Reduksi data, dan Penarikan kesimpulan. Hasil penelitian ini menunjukkan bahwa Implementasi Aplikasi Elektronik Office (E-Office) Pada Sekretariat DPRD Kabupaten Tabalong dikategorikan Sudah Terimplementasi.
Kata Kunci : Implementasi, Aplikasi, Elektronik Office (E-OFFICE)
PENGARUH PERSEPSI RISIKO TERHADAP KEPUTUSAN PEMBELIAN PADA E-COMMERCE SHOPEE OLEH MAHASISWA SEKOLAH TINGGI ILMU ADMINISTRASI TABALONG
Authors: Vera Wati  , Nadi Fikri Rijali
Published: October 2024

Keputusan pembelian adalah sebuah proses dimana konsumen mengenal masalahnya, mencari informasi mengenai produk atau merek tertentu dan mengevaluasi seberapa baik masing-masing alternatif tersebut dapat memecahkan masalahnya yang kemudian mengarah kepada keputusan pembelian. Perkembangan bisnis yang semakin maju selalu beriringan dengan perkembangan teknologi yang semakin pesat. Salah satu bisnis yang dipengaruhi perkembangan teknologi internet adalah e-commerce. Penelitian ini memiliki tujuan yaitu untuk mengetahui apakah ada Pengaruh Persepsi Risiko terhadap Keputusan Pembelian pada E-commerce Shopee oleh Mahasiswa Sekolah Tinggi Ilmu Administrasi Tabalong dan seberapa besar Pengaruh Persepsi Risiko terhadap Keputusan Pembelian pada E-commerce Shopee oleh Mahasiswa Sekolah Tinggi Ilmu Administrasi Tabalong. Metode Penelitian adalah deskriptif kuantitatif dan sumber data yang digunakan adalah primer dan sekunder. Data dikumpulkan melalui kuesioner yang disebarkan kepada 90 responden dengan teknik purposive sampling dan menggunakan analisis data menggunakan uji statistik. Hasil penelitian ini menunjukkan bahwa ada pengaruh persepsi risiko terhadap keputusan pembelian dan besarnya pengaruh adalah sebesar 9,1%. Terdapat juga perhitungan statistik yang diperoleh didalam model summary nilai Adjusted R-Square sebesar 0,091, artinya hubungan sangat rendah.
Kata kunci : Persepsi Risiko, Keputusan Pembelian, E-commerce
ANALISIS KOMPETENSI PROJECT SUPPORT PADA PROJECT SLURRY HANDLING PT ADARO WAMCO PRIMA DI SECTION MINE WATER MANAGEMENT HIGH WALL (TABALONG)
Authors: Sella Dara Piresa  , Taufik Rahman
Published: October 2024

Pada Section Mine Water Management High Wall (MWM HW) rata-rata Project Support memiliki latar pendidikan terakhir yaitu Sekolah Menengah Atas (SMA) dimana untuk pengetahuan mengenai pekerjaan pada Project Slurry Handling belum diketahui bahkan untuk memahami prosedur kerja ataupun langkah-langkah dari pekerjaan di Project Slurry Handling belum memiliki gambarannya karena belum pernah dilakukan sebelumnya, kemampuan atau keterampilan yang perlu Project Support berikanpun masih belum diketahui karena Project Support tidak memiliki pengalaman pada bidang Slurry Handling. Staff dan Non Staff Settling Pond Capacity Management Mine Water Management High Wall (SPCM HW) pun masih belum mengetahui bagaimana nilai, sikap dan minat Project Support yang akan bekerja pada Project Slurry Handling ini.Tujuan penelitian ini adalah untuk mengetahui Kompetensi Project Support pada Project Slurry Handling PT AWP di Section Mine Water Management High Wall. Penelitian ini menggunakan metode pendekatan kualitatif deskriptif. Penelitian dilaksanakan pada Field Office SP 21B LW Jl. Hauling Road KM 67. Sumber data yang digunakan diperoleh dari informan yang berjumlah 6 orang dan dari dokumen dan arsip. Teknik pengumpulan data dilakukan dengan Wawancara Mendalam dan Observasi. Analisis data kualitatif yaitu dengan reduksi data, penyajian data, dan penarikan kesimpulan. Hasil analisis data yang mengacu pada rumusan masalah dan tujuan penelitian serta dari tanggapan yang baik dari Project Support dan nilai rata-rata 1,96 atau predikat masuk kategori baik, maka dapat disimpulkan bahwa Project Support  berkompetensi pada bidangnya di Project Slurry Handling.
Kata Kunci : Kompetensi Project Support, Indikator Kompetensi, Slurry Handling
PENGARUH PENGEMBANGAN KARIR TERHADAP KUALITAS KERJA KARYAWAN HEALTH SAFETY ENVIRONMENT (HSE) COMPETENCY KABUPATEN TABALONG
Authors: Fitria  , Taufik Rahman
Published: October 2024

Pengembangan karir pada dasarnya berorientasi pada perkembangan organisasi/perusahaan dalam menjawab tantangan bisnis di masa mendatang. Setiap organisasi/perusahaan harus menerima kenyataan, bahwa eksistensinya di masa depan tergabtung pada SDM. Tujuan penelitian ini yaitu untuk mengetahui dan menganalisis pengaruh pengembangan karir terhadap kualitas kerja karyawan Health Safety Environment (HSE) Competency Kabupaten Tabalong dan untuk mengetahui dan menganalisis seberapa besar pengaruh pengembangan karir terhadap kualitas kerja karyawan Health Safety Environment (HSE) Competency Kabupaten Tabalong. Penelitian dilakukan dengan pendekatan kuantitatif. Adapun populasi dalam penelitian ini diambil dari jumlah karyawan yang sudah mengikuti kegiatan training pada Health Safety Environment (HSE) Competency Kabupaten Tabalong dengan jumlah 50 orang, dan sampel penelitian ini menggunakan teknik total sampling dimana jumlah populasi sama dengan jumlah sampel. Sumber data yang digunakan meliputi data primer dan sekunder. Teknik pengumpulan data menggunakan kuisioner dan teknik analis data meliputi uji validitas, reliabilitas, normalitas, regresi sederhana, uji t, dan koefisien determinasi (R2). Hasil penelitian menunjukan bahwa ada pengaruh pengembangan karir terhadap kualitas kerja karyawan Health Safety Environment (HSE) Competency Kabupaten Tabalong. Besarnya pengaruh pengembangan karir terhadap kualitas kerja karyawan Health Safety Environment (HSE) Competency Kabupaten Tabalong dengan persentase sebesar 69,50%, adapun 30,50% sisanya dipengaruhi oleh variabel lain diluar variabel yang diteliti
Kata Kunci : Pengaruh, Pengembangan Karir, Kualitas Kerja
EFEKTIVITAS PROGRAM BERAS SEJAHTERA DAERAH (RASDA) DI KELURAHAN HIKUN KECAMATAN TANJUNG KABUPATEN TABALONG
Authors: Yati Nor Anggaraini  , Lilis Suryani
Published: October 2024

ABSTRAK
Tingkat kemiskinan di Kabupaten Tabalong salah satu 13 Kabupaten di provinsi Kalimantan Selatan yang mengalami penurunan ditahun 2023, yang saat ini berada di angka 5,77%. Salah satu mengatasi kemiskinan di Kabupaten Tabalong melalui salah satu program kebijakan Pemerintah Peraturan Bupati Tabalong Nomor 07 Tahun 2017 tentang subsidi beras atau beras gratis untuk masyarakat berpendapatan rendah di Kabupaten Tabalong dapat bantuan sosial yaitu Program Beras Sejahtera Daerah (Rasda) sebelumnya dikenal sebagai Beras Miskin (Raskin). Tujuan  penelitian  ini adalah  untuk mengukur tingkat Efektivitas Program Bantuan Beras Sejahtera Daerah (Rasda) Di Kelurahan Hikun Kecamatan Tanjung Kabupaten Tabalong. Metode penelitian ini menggunakan pendekatan kuantitatif yang jenis penelitian ini bersifat deskriptif. Jumlah populasi 34 masyarakat keluarga penerima manfaat (KPM) di Kelurahan Hikun Kecamatan Tanjung Kabupaten Tabalong. Maka teknik sampel  yang digunakan dalam penelitian ini menggunakan teknik sampling jenuh yaitu teknik penarikan sampel digunakan apabila keseluruhan anggota populasi digunakan sebagai sampel dengan jumlah populasi 34 masyarakat keluarga penerima manfaat (KPM). Sumber data penelitian ini  menggunakan data primer yaitu kuesioner dan data sekunder yaitu memperoleh data penerima manfaat program rasda di Kelurahan Hikun. Teknik pengumpulan data menggunakan Kuesioner, observasi dan dokumentasi. Dan teknik analisis data penelitian ini menggunakan teknik analisis statistik deskriptif. Dari hasil pengukuran bahwa efektivitas program beras sejahtera daerah (rasda) di Kelurahan Hikun Kecamatan Tanjung Kabupaten Tabalong. menyatakan sangat efektif dengan persentase 80%.          
Kata Kunci : Efektivitas, Kemiskinan, Program Beras Sejahtera Daerah (Rasda).
PENGARUH CONTENT CREATOR TERHADAP KEPUTUSAN PEMBELIAN PRODUK AZARINE KOSMETIK DI INSTAGRAM
Authors: Istiqomah  , Saumira Mirnayanti
Published: October 2024

Di era sekarang ini, banyak pelaku usaha yang memanfaatkan kemajuan teknologi dalam memasarkan produk dan jasanya melalui internet, khususnya pada media sosial sebagai salah satu media pemasaran untuk mempromosikan produknya. Memanfaatkan media sosial dalam menjalankan kegiatan promosi mengalami peningkatan seiring dengan pertumbuhan jumlah pengguna internet setiap tahunnya. Melakukan promosi melalui content creator menjadi salah satu upaya untuk memperkenalkan produk ke khalayak luas sehingga dapat terjadinya keputusan pembelian suatu produk. Penelitian ini bertujuan untuk mengetahui dan menganalisis pengaruh content creator terhadap keputusan pembelian produk Azarine Kosmetik di instagram.. Metode penelitian yang digunakan adalah kuantitatif dengan desain survei. Data dikumpulkan melalui kuesioner yang disebarkan kepada 97 responden yang dipilih menggunakan teknik purposive sampling. Analisis data dilakukan menggunakan uji statistic. Hasil penelitian menunjukkan bahwa ada pengaruh content creator terhadap keputusan pembelian produk Azarine Kosmetik di Instagram. Besarnya pengaruh content creator terhadap keputusan pembelian pada produk Azarine Kosmetik di instagran adalah 30,2%, sedangkan sisanya yaitu 69,8% dipengaruhi oleh faktor lain.
Kata Kunci: Content Creator, Keputusan Pembelian, Azarine Kosmetik
Pediatric Pleomorphic Adenoma of Parotid Gland: A Case Report
Authors: Suryoprabowo Vincent , Lampus Harsali F. , Candy Candy , Saleh Denny
Published: October 2024

Abstract: Pleomorphic adenoma is a type of tumor that affects the parotid glands. It is also called a benign mixed tumor (BMT) because it has both epithelial and myoepithelial cells. This type of tumor is the most frequent parotid gland tumor, making up about 66% of all such tumors in parotid glands. We reported a case of 12-year-old male patient with a lump on his parotid gland, measured 7x3x3cm at Prof. Dr. R. D. Kandou Hospital Manado. CT Scan results of neck region of the patient revealed that there was a mass in the right side colli area and right frontal sinusitis A histopathological examination of the tumor tissue showed that it was encapsulated by connective tissue and composed of proliferating epithelial and myoepithelial tumor cells, some with clear nuclei, arranged in solid and microcystic patterns, and interspersed with fibromyxoid stroma. The patient was diagnosed as parotid gland adenoma, therefore, a parotidectomy was performed on him. He was discharged home and advised to return for a check-up one week later to remove the stitches. At the two-month follow-up visit, he was stable and did not require any additional therapy. In conclusion, a parotidectomy shows good result in the patient with parotid gland adenoma. However, due to the recurrence rate of parotid gland malignancies, several oncologists prefer to observe the patient periodically trough follow up at policlinic. Early detection and right management are required to achieve the best prognosis.
Keywords: pleomorphic adenoma; pediatric patient; parotid gland
Large tunneling photo-thermoelectric voltage using cyclotron resonance in bilayer graphene/MoS2/monolayer graphene van der Waals tunnel junction
Authors: Park Sabin , Moriya Rai , Watanabe Kenji , Taniguchi Takashi , Machida Tomoki
Published: October 2024

A tunnel junction using graphene in quantum Hall states (QHS) recently demonstrated the tunneling photo-thermoelectric effect (TPTE), generating a photovoltage under mid-infrared irradiation. Here, we investigate TPTE in a bilayer graphene (BLG)/6-layer MoS2/monolayer graphene (MLG) tunnel junction. The MoS2 layer facilitated the tuning of the resistance-area product RA of the tunnel junction with the gate voltage, which was challenging with the previously used h-BN barrier. The photovoltage responsivity R
v due to TPTE increased with increasing RA, and achieved a maximum responsivity R
v of 2.5 × 106 V W−1 at T = 2 K, which was substantially higher than earlier reports. In a device exhibiting high R
v and RA, TPTE voltage was generated when the MLG was in the QHS, in contrast to the low R
v and RA device, where TPTE voltage appeared at the boundary between the QHS and non-QHS. These findings provide insights into the TPTE effect for exploring the mid-infrared properties of 2D materials.
Chest tube management in COVID-19 thoracic trauma care unit
Authors: Dantis Klein , Rajput Vimesh , Reazaul Karim Habib Md
Published: October 2024

Key words: Chest tubes; Drainage; COVID-19; Pneumothorax; Thoracic injuries
Citation: Dantis K, Rajput V, Karim HMR. Chest tube management in COVID-19 thoracic trauma care unit. Anaesth. pain intensive care 2021;25(4):550–551.   DOI: 10.35975/apic.v25i4.1578
Chest X-ray examination
Authors: Hasan Shakir Hayat
Published: October 2024

Chest X-ray examination is one of the cheapest and common investigation to detect and diagnose certain conditions, by providing the physicians specific clues and findings. A clinical history of the patient is always important for a correct interpretation of a chest X-ray film. Reading can be challenging at times and it is recommended to follow the basic steps before jumping onto the conclusions in order to avoid missing some of the important findings. Please have a look at the chest X-ray of a young man, who was involved in a trauma and had been dependent on long term ventilation.
Massive pneumomediastinum and pneumoperitoneum during peroral endoscopic myotomy
Authors: Dhoon Taizoon Q , Ln Wei-Chen , Vaughn Douglas , Rajan Govind RC.
Published: October 2024

Peroral endoscopic myotomy (POEM) is a newly developed endoscopic intervention for esophageal achalasia. We present a case of a patient undergoing POEM, who suffered intra operative hemodynamic collapse due to massive pneumomediastinum as well as massive pneumoperitoneum requiring emergent needle decompression.
Key words: Peroral endoscopic myotomy; Endoscopic; Pneumomediastinum; Pneumoperitoneum; Needle decompression
Citation: Dhoon TQ, Wei-Chen L, Rajan GRC, Vaughn D. Massive pneumomediastinum and pneumoperitoneum during peroral endoscopic myotomy. Anaesth. pain intensive care 2021;25(4):523–526. DOI: 10.35975/apic.v25i4.1586
Relation of the successful block regional anesthesia with increased peripheral venous circumference and peripheral skin temperature at distal part of the block
Authors: Sumartono Christrijogo , Sulistiawan Soni Sunarso , Wirabuana Belindo , Putri Herdiani Sulistyo , Johansyah Arif , Hidayati Hanik Badriyah
Published: October 2024

Introduction: Evaluating the success rate of regional anesthesia is performed with pinprick test, Bromage score and pain scales, where they act as indicators of success or otherwise of motor, sensory and nociceptive blockade. The sympathetic system is also affected by the regional anesthesia blockade. The present study evaluated the relationship of peripheral venous dilatation and the skin temperature of the block area, to be used as an additional tool.
Methodology: An analytic, observational study was conducted in Dr. Soetomo Surabaya Hospital. 18 patients received peripheral nerve block (PNB) and 16 patients received subarachnoid block (SAB). Informed consent was obtained from all the participants. The peripheral venous circumference was measured by using linear probe of Sonosite® M–Turbo ultrasound, before the blocks and then one hour after PNB and SAB to assess the venous dilatation. The peripheral skin temperature was measured with a thermometer (Microlife NC-150 Bluetooth®) infrared thermometer before the blocks, and within the range of 5 min from the zero min after the block until the 30th min. The success rate of the blocks was performed with pain scale (VAS) and absence of motor, sensory and nociceptive response
Results: No relationship was found of sex, age, weight and type of block with increased peripheral venous circumference and peripheral skin temperature (p > 0.05). The block's success was associated with the increased peripheral venous circumference and peripheral skin temperature (p ≤ 0.001) in both PNB and SAB blocks. The average PNB block succeeded in 20 min while SAB took only 5 min (p < 0.05) to affect both of the parameters. The delta value of the increased temperature's successful block was 0.7oC in the PNB, and 0.275oC in the SAB group.
Conclusions: The success of the peripheral nerve block and the subarachnoid block is associated with an increase in the peripheral venous circumference and in the peripheral skin temperature in the block area.
Key words: Regional anesthesia; Peripheral nerve block; Subarachnoid block; Sympathetic block.
Abbreviations: RA – Regional anesthesia; PNB – Peripheral nerve block; SAB – Subarachnoid block
Citation:  Sumartono C, Sulistiawan SS, Wirabuana B, Putri HS, Johansyah A, Hidayati HB. Relation of the successful block regional anesthesia with increased peripheral venous circumferential length and peripheral skin temperature at distal part of the block. Anaesth. pain intensive care 2021;25(4):458-462. DOI: 10.35975/apic.v25i4.1383
Ethical Review Commission approval: No. 233/Panke.KKE/ III/ 2017.
Received: October 13, 2020, Reviewed: February 4, 2021, Accepted: April 1, 2021
Comparative study to evaluate equipotent doses of cisatracurium and atracurium in patients undergoing abdominal laparoscopic surgery
Authors: Upadhyay Manoj Kumar , Narang Deepak , Chaurasia Ajay , Kumar Geetesh
Published: October 2024

Background & objectives: Muscle relaxant make an important part of the balanced anesthesia, especially for abdominal surgery. Over a period of time, newer relaxants have been developed with lower side effects and better recovery profile. This study compared two relaxants – cisatracurium and atracurium, as a part of general anesthesia for the laparoscopic medical procedures.
Methodology: A total of 120 patients, 18-60 y of age, scheduled for the laparoscopic cholecystectomy were selected. Patients were randomly divided into two groups; Group C received cisatracurium 0.1 mg/kg as muscle relaxant and Group A received atracurium 0.3 mg/kg IV. The mean onset time and duration of action for the two groups was done by Stockholm rules of the pharmacodynamic investigations of muscle relaxants activity. Intubating conditions, hemodynamic changes, and safety profile were noted.
Results: The mean onset time was 4.04 ± 0.28 min vs. 5.12 ± 0.42 min for cisatracurium and atracurium respectively. The mean duration of action was 42.21 ± 1.71 min vs. 51.23 ± 6.1 min for cisatracurium and atracurium respectively (p < 0.001). Intubating conditions, hemodynamic changes, recovery time and safety profile were comparable between the groups. Recovery time following administration of cholinesterase inhibitors were 4.27 ± 0.23 vs. 3.24 ± 0.36 min (p < 0.001)in the cisatracurium and atracurium group respectively.
Conclusion: Cisatracurium has a quicker onset time and provides better conditions for tracheal intubation, compared to atracurium. Cisatracurium was demonstrated to have a better safety profile than atracurium.
Abbreviations: BMI – Body mass index; MAC – Minimum alveolar concentration; NMBD – Neuromuscular blocking drug; NMJ – Neuromuscular junction
Key words: Cisatracurium, atracurium, neuromuscular blockade, neuromuscular monitoring.
Citation: Narang D, Chaurasia A, Kumar G, Upadhyay MK. Comparative study to evaluate equipotent doses of cisatracurium and atracurium in patients undergoing abdominal laparoscopic surgery. Anaesth. pain intensive care 2021;25(5):667–671; DOI: 10.35975/apic.v25i5.1618
Received: March 20, 2021, Reviewed: April 11, 2021, Accepted: April 19, 2021
Feasibility of segmental thoracic epidural anesthesia in cancer patients undergoing feeding jejunostomy: A randomized controlled trial
Authors: Elsabeeny Walaa Y. , Elsamahy Khaled , Elazab Abdalla M. , Ibrahim Mostafa A.
Published: October 2024

Background: Malnourishment is very common in cancer patients secondary to the disease progression as well as the adverse effects of the treatment. Patients with gastroesophageal cancers and head and neck tumors are more prone to malnourishment. The enteral nutrition is the route of choice for nutritional support. Feeding jejunostomy is one of the routes used for long-term enteral nutrition. We compared the analgesia produced and the need of analgesics with the use of segmental thoracic epidural anesthesia (STEA) and general anesthesia (GA) for feeding jejunostomy.
Methodology: A total of 43 cancer patients scheduled for surgical feeding jejunostomy were enrolled and randomized into two groups; segmental thoracic epidural anesthesia group (Group STEA) (n = 21) and general anesthesia group (Group GA) (n = 22). The primary outcome was percentage of patients requiring rescue analgesia intraoperatively. Secondary outcome measures included hemodynamics, Visual Analogue Scale (VAS) scores, time to receive the first postoperative analgesic, total morphine consumption and any possible side effects or complications. Data were handled by SPSS v.25 (IBM©, Chicago, IL, USA). Data were expressed as mean ± standard deviation and analysed by unpaired student t-test, or median (range) and analysed using Mann Whitney-test. P < 0.05 was considered statistically significant.
Results: Significantly higher percentage of patients in the Group GA required intraoperative rescue fentanyl (59%) and postoperative morphine consumption (100%) compared to the Group STEA. Patients in GA group had higher heart rate (HR) and mean arterial blood pressure (MAP) values. Group SETA showed lower VAS scores in post anesthesia care unit (PACU) and throughout the first 24 hours postoperatively. The Group STEA had significantly higher patient satisfaction scores (PSS) and showed earlier ambulation.
Conclusions: Segmental thoracic epidural anesthesia has a better analgesic profile and can be used as a safe and effective alternative to general anesthesia in cancer patients undergoing surgical feeding jejunostomy.
Abbreviations: GA – General anesthesia; HR – Heart rate; IQR – Interquartile range; MAP – Mean arterial pressure; PACU – Post anesthesia care unit; PSS – Patient satisfaction score; STEA – Segmental thoracic epidural anesthesia; VAS – Visual Analogue Scale
 Key words: Anesthesia, Epidural; Anesthesia, General; Enteral Nutrition; Jejunostomy; Malnutrition.
Citation: Elsabeeny WY, Elsamahy K, Elazab AM, Ibrahim MA. Feasibility of segmental thoracic epidural anesthesia in cancer patients undergoing feeding jejunostomy: A randomized controlled trial. Anaesth. pain intensive care 2021;25(5):583–590; DOI: 10.35975/apic.v25i5.1623
Received: April 29, 2021; Reviewed: August 5, 2021; Accepted: August 5, 2021
The effect of adding magnesium sulfate to low dose rocuronium on neuromuscular blockade and anesthesia for direct laryngoscopy: A randomized controlled trial
Authors: Elsabeeny Walaa Y. , Wadod Mohamed A.
Published: October 2024

Background: Direct laryngoscopy is a day case procedure used for diagnosis and sometimes in treatment of laryngeal tumors. It is a short procedure that requires complete relaxation and rapid recovery. Rocuronium emerged as a good alternative to succinylcholine with better profile. Adding magnesium sulphate (MgSO4) to rocuronium can accelerate its onset of action with better relaxation. The aim of this study is to investigate the effect of MgSO4 when added to low dose of rocuronium on neuromuscular blockade and anesthetic profile.
Methodology: Sixty ASA I-II patients, scheduled for direct laryngoscopy were randomly allocated to group R: received rocuronium dose of 0.6 mg/kg and group RM: low dose rocuronium 0.4 mg/kg and MgSO4 50 mg/kg.
Results: RM group showed shorter onset, and less time to achieve deep level of neuromuscular blockade but prolonged duration when compared to R group (P value = 0.035, <0.001 and <0.001 respectively). Heart rate, mean arterial blood pressure and BIS values were lower in RM group compared to R group.
Conclusions: Adding MgSO4 to low dose rocuronium hastens its onset of action and shorten the time needed to achieve deep blockade but with prolonged duration. It had a favorable anesthetic profile when compared to conventional anesthesia.
Key words: Magnesium sulfate, rocuronium, neuromuscular blockade, anesthesia.
Trial registration: The trial was registered at ClinicalTrials.gov with registration number (NCT 04510337) https://clinicaltrials.gov/ct2/show/NCT04510337.
Citation: Wadod MA, Elsabeeny WY. The effect of adding magnesium sulfate to low dose rocuronium on neuromuscular blockade and anesthesia for direct laryngoscopy: A randomized controlled trial. Anaesth. pain intensive care 2021;25(5):607–612; DOI: 10.35975/apic.v25i5.1628
Received: June 28, 2021, Reviewed: August 19, 2021, Accepted: August 26, 2021
Correlation between central venous pressure and acute kidney injury in septic patients
Authors: Sucipto Ady , Permana Septian Adi
Published: October 2024

Background & objective: Sepsis is a medical emergency that requires quick and adequate treatment. In various epidemiological studies it is said that 11–60 % of sepsis patients may suffer from acute kidney injury (AKI). The incidence is 23% in the severe sepsis and 51–64 % in septic shock patients. A number of studies reported that a high value of central venous pressure (CVP) is associated with high incidence and morbidity of AKI in sepsis. We conducted this study to compare a cutoff point of 8 mmHg of CVP with the incidence of AKI in sepsis patients admitted in ICU.
Methodology: This study is an observational analytical cohort prospective study. The sampling was done by consecutive sampling technique. Patients were assigned into 2 groups with each group consisting of 41 samples. CVP measurement was done manually. AKI were assessed by measuring the serum creatinine twice and examining the patient's urine. To analyze the relationship between CVP and the frequency of AKI, chi-square test was performed.
Results: Of the 41 subjects with CVP ≥ 8 mmHg, 29 of them (60.4%) were diagnosed with AKI. Chi-square test revealed a significant correlation between target CVP and AKI incidence (p = 0.025). Also, age, sex, norepinephrine use and type of infection did not correlate with AKI incidence (p > 0.05). The only factor related to AKI significantly was CVP with RR 1.526 (95% CI: 1.04-2.24) and p-value of 0.025
Conclusion: In conclusion, a CVP target value of 8 mmHg or higher has a higher risk of AKI. The use of fluid therapy in managing sepsis requires strict fluid monitoring and evaluation.
Key words: Acute kidney injury; AKI, Central venous pressure; Fluid therapy; sepsis
Citation: Sucipto A, Permana SA. Correlation between central venous pressure and acute kidney injury in septic patients. Anaesth. pain intensive care 2021;25(5):638–642; DOI: 10.35975/apic.v25i5.1632
Received: March 05, 2021, Reviewed: June 14, 2021, Accepted: June 15, 2021
Massive pneumomediastinum and pneumoperitoneum during peroral endoscopic myotomy
Authors: Rajan Govind R. , Dhoon Taizoon Q. , Ln Wei-Chen , Vaughn Douglas
Published: October 2024

Peroral endoscopic myotomy (POEM) is a minimally invasive, and newly developed endoscopic intervention for esophageal achalasia. This technique has replaced open surgical techniques in centers, where expertise is available. It is comparatively a new procedure, so our knowledge about its short term and long term complications is yet very limited. We present a case of a patient undergoing POEM who suffered from hemodynamic collapse due to pneumomediastinum and massive pneumoperitoneum requiring emergent needle decompression.
Abbreviations: POEM – Peroral endoscopic myotomy; TV – Tidal volume; PEEP – Positive end-expiratory pressure; PIP – Peak inspiratory pressure; PACU – Post-operative care unit
Key words: Pneumomediastinum; Mediastinal emphysema; Subcutaneous emphysema; Hypercapnia; Pneumoperitoneum; Endoscopy; Esophagogastroduodenoscopy; Peroral endoscopic myotomy; POEM
Citation: Dhoon TQ, Ln WC, Rajan GR, Vaughn D. Massive pneumomediastinum and pneumoperitoneum during peroral endoscopic myotomy. Anaesth. pain intensive care 2021;25(5):_; DOI: 10.35975/apic.v25i5.1635
Received: Apr 09, 2021, Reviewed: Jun 26, 2021, Accepted: Jun 29, 2021
Airway management practices in Covid ICU during the first and second phase of Covid-19 pandemic: experience from a tertiary care hospital of Western Uttar Pradesh, India
Authors: Nazir Nazia , Saxena Anupriya
Published: October 2024

Key words: Airway management; Intubation; Laryngoscopes; aerosol box; COVID-19
Citation: Nazia N, Saxena A. Airway management practices in Covid ICU during the first and second phase of Covid-19 pandemic: experience from a tertiary care hospital of Western Uttar Pradesh, India (Correspondence). Anaesth. pain intensive care 2021;25(5):689–690  ; DOI: 10.35975/apic.v25i5.1640
Patient friendly operating room complexes: what can be done?
Authors: Ayesha Kiran
Published: October 2024

Primary objective of operating room complex (ORC) is to provide safe care, comfort and maximum benefit to the surgical patient. Stressful OR environment enhances the patient’s anxiety level. Preoperative patients need emotional support as they have fear of unknown. ORC needs to be designed to offer a pleasant and friendly environment. Patient’s safety should be given priority. Improving cost effectiveness along with providing best quality of care is a difficult task. Anesthesiologists and OR nurses play a major role in successful outcome and implementation of WHO surgical safety checklist. Stress will have more psychological impact on patients undergoing surgery under regional anesthesia. Pediatric patients will need distraction techniques in order to reduce preoperative anxiety and behavioral changes. Anesthesiologists and OR staff have a major responsibility to make the OR environment patient friendly by showing respect and empathy to every patient, maintenance of patient privacy, ambient OR temperature, strict aseptic measures, and avoiding unnecessary delays and postponement of cases.
Key words: Operating room; Operating room complex; Stress; Work environment; Anesthesiologist; OR nurse; WHO surgical safety checklist; Psychological; Pediatric patient; Distraction techniques; aseptic measures
Citation: Ayesha K. Patient friendly operating room complexes: What can be done? Anaesth. pain intensive care 2021;25(5):682–686. DOI: 10.35975/apic.v25i5.1641
Received: July 23, 2021. Reviewed: July 28, 2021, Accepted: August 31, 2021
Awareness during general anesthesia for cesarean section: A prospective observational cohort study
Authors: Srivastava Shubhra , Chandran Vineetha , Parikh Devangi Ashutosh
Published: October 2024

Objective: The incidence of intra-operative awareness with explicit recall in the western world has been reported to be between 0.1% and 0.2% in the general surgical population and up to 1-2% of patients at high risk for this complication. There is paucity of literature of awareness in the Indian population undergoing cesarean section (CS), therefore we wanted to study the incidence of awareness in this high-risk group in Indian population.
Methodology: We have prospectively evaluated the incidence and characteristics of awareness during general anesthesia (GA) in pregnant patients undergoing cesarean section in a tertiary care hospital. Structured interviews were conducted in the post–anesthesia care unit, at 4 hours post extubation, at 24 hours and on postoperative day 3. The perceived quality of the awareness episode, intraoperative dreaming, and sequelae were investigated. The anesthetic records were reviewed to search for data that might explain the awareness episode.
Results: The study included 350 patients. Calculated incidence of intraoperative awareness was 1.4% (5 out of 350 patients). Out of which 1.1% patients (i.e. 4 out of 350) were considered to have ‘definite awareness' and 0.3% patient (one patient) was categorized as ‘possible awareness'.
Conclusions: Incidence of awareness during general anesthesia was found 1.4%. In spite of not using benzodiazepine, opioids and volatile anesthetics before baby delivery in sizeable number of patients, it is a reassuring to know that incidence of awareness is lesser than assumed (3%).
Key words: Cesarean section; Consciousness; Anesthesia, General; Intraoperative awareness; Obstetric Anesthesia; Post traumatic stress disorder
Citation: Srivastava S, Chandran V, Parikh DA. Awareness during general anesthesia for cesarean section: A prospective observational cohort study. Anaesth. pain intensive care 2021;25(5):660–666; DOI: 10.35975/apic.v25i5.1643
Received: June 23, 2021, Reviewed: August 14, 2021, Accepted: August 20, 2021
The challenge of COVID–19 pandemic: a standpoint from a lower middle-income country
Authors: Ali Muhammad Asghar , Siddiqui Khalid Maudood , Salim Bushra , Sohaib Muhammad , Khan Muhammad Faisal
Published: October 2024

The current COVID–19 pandemic has posed a significant challenge not only to the developing countries but also to the rich and developed world. With a lack of well-developed healthcare system in the developing countries, the spread of COVID–19 can lead to catastrophic consequences. Patients suffering from this viral disease usually require well–equipped intensive care units. However, in most of the underdeveloped countries, there exists a substantial gap between demand and availability of specialized beds and facilities in the intensive care units, including monitors, ventilators, trained staff, and personal protective equipment. Coordinated efforts are required to overcome these problems. Here we mention few strategies in resource limiting critical care settings base upon our experience.
Key words: COVID–19 pandemic; COVID–19; Telemedicine; ICU; Lower middle-income countries (LMIC);
Citation: Siddiqui KM, Ali MA, Salim B, Sohaib M, Khan MF. The challenge of COVID–19 pandemic: a standpoint from a lower middle-income country. Anaesth. pain intensive care 2021;25(6):698-702;
DOI: 10.35975/apic.v25i6.1695
Received: September 02, 2021, Reviewed: October 09, 2021, Accepted: October 10, 2021
Knowledge and practices of local anesthetic systemic toxicity among doctors in Sri Lanka
Authors: Munasinghe B. M.
Published: October 2024

This paper has been retracted due to duplicate publication by an editorial mistake. The paper was earlier published in the February 2021 issue of the journal with the same title.
Comparing the effect of dexmedetomidine and metoprolol in reducing blood loss during craniotomies due to severe cerebral blunt trauma
Authors: Kamali Alireza , Rahimifar Rezvan , Zargar Shima , Rafie Ali Nazemi
Published: October 2024

Introduction: To control and reduce blood loss during craniotomy is one of the most important and significant goals of anesthesiologists and neurosurgeons. Numerous drugs including beta-blockers, calcium channel blockers, alpha-agonists, and narcotics have been used to achieve this goal. We compared the effects of dexmedetomidine and metoprolol in reducing blood loss during craniotomy due to severe cerebral blunt trauma.
Methodology: It was a randomized, double-blind clinical trial. Forty-four craniotomy candidates with severe head injuries were randomly divided into dexmedetomidine and metoprolol groups. For all groups, a questionnaire was completed so that data on MAP, pulse rate, mean blood loss score, mean number of packed cell units received, events of hypotension and bradycardia and the survival of the patients was recorded. Using SPSS-21 statistical software, the data obtained from the questionnaires were statistically inferred by the T-test and ANOVA test, and the results are expressed in tables and figures.
Results: There was no significant difference in age and sex frequency in this study (p = 0.6). There was a significant difference between the two groups in terms of blood loss after the start of surgery, so that the average blood loss in patients at 15, 30, 45, 60, 90, 120 min after the start of the surgery in the dexmedetomidine group was less than in the metoprolol group (p < 0.05).
Conclusion: Dexmedetomidine and metoprolol could reduce blood loss during surgery and provide controlled hypotension during craniotomies due to severe cerebral blunt trauma. The effect is more pronounced with the use of dexmedetomidine compared to metoprolol.
Key words: Dexmedetomidine; Metoprolol; Craniotomy; Head trauma; Hypotension
Citation: Kamali A, Rahimifar R, Zargar S, Rafie AN. Comparing the effect of dexmedetomidine and metoprolol in reducing blood loss during craniotomies due to severe cerebral blunt trauma. Anaesth. pain intensive care 2021;25(6):752–756 ;
DOI: 10.35975/apic.v25i6.1698
Received: November 26, 2020, Reviewed November 03, 2021, Accepted: November 03, 2021
Demographics and antimicrobial susceptibility patterns of lower respiratory tract infections in intensive care unit of a teaching hospital in South India
Authors: Cherukuri Bharath
Published: October 2024

Aim: We aimed to study the distribution and antimicrobial susceptibility patterns of lower respiratory tract infections over a six–month period in the medical and surgical intensive care units at NRI Academy of Medical Sciences, in the Southern Region of India.
Methodology: This was a retrospective study conducted from June 2019 to December 2019. The study included all patients of either gender, aged above 18 y, admitted in the medical and surgical intensive care units for whom specimens for culture were positive for lower respiratory tract infections. The data was compared for the location, type, number of isolates and their antibiotic susceptibility. The data was analyzed using the
Medcalc™ software.
Results: A total of 114 patients were included in the study, out of which 78 (68.4%) were males. The maximum patients were above 60 y (29.8%). Gram–negative pathogens accounted for majority of the isolates (89%). The bacteria were isolated predominantly from the tracheal aspirate (86.8%). Out of all the isolated organisms, Acinetobacter baumannii (n  =  34; 29.8%), pseudomonas aeruginosa (n = 29; 25.4%) and Klebsiella (n = 27; 23.7%) were the most common gram–negative isolates, whereas in the gram–positive isolates, Staphylococcus  aureus and Enterococcus were equally isolated (n = 4; 3.5%). A. baumannii was most susceptible to colistin (97.1%) followed by minocycline (70.6%) and amikacin (64.7%). Whereas, with P. aeruginosa, it was observed that only around half of the isolates were susceptible to doripenem (51.7%) and it was also observed that most of the isolates were resistant to all the commonly used antibiotics.
Conclusion: This current study provides useful information regarding the causative organisms of lower respiratory tract infections occurring in the intensive care units and their antibiotic susceptibility patterns. Gram–negative pathogens were predominantly responsible for lower respiratory tract infections. Moreover, antimicrobial resistance rate was high with the most commonly used antibiotics and also to higher antibiotics such as carbapenems.
Key words: Antimicrobial susceptibility; Intensive Care Unit; Lower Respiratory Tract Infection; Antibiotic; Resistance
Citation: Cherukuri B. Demographics and antimicrobial susceptibility patterns of lower respiratory tract infections in intensive care unit of a teaching hospital in South India. Anaesth. pain intensive care 2021;25(6):757-762;
DOI: 10.35975/apic.v25i6.1699
Received: March 29, 2021, Reviewed: July 26, 2021, Accepted: October 18, 2021
The match of CO–RADS score and vaccination status of COVID–19 patients applying to the emergency room
Authors: Guner Necip Gokhan , Durmus Ensar , Guneysu Fatih , Aslan Nuray , Yurumez Yusuf
Published: October 2024

Objective: This study examined COVID–19 Reporting and Data System (CO–RADS) scores, reverse transcription polymerase chain reaction (RT–PCR)  positivity, and COVID–19 vaccination status of COVID–19 patients who reported to the emergency room (ER). Thus, it aimed to present how much effective the vaccines were.
Methodology: It was a cross–sectional, retrospective, descriptive research, covering the period between June 08, 2021 to August 08, 2021. The study was conducted at Sakarya University Teaching & Research Hospital,  Sakarya. Institutional ethical review committee certificate was not required as it was a retrospective study.
Results: One hundred four cases were included in the study, of which 61 (58.7%) were male, and 43 (41.3%) were female. Of the patients, 35 (33.6%) had no COVID–19 vaccination, 46 (44.2%) had two–doses CoronaVac, one (1%) had two–doses BNT162b2. Out of 104 patients, 12 had a CO–RADS–3 score, 17 had a CO–RADS–4 score, and 60 patients had a CO–RADS–5 score. No significant difference was recognized between unvaccinated cases and vaccinated patients with two CoronaVac doses in terms of hospitalization, RT–PCR positivity and mortality (respectively: x2 = 0.176, SD = 1, p = 0.675; x2 = 0.025, SD = 1 , p = 0.874; x2 = 0.830, SD = 1, p = 0.362). Two doses CoronaVac vaccinated patients' length of stay in the hospital was determined to be more succinct than cases who had never been inoculated (U = 596.500, p = 0.045, z = 2.003, r = –0.22).
Conclusion: Prolonged time after CoronaVac vaccination may reduce the vaccine's protection against COVID–19 pneumonia. The protection of two doses of BNT162b2 against COVID–19 pneumonia presents promise in the fight against the pandemic. Those inoculated with at least two doses of CoronaVac or BNT162b2 had a shorter hospital stay than those not vaccinated. RT–PCR positivity may continue to be observed in vaccinated patients.
Key words: Emergency room; COVID–19; CO–RADS; Vaccination; Mortality
Abbreviations: LoS - Length of stay; CT- Computed tomography; ER - Emergency room; CO–RADS - COVID–19 Reporting and Data System; RT–PCR - Reverse transcription–polymerase chain reaction;
Citation: Guner NG, Durmus R, Guneysu F, Aslan N, Yurumez Y. The match of CO–RADS score and vaccination status of COVID–19 patients applying to the emergency room. Anaesth. pain intensive care 2021;25(6):771–776;
DOI: 10.35975/apic.v25i6.1701
Received: September 15, 2021, Reviewed: September 29, 2021, Accepted: October 18, 2021
Uncontrolled diabetic ketoacidosis can lead to brain stem infarct and death; a case report
Authors: Mohd Zukhi Nur Jihan , Mazlan Mohd Zulfakar , Suhaimi Fatanah Mohamad
Published: October 2024

Diabetic ketoacidosis (DKA) is a triad of hyperglycemia, metabolic acidosis and ketosis. It is a life-threatening complication of diabetes mellitus (DM) that can lead to death without appropriate treatment. DKA with stroke increases morbidity and mortality in the intensive care unit (ICU). A 37-year-old male was brought to the emergency department with sudden onset of weakness for the past two days. He had been diagnosed with type 2 DM five years earlier, but it was poorly controlled. On examination, his Glasgow Coma Scale was within normal limits. Laboratory and radiological investigations revealed severe hyperglycemia, metabolic acidosis, and brain stem infarct. He required intubation and was admitted to the ICU with a diagnosis of DKA and cerebellar and brain stem infarct. The patient succumbed to death despite 13 days of ICU management. DKA can precipitate a cerebellar and brain stem infarct, but it can be fatal despite extreme management in the ICU.
Abbreviations: DKA - Diabetic ketoacidosis; DM - Diabetes mellitus; ICU - Intensive care unit; CED - Cerebral edema; ED - Emergency department
Key words: Diabetic ketoacidosis; Stroke; Brain stem infarct; Cerebral edema; Mortality
Citation: Zukhi NJM, Mazlan MZ, Suhaimi FM. Uncontrolled diabetic ketoacidosis can lead to brain stem infarct and death; a case report. Anaesth. pain intensive care 2022;26(2):253-256; DOI: 10.35975/apic.v26i2.1808
Received: December 24, 2021; Reviewed: February 07, 2022; Accepted: February 07, 2022
Exploring barriers to the effective painless labor: a qualitative study
Authors: Rafiq Muhammad , Sajjad Faryal , Iqbal Muhammad Nasar , Haider Naqvi Syed Zeeshan , Razzaq Komal
Published: October 2024

Background: Studies have indicated that health professionals have already highlighted different factors responsible for painless labor. With the development of novel challenges from time to time, certain barriers may develop that need to be explored for effective painless labor. Such barriers even vary among different cultures and regions.
Purpose: This study was aimed to explore barriers to effective painless labor in context to Pakistani culture and socio-economic status.
Methodology: A qualitative research approach and exploratory-descriptive research design was used to explore the barriers to effective painless labor. The sample consisted of ten gynecologists with a minimum of five years of experience. Semi-structured interviews were conducted with the gynecologists from govt. and private hospitals in Punjab, Pakistan. The verbatims of the doctors were noted and transferred into nodes to create themes and categories through NVivo 11 plus software.
Results: The results indicated four master themes that emerged regarding barriers to effective painless labor i.e. Diseases, Improper Food and Nutrition, Professional Incompetency and Psychological Issues.
Conclusion: Exploratory-descriptive approach in exploring the barriers to effective painless labor indicated that the indigenous barriers are different and many in numbers as compared to the developed countries. This needs attention from the health care professionals and authorities to understand the dynamics which intensify the unnecessary labor.
Key words: Painless labor; Barriers; Qualitative research; NVivo; Pakistan
Citation: Rafiq M, Sajjad F, Iqbal MN, Naqvi SZH, Razzaq K. Exploring barriers to effective painless labor: a qualitative study. Anaesth. pain intensive care 2022;26(2):; DOI: 10.35975/apic.v26i2.1810
Received: November 29, 2020, Reviewed: December 13, 2021, Accepted: February 02, 2022