bluuebunny/crossref_metadata_2025 huggingface dataset:
Right to food in times of COVID-19
Authors: VILLAVICENCIO-PÁRRAGA Mirian , ARTEAGA-PEÑAFIEL Marina , ZAVALA-VILLAVICENCIO Katherine , VILLAO-VILLACRÉS Alex
Published: November 2022

COVID-19 pandemic caused countries to enter quarantine, which caused the total or partial closure of some activities. In Ecuador, the quarantine started on March 17, 2020, this caused the limitation of the manufacturing industry and food production, so the objective of this research is to determine the incidence of the index of food production and manufacturing industry in the malnutrition index of this population. Pearson's statistic was applied to determine if there is correlation between the variables of study, where it was obtained that there is a direct linear correlation between the index of people with malnutrition, Food Production Index and Index of production of the manufacturing industry of 0.41 and 0.61 respectively, Ecuador has an increasing trend of malnutrition rate since 2016, date that obtained 9.7% and currently has reached 12.5%. In addition, the decreasing trend of food is contrary to the trend of the population, a situation that threatens the availability of food.
An overview of the Knowledge of Level 1 Nurse Students about the 5M Health Protocol in Covid-19 Prevention at STIKes Santa Elisabeth Medan 2022
Authors: Gaol Rusmauli Lumban , Naibaho Juliana
Published: November 2022

Background: The 5M health protocol is a complement to the 3M, namely wearing masks, washing hands, keeping a distance to avoid crowds and reducing mobility which has been initiated by the government. This effort demands high discipline and must be applied consistently at all times. The problem involved in this research is regarding the 5M health protocol, where if someone does not carry out the 5M then positive cases of covid-19 will continue to increase in the community. So to overcome this, it is recommended for students to carry out the 5M movement, especially at STIKes Santa Elisabeth Medan to prevent the spread of covid-19. Knowledge is the result of sensing activities through the five senses such as smell, taste, touch and hearing. Objective: This study aims to describe the knowledge of level 1 nurse students about the 5M health protocol in preventing Covid-19 at STIKes Santa Elisabeth Medan in 2022. Methods: The method used in this study was descriptive, the number of respondents was 85 people. The sampling technique used a total sampling technique, namely the number of respondents at STIKes Santa Elisabeth Medan amounted to 85 respondents. The results showed that the 5M Health Protocol at STIKes Santa Elisabeth Medan from 85 respondents was good as many as 84 people (98.8%) and only 1 person (1.2%). Conclusion: It can be concluded that the majority of respondents have good knowledge in implementing the 5M health protocol in preventing Covid-19 84 respondents (98.8%) and only 1 respondent (1.2%). Suggestion: it is hoped that all students, especially level 1 nurses, so that the 5M health protocol needs to be improved to prevent the spread of covid-19.
The Effect Of Combination Of Progressive Muscle Relaxation And Mckenzie Neck Exercise On Intensity Pain Cases Of Myofascial Pain Syndrome Upper Trapezius Muscle On Students
Authors: Afifa Nor Adha Luthfia , Yuliadarwati Nungki Marlian
Published: November 2022

Background: Students often use gadgets for learning needs for a long time, and most of them do not pay attention to ergonomic body positions and tend to be in a static state. This causes tension in the muscles around the neck and shoulders that triggers point, resulting in myofascial pain syndrome in the upper trapezius muscles. This has an impact on student productivity. Objective: to determine the effect of the combination of progressive muscle relaxation and mckenzie neck exercise on the pain intensity of upper trapezius muscle myofascial pain syndrome in college student. Methods: this study used a pre-experimental design (one group pre-test and post-test). The subjects of this study were KM-HSS students in malang area, totaling 20 people. This research was conducted for 14 days in 2 times a day. The measuring instrument in this study used the Numerical Rating Scale (NRS) as a pain scale measuring instrument. Results: this study showed that there was a significant effect before and after being given a combination exercise on pain intensity in myofascial pain syndrome on the upper trapezius with p = 0.000 (p<0.005). Conclusion: There is an effect of a combination of progressive muscle relaxation an mckenzie neck exercise on the pain intensity of myofascial pain syndrome cases of upper trapezius muscle in KM-HSS students in the Malang area.
The Effect Of Combination Of Retrowalking Exercise And Static Contraction In Increasing Activity Daily Living Functions In Knee Osteoarthritis Risk Tea Pickers
Authors: Dewanti Wildha Rosita , Rahmawati Nurul Aini
Published: November 2022

The tea picker job involves a lot of standing, wich puts pressure on the knees. This routine activity can cause musculoskeletal problems, such as osteoarthritis, which can reduce tea pickers’ daily living activity in tea pickers at risk of osteoarthritis which can be handled by retrowalking exercise and static contraction in increasing the function of daily living activity in tea pickers at risk of knee osteoarthritis. Research Methods: This study used a quasi – experimental design (one group desihn pre – test and post – test) involving 31 sampels of tea pickers. This research was cinducted for 4 weeks with 3 times a combination of retrowalking exercise and static contraction in a week. This study uses The Western Ontario and McMaster University Osteoarthritis Index (WOMAC) as an instrument to regulate daily living activity risk of knee osteoarthritis in tea pickers. Results : The test using the Paired Sample t Test showed a value of 0.000 (p < 0.05) which means that it has a normal contribution. Conclusion : There is an effect of a combination of retrowalking exercise and static contraction in increasing daily living activity risk of knee osteoarthritis in tea pickers. Suggestion : For future researchers, the result of study can be used as a reference for students, educator and physiotherapy regarding the effect of the combination of retrowalking exercise and static contraction on increasing the function of daily living activities in the risk takers of knee osteoarthritis.
Differences Of The Effectiveness Of The Tai Chi Method On Reducing Insomnia And Hypertension In Elderly
Authors: Berampu Sabirin , Sembiring Elsaria Br
Published: November 2022

Hypertension is caused by stiffness in the arteries which results in an increase in blood pressure which can cause strokes in patients so that they cannot carry out daily activities, it can even be fatal, such as rupture of blood vessels in the brain which can cause death. If an elderly person experiences sleep disorders, it will worsen the underlying disease so that it will have an impact on health. The purpose of this study is the difference in the effectiveness of the Tai Chi method on reducing insomnia and hypertension in the elderly. This type of research is quantitative with a quasi-experimental design. The sample used is the elderly who live in the village of Lau Rakit. The sampling technique used is the Probability Sampling technique. Data were analyzed using Paired T-Test and One Way Anova (<0.05). The results showed that in the insomnia intervention group the p-value was 0.01 and in the hypertension intervention group the p-value was 0.02, which means that the Tai Chi exercise intervention group was effectively used to treat insomnia and hypertension, while in the control group the p-value was 0.16. it means that in the control group there is no effective change. The results of the ANOVA test obtained a p value of 0.04 < 0.05, which means that there is a significant difference between the three groups. It is recommended for the elderly to be able to do Tai Chi exercises regularly to overcome the problems of insomnia and hypertension.
The Effect Of Early Mobilization Measures On Heart Rate And Breathing Frequency In Patients Congestive Heart Failure (chf) At Lubuk Pakam Grandmed Hospital
Authors: Sitepu Sari Desi Esta Ulina , Sipayung Selamat Tuahta
Published: November 2022

Mobilisasi adalah kegiatan mendasar di dalam bidang keperawatan yang memerlukan keterampilan serta pengetahuan dalam menerapkannya secara efisien dalam mencegah tirah baring. Mobilisasi dini dilaksanakan perawat dengan cara mandiri atau dikerjakan dengan bekerjasama antar pemberi asuhan keperawatan, fisioterapi dan terapi okupasional. Tindakan mobilisasi dini dilakukan untuk mencegah terjadinya permasalahan akibat proses perawatan yang dikerjakan, memperbaiki mobilitasi pasien dan menambah kewaspadaan. Tujuan kegiatan penelitian ini yaitu untuk mengetahui pengaruh tindakan mobilisasi dini terhadap denyut jantung dan frekuensi pernafasan pada pasien congestive heart failure (CHF) di RS Grandmed Lubuk Pakam. Adapun jenis penelitian ini adalah quasi experiment dengan pendekatan one group pretest-posttest design , dengan teknik sampling total sampling. Pemberian tindakan mobilisasi dini diberikan kepada 23 orang pasien yang dengan penyakit jantung di RS Grandmed Lubuk Pakam. Pengumpulan data dikerjakan memakai lembar observasi dan memberikan intervensi mobilisasi dini pada pasien jantung. Observasi terhadap pernapasan dan denyut jantung dilakukan sebanyak dua kali, yaitu sebelum dilakukan mobilisasi dini dan setelah dilakukan mobilisasi dini kemudian hasil yang diperoleh dicatat pada lembar observasi. Hasil uji statistik dengan menggunakan uji paired test menunjukkan nilai rata-rata frekuensi pernapasan sebelum dan setelah dilakukan mobilisasi dini menunjukkan nilai p=0,000, nilai rata-rata denyut jantung sebelum dan setelah dilakukan mobilisasi dini menunjukkan nilai p=0,001. Hasil yang diperoleh menunjukkan bahwa mobilisasi dini berpengaruh terhadap frekuensi pernapasan dan frekuensi denyut jantung. Diharapkan agar perawat dapat lebih mengetahui manfaat dari melakukan tindakan mobilisasi dini terhadap denyut jantung dan frekuensi pernapasan pada pasien CHF.
Effect Of Massage Therapy Towards Weight Gain On Stunting Toddlers
Authors: Lestari Ayu Mutia , Laska Yulinda , Fariningsih Erika
Published: November 2022

Stunting is a chronic nutritional problem occurringin toddlers, characterized by shorter height compared to children of their age. Massage therapy is known to providevarious benefits such as increasing endurance, increasing body weight, stimulating the Vagus nerve, increasing breast milk production, overcoming stomach pain, and improving sleep quality. This research employed Quasi-Experiment method with Two Groups Pre-test and Post-test design, by observing and giving treatment for 14 days. The research involved 20 stunting toddlers in Tanjung Riau, Batam as the samples. The research results revealed that there was an effect of giving massage therapy on weight gain in stunting toddlers. The Independent Sample T-test obtained a significant p-value of 0.033 (P < 0.05).Therefore, it can be concluded that there is an effect of giving massage therapy on weight gain in stunting toddlers.
Analyzing The Effect Of Increasing Growth And Motoric Development Of Infants Aged 6-11 Months Who Are At Risk Of Stunting With Baby Spa Treatment
Authors: Prastiwi Ikha , Alindawati Rifka
Published: November 2022

Optimal growth and development of baby can be carried out by stimulation. Stimulation can be given through active tactile stimulation to baby, one of which is with massage, solus per aqua (SPA). This study was to analyze the improvement of growth and motoric development of infants aged 6-11 months who are at risk of stunting with Baby SPA Treatment. Research method with Quasi-experimental quantitative research, pre and posttest approach with two group intervention design with a total sample of 30 respondents. Statistical test using Paired Sample t-test. The results showed an average change in the baby SPA group before 8,413 grams and after treatment 8,930 grams, while in the baby massage group before 8,260 grams and after treatment 8,460 grams. The difference in average body weight in the baby SPA group was 517 grams, the baby massage group was 200 grams (p=<0.001). The average height of the baby SPA group before the treatment were 73.7cm and after the treatment 75cm, while in the baby massage group before the treatment 71.7cm and after the treatment 72.9cm. The difference in the average height of the baby SPA group was 1.36 cm, while the baby massage group was 1.2 cm (p = <0.001). Changes in the average motoric development of the baby SPA group before 9.07 and after treatment 9.93, while in the baby massage group before 9.00 and after treatment 9.87. The difference in the average motoric development the baby SPA group was 0.86, while the baby massage group was 0.87 (p=0.55). In conclusion, there are differences in the average value of weight and height gain before and after treatment, there is a difference in the mean difference in weight and height between baby SPA group and baby massage, there is no difference in the average difference in motoric development between baby SPA group and baby massage. Suggestions for baby SPA treatment as one of complementary care.
Effect of Inhaled Oil Aromatherapy on Emesis Gravidarum in First Trimester Pregnant Women
Authors: Anggraini Ririn , Rahma Melia , Andari Yuli
Published: November 2022

Emesis Gravidarum (nausea and vomiting) is a common complaint in early pregnancy due to increased production of the hormones estrogen, progesterone, and placental human chorionic gonadotrophs. Peppermint aromatherapy is a therapeutic measure to treat emesis gravidarum in pregnant women. This aromatherapy has a cool, refreshing, and makes you feel comfortable. This study aims to find out how to give inhaled peppermint oil aromatherapy that can affect emesis gravidarum in first trimester pregnant women. The research method used is a literature study where an analysis of journals and articles with a review of existing theories is carried out.The journals that have been reviewed are as many as 16 journals. The results of this study revealed that the content of peppermint that can overcome emesis gravidarum is methhol and methone. The amount of peppermint is given 2-3 drops of peppermint essential oil on a tissue with a distance of 3-5 cm and inhaled for 5-10 minutes by doing 2 times a day in the morning and evening. From the results of the study that there are differences in the effectiveness of peppermint aromatherapy with other aromatherapy, where peppermint oil aromatherapy is more effective in overcoming nausea and vomiting in first trimester pregnant women. Health workers, especially midwives, can provide peppermint aromatherapy care to reduce emesis gravidarum in first trimester pregnant women.
Les figures du consommateur/citoyen au cœur des stratégies publicitaires sur les médias socionumériques
Authors: Faris Jasmine , Equoy Hutin Séverine , Domenget Jean-Claude
Published: November 2022

Cet article s’intéresse aux nouvelles formes publicitaires exploitant des moyens discursifs pour convoquer les figures du consommateur/citoyen/coénonciateur en s’appuyant notamment sur les spécificités doxiques du contexte socioéconomique et culturel. Parmi ces formes, on trouve les productions audiovisuelles qui circulent sur les médias et les plateformes socionumériques. Inscrite dans cette tendance, la marque marocaine Mio a développé des stratégies publicitaires afin de percer sur le marché très concurrentiel des détergents au Maroc. L’annonceur a en effet choisi « le partage des tâches ménagères » comme thème de ses premières campagnes publicitaires en 2018 et 2019, et a misé sur les médias socionumériques comme principal support de communication. Cette étude de cas et la méthodologie proposée examinent dans un premier temps la rhétorique audiovisuelle de la première production audiovisuelle (vidéo), partagée sur les médias socionumériques de la marque. Puis elle montre comment la scénographie proposée estompe la visée communicationnelle du discours publicitaire [Charaudeau 1994] au profit d’une dimension argumentative [Amossy 2000] fondée sur la valeur culturelle et sociale du discours, des figures et des rapports de place [Flahault 1978] construits dans et par l’énonciation. Dans un second temps, l’étude s’intéresse à la réception sociale de la production audiovisuelle, en analysant les commentaires déposés sur les médias socionumériques et les métadiscours circulants.
Au contre-jour de l’histoire : Joë Bousquet
Authors: Campa Laurence
Published: November 2022

Ancien combattant valeureux de la Grande Guerre, grièvement atteint, paralysé à vie, Joë Bousquet incarne un itinéraire existentiel et poétique des plus singuliers, qui déroute les lectures historiennes. En revenant sur son expérience martiale ainsi que sur le travail conjoint de son écriture et de sa blessure, l’article tente de comprendre pourquoi son œuvre résiste aux analyses habituelles. À partir du cas Bousquet, il réfléchit aux conditions de possibilité d’un dépassement des antagonismes entre étude historique et lecture littéraire. Plutôt que d’opposer les deux démarches, il cherche ce qui, dans la lecture littéraire, peut enrichir l’étude historique et ce que la littérature peut offrir à l’histoire quand elle est autre chose qu’une simple source. Malgré les divergences épistémologiques et méthodologiques, trouve-t-on des carrefours où se nouent avec fruit les deux points de vue ? L’œuvre de Bousquet se prête parfaitement à cette quête.
Écrire dans les décombres : Philippe Jaccottet, des cendres à la semaison
Authors: Brossier Madeleine
Published: November 2022

Cet article interroge le rapport entretenu par Philippe Jaccottet avec l’Histoire. Il s’agit dans un premier temps de s’étonner du petit nombre de textes poétiques ouvertement inspirés par un événement historique. Philippe Jaccottet lui-même en a relevé trois, que l’on commentera : Requiem, une œuvre de jeunesse inspirée par des photographies de maquisards torturés, puis deux poèmes de L’Ignorant intitulés « L’insurrection au-delà des chênaies » et « Dans un tourbillon de neige ». Dans un deuxième temps, l’article étudie le motif de la pulvérisation, qui rapporte la désintégration des décombres de la guerre à un processus plus long d’enfouissement des civilisations. Le poète apparaît alors dans un troisième temps comme un chercheur de décombres, un glaneur en quête d’un éclat transitoire, apte à promener sur le monde qui se délabre un regard proche de celui des enfants.
Ca silicide films—promising materials for silicon optoelectronics
Authors: Galkin Nikolay G. , Galkin Konstantin N. , Goroshko Dmitrii L. , Dotsenko Sergei A. , Kropachev Oleg V. , Chernev Igor M. , Subbotin Evgenii Yu , Alekseev Aleksey Yu , Migas Dmitry B. , Fogarassy Zsolt , Pecz Bela , Gutakovskii Anton K.
Published: November 2022

Single-phase films of semiconductor and semimetallic calcium silicides (Ca2Si, CaSi, and CaSi2), as well as films with a significant contribution of Ca5Si3 and Ca14Si19 silicides, were grown on single-crystal silicon and sapphire substrates. The analysis of the crystal structure of the grown films was carried out and the criterion of their matching with silicon and sapphire substrates was determined. Some lattice-matching models were proposed, and the subsequent deformations of the silicide lattices were estimated. Film’s optical functions, including the optical transparency, were calculated from the optical spectroscopy data and an extended comparison was performed with the results of ab initio calculations. The real limits of the optical transparency for the films on sapphire substrates were established. The maximum transparency limit (3.9 eV) was observed for the CaSi film. Based on an analysis of the photoelectric properties of Ca2Si/Si diodes on n- and p-type silicon substrates, a perspective of their applications in silicon optoelectronics was discussed.
MEDIA LIMBAH BOTOL UNTUK MENINGKATKAN PEMBELAJARAN PAI DI RA MIFTAHUL KHOIR I KARANGREJO PURWOSARI
Authors: Wiwin Fachrudin Yusuf Wiwin Fachrudin Yusuf
Published: November 2022

Salahsatu komponen yang sangat penting dalam proses belajar adalah media. Mengingat kedudukan media pembelajaran ini tidak hanya sekedar alat bantu mengajar, tetapi juga merupakan salahsatu cara untuk memotivasi dan berkomunikasi dengan siswa agar lebih efektif. Selain dapat menggantikan sebagian tugas guru sebagai penyaji materi (penyalur pesan) media juga memiliki kegunaan untuk mengatasai hambatan dalam berkomunikasi, keterbatasan fisik dalam kelas, sikap pasif siswa serta mempersatukan pengamatan mereka. Berdasarkan latar belakang diatas maka peneliti mengangkat beberapa masalah yaitu, 1. Bagaimana mendesain media limbah botol  untuk meningkatkan pembelajaran PAI di RA Miftahul Khoir 1 Karangrejo Purwosari? 2. Bagaimanakah penerapan media limbah botol untuk meningkatkan pembelajaran PAI di RA Miftahul Khoir 1 Karangrejo Purwosari? 3. Apa kelebihan dan kekurangan media limbah botol untuk meningkatkan pembelajaran PAI di RA Miftahul Khoir 1 Karangrejo Purwosari?Langkah pertama dalam membuat media adalah mendesain media pembelajaran yang  diawali dengan: menyiapkan botol bekas, menggunting bagian atas botol dan merapikannya, menggunting menjadi 8 bagian, dan seterusnya. Dan langkah kedua adalah penerapan media ini yang diawali dengan: guru menyiapkan media terlebih dahulu, pengarahan guru pada peserta didik tentang media, guru mengacak botol yang sudah tertempel huruf huruf hijaiyah dan peserta didik menyusunnya kembali, dan seterusnya. Dan media ini tentunya menmpunyai kelebihan dan kelemahan, diantaa kelebihannya, botol yang mudah diperoleh, peserta didik lebih semangat, media ini menyenangkan, dan sebagainya, dan diantara kelemahnnya yaitu: media ini kurang efesien, membutuhkan waktu yang lebih dalam menyiapkannya, proses pembelajaran yang cukup lama, dan sebagainya
The role of simulation-based training to improve team performance in implementing one-hour sepsis bundle: a randomized trial
Authors: Sugiarto Adhrie , Tantri Aida Rosita , Manggala Sidharta Kusuma , Peddyandhari Fildza Sasri , Auerkari Aino Nindya , Fabiola Tissy , Swannjo Jonathan Pratama , Anakotta Vircha , Theresia Sandy
Published: November 2022

Background: Excellent team performance is one of the keys in managing patients with sepsis successfully. Simulation-based training with high fidelity manikin (HFM) is one of the many ways to enhance team performance. This study aims to compare the role of simulation-based training with HFM with conventional method to improve team performance in conducting one-hour sepsis bundle.

Methodology: This randomized single-blind study was conducted on 16 doctors and 24 nurses in intensive care unit. Subjects were divided randomly into two groups, the simulation group and the discussion group. Simulation group received simulation training with HFM in conducting one-hour sepsis bundle in sepsis patients, while conventional group received case-based oral discussion with their tutor. The training was rounded off by a case simulation exam using HFM for both groups. The team performance consisted of clinical skills and communication skills evaluated through a validated assessment tool. Skills being assessed included initial assessment, diagnosing sepsis with SOFA and conducting one-hour sepsis bundle.

Results: The simulation group with high fidelity manikin completed the one-hour sepsis bundle better than the conventional group (p = 0.022). Particularly in collecting venous blood samples (p = 0.027) and blood culture samples (p = 0.011), along with giving the correct intravenous fluid replacement, tailored for each scenario (p = 0.027). Communication aspect was not significantly different in both groups.

Conclusion. Team performance in implementing one-hour sepsis bundle is better in the simulation group trained with high fidelity manikin as compared to conventional training group, who received case-based oral discussion.

Abbreviations: HFM - high fidelity manikin; ICU - Intensive Care Unit; SOFA - Sequential Organ Failure Assessment

Key words: Simulation-based training; One-hour sepsis bundle; Intensive care unit; Medical education; Interprofessional training

Citation: Sugiarto A, Tantri AR, Manggala SK, Peddyandhari FS, Auerkari AN, Fabiola T, Swannjo JP, Anakotta V, Theresia S. The role of simulation-based training to improve team performance in implementing one-hour sepsis bundle: a randomized trial. Anaesth. pain intensive care 2022;26(3):463-468; DOI: 10.35975/apic.v26i4.1954

Received: November 08, 2021; Reviewed: May 03, 2022; Accepted: 31 May 2022
Intrarater reliability of cervical range of motion device in measuring cervical active range of motion in patients with chronic neck pain and respiratory dysfunction
Authors: Anwar Sahreen , Arsalan Syed Asadullah , Zafar Humayun , Ahmad Ashfaq , Gillani Syed Amir , Hanif Asif
Published: November 2022

Methodology: We enrolled 30 patients (14 males and 16 females) with chronic neck pain and respiratory dysfunction fulfilling inclusion criteria. Two trials of CAROM measurement for flexion, extension, left and right lateral flexion and left and right rotation were performed, with a gap of one week to measure test retest reliability of CROM device. Intraclass correlation coefficient (ICC), standard errors of measurement (SEM) and minimal detectable change (MDC) were calculated to test the intrarater reliability.

Results: Intrarater reliability of repeated measurements of CAROM using the CROM device was found to be good. The ICC values ranged between 0.88-0.97 for flexion, 0.93-0.98 for extension, 0.92-0.98 for right lateral flexion,0.93-0.98 for left lateral flexion. For right rotation it was 0.88-0.97, for left lateral rotation it was 0.95-0.99. The standard error of measurement for these movements ranged from 1.5° to 2.9°. Minimal detectable change ranged from 3.5°for extension to 6.8°for left lateral flexion.

Conclusion: Cervical range of motion device is a reliable tool for measuring cervical active range of motion in patients simultaneously suffering from chronic neck pain and respiratory dysfunction.

Abbreviations: CAROM - cervical active range of motion; CROM - cervical range of motion; ICC - Intraclass correlation coefficient; SEM - standard errors of measurement; MDC - minimal detectable change

Key words: Adult; Exercise Therapy / methods; Female; Humans; Male; Neck Pain / physiopathology; Neck Pain / therapy; Pain Measurement; Pulmonary function; Range of Motion, Articular; Reliability

Citation: Anwar S, Arsalan SA, Zafar H, Ahmad A, Gillani SA, Hanif A. Intrarater reliability of cervical range of motion device in measuring cervical active range of motion in patients with chronic neck pain and respiratory dysfunction. Anaesth. pain intensive care 2022;26(4):503-509; DOI: 10.35975/apic.v26i4.1957

Received: September 29, 2021; Reviewed: April 21, 2022; Accepted: May 10, 2022
Caudal epidural morphine versus intravenous morphine for postoperative analgesia in pediatric cardiac surgery
Authors: Nguyen Tat Dung , Ngo Dung , Pham Nhu Hien , Jantzen Tanja
Published: November 2022

Background & objective: Traditionally, analgesia after heart surgery is obtained with the use of intravenous opioids (particularly morphine). Continuous infusion of narcotic analgesics results in a more constant level of analgesia, but slow accumulation may cause excessive sedation. The caudal epidural narcotics, alone or with local anesthetics have been advocated following lower abdominal and thoracic surgery in children. We compared the analgesic effect and safety of caudal epidural morphine (CEM) after heart surgery with intravenous morphine infusion.

Methodology: Sixty children, aged 6 months to 5 y, undergoing elective cardiac surgery under general anesthesia were enrolled in the study. The patients were randomly allocated to one of the two groups to receive either 0.06 mg/kg CEM at induction of anesthesia (study group or CEM group) or postoperative morphine infusion at a rate of 0.025 mg/kg/h intravenously (control group or PIVM group). Postoperative pain scores were assessed according to the COMFORT behavior scale. Two patients were excluded from the study after randomization and 58 patients completed the study.

Results: Time from pediatric intensive care unit (PICU) admission to the need of intravenous morphine boluses was significantly longer in the CEM group compared with the control group (16-20 h vs 38 min; P < 0.0001). In CEM group, 68.97% of patients did not require additional morphine and the total intravenous morphine consumption over the 48 h postoperatively was lower (P < 0.0001). Moreover, the use of CEM resulted in earlier extubation and earlier discharge from the PICU (P = 0.011). Over-sedation was recorded in the control group on the first postoperative day. The incidence of adverse events was low in both groups. Respiratory depression was not seen in CEM group patients.

Conclusion: A single dose of morphine 0.06 mg/kg in caudal epidural, preoperatively in pediatric cardiac surgery, had a significant intravenous morphine sparing effect as compared to a postoperative morphine infusion at a rate of 0.025 mg/kg/h, and was associated with a low incidence of adverse events after pediatric cardiac surgery. Effective analgesia was achieved for 16-20 h after surgery.

Key words: Caudal epidural morphine; COMFORT behavior scale; Opioid–related adverse events; Pediatric cardiac surgery; Analgesia, Postoperative

Citation: Nguyen TD, Ngo D, Pham NH, Jantzen T. Caudal epidural morphine versus intravenous morphine for postoperative analgesia in pediatric cardiac surgery. Anaesth. pain intensive care 2022;26(4):514-522.

DOI: 10.35975/apic.v26i4.1959

Received: August 15, 2022; Reviewed: January 02, 2022; Accepted: July 07, 2022
Combined use of the GlideScope and flexible fiberoptic bronchoscope after several failed intubation attempts for a retrosternal thyroid mass: a case report
Authors: Abaalkhayl Mohammed Soliman
Published: November 2022

A GlideScope® and a flexible fiberoptic bronchoscope (FOB) were successfully used in combination, to intubate a 73-year-old female patient in which repeated previous intubation attempts with conventional laryngoscope had failed. GlideScope®, and FOB were used sequentially. She had been scheduled for an elective total thyroidectomy to remove a huge retrosternal goiter. A computed tomography (CT) scan revealed a large necrotic mass (measuring 10 x 16 cm) with heterogeneous enhancement involving the thyroid gland and extending to the anterior mediastinum, causing significant tracheal compression and left deviation. Endotracheal intubation was successfully performed while she was awake using a combination of GlideScope and FOB. The operation lasted for two hours and was uneventful. The patient was then transferred to the intensive care unit (ICU) and kept intubated, sedated, and mechanically ventilated overnight. She was awakened and extubated the following day with no airway complications.

Key words: Adult; Failed intubation; Female; Fiberoptic bronchoscope; GlideScope; Humans; Intubation, Intratracheal; Retrosternal thyroid mass

Citation: Abaalkhayl MS. Combined use of the GlideScope and flexible fiberoptic bronchoscope after several failed intubation attempts for a retrosternal thyroid mass: a case report. Anaesth. pain intensive care 2022;26(4):554-558; DOI: 10.35975/apic.v26i4.1965

Received: July 05, 2022; Reviewed: July 14, 2022; Accepted: July 16, 2022
Application of the compressed sense in the study of female pelvi in magnetic resonance 3 Tesla for the diagnosis of infertility in women
Authors: Curatolo Calogero , Amato Maria Chiara , Daricello Marco , Caruso Virginia , Lo Re Giuseppe , Galia Massimo , Lo Casto Antonio
Published: November 2022

Compressed Sense (CS) is a technological innovation in the field of Parallel Imaging (PI) that allows to reduce up to 50% the acquisition time per single sequence, reducing the whole duration of the MRI examination, and is based on the application of 3 principles: Incoherent k-space subsampling, sparsification transform and nonlinear iterative reconstruction. The purpose of our work was to evaluate the application of CS to the MRI protocol of the female pelvis performed for infertility, evaluating its Temporal Resolution and Signal/Noise Ratio (SNR) compared to the classic PI technique SENSE. MRI exams were performed with RM 3T scanners (Philips Ingenia, Philips Healthcare, Netherlands Eindhoven). The female pelvis MRI protocol included the following sequences: 3D PelvisView T2, 3D PelvisView T1, DWI (b0 and b1000), mDixon 3D THRIVE with ev. contrast media. The parameters of each sequence, with the exception of DWI in which the CS is not applicable, are shown in comparison between the application of Sense and Compressed Sense. The CS allows to obtain at the same spatial resolution, a protocol with faster acquisition times, correcting the effect of aliasing from data subsampling compared to conventional SENSE. In conclusion, the application of CS could bring multiple advantages in the field of MR imaging in the diagnosis of infertility in women, optimizing the image quality and the duration of each individual examination.
Application of the ultrafast sequence in the dynamic contrastographic study in the magnetic resonance imaging of the breast: our experience
Authors: Curatolo Calogero , D’Amato Elisa , Daricello Marco , Caruso Virginia , Orlando Alessia Angela Maria , Lo Re Giuseppe , Galia Massimo
Published: November 2022

In the last decade, breast MRI has played a role of primary importance, as a "gold standard" method in the early diagnosis of breast cancer in high-risk women, in assessing the extent of the disease and the response to neoadjuvant chemotherapy. Currently, the 3D GRE Rapid-Acquisition sequence in dynamic acquisition without and with endovenous administration of contrast medium, is fundamental for the breast MRI protocol, as the current diagnostic approaches in Magnetic Resonance are based precisely on this sequence, able to guarantee accurate diagnostic performances detecting pathological mass and non-mass-enhancement. Ultrafast sequences are modern sequences based on the 4D Time-Resolved technique with k-space sampling modalities which allow the evaluation of post-contrast images with very high temporal resolution. The purpose of our work is to illustrate in particular the use of the 4D-THRIVE sequence implemented in our breast MRI study protocol.
4D Free-Breathing Sequence For The Study Of Pancreatic Lesions In MRI 3 Tesla
Authors: Curatolo Calogero , Siino Manfredi , Cannella Roberto , Lo Re Giuseppe , Brancatelli Giuseppe
Published: November 2022

Pancreatic cancer is the fourth leading cause of cancer death in both the United States and Europe. A fundamental role in the characterization, early diagnosis, and staging of pancreatic cancer is played by Magnetic Resonance. An innovative and recently implemented sequence, the 4D Free-Breathing sequence, is demonstrating remarkable efficiency in the characterization of pancreatic lesions, as it allows to obtain images with high temporal resolution on the arterial phase, maintaining high spatial and temporal resolution, with the patient free breathing and with compensation of respiratory movement artifacts. The aim of this study was to analyze the 4D Free-Breathing sequence technique and to evaluate its advantages in terms of image quality and diagnostic value in the characterization of pancreatic lesions. The 4D Free Breathing sequence replaces the acquisition of the classic arterial post-contrast phase obtained with the 3D-THRIVE sequence: after a first acquisition of the k-space data in the non-contrast phase (lasting 58 seconds), multiple arterial subphases, each one lasting about 5 seconds, will be acquired with a complete coverage of the post-contrast phase of about 90 seconds. This sequence exploits the k-space sampling technique called "Stack of Stars", based on a radial sampling in the XY plane. In detail, along the slice phase-encoding direction (kz), uniform Cartesian-grid sampling is maintained. Within each kz-encoded plane, radial data is collected with consecutive views (1 per sequence repetition time TR) rotated by a golden-angle of 111.25°, allowing the sampling of a complete circle, also determining a considerably reduced presence of breath artifacts.
A RANDOMIZED STUDY COMPARING THE EFFICACY AND SAFETY OF TWO DIFFERENT BOLUS DOSES OF OXYTOCIN DURING CAESAREAN DELIVERY
Authors: R Nayak Shruthi , Kumar Karthik , Nayak Gopalakrishna , S Rao Gurudutt , Prasanth B Krishna
Published: November 2022

Background: Typically, oxytocin is used to induce uterine contractions during caesarean delivery. The intravenous administration of oxytocin is
known to have negative side effects, including tachycardia, hypotension, and alterations in electrocardiograms (EKGs), which can be harmful in
high-risk patients. In this study, we contrasted the outcomes of two oxytocin dosages. Methods: A total of 70 patients—35 in each group—were
receiving an I.V. bolus of 2 or 5 units of oxytocin while undergoing elective caesarean sections under spinal anaesthesia. An hourly infusion of ve
units of oxytocin was then administered. Evaluation of uterine tone, the need for further uterotonic drugs, changes in hemodynamics, and adverse
pharmacological effects were compared between the two groups. Results: The two groups' patients had similar characteristics. At two minutes,
uterine tone ratings remained similar. The difference between the two groups at the fth minute was statistically signicant. At the fth minute,
there was a substantial change in the clinically acceptable uterine tone measured over the entire trial time. At the rst minute, the percentage rise in
the mean maternal HR was observed to differ signicantly (p=0.002). No signicant difference in maternal tachycardia existed across the groups.
When the systolic blood pressure was compared to the baseline at 1, 2, 3, 4, 15, 18, and 21 minutes, there was a discernible difference in the percent
drop. There was a noticeable difference in the diastolic blood pressure during the entire trial period. Only few cases had side effects like nausea and
vomiting, there was no appreciable difference. Conclusion: In healthy adult women having an elective caesarean section, a 2-unit oxytocin bolus
followed by an infusion of 5 units per hour had a positive effectiveness and safety prole.
MODIFIED STOCK OCULAR PROSTHESIS- A SIMPLE METHOD TO REHABILITATE AN OCULAR DEFECT
Authors: Pai Pranati , Vasudevan Sneha , D B Nandeeshwar , Kumar B H Dhanya , N Shamnur Sunitha
Published: November 2022

Surgical removal of an infected eye can lead to various emotional and physical problems for the patients. A well- tting and esthetic ocular
prosthesis is necessary for such patients, thereby improving their facial features and providing psychological condence. This article describes the
case report of a patient with enucleated eye socket who was treated with the fabrication of modied stock ocular prosthesis.
PREDICTORS OF POST OPERATIVE MORTALITY AND MORBIDITY USING THE PPOSSUM SCORING SYSTEM IN GENERAL SURGICAL PATIENTS
Authors: Pinto Supriya , Tauro Leo Francis
Published: November 2022

Introduction: The risk scoring system in all elds of medicine is gaining popularity in order to assess the outcome and improve the patient care.
Various scoring systems are available to predict the surgical outcome, but most of them fail to incorporate surgical factors. Portsmouth
Physiological and Operative Severity Scores for the enumeration of Mortality and Morbidity (P-POSSUM) scoring system help in predicting the
outcome in the surgical patients. This study was conducted to evaluate the validity of P- POSSUM in patients undergoing major surgery and to
enumerate the risk factors for low outcome in our setup. Methods: A longitudinal observational study on 250 consenting patients who underwent
medium, major and major + surgeries as dened by POSSUM scoring system. Data was collected as per 12 physiological and 6 operative factors to
obtain P-POSSUM scores and statistical analysis was done to compare the actual and predicted mortality. Result: The predicted mortality score
was statistically signicant in predicting the death (p- 0.0004). Among all the risk factors studied, 12 physiological and the 5 operative parameters
had a signicant contribution towards predicting the post operative mortality. A threshold score beyond which the mortality can be predicted was
also obtained by plotting the ROC curve. Conclusion: This study validates P-POSSUM scoring system accurately in predicting mortality in
patients who underwent major surgical procedures in our setup and helped in identifying the factors responsible for the poor outcome.
CONVALESCENT PLASMA: ITS EFFECTIVENESS IN TREATING MODERATE AND SEVERE CASES OF COVID 19 IN A TERTIARY CARE CENTRE IN UTTARAKHAND
Authors: Batra Neha , Umar Sana , Uniyal Nidhi , Kumar Arvind , Hatwal Deepa , Ojha Sushil , Petwal Snigdha
Published: November 2022

Introduction: Convalescent plasma, is the component of blood which contains antibodies and is obtained from people that have recovered from
COVID- 19.These antibodies have antiviral properties and may be useful inCOVID 19 patientsIn ourstudy we intend to study the benets of plasma
by observing various clinical parameters on patients before and after therapy. If a signicant improvement is seen we can suggest its use in the
treatment of COVID-19. Since the current pandemic has taken a toll on millions of lives so far, it is important that we come up with newer treatment
methods and also study the importance and relevance of already suggested treatment modalities to improve patient care. Aim : To study the
effectiveness ofCOVID- 19 convalescent plasma in the treatment ofCOVID-19 by comparing 28 daymortality and variouslab parameters and clinical
improvement of patients that received plasma therapy vs those that did not. Material Method: This is a clinical case control study from September
2020 to May 2021 conducted in Blood Bank, Government Doon Medical College and Hospital, Dehradun. 100 patients suffering with moderate and
severeCOVID 19 disease were taken in the study who were transfused with convalescent plasma and 100 control patients were taken who were only
given bestsupportive treatment.Various clinical and serological parameterswere studied in the two groups to see its effectiveness on the patientsstatus.
Serological parameters included in the study are C- reactive protein, IL-6 and serum Ferritin. Results: On performing chi square test, no signicant
difference between plasma and control groupsin the clinical outcome after 28 days both formoderate cases(P=0.261) and severe cases(P=0.191) was
found. The overall difference in mortality in the two groups was also not statistically signicant (p=0.415). The mean biochemical lab parameters
showed an overall downward trend in both the groups but difference in the improvement was notstatistically signicant except in case of interleukin 6
that improved signicantly in patients that received plasma therapy (p=0.01) Summary: Convalescent Plasma therapy did not show any additional
benetinclinicaloutcome,reductionin28daymortality andlabparameterss exceptforIL-6.
STUDY OF FETO-MATERNAL OUTCOME IN PREGNANT WOMEN WITH BLEEDING PER VAGINUM IN FIRST TRIMESTER OF PREGNANCY.
Authors: Mehta Heeta , Patel Rakesh , Sheth Margi , Shah Margi
Published: November 2022

Background: Objective of the study was to study the feto-maternal outcome in patients with bleeding per vaginum in rst trimester of pregnancy.
Methods: This prospective observational study was carried out on 110 women attending with history of rst trimester vaginal bleeding at a tertiary
health centre Gandhinagar from June 2018 to May 2019 for a period of twelve months. Patients with history of amenorrhea and positive urine
pregnancy test with bleeding per vaginum in rst trimester were included. Those Results: patients with bleeding per vaginum in rst trimester and
whose pregnancy continued beyond 20 weeks of gestation, had increased rate of maternal and fetal morbidities. First trimester Conclusions:
bleeding is signicantly associated with adverse maternal and neonatal outcomes.
BILATERAL CHRONIC SUBDURAL HEMATOMA – CLINICAL PRESENTATION, RISK FACTORS, MANAGEMENT AND OUTCOME: A SINGLE CENTRE EXPERIENCE FROM NORTH-EASTERN INDIA
Authors: Bhuyan Mrinal , Pratim Boruah Manash
Published: November 2022

Study design: Background: Retrospective hospital-based study. Annual incidence of bilateral Chronic Subdural Hematoma (CSDH) is
increasing due to an increase in the aging population, associated medical comorbidities such as hemodialysis, anticoagulant and/or antiplatelet
therapy. 1. To study the clinical spectrum of Bilateral Chronic Subdural Hematoma Objectives: patients. 2. To study the treatment modalities used
and outcome of the patients. A retrospective hospital-based study was carried Method: out on 50 conrmed patients of bilateral CSDH.
Information of patients such as socio-demographic prole, clinical presentation, and laboratory investigations, along with treatment and outcome
were recorded and analyzed. Among 50 patients, male and female were 80% and 20% res Results: pectively. The mean age of patients was 62.08
years. A history of head injury was reported by 40% of patients. The mean Glasgow coma scale (GCS) was 12.24. Common presenting symptoms
were headache (76%), hemiparesis (40%), aphasia (28%), complete loss of consciousness (20%). Clinical improvement was observed in 80%
while 10% had no change, 04% showed clinical deterioration and 06% of patients died during treatment. Bilateral CSDH is common Conclusion:
in the elderly and prognosis is poor with increasing age. Bilateral hematoma has a higher risk of acute deterioration of clinical symptoms because of
downward herniation, resulting in a poor clinical outcome. Timely interventions can improve the outcome in bilateral CSDH patients.
Dynamics and Existence of Angkong in East Sumatra
Authors: Rudiansyah Rudiansyah
Published: November 2022

This paper reviewed the 'Dynamics and Existence of Angkong in East Sumatra'. Angkong is one of the public transportation used during the Dutch East Indies period in East Sumatra. This transportation is also known as the Hong Kong rickshaw. Humans formerly pulled it by running. These human-drawn angkong were generally brought indirectly by the Chinese who worked on the plantations. As Viktor Purcell wrote, most Chinese worked in the logging industry and as angkong porters. Before this, other forms of transportation were used, such as horse-drawn carriages, ox-carts, or buffalo carts. These kinds of transportation were used for special needs, such as in forest areas, and as a means to enter plantation areas that gardeners used at that time. This research intended to explain the dynamics and existence of rickshaw transportation in East Sumatra using the desk research method on research reports, various sources of books, journals, and related articles. This research also utilized the historical explanation theory from Kuntowijoyo. The distribution of angkong in East Sumatra did not immediately become public transportation but started from private ownership. It started with the gardeners seeing and supervising the plantations they manage.