bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of different doses of intrathecal dexmedetomidine used as adjuvant to hyperbaric prilocaine in short ambulatory procedures under spinal anesthesia: a randomized controlled study
Authors: Biekhet Eslam Gamal , Elazzazi Hesham , Hussein Wael , Zedan Mohamed , Abdelhamid Bassant Mohamed
Published: August 2024

Objective: This study aimed to determine the most effective dose of dexmedetomidine as an adjuvant to prilocaine in spinal anesthesia.
Methods: Sixty-nine adult patients (21 to 65 y) scheduled for elective surgeries under spinal anesthesia were included in the study. Patients received spinal anesthesia with 3 mL of prilocaine and 0.5 mL dexmedetomidine of dose according to randomization of 5,10 and15 µg (D5, D10 and D15 respectively). Time of the first request of analgesia was set as a primary outcome.
Results: Time of the first request of rescue opioid was significantly shorter in D5 group (8 ± 6 h) compared to D15group (21 ± 4 h) (P < 0.018). 24 h of postoperative Nalbuphine consumption was higher in D5 group (4.67 ± 0.59 mg) compared to D15 group (2.5 ± 0.71 mg) (P = 0.012). The onset of sensory and motor blocks was significantly earlier in group D15 and D10 compared to group D5. Group D15 showed a significantly prolonged duration of sensory and motor blockade than Groups D10 and D5. The duration of sensory and motor blockade was significantly prolonged in group D10 compared with group D5 (P < 0.001).
Conclusion: 10 and 15 μg dexmedetomidine as an adjuvant to prilocaine in spinal anesthesia shortened the onset of both sensory and motor block, prolonged the duration of sensory block, motor block, and the time to first analgesic.
Clinical trial registration: The study was registered on Pan African Clinical Trial Registry (www.pactr.org) (ID: PACTR202204558879194-April 2022).
Keywords: Intrathecal Dexmedetomidine; Hyperbaric prilocaine; Ambulatory Surgery; Spinal Anesthesia
Citation: Biekhet EG, Elazzazi H, Hussein W, Zedan M, Abdelhamid BM. The impact of different doses of intrathecal dexmedetomidine used as adjuvant to hyperbaric prilocaine in short ambulatory procedures under spinal anesthesia: a randomized controlled study. Anaesth. pain intensive care 2024;28(4):664−672; DOI: 10.35975/apic.v28i4.2509
Received: February 20, 2024; Reviewed: April 01, 2024; Accepted: April 20, 2024
The analgesic effect of non-nutritive sucking on neonates during invasive procedures
Authors: Ratnaningsih Tri , Peni Tri , Firdausiyah Nafidatul , Wahito Nugroho Heru Santoso
Published: August 2024

Background & objective: Neonates admitted and treated in the Neonatal Intensive Care Unit (NICU) often receive painful invasive procedures. In such situations, the treating physicians often find themselves in a fix regarding the use of analgesics to relieve their actual or potential pain. It has been observed that the sucking often distracts the neonates from their mild to moderate pain. We conducted this study to analyze the effectiveness of non-nutritive sucking as an analgesic for neonates who were to receive invasive procedures.
Methodology: This experimental study implemented a post-test-only control group design, involving 64 neonates in the NICU, selected using a simple random sampling technique, who were then divided into two groups, with 32 neonates each in a treatment group and a control group. The treatment group was given non-nutritive sucking, while the control group was given standard intervention, then the pain response was measured in both groups. Next, the pain levels of the two groups were compared using the Mann-Whitney U test.
Results: The measurement results showed that there was a difference in the mean scores of pain response between treatment and control group, respectively 1.53125 and 5.8125. The P-value of the difference test was 0.000000004252, so that it could be interpreted that there was a significant difference in pain levels between the two groups.
Conclusion: On the basis of the results of our study, it is concluded that non-nutritive sucking is an effective method for reducing the pain response in neonates during invasive procedures.
Keywords: Infant; Non-nutritive sucking; Neonatal Intensive Care UNIT; Pain; Pain management
Citation: Ratnaningsih T, Peni T, Firdausiyah N, Nugroho HSW. The analgesic effect of non-nutritive sucking on neonates during invasive procedures. Anaesth. pain intensive care 2024;28(4):640−645; DOI: 10.35975/apic.v28i4.2511
Received: April 27, 2024; Reviewed: June 10, 2024; Accepted: June 19, 2024
Effectiveness of epidural dexamethasone vs triamcinolone to relieve neuropathic pain of cervical disc herniation patients; 3-months follow-up
Authors: Budisulistyo Trianggoro , Yudhasyah Ria Astari , Kustiowati Endang , Husni Amin , Muhartomo Hexanto , Suryadi Suryadi
Published: August 2024

Background & objective: Cervical disc herniation (CDH) is the most common cause of radicular pain; with one-third of the patients suffering for more than six months. Epidural steroid injections (ESI) are widely performed by the pain specialists and the neurosurgeons in this disorder, acute or chronic. We compared triamcinolone and dexamethasone regarding their efficacy to improve neuropathic pain at three months follow-up. 
Methodology: This randomized blinded control trial was conducted at Dr. Kariadi Hospital in Semarang, Indonesia, on 42 chronic CDH patients. Patients were divided into two equal groups of 21 each, to receive, interlaminar cervical epidural injections of triamcinolone or dexamethasone under fluoroscopic guidance. The study was conducted from January 2022 to July 2023. Follow-up on the PainDETECT score was carried out before and 3 months after the ESI. Data collected was analyzed by using the Mann-Whitney test (P < 0.05).
Results: Forty-two CDH subjects were involved in the study grouped as Dexamethasone group (21) and Triamcinolone group (21). Both groups observed significant pain improvement (P < 0.001, and P = 0.020). In the Dexamethasone group 16 out of 21 (76.2%) subjects showed improvement at 3 months of follow-up in the neuropathic pain, while in Triamcinolone group 10 out of 21 (47.6%) showed improvement at 3 months of follow-up. The differences in the two groups were significant (P < 0.001 vs P = 0.007).
Conclusion: The results of this study prove that epidural injection of dexamethasone is more effective than triamcinolone for improving neuropathic pain syndrome associated with chronic cervical disc herniation.
Keywords: Chronic CDH, Neck pain, Epidural steroid injection, Dexamethasone, Triamcinolone, Pain DETECT
Citation: Budisulistyo T, Yudhasyah RA, Kustiowati E, Husni A, Muhartomo H, Suryadi. Effectiveness of epidural dexamethasone vs triamcinolone to relieve neuropathic pain of cervical disc herniation patients; 3-months follow-up. Anaesth. pain intensive care 2024;28(4):732−736; DOI: 10.35975/apic.v28i4.2515
Received: December 28, 2023; Reviewed: February 12, 2024; Accepted: February 17, 2024
Assessing the impact of opioid-free anesthesia using the modified Mulimix technique on postoperative pain in bariatric surgery patients: a correlative randomized double-blinded trial
Authors: Seyam Sameh Hamdy Abdelhamid , Hassan Abdallah Elabd , Elsayed Mostafa Mohamed
Published: August 2024

Background & objective: The effective management of postoperative pain in bariatric surgery poses significant challenges to the anesthesiologists and the surgeons. Opioids have been the mainstay of postoperative pain management; but recently, opioid-free anesthesia (OFA) has been a popular option in an effort to prevent the opioid related side-effects. The objective of this study was to assess the effects of OFA utilizing the modified mulimix technique on the levels of plasma interleukin-2 (IL-2) and interleukin-6 (IL-6). In addition, the study aimed to evaluate the duration of analgesia and the analgesic requirements during the first 24 hours postoperatively.
Methodology: A total of 60 patients were randomly assigned to the OFA Group, which received opioid-free anesthesia, and the OBA Group, which received Opioid-Based Anesthesia. The modified Mulimix technique was used in both groups. Serum samples were collected from all patients during skin incision and after the surgical procedure. Subsequently, these samples were assessed for IL-2 and IL-6 levels. The postoperative analgesic consumption was compared in both groups.
Results: Regarding serum IL-2 and IL-6 levels in the two study groups, there was a statistically significant difference after the conclusion of surgery, and the skin incision was made. Regarding the initial rescue analgesia postoperatively assessment, the OBA group demonstrated a substantially greater overall consumption of analgesics within the first 24 h. The study revealed a significant difference in VAS values between the OBA Group and the OFA Group at 2 h, 4 h, and 6 h postoperatively.
Conclusion: The modified mulimix technique effectively reduces postoperative plasma inflammatory mediators, interleukin-2 and interleukin-6, and results in decreased postoperative pain, thus reducing the postoperative analgesia consumption
Abbreviations: OBA - Opioid based anesthesia; OFA - opioid-free anesthesia; IL-2 - interleukin-2; IL-6 - interleukin-6; VAS - visual analogue scale
Keywords: Bariatric surgery, interleukin, Mulimix, opioid, pain, immunological response.
Citation: Seyam SHA, Hassan AE, Elsayed MM. Assessing the impact of opioid-free anesthesia using the modified Mulimix technique on postoperative pain in bariatric surgery patients: a correlative randomized double-blinded trial. Anaesth. pain intensive care 2024;28(4):721−726; DOI: 10.35975/apic.v28i4.2516
Received: March 04, 2024; Reviewed: May 18, 2024; Accepted: May 19, 2024
Correlation between human BDNF rs6265 gene polymorphism and type-2 diabetes and diabetic peripheral neuropathy
Authors: Hamid Rahma , Al-Wasiti Estabraq , Jabbar Assad Mubarak
Published: August 2024

Background & objective: Diabetes mellitus is quite common and globally prevalent condition affecting patients’ quality of life. Patients who have type 2 diabetes mellitus (T2DM), are more likely to get diabetic peripheral neuropathy (DPN), which may affect feet, legs, hand, and arm. A BDNF gene rs6265 polymorphism in humans results in the substitution of valine with methionine at codon 66 (Val66Met). We aimed to find the possible link between human BDNF rs6265 gene polymorphism and T2DM with and without peripheral neuropathy and compare it with healthy subjects in Kirkuk City, Iraq.
Methodology: One hundred subjects were chosen to participate in this research, aged from 35 to 75 y and divided into three groups: 35 DPN, 35 T2DM patients, and 30 healthy controls were selected randomly for BDNF gene rs6265 SNP screening by using conventional PCR with specific sets of primers. Products of PCR for patients and control groups were run on the gel electrophoresis to detect the SNP rs6265 fragment. A nerve-conducting study was used to examine DPN.
Results: The observed results demonstrated the presence of two types of alleles identified as genotypic variants (GG and GA) among all participants in this investigation. By applying the Hardy-Weinberg Equilibrium principle (HWE) for both patient and control groups, the results proved that there was a statistically significant variance (P < 0.05) in the genotypic frequencies between each of the groups that had been studied. The wild homozygous GG genotype in type 2 diabetic without neuropathy, with DPN, and healthy control group were 51.4%, 40% and 80% respectively. The heterozygous GA genotype were 48.6%, 60% and 20%, respectively in the three groups.
Conclusion: The present study showed that the BDNF (Val66Met) rs6265 polymorphism is associated with type 2 diabetes mellitus and diabetic peripheral neuropathy in heterozygous allele G/A (Met/Met) and homozygous allele GG (Val/Val) genotype. Also, the current study found the absence of the mutant genotype AA, possibly due to the evidence that the distribution of the BDNF polymorphisms varies widely among different ethnic groups.
Abbreviations: BDNF - Brain-derived neurotrophic factor; DPN - Diabetic peripheral neuropathy
Keywords: Type2 diabetes mellitus; Diabetic peripheral neuropathy; Brain-Derived Neurotrophic Factor; BDNF rs6265 SNP; BDNF Val66Met polymorphism.
Citation: Hamid R, Al-Wasiti E, Jabbar AM. Correlation between human BDNF rs6265 gene polymorphism and type-2 diabetes and diabetic peripheral neuropathy. Anaesth. pain intensive care 2024;28(4):752−756.
DOI: 10.35975/apic.v28i4.2517
Received: March 08, 2024; Reviewed: April 20, 2024; Accepted: April 28, 2024
Antimicrobial resistance patterns in patients admitted in a medical intensive care unit at Rawalpindi, Pakistan
Authors: Bacha Muhammad Faisal , Sayed Tahir Mukhtar , Maqsood Jehanzaib , Noaman Muhammad , Aslam Muhammad , Noureen Fakhra , Ikram Nadeem
Published: August 2024

Background & objective: The prevalence of antibiotic resistance has increased with the excessive use of antibiotics in our country. We aimed to examine the patterns of antibiotic resistance in different organisms found in patients admitted to our Medical Intensive Care Unit (MICU). Additionally, the study sought to determine the relationship between the pathogen causing the infection and the outcome of the patients.
Methodology: This retrospective observational cross-sectional study was conducted in the MICU of Farooq Hospital affiliated with Akhtar Saeed Medical College, Rawalpindi, Pakistan, from January 01, 2024 to March 31, 2024. The data was collected from the medical records of adult patients (aged 12-79 y) who were admitted to the MICU during the study period. SPSS 29 was used for data analysis. Analyzed data included information on demographics, culture results, and antibiotic resistance patterns. We included culture results of blood, urine, and Foley catheter tip. The final disposal of the patients was noted and linked to the pathogen responsible for the disease.
Results: The study involved 104 patients admitted to the MICU. The average duration of stay was 5.36 days, the average age was 51.17 ± 18.47 y, and 61.53% of the patients were male. The primary diagnoses were urinary tract infection (18.22%) and sepsis (15.76%). Pre-existing conditions included diabetes mellitus (24.15%) and hypertension (23.59%). Klebsiella pneumoniae was the predominant organism, followed by E. coli. Overall, 58.52% of the isolates showed resistance to the tested antibiotics. Specific drugs, such as ceftazidime and amoxicillin-clavulanic acid, demonstrated absolute resistance (100%), while vancomycin and tigecycline showed no resistance. In this study, patients with infections caused by Enterobacter, Enterococcus faecalis, Proteus, and Salmonella spp. had discharge rates of 100%. In contrast, infections caused by Candida, Acinetobacter species, and Klebsiella pneumoniae were associated with 100%, 75%, and 48.5% mortality rates, respectively.
Conclusion: The study revealed a significant prevalence of antibiotic resistance among microorganisms in our Medical Intensive Care Unit. Klebsiella pneumoniae was the predominant organism, and distinct bacterial infections were linked to diverse patient outcomes.
Abbreviations: MDR - multidrug resistance; MICU - Medical Intensive Care Unit; MRSA - methylene resistant S. aureus XDR - extensively drug resistant
Keywords: Antibiotic, Resistance, Pakistan, Intensive Care Units.
Citation: Bacha MF, Sayed TM, Maqsood J, Noaman M, Aslam M, Noureen F, Ikram N. Antimicrobial resistance patterns in patients admitted in a medical intensive care unit at Rawalpindi, Pakistan.  Anaesth. pain intensive care 2024;28(4):727−731; DOI: 10.35975/apic.v28i4.2521
Received: June 10, 2024; Reviewed: June 21, 2024; Accepted: July 15,2024
Dexmedetomidine administration in a laryngeal cancer patient with emergency tracheostomy: a case report
Authors: Kaya Filiz , Evirgen Evren Selma , Aydin Eda Uysal , Kocagil Sümeyye , Erkiliç Ezgi
Published: August 2024

The maintenance of vital functions in any patient depends upon the preservation and maintenance of airway patency. Conditions that may cause difficult airway, such as a laryngeal mass, require rapid and expert intervention. We briefly review the current knowledge on this subject by presenting the report of a patient who required emergency airway intervention and in whom a tracheostomy had to be resorted to under sedation. A 59-year-old male patient who was scheduled for total laryngectomy and neck dissection due to laryngeal cancer was taken to the operating room with the decision of emergency tracheostomy after developing respiratory distress. Nasoendoscopic visualization of the patient showed an exophytic lesion starting from the root of the tongue on the left and extending to the chordae. Inj fentanyl and dexmedetomidine were administered to the patient for sedation and dexmedetomidine infusion was continued after the loading dose. When the thyroid isthmus was encountered during the surgical intervention, a tracheostomy was made at 45 min. A 7.5 mm cuffed tube was inserted and respiratory control was achieved. This case report stresses that a combination of dexmedetomidine and fentanyl can be used safely in such cases.
Keywords: tracheostomy, dexmedetomidine, diffuculut airway
Citation: Kaya F, Evirgen ES, Aydin EU, Kocagil  S, Erkiliç E. Dexmedetomidine administration in a laryngeal cancer patient with emergency tracheostomy: a case report. Anaesth. pain intensive care 2024;28(4):772−775; DOI: 10.35975/apic.v28i4.2522
Received: April 17, 2024; Reviewed: June 05, 2024; Accepted: June 05, 2024
Radiofrequency ablation of superior hypogastric ganglion and dorsal root ganglion reduces neuropathic pain in L5-S1 disc anterior protrusion: a case report
Authors: Budisulistyo Trianggoro
Published: August 2024

Approximately 36%-55% of patients with chronic low back pain (LBP) have neuropathic pain syndrome. Prescription of adjuvant analgesics or   antidepressants is effective in reducing pain but requires special attention.
A female patient, 57 y, presented with complaints of LBP for 5-7 days. Pain was spread bilateral  in the hips-groin, as well as to the fingers and soles (NRS 6-8, PainDETECT 35). She had history of falls 10 y ago, but still worked for 5 hours daily. She had allodynia, dysesthesia, hyperalgesia, and L4-5 and L5-S1 hypesthesia. Magnetic resonance imaging (MRI) showed postero-central and lateral bulged L4-5 and L5-S1 discs. Radiofrequency ablation (RFA) 70o of superior hypogastric ganglion for 90 sec, and pulsed radiofrequency (PRF) 42o of dorsal root ganglion (DRG) L4-5, L5-S1 bilaterally for 2 min reduced nociceptive pain (NRS 2-3) and     neuropathic pain (PainDETECT 12). Post-surgical medication included levofloxacin, gabapentin, paracetamol, amitriptyline and Vitamin B12.
The sympathetic ganglia supply the anterior segments of the lumbar vertebrae and the anterior longitudinal ligament, often overlooked as a cause of pain. The management of LBP patient depends upon the etiology, whether associated to structural abnormalities or nerve dysfunction.
Keywords: anterior disc herniation, dorsal root ganglion,  lumbar disc herniation, neuropathic pain, superior hypogastric ganglion, radiofrequency
Citation: Budisulistyo T. Radiofrequency ablation of superior hypogastric ganglion and dorsal root ganglion reduces neuropathic pain in L5-S1 disc anterior protrusion: a case report. Anaesth. pain intensive care 2024;28(4):757−761; DOI: 10.35975/apic.v28i4.2523
Received: August 02, 2023; Reviewed: December 26, 2023; Accepted: December 26, 2023
GREIVSO LIGA: DIAGNOSTIKA IR GYDYMAS
Authors: Karčiauskaitė Karolina
Published: August 2024

Greivso liga yra organui specifinė autoimuninė liga, kuria sergant kraujyje aptinkami cirkuliuojantys antikūnai prieš tirotropinio hormono receptorius (TSH-R autoantikūnai). Tai pati dažniausia liga, sukelianti hipertirozę išsivysčiusiose šalyse. Greivso liga diagnozuojama remiantis klinikiniais požymiais, paciento simptomais ir laboratorinių tyrimų rezultatais. Sergant padidėja T3 ir laisvo T4 koncentracija, o TSH kiekis labai sumažėja ar yra neaptinkamas, aptinkami TSH-R antikūnai. Greivso ligos gydymas yra kompleksinis, susideda iš ligos sukeltų simptomų kontrolės ir hipertiroidizmo gydymo. Hipertiroidizmui gydyti skiriami medikamentai, sukeliantys tirostatinį poveikį, radioaktyviojo jodo terapija arba tiroidektomija.
PACIENTŲ FIZINĖ IR EMOCINĖ BŪSENA: JĄ LEMIANČIŲ VEIKSNIŲ VERTINIMAS PERIOPERACINIU LAIKOTARPIU
Authors: Mačiulienė Asta , Užuotaitė Rusnė , Gulbinaitė Eglė , Mačiulis Vytautas
Published: August 2024

Pacientų pasitenkinimas suteikta anestezija yra daugialypis kintamasis, todėl siekiant aukštesnės sveikatos priežiūros paslaugų kokybės, svarbu nustatyti svarbiausius veiksnius, galinčius turėti įtakos pacientų emocinei būsenai ir psichologiniam komfortui.

Tikslas – įvertinti pacientų, kuriems numatoma operacija, emocinius ir fizinius pojūčius perioperaciniu laikotarpiu prieš ir po anestezijos.

Tyrimo metodai. Tyrimas atliktas Lietuvos sveikatos mokslų universiteto ligoninėje Kauno klinikose (LSMUL KK) Anesteziologijos skyriuje nuo 2023 m. lapkričio 17 d. iki gruodžio 15 d. Tyrimo atlikimui gautas LSMU BEC leidimas BEC2-316. Tyrime dalyvauti sutiko 102 asmenys. Buvo naudojamas originalus klausimynas, sudarytas iš 30 klausimų.

Rezultatai. Tyrimo metu nustatyta, kad prieš operaciją nerimą statistiškai reikšmingai dažniau jautė moterys nei vyrai, 76,1 proc. (n = 54) moterų nurodė jaučiančios nerimą, lyginant su 32,3 proc. (n = 10) vyrų (p =< 0,001). Nustatytas ryšys tarp nerimo prieš operaciją ir pooperaciniu periodu (p = 0,021, rs= 0,228). 90 pacientų (88,2 %) teigė, kad informacijos apie anesteziją, jos būdą gavo pakankamai, 12 respondentų (11,8%) nurodė, kad informacijos trūko. Pacientai reikšmingai dažniau patyrė nemalonius fizinius pojūčius prieš operaciją, atvykus į operacinę šių potyrių dažnumas buvo statistiškai mažesnis (p < 0,001, rs = 0,485). Vertindami pooperacinio skausmo gydymą, pacientai nurodė: adekvatus (n=86; 84,3%.), patenkinamas (n=14; 13,7%), neadekvatus (n=2; 2,0%).

Išvados. Gauti rezultatai pabrėžia svarbų poreikį užtikrinti, kad pacientai būtų tinkamai informuoti, gerai pasirengę operacijai ir gautų reikiamą emocinę bei fizinę priežiūrą perioperaciniu laikotarpiu, siekiant pagerinti jų patirtį ir pasitenkinimą medicininėmis paslaugomis.
VEIKSMINGAS INDIVIDUALUS IV STADIJOS KASOS KARCINOMOS GYDYMAS: KLINIKINIS ATVEJIS
Authors: Rimšaitė Urtė , Kraulytė Agnė , Mačiulienė Dainora , Dambrauskas Žilvinas
Published: August 2024

Kasos vėžys yra pirmaujanti mirties nuo vėžio priežastis visame pasaulyje. Penkerių metų išgyvenamumas yra mažesnis nei 5 procentai. Kasos vėžio išsivystymas siejamas su šiais rizikos veiksniais: cukriniu diabetu, nutukimu, tabako rūkymu, alkoholio vartojimu ir kitais. Ligos diagnozei ir vėžio stadijai nustatyti naudojamas trijų lokalizacijų (krūtinės, pilvo ir dubens organų) kompiuterinės tomografijos (KT) tyrimas su kontrastavimu. Gydymo metodas pasirenkamas atsižvelgiant į ligos išplitimą. Kadangi bendras išgyvenamumas yra žemas, būtina ieškoti naujų veiksmingų gydymo būdų. Straipsnyje pristatomas klinikinis atvejis, pritaikyti individualizuoti gydymo metodai bei gydymo gairės, naudojamos visame pasaulyje.
MULTIMODAL NEUROMONITORING IN DIFFERENT NEUROCRITICAL CONDITIONS – FIRST EXPERIENCES IN SINGLE NEUROCRITICAL CARE CENTRE
Authors: Šaknys Laurynas , Bajorūnaitė Elžbieta , Balčiūnienė Neringa
Published: August 2024

The study explores the use of multimodal neuromonitoring in a neurocritical care center, focusing on patients with acute brain injuries. The monitoring involves various sensors to track intracranial pressure (ICP), partial brain tissue oxygenation (PbO2), cerebral perfusion pressure (CPP), and more. The research, conducted at the Lithuanian University of Health Sciences, covers a small sample size (13 patients), mainly dealing with subarachnoid hemorrhage and traumatic brain injury cases. Results indicate challenges, such as episodes of intracranial hypertension and cerebral hypoxia, despite adherence to treatment protocols. The study faces limitations due to manual data registration, leading to potential inaccuracies. The outcomes reveal a mortality rate of 23.1%, with the majority experiencing unfavorable results. In conclusion, the study underscores the significance of multimodal monitoring but highlights the need for larger sample sizes, improved data recording methods, and emphasizes the complexity and challenges in managing neurocritical conditions.
GADOLINIO PAGRINDU PAGAMINTŲ KONTRASTINIŲ MEDŽIAGŲ NEPAGEIDAUJAMŲ REAKCIJŲ KLASIFIKACIJA IR APŽVALGA
Authors: Kondrotaitė Julija
Published: August 2024

Magnetinio rezonanso tyrimuose dažniausiai yra naudojamos gadolinio pagrindu pagamintos kontrastinės medžiagos. Šių medžiagų sukeliamas nepageidaujamų reakcijų dažnis yra mažas, tačiau jų naudojimas reikalauja gydytojų budrumo. Dėl gadolinio nusėdimo organizmo audiniuose, jo poveikio susikaupimo vietose bei organizmo imuninio atsako išsivysto skirtingos ligos ar būklės, kurių galima išvengti taikant tinkamas prevencines ar profilaktines priemones. Tyrimo tikslas – išanalizuoti mokslinę literatūrą ir apžvelgti gadolinio pagrindu pagamintų kontrastinių medžiagų dažniausias nepageidaujamas reakcijas ir jų klasifikaciją.
SKYDLIAUKĖS VĖŽIO DIAGNOSTIKA
Authors: Kondrotaitė Julija
Published: August 2024

Sergamumas skydliaukės vėžiu didėja, todėl esant specifinių ligai skundų, objektyvios apžiūros metu rastų pakitimų, laboratoriniais ar vaizdo tyrimais nustatytų patologinių radinių, svarbu žinoti tinkamos diagnostikos tvarką ir ją taikyti. Įsitikinus kaklo ultragarsinio tyrimo tikslingumu, apžiūrimi ir įvertinami skydliaukės mazgai. Įtariami piktybiškumu mazgai aspiruojami plona adata ir ėminys vertinamas pagal Bethesda sistemą. Gavus citologinį atsakymą, sprendžiama individualiai dėl tolesnių tyrimų poreikio ir gydymo. Tyrimo tikslas – išanalizuoti ir aptarti įrodymais pagrįstą informaciją apie skydliaukės vėžio diagnostiką.
BAZALINIŲ LĄSTELIŲ KARCINOMA: ETIOLOGIJA, EPIDEMIOLOGIJA, KLINIKINIAI POŽYMIAI, DIAGNOSTIKA IR GYDYMAS
Authors: Šukevič Bogdan
Published: August 2024

Bazalinių ląstelių karcinoma yra dažniausias žmogaus odos vėžys. Pagrindinis išorinis etiologinis veiksnys yra ultravioletinių spindulių poveikis odai. Bazalinių ląstelių karcinoma dažnesnė vyrams, vidutinis susirgimo amžius yra 68 metai. Šis navikas pasižymi mažu mirštamumu ir metastazavimo dažniu, tačiau sukelia aplinkinių audinių dislokaciją ir destrukciją. Tipiška naviko išvaizda – rožinės ar raumeninio audinio spalvos papulės su opele arba teleangiektazinėmis kraujagyslėmis ant viršaus, neretai pleiskanojančios, dažnai pažeidžiamos ir kraujuojančios. Būdingiausia lokalizacija – ant galvos ir veido, o pagrindinė diagnostikos priemonė yra odos biopsija. Auksinis gydymo standartas yra chirurgija (Mohs mikrografinė chirurgija, standartinė chirurginė ekscizija), dar taikoma elektrodesikacija ir kiuretažas, radiacinė ir fotodinaminė terapija, kriochirurgija, vietinio arba sisteminio poveikio vaistai.
Improving Educational Quality: The Leadership Role of Private Islamic College Leaders
Authors: Astani Lalu Gede Muhammad Zainuddin , Kojin Kojin , Akhyak Akhyak
Published: August 2024

The present study examines the leadership responsibilities undertaken by leaders inside private Islamic universities. The present study was directed by a singular research issue, specifically focusing on the leadership role of leaders inside private Islamic religious universities in their efforts to enhance the quality of education. The present investigation is characterised as a qualitative study employing a case study design. The study was conducted at the Nahdlatul Wathan Islamic College (STAI NW) in Samawa, Sumbawa Besar Regency, located in the province of West Nusa Tenggara. Data gathering strategies encompass several methods such as interviews, observation, and documenting. In the interim, the process of data analysis was conducted utilising a series of established techniques, namely data reduction, data display, data condensation, and conclusion drawing/verification. This study demonstrates that in order to enhance the educational standards, the chairman of STAI NW Samawa undertakes various primary responsibilities, including: 1) managerial duties; 2) Developing academic quality and sustainability; 3) Fostering campus entrepreneurship; 4) providing motivation; and 5) optimising the allocation of responsibilities among lecturers and staff members. The findings of this research have the potential to enhance the significance of leadership within the framework of private Islamic religious universities.
Present Scenario of Drug Addiction in India: An Overview
Authors: Chaudhuri Pamela Datta , Sikdar Deb Prasad
Published: August 2024

Drug addiction is a complicated neurobiological illness that alters a person's brain and behaviour to the point that they are unable to control their need to consume drugs. Here researcher finds out a few objectives. These are, to state the present scenario of drug addicts from the perspective of India and explain the government initiative to prevent drug addiction. The researcher will conduct this research through the documentary analysis method. The researcher’s main intention is to observe the current situation in India regarding drug addiction as well as how much government initiatives are able to control the structure. Since the younger generation is primarily responsible for leading India and positioning it as a developed nation, developing nations like India need to raise awareness to end this out-of-control situation.
Triple Negative Evaluation of FFPE (Formalin Fixed Embedded Tissue) Breast Cancer Tissues in A Tertiary Health Institution of Bayelsa State, Nigeria
Authors: Godwin Ilegbedion I. , Tobias Choji P. P. , Samuel Ogenyi I. , Nkechi Chukwuedo J. , Ebiakpo Mirinn K.
Published: August 2024

Breast cancer is a common disease worldwide, with over two million cases reported in 2018. Various therapy modalities use biological characteristics that influence treatment and outcomes to provide individualized care. Some biomarker advancements, such as hormone receptors, vascular endothelial growth factors, and HER2/neu receptors, have significantly contributed to the biological characterization of breast cancer. Triple-negative breast cancer is defined as malignancies that do not express hormone responsiveness or HER-2. Approximately 12% of women with breast cancer will have triple-negative illness, which is more common among non-Hispanic black women regardless of age, but is detected at a younger age than other subtypes. Women with triple-negative illness are more likely to be diagnosed at a later stage (stage III or IV). The pathogenesis of breast cancer is complex and poorly understood, however many risk factors are known. This cross-sectional study spanned from 2010 to 2022. In this study, the prevalence of triple-negative breast cancer in archived breast cancer cases at Federal Medical Centre Yenagoa, Bayelsa State, was analyzed using the Haematoxylin and Eosin Staining Technique on breast cancer samples collected over the study period. This study, done at Bayelsa State's Federal Medical Centre Yenagoa, analyzed 178 breast specimens. Ninety-six percent (96%) of the patients were IDC, and 5% were TNBC. The average age at presentation was 48.21 years, with 59.1% of patients being under 50 years. 40% of the patients exhibited HER-2/neu positive, and 65% had estrogen receptor (ER) positivity. The study was conducted in a single medical institution, and specific types of lesions were not included. Other potential limitations include comparing findings with various techniques and diagnostic protocols.
The Proposed Model for Pharmacy Led Med-to-bed Discharge Service in Tertiary Care Hospital
Authors: Amer Mohammad Abdul Kareem , Mohiuddin Syed Iqbal , D AlQahtani Bushra , Ghamdi Fuad AL , Alhomoud Ali , Khazi Anees , Shaikh Shafeeque
Published: August 2024

Introduction: The pharmacy-led discharge medication delivery to bedside (Med-to-bed) service in a tertiary care Johns Hopkins Aramco Healthcare (JHAH) hospital aims to optimize medication management during patient transitions from admission to discharge, especially for those with chronic conditions. The service entails the direct delivery of discharge medications to patients at the pharmacy following their discharge from inpatient wards, accompanied by comprehensive medication counseling. The pharmacy-led Med-to-Bed service aims to reduce patient wait times and improve overall clinical outcomes. Methods: This article highlights common challenges in medication reconciliation and post-discharge prescription fulfillment, highlighting the need for standardized protocols and improved hospital adherence to ensure seamless care transitions. It also discusses future considerations for optimizing the Med-to-Bed service, including proposed pharmacy renovations, installing a dedicated robotic dispensing system, and providing private spaces for patient counseling during medication pickup. Additionally, the proposal suggests deploying more pharmacy staff to address delayed discharge orders and making systemic enhancements to the EHR system to streamline prescription pickup. Result: The successful implementation of the proposed pharmacy-led Med-to-Bed service demonstrates the efficacy of interdisciplinary collaboration among nurses, physicians, and pharmacists. Through this collaborative approach, the Med-to-Bed service has shown tangible improvements in operational efficiency and patient outcomes, underscoring its potential to transform healthcare delivery models. Conclusion: Overall, this proposed model provides valuable insights into the transformative impact of integrated care initiatives like the Med-to-bed service in tackling complex medication management and enhancing quality patient care in hospitals.
The effect of profitability, company size, liquidity, bond age and collateral on bond ratings in banking companies listed on the Indonesia Stock Exchange
Authors: Fadli M.Fajar Zahrul , Ilhami Susanti Dwi
Published: August 2024

The only form of funding that a company used to obtain funds was by issuing bonds. This research aims to determine the significance of the effect of profitability, company size, liquidity, bond age, and collateral on bond ratings in banking sector companies listed on the IDX. The data in this research is secondary data obtained from www.idx.co.id and the PT Pefindo website. The total sample was 14 banking sector company bonds for the 2018–2022 period, using a purposive sampling method. The data analysis technique used is a logistic regression analysis test with the IBM SPSS Statistics 26 program. The results of the analysis show that profitability has a significant positive effect on bond ratings. Company size has an insignificant negative effect on bond ratings. Liquidity has a significant positive effect on bond ratings. Bond age has an insignificant positive effect on bond ratings. Collateral has a significant negative effect on bond ratings.
Analisis determinan kinerja pasar modal (IDX30) di Indonesia
Authors: Sundoro Hary Saputra , Putlia Grace , Lie Jessica Vonnie
Published: August 2024

Indonesia has a capital market called the Indonesian Stock Exchange (IDX). IDX performance can be measured from existing indices and one of them is the IDX30 index. IDX 30 performance can be influenced by several factors such as macroeconomic variables and CPO prices. This research aims to determine movements in capital market performance in Indonesia caused by influencing factors. The VECM method will be used in this research. The research period starts from 2019 to June 2023. The result of this research is that CPO prices and inflation have a positive influence, while reference interest and exchange rates have a negative influence on IDX30 performance in the short and long term. The performance response of the IDX30 is most influenced by the IDX30 variables themselves.
Public interest statements
The research hopes that the relevant parties, especially the government, issuers and investors can take the necessary policies. The results of this research can be a reference material in predicting capital market movements in Indonesia, especially the IDX30 index, which is caused by factors that influence it, such as macroeconomics and CPO prices.
Pengaruh kompetensi auditor, penggunaan analitik big data, dan penggunaan forensik digital terhadap kualitas audit investigatif
Authors: Aji Wahyu Nugroho Dwi Kuncoro , Wardhani Nurhastuty Kesumo
Published: August 2024

Investigative audits are crucial in uncovering indications of state losses and criminal acts of corruption in Indonesia. The quality of investigative audits influences the success of the law enforcement process and the justice system's integrity. Factors such as auditor competency, Big Data analytics, and digital forensics are important in improving the quality of investigative audits. This research aims to test the impact of auditor competency, Big Data analytics, and digital forensics on improving the quality of investigative audits. A purposive sampling method was used with 127 BPK auditor respondents. The data analysis method used is multiple linear Regression. The research achievements show that auditor competency, the use of Big Data analytics, and the application of digital forensics significantly impact the quality of investigative audits. BPK institutions should pay attention to selecting auditors with a high level of competency, use Big Data analytics, and apply digital forensic technology to improve their investigative audit performance.
Public interest statements
This research directly contributes to improving the quality of investigative audits, which has the potential to promote transparency and accountability in public financial management. The findings provide practical guidance for audit institutions to enhance their selection, training, technology, and audit practices, empowering them to make positive changes.
Pengaruh profitabilitas, cash holding, ukuran perusahaan terhadap manajemen laba dengan kepemilikan manajerial sebagai variabel moderasi
Authors: Rosiana Ela , Rafa Wukuf Dilvan , Heniwati Elok
Published: August 2024

This research was carried out with the aim of testing and analyzing the influence of profitability, cash holding, and firm size on earnings management through moderating managerial ownership. The type of research applied is causal based and involves quantitative methods from secondary data. The population of this study consists of companies in the real estate, property and building construction sectors that are officially listed on the IDX for the 2020-2023 period. Purposive sampling technique is a data collection technique. Data processing involves the Eviews version 10 application. Sample selection. Profitability has a positive influence on earnings management, cash holding does not affect earnings management, and company size does not affect earnings management. Meanwhile, managerial ownership cannot moderate profitability in earnings management, cash holding with earnings management can be moderated by managerial ownership, and company size in earnings management cannot be moderated by managerial ownership.
The effect of finacial performance, devidend policy on the firm value with corporate social responsibility (CSR) as moderating variable
Authors: Prahelga Vica
Published: August 2024

Abstract
This study investigates the impact of capital structure, profitability, leverage, and dividend policy on company value, focusing on how corporate social responsibility (CSR) moderates these relationships. The research was conducted on financial services companies in the banking sub-sector listed on the Indonesia Stock Exchange from 2019 to 2023. The sampling method used was purposive sampling, resulting in 16 companies meeting the criteria for analysis. Secondary data from each sample company's official website or www.idx.co.id was used. The data was analyzed using descriptive statistics, classic assumption tests, normality, heteroscedasticity, multicollinearity tests, model selection tests, panel data regression analysis, hypothesis tests, and moderated regression analysis (MRA) tests. Eviews Software Version 12 was used for data processing. The findings suggest that capital structure, profitability, leverage, and dividend policy positively and significantly impact company value. Additionally, the moderated regression analysis (MRA) results indicate that CSR plays a moderating role in the relationship between these financial factors and company value.
Public interest statements
This research emphasizes the importance of capital structure, profitability, and dividend policy in determining company value. It provides valuable insight for investors and consumers into a company's financial management and decision-making, enabling informed investment choices and employment decisions.
CLIMATE CHANGE IMPACT ON RICE PRODUCTIVITY IN BANGLADESH AGRICULTURE:
Authors: Mohammad A. Ashraf
Published: August 2024

This paper has two objectives. First it attempts to detect the trend in the present upshots of global warming temperature data. It has been done through the estimation of the long memory fractional parameter, d using simulation technique in the presence of additive outliers, which stand as wild observations generated in the atmosphere due to global warming. Then, the study investigates into the impact of global warming, precipitations and carbon concentration in the air on the particular aspect of rice production in Bangladesh agriculture. The simulation result exhibits a non-trend or a natural cyclical variability that is influenced by a stochastic process in the case of climate change behavior with wild observations (outliers) that produce a contradictory outcome of profound uncertainties against the case of true world temperature systematic data trend. The results of regression analysis show that climate change has a profound impact on rice productivity in Bangladesh agriculture. Overall results of the study indicate that climate change has profound effects on agricultural food production of Bangladesh agriculture
ATUAÇÃO DO ENFERMEIRO À PACIENTES EM CUIDADOS PALIATIVOS: UMA REVISÃO INTEGRATIVA DE LITERATURA
Authors: Ferreira Silva Brisa Emanuelle , Nancy Bernardes do Nascimento  , Verônica Lorraine de Assis  , Fernandes de Castro Cristiane Maria , Ferreira Gabrielle Rosa , Dias Pereira Victória Lee , Elisa Lima e Silva  , Araújo Claudirene Milagres
Published: August 2024

Os cuidados paliativos visam melhorar a qualidade de vida de pacientes e suas famílias que enfrentam doenças ameaçadoras, proporcionando alívio ao sofrimento físico, psicossocial e espiritual. Objetivo: Descrever o papel do enfermeiro nos cuidados paliativos, destacando a importância do conhecimento em cuidados paliativos e bioética para tomar decisões adequadas e implementar as diretrizes antecipadas de vontade dos pacientes. Método: Para realizar esta revisão, foram analisados sete artigos publicados entre 2018 e 2022. Os estudos selecionados abrangiam pesquisas qualitativas, revisões sistemáticas e guias de prática clínica. Resultados: Os resultados mostraram um aumento na produção científica sobre cuidados paliativos nos últimos anos, com a publicação de artigos em revistas de diferentes qualidades. Os estudos destacaram a importância do conhecimento em cuidados paliativos e bioética para os enfermeiros, ressaltando a necessidade de qualificação para tomar decisões adequadas e implementar as diretrizes antecipadas de vontade dos pacientes. A pesquisa também identificou os diagnósticos de enfermagem mais comuns e estabeleceu intervenções plausíveis no contexto de terminalidade. Além disso, enfatizou-se a relevância do conhecimento dos enfermeiros sobre práticas integrativas e complementares, buscando uma abordagem holística e humanizada no cuidado paliativo. Conclusão: Esta revisão destaca a importância da atuação do enfermeiro nos cuidados paliativos e ressalta a necessidade de qualificação e desenvolvimento de ações que promovam uma abordagem humanizada e melhoria na qualidade de vida dos pacientes. Apesar dos desafios identificados na prática de enfermagem nesse contexto, como a falta de preparo na graduação para lidar com o processo de morte e a necessidade de abordagens mais aprofundadas, é essencial que os enfermeiros baseiem suas condutas na humanização, bioética e respeito à dignidade humana do paciente, incluindo a intervenção nos sintomas físicos, sociais e emocionais.
PERCEPÇÕES E SIGNIFICADOS DE DOULAS NA ATENÇÃO OBSTÉTRICA E NEONATAL NO PROCESSO DE PARTURIÇÃO
Authors: Rezende Leticia Volpe , Dias Thiago , Custódio Silva Maria Paula , Ruiz Mariana Torreglosa , Rocha Jesislei Bonolo do Amaral , Contim Divanice
Published: August 2024

Objetivo: Compreender percepções e significados de doulas na Atenção Obstétrica e Neonatal no processo de parturição. Método: Pesquisa qualitativa, descritiva, realizada entre outubro de 2021 a maio de 2022, com dez doulas. Utilizou-se a técnica de Snowball Sampling para composição amostral. Para coleta de dados foram utilizadas entrevistas semiestruturadas, analisadas por meio da técnica de análise textual discursiva. Resultados: Emergiram quatro categorias: porque escolher atuar como doula; a doula como fonte de conhecimento e empoderamento feminino; o trabalho da doula para a garantia de uma assistência digna à mulher; e as barreiras impostas à atuação da doula pela equipe multiprofissional. Conclusão: A doula causa uma ruptura no universo obstétrico hegemônico, pois ao mesmo tempo que sua prática remete ao apoio entre mulheres no processo de parturição, a sua ascensão representa uma frente contra o modelo atual de saúde centrado na doença, no profissional de saúde, em intervenções e no hospital.
UMA ANÁLISE DOS USUÁRIOS SUBMETIDOS AOS TESTES RÁPIDOS EM UMA UNIDADE SAÚDE DA FAMÍLIA.
Authors: Santos Adriana Purificação da Silva , Batista Cassia de Castro , Renata Lira do Nascimento  , Coutinho França Suzana Kelly
Published: August 2024

UMA ANÁLISE DOS USUÁRIOS SUBMETIDOS AOS TESTES RÁPIDOS EM UMA UNIDADE SAÚDE DA FAMÍLIA.
OBJETIVO: Conhecer o público que busca o serviço para testagem. Promover ações para alcançar os usuários que não buscam o serviço. METODOLOGIA: Estudo descritivo, com abordagem quantitativa. Os dados coletados correspondem a janeiro de 2020 a dezembro de 2022. RESULTADOS: Em 2020 foram realizados 570 testes em 146 pacientes. Destes 20,5% sexo masculino e 79,4% do sexo feminino, sendo 66,3%mulheres grávidas. Em 2021 foram realizados 616 testagens em 156 pacientes. 15,3% sexo masculino e 84,6% sexo feminino, sendo 61,3% mulheres grávidas. Em 2022 foram realizados 541 testagens em 142 pacientes. 18,3% do sexo masculino e 81,6% do sexo feminino, destas 55% estavam grávidas. CONCLUSÃO: é preciso buscar ações para alcançar as mulheres fora do ciclo gravídico assim como o público masculino, ambos com baixa representatividade. DESCRITORES: Testes Rápidos; Infecções Sexualmente Transmissíveis; Estratégia Saúde da Família.
PERFIL EPIDEMIOLÓGICO E TENDÊNCIA DA MORTALIDADE POR CÂNCER DE PRÓSTATA NO BRASIL E SUAS REGIÕES DE 2012 A 2021
Authors: Dantas Lucas Gomes , Campos Ana Helena Prado Santana , Lima Yvnna Santos , Barretto Júlia Santos de Almeida , Sobral Neto José Monteiro , Lopes Pionorio Vitor Alcantara , Calazans Batista Jefferson Felipe , Lima Sonia Oliveira
Published: August 2024

Objetivo: analisar a tendência temporal da mortalidade por câncer de próstata no país e macrorregiões no período de 2012 a 2021. Métodos: O presente estudo consiste em um estudo ecológico, descritivo e exploratório do câncer de próstata no Brasil de 2012 a 2021. Foram calculadas as taxas padronizadas de mortalidade (TPM). A tendência temporal foi estipulada pela regressão de Prais-Winsten. Resultados: As maiores médias da TPM no Brasil foram para a região Centro-Oeste com 61,70 óbitos por 100 mil homens (desvio padrão - DP=4,25), seguida do Nordeste com 60,71 óbitos/100mil (DP=1,77). A região Centro-Oeste apresentou uma variação percentual anual (VPA) entre 55-59 anos de -5,07% (intervalo de confiança de 95% - IC95% = -8,44; -1,57), enquanto no Nordeste foi de -1,75% (IC95% = -2,43; -1,05). A raça indígena no Brasil obteve VPA de 5,58% (IC95% = 1,35; 10,03). Conclusão: A tendência temporal do Centro-Oeste e Nordeste entre 55-59 anos foi de diminuição no Brasil, enquanto a mortalidade na cor indígena no padrão Brasil houve crescimento.