bluuebunny/crossref_metadata_2025 huggingface dataset:
Hubungan Kegiatan Ekstrakurikuler dengan Psychological Well-Being Mahasiswa Program Studi Pendidikan Dokter Fakultas Kedokteran Universitas Sam Ratulangi
Authors: Gunawan Felicia A. , Opod Hendri , David Lydia E. V.
Published: February 2024

Abstract: Pre-Clinical Students tend to experience a decline in quality of life and well-being due to different responsibilities in curriculum, tasks, and demands during their studies. Extracurricular activities involve aspects of perseverance, empathy, and mindfulness, where these elements can prevent, and even enhance, an individual's psychological well-being (PWB). This study aimed to evaluate the correlation between extracurricular activities and PWB in pre-clinical medical students of Universitas Sam Ratulangi, Manado. This was a quantitative approach study employing data collection through the administration of the PWB scale (PWBS) questionnaire with 84 items developed by Ryff. The results obtained a total of 155 respondents participated in this study. The analysis did not reveal any correlation between participation in extracurricular activities and the dimensions of PWB. Albeit, a correlation was identified between the duration of involvement in extracurricular activities and specific dimensions of PWB (p<0.05). In conclusion, there is no correlation between extracurricular activities and PWB. However, there is a correlation between the duration aspect of involvement in extracurricular activities and PWB dimensions, especially the dimensions of positive relations with others and personal growth.
Keywords: extracurricular activities; psychological well-being; duration aspect
 
Abstrak: Mahasiswa Program Studi Pendidikan Dokter cenderung mengalami penurunan kualitas hidup dan kesejahteraan karena adanya perbedaan dari segi kurikulum, tugas, dan tuntutan dalam menjalani studi. Kegiatan ekstrakurikuler merupakan suatu kegiatan yang melibatkan aspek ketekunan, empati, dan mindfulness, di mana aspek-aspek ini dapat mencegah penurunan, bahkan meningkatkan psychological well-being (PWB) seseorang. Penelitian ini bertujuan untuk mengevaluasi korelasi antara kegiatan ekstrakurikular dengan PWB pada mahasiswa pre-klinik Universitas Sam Ratulangi, Manado. Jenis penelitian ialah kuantitatif dengan metode pengambilan data menggunakan kueisioner PWB scale (PWBS) 84–items oleh Ryff. Hasil penelitian mendapatkan 155 responden yang terlibat dalam penelitian ini yang mengikuti kegiatan ekstrakurikuler. Tidak ditemukan adanya korelasi antara kegiatan ekstrakurikuler dengan dimensi PWB, tetapi terdapat korelasi antara aspek durasi keterlibatan ekstrakurikuler dengan dimensi-dimensi PWB tertentu (p<0,05). Simpulan penelitian ini ialah tidak terdapat hubungan antara ekstrakurikuler dengan PWB, tetapi terdapat hubungan antara aspek durasi keterlibatan ekstrakurikuler dengan dimensi PWB, terkhususnya dimensi positive relations with others dan personal growth.  
Kata kunci: aktivitas ekstrakurikuler; psychological well-being; aspek durasi
Peningkatan Pengetahuan Masyarakat Tentang Pemeriksaan Gula (Glukosa) Darah Mandiri Melalui Program Kemitraan Masyarakat
Authors: Kaligis Stefana Helena Margaretha , Purwanto Diana Shintawati , Tiho Murniati
Published: February 2024

Saat ini prevalensi dan insiden penyakit Diabetes Melitus (DM) terus meningkat sehingga masih menjadi masalah kesehatan di seluruh dunia. Salah satu cara menegakkan diagnosis DM adalah dengan pemeriksaan kadar gula (glukosa) darah. Pemeriksaan ini selain dapat dilakukan di fasilitas kesehatan, juga dapat dilakukan secara mandiri oleh individu yang memerlukan. Pengetahuan dan ketrampilan tentang bagaimana melakukan pemeriksaan gula (glukosa) darah secara mandiri penting diketahui oleh masyarakat untuk deteksi dini penyakit maupun untuk mencegah terjadinya komplikasi pada individu penderita DM. Program Kemitraan Masyarakat (PKM) yang dilakukan pada Wanita Kaum Ibu kolom 17 Jemaat GMIM Eben Haezar Watutumou bertujuan untuk meningkatkan pengetahuan tentang pemeriksaan gula (glukosa) darah mandiri melalui kegiatan penyuluhan, diskusi, dan demonstrasi. Kegiatan ini dihadiri oleh 35 orang dan dilakukan pengambilan data sebelum dan sesudah penyuluhan lewat kuisioner untuk mengukur tingkat pengetahuan peserta. Hasil analisis menunjukkan sebelum mengikuti penyuluhan sebesar 69.52% peserta tahu tentang pemeriksaan gula (glukosa) darah maupun pemeriksaan gula (glukosa) darah secara mandiri. Setelah mengikuti penyuluhan semua peserta (100%) tahu tentang pemeriksaan gula (glukosa) darah maupun pemeriksaan gula (glukosa) darah secara mandiri. Dapat disimpulkan terjadi peningkatan pengetahuan peserta tentang pemeriksaan gula (glukosa) darah secara umum dan secara khusus pemeriksaan gula (glukosa) darah mandiri setelah mengikuti kegiatan PKM.
Projeto mecânico de um equipamento portátil para ensaio de fadiga por flexão rotativa
Authors: Maciel Ziehlsdorff Jonathan , Cardoso Castaldo Eduardo , Moura Cassiano Rodrigues
Published: February 2024

O estudo da fadiga é realizado de forma teórica e pratica através de ensaios em equipamentos específicos. Estes equipamentos não são encontrados facilmente disponíveis no mercado, o que gera um alto custo de aquisição. Diante disso este trabalho tem como objetivo o desenvolvimento do projeto mecânico de um equipamento didático para ensaio de fadiga por flexão em barras simétricas rotativas. A metodologia aplicada neste trabalho caracteriza-se por meio de pesquisa tecnológica, que busca a geração de novos produtos. A fase de desenvolvimento inicia-se com o Projeto Informacional onde é realizada uma pesquisa sobre o mercado e os clientes potenciais para o equipamento, nesta fase as informações são estruturadas com auxílio da matriz QFD. Na sequência é desenvolvido o Projeto Conceitual onde a visão do mercado é transformada em um conceito tecnologicamente atrativo. Por fim é realizado o projeto Detalhado onde são realizados os cálculos referentes às questões técnicas de funcionamento do equipamento, bem como são apresentados os resultados do produto e suas principais características e componentes. Dentre os principais resultados são apresentados o layout do equipamento para a opção de projeto selecionada e o detalhamento técnico, envolvendo cálculos relacionados as variáveis mecânicas e a lista de componentes do produto.
Desempenho de revestimentos de Politetrafluoroetileno e Dissulfeto de Molibdênio em brocas para furação de madeira
Authors: Barro Clederson , Luis Gasparin Alexandre
Published: February 2024

Este estudo mostra a performance dos revestimentos superficiais politetrafluoroetileno (PTFE) e dissulfeto de molibdênio (MoS2) aplicado em brocas para a furação de madeira. A caracterização química dos revestimentos foi feita por espectroscopia de infravermelho por transformada de Fourier (FTIR). A avaliação da vida útil da ferramenta, através de testes de bancada, mediu o torque e potência na furação. A dureza dos corpos de prova de madeira foi verificada na escala Shore D, os filmes e substrato na escala Vickers. Metalografia determinou a microestrutura da broca e espessura de camada dos filmes. As análises foram realizadas de forma comparativa entre as amostras com PTFE, MoS2 e sem revestimento (padrão). As brocas com PTFE em relação as padrão obtiveram reduções do torque de furação de até 35 %, reduzindo-se o gasto de potência elétrica. Já as amostras de MoS2 obtiveram um aumento do torque de furação de até 28 % e consumo de energia de 18 % superior a padrão, desplacando-se totalmente nas arestas de corte. O torque nas amostras com PTFE foi de até 49 % menor comparadas a MoS2. Houve revenimento nas microestruturas de todos os substratos. Os resultados viabilizam as brocas com filmes de PTFE em detrimento ao MoS2.
Curso Técnico em Biotecnologia Instituto Federal de Educação Ciência e Tecnologia – Campus Porto Alegre – 20 anos de história
Authors: Tallini Karin , Liliane Madruga Prestes  , Paulo Artur Konzen Xavier de Mello Silva
Published: February 2024

Este trabalho apresenta uma breve reflexão acerca dos 20 anos do Curso Técnico em Biotecnologia do IFRS - Campus Porto Alegre. O curso teve o início de suas atividades em 1996 na Escola Técnica de Comércio da Universidade Federal do Rio Grande do Sul e hoje faz parte do  Instituto Federal de Educação, Ciência e Tecnologia do Rio Grande do Sul (IFRS) – Campus Porto Alegre. O trabalho relata sua origem, contextualizando o estudo: da Escola de Artes e Ofícios à oferta do Curso Técnico de Biotecnologia no IFRS - Campus Porto Alegre, assim como a sua organização curricular ao longo do período. Além disso, este artigo menciona as reflexões acerca dos pressupostos teóricos e metodológicos e das práticas educativas voltadas à formação do indivíduo como técnico em Biotecnologia, além das atividades de ensino, pesquisa e extensão e desafios na carreira na atualidade.
Ensino superior público no Brasil: o percurso histórico e o papel da assistência estudantil no acesso e permanência dos estudantes
Authors: De Jesus Moraes Nidia , Bortolanza Spessatto Marizete
Published: February 2024

Este artigo discorre acerca do acesso ao ensino superior público no Brasil e sobre o Plano Nacional de Assistência Estudantil – PNAES. Propõe problematizar as ações dos governos nacionais iniciadas no ano de 2007, que levaram à expansão da oferta e avanços no acesso por estudantes oriundos de famílias de baixa renda. Aborda os desafios para a permanência destes, tendo como base as pesquisas sobre o perfil socioeconômico do estudante do ensino superior público, realizadas pelo FONAPRACE/ANDIFES em 2010, 2014 e 2018. Analisa também os impedimentos para a efetivação da assistência estudantil como política pública universal a partir da análise do seu financiamento entre os anos de 2010 e 2018 pelo Governo Federal. Trata-se de uma pesquisa bibliográfica e documental, com a análise de dados quantitativos e qualitativos que direcionam para um acesso ao ensino superior público elitizado que começou a ser democratizado a partir das políticas de expansão do ensino superior e após a adesão ao sistema de cotas nas universidades. A análise permite concluir que, embora a assistência estudantil tenha obtido avanços nos últimos anos, na atual conjuntura, tem sua efetividade comprometida pela insuficiência de recursos financeiros que afeta o atendimento dos estudantes público-alvo dessa política.
Juventudes e mundo do trabalho: considerações acerca dessa relação
Authors: Emerim Marcos , De Aparecido Vieira Josimar , Dias Mathies Marcos
Published: February 2024

Este estudo, recorte de pesquisa desenvolvida em um mestrado em educação profissional e tecnológica, estrutura-se com o tema de “juventudes e mundo do trabalho” e possui como problema de pesquisa: como ocorre o processo de constituição do sujeito jovem na sociedade contemporânea e que perspectivas/possibilidades existem para a sua formação e desenvolvimento profissional crítico no mundo do trabalho atual? Busca-se compreender os principais fatores que influenciam na constituição do sujeito jovem na sociedade contemporânea e as perspectivas/possibilidades que as juventudes atuais encontram para a sua formação e desenvolvimento profissional. Trata-se de um estudo do tipo descritivo, com dimensão exploratória que foi desenvolvida seguindo abordagem assentada numa perspectiva qualitativa e dialética. Contou com pesquisa bibliográfica realizada em obras já publicadas: livros, artigos e material disponibilizado na Internet de autores como Abramo, Leon e Freitas (2005), Antunes (2018), Dayrell (2003), Frigotto (1985), Gramsci (1977), Marx e Engels (1979), Ramos (2017), entre outros. Dentre os resultados, destaca-se a percepção de que as juventudes contemporâneas são múltiplas e diversas; bem como a compreensão de que o mundo do trabalho atual passa por importantes processos de transformação e apresenta-se de forma precária, incerta e instável, oferecendo desafios para a formação e o desenvolvimento profissional dos sujeitos jovens. Cenário esse diante do qual faz-se importante refletir, debater e propor alternativas como a perspectiva da Educação Politécnica e as possibilidades existentes da Educação Profissional e Tecnológica e Ensino Médio Integrado à Educação Profissional.
[Re]construção da docência: análise das competências do professor na contemporaneidade
Authors: Scherer Leonardo
Published: February 2024

O termo “competência” vem cada vez mais sendo empregado na área da educação. A partir desse fato surgiu a provocação de realizar um estudo com a finalidade de contribuir para as reflexões de mobilização de competências para a formação de professores na contemporaneidade. O presente trabalho tem como objetivo analisar as competências para a atuação do professor na contemporaneidade e quais os papeis que o coordenador pedagógico assume frente a reconstrução dessas competências, relacionando-as com a prática de docentes no município de Alto Feliz (RS). Procura-se identificar quais as competências necessárias para a atividade docente a fim de aprimorar a formação desse profissional no cenário educacional atual. A metodologia empregada foi qualitativa, com enfoque exploratório, utilizando-se o questionário como instrumento de coleta de dados. Os resultados, analisados sob a ótica da análise de conteúdo, apontaram algumas similaridades com as concepções de competências e habilidades dos autores pesquisados, sobretudo com Perrenoud (2000) e Morin (2000) e com as ideias acerca de contemporaneidade propostas por Bauman (2013). Observou-se que as competências abordadas nos cursos de Pedagogia e Licenciaturas, nas formações continuadas e na prática diária refletem nas atividades docentes tanto das professoras quanto da coordenadora pedagógica pesquisadas.
Estudo da concepção de um cicloergômetro para reabilitação de pacientes críticos
Authors: Moura Cassiano Rodrigues , Moura Nathália Moreira Nanni
Published: February 2024

Uma das preocupações do PDP – Processo de Desenvolvimento de Produtos está ligado as questões relacionadas a ergonomia. Está se preocupa fortemente com a reabilitação de pacientes, inclusive os que são internados em leitos hospitalares, onde um dos principais problemas relatados é a fraqueza muscular. A exposição desses pacientes os coloca frequentemente por um processo de imobilização prolongada, o que pode gerar danos, devido ao repouso excessivo. Diante disso este trabalho utiliza a metodologia do PDP alinhada as ferramentas de DfErg - Projeto para Ergonomia para a elaboração da concepção de um cicloergômetro para reabilitação de pacientes críticos em leito hospitalar. O procedimento metodológico seguiu uma sequência lógica de atividades, entre eles: avaliação do problema, revisão bibliográfica, desenvolvimento do projeto e avaliação dos resultados. O trabalho foi realizado em parceria com o LADEP – Laboratório de Desenvolvimento de Produtos, na UDESC. A metodologia aplicada iniciou-se com o Projeto Informacional onde são levantadas as informações necessárias sobre as necessidades relacionadas com auxílio da matriz QFD – Desdobramento da Função Qualidade e de pesquisa de mercado. Posteriormente foi desenvolvido o Projeto Conceitual onde a visão do mercado foi transformada em um conceito tecnologicamente atrativo, nesta etapa foi realizada a modelagem funcional do processo, a pesquisa pelos princípios de solução e a seleção de uma alternativa de concepção. Por fim foi realizado o Projeto preliminar onde foi apresentado o croqui do produto e uma lista preliminar de materiais.
Quando o essencial é invisível aos olhos: a importância da experimentação em microbiologia no ensino médio integrado à formação profissional
Authors: Neugebauer Wille Caroline , Schwanke Cibele
Published: February 2024

Os conhecimentos de microbiologia são essenciais para compreensão da importância dos micro-organismos no nosso cotidiano, na saúde pública e no equilíbrio ecológico. Mas, apesar da importância desta área do conhecimento, seu aprendizado é complexo, principalmente devido à dificuldade de observar os organismos estudados, em virtude do seu tamanho microscópico. Entre as estratégias disponíveis para superar esse obstáculo, a experimentação é sugerida por diversos autores, para facilitar a compreensão e contextualização dos conteúdos de microbiologia no ensino médio. No entanto, considerando o contexto do Ensino Médio Integrado, onde, além de garantir o ensino-aprendizado da microbiologia como conteúdo específico, é necessário desenvolver a formação dos alunos de forma integrada, considerando uma filosofia, uma política e uma abordagem pedagógica própria desta modalidade. É importante verificar a utilização de ferramentas que promovam uma formação integral. Neste sentido, buscamos avaliar a contribuição da experimentação no ensino-aprendizado de microbiologia e na concretização dos princípios do ensino médio integrado; através de uma pesquisa bibliográfica. A pesquisa coletou trabalhos dos últimos 10 anos, observando que, além de desenvolver o ensino e aprendizado de microbiologia, a experimentação possui potencial para promover a interdisciplinaridade e a aplicação do trabalho como princípio educativo, podendo contribuir para formação integral.
As tecnologias cívicas na região do Vale do Caí como forma do exercício da participação cidadã digital na esfera pública
Authors: Hartmann Ferreira Vinicius , Gradischnig Eduardo Luiz , Paes Luciano Marcos , Petró Vanessa , Paes Bárbara Manoela
Published: February 2024

Neste artigo apresentam-se resultados de uma pesquisa realizada no ano de 2020 que teve como foco investigar a disponibilidade de tecnologia digital para a participação cidadã através da internet em cerca de vinte (20) dos municípios que integram a região do Vale do Caí, interior do estado do Rio Grande do Sul. Para alcançar o objetivo proposto optou-se por uma abordagem quanti-qualitativa, realizada a partir de critérios levantados por meio da literatura pertinente e mapeamento exploratório dos sites do poder executivo - prefeituras - dos vinte municípios selecionados, e categorizados a partir das descrições das funcionalidades de cada tecnologia cívica disponibilizada aos cidadãos, ou seja, agruparam-se as tecnologias cívicas com características semelhantes, a fim de facilitar a análise e oportunizar uma nova interpretação dos dados. A partir do mapeamento dos sites da amostra de estudo, foi possível contabilizar cerca de 148 tecnologias cívicas identificando-se o predomínio de tecnologias de transparência. Com a pesquisa foi possível concluir que embora todas as cidades tenham infraestrutura digital que disponibiliza ao cidadão tecnologias cívicas através da internet, não foi possível identificar qualquer tecnologia cívica capaz de proporcionar uma participação digital cidadã mais direta na tomada de decisões da esfera pública.
The influence of competence, motivation, and work culture on employee performance through self-efficacy as an intervening variable for medical support employees Regional General Hospital Tanjungpinang City
Authors: Muliyanto Muliyanto , Indrayani Indrayani , Satriawan Bambang , Ngaliman Ngaliman , Catrayasa I Wayan
Published: February 2024

Purpose: This study investigates the impact of competence, motivation, and work culture on employee performance, with self-efficacy serving as the mediating variable. It hypothesizes that competence, motivation, and work culture influence self-efficacy, and in turn, self-efficacy affects performance.

Research methodology: The sample in this study were all Medical Support employees at the Tanjungpinang City Regional General Hospital. The number of samples used was 105 respondents. The data obtained was analyzed using data analysis techniques with AMOS 24.0 software rocks.

Results: The findings reveal the significance of these relationships: Competence positively affects self-efficacy, as indicated by CR Value (5.045) and Probability (0.000 < 0.05). Similarly, motivation (CR Value 2.802, P-Value 0.002 < 0.05) and work culture (CR Value 4.267, P-Value 0.001 < 0.05) have a positive impact on self-efficacy. Competence (CR Value 3.066, P-Value 0.002 < 0.05) and work culture (CR Value 2.075, P-Value 0.039 < 0.05) significantly influence performance through self-efficacy. However, motivation does not have a direct significant effect on performance (CR Value 1.157, Probability 0.248 > 0.05).

Limitations: The research focuses on 105 Medical Support employees at the Tanjungpinang City Regional General Hospital, employing AMOS 24.0 for data analysis.

Contribution: This study underscores the importance of competence, motivation, and work culture in enhancing employee performance via the mediating role of self-efficacy.
The influence of product quality, prices, and promotions on buyer decisions in the Small and Medium industry handicrafts of Tanjungpinang City
Authors: Zairina Syarifah , Wibisono Cablullah , Ngaliman Ngaliman , Indrayani Indrayani , Satriawan Bambang , Satriawan Bambang
Published: February 2024

Purpose: The purpose of this research is to Analyse the impact of promotions, pricing, and product quality on consumer choices in Tanjungpinang City's small and medium-sized handicraft industry. The goal of the study is to comprehend how these variables influence consumers' decision-making processes and, in turn, influence the purchases that they make.

Research methodology: The study used a mixed methods research approach with structural equation modeling and partial least squares data analysis.

Results: Results show that product variables have a significant influence on purchase decisions, price variables have a very significant influence, and variable promotion has no significant influence.

Limitations: Acknowledging the evolving nature of legal landscapes, this study recognizes the temporal constraints that may impact the generalizability of its findings. Additionally, variations in legal interpretations across regions may influence the outcomes.

Contribution: This research contributes a nuanced exploration of the legal dimensions surrounding spousal consent in land transfers from jointly owned property, specifically within the context of unregistered marriages. The insights provided serve as a foundation for legal practitioners, policymakers, and scholars grappling with similar issues.

Implementation: The quality of service also has a major impact on buying decisions, and the quality of the product, which is mediated by the quality of the service, has a major impact on purchasing decisions. The quality of service also acts as a mediator in the price of a product; however, promotion is not greatly affected by service quality.
Survival of a cohort of COVID-19 patients on mechanical ventilation in the ICU of a Level III hospital in Bogotá, Colombia
Authors: Ortiz Guillermo , Garay Manuel , Lara Antonio , Llinas Elena , Betancur John , Mahecha Jorge , Gomez Diana , Celemín Carlos , Maiguel Jorge , Murillo Mayra
Published: February 2024

Background & Objective: The COVID-19 mortality varies from country to country. The pandemic has enriched our knowledge about the pathogenesis of the viral diseases in the human race. We aimed to establish survival curves based on a population of patients with confirmed diagnosis of COVID-19 who received mechanical ventilation in ICU of our level-III hospital.

Methodology: It is an observational study with a prospective cohort. All patients with a positive RT-PCR test for SARS-CoV-2 after the nasopharyngeal swab and who needed mechanical ventilation were identified. Kaplan–Meier survival estimates were calculated until the follow-up date of September 26, 2020.

Results: We included 62 patients in the study. The bivariate analysis found that congestive heart failure, kidney injury, dysnatremia, acid-base disorders, delta CO2, and lactate levels were associated with higher mortality. When performing backward-type Cox regression, it was observed that the CO2 delta [Hazard Ratio (HR) = 14.78, 95% CI: 2.1-100.5, P = 0.00] and lactate levels (HR = 6.15, 95% CI: 1.1-34.2, P = 0.038), were associated with an increase in mortality, for the admission variables. And only dysnatremia (HR = 5.28, 95% CI: 1.8-15.3, P = 0.00) and acid-base disorders (HR = 12.04: 95% CI: 4.1-35.3, P = 0.00) for the follow-up variables.

Conclusions: Among the factors associated with increased mortality in COVID-19 patients on mechanical ventilation in the first 24 h, parameters related to tissue hypoperfusion were identified. For the variables associated with mortality at 14 days, dysnatremia and acid-base disorders were identified.

Abbreviations: ng - Nanogram; FiO2 - Inspired Oxygen Fraction, PEEP - Positive End-Expiratory Pressure; PAFI - Index of PaO2/FiO2; Delta CO2 - Venous-to-Arterial Carbon Dioxide Difference; SIC - Sepsis-Induced Coagulopathy; SOFA - Sequential Organ Failure Assessment; NEW2 - National Early Warning Score 2

Key words: COVID-19; Critical Care; Mortality; Pulmonary Ventilation; Respiratory Distress Syndrome, Adult

Citation: Ortiz G, Garay M, Lara A, Llinas E, Betancur J, Mahecha J, Gomez D, Celemín C, Maiguel J, Murillo M. Survival of a cohort of COVID-19 patients on mechanical ventilation in the ICU of a Level III hospital in Bogotá, Colombia. Anaesth. pain intensive care 2023;27(5):458−463; DOI: 10.35975/apic.v27i5.2295

Received: September 28, 2022; Reviewed: June 12, 2023; Accepted: June 12, 2023
Epidural anesthesia in a patient with placenta accreta for intra-aortic ballooning and cesarean section
Authors: Supraptomo RTH
Published: February 2024

Postpartum hemorrhage (PPH) is one of the main causes of maternal death besides cardiovascular disease. Among the causes of PPH is placenta accreta. Hysterectomy is usually performed in placenta accreta to save the mother's life. However, hysterectomy has a direct impact on fertility so that a new strategy was developed, namely the use of prophylaxis Intra-abdominal Aortic Balloon Occlusion (IABO). Anesthetic management plays an important role in ensuring the safety of placenta accreta patients.
We present a case of a 34-year-old woman G3P1A1 38+3 weeks with a history of antepartum hemorrhage, complete placenta previa with moderate risk morbidly adherent placenta (MAP), oblique breech position, oligohydramnios, intrauterine growth restriction (IUGR), and previous cesarean section (CS) 4 y ago. She was ASA-II and planned cystoscopy and ureteral catheter insertion by a urologist. The aortic ballooning angioplasty was done through inguinal area by a cardiothoracic surgeon. Followed by CS for 120 minutes, and duration of arterial blockade that can be maintained for 20 min during CS. The operation was performed using epidural anesthesia. Induction with an initial epidural dose was carried out using levobupivacaine 0.5% 15 ml in 5 ml increments every 5 min.
Placenta accreta can cause massive bleeding, disseminated intravascular coagulation (DIC), and damage to the liver and kidneys. Massive bleeding caused by placenta accreta significantly increases maternal morbidity and mortality. The latest technology called Intra-abdominal Aortic Balloon Occlusion (IABO) is an option to reduce bleeding and the need for transfusions during and after surgery. Epidural anesthesia is considered a favorable anesthetic option for these patients, as it can also be used as a good postoperative analgesia.
Key words: Placenta Accreta; Intra-abdominal Aortic Balloon Occlusion; Epidural anesthesia
Citation: Supraptomo RTH. Epidural anesthesia in a patient with placenta accreta for intra-aortic ballooning and cesarean section. Anaesth. pain intensive care 2023;27(6):768−771; DOI: 10.35975/apic.v27i6.2144
Received: January 27, 2023; Revised: March 05, 2023; Accepted: October 26, 2023
Potential role of S100A8/A9 and RNA-binding protein in microvascular complications of type2 diabetes mellitus
Authors: Sarhan Ashwaq , Almzaiel Anwar Jasib , Majeed Alrufaie Mohauman Mohammed
Published: February 2024

Background & objective: Persistent hyperglycemia is the driving force for the progression of diabetic vascular complications and inflammatory response. S100A8 and S100A9 are small calcium-binding proteins involved in various cellular processes, including inflammation and immune responses. Tristetraprolin (TTP), alternatively known as zinc finger protein 36, acts as an RNA-binding molecule that has an important role in regulating the expression of messenger RNAs containing AU-rich elements. We aimed to address the involvement of inflammatory mediators like S100A8/A9 proteins and, RNA-binding proteins, in microvascular complications of type 2 diabetes mellitus (T2DM).
Methodology: The study was conducted from October 2022 to April 2023. We enrolled 200 subjects in this study involved in five equal groups: T2DM, diabetic nephropathy (DN), diabetic retinopathy (DR), diabetic neuropathy (DNR) and 40 normal healthy subjects as control group. CBC analysis was performed directly using the hematology analyzer CBC (Sysmex, Japan) technique. Serum S100 A8/A9 were measured by ELISA, and TTP gene expression was measured by RT-qPCR.
Results: The study's findings revealed a notable increase in neutrophil/lymphocytes ratio (NLR) and S100A8/A9 levels in patients groups compared to the healthy group (P < 0.05), while decreased TTP mRNA expression was observed in all patient groups compared to control (P < 0.05)
Conclusion: An increase in S1008A/9A levels with down regulation of anti-inflammatory binding protein (TTP) in patients suffering from type 2 diabetes mellitus with diabetic nephropathy, diabetic retinopathy, or diabetic neuropathy, suggests to be the therapeutic targets to regulate inflammatory response in type 2 diabetes mellitus and its complications.
Abbreviations: T2DM - Type 2 Diabetes Mellitus; DN - Diabetic Nephropathy; DR - Diabetic Retinopathy; DNR - Diabetic Neuropathy; NLR- Neutrophil/Lymphocyte Ratio; TTP - Tristetraprolin
Key words: Diabetes Mellitus; Inflammation; S100A8/A9; Inflammation; RNA-binding protein; T2DM; Neutrophil/Lymphocyte Ratio
Citation: Sarhan A, Almzaiel AJ, Majeed Alrufaie MM. Potential role of S100A8/A9 and RNA-binding protein in microvascular complications of type2 diabetes mellitus. Anaesth. pain intensive care 2023;27(6):673−680.
DOI: 10.35975/apic.v27i6.2338
Received: August 15, 2023; Reviewed: September 03, 2023; Accepted: September 15, 2023
Effect of oral clonidine premedication on PR interval in patients undergoing rhinoplasty and functional endoscopic sinus surgery (FESS)
Authors: Saeed Riffat , Salman Qazi Zia Us , Ali Shah Syed Mehmood , Bukhari Sadaf , Kanwal Romana , Kakepotto Irfan Ali
Published: February 2024

Background & Objective: Clonidine, an alpha-2-agonist, plays a pivotal role in mitigating the sympathetic response during general anesthesia, thereby enhancing intraoperative hemodynamic stability. Despite its recognized benefits, reports of adverse cardiopulmonary effects have surfaced. This study investigates the impact of oral clonidine administered as premedication on patients undergoing rhinoplasty or Functional Endoscopic Sinus Surgery (FESS), with a focus on assessing alterations in the PR interval observed in postoperative electrocardiograms (ECG).
Methodology: A Randomized Clinical Trial (RCT) comprised fifty patients scheduled for rhinoplasty or FESS under general anesthesia. Each participant underwent a standard 12-lead ECG, followed by the administration of 300 µg oral clonidine 30 min prior to entering the operating room. Anesthesia induction adhered to a uniform protocol for all subjects. Comprehensive ECG monitoring throughout the surgical procedure and recovery period facilitated the recording of any observed changes. Six hours post-clonidine administration, a second standard 12-lead ECG was obtained and juxtaposed with the initial recording.
Results: Analysis revealed a lengthening of the PR interval in 23 (46%) of the cases. Within this cohort, 21 instances exhibited a prolongation falling within the normal range (0.12-0.2 sec), while the remaining two cases displayed abnormal prolongation (> 0.2 sec) (P < 0.001).
Conclusion: This investigation suggests that premedication with oral clonidine, in the patients undergoing rhinoplasty or functional endoscopic sinus surgery, has the potential to extend the PR interval.
Key words: Clonidine; PR interval; Rhinoplasty; Functional Endoscopic Sinus Surgery
Citation: Saeed R, Qazi ZUS, Shah SMA, Bukhari S, Kanwal R, Kakepotto IA. Effect of oral clonidine premedication on PR interval in patients undergoing rhinoplasty and functional endoscopic sinus surgery (FESS). Anaesth. pain intensive care 2023;27(6):731−736; DOI: 10.35975/apic.v27i6.2343
Received: August 24, 2023; Revised: November 03, 2023; Accepted: November 22, 2023
Nebulized dexmedetomidine for preventing postoperative sore throat after tracheal intubation: a randomized, double‐blind clinical trial
Authors: Pradian Erwin , Kestriani SS Nurita Dian , Ritonga Diva Zuniar
Published: February 2024

Background and Objective: Endotracheal intubation is part of general anesthesia, and probably the most commonly performed airway related procedure in operating rooms as well as intensive care units. It may be a causative factor in about 74% of patients who experience postoperative sore throat (POST) due to airway mucosal injury. This double-blind randomized clinical trial assessed the effectiveness of nebulized dexmedetomidine in preventing POST by comparing with a control group.
Methodology: In this randomized, double‐blind clinical trial, we enrolled 56 patients, who were to undergo general anesthesia with endotracheal intubation. Patients were randomly divided into two groups of 28 each. Group A received dexmedetomidine nebulization, and Group B had normal saline nebulization, both for 15 min before induction. POST was assessed at 1, 2, 4, 6, 12, and 24 h after extubation using a POST scale. Data were collected and statistically analyzed
Results: The overall incidence of POST was 60.3%: Control group experienced POST by 28 (96.6%) patients, compared to 7 (24,1%) patients in dexmedetomidine group (P = 0.0001). Differences were significant at recording times post-operatively. The dexmedetomidine group had milder sore throats, less coughing, and lower heart rates/blood pressures compared to the control group.
Conclusion: Patients who were nebulized with dexmedetomidine, experienced lower rates and intensity of postoperative sore throat compared to the control group. Administering dexmedetomidine via nebulization before intubation can be considered a safe and effective method for reducing postoperative sore throat, with less postintubation hemodynamic derangement.
Abbreviations: ETT: Endotracheal Tube; GA: General Anesthesia; IL: Interleukin; MAC: Minimum Alveolar Concentration; N2O: Nitic Oxide; PACU: Post Anesthesia Care Unit; PONV- Postoperative Nausea and Vomiting; POST- Postoperative Sore Throat; TNF: Tumor Necrosis Factor
Key words: Dexmedetomidine; Endotracheal Intubation; Anaesthesia, General; Nebulization; Postoperative sore throat
Citation: Pradian E, Kestriani SS ND, Ritonga DZ. Nebulized dexmedetomidine for preventing postoperative sore throat after tracheal intubation: a randomized, double‐blind clinical trial. Anaesth. pain intensive care 2023;27(6):737−744. DOI: 10.35975/apic.v27i6.2348
Received: Aug 28, 2023; Revised: Oct 21, 2023; Accepted: Oct 21, 2023
Experience of permacath placement in patients with end stage renal failure in a tertiary hospital
Authors: Ali Liaquat , Ali Tehniat , Mustafa Syed Ihlal , Qureshi Ali Ahmed
Published: February 2024

Background & objective: Renal failure patients often need hemodialysis to optimize the deranged fluid and electrolyte balance in their blood. It involves drawing patients’ venous blood, route it through the hemodialysis (HD) machine and pump it back into the blood circulation. Frequent HD is conveniently performed through large bore, double lumen catheters and to prevent infection it is tunneled for a few centimeters. We conducted this retrograde study to determine the frequency of complications of tunneled permacath insertions in patients with end stage renal disease (ESRD) undergoing hemodialysis in our tertiary hospital
Methodology: This retrograde descriptive study was conducted at Department of Anesthesiology, Fauji Foundation Hospital, Rawalpindi. from 1st Jan, 2019 – 1st Jan 2023. We searched and included data from the patient records of 804 patients in whom permacath was inserted for hemodialysis under ultrasound guidance and follow-up was done for 8 weeks. Data was retrieved and stored on a Performa and was analyzed on SPSS version 16.
Results: Out of 812 permanent catheters passed in 804 patients, 19% had complications. The most common complication was catheter thrombosis (8%), followed by local site bleeding (5%), infection (3%), arterial prick (2%) and hematoma formation (1%).
Conclusion: Tunneled permacath central venous catheter can be used in patients undergoing hemodialysis until maturation of arteriovenous fistula. It is quite a safe procedure under ultrasound guidance, but strict vigilance is required to prevent short-term and long-term complications.
Key words: Central Venous Catheters; Renal Dialysis; Thrombosis; Hematoma; Kidney Failure, Chronic; Fluoroscopy; Ultrasonography.
Citation: Ali L, Ali T, Mustafa SI, Qureshi AA. Experience of permacath placement in patients with end stage renal failure in a tertiary hospital. Anaesth. pain intensive care 2022;27(2):726−730; DOI: 10.35975/apic.v27i2.2357
Received: June 24, 2023; Revised: September 26, 2023; Accepted: November 15, 2023
Oxytocin infusion is a safe uterine bleeding controller alternative to blood transfusion in patients undergoing abdominal myomectomy
Authors: Nasief Hisham , Hassan Amber , AlDardeir Nashwa , Khadawardi Khalid , Alwazzan Ahmad B. , Alothmani Haneen , Hammad Ziyad
Published: February 2024

Background & objective: Uterine bleeding is a notable complication that can occur after the surgical removal of uterine fibroids, and oxytocin infusion has been a commonly used method to control blood loss in such cases. The objective of this study was to evaluate the effectiveness of oxytocin infusion in managing surgical bleeding following abdominal myomectomy, as an alternative to immediate blood transfusion.
Methodology: The study population consisted of 120 patients who experienced acute blood loss following abdominal myomectomy. These patients were divided into two groups: Group A, which included 50 patients who received an oxytocin infusion, and Group B, which included 60 patients who received a placebo. All myomectomies were conducted according to department protocols, and various variables related to the study were recorded. Postoperative hemoglobin levels were checked in every patient.
Results: In Group A, the average blood loss was 470.02 ± 81.65 ml, while in Group B, it was 721.42 ml ± 63.55 ml (P < 0.0001). The need for urgent blood transfusion was significantly lower in Group A (3.3%) compared to Group B (20.0%), (P = 0.044). Postoperative hemoglobin levels also showed a significant difference between the two groups, with Group A demonstrating better results than Group B.
Conclusion: Oxytocin infusion can be safely used for managing blood loss in patients undergoing abdominal myomectomy. However, in cases where oxytocin is unable to effectively control the bleeding, blood transfusion may be needed as a means to compensate for the blood loss.
Key Words: Uterine leiomyomas; Myomectomy; Surgical blood loss; Oxytocin
Citation: Nasief H, Hassan A, AlDardeir N, Khadawardi K, Alwazzan AB, Alothmani H, Hammad Z. Oxytocin infusion is a safe uterine bleeding controller alternative to blood transfusion in patients undergoing abdominal myomectomy. Anaesth. pain intensive care 2024;28(1):05−09; DOI: 10.35975/apic.v28i1.2298
Received: October 05, 2023; Reviewed: October 17, 2023; Accepted: November 19, 2023
Study of some cytokines in patients with brucellosis in Najaf province
Authors: Abbas Khitam F. , Abdul-Hassan Layla Saleh , Hadi Oday Mitib , Almulla Abbas F. , Kathair Zahraa Yosif
Published: February 2024

Background: To evaluate the levels of pro-inflammatory cytokines for ‘Th1/Th2 brucellosis’ patients serum to determine ‘antimicrobial susceptibilities’ of Brucella strains.
Methodology: The study comprised 35 individuals with acute brucellosis, and 21 patients with chronic brucellosis, identified clinically. A group of 20 healthy adult persons was also enrolled in the study. For all of the participants, blood cultures and standard tube agglutination tests for Brucella were performed. ELISA was used to detect cytokine levels in serum samples collected following the treatment period and detect Brucella strains celebrated from different sites of infection, and in order to find-out the susceptibilities against antibiotics including rifampicin (RIF), streptomycin (STR), doxycycline (DOX), and ciprofloxacin (CIP) via the gradient strip (E test).
Results: The patients included 22 (39.29 percent) males and 34 (60.71 percent) females based on their gender and age. Fever was the most common clinical feature (92%), sweating came in second place (75%), followed by back pain with 18%. Patients with brucellosis had substantially higher blood levels of interleukin-6 (IL-6), interferon (IFN), and tumor necrosis factor-alpha (TNF-alpha) analogous to the control group (P = 0.05). IL-4 and IL-2 levels between the sick and control groups did not vary significantly. The amounts of these cytokines were found to be identical in acute and chronic individuals. Rendering to "minimum inhibitory concentrations (MIC) 90 levels," CIP was determined to be the most effective antibiotic. Then followed DOX and then STR, correspondingly. All of the samples were CIP and DOX susceptible; 18 (23.2%) strains were discovered to be only mildly sensitive to RIF, with MIC50 and MIC90 maximal values.
Conclusions: Our findings point to an important role for IFN and proinflammatory cytokines in brucellosis pathogenesis. However, these changes were shown to be unrelated to the severity or activity of the illness. Furthermore, all strains were identified as Brucella strains. ciprofloxacin, doxycycline, rifampicin and streptomycin were found to be effective for the treatment of brucellosis.
Key words: Antimicrobial Susceptibilities; Brucellosis; Cytokines; Interferon; Pro-Inflammatory Cytokines
Citation: Abbas KF, Abdul-Hassan LS, Hadi OM, Almulla AF, Kathair  ZY. Study of some cytokines in patients with brucellosis in Najaf province. Anaesth. pain intensive care 2024;28(1):39-43; DOI: 10.35975/apic.v28i1.2379
Received: September 15, 2023; Reviewed: November 03, 2023; Accepted: December 23, 2023
Rationality of antibiotic use in COVID-19 patients in the ICU of Dr. Hasan Sadikin General Hospital, Bandung; a cohort study
Authors: . Indriasari , Oktaliansah Ezra , Munazat Rikda Irham
Published: February 2024

Background and Objectives: Nearly three-quarters of the patients with COVID-19 received antibiotic therapy despite the bacterial coinfection being only less than 10% in many studies and ranging from 8-22% in ICU patients. The use of broad-spectrum antibiotics in COVID-19 patients has not been proven effective. Overuse of antibiotics may be associated with side effects and antibiotic resistance. The purpose of this study was to determine the antibiotic rationality in COVID-19 patients in the ICU of Dr. Hasan Sadikin Hospital, Bandung, Indonesia.
Methodology: This descriptive, retrospective cohort study was carried out by analyzing medical records of COVID-19 patients admitted in the ICU of Dr. Hasan Sadikin Hospital from January-June 2021.
Results: There were 138 patients who met the inclusion criteria. A total of 126 (91.3%) patients received antibiotics. A total of 12 (8.7%) severe/critical patients did not receive antibiotics and 79 (62.70%) received inappropriate antibiotic duration. Inappropriate regimen was found in 59 patients (74.68%) with COVID-19 without HAP/VAP and 15 patients (31.92%) with HAP/VAP. The primary issue identified was the inappropriate regimen of antibiotics, Gyssens category 4a.
Conclusion: This study concludes that 23.02% patients used rational empirical antibiotics and 45.98% used rational definitive antibiotics in COVID-19 patients in the ICU at RSUP Dr. Hasan Sadikin Bandung during January-June 2021.
Abbreviations: ACE- Angiotensin Converting Enzyme; ICU- Intensive Care Unit; HAI- Hospital-Associated Infections; HAP- Hospital-Acquired Pneumonia; IDSA- Infectious Diseases Society of America VAP- Ventilator-Associated Pneumonia
Key words: Antibiotics; Antimicrobial Resistance; COVID-19; Intensive Care Units; Prescribing Pattern
Citation: Indriasari, Oktaliansah E, Munazat RI. Rationality of antibiotic use in COVID-19 patients in the ICU of Dr. Hasan Sadikin General Hospital Bandung; a cohort study. Anaesth. pain intensive care 2024;28(1):115−125.
DOI: 10.35975/apic.v28i1.2384
Received: November 20, 2023; Reviewed: December 03, 2023; Accepted: December 26, 2023
The relationship between morphological electrocardiographic characteristics and survival in critical COVID-19 patients
Authors: SAYAN Mihrican , ALTINISIK Hatice Betul
Published: February 2024

Background: Myocardial damage is a sign of poor prognosis in coronavirus disease 2019 (COVID-19). Electrocardiography (ECG) would be useful to evaluate the effects of ECG findings on survival in severe COVID-19. We studied the relationship of pathological ECG findings in patients of COVID-19 admitted in ICU with other adverse physiological parameters as well as the mortality.
Methodology: The study population comprised critical COVID-19 patients in the intensive care unit (ICU). Patients with findings other than normal sinus rhythm, atrial extra beat, and ventricular extra beat were defined as patients with pathological ECG findings. Two groups were formed: patients with pathological ECG findings (n = 109) and patients without pathological ECG findings (n = 84). Data were compared and analysed between the groups.  The relationship among the risk factors, and ECG findings with mortality was investigated.
Results: The presence of hypertension (69% vs. 40%, OR 5.49, CI 1.71-17.66, P = 0.004), peripheral oxygen saturation (SpO2) (88 vs. 95, OR 0.8, CI 0.7-0.9, P < 0.001) were found to be related to mortality in multivariable analyses. Patients with pathological ECG finding were older [74 (27-98) vs. 61 (22-89); P < 0.001], and more likely to have hypertension (68% vs. 44%, P = 0.001). Pathological ECG findings (66% vs. 51%, P = 0.02), atrial fibrillation (AF) (37% vs. 20%, P = 0.01), right branch bundle block (RBBB) (10% vs. 3%, P = 0.048) were associated with higher mortality in univariable analyses.
Conclusion: Although abnormal findings on ECG, especially AF and RBBB, are associated with a poor prognosis, they are not primary effective in increasing the mortality of critical COVID-19 patients.
Abbreviations: AF- Atrial Fibrillation; CRP- C-reactive protein; ICU- intensive care unit; RBBB- Right Bundle-Branch Block; RT-PCR- reverse-transcription polymerase chain reaction; VTE- venous thromboembolism
Key words: Atrial Fibrillation; Biomarkers; COVID-19; ECG; Mortality; Right Bundle-Branch Block
Citation: Sayan M, Altinisik HB. The relationship between morphological electrocardiographic characteristics and survival in critical COVID-19 patients. Anaesth. pain intensive care 2024;28(1):139−150.
DOI: 10.35975/apic.v28i1.2385
Received: November 21, 2023; Reviewed: November 30, 2023; Accepted: December 21, 2023