bluuebunny/crossref_metadata_2025 huggingface dataset:
Perpindahan Tenaga Kerja Non Pertanian Ke Tenaga Kerja Pertanian Pada Masa Pandemi Covid-19 Di Desa Woloan II Kota Tomohon
Authors: Kaemba Adrian , Talumingan Celcius , Waney Nordy Fritsgerald Lucky
Published: February 2024

The purpose of the study was to determine the transfer of non-agricultural labor to agricultural labor during the Covid-19 pandemic in Woloan II Village, Tomohon City. The research lasted for three months from August to October 2022. The research was conducted in Woloan II Village, West Tomohon Sub-district. The data collected included primary data obtained through interviews using questionnaires, to labor respondents who moved from the non-agricultural sector to the agricultural sector during the Covid-19 pandemic. Secondary data were collected through research reports through the internet, journals, and other information related to the research. The sample in this study is workers in Woloan II Village, Tomohon City who have moved from the non-agricultural sector to the agricultural sector during the Covid-19 pandemic. Data were collected using purposive sampling with a sample of 15 respondents. The data is presented in a table and then described descriptively. The results of the research on the transfer of non-agricultural labor to agricultural labor in Woloan II Village, West Tomohon Subdistrict during the Covid-19 pandemic showed that the transfer to the agricultural sector with the rice commodity received a percentage of 46.67 percent and the second largest was the cabbage commodity of 40.00 percent and for the corn commodity had a percentage of 13.33 percent.
Peran Penyuluh Pada Kelompok Tani “Palemboyan” Di Desa Taraitak Satu Kecamatan Langowan Utara Kebupaten Minahasa
Authors: Mokalu Asyer Gabriel , Sendow Martha Mareyke , Tangkere Ellen Grace
Published: February 2024

This research aims to determine the perceptions of members of the "Palemboyan" farmer group regarding the role of Extension Officers in farmer groups. This research was conducted from March to May 2023 at Taraitak Satu Village, Langowan Sub-district, Minahasa District, Sulawesi Utara Province. This research was carried out using the data sampling method purposive sampling or intentionally. This research is in descriptive quantitative form with variable data calculated using the scoring method. The method used to compile the data is using a Likert scale through tabulation. The results of the research show that the perception of the role of instructors in the "Pelemboyan" farmer group in Taraitak Satu Village, North Langowan District, Minahasa Regency, results in the level of the role of instructors as motivators reaching 35 percent with the criteria of Less Role, the role of instructors as catalysts reaching 32.5 percent with the criteria of Less Role. , the role of instructors as organizers reached 32.5 percent with the criteria of Less Role, the role of instructors as communicators reached 37.5 percent with the criteria of Less Role and the role of instructors as advisors reached 35 percent with the criteria of Less Role.
IMPLEMENTASI PELAYANAN KIA MELALUI WEBSITE KLAMPID NEW GENERATION DI KELURAHAN MEDOKAN AYU KOTA SURABAYA
Authors: Nugroho Tesalonika Devvany , Reviandani Oktarizka
Published: February 2024

Identity is a constitutional right for all Indonesian citizens. The issuance of citizens who aren’t in 17 years old is carried out by Dinas Kependudukan dan Pencatatan Sipil by supporting the publication of Kartu Identitas Anak as for the citizens who haven’t in age 17 years old to get their KTP-El. This regulation is supported by Peraturan Daerah Kota Surabaya Nomor 6 Tahun 2019 Pasal 1 Ayat 20 about Kartu Identitas Anak the official identity for children under 17 years old. This research uses descriptive qualitative research methods. The results of this research are the application of the Klampid New Generation website in issuing Kartu Identitas Anak in Kelurahan Medokan Ayu which is presentable but still requires improvements in aspects through telecommunications, services and human resources.
Adultità
Authors: Rainer Franz
Published: February 2024

Alcuni lettori e lettrici hanno espresso dubbi sulla legittimità della parola adultità.
Changes in blood oxidative stress biomarker and cholinesterase activity after general vs spinal anesthesia for elective cesarean sections
Authors: Karam Rozheen Shukri , Mohammad Fouad K.
Published: February 2024

Background & Objective: There is an increased ratio of cesarean sections (CS) compared to normal deliveries the world over. Both general and regional anesthetic techniques are in practice for CS. Limited information is available on the determination of blood cholinesterase (ChE) activity in conjunction with oxidative stress biomarkers after the CS. The purpose of the present study was to determine and compare the plasma and erythrocyte ChE activity as well as malondialdehyde (MDA) level and total antioxidant status in pregnant women before anesthesia and after the use of general anesthesia (GA) or spinal anesthesia (SA) for elective CS.

Methodology: A pre-post study was conducted on 102 full-term pregnant women, who underwent elective CS in four hospitals at Duhok (Iraq) from January 2022 to July 2022. GA with propofol and SA with bupivacaine 0.5% were administered to 52 and 50 women, respectively. Maternal blood samples before anesthesia and after the completion of operation were assayed for the ChE activity in the plasma and erythrocytes, and plasma oxidative stress biomarkers malondialdehyde and total antioxidant status.

Results: Plasma ChE activity significantly decreased in the GA and SA groups after the cesarean-deliveries compared to the corresponding pre-anesthetic values. The plasma MDA level in both GA and SA groups, but not the total antioxidant status, was significantly reduced. Estimation of the odds ratio and the relative risk indicated that a risk factor is associated with the reduced plasma ChE activity in women after the CS when the general anesthetic propofol is used.

Conclusion: Both general anesthesia with propofol and spinal anesthesia with bupivacaine inhibited plasma cholinesterase activity and reduced oxidative stress biomarker malondialdehyde after the cesarean sections.

Abbreviations: CS - Cesarean section; ChE: Cholinesterase; EChE: Erythrocyte Cholinesterase; MDA: Malondialdehyde; OS: Oxidative Stress; PChE: Plasma ChE; TAS: Total Antioxidant Status.

Key words: Anesthesia, Spinal; Cesarean section; General anesthesia; Malondialdehyde; Oxidative stress

Citation: Karam RS, Mohammad FK. Changes in blood oxidative stress biomarker and cholinesterase activity after general vs spinal anesthesia for elective cesarean sections. Anaesth. pain intensive care 2023;27(3):396−404; DOI: 10.35975/apic.v27i3.2244

Received: March 23, 2023; Reviewed: May 06, 2023; Accepted: May 09, 2023
Lung ultrasonography for detection of atelectasis in adults undergoing robot assisted laparoscopic pelvic surgeries
Authors: Sethi Sameer , Kathuria Rahul , Samra Tanvir , Saini Vikas , Toshkhani Dheemta , Kushal Pankaj
Published: February 2024

Introduction: Robot-assisted laparoscopic pelvic surgeries are minimally invasive techniques that require the patient to be placed in the steep Trendelenburg position. Pneumoperitoneum further increases the risk of postoperative pulmonary complications. We used lung ultrasound score (LUSS) to detect post-operative atelectasis in this subset of patients.

Methodology: Patients aged 18 to 70 y with ASA physical status I/II undergoing robot assisted pelvic surgeries in steep Trendelenburg position were enrolled. Patients were mechanically ventilated with 50% oxygen in air with a tidal volume of 6 to 8 ml/kg in volume control mode to maintain an end tidal carbon dioxide at 35−45 mmHg with positive end-expiratory pressure (PEEP) of 5 cmH2O. Ultrasonographic assessment was done; before induction (A), after extubation (F), 12 h (G) and 24 h after surgery (H) by dividing chest into 12 regions.

Results: A total of 1152 cine-loops acquired during the study period in 32 patients were analyzed. Incidence of postoperative atelectasis was 87.5% and each lung ultrasound examination required 12.35 ± 4.68 min. Statistically significant fall in PaO2 was recorded at extubation from baseline and intra-operative values (P < 0.0001). Statistically significant difference was established between change in baseline and post-extubation LUSS to the total volume of fluid given (P = 0.002).

Conclusion: A high incidence (87.5%) of atelectasis in adults after robot assisted laparoscopic pelvic surgeries was detected using lung ultrasound score. Lung oxygenation decreased significantly after steep Trendelenburg position and extubation. The observed statistical difference in total IV fluids administered between patient subgroups who showed increased ultrasound signs of lung edema from the A period to the F period, although suggestive of association, is no evidence of causation.

Abbreviations: ARISCOT- Assess Respiratory Risk in Surgical patients in Catalonia; LUS- Lung Ultrasound; LUSS- Lung Ultrasound Score; OR- Operating room; PEEP- Positive End-Expiratory Pressure

Key words: LUSS; Lung ultrasound score; Pneumoperitoneum; Robotic Surgery; Ultrasonography

Citation: Sethi S, Kathuria R, Samra T, Saini V, Toshkhani D, Kushal P. Lung ultrasonography for detection of atelectasis in adults undergoing robot assisted laparoscopic pelvic surgeries. Anaesth. pain intensive care 2023;27(4):573−578; DOI: 10.35975/apic.v27i4.1503

Received: October 28, 2021; Reviewed: June 06, 2022; Accepted: September 17, 2022
Effect of height-based spinal anesthetic dose versus conventional dose on hemodynamics in lower limb surgeries in geriatric patients: a randomized controlled trial
Authors: Alkonaiesy Ramy M. , Amin Shereen Mostafa , Abdallah Nasr M. , Muhammad Sherif Ismail , Hassan Haitham
Published: February 2024

Background: An adequate dose of spinal anesthetic is very crucial in elderly surgical patients. The routine method to calculate the dose in a particular patient is usually based upon the weight of the patient, but the effect cannot always be predictable. We evaluated the efficacy and safety of the height-based dose of spinal anesthetic versus the conventional dose on intraoperative hemodynamics and spinal block characteristics in geriatric patients scheduled for lower limb surgeries.

Methodology: This single-blinded, parallel-group, randomized, clinical trial enrolled 56 patients, aged 60 y or above who were scheduled for lower limb orthopedic surgeries under spinal anesthesia. The patients were randomly divided into two groups. In the height-based group, 0.06 mg of 0.5% hyperbaric bupivacaine/cm height of the patient was administered intrathecally. The control group received a fixed dose of 12.5 mg of 0.5% hyperbaric bupivacaine intrathecally. All patients received 25 µg of fentanyl (0.1 mg / 2 ml) intrathecally. The incidence of hypotension was the primary outcome. The incidence of bradycardia, highest sensory level, onset and duration of sensory and motor block, incidence of shivering, the total dose of bupivacaine, total amount of fluid infused, vasopressors needed, and blood loss were the secondary outcomes.

Results: The incidence of hypotension was significantly reduced in patients receiving height-based spinal dose compared to those in which standard dose was administered (57.1% vs. 82.1%, P = 0.042). The duration of sensory blocks was significantly shorter in height-based group compared to the control group (116 ± 32.77 vs. 90.59 ± 19.66 min; P = 0.001) as was the duration of the motor block (153.18 ± 42 and 117 ± 25.37 min; P < 0.001).

Conclusion: In geriatric patients undergoing orthopedic lower limb surgery, the height-based dose of spinal anesthesia was effective and safe in reducing the incidence of hypotension with fast recovery from sensory and motor block.

Abbreviations: ASA- American Society of Anesthesiologists; COPD- Chronic Obstructive Pulmonary Disease; CSF- Cerebrospinal Fluid; DVT- Deep Venous Thrombosis; IQR- Interquartile range- n: Numbers; SD- Standard Deviation; SA- Spinal Anesthesia

Key words: Bromage scale; Elderly; Height; Hypotension; Orthopedics; Anesthesia, Spinal

Citation: Alkonaiesy TM, Amin SM, Abdallah NM, Sherif Ismail Muhammad SI, Hassan H. Effect of height-based spinal anesthetic dose versus conventional dose on hemodynamics in lower limb surgeries in geriatric patients: a randomized controlled trial. Anaesth. pain intensive care 2023;27(4):565−572; DOI: 10.35975/apic.v27i4.2160

Received: February 20, 2023; Reviewed: May 16, 2023; Accepted: June 16, 2023
Mortality among patients with subarachnoid hemorrhage: a retrospective study
Authors: Sindi Anees A. , Abushoshah Ibrahim , Bokhary Diyaa H. , Banser Sultan M. , Bedaiwi Wejdan H. , Bajuneid Khalid M. , Algethamy Haifa M.
Published: February 2024

Background & Objective: Subarachnoid hemorrhage (SH) accounts for 50% of hemorrhagic strokes. Few individuals present with ‘thunderclap headaches’, resulting in delayed diagnoses of aneurysmal SH (aSH). We conducted this retrospective study to explore factors for predicting the risk, severity and mortality patterns of aSH and traumatic SH (tSH).

Methodology: A retrospective study was conducted on 68 SH patients admitted to Intensive Care Units (ICUs) of a Middle East tertiary care hospital. Medical history, demographics, risk factors, outcome and the type of SH were evaluated.

Results: The mean age of the patients was 47.84 ± 18.24 y, and 38 (55.8%) were males, showing most SH cases occur in middle-age and in males. Majority 59 (86.7%) of the patients presented with risk factors such as trauma (35%), hypertension (37%), anti-thrombotic use (15.25%), alcoholism (3%) and smoking (1.5%). The regression model showed age and risk factors significantly influence the type and severity of SH (P < 0.05). The mortality was significantly higher in those suffering from traumatic SH compared to non-traumatic SH (84.6% versus 10.5%, P < 0.0061).

Conclusion: Age, male gender and risk factors predispose the type and severity of SH. Mortality rates are higher among traumatic SH in comparison to non-traumatic SH patients.

Abbreviations: SH - Subarachnoid Hemorrhage; aSH - Aneurysmal Subarachnoid Hemorrhage; tSH - Traumatic Subarachnoid Hemorrhage; WFNS - World Federation of Neurological Surgeons; MRI - Magnetic resonance imaging

Key words: Subarachnoid hemorrhage; Risk Factors; Severity; Classification; WFNS

Citation: Sindi AA, Abushoshah I, Bokhary DH, Banser SM, Bedaiwi WH, Bajuneid KM, Algethamy HM. Mortality among patients with subarachnoid hemorrhage: a retrospective study. Anaesth. pain intensive care 2023;27(4):545−552; DOI: 10.35975/apic.v27i4.2161

Received: February 27, 2023; Reviewed: May 15, 2023; Accepted: May 16, 2023
Management of peritoneal dialysis in an adolescent with septic shock, AKI, multi-organ failure and COVID-19: a case report
Authors: Andiantoro Dirgo Suseno , Sedono Rudyanto , Jennefer Jennefer
Published: February 2024

The kidneys is the most commonly injured organs in sepsis, which might manifest as acute kidney injury (AKI). Peritoneal dialysis (PD) is the preferred modality of renal replacement therapy (RRT), especially in the developing countries. Furthermore, the COVID-19 pandemic has  made hemodialysis (HD) unavailable due to infection concerns. We present a critically-ill 16-year-old male with morbid obesity (BMI 43.3 kg/m2), diabetic ketoacidosis, acute pancreatitis, acute kidney injury, and COVID-19 pneumonia. The patient looked somnolent on admission with very high random blood glucose and hypernatremia. Blood gas analysis showed metabolic acidosis. The patient was treated with 1 g/day Meropenem, 0.5 µg/kg/min norepinephrine, 0.04 unit/kg/h vasopressin, and correction of electrolyte imbalance and metabolic acidosis. After 48 h, the diuresis and the creatinine levels worsened. We placed a Tenckhoff catheter and started PD. The patient showed improvement after 72 h of peritoneal dialysis.

This case report highlighted the use of PD as a modality of RRT in sepsis-induced AKI, multi-organ failure, and COVID-19. Although it remains controversial, we observed an improvement in diuresis and creatinine levels following PD. PD is more cost-effective and provides a similar outcome compared to other modalities.

Abbreviations: AKI - Acute Kidney Injury; BMI- Body Mass Index; CRRT- Continous Renal Replacement Therapu; GCS- Glasgow Coma Scale; HD- Hemodialysis; ICU- Intensive Care Unit; PD- Peritoenal Dialysis; RRT- Renal Replacement Therapy; S-AKI- Sepsis-Associated Acute Kidney Injury; SIRS- Systemic Inflammatory Response Syndrome

Key words: Septic shock; Acute kidney injury; Peritoneal dialysis

Citation: Andiantoro DS, Sedono R, Jennefer J. Management of peritoneal dialysis in an adolescent with septic shock, AKI, multi-organ failure and COVID-19: a case report. Anaesth. pain intensive care 2023;27(4):600−603.

DOI: 10.35975/apic.v27i4.2163

Received: February 14, 2023; Reviewed: April 17, 2023; Accepted: April 22, 2023
A randomized prospective comparative study between intrathecal chloroprocaine 1% and ropivacaine 0.5% for short duration surgery
Authors: Prakash Vivek , Jain Payal , Prasad Mukesh Kumar
Published: February 2024

Background and Objectives: Spinal anesthesia (SA) has recently seen a rapid surge in is popularity due to its edge over general anesthesia, being easier, cost-effective, lack of addictive drugs, reduced analgesic demand in the post anesthesia care unit, less nausea and vomiting within 24 h postoperatively, and a shorter hospital stay. Research continues regarding the best and the safest drug to be used for SA. We compared chloroprocaine 1% and ropivacaine 0.5% for SA in short duration surgery.

Methodology: A total of 70 patient were enrolled and subdivided into two groups; Group R (35 patients), to receive 4 ml of 0.5 % ropivacaine (20 mg) and Group C (35 patients), to receive 4 ml of 1% chloroprocaine (40 mg). Hemodynamic parameters and block characteristics were compared between the two groups.

Conclusion: This study shows that chloroprocaine 1% and ropivacaine 0.5% are equally effective in spinal anesthesia. However, chloroprocaine 1% is better suitable for shorter duration surgeries.

Key words: Chloroprocaine; Ropivacaine; Hemodynamics; Block Characteristics

Citation: Prakash V, Jain P, Prasad MK. A randomized prospective comparative study between intrathecal chloroprocaine 1% and ropivacaine 0.5% for short duration surgery. Anaesth. pain intensive care 2023;27(4):508−513; DOI: 10.35975/apic.v27i4.2260

Received: March 13, 2023; Reviewed: May 22, 2023; Accepted: May 22, 2023
Compliance with the 2016 Surviving Sepsis Campaign Bundle and the 2018 Surviving Sepsis Campaign 1-Hour Bundle and patient outcomes in emergency presentation at a tertiary referral hospital
Authors: Utariani Arie , Semedi Bambang Pujo , Salinding Agustina , Hamzah Hamzah
Published: February 2024

Background & Objective: Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Sepsis has always been associated with high morbidity and mortality. Consensus committees of international organizations have recommended packages to reduce the high mortality. We evaluated the 2016 Surviving Sepsis Campaign (SSC) package with 3 and 6-hour sepsis packages and the 2018 SSC with 1-hour sepsis package on the mortality of septic patients who came to a tertiary referral hospital.

Methodology: We enrolled 164 retrospective cohort patients in the tertiary emergency referral general hospital resuscitation ward. The patients were followed up for 48 h of observation. Sepsis and septic shock criteria are based on the Third International Consensus Definition of Sepsis and Septic Shock (Sepsis-3) 2016. Patients were divided into 3 groups, based upon compliance with SSC 16 at 3 h, 6 h, and SSC 18 at 1 h, and the mortality was recorded before 48 h and after 48 h.

Results: Compliance rates at 1 h (27.4%), 3 h (39.6%), and 6 h (43.3%) were significantly associated with patient mortality (P ≤ 0.001). Population patients who met the criteria for SSC, 73.3% had been referred from peripheral  hospitals. The mortality rate was 76 (46.34%) for < 48 h and 37 (22.56%) for more than 48 h.

Conclusion: Compliance with sepsis management contributes to improved patient condition and a better prognosis when the Surviving Sepsis Campaign package is adequately implemented.

Abbreviations: SSC - Surviving Sepsis Campaign; SOFA - Sequential Organ Failure Assessment; qSOFA - quick Sequential Organ Failure Assessment; VIS - Vasopressor Inotropic Score

Key words: Sepsis; SSC Sepsis Bundle Compliance-2016; 1 Hour SSC Sepsis Package 2018; Death; Vasopressors; Outcome; Mortality

Citation: Utariani A, Semedi BP, Salinding A, Hamzah H. Compliance with the 2016 Surviving Sepsis Campaign Bundle and the 2018 Surviving Sepsis Campaign 1-Hour Bundle and patient outcomes in emergency presentation at a tertiary referral hospital. Anaesth. pain intensive care 2023;27(5):478−485; DOI: 10.35975/apic.v27i5.1852

Received: March 26, 2022; Reviewed: December 21, 2022; Accepted: August 08, 2023
Serratus anterior plane block for postoperative analgesia in modified radical mastectomy
Authors: . Mochamat , Arifin Johan , Pramadika Taufan , Manapa Chandra Hermawan , Istanto Widya , Wicaksono Satrio Adi , Nugroho Taufik Eko
Published: February 2024

Introduction: Serratus Anterior Plane (SAP) block can be used as part of multimodal analgesia, reducing the need for additional analgesia for 24 h postoperatively. The SAP block (SAPB) is easy to apply with a safe technique and low side effects. This study analyzes serratus anterior plane block as postoperative analgesia in Modified Radical Mastectomy (MRM) surgery by assessing the level of pain, side effects, and complications.

Methods: This study was a double-blind randomized control trial (RCT) conducted on patients scheduled to undergo MRM, at Dr. Kariadi Hospital Semarang during August-October 2022. A total of 44 patients were enrolled, and divided into two groups; 22 patients in each group. The treatment group received SAPB and was compared with the control group of morphine 0.1 mg/kg, in terms of the numeric pain rating scale, at 4, 8, 12, and 24 h postoperatively, time and number of analgesic rescue doses, the incidence of PONV and pruritus within 24 h postoperatively. Independent T-test, Mann-Whitney, Chi-square, and Fischer tests were performed to analyze the data. P < 0.05 was considered significant.

Results: The mean NRS at 4, 12, and 24 h postoperatively was lower in the SAPB group than in the control group (2.73 ± 0.77 vs. 3.23 ± 0.53; 1.77 ± 0.61 vs. 2.32 ± 0.48, and 1.45 ± 0.59 vs. 2.09 ± 0.61). The difference was statistically significant, e.g., P = 0.017, P = 0.003, and P = 0.001, respectively. Time to the first request of rescue analgesia was prolonged in the SAPB group than in the control group (398.86 ± 140.6 vs. 100.91 ± 10.3; P = 0.000). The mean rescue analgesic dose in the SAPB group was lower than in the control group (3.59 ± 1.56 vs. 8.55 ± 2.4; P = 0.000). The control group showed a higher incidence of PONV (68.2% vs. 18.2%, P = 0.01). There was no significant difference in the groups regarding the frequency of pruritus (P = 0.073).

Conclusion: Serratus anterior plane block reduced pain significantly up to 24 h postoperatively compared to the control group. The patients in this group needed rescue analgesia after longer duration and needed lower doses of rescue analgesia. There was lower frequency of PONV than the control group.

Abbreviations: MRM - Modified Radical Mastectomy; PONV – Postoperative Nausea and Vomiting; PMPS - Post-Mastectomy Pain Syndrome; PVB – Para Vertebral Block; SAP - Serratus Anterior Plane; VAS - Visual Analog Scale

Key words: Serratus Anterior Plane Block; Breast Cancer; Modified Radical Mastectomy

Citation: Mochamat, Arifin J, Pramadika T, ManapaCH, Istanto W, Wicaksono SA, Nugroho TE. Serratus anterior plane block for postoperative analgesia in modified radical mastectomy. Anaesth. pain intensive care 2023;27(5):486−490; DOI: 10.35975/apic.v27i5.2297

Received: January 05, 2023; Reviewed: January 18, 2023; Accepted: March 31, 2023
Assessment of serum fractalkine level as potential role for complications in splenectomized and non-splenectomized patients with β-thalassemia major
Authors: Awad Ayat Saeed , Ali Hanaa Addai , Althalmi Safaa Abdazahra Alwan
Published: February 2024

Introduction: Thalassemia is a serious genetic blood related condition characterized by a lack of or malfunctioning hemoglobin in the RBCs. One of the most widespread inherited disorders is beta thalassemia (β-TM). The high susceptibility to infection in these individuals' is related to high mortality and morbidity rates. Fractalkine is known as CX3C chemokine ligand 1 (CX3CL1), which contains a total of 371 amino acid, and participates in a number of functions, including repair of tissues after injury, immunological response during inflammation, and chemotaxis effet.

Methodology: A case control study, containing sixty patients recognized as suffering from β-TM, was conducted at Al Zahra Teaching Hospital, Najaf (Iraq). The patients were divided into two groups; splenectomized and non-splenectomized patients. The thalassemia disease was enrolled in the “Thalassemia Unit”. Suitable statistical techniques were used to analyze the outcomes.

Results: In the current study, a significant increase in serum level of CX3CL1 was found in patients with β-TM, especially in splenectomized group (14.914 ± 2.636), (P = 0.01) and non-splenectomy (13.816 ± 2.686), (P = 0.05) group as compared with control group (12.26 ± 1.797).The linear regression analysis showed that a significant positive correlation in ferritin with serum CX3CL1 level in splenectomy patients with β-TM group. ROC curve for CX3CL1 that might be diagnosis of patients with β-TM with an AUC of 0.757 (95% CI: 0.623-0.890), sensitivity and specificity equally 75% and 83.3%.

 Conclusion: Increase level of CX3CL1 due to its interaction with CX3CR1 receptor may lead to buildup of inflammatory cells in the β-TM patients, blocking CX3CL1 signaling may be helpful for patients with β-TM.

Abbreviations: AUC – Area Under Curve; β-TM - Beta Thalassemia; ROC - Receiver Operating Characteristic UIBC - Unsaturated Iron-Binding Capacity test; TIBC - Total Iron-Binding Capacity

Key words: Thalassemia, β thalassemia major, Fractalkine

Citation: Awad AS, Ali HA, Althalmi SAA. Assessment of serum fractalkine level as potential role for complications in splenectomized and non-splenectomized patients with β-thalassemia. Anaesth. pain intensive care 2023;27(5):495−500; DOI: 10.35975/apic.v27i5.2302

Received: August 03, 2023; Reviewed: August 12, 2023; Accepted: August 14, 2023
Clinical spectrum and outcomes of cancer patients affected with COVID-19 in Indian population: A single-center retrospective study
Authors: Kakati Sonai Datta , Das Anupam , Ninu Marie , Kakati Barnali
Published: February 2024

Introduction: Cancer patients affected with COVID-19 are at high risk of severe infection and death which depends upon their functional status, cancer type and treatment modality. In this study, we measured outcome by mortality and length of stay in hospital and intensive care unit, need of oxygen and respiratory assist devices and performance status after discharge.

Methodology: This retrospective observational study was carried out in active cancer patients with confirmed positive RT-PCR for SARS-CoV-2 between April 2021 and August 2021. Patients with cancer treated more than 6 months back, those in remission and home isolation were excluded. Demographic profile, cancer type, staging and treatment, severity of COVID, treatment, oxygen supplementation, as well as ICU and hospital stay were analyzed. Statistical analysis was done using descriptive and inferential analysis. Significance was assessed at 5% level of significance. Chi-square/ Fisher Exact test was used to find the significance of the study parameters on categorical scale between two or more groups, non-parametric setting for qualitative data analysis. Fisher Exact test was used when cell samples were very small. P £ 0.01 was considered as strongly significant.

Results: Out of 92 patients, there were 17 deaths (mortality 18.4%). Mortality was associated with cancer stage, comorbidities, severity of COVID symptoms, use of oxygen, high flow nasal cannula, non-invasive ventilation and decreased Eastern Cooperative Oncology Group score on discharge (P = 0.001). Age, raised C-reactive protein and D dimer levels were associated with increased severity of COVID-19.

Conclusion: Cancer patients with COVID-19 have increased morbidity and mortality affected by various factors related either to pre-existent cancer or the newly acquired COVID-19.

Abbreviations: CRP - C-reactive protein; ECOG - Eastern Cooperative Oncology Group score; RT-PCR - Reverse Transcriptase Polymerase Chain Reaction; HFNC - High Flow Nasal Cannula

Key words: COVID-19; Critical Illness; Neoplasms; Death; Oxygen

Citation: Kakati SD, Das A, Ninu M, Kakati B. Clinical spectrum and outcomes of cancer patients affected with COVID-19 in Indian population: A single-center retrospective study. Anaesth. pain intensive care 2023;27(5):506-512.

DOI: 10.35975/apic.v27i5.2305

Received: July 18, 2023; Reviewed: August 09, 2023; Accepted: August 17, 2023
Effectiveness of ultrasound-guided perineural hydro-dissection with 5% dextrose for pronator teres syndrome: a case series
Authors: Siahaan Yusak Mangara Tua
Published: February 2024

Pronator teres syndrome (PTS) is s a proximal compressive neuropathy of the median nerve at the elbow level by the pronator teres muscle leading to pain and numbness in the area of the nerve distribution. Conservative treatment may be effective in 50-70% of cases with extremity rest and non-steroidal anti-inflammatory drugs, corticosteroids, and surgical decompression. Dextrose perineural hydro-dissection under ultrasound guidance is an interventional therapeutic option in cases of peripheral neuropathy due to nerve entrapment. This is a serial case study investigating the efficacy of dextrose perineural hydro-dissection for long-term pain relief in PTS. A numeric rating scale (NRS) and Quick-DASH (Quick-Disability of the Arm, Shoulder and Hand) were used to evaluate pre- and post-treatment states with ultrasound-guided 5% dextrose hydro-dissection therapy. All patients experienced satisfactory resolution on evaluation twelve months after treatment. In long-term evaluation, dextrose perineural hydro-dissection exhibits good clinical and functional outcomes for patients with PTS.

Abbreviations: CTS - carpal tunnel syndrome; HD - hydro-dissection; NRS - numeric rating scale; PTS - Pronator teres syndrome; Quick-DASH - Quick-Disability of the Arm, Shoulder and Hand

Key words: Pronator Syndrome; Pain; Perineural Hydro-Dissection; Median Neuropathy

Citation: Tua Siahaan YM. Effectiveness of ultrasound-guided perineural hydro-dissection with 5% dextrose for pronator teres syndrome: a case series. Anaesth. pain intensive care 2023;27(5):607−613; DOI:

10.35975/apic.v27i5.2318

Received: July 11, 2023; Reviewed: August 27, 2023; Accepted: August 27, 2023
Comparative effect of preoperative oral pregabalin 50 mg vs. 75 mg on nerve growth factor (NGF) levels in parturients undergoing cesarean section
Authors: Ahmad Muhammad Ramli , Harahap Muhammad Wirawan , Wirawan Nur Surya
Published: February 2024

Background & objectives:  Postoperative pain after cesarean section (CS) is a crucial problem faced by the parturients. Pregabalin is a choice of preventive analgesia to reduce neuropathic pain, inflammation, tissue irritation, and post-cesarean section pain. The purpose of this study was to compare the effect of giving pregabalin 50 mg or 75 mg in combination with paracetamol 1 g on nerve growth factor (NGF) levels after cesarean section. 
Methodology: A prospective, comparative model was used in this study. The study took place at Mother and Children Hospital of Sitti Khadijah I, Makassar, Indonesia. A total of 30 patients who underwent CS were randomly divided into two groups; group P1 who received pregabalin 50 mg orally and 1 g paracetamol intravenously, 1 h before surgery (n = 15), and group P2 who received pregabalin 75 mg orally and 1 g paracetamol intravenously, 1 h before surgery (n = 15). Nerve Growth Factor (NGF) levels were measured 2 h before surgery, and at 4 and 6 h post-surgery. Data were analyzed by the Mann-Whitney test using SPSS 26.0.
Results: There was a decrease in NGF  levels in the pregabalin 75 mg group at 6 h post-surgery, while in the pregabalin 50 mg group it tended to increase at 4 and 6 h post-surgery. In the pregabalin 50 mg group, there was a significant increase in NGF levels from measurements of NGF1 to NGF2 and NGF0 to NGF2 (P < 0.05), whereas, in the pregabalin 75 mg group, there was a significant decrease in NGF levels from measurements of NGF1 to NGF2 and NGF0 to NGF2 (P < 0.05). 
Conclusion: The combination of pregabalin 75 mg orally with paracetamol 1 g intravenously is effective as perioperative multimodal analgesia by reducing nerve growth factor levels after cesarean section surgery.
Abbreviations: BDNF- brain-derived neurotrophic factor; CS- Cesarean section; GABA- Gamma Amino Butyric Acid; NGF- Nerve Growth Factor
Keywords: Cesarean section; Nerve Growth Factor (NGF); Postoperative; Pregabalin
Citation: Ahmad MR, Harahap MW, Wirawan NS. Comparison between pregabalin 50 mg and 75 mg on nerve growth factor (NGF) levels after cesarean section. Anaesth. pain intensive care 2022;27(6):721−725; DOI: 10.35975/apic.v27i6.2159
Received: February 20, 2923; Revised: July 11,2023; Accepted: October 29, 2023
A pregnant lady (G3P2A0) with fetal distress and brain tumor
Authors: Arianto Ardana Tri , Heryadi Mohamad Ismu
Published: February 2024

Intracranial tumors or brain tumors are one of the most feared diseases because the brain is an important central organ. Brain tumors share several pathophysiologic features and may present with a variety of signs and symptom.
A 39-year-old female patient, G3P2A0 of 28 weeks gestation complained of frequent throbbing headaches for the last 2 y. On physical examination, she had decreased consciousness, fever and anisocor pupil. Laboratory tests found leukocytosis. Cerebral multi-slice computed tomography (MSCT) found heterodense lesion at intraaxial supratentorial region with irregular border, necrotic components and bleeding in the right basal ganglia to the right temporal lobe. There were signs of fetal distress on cardiotocography (CTG).
Management during pregnancy depends on the nature of the tumor. There may be some conflict between maternal and fetal interests in the patient with increased ICP. The patient was diagnosed with brain tumor in the right basal ganglia and undergoing treatment in the ICU. As a 28-week pregnant patient with fetal distress diagnosed with brain tumor, she needed to be observed and periodically evaluated. However, the patient's prognosis was dubia ad malam.
Key words: Brain Tumor; Fetal Distress; Pregnancy
Citation: Arianto AT, Heryadi MI. A pregnant lady (G3P2A0) with fetal distress and brain tumor. Anaesth. pain intensive care 2023;27(6):772−775; DOI: 10.35975/apic.v27i6.2233
Received: May 22, 2923; Revised: August 08, 2023; Accepted: October 22, 2023
Efficacy and safety of dexmedetomidine to prevent shivering in cesarean delivery under spinal anesthesia: a double-blind, randomized controlled trial
Authors: Md Adnan Wan Ahmad Asyraf Wan , Wan Hassan Wan Mohd Nazaruddin , Seevaunnamtum Praveena , Omar Sanihah Che , Nik Mohamad Nik Abdullah
Published: February 2024

Background & objective:  Postoperative shivering is a source of much discomfort to the patients following spinal anesthesia (SA), especially in patients undergoing cesarean delivery. The anesthetists have employed various medications and a variety of measures to prevent shivering in their patients. The objective of this study was to investigate the efficacy and safety of intravenous (IV) dexmedetomidine in preventing shivering in patients undergoing cesarean delivery under SA.
Methodology: This prospective, double-blind, randomized trial involved 62 parturients undergoing cesarean delivery under SA. They were randomly divided into two groups; patients in dexmedetomidine group (Group D, n = 31) received dexmedetomidine 0.5 µg/kg IV over 10 min followed by infusion of 0.4 µg/kg/h until the end of surgery; whilst patients in the control group (Group C, n = 31) received equivalent loading and infusion volume of 0.9% saline. Both groups were operated upon by a standardized spinal anesthesia technique. The occurrence of shivering, sedation score and hemodynamic parameters were recorded intraoperatively. The recording anesthetist was blinded regarding the study or the control groups.
Results: The occurrence of shivering was significantly reduced in Group D as compared to Group C (3.2% vs 64.5%, P < 0.001). Patients in Group D were more sedated as compared to Group C (51.6% vs 0%, P < 0.001). There was no statistically significant difference in systolic and diastolic blood pressure readings between both of the groups. Heart rates in Group D were significantly lower than the Group C but still were within normal physiological range.
Conclusion: IV dexmedetomidine was effective in reducing the occurrence of shivering but with significant sedative effect and lowering of heart rate than the placebo. Although the heart rates remained within normal range in both groups.
Key words: Anesthesia, Spinal; Cesarean; Dexmedetomidine; Shivering
Citation: Wan Md Adnan WAA, Wan Hassan WMN, Seevaunnamtum P, Omar SC, Nik Mohamad NA. Efficacy and safety of dexmedetomidine to prevent shivering in cesarean delivery under spinal anesthesia: a double-blind, randomized controlled trial. Anaesth. pain intensive care 2023;27(6):632−638; DOI: 10.35975/apic.v27i6.2346
Received: January 09, 2023; Reviewed: January 29, 2023; Accepted: February 08, 2023
Dual role of sclerostin and other parameters in postmenopausal women with osteoporosis
Authors: Ahmed Narjis Hasan , Jaffat Haider Salih , Alrufaie Mohauman Mohammed
Published: February 2024

Background & objective: Osteoporosis is a chronic progressive disease, characterized by decreased bone mass and damage to the microstructure of bone tissue, leading to decreased bone strength and increased risk of fractures. The main serious consequence of osteoporosis is fragility fracture. This case-control study was conducted to know the prevalence of osteoporosis in Iraqi postmenopausal women.
Methodology: One hundred female patients visiting Al-Sader Teaching Hospital in Al-Najaf province of Iraq, were included in the study. To determine the percentage of their bone density we used a dual energy x-ray absorptiometry (DEXA). Blood samples were taken after diagnosing the disease. In addition, serum estrogen and vitamin D3 were measured by enzyme linked immune sorbent assay (ELISA), while alkaline phosphatase was measured by spectrophotometer. Data were gathered by direct interviews with the women. The study excluded those who had chronic diseases.
Results: This study showed a significant increase (P < 0.05) in the concentration of sclerostin and alkaline phosphatase and non-significant differences in vitamin D3 concentrations between patients and healthy group.
Conclusion: Increased serum sclerostin and alkaline phosphatase levels in postmenopausal women with osteoporosis play an important role in the development of primary osteoporosis.
Key word: Osteoporosis; Sclerostin; DEXA
Citation: Ahmed NH, Jaffat HS, Alrufaie MM. Dual role of sclerostin and other parameters in postmenopausal women with osteoporosis. Anaesth. pain intensive care 2023;27(6):745−749; DOI: 10.35975/apic.v27i6.2349
Received: August 22, 2023; Revised: August 29, 2023; Accepted: September 11, 2023
Incidence and risk factors for delirium after open heart surgery with cardiopulmonary bypass
Authors: Nguyen Thang Toan , Ta Do Dinh , Ho Hai Sy , Duong Hung Duc
Published: February 2024

Background & objectives: Postoperative delirium is a prevalent complication, particularly following cardiac surgery, and has detrimental effects on patient outcomes, including increased morbidity and mortality and prolonged stays in the intensive care unit. This study aims to estimate the incidence and identify the risk factors for delirium.
Methodology: This prospective observational study was conducted on adult patients undergoing open-heart surgery with cardiopulmonary bypass at the Cardiovascular Surgery Unit at Bachmai Hospital, Vietnam. The Confusion Assessment Method for the ICU (CAM-ICU) was utilized to assess delirium twice daily during the initial four days post-surgery. Perioperative variables were analyzed by univariable and multivariable logistic regression.
Results:  Among the 285 patients included in this study, 56 were diagnosed with delirium using the CAM-ICU, representing a prevalence rate of 19.6%. Multivariate regression analysis revealed several independent risk factors for delirium, including advanced age (odd ratio - OR; 95% confidence interval-CI) (1.07; 1.03-1.10), a history of cerebrovascular accident (3.95; 1.31-11.84), prolonged cardiopulmonary bypass duration (1.02; 1.00-1.03), postoperative atrial fibrillation (2.47; 1.15-5.28), and opioid use time (13.65; 5.69-32.75).
Conclusion: The incidence of delirium after open heart surgery with cardiopulmonary bypass was 19.6%. Advanced age and a history of cerebrovascular accidents were identified as non-modifiable risk factors for postoperative delirium. Meanwhile, there were three modifiable risk factors, including cardiopulmonary bypass duration, atrial fibrillation, and the time of opioid administration.
Abbreviations: CAM-ICU: Confusion Assessment Method for the Intensive Care Unit
Key words: Postoperative Delirium; Risk Factors; Incidence; Open-Heart Surgery; Cardiac Surgery
Citation: Nguyen TT, Ta DD, Ho HS, Duong HD. Incidence and risk factors for delirium after open heart surgery with cardiopulmonary bypass. Anaesth. pain intensive care 2023;27(6):639−645; DOI: 10.35975/apic.v27i6.2354
Received: Oct 04, 2023; Revised: Oct 28, 2023; Accepted: Oct 31, 2023
Nasotracheal intubation with the aid of nasopharyngeal airway
Authors: Al-Qader Ban Khalid Abd , Abdulahad Samar Antoine , Mohammad Husam Mustafa
Published: February 2024

Introduction & objective: Oral and maxillofacial surgeries commonly require nasotracheal intubation (NTI) to overcome difficulty of work in the oropharyngeal space. Several variables affect intubation difficulty and complications and include tube type or design, topical vasoconstrictors, lubricating the endotracheal tube (ETT), selecting smaller diameter ETT, using urethral catheter to assist NTI, using some catheters etc. We aimed to explore the effectiveness of nasopharyngeal airway (NPA) as a factor facilitating the passage of ETT in the nasopharynx and diminishing trauma and bleeding during NTI.
Methodology: One hundred-forty patients undergoing surgery in the oral and maxillofacial area were divided into groups of 70 each; NPA group, in which an NPA was used as an assist device, and non-NPA group with non-NPA use. Before intubation, the more patent nostril was identified, topical nasal vasoconstrictor was used, lubricant jelly applied and thermo softening of the ETT achieved. In NPA group, nasal cavity dilatation was done with an NPA before NTI. The ease of ETT passage and any nasopharyngeal bleeding were assessed by a scale of four grades.
Results: About 95.71% patients had easy (grade 0 or 1) passage of ETT in the NPA group compared to 81.43% in the non-NPA group (P < 0.0001, P = 0.006), and the remaining grades also showing significant differences between groups. About 98.57% patients had grade 0 to 1 bleeding (no or traces of blood) in the NPA group, compared to 97.14% in the non-NPA group (P = 0.001) and the remaining grades also showed significant differences between the groups. NPA minimized difficulties in passage of the ETT and complications.
Conclusion: Application of nasopharyngeal airway in patients undergoing nasotracheal intubation for general anesthesia proved to be effective in increasing nasal cavity space and minimizing difficulties faced in the passage of the endotracheal tube through the nasal passages and diminishing the resulting complications.
Abbreviations: ETT- Endotracheal Tube; NPA- Nasopharyngeal Airway; NTI- Nasotracheal Intubation
Keywords: Endotracheal Tube; Lubricating Gel; Maxillofacial; Nasopharyngeal Airway; Nasotracheal Intubation; Surgery, Oral; Surgery
Citation: Abd Al-Qader BK, Abdulahad SA, Mohammad HM. Nasotracheal intubation with the aid of nasopharyngeal airway. Anaesth. pain intensive care 2024;28(1):50−54; DOI: 10.35975/apic.v28i1.2263
Received: July 09, 2023; Reviewed: December 10, 2023; Accepted: December 30, 2023
‘Nursing Care Pain Management Program’ for children with cancer: novel views by a qualitative study
Authors: Naseri Nayereh , Irajpour Alireza , Shamsi Atefeh
Published: February 2024

This paper was withdrawn by the authors, due to possible duplicate submission. (Editorial Team)
“ESICM guidelines on acute respiratory distress syndrome 2023”- a short summary
Authors: Mansoor Faraz
Published: February 2024

New European Society of Intensive Care Medicine (ESICM) guidelines on acute respiratory distress syndrome (ARDS) were published in June, 2023. This is the commentary and the comparison of changes to the previous guidelines that were published in 2017. These new guidelines are applicable to adult patients and cover only non-pharmacological respiratory support strategies that also cover ARDS due to coronavirus disease 2019 (COVID-19).
Abbreviations: AHRF- Acute Hypoxemic Respiratory Failure; ARDS- Acute Respiratory Distress Syndrome; ECMO- Extra Corporeal Membrane Oxygenation; ESICM- European Society of Intensive Care Medicine; CPAP- Continuous Positive Airway Pressure; HFNO- High Flow Nasal Oxygen; NIV- Non-invasive Ventilation; PEEP- Positive End Expiratory Pressure; RM- Recruitment Maneuvers
Key words: Acute Hypoxemic Respiratory Failure; Acute Respiratory Distress Syndrome’ Mechanical Ventilation; Extracorporeal Membrane Oxygenation; Prone Position; Non-Invasive Ventilation; Prognosis.
Citation: Mansoor F. “ESICM guidelines on acute respiratory distress syndrome 2023”- a short summary. Anaesth. pain intensive care 2024;28(1):155−158; DOI: 10.35975/apic.v28i1.2392
Received: October 05, 2023; Reviewed: January 07, 2024; Accepted: January 07, 2024