bluuebunny/crossref_metadata_2025 huggingface dataset:
Choosing Objective and Non-objective Test as Instrument for Assessment of EFL Student Learning Outcomes
Authors: Fitria Tira Nur
Published: March 2024

This research describes the type of questions both objective and non-objective tests, benefits, and weaknesses of EFL students’ learning outcomes. This research is a descriptive qualitative. The analysis shows that the written test can be used as a measuring instrument for knowing students’ abilities. The form of the written test consists of objective and non-objective. An objective test consists of multiple potential answers or responses for students to choose one including completion, multiple-choice, matching, short answer, and true-false test. Non-objective tests consist of essays/descriptions for students to compose or organize answers in their language including an essay in limited/restricted essay and free essay tests. Teachers/lecturers should consider aspects of making the tests. They have differences in measured learning outcomes, preparation of question items, sampling of learning materials, control of student answers, scoring, influence on the learning process, and reliability. However, both objective and non-objective tests also have several advantages and disadvantages.
A COMPARATIVE STUDY ON TASK FEATURES IN LEARNING MANAGEMENT SYSTEM (LMS)
Authors: Mufliharsi Risa
Published: March 2024

his paper aims to analyze features in selected distance learning management systems in improving students' experiential learning through Flipped Classrooms and Task-Based Language Teaching for higher educational institutions. Learning through Flipped Classroom has enriched broad teaching-learning activities to strengthen students' concepts in independent learning. Positively, it is also developing students' electronic literacy through technology. The use of learning management systems not only improves students' activity but also helps construct students' learning experiences for understanding the nature of comprehension through various tasks. However, many lecturers are doubtful about selecting the Learning Management System appropriate to learning tools to facilitate students' work in doing tasks. Therefore, the paper compares four Learning Management Systems, namely Moodle, Chamilo, Efront, and Dokeos, based on features under various criteria and parameters to choose the right one. The result showed that Moodle fulfilled most criteria needed for a Task-Based Flipped Classroom in a Higher Educational Institution.Keywords: flipped classroom; learning management system; task-based language teaching; task featuresMakalah ini bertujuan untuk menganalisis fitur dalam beberapa sistem manajemen pembelajaran jarak jauh untuk digunakan dalam meningkatkan pengalaman belajar siswa melalui flipped classroom dan Task-based language teaching untuk institusi pendidikan tinggi. Pembelajaran melalui Flipped Classroom telah memperkaya kegiatan belajar mengajar yang luas untuk memperkuat konsep siswa dalam belajar mandiri. Penggunaan sistem manajemen pembelajaran jarak jauh tidak hanya meningkatkan aktivitas siswa tetapi juga membantu membangun pengalaman belajar siswa untuk memahami hakikat pemahaman melalui berbagai tugas. Positifnya, Penggunaan sistem manajemen pembelajaran jarak jauh juga mengembangkan literasi elektronik siswa melalui teknologi.  Namun, banyak dosen yang ragu dalam memilih Learning Management System yang tepat sebagai perangkat pembelajaran untuk memudahkan pekerjaan mahasiswa dalam mengerjakan tugas. Oleh karena itu, makalah ini membandingkan empat Sistem Manajemen Pembelajaran, yaitu Moodle, Chamilo, Efront, dan Dokeos, berdasarkan fitur dengan berbagai kriteria dan parameter untuk memilih yang tepat. Hasilnya menunjukkan bahwa Moodle memenuhi sebagian besar kriteria yang dibutuhkan untuk Kelas Terbalik Berbasis Tugas di Perguruan Tinggi. Kata Kunci: flipped classroom; system manajemen pembelajaran; pembelajaran bahasa berbasis tugas; fitur tugas
The Effectiveness of Picture Word Inductive Model on Writing Ability in Narrative Text at Tenth Graders of MAN 1 Wonosobo
Authors: Ungu Niken Kencono , Qathrunnada Zanuba
Published: March 2024

This research is motivated by the low ability of class X L students of MAN 1 Wonosobo in writing English texts, especially in writing Narrative Texts. The study aims to investigate how the Picture Word Inductive Model (PWIM) affects students' ability to write narrative texts. This study uses Classroom Action Research (CAR) as the research design. This  research was conducted by the students in class X L MAN 1 Wonosobo in the Odd Semester of the 2022/2023 Academic Year. The location of this research is MAN 1 Wonosobo. The subjects of this study are 36 students of class X L MAN 1 Wonosobo. The results show that there is an effect of the Picture Word Inductive Model (PWIM) method on student learning outcomes in writing English narrative texts in class X L MAN 1 Wonosobo. Therefore, it is suggested that English teachers apply the Picture Word Inductive Model (PWIM) in teaching writing skills
Willingness to Communicate (WTC) in English: Insights from Pre-service EFL Teachers
Authors: Mudra Heri
Published: March 2024

Oral language skill among EFL students can be indicated from willingness to communicate in English. This current study aimed to investigate pre-service EFL teachers’ (PST) willingness to communicate (WTC) in English across rural setting. A survey study with 217 EFL students as the participants selected through a convenience sampling was employed. A questionnaire of the willingness was distributed through in-class meeting and online mode. The first result revealed that there is a variety of perceptions on oral skill willingness, self-confidence, and English use frequency. The second result showed that from junior and senior PST, it is noted that seniors mostly overdid juniors in terms of willingness to speak English. Meanwhile, female PST had greater levels of WTC if compared to that of the males. In conclusion, WTC not only emerge to be a valuable aspect in learning oral language skills, but also impact on other English skills indirectly.
Improving Students’ English Public Speaking Skill toward Campus Visit Program
Authors: Gunawan Yudhie Indra , Haikal Muhammad Daffa , Riansyah Rafli Riansyah , Rizky Daffa Andhika , Afrizal Muhammad Nabhan
Published: March 2024

The purpose of this study is to open the author's knowledge window directly, namely by conducting workshops so that UMT and UAD students can explore their public speaking in accordance with language cultures abroad and locally. not only that the workshop has a good impact, namely improving the quality and providing experience to students so that they can evaluate their English skills to speak in public, It is also useful in the context of globalization which will provide cross-cultural knowledge that is very important and valuable. In this paper, the author shares information about the Muhammadiyah museum and several tourist attractions and its history as learning material for a broader insight into an area.
Current Role and Future Perspectives of Cardiac Rehabilitation in Heart Disease
Authors: Yang Lamei , Bai Yi , Li Li , Zheng Sisi , Yan Xiaoli , Yu Li , Luo Shilan
Published: March 2024

As a comprehensive secondary prevention program, cardiac rehabilitation (CR) is a beneficial and cost-effective intervention for patients with heart disease, but the participation rate of patients in CR is low globally. In recent years, due to the COVID-19 pandemic and scientific and technological advances, an increasing number of alternative CR modes have been developed, such as remote CR, home-based CR, hybrid CR and virtual CR. These alternative CR modes represent changes and new opportunities for patients with heart disease. In this review, we will discuss in detail the impact of CR on patients with different types of heart disease, review the various alternative CR models, and explore some prospects for the future of CR in the field of heart disease.
Progress in the Application of the Residual SYNTAX Score and Its Derived Scores
Authors: Lin Xinjun , Mei Zhibin , Ji Wei , Wang Yaoguo , Xu Chaoxiang
Published: March 2024

The residual SYNTAX score (rSS) is employed for the quantification of residual coronary lesions and to guide revascularization. rSS can be combined with other examinations to evaluate the severity of vascular disease and play an evaluative and guiding role in various scenarios. Furthermore, combining rSS with other indicators, benefits prognosis evaluation, and rSS-derived scores have been increasingly used in clinical practice. This article reviews the progress in the clinical application of rSS and its derived scores for complex coronary arteries and other aspects, based on relevant literature.
Risk and Protective Factors of Recurrence after Catheter Ablation for Atrial Fibrillation
Authors: Guo Xinwei , Li Jingbo
Published: March 2024

Atrial fibrillation (AF) is a common disease and is effectively managed through catheter ablation (CA). However, post-ablation AF recurrence can compromise patient outcomes, making the identification of associated risk factors crucially important. Factors influencing poor clinical outcomes include age, female sex, body mass index (BMI), non-paroxysmal AF, and comorbidities including diabetes mellitus (DM) and obstructive sleep apnea (OSA). Furthermore, the selected ablation strategy and employed technology are pivotal to long-term success in maintaining sinus rhythm control. The mechanisms of AF recurrence are complex and multifactorial; no single predictor is definitive. Thus, a personalized assessment of each patient should be tailored to the individual situation. A high risk of relapse does not preclude the option of ablation therapy, but rather underscores the necessity to address and manage underlying conditions contributing to AF pathogenesis, aiming to mitigate the risk of recurrence.
The Effect Of Country Of Origin, Perceived Quality, And Brand Image On Purchase Intention (Case Study On Consumers Of Samsung Smartphone Users In Bandung City)
Authors: Muhaqi Jodi , Nurbasari Anny
Published: March 2024

Indonesia is one of the countries withhuge numbers of Internet users. Indonesia's population of 250 million is a big market. Indonesian smartphone users are alsoproliferating. One of the smartphone market leaders is Samsung. This study aimed to determine the effect of country of origin, perceived quality, and brand image on purchase intention. The research design used in this research is causal explanatory. The samplehas beenusing a Samsung Smartphone for more than 1 year and is a student. the number of respondents used is 130 respondents. Based on the results of the study, there is an influence of Country of origin on Purchase Intention of Samsung Smartphone users. There is an influence of Perceived quality on the Purchase Intention of Samsung Smartphone users. There is an influence of Brand image onthePurchase Intention of Samsung Smartphone users. For this reason, researchers suggest Samsung smartphones, to be able to improve Country of origin, Perceived quality, and Brand image as variables that can encourage consumer Purchase Intentions.
Analisis Tingkat Literasi Keuangan UMKM di Kawasan Lapangan Saparua, Kota Bandung
Authors: Komara Wildan Gilang , Da'i Dr. Ratna Meisa , Suryanto Dr.
Published: March 2024

Saat ini, UMKM menjadi salah satu sektor yang berperan besar bagi perekonomian Indonesia. Namun, dalam mendirikan UMKM, diperlukan ilmu literasi keuangan yang baik, sebab ilmu tersebut dapat memberikan pemahaman mengenai konsep dasar produk keuangan, perencanaan dan pengelolaan keuangan yang baik, serta sebagai perlindungan dari kejahatan finansial berupa penipuan atau investasi bodong. Penelitian ini bertujuan untuk mengetahui seperti apa pemahaman serta tingkatan literasi keuangan yang dimiliki oleh pelaku UMKM di kawasan Lapangan Saparua, Kota Bandung. Penelitian merupakan penelitian deskriptif dengan metode penelitian kuantitatif. Metode analisis data menggunakan analisis deskriptif dan analisis regresi linear berganda. Berdasarkan hasil penelitian yang dilakukan, ditemukan bahwa tingkat literasi keuangan UMKM Lapangan Saparua berada di tingkat cukup tinggi dan sangat tinggi. Ditemukan pula bahwa usia memiliki pengaruh signifikan terhadap tingkat literasi keuangan. Kesimpulan yang didapat adalah UMKM di Lapangan Saparua telah terliterasi dengan baik dalam hal literasi keuangan.
Pengaruh Perilaku Konsumen Sadar Lingkungan Dan Niat Pembelian Produk Ramah Lingkungan Terhadap Perilaku Pembelian Produk Ramah Lingkungan (Studi Kasus Pada Konsumen Zero Waste Indonesia)
Authors: Maulana Farhan , Hermanto Bambang , Rivani Rivani
Published: March 2024

Maksud dari penelitian ini adalah untuk menunjukankorelasi antara perilaku konsumen sadar lingkungan, niat pembelian produk ramah lingkungan dan perilaku pembelian produk ramah lingkungan dalam komunitas Zero Waste Indonesia. Data dikumpulkan dari 175 konsumen di Zero Waste Indonesia. Cara yang digunakandalam penelitian ini adalah dengan cara metode riset kuantitatif. Cara mengumpulkan data utama dilakukan dengan menyebar kuesioner. Pengumpulan data sekunder dengan mengumpulkan data dari jurnal dan sumber berita nasional. Hasil dari penelitian ini menunjukkan bahwa niat pembelian produk ramah lingkungan dipengaruhi oleh perilaku konsumen sadar lingkungan, perilaku pembelian produk ramah lingkungan dipengaruhi oleh niat pembelian produk ramah lingkungan, dan perilaku pembelian produk ramah lingkungan tidakdipengaruhi oleh perilaku konsumen sadar lingkungan.
Pengembangan Konten Media Sosial Di Balai Besar Pengembangan Penjaminan Mutu Pendidikan Vokasi Bidang Mesin Dan Teknik Industri
Authors: Firmansyah Yayan , Rahiela Raihana
Published: March 2024

Balai Besar Pengembangan Penjaminan Mutu Pendidikan Vokasi Bidang Mesin dan Teknik Industri (BBPPMPV BMTI) sebagai organisasi dan Unit Pelaksana Teknis (UPT) Kementerian Pendidikan dan Kebudayaan adalah lembaga yang bertugas melaksanakan program pendidikan dan pelatihan di bidang mesin dan teknik industri. Berdasarkan identifikasi masalah diperoleh informasi bahwa media sosial BBPPMPV BMTI perlu dioptimalkan. Hal ini ditandai dengan rendahnya nilai engagement rate. Sebagai upaya meningkatkan nilai engagement rate maka dilakukan pengembangan konten media sosial milik lembaga yaitu Facebook (Bbppmpv BMTI Kemdikbud), Instagram (@bmti.kemdikbud), dan Twitter (@bmti_kemdikbud). Tujuan dari proyek ini adalah untuk melakukan perencanaan, pelaksanaan, hingga evaluasi pada media sosial.. Metode pengumpulan data yang digunakan dalam proyek ini adalah metode wawancara terhadap informan kunci dan analisis analisis STP (Segmenting, Targeting, Postioning). Hasil dari proyek ini adalah 8 (delapan) konten media sosial dan desain template Instagram bulan Juni 2023 hingga bulan Desember 2023 yang disertai dengan e-manual book. Uji keberhasilan proyek melalui analisis engagement rate menunjukkan bahwa setelah dilaksanakan pengembangan konten, interaksi audiens dengan media sosial BPPMPV BMTI berada pada kategori di atas rata-rata atau tinggi dengan nilai engagement rate untuk Facebook adalah 6,72%, Instagram 4,42%, dan Twitter 20,5%.
Analysis Of Tandamata Saving Event Marketing in Increasing The Number Of Customers At Bank Bjb Bandung Head Office
Authors: Putri Mega , Hendriyani Chandra , Rochmah Tengku Sitti
Published: March 2024

In today's competitive era of inter-bank competition, companies must be able to adjust the right marketing strategy, because everything is done to maintain the company's existence. Banks are financial institutions that collect funds from the public and then channel them back through credit. To attract consumers or prospective customers, Bank bjb's head office conducts event marketing promotions through concerts by inviting various top artists. It is hoped that this will become an attraction for prospective Bank bjb customers. The purpose of this study was to determine the success of the event marketing of the Tandamata savings and the DIGI Cash Application, in increasing the number of customers at Bank bjb's head office. The research method used is qualitative, with a descriptive approach through interviews and direct observation. The results of the study show that the strategy used by Bank bjb has been effective, as evidenced by the increasing number of Tandamata savings customers, the procedure for opening Tandamata savings can run well, reflected in the convenience provided by Bank bjb to customers. However, for a good marketing event, it must be able to influence the number of customers who open bjb Tandamata savings at bank bjb.
Evoked and entrained pupillary activity while moving to preferred tempo and beyond
Authors: Spiech Connor , Hope Mikael , Bégel Valentin
Published: March 2024

People synchronize their movements more easily to rhythms with tempi closer to their preferred motor rates than with faster or slower ones. More efficient coupling at one’s preferred rate, compared to faster or slower rates, should be associated with lower cognitive demands and better attentional entrainment, as predicted by dynamical system theories of perception and action. We show that synchronizing one’s finger taps to metronomes at tempi outside of their preferred rate evokes larger pupil sizes, a proxy for noradrenergic attention, relative to passively listening. This demonstrates that synchronizing is more cognitively demanding than listening only at tempi outside of one’s preferred rate. Furthermore, pupillary phase coherence increased for all tempi while synchronizing compared to listening, indicating that synchronous movements resulted in more efficiently allocated attention. Beyond their theoretical implications, our findings suggest that rehabilitation for movement disorders should be tailored to patients’ preferred rates to reduce cognitive demands.
Impression formation through social interaction: Effects of ethnicity in the Dutch context
Authors: Traast Iris J. , Doosje Bertjan , Amodio David
Published: March 2024

Research conducted in the United States shows that White Americans form more positive impressions of White than Black interaction partners through instrumental learning (Traast et al., 2024). We asked whether this pattern generalizes to the cultural context of the Netherlands, which differs in norms for expressing intergroup bias. In three pre-registered studies (Ns= 66/83/80), White Dutch participants played a money-sharing game, based on a reward reinforcement task, with White and Moroccan partners. Although players shared at different rates, average sharing rates for White and Moroccan players were equated. Unexpectedly, and despite anti-Moroccan explicit and implicit attitudes, participants displayed a pro-Moroccan choice preference across studies. Nevertheless, computational modeling indicated the same learning effects of ethnicity as in past research: ethnicity biased initial reward expectations, and these were updated via group-specific learning rates. We discuss potential explanations for this unexpected pattern and broader implications for cross-cultural research on intergroup social cognition.
Individual differences in interpersonal synchronization and self-other Integration: Investigating the role of creativity and empathy in a mixed-reality musical setting.
Authors: Kempf Adrian , Maes Pieter-Jan , Gener Canan , Schiavio Andrea
Published: March 2024

It has been demonstrated that moving together in synchrony to music makes us feel connected. Yet, little is known about the individual differences that shape the relationship between interpersonal synchronization to music and social bonding. The present research tests the hypothesis that this association is influenced by differences in empathy and creativity - two highly relevant factors in many musical activities. We implemented a synchronization task featuring a virtual drummer and measured self-other integration, a core component of social bonding. We employed a dual-measurement paradigm, incorporating both an explicit assessment (Inclusion of Other in the Self scale) and an implicit assessment (joint-Simon effect) of self-other integration . Surprisingly, our analysis did not reveal explicit and implicit measurements correlating, nor were they similarly affected by interpersonal synchronization. This raises questions about the assessment of self-other integration in interpersonal synchronization experiments. Furthermore, we observed no moderating role of empathy or creativity in the association between interpersonal synchronization and self-other integration. Nevertheless, we found creativity to correlate with self-other integration. In light of this finding, we recommend placing greater emphasis on creativity as a decisive factor in the study of musical interaction.
Letters from Queer Elders: Transmitting Intergenerational Wisdom in LGBTQ+ Communities
Authors: McLean Kate C. , Moriarity Nicole , Starling Kaleb , Weststrate Nic M.
Published: March 2024

Intergenerational relationships have been established as a critical locus of psychosocial development, meeting needs of identity development for youth, generativity for elders, and connection and belonging for both. However, intergenerational relationships are both rare in the LGBTQ+ community and sorely needed as a buffer to the discrimination and harm that those within the community experience from systemic and structural oppression. Focusing on sexual identity, and employing a letter writing paradigm, we investigated the content of wisdom that LGB elders have to share with youth. In a descriptive, exploratory, mixed-methods, and pre-registered study, 94 adults ranging in age 50 to 79 years (M = 55.98; SD = 6.30) wrote letters to a fictional youth, Sam, as well as completed surveys of psychosocial development and well-being. Letters were content coded for themes, as well as for emotional tone and subjective perspective. The most common themes of wisdom shared included knowing and celebrating oneself, negotiating an oppressive society, and finding one’s community. Those who wrote more emotionally positive letters scored higher on measures of wisdom and generativity, and lower on embitterment. Results are discussed in terms of the importance of cultivating opportunities for wisdom-sharing within LGBTQ+ communities to promote flourishing across the lifespan.
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Authors: Luan Sitao
Published: March 2024

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Early-stage endometrial carcinoma; risk factors for recurrence
Authors: Andleeb Asifa , Fatima Kaneez , Nasreen Shahida , Sofi Mushtaq Ahmad , Malik Tariq Rasool  , Arshad Manzoor Najmi  , Wani Shaqul Qamar
Published: March 2024

Background: Endometrial carcinoma (EC) is the most common gynecological malignancy in developed countries. The overall prognosis is excellent, as most cases are diagnosed at an early stage with low-grade histology, but once the recurrence occurs, the median survival decreases severely.
Aims and Objectives: The aim of this study was to identify the risk factors associated with recurrence in early-stage EC and explore their impact on overall survival (OS) after recurrence.
Materials and Methods: Records from patients diagnosed with EC were retrospectively reviewed. 220 patients were identified as early-stage, low-risk EC who underwent primary surgical treatment between January 2010 and December 2022, and their baseline characteristics were analyzed. Cox regression analysis was used to identify various factors for tumor recurrence. Survival analysis was done using the Kaplan-Meier method.
Results: In a cohort of 220 patients, we observed tumor recurrence in 44 (20%) patients and 34 (15.45%) deaths over a median follow-up of 72 months (range, 12–144 months). Multivariate analysis confirmed two risk factors: myometrial invasion (MMI) of any depth and lymphovascular invasion (LVI) as independent predictors of recurrence. The prognosis was worse for patients with recurrence than for those without. The OS for the recurrent group was 38.6%, compared to 96.0% in the non-recurrent group. In our study, the median time to recurrence was 19 months (confidence interval 18–30) months.
Conclusion: The presence of MMI and LVI are important predictors for recurrence in early-stage low-risk EC.
A clinico-etiological profile of adult extrahepatic portal venous obstruction in patients from Northern India. Is it a novel subset of occult extrahepatic portal vein obstruction?
Authors: Zeeshan Ahmad Wani  , Mir Mohamad Muzzafer  , Khan Afaq Ahmad  , Lone Shaheen Nazir
Published: March 2024

Background: Extrahepatic portal vein obstruction (EHPVO) is caused by occlusion and cavernomatous transformation of the portal vein. The EHPVO is well characterized in children. However, the same is not valid for adults. We aimed to evaluate the clinico-etiological profile along with the management of adult patients.
Aims and Objectives: We evaluated the clinico-etiological profile along with the management and outcomes of adult patients presenting with EHPVO.
Materials and Methods: In a descriptive, observational study, patients between ages 15 and 75 years diagnosed with EHPVO on ultrasonography abdomen were included in the study. Liver cirrhosis and malignancy were considered as an exclusion criterion. There was evaluation of clinical and imaging findings along with biochemical analysis, workup for thrombophilia, treatment given to the patients, and follow-up.
Results: Out of total 109 patients enrolled in the study, the median age of patients was ±40.25. Main clinical features were dyspepsia, abdominal discomfort, and splenomegaly. Out of 109, 27.5% patients showed fatty liver and 5.5% had both splanchnic vein thrombosis and fatty liver. Idiopathic EHPVO in majority of patients (80%), adult EHPVO with polycythemia rubra vera in 7.33% patients, adult EHPVO with heterozygous MTHFR mutation in 7.33% patients, and adult EHPVO with antiphospholipid antibody in 3.66%. No mortality was seen in this 5-year observational study and majority of the patients, i.e., 96 (88.1%) did not require any treatment.
Conclusion: Relatively benign nature of adult EHPVO was found in the selected group of patients. Majority of the cases in our study were idiopathic and few had positive thrombophilia profile.
Long-term hemodynamic response of carvedilol and simvastatin in compensated versus decompensated chronic liver disease with portal hypertension
Authors: Nazir Shaheen , Wani Zeeshan Ahmed , Ahmad Afaq , Asif Iqbal  , Hussain Altaf
Published: March 2024

Background: A combination of carvedilol and Simvastatin have recognized their role as rescue therapy for carvedilol non-responders in chronic liver disease (CLD)-associated portal hypertension. However, there are scarce data regarding its role in specific subclasses, and stratification of response according to the computed tomographic perfusion (CTP) score has never been seen before.
Aims and Objective: (1) To compare hemodynamic response and side effects of a combination therapy in decompensated and compensated patients. (2) Stratify the effect of combination therapy according to CTP score.
Materials and Methods: In 102 consecutive patients of CLD with esophageal varices, the hepatic venous pressure gradient was measured at baseline and after 3 months of dose optimization of carvedilol. Simvastatin was added to non-responders and hemodynamics repeated at 1 month of dual therapy. The response of compensated CLD was compared with decompensated patients and was stratified as per the CTP on follow-up.
Results: Overall, out of 43 compensated patients, 21 responded acutely and response increased to 29 (67.44%) at 3 months. While 31 of 59 (52.54%) decompensated patients responded acutely but dose escalation did not increase response significantly after 3 months. The addition of Simvastatin did increase the response, although side effects were more in decompensated group. The addition of Simvastatin also decreased decompensation in the high-risk compensated group and maintained their MELD.Na.
Conclusion: Response in compensated CLD patients was more than in decompensated patients; however, it was statistically insignificant. Attrition was more in patients with CTP >10 due to drug intolerance, side effects, or deaths.
Utility of ultrasonography for prediction of difficult airway and assessment of dynamic airway changes
Authors: Shehla Bashir  , Suhail Sidiq  , Bashir Ahmad Dar  , Majid Jehangir  , Razia Hamid  , Feroze Shaheen  , Abdul Waheed Mir
Published: March 2024

Background: Several clinical tools are used for preoperative airway assessment. Ultrasound is an emerging tool in anesthesia, and its role in the upper airway needs to be explored.
Aims and Objectives: We aimed to assess the role of airway ultrasound in predicting difficult laryngoscopy and airway changes following induction of anesthesia.
Materials and Methods: Clinical airway assessment was performed with a modified Mallampati score in 100 elective surgical patients. Ultrasound variables in pre- and post-induction of anesthesia were: distance between the skin and vocal cords at the hyoid bone (DSVC hb), distance from the skin to the thyroid isthmus, distance from the skin to the tracheal ring at suprasternal notch level, and distance between the skin and the cricothyroid (DSCM). Cormack–Lehane (CL) grades 3b and 4 were classified as having a DL. Association of clinical, ultrasonography (USG) indicators and CL grading was correlated. Dynamic changes in anterior neck tissues following induction of anesthesia were also measured.
Results: Pre-induction USG variables were significantly higher in the DL group compared to the NDL group (P<0.05), except DSCM. Post-induction all USG parameters were significantly higher in the DL group. Among USG variables, DSVC hb and DTSI had the highest AUCs of 0.801 and 0.772, respectively. DSVC hb had a sensitivity of 76% and a specificity of 100% for DL. DTSI had a sensitivity of 92% and a specificity of 72%. There was a significant increase in depth after anesthetic induction of all USG parameters except DSCM.
Conclusions: Ultrasound of anterior airway tissues can be considered for prediction of DL and allows dynamic airway assessment.
Comparison of volume-controlled ventilation and pressure-limited ventilation in laparoscopic appendicectomy - a randomized controlled clinical trial
Authors: Ilamparithi Jayaraman  , Gokul R  , Arulanandam R  , Nirmaladevi S
Published: March 2024

Background: Laparoscopic appendicectomy is a widely performed surgery globally, offering notable benefits such as reduced postoperative pain, quicker mobility, and shorter hospital stays.
Aims and Objectives: The study aimed to assess the changes in respiratory mechanics and compare the outcomes of volume-controlled and pressure-limited ventilation (PLV) in patients undergoing laparoscopic appendectomy.
Materials and Methods: This randomized, prospective, single-blinded control study was conducted at K.A.P.V. Government Medical College, Tiruchirapalli, on 60 ASA I and II patients scheduled to undergo laparoscopic appendicectomy under general anesthesia. The patients were randomly divided into two groups (volume-controlled ventilation [VCV] group and the PLV group) of 30 patients. A patient’s history includes age, sex, history of diabetes, hypertension, or any cardiovascular disease, respiratory tract infection, wheezing or chronic chest infections, seizures, neuromuscular disease or weakness, etc.
Results: There was no significant difference in gender, age, or body mass index between groups. There is no significant difference in the mean arterial pressure or ETCO2 between groups at various intervals. There was a significant difference in the mean heart rate between the VCV and the PLV groups at 5 and 20 min after induction. There was a significant difference in the peak airway pressure, dynamic compliance, and airway resistance between the VCV group and the PLV group at 10 min after induction (T1), 5 min after pneumoperitoneum (T2), 10 min after pneumoperitoneum (T3), and immediately after Trendelenburg position (T4).
Conclusion: The airway resistance and peak airway pressure do not increase, and the dynamic compliance was improved in the PLV during laparoscopic appendicectomy.
Comparative evaluation between oral gabapentin and oral pregabalin premedication for attenuation of hemodynamic surge to laryngoscopy and endotracheal intubation in elective procedures under general anesthesia
Authors: Dubey Kunal Chandra , Bajpai Nupur , Richeek Kumar Pal  , Chattopadhyay Subhrajyoti , Sah Sunil Kumar , Sarkar Susanta
Published: March 2024

Background: Effective attenuation of the sympathetic surge due to laryngoscopy and endotracheal intubation is needed. We wanted to compare the role of oral gabapentin (600 mg) and oral pregabalin (150 mg) in controlling this sympathetic surge.
Aims and Objectives: To compare the role of oral gabapentin (600 mg) and oral pregabalin (150 mg) as premedications for attenuating hemodynamic surge to laryngoscopy and endotracheal intubation.
Materials and Methods: 90 patients aged 18–45 years with ASA grade I or II posted for elective surgical procedure under general anesthesia were randomly allocated to two equal groups (45 in each group) to receive either 600 mg oral gabapentin or 150 mg oral pregabalin 1 h prior to surgery. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and rate pressure product (RPP) were recorded after intubation at 1 (T1), 3 (T3), 5 (T5), and 10 (T10) min. Post-operative sedation and post-operative nausea and vomiting (PONV) were recorded and compared.
Results: Gabapentin attenuates hemodynamic surge in terms of HR, SBP, DBP, MAP, and RPP better than pregabalin during laryngoscopy and endotracheal intubation at 3, 5, and 10 min after intubation, while there was no significant difference between the two groups at 1 min after intubation. Post-operative sedation score and adverse effects like PONV and SpO2 fluctuations at different points in time were comparable.
Conclusion: Oral gabapentin (600 mg) was found to be more effective than oral pregabalin (150 mg) in attenuating the hemodynamic surge to laryngoscopy and intubation.
Serum Vitamin D3 level in spontaneous abortion cases in comparison to ongoing viable pregnancies: A case–control study in a tertiary medical college
Authors: Chaitali Sengupta  , Sengupta Ritankar , Datta Dibyendu , Ghosh Santanu , Naskar Tapan Kumar
Published: March 2024

Background: The immunoregulatory functions of Vitamin D3 play a vital role in the maintenance of normal pregnancy. Several studies have reported the association of low serum Vitamin D3 levels with spontaneous abortion.
Aims and Objectives: The purpose of the study was to determine the association between serum Vitamin D3 level and spontaneous abortion cases in a tertiary medical college.
Materials and Methods: The case–control study was conducted at the Department of Gynecology and Obstetrics, Medical College, Kolkata. The study population included 50 women with spontaneous abortion (cases) and 50 women with viable pregnancy beyond 20 weeks of gestation (controls). The cases and controls were matched with respect to age, socioeconomic status, and laboratory parameters. Investigations performed for both groups were ultrasonography for confirmation of abortion and viable pregnancy, serum Vitamin D3, and other biochemical markers. Data were compared between cases and controls using the Chi-square test and unpaired “t” test along with the calculation of odds ratios (OR).
Results: About 24% of cases and 10% of controls belonged to Vitamin D3 deficient category. The difference was statistically significant (P=0.009, d.f.=2) (OR: 2.84, 95% confidence intervals [CI]: 0.92–8.80). Bleeding PV was present in 50% of cases and 4% of controls (P=0.0001, d.f.=1) (OR: 24.00, 95% CI: 5.25–109.65). Abdominal pain was complained by 46% of cases and 10% of controls (P=0.0001, d.f.=1) (OR: 7.67, 95% CI: 2.61–22.54).
Conclusion: Vitamin D3 deficiency was present more in spontaneous abortion cases in comparison to viable pregnancies. Routine daily supplementation of vitamin D3 during the first trimester of pregnancy should be incorporated into the ongoing national program. Training of health workers to educate pregnant women and their family members regarding the importance of vitamin D3 is the need of the hour.
Monitoring of general anesthesia by qCON and qNOX indices versus conventional clinical parameters in urological surgery: A randomized controlled clinical trial
Authors: Himalaya Dutta  , Suchismita Mallick  , Baisakhi Laha  , Sarbari Swaika  , Uday Sankar Mandal  , Sarmila Ghosh
Published: March 2024

Background: Awareness during anesthesia is a major anesthetic concern. Depth of anesthesia is commonly assessed in clinical practice by the patient’s clinical signs and symptoms such as blood pressure, heart rate variability, and body movement. At present, many studies have focused on qCON monitoring for sedative depth, but only a few studies have focused on qNOX monitoring for analgesic depth.
Aims and Objectives: The aim of the present study was to evaluate the relative efficacy of qCON and qNOX versus commonly used vital signs such as blood pressure and heart rate in monitoring the anesthetic depth and analgesia.
Materials and Methods: A total of 100 patients of either sex and of ASA Physical status I & II, scheduled for urogenital surgeries, were selected and randomly placed into two groups. Group A was monitored by conventional clinical technique and Group B was monitored by qCON and qNOX indices. The primary outcome was the total dose of propofol and fentanyl required to maintain the depth of anesthesia and analgesia. The secondary outcomes were propofol and fentanyl adjustment frequency, infusion duration, and quality of recovery from anesthesia.
Results: Results showed statistically significant differences between the two groups in mean dose of both propofol (P=0.000) and fentanyl (P=0.006), adjustment frequency of both propofol (P=0.000) and fentanyl (P=0.010), time required to voluntary eye-opening (P=0.000) and extubation time (P=0.000) and visual analog scale score (P=0.000). There was no statistically significant difference found in infusion duration (P=0.317) and Ramsay Sedation Score (P=0.709) between the groups.
Conclusion: Using the qCON and qNOX indices, an anesthesiologist can monitor the depth of anesthesia and analgesia more effectively and can adjust the anesthetic or analgesic drug dosing in a better possible way with lesser requirement of drugs than with conventional clinical monitoring.
A comparative study of postoperative acidemia after intraoperative administration of balanced crystalloid (Plasma-lyte A@) versus 0.9% sodium chloride in gastrointestinal surgery
Authors: Laxmi Narayan Dash  , Jagannath Panda  , Shibanee Jena  , Harikrishna Dalai  , Pritish Chandan Sahu  , Biswal Debadas
Published: March 2024

Background: The administration of intravenous fluids is one of the most common and universal interventions in medicine. Fluid therapy is the most challenging and debated aspect of perioperative care. Plasma-lyte A® Injection (multiple electrolytes injection, type 1, USP) is indicated as a source of water and electrolytes or as an alkalinizing agent. 0.9% sodium chloride is an isotonic crystalloid solution having a sodium concentration higher is useful in replacing fluid and electrolyte loss.
Aims and Objectives: The study was designed to compare the effects of intraoperative administration of balanced crystalloid solution (Plasma-Lyte A®) and 0.9% NaCl on acid-base balance in the post-operative period in patients undergoing gastrointestinal surgery.
Materials and Methods: Eighty consenting patients of ASA-l and ASA-II who underwent Gastrointestinal surgery were at first randomly allocated to 2 groups. One group received Plasma-Lyte A® as the sole crystalloid and the other group received 0.9% sodium chloride.
Results: Serum Na+ conc. of the groups were comparable and no difference was shown at the time of induction, but postoperatively at 12 h, there was a significant increase in group 2. There was no significant difference in serum K+ concentration in both the groups except at 6 h postoperatively when there was an increase in K+ concentration in group 1. Serum Cl− concentration was having no significant difference at the time of induction and 1 h intraoperative, but postoperatively at 1, 6, and 12 h the Cl− concentration significantly increased in group 2. HCO3− concentration of the two groups had no difference between them throughout the study period. The pH of patients in both the groups showed no statistically significant difference during the entire procedure (P>0.05). A significant decrease in pH observed in 0.9% sodium chloride group in comparison to Plasma-Lyte® group when the duration of surgery increased to more than 120 min.
Conclusion: Both plasma-lyte A and 0.9% sodium chloride can be used safely as intravenous infusion fluid without altering pH status and blood electrolyte concentration in patients undergoing gastrointestinal surgery.
Antishivering effect of intrathecal versus intravenous tramadol in patients undergoing urethroscopic lithotripsy under spinal anesthesia
Authors: Manasa M  , Jyoti Petkar  , Dokku Kirtana  , Karthik GS  , Rangalakshmi S
Published: March 2024

Background: Shivering is the most common complication seen in the perioperative period in patients undergoing urological surgeries under spinal anesthesia. Intravenous tramadol is used for the treatment of shivering.
Aims and Objectives: In this study, we wanted to assess the prophylactic effect of tramadol, intrathecal (IT) versus intravenous with the control group, in decreasing the incidence of shivering.
Materials and Methods: Fifty-four eligible patients posted for urethroscopic lithotripsy (URSL) were randomly allocated into three equal groups – Group C: Received 2.5 mL 0.5% bupivacaine heavy + 0.5 mL normal saline intrathecally and 5 mL of normal saline intravenously, Group V: Received 2.5 mL of 0.5% bupivacaine heavy+0.5 mL normal saline intrathecally and 25 mg tramadol in 5 mL of normal saline intravenously, and Group T: Received 2.5 mL of 0.5% bupivacaine heavy + 25 mg (0.5 mL) of tramadol intrathecally and 5 mL of normal saline intravenously. The incidence and severity of shivering were noted. Onset of sensory and motor block, duration of post-operative analgesia, core body temperature, and adverse effects such as nausea, vomiting, and hypotension were noted.
Results: The incidence of intraoperative shivering was significantly lower in Group T versus C (P=0.014) but comparable among Group I versus C (P=0.502) and Group T versus I (P=0.06). The duration of analgesia was significantly higher in Group T compared to Groups I and C (P<0.001). The additional tramadol requirement was significantly lower in Group T versus I and in Group T versus C but comparable among Group I versus C.
Conclusion: The addition of 25 mg tramadol to IT 0.5% bupivacaine heavy is effective in preventing intraoperative shivering in patients undergoing urological surgeries like URSL.
Radiofrequency ablation versus stripping of great saphenous vein in the management of varicose veins
Authors: Tyagi Vikas , Chopra Saumya , Ahmad Samir , Sudhir Kumar Jain  , Amrita Dua
Published: March 2024

Background: Varicose veins are defined as dilated, tortuous subdermal veins >3 mm in diameter. It is a common entity affecting an estimated 10% of population.
Aims and Objectives: The aim was to compare the efficacy of radiofrequency ablation (RFA) with great saphenous vein (GSV) stripping in patients with lower limb varicose veins in terms of disappearance of visible varicosities.
Materials and Methods: It was a prospective randomized controlled study, conducted in a tertiary care medical college with the study population consisting of patients suffering from varicose veins. Totally 30 patients were enrolled and divided into 2 groups of 15 patients each. Group A underwent RFA while Group B underwent stripping of GSV with flush ligation of saphenofemoral junction.
Results: The mean duration of the procedure in Group A was 53.67±6.6 min while in Group B it was 101.4±11.85 min which was statistically significant (P<0.0001). The mean duration of return to routine activities and work was 2.2±0.41 days in Group A and 3.07±1.16 days in Group B which was statistically significant (P=0.024). Post-operative analgesic requirement was similar in both groups (P=0.224). Complete remission was observed in all patients at 12 months visit and there was no recurrence identified even after a follow-up period of 4 years.
Conclusion: RFA was found to be as effective as stripping of GSV in terms of obliteration of veins. The duration of procedure was found to be much less in RFA. Furthermore, cosmetic results, ulcer healing and patient satisfaction rate was better in RFA group. Patient return to normal activity was significantly earlier in RFA group.
A study on correlation between neuroimaging and maternal outcome in eclampsia
Authors: Kadambi Mythreyi , Sushma V Dev
Published: March 2024

Background: Hypertensive disorders remain among the most significant complications of pregnancy. Neurological complications of eclampsia are a major contributor to morbidity and mortality that is associated with eclampsia. Neuroimaging studies have revolutionized visualization of hypertensive encephalopathy aids in timely intervention and a favorable maternal and perinatal outcome.
Aims and Objectives: (1) To study the spectrum of neuroimaging findings in patients with eclampsia. (2) To correlate these findings with the maternal outcome.
Materials and Methods: A prospective observational study was undertaken in the Department of Obstetrics and Gynecology, Mysore Medical College and research institute Mysore, for 18 months. All the eclamptic mothers during the study were included in the study. They were studied in terms of neuroimaging and its correlation with maternal outcomes.
Results: The incidence of eclampsia was 7.14% which is relatively high, attributed to the fact that being a tertiary care center many cases are referred. Higher incidence was seen in primigravida (72.4%) and lower maternal age of 18–20 years (48%). Cesarean section was indicated in 50% of deliveries indicating immediate action was necessary for better fetomaternal outcome. They presented with varied imminent symptoms such as headache in 20.4%, vomiting in 22.4%, and visual blurring in 22.4%. About 50% presented with altered sensorium. On non-contrast computed tomography brain, 64.3% (63) had normal findings, 17.3% (17) had posterior reversible encephalopathy syndrome (PRES) with a sensitivity of 68.42% and specificity of 85%, whereas on magnetic resonance imaging (MRI) brain, 36.26% had no abnormalities, 40.81% had PRES with a sensitivity of 86.84%, and specificity of 85%. About 58.6% had an uneventful maternal outcome. The others were hemolysis, elevated liver enzymes, and low platelet syndrome seen in 9.18% of patients, acute kidney injury in 6.12%, postpartum hemorrhage seen in 5.1%. The maternal mortality rate was 7.66%, the most common cause of death was intracranial hemorrhage.
Conclusion: The common neuroimaging findings in eclampsia are cerebral edema, PRES, cerebral venous thrombosis, infarcts, hemorrhage, and hypertensive leukoencephalopathy. Although some abnormalities seen in neuroimaging studies are incidental and transient without chronic neurologic sequelae, both CT and MRI findings correlate with the clinical presentation and maternal outcome but MRI correlates better compared to CT and can be a better imaging modality in eclampsia patients and is indicated in all patients of eclampsia.