bluuebunny/crossref_metadata_2025 huggingface dataset:
A Review of Experimentation Numerical Simulation of Low-Velocity Impact Performances and Damages of Fiber-Reinforced Composites
Authors: Rahman Md. Mominur , Ismail Al Emran , Ramli Muhammad Faiz , Abdul Rashid Azrin Hani
Published: September 2024

Fiber-reinforced composites (FRCs) are extensively utilized in various industries due to their lightweight and high-strength properties, making the understanding of their response to low-velocity impact (LVI) crucial for ensuring structural integrity, performance and invisible internal damages that can compromise performance and safety. This paper critically examines the current state of research on the low-velocity impact behavior of FRCs, focusing on both experimental and numerical simulation approaches. The review comprehensively surveys on characterizing and modeling the response of FRCs to low-velocity impacts leading to damages. The effects of parameters including composites preparation; impact mechanics; testing methods; induced damages including assessment methods; different performance parameters including impact energy, force, load, impact resistance; post-impact damages and their resistance; performance and damage affecting different factors; numerical and simulation modeling are discussed. Current challenges and future prospects regarding the subject matter is highlighted. The comprehensive analysis presented in this review goals to consolidate current knowledge, identify research gaps, and guide future endeavors in enhancing the understanding of low-velocity impact (LVI) behavior in fiber-reinforced composites (FRCs).
PENGARUH MEDIA EDUKASI VIDEO TERHADAP PENGETAHUAN IBU TENTANG DIARE DI DUSUN JUMENENG KIDUL DESA SUMBERADI WILAYAH KERJA PUSKESMAS MLATI II
Authors: A. Huik Jona Maria , Ernawati Yuli , Istanti Novi
Published: September 2024

In the world, diarrhea is one of the main causes of death, recorded at 5-10 million/year. Lack of knowledge is one of the factors causing diarrhea. The study aimed to evaluate the effectiveness of videos as a health promotion medium regarding maternal knowledge about diarrhea. Quantitative research was conducted on 40 mothers according to inclusion and exclusion criteria with a pre-experimental design, one group pre-test and post-test, through accidental sampling. Intervention with video media about diarrhea in children, with measuring instruments in the form of questionnaires. Analysis uses the Wilcoxon test. Mothers' knowledge about diarrhea before the intervention had a median value of 31, while after the intervention it was 34. There was an influence of health education with videos on respondents' knowledge about diarrhea with p value = 0.000 < 0.05).  Video media optimizes mothers' knowledge about diarrhea.
Generalized Seizure Masquerading the Cause of Coma
Authors: Nirosha Metta , Babu Abdullah Aqila , Reddy K Ajay
Published: September 2024

Background: Diagnosis is traditionally made by taking a medical history and performing a medical examination. These have become less useful in contemporary emergency and critical care medicine.  Objective: The objective was to show the importance of obtaining the medical history and re-evaluating it in medical emergencies for diagnosis and management.  Methods and Materials: In our instance, a female patient, age 22, was taken to the emergency room by her parents when she was unconscious and exhibiting tonic posture in all limbs. Due to our insufficient medical history, we ended up doing unnecessary and expensive investigations. The re- evaluation of the patient played a crucial role in diagnosis and management.  Results: The patient's re-evaluation to obtain a proper medical history revealed the actual cause of unconsciousness in our case, which led to proper management.  Conclusion: Our case showed the importance of obtaining a medical history in a medical emergency.  Key message: In cases of unconsciousness or other medical emergencies, taking a proper medical history and conducting a clinical examination are crucial. A re- evaluation of the patient helps in taking a proper medical history. It helps in proper diagnosis and management.
Image Caption Generator Using CNN and LSTM
Authors: Kapuriya Monali , Lakkad Zemi , Shah Satwi
Published: September 2024

In this have a look at, we discover the integration of Convolutional Neural Networks (CNNs) and Long Short-Term Memory (LSTM) networks for the motive of image caption generation, a mission that involves a fusion of herbal language processing and computer imaginative and prescient techniques to describe images in English. Delving into the realm of photograph captioning, we meticulously investigate several fundamental concepts and methodologies associated with this area. Our technique includes leveraging prominent equipment inclusive of the Keras library, numpy, and Jupyter notebooks to facilitate the development of our studies. Furthermore, we delve into the utilization of the flickr_dataset and CNNs for image category, elucidating their significance in our examination. Through this research endeavor, we aim to make a contribution to the development of image captioning structures with the aid of combining modern-day strategies from both laptop imaginative and prescient and herbal language processing domain names.
Combining Gyroscope and Electromyogram Analysis for the Detection of Resting Tremor and Muscle Activity in Parkinson's Disease
Authors: Biswas Arnab , Mukherjee Shamayita , Maji Arnab , Manna Ayan , Sarkar Shouvik
Published: September 2024

In this paper, we focus on designing and implementing a wearable device for detecting Parkinson's disease (PD) symptoms by analyzing resting tremors and abnormal muscle activity which contribute to PD combining gyroscope and electromyogram(EMG) analysis. Using advanced sensor technology, real-time data about movement and muscle activity is captured by the device. Here, we outline a hardware framework for optimizing data acquisition by identifying sensors to be used, their placement and integration strategies. In order to analyze data, machine learning algorithms are used to distinguish between tremors and muscle activity that are specific to Parkinson's disease and normal movements using classification technique. By enabling proactive healthcare interventions and customized patient management strategies, the proposed device represents a promising tool for the detection of early-stage Parkinson's disease.
Factors Influencing Information Security Policy Compliance Behavior “A Case – Study Healthcare Workers in a Private Hospital in Mogadishu – Somalia”
Authors: Abukar Aweis Zakarie , Isak Abdirahman Mohamed Adam , Jeilani Mohamud Abdulkadir
Published: September 2024

Information security policy compliance is crucial for safeguarding sensitive data in healthcare settings. This study investigates the factors influencing information security policy compliance behavior among healthcare workers at a private hospital in Mogadishu, Somalia. Findings reveal that beliefs in the importance of information security, effectiveness of communication and training programs, usability of security tools, and socio- cultural factors significantly impact compliance behavior. The study provides insights for healthcare administrators and policymakers to enhance compliance strategies in healthcare organizations.
BIOFAIR Data Network’s Listening Sessions for Engagement and Data Integration
Authors: Ellwood Elizabeth , Bentley Andrew , Thiers Barbara , Moser William , Watkins-Colwell Gregory , Zimkus Breda , Monfils Anna , Franz Nico , Bates John , Poo Sinlan , Contreras Dori , Webster Michael , Nelson Gil , Abeyrathna Nimanthi , Kunkel David , Long-Fox Brooke , Portmann Julia , Pittman Cameron , Sheik Matthew , Lomas Michael , Pandey Jyotsna
Published: September 2024

During the last two decades, a wealth of data on biodiversity and associated environments has been mobilized in digital form. Collectively, these data provide a powerful resource that when curated and integrated with intention, can provide critical information to address emerging complex global biological, environmental, and public health challenges. Tapping into the vast potential of specimen, observation, and environmental data requires us to integrate diverse and multifaceted datasets, connect domain-specific communities, and bridge discipline-specific social norms and data infrastructures. Linking data and their respective communities is a critical next step to creating the accessible and enriched data source needed to empower broad integrative biological research and education.

To initiate cross-domain collaborations, the Building an Integrated, Open, Findable, Accessible, Interoperable, and Reusable (*1) Data Network project, led by the Biodiversity Collections Network (BCoN) and funded by the United States National Science Foundation, convened stakeholders through six listening sessions over the summer of 2024. The sessions were aimed at building connections between disparate data communities—highlighting an iterative process of building a larger, interdisciplinary community from within. These listening sessions brought together representatives from federal agencies, the genetic data community, the ecology data community, the climate and environmental data community, the One Health community, and the biodiversity informatics community to initiate a collaborative and accessible partnership toward an integrative and expanded data network. Discussions focused on advancing data culture and infrastructure that meets emerging needs in research, education, conservation, biosecurity, and the bioeconomy. Participants discussed building on and bridging the Extended Specimen Network (ESN) vision with other existing conceptual frameworks for data integration and application (Lendemer et al. 2019, Thiers et al. 2019). Stakeholder groups will be brought together at an interdisciplinary workshop in early 2025, to develop a roadmap to augment existing initiatives with the aim of producing a FAIR (Findable, Accessible, Interoperable, and Reusable), open, integrated data network.
Evidence for moth pollination in a rhinomyiophilous Erica species from the Cape Floristic Region of South Africa
Authors: van der Niet Timotheüs , Cozien Ruth J.
Published: September 2024

Contrasting pollination syndromes in closely related species suggest that floral trait divergence is associated with differences in pollination system, but empirical observations are required to confirm syndrome-based predictions. We present a comparative study of two closely related Erica species with contrasting pollination syndromes from the Cape Floristic Region of South Africa. Erica cylindrica has narrowly tubular pale and strongly scented flowers and is known to be hawkmoth-pollinated. The closely related Erica infundibuliformis has bright flower colours and appears to lack scent, traits that are suggestive of pollination by long-tongued nemestrinid flies (rhinomyiophily). Floral trait measurements revealed that both species exhibit predominantly upright flower orientation and elongated floral tubes, although tube length of E. infundibuliformis is consistently greater than that of E. cylindrica. For both species, petals are brighter than floral tube surfaces, but flowers of E. cylindrica lack the strong UV reflectance found in E. infundibuliformis. Nectar of E. infundibuliformis is more concentrated and produced in larger volumes. Scent composition, but not evening scent emission rates, differed between the species: scent of E. cylindrica is dominated by aromatic compounds, whereas scent of E. infundibuliformis is dominated by (E)-ocimene and other terpenoid compounds and is emitted at higher rates during the day than the evening. Pollinator observations contradicted trait-based predictions: although a single nemestrinid fly captured in the vicinity of E. infundibuliformis did carry Erica pollen, almost all other diurnal flower visitors were nectar-robbing Hymenoptera which did not carry Erica pollen. Contrary to predictions, at two sites and over two flowering seasons, flowers were consistently visited in the evenings by several species of settling moths and hawkmoths which carried pollen, almost exclusively of Erica, on their proboscides. Our findings thus suggest that, despite objective differences in key floral traits between the closely related hawkmoth-pollinated E. cylindrica and E. infundibuliformis, moths are also important pollinators of E. infundibuliformis. A bimodal pollination system involving predominant pollination by moths and occasional visits by long-proboscid flies could partially reconcile findings with predictions. Our study further suggests that hawkmoth pollination may be more widespread in both Erica and the broader Cape flora than has hitherto been assumed and emphasises the importance of nocturnal pollinator observations.
Further notes on the genus Eurhaphidophora Gorochov, 1999 (Orthoptera, Rhaphidophoridae) with description of a new species from China
Authors: Zhu Qidi , Shi Fuming
Published: September 2024

This paper revises the genus Eurhaphidophora from China and describes a new species, i.e., Eurhaphidophora dulongjiangensis Zhu & Shi, sp. nov. The females of Eurhaphidophora tarasovi doitungensis Dawwrueng, Gorochov & Suwannapoom, 2020 and Eurhaphidophora fossa Lu, Huang & Bian, 2022 are described for the first time. Moreover, Eurhaphidophora curvata Lu, Huang & Bian, 2022, syn. nov. is considered as a new synonym of Eurhaphidophora pawangkhananti Dawwrueng, Gorochov & Suwannapoom, 2020. Images illustrating the morphology of these species are provided.
Review of the genus Salicarus (Hemiptera, Heteroptera, Miridae)
Authors: Konstantinov Fedor V. , Hosseini Reza
Published: September 2024

The genus Salicarus Kerzhner, 1962 is revised, with differential diagnoses and redescriptions provided for nine species. Three distinct species groups were recognized within the genus: S. nitidus group (S. cavinotum, S. genistae, S. nitidus, S. perpusillus), S. roseri group (S. concinnus, S. roseri, S. urnammu), and S. fulvicornis group (S. halimodendri, S. fulvicornis). A key to species, illustrations of dorsal habitus, male and female genitalia, and selected diagnostic structures are included. Additionally, available host information and distributional records are summarized. Phoenicocoris qiliananus Zheng, 1996 is synonymized with Salicarus halimodendri V. G. Putshkov, 1977.
Tscherskia ningshaanensis: A neglected species based on phylogenetic and taxonomic analysis of Tscherskia and Cansumys (Cricetidae, Rodentia)
Authors: Jiang Haijun , Wang Xuming , Yang Yaohua , Pan Xuan , Liu Shaoying , Lu Jiqi
Published: September 2024

The greater long-tailed hamster is primarily distributed in North Korea, Siberia (Russia), and central and northern China, while the Gansu hamster is restricted to southern Gansu Province, China. The genera Tscherskia and Cansumys have each been considered monotypic. The taxonomic status of these two genera has long been debated, and the specific status of T. ningshaanensis has also been contentious. Researchers have variously treated T. ningshaanensis as a subspecies of either T. triton or Can. canus. In this study, we estimated the phylogeny, divergence times, species delimitation, and biogeographical history of T. ningshaanensis by using one mitochondrial (CYT B) and three nuclear loci (GHR, IRBP, and RAG1) and compared the external and skull morphology variations between T. ningshaanensis and T. triton. The results showed that: 1) The genus Cansumys is a distinct genus in Cricetinae; 2) The notion that the genus Tscherskia is a monotypic genus is unsupported, T. ningshaanensis and T. triton were identified within this genus; and 3) The formation of T. ningshaanensis may have been driven by uplift of the Qinling Mountains. We conclude that T. ningshaanensis is a valid species within the subfamily Cricetinae.
A new species of Thermocyclops Kiefer, 1927 (Crustacea, Copepoda, Cyclopoida, Cyclopidae) from temporary habitats, with a discussion on the diversity and distribution of the genus in Thailand
Authors: Saetang Thanida , Koompoot Kamonwan , Watiroyram Santi , Maiphae Supiyanit
Published: September 2024

Thermocyclops Kiefer, 1927, is a genus of Cyclopidae, one of the most diverse families among cyclopoids. To date, 13 species of this genus have been recorded in Thailand. Through intensive sampling of rice fields in central Thailand and temporary waters in northeastern Thailand, one new species, Thermocyclops oryzaesp. nov., was discovered. This new species is clearly distinguished from other Thermocyclops by the presence of a serrated lobe on the posterior surface of the medial expansion of the basipodite of the fourth swimming leg. Moreover, it can be distinguished from its congeners by (i) ornamentation on the genital double-somite, succeeding two urosomites and caudal ramus; (ii) the length and width ratio of the caudal ramus; (iii) the length ratio of the innermost terminal seta (VI) and the outermost terminal seta (III); (iv) the number of setae on the second endopodal segment of the antenna; (v) projection and ornamentation on the intercoxal sclerites of the first to fourth swimming legs; (vi) the surface ornamentation of the medial margin of the basipodite of the first to fourth swimming legs; and (vii) the relative length of two apical spines of the third endopodal segment of the fourth swimming leg. The present discovery increases the number of species in this genus in Thailand to 14. A pictorial key to all species is proposed, and their ecologies and distributions within Thailand are updated and discussed.
Medieval Murals
Authors: Kónya Anna , Turk Marolt Sara , Neža Sitar Mateja , Salvadori Sara , Richter Katarina , Monteiro Patrícia , Mohar Katarina , Mladenović Ajda , Menoni Muršič Simona , Križnar Anabelle , Oter Gorenčič Mija , Lesar Kikelj Martina , Kavkler Katja , Kaun Susanne , Klančar Kavčič Anita , Dolenec Sabina , Čobal Sedmak Vlasta , Bence Gorazd , Andersen Elisabeth
Published: September 2024

Medieval mural paintings represent one of the most precious parts of artistic heritage and a crucial source for studying the culture of the relevant times and places, everyday life, and beliefs. They are also helpful for the reconstruction of religious practices and sometimes even historical events. Even the most fragmented remains of medieval murals make for a crucial methodological tool for reconstructing the buildings’ architectural history. The present monograph includes 12 studies by researchers from the broader European area on the selected medieval mural paintings from the end of the 12th to the middle of the 15th century, and it also focuses on the reception of these murals in the 20th century. The monograph thus also brings significant insights into the previously often overlooked question of the interpretation and instrumentalisation of medieval art in the 20th century. The contributions provide several new datings and attributions and reveal many new findings in the fields of iconography, stylistic connections, models, mobility of artists and workshops, commissioning backgrounds, and reception. They also raise new questions and describe modern methodological approaches to studying medieval murals.
Some of the research also extends to technical analysis, restoration and conservation, as a full understanding of medieval murals requires not only their iconographic and stylistic evaluation, but also an insight into their material reality.
Congregation members’ response to worship and fellowship in the digital space during the COVID-19 pandemic
Authors: Pakpahan Binsar J. , Aritonang Puji H. , Hendratmo Agus
Published: September 2024

This article investigates the congregation members to the transition from face-to-face worship and fellowship to digital spaces amid the coronavirus disease 2019 (COVID-19) pandemic, with a sample of the Huria Kristen Batak Protestan (HKBP – Batak Protestant Christian Church), specifically in District Daerah Khusus Ibukota (DKI) Jakarta province, Indonesia. This study uses an empirical questionnaire method to assess the level of satisfaction, engagement and future preferences of the congregation regarding digital versus face-to-face worship practices. The questionnaire was built on current theories of encounter and fellowship and what the congregation members need in digital worship services. Data from 421 congregations with a 95% confidence level and 5% margin of error showed a dominant 62.7% preference for returning to face-to-face worship services and a participation decline during the pandemic. Respondents also felt a 60%–90% difference in digital services from church services, especially related to the need for communal fellowship. Participation in digital services correlates with higher education levels, while older congregations preferred face-to-face worship.Contribution: This study highlights the importance of incorporating Batak cultural values into digital ministry strategies to increase community connectivity and engagement. This article suggests further research on integrating cultural elements into digital religious practices, aiming to provide insights for churches navigating the digital transformation of religious services.
Evaluation of implementation of evidence-based public health training in sub-Saharan Africa
Authors: Rohwer Anke C. , Jessani Nasreen S. , Mbeye Nyanyiwe M. , Balugaba Bonny E. , Akiteng Ann R. , Tumusiime David , Ntawuyirushintege Seleman , Kedir Kiya , Howe Rawleigh , Durao Solange , Toews Ingrid , Burns Jacob
Published: September 2024

Background: The Collaboration for Evidence-based Healthcare and Public Health in Africa (CEBHA+) developed and offered a course on evidence-based public health (EBPH) in five sub-Saharan African (SSA) countries to enhance individual and institutional capacity.Aim: This study aims to assess, compare and learn from implementing the CEBHA+ EBPH course using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework and Practical, Robust, Implementation and Sustainability Model (PRISM).Setting: This study involved CEHBA+ partner universities in five countries in SSA.Methods: We developed a framework that draws on signalling questions for RE-AIM and PRISM dimensions. Country teams reflected on, discussed and mapped unique experiences. Using this framework, we then elicited common themes across countries and distilled country-specific experiences through virtual discussions.Results: Across countries, 130 public health practitioners, researchers and students completed the course (Reach). The course increased EBPH knowledge and skills and the capacity to teach EBPH and resulted in immediate opportunities for applying skills (Effectiveness). Hybrid offering in two countries presented challenges regarding Internet connectivity and hybrid discussions. Facilitators had previous training in teaching EBPH. While learning material was the same across countries, the content was adapted to represent local public health priorities (Implementation, Adoption). Course materials have informed other related training leading to spin-offs (Maintenance). Institutionalisation is dependent on external funding.Conclusion: Strengthening EBPH capacity across contexts is feasible. Curricula containing both core and contextualised elements create an authentic learning environment. Formal evaluations should be embedded within capacity-strengthening initiatives.Contribution: This is the first study evaluating EBPH training in SSA using an implementation science lens, offering learning about context-relevant adaptations that assist with plans for sustainability and scale.
5: Comparison of intubating conditions with sniffing versus ramp position in non-obese patients
Authors: ChavanPritamDilip
Published: September 2024

Background and Aims:

Proper positioning is essential in laryngoscopy for optimal laryngeal visualisation. In sniffing position (SP), the neck is flexed 35° on the chest and the head extended at the atlanto-occipital joint to produce a 15° angle between the facial and the horizontal planes in normal-weight patients. This was considered the optimal position for successful direct laryngoscopy.Rapid Airway Management Position (RAMP) was introduced by Collins in 2004 in which the patient’s external auditory meatus and sternal notch are in the same horizontal plane.

Methods:

After Institutional Ethics Committee approval for a randomised prospective study, 50 patients of age 18-60 years, with body mass index < 25, of American Society of Anesthesiologists(ASA) I and II, having Mallampati classification (MPC) I and II, mouth opening angle (MOA)≥2, thyromental distance>6.5, undergoing routine elective surgery under general anaesthesia were divided into Group S (SP) and Group R(RAMP) (25 each). Patients in Group S were given 8 cm high pillow to elevate the occiput while that in Group R were laid on a ramp made of folded blankets. After laryngoscopy, both groups were compared for number of single attempt successful intubations, intubation time, Cormack Lehane (CL) view and need for ancillary manoeuvres.

Results:

Intubation time with RAMP was significantly lesser than SP. (p < 0.0001). Also, RAMP was associated with greater number of single attempt intubations (p= 0.034), better CL view (p=0.041) and lesser number of ancillary maneuvers(p=0.03).

Conclusion:

RAMP is superior to SP in terms of better laryngeal view, faster intubation time and lesser need for external manoeuvres.

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Abstract No.: ABS0615: Anaesthesia management of bilateral bronchopleural fistula for repair
Authors: Shah Hetalkumar
Published: September 2024

Background and Aims:

Bronchopleural fistula (BPF) poses ventilatory challenges during general anaesthesia (GA). Without repair of large BPF, patient’s condition is unlikely to improve. Hence thoracic surgery in these patient is a challenging task. Coronavirus disease 2019 (COVID-19) pandemic, has caused immense morbidityincluding pulmonary sequelae pulmonary complications such as BPF. Perioperative strategies included to maintaining adequate ventilation and haemodynamics.

Methods:

We present anaesthesia management of five cases, who developed bilateral significant BPF as post COVID-19 sequelae. Conservative treatment with bilateral ICD did not reduce the BPF leak. Hence, surgical closure of BPF was planned. Maintaining adequate ventilation was challenging task. Regional blocks are considered safer alternative in patients with pulmonary disease. Erector spinae blocks (ESP) was performed. Ventilatory and haemodynamic parameters were measured. Pain score and patient comfort was also recorded.

Results:

Out of five patients , four patients received ESP block and one patient had haemodynamic instability in intensive care unit so,the patient was operated under GA Table 1. Desaturation during positioning were noted in only one patient. Inotropes to maintain haemodynamics were required in two patients . All patients managed under ESP block were comfortable during intraoperative period.

Conclusion:

ESP block was found to be a a safer option for perioperative management in BPF repair in these patients of post COVID-19 sequelae .

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Abstract No. : ABS0801: Prevalence of ‘Bertolotti Syndrome’ in patients with chronic low back pain coming to pain clinic- out patient department in an urban tertiary care hospital.
Authors: Nandi Gargi
Published: September 2024

Background and Aims:

Bertolotti syndrome(BS) was first identified in 1917, as a common cause of lower back pain(LBP), especially in the younger population. This study aimed to estimate the prevalence of BS in LBP patients and produce frequency estimates of BS for different demographics.

Methods:

Five hundred patients of both sex aged >18 years, presenting with lumbago, pygalgia or lower back or buttock pain, isolated or with radiculopathy with pain persisting for >3 months, numereical rating scale(NRS) score >5, were recruited. Patients with painful symptoms associated with other obvious etiology were excluded. Patients were investigated by ferguson view of antero-posterior lumbar spine radiograph. If pain was present at pseudoarticulation site on palpation then a diagnostic injection of 3 ml of 2% lignocaine was given at the pseudoarticulation or sacro-iliac neo joint. NRS was evaluated before and after injection. >50% improvement in NRS score were differentiated as BS.

Results:

The prevalence of lumbosacral transitional vertebra(LSTV) in the sample was 29.2%.The prevalence of BS was 15.2% which was higher in the study population (table 1). There were no statistically significant differences between men and women who had BS. No statistically significant difference was found between different age groups regarding the prevalence of BS.

Conclusion:

We conclude that Bertolotti syndrome is an underdiagnosed condition and a suitable analysis of a low back pain patient should be done to rule out BS Confirmation of pain originating from the pseudo articulation site can be made with local anaesthesia injections.

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Abstract No. : ABS0814: Comparison of lung ultrasound technique versus clinical method to evaluate the accuracy of positioning of left endobronchial double lumen tube in patients undergoing elective thoracic surgery- a prospective observational study
Authors: Gupta Ekta
Published: September 2024

Background & Aims:

Clinical methods like height and gender were found to be inaccurate in predicting the size of double-lumen tube (DLT).Tracheal ultrasonography (TUS) reliably predicts the size of DLT by measuring tracheal diameter. The aim wasto check theaccuracy of ultrasound over clinical methods.

Methods:

This study was conducted on 68 patients undergoing elective thoracic surgery requiring one-lung ventilation (OLV) withDLT. The subjects were divided into two groups depending on the prediction of size of DLT by either clinical (Group1) orultrasound method. (Group 2). The transducer was placed perpendicular to skin over cricoid cartilage to measure the transversediameter of the column of air in the cricoid cartilage which denoted the size of the DLT. The primary objective of the study was to assess the accuracy in prediction of size and placement of DLT through various parameters in both clinical andultrasound groups.

Results:

The accuracy of predicted DLT size between the Group U and Group C was found to be statistically significant (p=0.044). In Group 1, 56% of patients showed a mismatch between the predicted DLT size and the actual size required, while in Group 2, the mismatch was only 32.4%. The accuracy of placement of DLT in the first attempt suggested by adequate lung isolation was also significantly higher (p=0.028) in the ultrasound group compared to the clinical group.

Conclusion:

The size of DLT can be predicted by using clinical parameters but have low accuracy. In our study, the size of DLT was calculated by measuring tracheal diameter using TUS, which significantly improved the selection of appropriate DLT size, avoiding complications.

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Abstract No. : ABS1022: Effect of use of Entropy Monitoring on Consumption of Sevoflurane Inhalational Agent in patients undergoing off-Pump Coronary Artery Bypass Graft Surgery
Authors: Trivedi Virali
Published: September 2024

Background & Aims:

Assessing depth of anaesthesia using entropy is resourceful as it allows for accurate hypnotic drug administration and decreased anaesthetic drug consumption. This study was performed to evaluate the effect of entropy monitoring on sevoflurane consumption in patients undergoing off-pump coronary artery bypass graft (OPCABG) Surgery.

Methods:

60 patients of American Society of Anesthesthesiologists grade II and III between 40-70 years of age, of either sex planned for OPCABG surgery were randomly allocated to two groups. In the control group B, sevoflurane was titrated according to changes in clinical parameters and in the study group A, sevoflurane was titrated to maintain state entropy values between 40-60 accordingly. Response entropy and state entropy values were continuously recorded in both the groups but were displayed on the monitor only in the study group. The entropy values, sevoflurane consumption andrecovery times were compared.

Results:

Sevoflurane consumption and recovery time were significantly reduced in the study group A than the control group B (p-value <0.001); Sevoflurane consumption was 7.03±0.67 ml/h vs 12.42±0.68 ml/h; recovery time 6.47±0.65 h vs 12.05±1.11 h). Response and state entropy values were lower in the control group than the study group (p < 0.001). Systolic blood pressure during skin incision, sternotomy and at the time of completion of all grafts were significantly lower in study group.

Conclusion:

Monitoring the depth of anaesthesia using entropy monitoring leads to significant reduction in sevoflurane consumption. Significantly faster recovery rate from surgery could be associated with more accurate hypnotic and analgesic drug administration.

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Abstract No.: ABS2258 : Evaluation of the efficacy of preoperative oral glucose loading for attenuating perioperative stress response to surgery under general anesthesia.
Authors: K P Archana
Published: September 2024

Background & Aims:

Nutritional and metabolic preparation of the body facilitates mitigation of increased catabolism, insulin resistance and therby attenuates the stress responses to surgery. . Nutritional and metabolic preparation of the body facilitates in mitigation of increased catabolism, insulin resistance and thus stress response to surgery. The present study therefore aimed at evaluating the effects of preoperative oral glucose loading and its effects in decreasing the stress response to surgery.

Methods:

The present study included Forty adult patients scheduled for elective surgery under general anesthesia who were then randomly allocated into two groups of 20 patients each. Patients in group G received glucose orally on the evening before surgery (100g) and on the morning of surgery (50g). Patients in group N did not receive glucose. All patients of both groups followed standard American Society of Anaesthesiologists ( ASA) fasting guidelines. Assessment for blood glucose, cortisol and interleukin-6 along with patient well-being were made at different time intervals.

Results:

The magnitude of increase in the Serum Cortisol from the baseline was significantly more in group-N as compared to group-G. The increase in the blood glucose levels was significantly less in group-G at T24. The magnitude of increase in the interleukin-6 levels from the baseline was significant at T24 in both the groups. Also significant number of patients in group-N experienced thirst, hunger and anxiety. Patients in group-G experienced less intense pain when compared to group-N.

Conclusion:

I Preoperative oral glucose loading was associated with significant reduction in the stress-response to surgery because of the concomitant decrease in the magnitudeof increase in blood-glucose and serum-cortisol levels.Also enhanced a patient well-being postoperatively in the form of reduced pain and anxiety was the additional Benefit of preoperatively glucose loading.

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Abstract No.: ABS2271: A Comparative Study of Optic Nerve Sheath Diameter and Lung Ultrasound Score in Healthy and Preeclampsia Parturients.
Authors: Nagpal Akshita
Published: September 2024

Background & Aims:

Complications of preeclampsia include cerebral and pulmonary oedema which strongly correlate with optic nerve sheath diameter (ONSD) and lung ultrasound score (LUSS) respectively. This study was conducted to compare ONSD and LUSS in healthy and preeclamptic parturients.

Methods:

In this prospective observational analytical study, healthy pregnant women and preeclamptic women, 35 each, age >18 years and gestational age >34 weeks up to 24 hours of delivery, were included. Approval from institutional ethical committee was obtained and trial registered with clinical trial registry of India. Ultrasound assessment for ONSD and LUSS (12 region lung technique) was performed. Severity of preeclampsia was noted. Data was analysed using appropriate statistical tests. ROC analysis was performed to obtain a cutoff value for both ONSD and LUSS to predict complications of preeclampsia. A p-value of <0.05 was considered significant.

Results:

Of the 35 preeclamptic women, 19 had severe preeclampsia. Severe preeclamptics had higher ONSD and LUSS than mild preeclamptics and healthy parturients (p-value < 0.001). No difference was observed in LUSS between mild preeclamptics and healthy parturients. Mean ONSD of >4.65mm and LUSS of >2 predicted preeclampsia complications with a sensitivity of 77.14% and 68.57%, specificity of 91.43% and 85.71% and AUC of 0.907 and 0.806 respectively.

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Conclusion:

ONSD and LUSS assessment is an easy, bedside, noninvasive technique to assess complications, guide fluid therapy and monitor response to treatment in preeclamptic parturients. Thus, early intervention can help in reducing maternal/fetal morbidity and mortality
Abstract No. : ABS2675: Effects of avoiding neuromuscular blocking agents during maintenance of anaesthesia for recovery characteristics in patients undergoing craniotomy supratentorial lesions: A randomised controlled trial.
Authors: Grace Ruby
Published: September 2024

Background & Aims:

With the advent of newer anesthetic techniques, the utility of neuromuscular blocking agents (NMBA) in neuroanaesthesia seems dispensable. The aim was to determine whether NMBAs are required in patients undergoing supratentorial surgery when balanced anaesthesia with desflurane, dexmedetomidine and scalp block is used.

Methods:

Sixty patients with American society of anesthesiologists physical status I/II, aged between 18 & 60years were included. All patients received general anaesthesia along with desflurane, dexmedetomidine and scalp block. The patients were randomly allocated to receive no NMBA (groupA) or atracurium infusion to maintain a train of four count 2 (groupB). The two groups were compared with respect to haemodynamic stability, brain relaxation scores and recovery characteristics. Haemodynamic parameters and time taken to achieve Aldrete score >9 and secondary outcomes were analysed using Student’s t-test. Non-parametric data were analysed using the Mann-Whitney test.

Results:

The mean arterial pressure and intraoperative heart rate were comparable between the groups. However, in the postoperative period, heart rate remained higher in group B for 30 min after extubation (p=0.02). The brain relaxation scores were comparable among the groups (p=0.27).Tracheal extubation time, time taken for orientation and time required to reach Aldrete score >9 were comparable among the two groups.

Conclusion:

The present study suggested that balanced anaesthesia using desflurane, dexmedetomidine and scalp block can preclude the use of neuromuscular blocking agents in patients undergoing supratentorial surgery under intense haemodynamic monitoring.
Abstract No.: ABS2768: Comparison of pre-emptive ketamine nebulisation with intravenous ketamine for post-operative analgesia in children undergoing tonsillectomy: A randomised controlled trial
Authors: K Priyanka Kamal
Published: September 2024

Background and Aims:

Nebulised ketamine is a painless route of drug administration in children.This study aimed to compare the effectiveness of ketamine nebulisation as opposed to intravenous ketamine as premedication in children

Methods:

64 children aged 5-10 years, undergoing tonsillectomy were randomly allocated into 2 groups.Both groups received glycopyrrolate 5mcg/kg. First group received ketamine nebulisation (1mg/kg) 20minutes prior to the surgery and other group received intravenous ketamine (1mg/kg) just before shifting to operating room. Children were anaesthetised by standard technique using fentanyl 1 µg/kg, propofol 2mg/kg, atracurium 0.5mg/kg and sevoflurane. Postoperatively, pain score using verbal rating scale(VRS) was assessed immediately after shifting to post anaesthesia care unit (PACU)and after one hour and the time of first rescue analgesic requirement was noted. Children were also assessed for parental separation scores and levels of sedation using 5-point sedation scale preoperatively.

Results:

There was no difference in VRS pain score immediately after shifting to PACU but there was significant difference in the VRS pain score at one hour postoperatively (p<0.05).The mean time for rescue analgesia was significantly prolonged in ketamine nebulisation group (300±26.40min) in contrast to intravenous ketamine group (237.19±34.38min) (p<0.05). Nebulised and intravenous ketamine produced similar levels of sedation (score-2) and acceptable parental separation scores (score1,2) (table 1).

Conclusion:

Ketamine nebulisation (1mg/kg) administered before tonsillectomy significantly prolonged postoperative analgesia as opposed to intravenous ketamine with similar parental separation scores and sedation scores. Hence nebulisation can be used as an alternative route for administering ketamine.
Abstract No. : ABS2974: Comparative study between pulsed radiofrequency ablation and continuous radiofrequency ablation of splanchnic plexus for pain relief in patients with upper abdominal cancers - Adouble blinded randomised controlled study
Authors: Kaur Harsimran
Published: September 2024

Background and Aims:

The study compares the efficacy of pulsed radiofrequency ablation(RFA) versus continuous RFA in relieving pain ,improving quality of life and reducing daily morphine dosage amongst patients suffering from upper abdominal cancers.

Methods:

Fifty six patients presenting to the out patient department with intractable pain (visual analogue scale (VAS) score≥4) due to upper abdominal cancers despite taking oral morphine were randomly divided into two groups of 28 patients each. Patients in group 1 were given splanchnic plexus block using pulsed RFA at 42 degrees for 7 min and group 2 were given continuous RFA at 80 degrees for 90 seconds using C-arm and fluoroscopy-guided technique. The patients were followed up at 15 days, 1 month, 3 months and 6 months for the assessment of pain severity(VAS), quality of life(Edmonton Scale) and daily oral morphine dose.

Results:

Mean reduction in VAS Score was more for group 2 than group 1, at all follow ups and the difference was statistically significant at 1, 3 and 6 months. Mean Edmonton score and mean daily morphine dosage were significantly reduced in both groups at 15 days but the difference between 2 groups was statistically insignificant, and at subsequent follow ups these variables increased in both groups but the increase in group 1 was more than group 2 (figure 1).

Conclusion:

Continuous RFA provides a better pain relief than pulsed RFA but there is no significant long term improvement in the quality of life and opioid consumption of patients with these interventions.
Abstract No. : ABS3263: Comparison of efficacy of ultrasound guided pectoral blocks plus serratus anterior plane block versus ultrasound guided erector spinae block with fentanyl group as control for analgesia in patients undergoing off-pump coronary artery bypass Grafting.
Authors: K Jose Abin
Published: September 2024

Background & Aims:

To compare the efficacy of Ultrasound-guided Pectoral block (PECS 1&2) plus Serratus Anterior Plane (SAP) block versusErector Spinae Plane (ESP) block for post-op analgesia in patients undergoing Off-Pump Coronary Artery Bypass Grafting(OPCAB). Postoperative analgesia in terms of Numerical Rating Scale (NRS) pain scores at rest (static) and during movement (dynamic) was taken as the primary outcome. Haemodynamic variations,opioid consumption at 48 hours postoperative, time to mobilisation, level of pain at rest and after mobilisation and complications were noted as secondary outcomes.

Methods:

81 American Society of Anesthesiologists Grade III and IV patients between 35 -70 years, undergoing off-pump coronary artery bypass grafting were recruited.

Patients were randomly allocated into three groups, each with 27 subjects: (Group A: Pectoral +Serratus anterior plane block group; Group B: Erector spinae block group ;Group C: Control group with only intravenous opioids).10 ml of 0.25% Bupivacaine + 1% Lignocaine with adrenaline (1 in 2 Lac)+8 mg dexamethasone was givenultrasound guidedPECS 1 and 2 & SAP- 10 ml; on either side and 30ml on either side for Erector spinae block.

Results:

ESP block had comparable analgesic profile as PECS +SAPB at rest andduring movement in terms of NRS pain scores. Total perioperative opioid consumption was markedly decreased with the supplementation of newer blocktechniques, and better sedation profile wasobserved. The need for rescue analgesia was markedly reduced in block groups.Haemodynamic variationsduration of postoperative ventilation, ICU and hospital stay were comparable in all the three groups.

Conclusion:

The study concluded that regional blocks were superior to intravenous fentanyl for postoperative pain relief following cardiacsurgery. The use of narcotics leads to poor pain relief and greater sedation in the postoperative period.
Abstract No. : ABS3342: Comparison of erector spinae block versus epidural catheter infusion for analgesia in thoracic surgery
Authors: M RubiyaSayed
Published: September 2024

Background & Aims:

Theprimary objective was to compare the efficacy of analgesia provided by epidural catheter and erector spinae blockin the postoperative period based onnumerical rating scale. Rescue analgesia, time of mobilisation, any complications associated were assessed as secondary objectives.

Methods:

This Prospective randomised single-blinded comparative study included 76 patients of American Society of Anesthesiologists grade I, II and III. Haemodynamicdata including heart rate, blood pressre and oxygen saturation were recorded preoperatively, 5 minutes after induction, 5 minutes after nerveblock/epidural, at skin incision, 20 minutes after incision. Local anaesthetic infusion of 0.125% bupivacaine + 2 µg/mlfentanyl was given @ 6-8 ml/h at 1 h after block/epidural.Postoperative pain assessment was done for pain at rest anddynamic pain with Numerical rating scale (NRS) and sedation level based on the Ramsay sedation scale was noted. The need for rescueanalgesia and complications was documented.

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Results:

NRS score at rest was statistically significant in the period between 12 to 24 h, while thedynamic score was found to be statistically significant from 4 to 24 h. The epidural group required more rescue analgesic and total amount of intraoperative fentanyl doses compared to the erector spinaegroup with a P-value of 0.02.

Conclusion:

Ultrasound-guided ESP block is comparable with thoracic epidural technique in patientsundergoing elective thoracotomy with regards to post operative analgesia, less opioid requirement, patient satisfaction, and fewer complications.

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