bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of ketamine versus sevoflurane on the right ventricular pressure during balloon dilatation of congenital pulmonary valve stenosis
Authors: Sayed Amr Gaber , El Moez Walaa Adel Abd , Shoukry Aktham , Elshafeey Ahmed Elsayed
Published: February 2024

Background & Objective: Congenital pulmonary stenosis (PS) is a prevalent cardiac anomaly that is commonly treated with balloon dilatation. The procedure can be successfully completed under appropriate anesthetic technique, depending upon the choice of the anesthetist and the patients’ physical status. We compared the effect of IV ketamine with sevoflurane inhalational anesthesia on right ventricular pressure in infants undergoing balloon dilatation for congenital pulmonary valve stenosis.

Methodology: This double-blinded, randomized, clinical trial included 40 infants, aged from 1 to 12 months, with congenital PS undergoing balloon dilatation. They were randomly allocated to one of the two groups. In the ketamine group, 20 patients received 2 mg/kg of ketamine intravenously till being unconscious. In the sevoflurane group, 20 patients received 3% sevoflurane and were maintained using the open circuit technique till losing consciousness. The right ventricular pressure was the primary outcome. Secondary outcomes were the hemodynamics and oxygen saturation.

Results: Compared to sevoflurane, ketamine showed a non-significant difference in the right ventricular pressure before and after induction of anesthesia and after balloon dilatation. The mean arterial blood pressure significantly dropped immediately after sevoflurane induction and after the initial 10 min (P = 0.031 and 0.041, respectively). The heart rate significantly decreased immediately after sevoflurane induction (P = 0.028). The oxygen saturation remained comparable in both groups at 10 and 20 min after induction, and at postoperative anesthesia care unit.

Conclusion: Intravenous ketamine is considered a safe and effective alternative to sevoflurane for infants with congenital pulmonary stenosis undergoing balloon dilatation. It maintains the right ventricular pressure with stable hemodynamic effects, compared to sevoflurane inhalational anesthesia.

Abbreviations: PS - Pulmonary Stenosis; TS – Tricuspid Stenosis; PACU – Post Anesthesia Care Unit; TTE - Transthoracic Echocardiography

Key words: Balloon Dilatation; Infants; Ketamine; Pulmonary Stenosis; Sevoflurane.

Citation: Sayed AG, Abd el Moez WA, Shoukry A,  Elshafeey AE. Effect of ketamine versus sevoflurane on the right ventricular pressure during balloon dilatation of congenital pulmonary valve stenosis. Anaesth. pain intensive care 2023;27(5):451−457; DOI: 10.35975/apic.v27i5.2210

Received: April 18, 2023; Reviewed: July 18, 2023; Accepted: August 21, 2023
Discovering a combination of natural compounds for treatment of chronic cancer pain based on bioinformatics
Authors: Si Weichen
Published: February 2024

Background & Objective: The incidence of malignant disease has been increasing the world over, and with it the number of patients suffering from severe cancer pain is also increasing with every passing day. We aimed to find a potentially effective combination of natural compounds for the treatment of chronic cancer pain (CCP) using bioinformatics methods, and provide a theoretical basis for subsequent laboratory experiments and clinical trials.

Methodology: Six natural compounds, including bakuchiol, cinnamaldehyde, curcumin, eugenol, salicin and xanthoxylin, were selected as candidates for new drugs by consulting a large number of relevant literatures. Their targets were obtained from the Swiss Target Prediction database. The related targets of CCP were obtained from GeneCards, OMIM and DisGent databases. Cytoscape software was used to construct the "compound-target-disease" network. Protein-protein interaction network (PPI) was constructed by STRING platform; GO function and KEGG pathway enrichment analysis were performed by R language software.

Results: A total of 197 targets were obtained from the Swiss Target Prediction database; 10767 CCP of disease targets were obtained after searching and removing duplications in the disease database. Twelve core targets, AKT1, SRC, STAT3, ESR1, RELA, EP300, MAPK1, MAPK14, CCNA2, EGFR, GSK3B and PRKCZ, were identified by PPI analysis. GO functional enrichment analysis yielded 1950 entries. KEGG enrichment analysis revealed 134 pathways with statistical significance, among which pathways related to CCP were more than those related to nerve.

Conclusion: The mechanism of action of these six compounds in the treatment of chronic cancer pain is multi-target and multi-pathway related. Through protein-protein interaction analysis, GO function and KEGG pathway enrichment analysis, it is found that these six compounds can be used as candidate drugs for the treatment of chronic cancer pain, which will be further studied in the future.

Key words: Bioinformatics; Natural Compounds; Chronic Cancer Pain; New Drug Discovery

Citation: Si W. Discovering a combination of natural compounds for treatment of chronic cancer pain based on bioinformatics. Anaesth. pain intensive care 2023;27(5):431−439; DOI: 10.35975/apic.v27i5.2293

Received: February 21, 2023; Reviewed: March 06, 2023; Accepted: April 28, 2023
"Resilience unveiled: empowering Pakistani anesthetists in challenging low-resource environment"
Authors: Zahid Muhammad Arslan , Ali Pervaiz , Saddique Faisal , Khan Bahram , Rehman Muhammad Abdul , Kumar Ajeet
Published: February 2024

This review paper explores the difficulties that the Pakistani anesthetists experience while working in settings with limited resources and emphasizes the need of offering them support, help, and encouragement. Similar to many other poor nations, Pakistan has substantial shortages of the healthcare resources, which can have a negative influence on anesthetists' working conditions. The paper emphasizes the need for efforts to improve Pakistani anesthetist’s well-being and professional growth, while also inviting attention to the special challenges they have to confront during discharge of their professional duties. This narrative review suggests that encouraging, assisting, and supporting anesthetists who operate under such demanding circumstances can improve their motivation, job satisfaction, and generally, their ability to offer high level of patient care.

Key words: Low Resource Settings; Limited Resources; Encouragement; Professional Growth; Challenges; Motivation; Job Satisfaction; Workload; Continuing Education; Training; Psychological Stress; Emotional Support

Citation: Zahid MA, Ali P, Saddique F, Khan B, Rehman MA, Kumar A. "Resilience unveiled: empowering Pakistani anesthetists in challenging low-resource environment". Anaesth. pain intensive care 2023;27(5):592−598; DOI: 10.35975/apic.v27i5.2299

Received: Jul 29, 2023; Reviewed: Aug 07, 2023; Accepted: Aug 10, 2023
Comparative study on analgesia duration with bupivacaine-buprenorphine combination vs. bupivacaine alone for cesarean delivery
Authors: Memon Muhammad Saleh , Malik Shoaib , Memon Ghulam Nabi , Rehman Memoona
Published: February 2024

BACKGROUND: Spinal anesthesia has been the preferred type of anesthesia for cesarean sections and other obstetric operations. Bupivacaine has been used for this purpose being long acting. Lately various narcotic analgesics have been added to prolong the analgesia and reduce the expected toxicity of bupivacaine alone. We evaluated the duration of analgesia achieved with the combination of bupivacaine-buprenorphine versus bupivacaine alone in cesarean delivery under spinal anesthesia.

Methods: A comparative study was conducted at a tertiary care teaching healthcare center in Karachi, Pakistan. One hundred patients scheduled for elective cesarean section were enrolled and divided into two groups. Group A received 10 mg of hyperbaric bupivacaine 0.5% along with normal saline, while Group B received the same dose of bupivacaine along with buprenorphine 75 µg. Preoperative assessment, intraoperative procedures, and postoperative management were performed following standard protocols of our institution. Statistical analysis was conducted using independent t-tests and chi-square tests.

Results: The findings revealed significantly longer mean time to request for analgesia in Group B compared to Group A (825.33 min vs. 166.78 min; P = 0.182), Only 14 patients in Group B (28%) required analgesia within 24 h, while all patients in Group A requested analgesia within that time frame (P = 0.0001). Moreover, an insignificantly lower incidence of hypotension and reduced need for phenylephrine administration was observed in Group B compared to Group A (P = 0.585). Group B also demonstrated a lower incidence of nausea (P = 0.380) and vomiting (P = 0.370) compared to Group A, but the difference was statistically not significant.

Conclusion: This study suggests that the addition of buprenorphine to bupivacaine in spinal anesthesia for cesarean delivery provides prolonged analgesia, reduces the incidence of nausea and vomiting, and decreases the need for vasopressor administration. These findings support the potential benefits of using the bupivacaine-buprenorphine combination in cesarean deliveries.

Key words: Cesarean Delivery; Opioids, Intrathecal; Anesthesia, Spinal; Bupivacaine; Buprenorphine; Analgesia, Duration

Citation: Saleh M, Malik S, Memon GN, Rehman M. Comparative study on analgesia duration with bupivacaine-buprenorphine combination vs. bupivacaine alone for cesarean delivery. Anaesth. pain intensive care 2023;27(5):501−505; DOI: 10.35975/apic.v27i5.2303

Received: July 29, 2023; Reviewed: August 10, 2023; Accepted: August 10, 2023
Bilateral ultrasound guided erector spinae plane block vs. preoperative pregabalin for postoperative pain management in lumbar spine surgery
Authors: Mohamed Rabab Mohamed , Morsy Islam , Hamed Jehan Mohammad Darwish
Published: February 2024

Background & Objective: Injecting local anesthetics into the erector spinae plane and obstructing the dorsal and ventral rami could reduce the pain. Pregabalin and gabapentin are used to reduce neuropathic pain; however, pregabalin has demonstrated greater analgesic potency than gabapentin. This work aimed to compare the analgesic effects and complications between preoperative pregabalin and erector spinae plane block (ESPB) for lumbar spine surgery under general anesthesia.

Methodology: Sixty patients were allocated to the 2 groups using a computer-generated random number that was hidden in sealed, opaque envelopes. In Group 1, the patients received pregabalin 150 mg twice daily for 3 days before surgery. After preoxygenation and before induction of anesthesia, dexmedetomidine 1 µg/kg was given in both of the groups. In Group 2, after the patient was placed in the prone position for the operation and after the induction of general anesthesia, ESPB was carried out bilaterally under ultrasound guidance. Ropivacaine hydrochloride was administered at a quantity of 20 mL upon confirmation of the needle's proper insertion. Numerical Rating Scale (NRS) was used to assess the pain intensity.

Results: There was a longer-lasting analgesia in the ESPB group with significantly lower NRS only at 12 h and 18 h (P = 0.001) compared to the pregabalin group, but they were comparable at 24 h (P = 0.407). The time to request first rescue analgesic and the total morphine consumption were significantly different; a significantly longer time for the first rescue analgesic (17.10 vs. 11.73 h) and a significantly reduced amount of morphine consumption (6.30 vs. 10.33 mg) in ESPB group.

Conclusion: Both bilateral erector spinae plane block and preoperative pregabalin seem to be helpful for providing adequate pain management postoperatively for lumbar spine surgery; however, bilateral erector spinae plane block was superior in pain management during the first 24 h postoperatively with fewer side effects.

Abbreviations: ESPB - Erector Spinae Plane Block; α2-AR - Alpha 2 Adrenoreceptors; NRS - Numerical Rating Scale; ACE - Angiotensin Converting Enzyme; NaCl - Normal Saline; MAP - Mean Arterial Blood Pressure; IV - Intravenous; PACU - Post-Anesthesia Care Unit; X2 - Chi-square; IQR - Interquartile Range; MAC - Minimum Alveolar Concentration;

Preregistration: The study had approval from the Ethical Committee and Institutional Review Board of the Faculty of Medicine, Tanta University with approval code (35692/9/22).

Key words: US-ESPB; Ultrasound Guided; Erector Spinae Plane Block; Pregabalin; Lumbar Spine Surgery

Citation: Mohamed RM, Morsy I, Hamed JMD. Bilateral ultrasound guided erector spinae plane block vs. pregabalin for postoperative pain management in lumbar spine surgery. Anaesth. pain intensive care 2023;27(5):513−520; DOI: 10.35975/apic.v27i5.2306

Received: April 07, 2023; Reviewed & Accepted: July 01, 2023
Clinical effect of cervical vs. targeted epidural blood patch in spontaneous intracranial hypotension with unclear leakage sites
Authors: Ryu Hansung , Lee Hyeon Seung , Kim Hyuckgoo
Published: February 2024

Background and Aims: Epidural blood patch (EBP) is the most commonly used treatment for spontaneous intracranial hypotension (SIH). EBP is generally targeted at the cerebrospinal fluid (CSF) leakage site; in unclear leakage sites, it is performed blindly in the lumbar region. Therefore, to investigate effectiveness of cervical EBP in SIH patients having unclear CSF leakage sites, we conducted a retrospective case control study to compare the effectiveness of cervical EBP for unclear leakage site and targeted EBP at leakage sites.

Methodology: We reviewed the records of SIH patients who had undergone EBP at a single hospital. Patients were divided into Group CE (cervical EBP for unclear leakage site) and Group TE (targeted EBP at leakage site). the demographics, clinical characteristics, leakage site, EBP injection level, injected volume, and change in pain score (numeric rating scale [NRS]) were analysed for both groups.

Results: We analysed 54 patients, with 13 and 41 patients in the CE and TE groups, respectively. EBP regions in the TE group included the cervical, thoracic, and lumbar regions. There were no significant differences in demographic data between the groups. The baseline NRS scores for headache were 7.8 ± 0.9 and 7.7 ± 0.8 (P = 0.771); scores after EBP were 2.9 ± 1.7 and 2.2 ± 1.1 (P = 0.195) in groups CE and TE, respectively. NRS changes of 4.9 ± 2.0 and 5.6 ± 1.5 (P = 0.348) occurred in groups CE and TE, respectively. The mean blood volume in the CE group was 10.4 ml. Clinical effectiveness did not differ significantly between the groups.

Conclusion: Cervical EBP is as effective as targeted EBP when the CSF leakage site is unclear. Therefore, cervical EBP is appropriate for SIH in patients with unclear CSF leakage.

Abbreviations: CSF - Cerebrospinal Fluid; EPB - Epidural Blood Patch; NRS - Numeric Rating Scale; SIH - Spontaneous Intracranial Hypotension

Key words: Epidural Blood Patch; Spontaneous Intracranial Hypotension; Headache

Citation: Ryu H, Lee HS, Kim H. Clinical effect of cervical vs. targeted epidural blood patch in spontaneous intracranial hypotension with unclear leakage sites. Anaesth. pain intensive care 2023;27(5):521−525; DOI: 10.35975/apic.v27i5.2307

Received: July 07, 2023; Reviewed: August 28, 2023; Accepted: September 01, 2023
Comparison of low dose ropivacaine plus dexmedetomidine vs. low dose bupivacaine for spinal anesthesia in transurethral resection of prostate
Authors: Hassan Jawad Ul , Zafar Ehsan , Ameer Khalid , Saleem Muhammad Asif , Akram Muhammad , Sami Aqeela
Published: February 2024

Background & Objective: Spinal anesthesia (SA) has been preferred for transurethral resection of prostate (TURP) due to various advantages over general anesthesia. The most commonly used drug for SA is bupivacaine, but recently ropivacaine has been introduced with better hemodynamic profile. Dexmedetomidine is sedative-analgesic, and can be used through multiple routes. We compared low dose ropivacaine plus dexmedetomidine vs. low dose bupivacaine for SA in TURP.

Methodology: This comparative, cross-sectional study was conducted at Anesthesia Department of Combined Military Hospital, Lahore, from December 2021 to June 2022.

A total of 197 patients, planned to undergo TURP under SA were included in the study. The patients were randomly allotted to one of the two groups by lottery method and using concealed envelops. Group RD took low dose ropivacaine (7.5 to 10 mg) plus dexmedetomidine (5 µg) and in Group B low dose bupivacaine (7.5 to 10 mg) was used for spinal anesthesia. Parameters of efficacy and safety were compared in both groups during and immediately after the surgery to look for better option among the two regimes.

Results: Out of 197 patients randomized into two groups, Group RD, 99 (50.2%) took low dose ropivacaine (7.5 to 10 mg) plus dexmedetomidine (5 µg) and 98 (49.8%) took low dose bupivacaine (7.5 to 10 mg) for spinal anesthesia. Mean age of patients who underwent TURP in our study was 61.66 ± 7.88 y. Hemodynamic instability and requirement of opiate analgesia was not significantly different in both the groups (P > 0.05) while all other efficacy parameters were better in patients who took low dose ropivacaine plus dexmedetomidine (P < 0.05) as compared to those who only took low dose bupivacaine.

Conclusion: Both groups showed no difference in safety parameters related to hemodynamic stability but the anesthesia profile was better in patients who took low dose ropivacaine plus dexmedetomidine as compared to the bupivacaine group.

Abbreviations: SA - Spinal anesthesia; TURP - Transurethral resection of prostate

Key words: Bupivacaine; Dexmedetomidine; Ropivacaine; Anesthesia, Spinal; Transurethral Resection of Prostate

Citation: Ul Hassan J, Zafar E, Akram M, Saleem MA, Sami A. Comparison of low dose ropivacaine plus dexmedetomidine vs. bupivacaine for spinal anesthesia in transurethral resection of prostate. Anaesth. pain intensive care 2023;27(5):535−538; DOI: 10.35975/apic.v27i5.2309
A randomized clinical trial of addition of IPACK block or selective tibial nerve block to adductor canal block for postoperative pain management after total knee arthroplasty
Authors: Abogabal Marwa Ahmed , Zahra Shaimaa Waheed , Abdel-Elsalam Wafaa Mohamed , Abdelwahed Wafaa Madhy
Published: February 2024

Background & Objective: Postoperative pain after total knee arthroplasty (TKA) is a significant factor influencing the surgical outcome. Adductor canal block (ACB) has no analgesic effect on the posterior knee capsule, which is innervated by the terminal branches of the tibial nerve and the posterior branch of the obturator nerve. We compared ACB plus IPACK block (infiltration of the interspace between the popliteal artery and the posterior capsule of the knee) versus ACB with selective tibial nerve block (TNB) for pain management after TKA.

Methodology: We enrolled 70 patients, aged 40-80 y, body mass index of 18.5-35 kg/m2, scheduled for TKA in the study. Patients were randomly allocated to one of the two equal groups; Group 1 to receive ACB with IPACK block and Group 2 to receive ACB with TNB. Duration of sensory block, motor block, time to first rescue analgesic request, time to ambulation, and hospital length were noted in both groups. The 0-10 numeric rating scale (NRS) was used to measure the pain intensity in the patients. 

Results: Duration of sensory block, motor block, time to first rescue analgesic request, time to ambulation, and hospital length were significantly increased in Group 2 than in Group 1 (P < 0.001). The numeric rating scale was significantly lower in Group 2 at 8 h only but was comparable in other measurements. Range of motion and the strength of quadriceps were comparable between both groups at 24, 48, and 72 h postoperatively.

Conclusions: Adductor canal block with IPACK preserved motor function better and reduced the time to ambulation and hospital stay compared to tibial nerve block with adductor canal block. However, adductor canal block with selective tibial nerve block prolongs sensory block, the time to first analgesia request, and reduces postoperative opioid consumption at first 24 h. Both methods had a comparable effect on quadriceps strength.

Abbreviations: ACB - Adductor Canal Block; IPACK - Infiltration of local anesthetic between the Popliteal Artery and Capsule of the Knee; TNB - Tibial Nerve Block; TKA - Total Knee Arthroplasty

Key words: Total Knee Arthroplasty; Adductor Canal Block; IPACK; Selective Tibial Nerve Block.

Citation: Abogabal MA, Zahra SW, Abdel-ElsalamWM, Wafaa Madhy Abdelwahed WM. A randomized clinical trial of addition of IPACK block or selective tibial nerve block to adductor canal block for postoperative pain management after total knee arthroplasty. Anaesth. pain intensive care 2023;27(5): 567−574. DOI: 10.35975/apic.v27i5.2313

Received: July 25, 2023; Reviewed: August 18, 2023; Accepted: August 26, 2023
The impact of reproductive hormone changes on the immune response of patients with leukemia
Authors: Thabit Jinan Azeez , Almzaiel Anwar Jasib , Kadhim Muqdad Irhaeem , Alrufaie Mohauman Mohammed
Published: February 2024

Background & Objective: Leukemias have been associated with various immune and endocrine changes. Several studies have established a correlation between an imbalance in pituitary hormones and sex steroids and the initiation of illness in either one or both genders. The hormone changes can affect normal physiological homogeneity of the human body, thus effecting health as well as the course of unrelated diseases. We aimed to investigate the influence of alterations in reproductive hormones on the immune response of individuals diagnosed with leukemia.

Material and Methods: In this case-control study, a total of 130 subjects, out of which 80 patients were known cases with hematological cancer, were enrolled at the Medical City Department/Hematology Center in Baghdad, Iraq, from February-October 2022. Out of 80 patients diagnosed with leukemia, 45 patients had acute myeloid leukemia (AML), and 35 patients had acute lymphoblastic leukemia (ALL). The study involved 50 healthy controls. Estradiol (E2), triiodothyronine (T3), follicle-stimulating hormone (FSH), and progesterone levels were measured using both ELISA and the immunofluorescence assay method in all participants. C-reactive protein (CRP), ferritin, and neutrophil-to-lymphocyte ratio (NLR) was also determined.

Results: The findings of the study demonstrated a significant elevation in the levels of CRP, ferritin (P < 0.001), and NLR (P = 0.01) in the individual’s group when compared to the control group. Serum progesterone was increased in patients diagnosed with AML and ALL in comparison to the control group (P = 0.01). FSH was elevated (P = 0.02) in AML and decreased in ALL. This difference was found to be statistically significant. The levels of T3 and E2 were found to be significantly reduced in both AML and ALL patients when compared to the control group (P = 0.1 and 0.02 respectively).

Abbreviations: ACTH - Adrenocorticotropic Hormone; ALL - Acute Lymphoblastic Leukemia; AML - Acute Myeloid Leukemia; E2 – Estradiol; LH - Luteinizing Hormone NLR - Neutrophil-To-Lymphocyte Ratio

Conclusions: The findings of the study offer empirical support for the impact of hormones on the immune response in leukemia pathogenesis.

Key words: Leukemia; Reproductive Hormones; Immune Response

Citation: Thabit JA, Almzaiel AJ, Kadhim MI, Alrufaie MA. The impact of reproductive hormone changes on the immune response of patients with leukemia. Anaesth. pain intensive care 2023;27(5):585−591; DOI: 10.35975/apic.v27i5.2317

Received: August 06, 2023; Reviewed: August 12, 2023; Accepted: August 12, 2023
The use of antivenom serum, fresh frozen plasma, and platelet concentrate for management strategy of snakebite related coagulopathy: a case series
Authors: Permana Septian Adi , Shalihin Muhammad Markam
Published: February 2024

Snakebite is a medical emergency. It can cause local and systemic effects in humans. Different venomous snakes produce different types of venom, which can cause a variety of symptoms and complications. The scarcity of anti-snake venom serum (SABU) in Indonesia encourages alternative administration strategies to patients, namely suboptimal doses or subdose.
Three cases of adult patients with a history of snakebite and diagnosed with snakebite grade III were reported. The patient underwent initial antivenom therapy using suboptimal doses of anti-snake venom serum (SABU) due to the scarcity of SABU and fresh frozen plasma (FFP) and thrombocyte concentrate (TC) transfusions as well as initial emergency management and routine blood tests and coagulation function. Evaluation was done daily of clinical improvement and coagulation function.
This case series proves that administration of suboptimal antivenom therapy, when combined with additional FFP and TC transfusions, coupled with appropriate supportive care and patient monitoring can result in good outcome in patients.
Key words: Anti-snake Venom Serum; FFP; Snakebite; Thrombocyte Concentrate; Toxin
Citation: Permana SA, Shalihin MM. The use of antivenom serum, fresh frozen plasma, and platelet concentrate for management strategy of snakebite related coagulopathy: a case series. Anaesth. pain intensive care 2023;27(6):750−756; DOI: 10.35975/apic.v27i6.2250
Received: July 27, 2023; Revised: October 17, 2023; Accepted: October 17, 2023
Anesthetic management of a parturient with spondylocostal dysostosis (Jarcho-Levin syndrome) for cesarean delivery
Authors: Ibrahim Mohamed A. , Almetwalli Roshdi R.
Published: February 2024

Jarcho Levin syndrome was first described by Saul Jarcho and Paul Levin in 1938. The syndrome is characterized by multiple skeletal deformities due to axial skeletal developmental defects during the embryologic stage. Generalized vertebral defects include fused, missing, or deformed vertebrae, and these are seen throughout the cervical, thoracic, and lumbar spine. The patients have short stature and kyphoscoliosis. In pregnancy, these skeletal defects may have pronounced effects on the parturient and the baby, so special considerations are needed by the obstetricians as well as the obstetric anesthesiologists. This case report highlights the challenges our anesthesiology team faces while providing patient care and points out the different anesthetic management approaches that can be used in cesarean delivery for parturients with spondylocostal dysostosis.
Key words: Jarcho-Levin Syndrome; Anesthesia; Congenital; Hereditary; Abnormalities; Growth Disorders; Physical Appearance
Citation: Ibrahim MA, Almetwalli RR. Anesthetic management of a parturient with spondylocostal dysostosis (Jarcho-Levin syndrome) for cesarean delivery. Anaesth. pain intensive care 2023;27(6):780−782; DOI: 10.35975/apic.v27i6.2353
Received: September 02, 2023; Reviewed: October 25, 2023; Accepted: November 01, 2023
Early hemofiltration as immunomodulation for septic shock in acute on chronic kidney disease: a case report
Authors: AS Elvia , Sedono Rudyanto , George Yohanes WH
Published: February 2024

Bacterial endotoxins in sepsis induce dysregulation and excessive release of inflammatory mediators and cytokines, leading to organ dysfunction. Removing excess endotoxins and cytokines from the circulation could potentially reverse the dysregulation of the immune response. oXiris filter is capable of filtration and adsorption middle-size molecule cytokines and large molecular archives such as endotoxins.
A man, 77 years old, weighing 70 kg, with 174 cm height and 23.17 BMI was diagnosed with septic shock with Fournier gangrene, acute on chronic kidney disease, uncontrolled blood sugar, and history of diabetes mellitus. He was put on meropenem antibiotic therapy. After necrotomies, increase in the levels of leukocytes, urea, creatinine, procalcitonin, D-dimer, NT-proBNP, and IL 6 was observed. Vasopressor dose was increased, and the patient also experienced tachycardia and fever.
Meropenem was stopped and replaced with ceftaroline fosamil, and 24 h later hemofiltration with an oXiris filter was performed for 48 h. After hemofiltration, there was a decrease in vasopressor dose, urea, creatinine, and procalcitonin values. The patient′s hemodynamic status was stable without vasopressor, the dose of furosemide was decreased, and the urine output was increased. Then, the patient was transferred to the ward. The current patient had an upregulation of pro-inflammatory mediators as evidenced by clinical symptoms and laboratory findings. Additional treatment with extracorporeal blood purification techniques such as hemofiltration is required in these patients to facilitate the treatment of septic shock through the modulation of the immune response.
Keywords: septic shock, dysregulation, hemofiltration, immunomodulation
Citation: Elvia AS, Sedono R, George YWH. Early hemofiltration as immunomodulation for septic shock in acute on chronic kidney disease: a case report. Anaesth. pain intensive care 2024;28(1):182−186.DOI: 10.35975/apic.v28i1.2271
Received: August 17, 2023; Reviewed: December 23, 2023; Accepted: December 23, 2023
Neurological manifestations of hypokalemia: a case report
Authors: Puspamaniar Vania Ayu , Firdha Azizah Amimathul , Azizah Nurul , Hidayati Hanik Badriyah
Published: February 2024

Hypokalemic Periodic Paralysis (HPP) is a neurological manifestation of hypokalemia, with a prevalence of 1 in 100,000. HPP is recognized by the sudden onset of muscle paralysis and low serum potassium. Due to its various causes, it may be misdiagnosed and neglected.
We present a case of 42-year-old Asian female with weakness of both legs and cramps. The weakness was felt upon awakening from sleep. She also complained of palpitation, tiredness, sweating, heat intolerance, and hand tremors. In the recent weeks, her appetite increased.
Periodic paralysis (PP) is characterized by bursts of painless muscle weakening. A possible cause of periodic paralysis is hypokalemia which was found in our case. Hyperthyroid is classified into potassium depletion by extra renal route which was found in this case. Management
When managing a patient with sudden onset weakness or paralysis, it is crucial to consider the possibility of periodic paralysis. HPP is a rare but serious medical emergency. This should be suspected in any patient presenting with sudden muscle weakness. Prompt correction of any abnormalities in potassium levels can lead to rapid and complete symptom resolution. To avoid persistent or recurrent paralysis, any underlying causes should be effectively managed wherever possible.
Keywords: Hypokalemia; Paralysis; Hyperthyroid; Hypokalemic Periodic Paralysis
Citation: Puspamaniar VA, Firdha AA, Azizah N, Hidayati HB. Neurological manifestations of hypokalemia: a case report. Anaesth. pain intensive care 2024;28(1):187−190; DOI: 10.35975/apic.v28i1.2387
Received: September 03, 2023; Reviewed: September 16, 2023; Accepted: September 19, 2023
Ultrasound-guided third occipital nerve (TON) blocks
Authors: Hidayati Hanik Badriyah , Puspamaniar Vania Ayu , Sugondo Alexander Tikara , Firdausa Fajar Sena
Published: February 2024

Peripheral nerve blocks, including occipital nerve blocks (ONBs), have received increased attention and support as pain management tools during the previous few decades. Researchers have documented usefulness of ONBs particularly for acute headache management in the outpatient setting. The blocks also play a role in other healthcare settings, such as in the emergency department. The potential role of ONBs for the management of acute headache episodes in primary and emergency care settings is not yet fully practiced. In this paper, we will review block techniques of third occipital nerve (TON): indication, medication selection, complications and measures that can help improve safety in this procedure of headache management.
Key word: Analgesia, Regional; Headache; Occipital Nerve Block; Occipital Neuralgia; Third Occipital Nerve; Ultrasound-Guide.
Citation: Hidayati HB, Puspamaniar VA, Sugondo AT, Firdausa FS. Ultrasound-guided third occipital nerve (TON) blocks. Anaesth. pain intensive care 2024;28(1):166−170; DOI: 10.35975/apic.v28i1.2390
Received: October 13, 2023; Reviewed: October 18, 2023; Accepted: January 02, 2024
Ethics of AI (Artificial Intelligence)
Authors: Talati Dhruvitkumar
Published: February 2024

The standard solution to new technology is to center the ethics of
robotics and artificial intelligence on ”concerns” of various kinds.
Many of these fears end up being rather outdated; a few are essentially
accurate but barely relevant (computer technological advances will
annihilate businesses that make pictures on film, audio cassettes, or
vinyl records); others are essentially accurate but extremely pertinent
(automobiles will cause the deaths of children and drastically alter the
landscape). Some of these fears are consistently incorrect when they
indicate that technology will totally transform humans. This paper
analyzes the problems and deflates the non-problems.
COMPARAÇÃO DA EFICÁCIA DA ANALGESIA EPIDURAL E RAQUIDIANA EM PARTURIENTES PRIMÍPARAS
Authors: Cardoso Rômulo Henrique da Silva , Coelho Joyce Araújo Ribeiro , Vieira Solange Mendes , Beirith Victoria Wollf , Eulálio João Pedro Libório Neiva , kudo Kin Alexia da Rocha , Cunha Lucas Andrade Fidalgo , Camilo Darlenne Galdino , Fernandes Brena Suanne Carvalho , Martins Milena Villela , Carvalho Carolina de Castro , Vieira Ingrid Paloma machado , Buarque Mariana Delgado Santos , Farias Thiago Webster Fernandes , Castro Pedro Victor Alves , Rezende Mateus ribeiro Vasconcelos
Published: February 2024

O objetivo deste estudo é comparar de maneira abrangente a eficácia da analgesia epidural e raquidiana no alívio da dor durante o trabalho de parto em parturientes primíparas. Metodologia: Para atingir o objetivo proposto, realizamos uma revisão sistemática da literatura, consultando bases de dados eletrônicas, como PubMed, Scopus e Web of Science. Utilizou-se uma combinação de termos de busca. Foram incluídos apenas estudos comparativos, como ensaios clínicos randomizados e estudos de coorte, que investigaram diretamente a eficácia da analgesia epidural versus raquidiana em parturientes primíparas. A qualidade metodológica dos estudos selecionados foi avaliada seguindo diretrizes específicas e critérios predefinidos. Resultados: Após uma análise minuciosa dos estudos incluídos, observamos que tanto a analgesia epidural quanto a analgesia raquidiana demonstraram ser eficazes no alívio da dor durante o trabalho de parto em parturientes primíparas. No entanto, os resultados indicaram que a analgesia epidural pode proporcionar um alívio mais completo e prolongado da dor, enquanto a analgesia raquidiana tende a ter um início mais rápido de ação. Além disso, ambas as técnicas foram associadas a taxas aceitáveis de complicações e efeitos adversos, embora algumas diferenças tenham sido observadas em relação aos perfis de segurança. Conclusão: Com base nos resultados obtidos, concluímos que tanto a analgesia epidural quanto a raquidiana são opções eficazes de alívio da dor durante o trabalho de parto em parturientes primíparas. A escolha entre essas técnicas deve ser individualizada, levando em consideração as preferências da paciente, a progressão do trabalho de parto e as características específicas de cada técnica. É fundamental uma discussão detalhada entre a paciente e a equipe médica para determinar a melhor abordagem analgésica para cada caso.
СПЕЦИФИКА КОНТЕНТА РУССКОЯЗЫЧНЫХ НОВОСТНЫХ TELEGRAM-КАНАЛОВ (НА ПРИМЕРЕ КАНАЛОВ «BBC NEWS | РУССКАЯ СЛУЖБА» И «ОСТОРОЖНО, НОВОСТИ»)
Authors: Болдина К.А. , Константинова В.С.
Published: February 2024

Статья посвящена изучению особенностей новостного контента русскоязычных новостных каналов на платформе мессенджера Telegram за период с 2021 по 2023 гг. Объектом научного интереса выступают два канала с большой аудиторией: официальный канал русской службы BBC, который был создан в 2015 году и на данный момент имеет более 390 тысяч подписчиков, и канал «Осторожно, новости», имеющий более 1,5 млн. подписчиков. Особое внимание в статье уделяется определению причин популярности мессенджера в среде русскоязычных медиа, активно развивающих свои информационные каналы. Было выявлено, что одной из таких причин является сформировавшиеся особенности медиапотребения россиян. Согласно исследованию компании Mediascope, в 2022 году 80% населения России использовало Интернет, а 90% медиапотребления приходилось на мобильные устройства. В этом контексте новостные СМИ активно используют Telegram для распространения своих материалов, чтобы отвечать актуальному запросу пользователей на получение оперативной информации с помощью мобильного телефона. В рамках исследования было выявлено, что каналы в Telegram делятся на официальные новостные каналы медиакомпаний, независимые каналы, специализированные тематические каналы, юмористические и аналитические каналы. Некоторые из них имеют аудитории более одного миллиона человек. Анализируя контент Telegram-каналов «BBC News | Русская служба» и «Осторожно, новости», авторы пришли к выводу, что их высокая популярность обусловлена спецификой контента, который часто лишен объективности и не соответствует журналистским этическим нормам. При этом авторами были выявлены некоторые сходства и различия между каналами. В числе сходств можно назвать активное использование Telegram-каналов в качестве инструмента продвижения других информационных продуктов указанных СМИ: и в первом, и во втором случае прослеживается четкая политика публикации в материалах каналов ссылок на другие информационные платформы (сайты, подкасты, Youtube). Также оба канала нередко транслируют субъективные оценки происходящих событий под видом новостного контента. Что касается различий, то в основном они относятся к выбору тем для освещения: «BBC News | Русская служба» чаще фокусируется на глобальной политической повестке, в то время как «Осторожно, новости» уделяет большое внимание локальным новостям (в том числе бытового характера) и местным происшествиям.
HUMANISTIC BASIS OF MEDIA EDUCATIONAL ACTIVITY OF CHILDREN'S REGIONAL PRESS
Authors: Дякина А.А. , Белоусов К.И.
Published: February 2024

Статья посвящена рассмотрению вопросов, связанных с медиаобразовательной деятельностью СМИ. Подчеркивается ее актуальность в условиях цифровизации жизни и постоянно возрастающего насыщения информационно-коммуникационного пространства. Особое значение в процессе массового медиаобразования приобретают детские издания. Современная медиареальность обусловлена технологически, но должна обретать гуманистическую стратегию развития на основе отечественных духовных традиций. Медиапедагогика рассматривается в качестве одного из средств ее освоения и формирования грамотного отношения к медиа. Сделан акцент на том, что региональная детская печать всегда находилась в русле традиционных нравственных ценностей. В этом контексте рассматривается медиаобразовательная деятельность детского журнала «Золотой ключик», ориентированная на решение просветительских и воспитательных задач. Приводятся примеры многообразных форм взаимодействия редакции с юными читателями. В процессе конвергенции печати произошли позитивные перемены в ее медиаобразовательной деятельности. Редакция направляет усилия на свое представительство в интернет-пространстве: продвигает контент в электронной версии и в социальных сетях. Это позволяет устанавливать интерактивные связи с читательской аудиторией, содействовать повышению ее медиакультуры. Наряду с положительными примерами медиаобразовательной деятельности журнала «Золотой ключик» отмечены недостатки в освоении редакцией мультимедийных возможностей различных цифровых платформ. Данный момент снижает потенциал издания как медиаобразовательного ресурса, направленного на новое цифровое поколение пользователей. Работа редакции в цифровых форматах отмечена как неизбежность, которая должна быть воспринята и тактически верно использована. При этом гуманистическая основа медиаобразовательной деятельности детского журнала как издания качественного, имеющего изначально верные профессионально-творческие ориентиры и деонтологические установки, не должна пострадать.
ГЕНДЕРНАЯ ЛЕКСИКА КАК СРЕДСТВО ХАРАКТЕРИСТИКИ ЖЕНСКИХ ПЕРСОНАЖЕЙ (НА ПРИМЕРЕ РОМАНА Л. УЛИЦКОЙ «ЛЕСТНИЦА ЯКОВА» И ЕГО ПЕРЕВОДНОЙ НЕМЕЦКОЯЗЫЧНОЙ ВЕРСИИ)
Authors: Козлова Л.Н.
Published: February 2024

В статье рассматриваются особенности употребления гендерно маркированной лексики в романе Л. Улицкой «Лестница Якова» при описании женских персонажей. Целью данной работы является определение возможности передачи характерологической специфики гендерной лексики в переводном тексте. Полученный методом сплошной выборки практический материал классифицируется, выделяется пять основных тематических групп, в которых характеризуются такие аспекты жизненного пространства женщины, как внешность, с преимущественным акцентированием полноты и некрасивости, профессия и род деятельности, материнство, а также даётся позитивная или негативная характеристика поведения и образа жизни. Лексический массив каждой тематической группы подвергается тщательному сопоставительному лингвистическому анализу с привлечением различных лексикографических источников. Особое внимание уделяется эксплицитному выражению принятых в обществе гендерных стереотипов и специфике их передачи в переводной версии романа. Описываются основные способы перевода гендерной лексики на немецкий язык, среди которых наиболее частотным является использование адекватной замены. Также весьма употребительны лексическое развёртывание, перераспределение значения с применением частеречной трансформации и использование абсолютных межъязыковых соответствий. Опущение и описательный перевод встречаются в исследуемых текстах редко. В заключении выделяются типичные черты гендерно маркированных лексических единиц при характеристике женских персонажей: образность, наличие оценочного и разговорного характера. Подчёркивается словообразовательная обусловленность разговорности ряда лексем, а также их окказиональное употребление, определяющее специфику индивидуально-авторского стиля Л. Улицкой. Делается вывод об общей нейтрализации разговорности гендерной лексики в переводном немецкоязычном тексте при сохранении её характерологических свойств. Ключевые слова: гендерная лексика, гендерные стереотипы, женские
FEATURES OF WORKING WITH PERSONALITIES IN RUSSIAN AS A FOREIGN LANGUAGE CLASSES
Authors: Рыкова Е.Б.
Published: February 2024

В статье рассматриваются сложности, возникающие на занятиях по русскому языку при изучении текстов культурологической направленности иностранными слушателями подготовительных курсов нефилологических вузов, и пути их преодоления с опорой на опыт работы преподавателей кафедры русского языка СЗГМУ им. И.И. Мечникова. В статье определен круг персоналий, представленных в 35 уроках в учебнике Л.В. Московкина и Л.В. Сильвиной, который используется на подготовительных курсах для иностранцев в СЗГМУ в качестве основного учебника по русскому языку. Среди большого количества данных культурологических единиц выделены только персоналии, представляющие отечественную культуру. Из них по частотности употребления на первом месте находится фигура великого русского поэта Александра Сергеевича Пушкина. Автором статьи анализируется предъявление в учебнике этой персоналии как реалии российской культуры и указываются необходимые дополнения, которые были сделаны в ходе работы с данным культурологическим материалом в процессе преподавания русского языка как иностранного. В статье подробно рассмотрены четыре сложности, возникшие при изучении разнообразных персоналий, представленных в учебнике: во-первых, изменившийся контингент иностранцев, приезжающих на обучение на подготовительный курсы, во-вторых, новая ситуация для российской культуры в меняющемся мире, когда замалчиваются достижения нашей страны, в-третьих, сложность знакомства с этими текстами на подготовительном этапе обучения русскому языку, связанная с использованием пассивной лексики и однократным упоминанием персоналий, в-четвертых, сложности восприятия, возникающие в силу вовлеченности прибывших молодых иностранцев в адаптационные процессы обучения и проживания в стране иной культуры.
Command Directive Illocutionary Act Found in “Hobbs & Shaw” Movie
Authors: Rama Jayantha  , Maharani Putu Devi , Permana I Putu Andri
Published: February 2024

This study entitled “Command Directive Illocutionary Acts found in Hobbs & Shaw Movie” It aims for finding out the command directive illocutionary acts and the context of situation of directive illocutionary acts utterance expressed by the main characters. The command directive illocutionary acts are discussed using the theory of directive illocutionary acts proposed by Kreidler (1998: 189-190) and the context of situation is discussed using theory of the context of situation proposed by Halliday and Hasan (1985: 12). In collecting the data, the writer watched the movie and marked the utterances that contain command directive illocutionary acts in the movie script. The method used in analyzing data was descriptive qualitative method. The writer classified the data based on the sentence structure of the command directive illocutionary act and then analyzes the context of the situation. In presenting the findings, formal and informal methods are used. The formal method is used to show the percentage of sentence structure of command directive illocutionary acts using table and the informal method is used to explain the data descriptively through words. In this study, 31 data were found regarding illocutionary acts of directive orders.
Code Switching Found in Daniel Mananta Network Podcast by Agnes Monica and Daniel Mananta
Authors: Ni Kadek Alit Marta Dila  , I G B Wahyu Nugraha Putra  , Putu Devi Maharani
Published: February 2024

This study discusses the types and reasons of code-switching occurred during conversations between Agnes Monica and Daniel Mananta on the Daniel Mananta Network Podcast. This study aims to answer research problems, namely (1) What types of code switching are used by Agnes Monica and Daniel Mananta on the Daniel Mananta Network (2) What are the reasons behind the occurrence of code switching by Agnes Monica and Daniel Mananta on the Daniel Mananta Network. This study uses a descriptive qualitative method by classifying and describing the types of code switching based on the theory from Appel and Muysken (1987) and the reasons behind the occurrence of code switching based on Hoffman's theory (1991). The result shows that 90 data were found, 6 data of tag switching, 70 data of intra-sentential switching, and 13 data of inter-sentential switching. Intra-sentential switching is the most dominant types found in data source. Meanwhile, tag switching is the least. Moreover seven reasons motivating code switching were found in Podcast Daniel Mananta Network. Where talking about particular topic is the most dominant reasons found. It's because Agnes Monica and Daniel Mananta occasionally favor using one language over another while discussing a certain subject. In a language other than his native tongue, a speaker may occasionally feel more at ease and free to express his or her emotional feelings. The character can grab the audience's attention and add interest to the narrative by using code switching.
Perception of EFL Mahasaraswati Denpasar University Students Toward Code Mixing on Social Media
Authors: Putu Tryssa Kirana Sanjiwani  , Ida Bagus Gde Nova Winarta  , I Made Yogi Marantika
Published: February 2024

This study elaborates with EFL (English Foreign Language) students’ responses on Google Form. This study focused on how to do code mixing and perception of EFL students toward code mixing on social media. Hoffman’s theory (1991) is implemented to compare with students’ responses about how to doing code mixing on social media and Ulya’s formula (2015) is used to analyzed closed questions about perception toward code mixing. To analyzed the data, descriptive qualitative and quantitative methods were used in this study. The data were obtained from an online questionnaire in Google Form. In collecting the data, this study applies an online survey technique. For the data analysis, it was represented using formal and informal methods. The result shows there are 5 similarities between how to students doing code mixing and reason for applying code-mixing from Hoffman’s theory. Whilst, about perception, it was found that students had 15 positive perception, 6 neutral and 4 negatives.