bluuebunny/crossref_metadata_2025 huggingface dataset:
PENINGKATAN NILAI MANFAAT AIR MELALUI PAMDES DI DESA PANGALENGAN, KECAMATAN PANGALENGAN, KABUPATEN BANDUNG
Authors: Nugroho Joko , Susanto Arif , Irawan Dasapta Erwin
Published: May 2021

Di Daerah Pangalengan terdapat banyak mata air yang telah dimanfaatkan untuk kegiatan perkebunan dan pemenuhan kebutuhan domestik. Dari penelitian terdahulu, diketahui ada beberapa mata air yang telah dimanfaatkan penduduk dan layak untuk digunakan sebagai air baku, diantaranya adalah mata air Cidurugdug. Di daerah studi terdapat sekitar 300 KK yang memanfaatkan air dari sumber mata air. Namun demikian kondisi distribusi yang ada secara teknis memiliki banyak kekurangan, antara lain memiliki kehilangan energi yang cukup tinggi. Karena debit aliran yang menuju ke pengguna sangat kecil maka pengguna cenderung membuka secara menerus sambungan mereka. Hal ini mengakibatkan kehilangan air yang relatif besar. Debit yang tersedia berdasarkan hasil pengamatan lapangan adalah 2 l/s. Tujuan penelitian adalah untuk memperoleh sistem distribusi air secara gravitasi yang sesuai dengan topografi serta sebaran populasi, sehingga dapat mencukupi kebutuhan masyarakat. Selain itu pemanfaatan air bisa lebih efektif dan tidak banyak air yang terbuang, serta sistem ini dapat dikelola secara berkelanjutan. Metodologi dalam pelaksanaan studi ini adalah dengan melakukan pengumpulan data, survei lapangan, analisis kebutuhan air domestik, evaluasi kondisi eksisting, dan pemodelan sistim distribusi dengan menggunakan perangkat lunak EPANET. Dari data dan hasil pemodelan diperoleh sistem yang ideal, untuk kemudian akan disesuaikan dengan kondisi lapangan dalam hal penerapannya. Hasil dari penelitian ini berupa skema jaringan transmisi dan distribusi air baku yang saat ini telah diterapkan di kawasan penelitian (RW 13 dan 14, Desa Pangalengan). Dengan adanya jaringan distribusi melalui Pengelolaan Air Minum Pedesaan (PAMDES) maka nilai manfaat air di Desa Pangalengan dapat ditingkatkan secara merata dan berkelanjutan.
TRANSITIVITY ANALYSIS REPRESENTING HONG KONG PROTEST 2019 IN THE GUARDIAN NEWS ARTICLE
Authors: Rahmasari Shafira
Published: May 2021

News is one of a medium to give new and recent information regarding particular event including the person that is involved that is published by news publishers. One of the leading publishers in The United Kingdom is The Guardian. The Guardian reported an international news which was the activists and pro-democracy figures arrested on Hong Kong protest 2019 that was published in August, 30 2019. The paper attempts to find out the transitivity process to see how the protest is represented. It applied transitivity as the theoretical framework and discourse analysis as the approach. Based on the analysis, material process appears as the most frequent process followed by verbal, mental, and relational process. It is seen that the authorities and the government have the authority to control the protest including the activists and the activists are powerless during the arrested. Besides, the pro-democracy figures still have a room to express their opinion while the activists give their statement after being released seen through the verbal process. Relational process and mental process remark that the activists are prominent figures through the protest. In addition, circumstances are used to give detail information regarding the process.
Empirical potential profile model for subbands with unusual energy separation in Si(111) p-type inversion layer
Authors: Ayob Nur Idayu , Inagaki Takeshi J. , Daimon Hiroshi , Takeda Sakura N.
Published: May 2021

To explain the deviation in the valence subband energy levels of the Si(111) inversion layer obtained by experiments and calculations, the band edge profile that has the same subband levels as the experimental results is searched through numerical calculations. The obtained band edge profile is characterized by its flat feature in the subsurface region over 1.2 nm from the surface of the Si substrate. By taking the second derivative of the obtained band edge profile, the carrier distribution in the space charge layer is obtained, and the existence of negative charges in the subsurface region is revealed. The origin of the negative charges is attributed to the inhomogeneous valence electron distribution due to the standing wave formation in the narrow space charge layer.
Surface grating VCSEL-integrated amplifier/beam scanner with high power and single mode operation
Authors: Hu Shanting , Hassan Ahmed , Gu Xiaodong , Nakahama Masanori , Shinada Satoshi , Koyama Fumio
Published: May 2021

We propose and demonstrate a novel surface-grating vertical cavity surface emitting laser (VCSEL)-integrated amplifier/beam scanner. When the surface of the VCSEL section is periodically etched, a single slow-light mode which travels laterally into the amplifier section is selected due to the wavelength selectivity of the grating. The coupled slow light can be amplified with pumping the amplifier above the threshold. The far field angle of the amplified slow light can be continuously tuned through changing the pumping current at the VCSEL. We fabricated the integrated device with a 400 μm long VCSEL section and 1 mm long amplifier section, realizing in a single mode coupling power of over 7 mW and high output power of over 500 mW under pulsed operations of the amplifier. The continuous fan beam steering of 1.5° and a diffraction-limited narrow beam divergence of 0.06° are also achieved. We also fabricated device with extending the amplifier section length to 2 mm. A high single mode power of 1 W under pulsed operations is achieved, which is the record high power operation for single-mode VCSELs. With the performance of both high power and good beam quality, our new device shows great potential to be used as light source for LiDAR and other sensing applications.
Terahertz superlattice modes in moiré metasurface composed of twisted square and hexagonal lattices
Authors: Wang Lei , Zhao Zhenyu , Ako Rajour Tanyi , Sriram Sharath
Published: May 2021

We numerically investigate the terahertz superlattice mode in a moiré metasurface containing fringe of squares and hexagonal structures. The edge of moiré fringes works as a route of uni-directional surface current driven by the incident terahertz polarization. As such, each lateral edge of moiré fringe works as dipole oscillator, which collectively resonate in-phase leading to the lattice mode. A large twisted angle leads to a relatively high resonance frequency, as well as, a high quality factor. Our finding manifest a new method to tuning the lattice mode by terahertz twistronics.
Promotion Strategy On Decisions On Using J&T Express Services, Pekanbaru
Authors: Lussianda Erfa Okta , Munawir Munawir
Published: May 2021

In this study discusses the promotion of the Decision on the Use of J & T Express Services at PT Garuda Ekspress Nusantara in the city of Pekanbaru. The method used is using simple linear regression with the result Y = 5.878 + 0.925 X. From this equation it can be explained that kαonstanta (Y = 5.878 + 0.925 X, from the equation can be explained that, the constant (a) is 5.878 stating that there is no the promotion of the use decision of 5.878. The regression coefficient of 0.925 states that each addition of one promotion unit it is predicted that the decision to use will increase by 0.925. This is because there is a relationship between promotion and decision to use services.The hypothesis testing is done by comparing the t statistic value with t table at alpha 5% and degree of freeom (df) = 96 - 2 = 94. So that the ttable value is 1,986. It is known that t count is 12,892 while t table is 1,986 (tcount 12,892 > ttable 1,986). t table, then t count > t table so the result is H0 is rejected, meaning the promotion has a role significant influence on Decision Use of J & T Express services at PT Garuda Ekspress Nusantara Pekanbaru.
PELATIHAN PEMBUATAN VIDEO PEMBELAJARAN BERBASIS POWTOON SEBAGAI ALTERNATIF MEDIA PEMBELAJARAN PADA GURU SMP-TQ MU’ADZ BIN JABAL KENDARI
Authors: Takda Amiruddin , Tahang La , Sukariasih Luh , Sahara La , Nursalam La Ode
Published: May 2021

Activities seek to improve the awareness and information of teachers about the role of educational media in Junior High School learning activities. Furthermore, this curriculum also teaches SMP TQ-Mu'adz Bin Jabal teachers to use the Powtoon technology to design and render instructional videos. Increasing teacher imagination in the creation and use of video learning media is the specific goal to be accomplished, so that science learning in schools can be more contextual. The method used in implementing this Community Service is counselling, training, and question and answer methods. This activity begins with observations in schools and related institutions/agencies in the first week, followed by core activities at SMP TQ-Mu'adz Bin Jabal Kendari. From the results of the dedication, it was found that: (1). This activity has been able to increase teacher knowledge about the urgency of instructional media and the development of forms of instructional media, especially those related to technological developments; (2) This activity has been able to improve the ability of teachers to operate computers or laptops, including in making online-based learning videos that are integrated into Powtoon.
PEMBERDAYAAN EKONOMI MASYARAKAT MELALUI DANA ZAKAT DI GAMPONG BALOY KECAMATAN BLANG MANGAT KOTA LHOKSEUMAWE
Authors: Hakim Hasibuan Ahmad Fauzul , Abbas Ichsan , Fuadi Fuadi , Hasan Nazli , Nur Muhklis Muhammad
Published: May 2021

The purpose of this community service is to increase community understanding of the concept of zakat distribution in Baloi Village, Blang Mangat District, Lhokseumawe City. Specific targets in this community service are increasing community income in Baloi Village, Blang Mangat District, Lhokseumawe City, and how to improve community welfare through the zakat fund zakat of the Malikussaleh University Amil Zakat Agency (BAZMAL). The material that will be delivered at this community service is: community knowledge of the concept of zakat, then distribution of zakat funds to the community in Baloi Village, Blang Mangat District, Lhokseumawe City. Which is related to improving the welfare of coastal fishermen in Baloi Village, Blang Mangat Subdistrict, Lhokseumawe City. BAZMAL) Malikussaleh University.
Implementasi dan Sosialisasi Pengelolaan Daftar Hadir Siswa Di SMK Negeri 5 Talaud Kelas 12 RPL Secara Terkomputerisasi
Authors: Pandengkalu Reky Pres , Ratu Keturunan , Sampetoding Eliyah A M , Manapa Esther Sanda
Published: May 2021

Proses pendidikan memiliki sejumlah tujuan yang ingin dicapai berdasarkan tujuan pendidikan inilah, semua kegiatan dirancang untuk memfasilitasi siswa dalam memperoleh ilmu pengetahuan. Lewat pendidikan yang ada di SMK Negeri 5 Talaud siswa dapat mengembangkan potensi dirinya untuk memiliki kekuatan spiritual keagamaan, pengendalian diri, kepribadian, kecerdasan, akhlak mulia, serta keterampilan yang diperlukan dirinya dan masyarakat. Adapun yang menjadi permasalahan adalah belum adanya sistem yang memuat daftar hadir dan masih manual menggunakan buku. Oleh itu, tim peneliti menawarkan Pengelolaan Daftar Hadir yang ter-Komputerisasi. Implementasi Pengelolaan Daftar hadir menggunakan bantuan perangkat lunak. Setelah dilakukan implementasi, dilakukan Sosialisasi kepada para guru dan para murid untuk menggunakan sistem yang sudah dibuat. Hasilnya guru dapat melaksanakan absensi bagi mahasiswa secara langsung baik saat pembelajaran luring maupun daring (blended learning) secara terkomputerisasi.
PREVALENCE OF EPIDURAL HEMATOMA FOLLOWING CERVICAL EPIDURAL
INJECTIONS IN INTERVENTIONAL PAIN MANAGEMENT SETTINGS: LITERATURE
REVIEW WITH TWO CASE REPORTS
Authors: Manchikanti Laxmaiah
Published: May 2021

Epidural injections are performed frequently in
managing chronic neck pain secondary to disc
herniation, spinal stenosis, discogenic pain, and
post cervical surgery syndrome. Major risks and
devastating complications have been reported
with cervical transforaminal epidural injections.
Cervical interlaminar epidural injections have
been considered as safe and effective in managing
chronic spinal pain of multiple origins. Epidural
hematoma is one of the rare complications.
Efforts at prevention of cervical epidural hematoma
have focused on avoidance of the procedures
or cessation of therapy in patients with bleeding
disorders, on antiplatelet therapy, fi sh oil, and
multiple other drugs. The guidelines from multiple
organizations have provided variable recommendations
regarding the need to stop nonsteroidal
anti-infl ammatory drugs (NSAIDs) including low
dose aspirin and antithrombotic agents. The
risks of thrombotic events have been reported
to be higher than of bleeding during surgery or
interventional techniques with discontinuation of
antiplatelet therapy.
We looked at a 16 year span of cervical interlaminar
epidural injections (2000 through 2015),
performed in a single facility during which time
there were two epidural hematomas. The fi rst
patient was managed conservatively while the
second patient required surgical intervention. Both
patients recovered without residual complications.
During the same period, 2 cases of cardiovascular
events were reported in our practice associated
with the cessation of antithrombotic therapy.
They also recovered without residual complications.
Nevertheless, rapid diagnosis is crucial as
manifested by increased or unusual axial pain at
the site of injection which is often different from
patient’s previous experience.
Two cases provided a prevalence rate of 0.0085%
(2/23,552) over 16 years at this facility. Based on
occurrence of the year, the prevalence was one
of 2,604 cases, or 0.03%, in 2012 and one of
2,287 cases, or 0.04%, in 2015. This provides a
prevalence rate of 0.085 per 10,000 procedures.
Even though complications are extremely rare, it
is essential to weigh the risk benefi t ratio of these
procedures and select the patients with extreme
caution and perform the procedures with diligence.
Key words: Interventional techniques, bleeding
disorders, aspirin, antithrombotic agents, cervical
epidural injection, cervical epidural hematoma
Dorsal Column Stimulation Treats Pain from Chemotherapy-induced,
Small Fiber Neuropathy
Authors: Dickerson David
Published: May 2021

Small fiber neuropathy (SFN) is a disorder of
small afferent nerve fibers that can result in debilitating
pain and functional limitations. There
are many etiologies including, but not limited
to, diabetes, vitamin deficiencies, infections,
and exposure to neurotoxic drugs such as chemotherapeutics.
The constellation of signs and
symptoms overlap with other disease states leading
to potential misdiagnosis. New tests including
histologic studies of skin biopsies and autonomic
nerve tests have emerged in the last 20 years
improving differentiation between these disease
processes and SFN.
Multiple chemotherapeutic medications have
been implicated in causing SFN, including vincristine
which was the causative agent in this case
report. The exact incidence of chemotherapy-induced
peripheral neurotoxicity (CIPN) is currently
unknown, but according to some publications it
has been reported to be as high as 40% in patients
that have been treated with chemotherapy.
As the number of cancer survivors continues to
grow, the number of patients with painful SFN
will potentially increase.
Devising an effective analgesic regimen for patients
with painful SFN can be difficult, and often
requires the pain physician to employ multiple
pharmacologic and non-pharmacologic therapies.
Treatments include analgesics from several drug
classes: antidepressants, opioids, and anticonvulsants.
Often times however, more advanced
interventional techniques must be employed as
effective pain control may be limited by medication
side effects or inadequate return of function.
While dorsal column stimulation was approved
for a limited number of applications, a number of
new applications are reported in the literature.
In this paper, we present a case of vincristineinduced
SFN successfully treated with neuromodulation
via spinal cord stimulator.
Key words: Vincristine, vinblastine, chemotherapy-
induced neuropathy, chronic pain, spinal cord
stimulation, dorsal column stimulation, neuromodulation,
small fiber neuropathy, neuropathic pain
Optimal Steroid Dos age with Three Success ive Hydrodilatation
Treatment for Adhesive Capsulitis of the Shoulder: A Randomized
Controlled Study
Authors: Seop Kim Hyoung
Published: May 2021

Background: Idiopathic adhesive capsulitis of
the shoulder is a common disease, however, the
optimal dosage of steroid in serial hydration has
not been defined.
Objectives: The aim of this study is to find the
optimal dosage of triamcinolone acetonide with
serial hydrodilatation for adhesive capsulitis of
the shoulder.
Study Design: Prospective, double
blinded randomized controlled study.
Setting: Secondary Training Hospital.
Methods: Forty-two patients with adhesive capsulitis
of the shoulder were randomly assigned
to 20 mg or 40 mg intraarticular steroid injection
with hydrodilatation groups using a double blind
method. Data were assessed by visual analog
scale (VAS) for pain, range of motion (ROM)
questionnaire, shoulder pain questionnaire, and
actual shoulder ROM (flexion, abduction, internal
rotation, and external rotation). Data were
collected before the injection and once every 4
weeks after the injection.
Results: The baseline characteristics of the patients
were not statistically different. Both groups
were compared with their pretreated status in all
measurements. (P < 0.05). There were no statistical
differences between groups between the
measurements.
Limitations: The absence of a control group:
a group that was administered hydrodilatation
without steroid.
Conclusion: We suggest 20 mg of steroid injection
with serial hydrodilatation for adhesive capsulitis
of the shoulder patients.
Key words: Injections, intra-articular, triamcinolone
acetonide, lidocaine, shoulder pain, shoulder
joint, pain management, bursitis, pain measurement,
adhesive capsulitis
Cerebrospinal Fluid Leak Presenting with Radiculitis and Delayed
Onset Headache Following Intrathecal Pump Implantation
Authors: Lynem Laura Anne
Published: May 2021

The issue of cerebrospinal fluid (CSF) leak
due to catheter-related failure persists despite
new approaches to surgical techniques. There
is limited literature about atypical presentations
of post dural puncture headaches post intrathecal
drug delivery system (IDDS) implantation. A
59-year-old woman with a past medical history
of lumbar postlaminectomy syndrome, chronic
pain, and lower back pain underwent an intrathecal
drug delivery system implantation after
exhausting other modalities for pain relief. The
patient presented to the office one-month postoperatively
with symptoms of lower back pain,
left lower extremity radiculopathy, and lower
back subcutaneous fluid collection. A dye study
using catheter access port access revealed a
patent intrathecal catheter with no fluid leakage
or collection after injecting contrast dye through
the catheter access port. A fine needle aspiration
performed under ultrasound guidance revealed a
clear fluid. Using laboratory evaluation, this was
confirmed to be CSF using laboratory evaluation.
An epidural blood patch was performed, which
provided minimal radicular pain relief. Several
days after, she began experiencing fronto-occipital
headaches and the lumbar fluid collection reaccumulated.
An intrathecal dye study again was
done and showed retrograde flow from the catheter
causing a lumbar fluid collection. A catheter
exchange was performed resolving the CSF leak
and the patient’s symptoms.
Post dural puncture headaches after IDDS
implantation may have an atypical presentation.
Providers should ensure the intrathecal catheter
is well secured and firmly anchored to prevent migration.
Patient symptoms after IDDS implantation
may necessitate further investigation, including:
patient evaluation, confirming catheter continuity,
and minimally invasive or surgical management.
Complications from IDDS may be reduced with
further research on equipment and implantation
techniques.
Key words: Intrathecal drug delivery system,
neuraxial analgesia, chronic pain, post dural
puncture headache, post laminectomy syndrome,
intrathecal catheters
Combined Ultrasound and Fluoroscopic Guidance for Percutaneous
Ilioinguinal Peripheral Nerve Stimulation
Authors: Ramos Juan A.
Published: May 2021

Postprocedure surgical pain can progress from
acute to an unyielding chronic pain pattern.
Inguinal herniorrhaphy pain is one of the most
common procedures to undergo this progression.
Peripheral nerve field stimulation of the
ilioinguinal nerve has been well documented as a
successful means of treating this pain condition.
Various imaging modalities have been utilized
for placing the electrodes, including fluoroscopy
and ultrasound, with each having specific advantages.
A review of the literature did not show any
prior documented combination of the two. We
describe here combined fluoroscopic/ultrasound
guidance for ilioinguinal nerve stimulation.
A 59-year-old patient with intractable pain following
inguinal herniorrhaphy underwent an
ilioinguinal nerve stimulation trial with combined
ultrasound and fluoroscopic guidance; he received
significant relief during the trial period and
was subsequently implanted permanently. Following
implantation he obtained significant pain
relief and ceased opioid and benzodiazepine use.
The combination of the 2 imaging modalities allowed
for easy identification of the relevant fascial
layers for nerve localization, lead maneuverability,
and pain coverage. The reliable identification of
specific target nerves and electrode orientation
helped to allow reproducibility from successful
trial to permanent lead placement.
Combined ultrasound and fluoroscopy use for
Ilioinguinal nerve stimulation is feasible and
provides anatomic reassurance; further research
needs to be conducted to ascertain cost effectiveness
and large-scale outcomes of this combined
imaging modality. Limitations include the small
number of cases and short outcome follow-up.
Key words: Neuralgia, ilioinguinal, implantable
neurostimulators, peripheral nerve stimulation,
neuromodulation, neuropathic pain, ultrasound,
fluoroscopy, combination technique
The Treatment and Natural Course of “Insulin Neuritis” or
Treatment-induced Neuropathy from the Perspective of 2 Cases
Authors: van Haren Frank
Published: May 2021

“Insulin neuritis” or “treatment-induced neuropathy”
is a relatively rare disease course after the
adequate regulation of glucose levels by insulin
in diabetes mellitus. In 1933 the syndrome was
first described.
Typically, the onset of pain, presenting as polyneuropathy,
is just after the start of the (adequate)
treatment for diabetes mellitus. In this article we
present 2 cases (both women, 15 and 22 years
of age) with a course such as was described in
1933. They were treated with oral gabapentin,
pregabalin, amitriptyline, duloxetine, tramadol
and with transdermal capsaicin 8% patch. Simultaneously,
glucose levels were carefully monitored
and diabetes mellitus and comorbidities
(mainly ocular and gastro-intestinal) were treated.
Treatment effects were variable, and patients
seemed to show some spontaneous/ natural
recovery of complaints.
Furthermore, we describe the pathophysiology,
diagnosis, therapy, and natural course.
“Insulin neuritis” or “treatment-induced neuropathy”
is pain in polyneuropathy with a (sub)acute
onset after adequate glycemic control of diabetes
mellitus with insulin, whereby traditionally this is
seen as one of the mainstays in the treatment
for polyneuropathy in diabetes mellitus. Possibly
this is due to ectopic generation of impulses in
regenerating axons.
From the limited literature, it follows that the
course is variable, but that spontaneous remission
of pain is possible, especially after 18 months of
adequate glycemic control.
There are no separate treatment strategies
described in this form or genesis of pain in
polyneuropathy, other than that which could be
derived from the treatment of other forms of pain
in polyneuropathy.
Key words: Insulin neuritis, treatment induced
neuropathy, polyneuropathy, transdermal capsaicin,
diabetes mellitus
USAGE PATTERNS OF SACROILIAC JOINT INJECTIONS - A COMPARATIVE
EVALUATION OF PRE AND POST AFFORDABLE CARE ACT IN MEDICARE
POPULATION
Authors: Manchikanti Laxmaiah
Published: May 2021

Background: The sacroiliac joints (SIJ) have
been implicated as highly prevalent, pervasive,
expensive, causes of chronic low back pain. The
utilization of SIJ injections is escalating. A recent
analysis demonstrated a reversal of growth of
utilization patterns of interventional techniques
post passage of the Affordable Care Act (ACA).
Bearing that in mind, SIJ injections along with
facet joint interventions seem to have increased
modestly in that same period.
Study Design: Analysis of growth patterns of SIJ
injections from 2000 to 2016 with comparative
analysis of pre- and post- ACA.
Objectives: To assess utilization patterns of SIJ
injections from 2000 to 2016.
Methods: The Centers for Medicare and Medicaid
Services (CMS) Physician/Supplier Procedure
Summary (PSPS) Master dataset was
utilized in this analysis.
Results: The results of the evaluation from 2000
to 2016 showed, 11.7% increase from 2009 to
2016, with an annual increase of 1.6% per 100,000
Medicare population compared to an increase of
299.8% from 2000 to 2009 with annual increase
of 16.6%.
Limitations: The limitations of this study included
a lack of inclusion of Medicare Advantage patients
and the possibility that state claims data may include
claims from other states. As with all claims
based data analyses, this study is retrospective
and thus potentially limited by bias. Finally, patients
who are self or commercially insured are
not part of the dataset.
Conclusions: Study shows dampened increase
in utilization patterns of SIJ injections from 2009
to 2016 as compared with a like time period prior.
Key words: Chronic spinal pain, low back pain,
sacroiliac joint arthritis, interventional techniques,
interventional pain management, sacroiliac joint
injections
WIRELESS HIGH FREQUENCY SPINAL CORD STIMULATION FOR THE TREATMENT OF POST-HERPETIC OCULAR NEURALGIA: A CASE REPORT
Authors: Vanquathem Nick
Published: May 2021

Background: High frequency wireless Spinal
Cord Stimulation (SCS) at the C1-C2 vertebral
levels provides analgesia for the treatment of
refractory ocular pain on the left side secondary
to post-herpetic neuralgia.
Objective: To assess analgesic effects of minimally
invasive wireless neuromodulation in the
treatment of chronic pain due to post-herpetic
neuralgia.
Study Design: This observational, prospective
case report was designed to illustrate the effectiveness
of relieving chronic, intractable pain
utilizing wireless spinal cord stimulation at multiple
frequencies for the treatment of post-herpetic
neuralgia.
Setting: Private Practice Interventional Pain
Clinic.
Methods: This is a single case study of a 62-yearold
patient who experienced an episode of
shingles with rash over the left frontal and lateral
ocular margin. After the rash subsided, the patient
began suffering from severe pain in the left eye.
The patient was placed on a 10-day course of
valacyclovir, gabapentin, which was discontinued
secondary to sedation intolerance, pregabalin
titrated to 300 mg/day and oxycodone, all of which
were ineffective in relieving the pain. The patient
received a stellate ganglion block injection on 6
occasions, experiencing pain relief of only up to
one-day after each injection. Stellate ganglion
radiofrequency ablation was also unsuccessful.
With original Visual Analog Scale (VAS) score of
9/10, inability to sleep and incapacity to perform
activities of daily living (ADLs), the patient had
Stimwave Freedom wireless stimulators placed
sequentially at the C1-C2 vertebral levels.
Results: Programming at low frequencies from
40-120 Hz was unsuccessful in reducing left eye
pain. Stimulation was increased to high frequency
on the Stimwave SurgeTM adjustable waveform,
and within 12 hours, the patient noted significant
decrease in pain. At 3 days post-procedure, the
patient’s VAS score was 1/10. The patient had
permanent placement of the devices, and at
8-month follow-up, VAS scores were 0-2/10, and
the patient’s mood, sleep and ability to perform
ADLs all improved substantially.
Limitations: The study was limited by the novelty
of the device. Although the doctor who implanted
the device is very experienced, more cases of the
use of the wireless Stimwave Freedom apparatus
are necessary to establish its long-term effectiveness
and safety. More clinical trials investigating
the utilization of multiple frequencies are also
required.
Conclusions: Epidural placement of 2, wireless
sequentially placed octopolar stimulators with a
minimally invasive technique at high frequency
stimulation was safe and effective.
Key words: post-herpetic neuralgia, ocular, spinal
cord stimulation, wireless, shingles, trigeminal
nerve, high frequency
Adult Abdominal Migraine Presenting with Abdominal Myofascial
Pain Syndrome: Case Report
Authors: G Giraj
Published: May 2021

Background: Abdominal migraine in adults is
poorly understood and often undiagnosed. It results
in recurrent episodes of abdominal pain associated
with nausea, vomiting, and retching. Abdominal
myofascial pain syndrome is a common
but unrecognized cause of chronic abdominal wall
pain. Abdominal migraine can result in abdominal
myofascial pain syndrome due to either trauma
to the rectus abdominis muscle from excessive
retching or due to viscerosomatic convergence
from underlying esophageal-gastric inflammation.
Objective: Our objective is to present a case
report of undetected abdominal migraine in an
adult patient presenting with abdominal myofascial
pain syndrome and its diagnosis following
successful management of abdominal myofascial
pain syndrome.
Study Design: This case report describes a patient
presenting with 3 different types of abdominal
pain to a pain medicine clinic.
Setting: The patient was seen in a tertiary pain
medicine clinic based in a university teaching
hospital.
Methods: This report describes the successful
management of abdominal myofascial pain syndrome
by trigger point treatment with depot steroids
followed by pulsed radiofrequency treatment.
Results: Successful management of abdominal
myofascial pain syndrome resulted in subsequent
diagnosis of abdominal migraine. There was
improvement reported in pain intensity scores,
quality of life, anxiety, and depression scores
following the interventional management of abdominal
myofascial pain syndrome as well as
abdominal migraine.
Limitations: This report represents a single
patient presenting with a previously unreported
combination of persistent abdominal pain.
Conclusion: Abdominal migraine and abdominal
myofascial pain syndrome are often unrecognized
conditions that result in significant health care
utilization. Undiagnosed abdominal migraine can
result in abdominal myofascial pain syndrome and
this can result in a delay in the correct diagnosis
of abdominal migraine.
Key words: Abdominal migraine, abdominal
myofascial pain syndrome, chronic abdominal
wall pain, trigger point treatment, viscerosomatic
convergence
LOCAL ANESTHETIC SPREAD TO THE CONTRALATERAL TRIGEMINAL GANGLION
Authors: Nguyen Kim T.
Published: May 2021

Chronic neuropathic pain syndromes can severely
affect a person’s quality of life. Trigeminal
neuralgia is among these syndromes and involves
the mandibular branch of the fifth cranial
trigeminal nerve. Patients typically present with
facial pain described as electrical and shock-like
in nature, exacerbated by movements of the jaw
such as talking and chewing. Many patients are
unable to achieve adequate relief with medical
management and therefore require interventions
such as injections of local anesthetics, steroids,
or glycerol. One method of injection uses ultrasound
guidance for local anesthetic injection in
the pterygopalatine fossa affecting the trigeminal
ganglion.
A 64-year-old woman with a history of trigeminal
neuralgia presented for a trigeminal nerve block on
her right side via ultrasound guidance. Following
the injection, she experienced the desired effect
of numbness on her right side in the distribution
of the trigeminal nerve. In addition, the patient
reported feeling the same effects on her left side
despite no injection being done on that side.
We describe a unique case in which local anesthetics
spread through the pterygopalatine fossa
and across the midline, affecting the contralateral
trigeminal ganglion. Patients should be monitored
for hemodynamic changes following this injection.
Key words: Trigeminal neuralgia, trigeminal
nerve block, pterygopalatine fossa, regional block,
trigeminal ganglion
Multiple Fibrin Glue Use in a Complicated Case of Postdural
Puncture Headache Following Intrathecal Drug Delivery System
Placement: A Case Report
Authors: Chung Matthew
Published: May 2021

A postdural puncture headache (PDPH) is a
well-described complication after implantation
of an intrathecal drug delivery system (IDDS).
Treatment is typically with supportive management
with the occasional need for an epidural
blood patch. We describe a case of a patient with
refractory muscle spasticity secondary to cerebral
palsy that required a baclofen IDDS implantation
and subsequently developed a PDPH. After failing
conservative therapy as well as an epidural
blood patch, the decision was made to attempt
an epidural fibrin patch, which transiently improved
her headache. Upon return of the patient’s
symptoms, computed tomography myelogram
demonstrated an extensive cerebrospinal fluid
leak with ventral spread into the retroperitoneal
space. Using a novel technique, a second epidural
fibrin glue patch was administered just adjacent to
the IDDS catheter insertion point, which was then
successful in resolving her symptoms.
Key words: Intrathecal drug delivery system,
postdural puncture headache, dural tear, cerebrospinal
fluid (CSF) leak, fibrin glue, epidural
blood patch
Cervical Pain and Tuberculosis: Case Report
Authors: Jones Mark R.
Published: May 2021

The presenting symptoms of tuberculosis
(TB)
are varied and may include acute and chronic
pain in anatomical regions with active TB infection.
Cervical spine TB, although rare, can present
with nonspecific symptomatology emanating
from the upper cervical spine, leading providers
to overlook TB in their diagnostic approach.
This case report demonstrates the necessity of
a thorough history and physical with particular
emphasis on pertinent sociodemographic risk
factors for pain medicine clinicians to reliably
ensure accurate diagnosis and treatment. A patient
with TB of the cervical spine presented as a
referral with pain symptoms refractory to standard
pharmacologic analgesic regimens. Only with a
thorough social history, made difficult by language
and sociodemographic barriers, were we able to
direct our diagnostic approach to elucidate the
etiology, and engage the patient with the appropriate
therapy.
Key words: Tuberculosis, cervicalgia, cervical
spine, extrapulmonary tuberculosis, pregabalin,
social history
Particulate Epidural Steroid may not be Detectable on
Magnetic Resonance Imaging
Authors: Schwartz Ruben H.
Published: May 2021

Lumbar epidural steroid injections (LESI) have
become a staple in the interventional pain physician’s
armamentarium. For patients with radicular
symptomatology, LESIs provide substantial pain
relief with a favorable safety profile. Adverse effects,
although rare, can occur as with any procedure.
One of the most dreaded complications is
the development of an epidural hematoma, which
should be readily seen on Magnetic Resonance
Imaging (MRI). It has been previously thought
that particulate steroid injections should also be
seen on MRI potentially obscuring a physician’s
clinical judgment. We present two cases where
patients underwent an uncomplicated LESI and
subsequently went for a lumbar MRI that displayed
no injectate in the epidural space.
Key words: Epidural steroid injection, magnetic
resonance imaging, particulate injection, hematoma
Arachnoiditis with Intrathecal
Morphine 12 Months Following
Implantation of an Intrathecal
Pump: A Case Report
Authors: Chow Robert
Published: May 2021

Abstract: The utilization of intrathecal pumps is increasing as more practitioners are becoming familiar with their use,
and as the applications of continuous intrathecal infusions increase. There are many potential risks with
intrathecal pump implantation, which include the risk of infection, bleeding, nerve damage, as well as other
potential issues. After prolonged usage, granuloma formation, medication tolerance, disease progression,
mechanical failure, and arachnoiditis can also occur. Arachnoiditis has been associated with spinal disease,
contrast media, preservatives in medications, infectious causes, hemorrhage, and more. The potential
causes of arachnoiditis are many; however, it is infrequently associated with intrathecal pump infusates.
Morphine is commonly used in intrathecal pumps, either as a sole agent or in combination with other
medications. Its role in arachnoiditis and catheter granuloma formation can be extrapolated from its
effects on inflammation. In particular, it is well known that morphine causes mast cell activation and
subsequent release of substance P and tryptase. In addition, morphine can sensitize the central nervous
system to inflammatory effects as it can enhance the release of substance P from the dorsal root
ganglia as well. Lastly, activation of μ receptors on lymphocytes can result in lymphocyte proliferation.
When arachnoiditis occurs in the setting of an intrathecal pump, there are several important considerations.
These include the appropriate diagnosis of the cause as well as evaluation of potential treatment
options. We report a case of intrathecal morphine-associated arachnoiditis that was diagnosed using both
clinical and magnetic resonance imaging findings. This case describes a successful exchange of intrathecal
morphine for intrathecal hydromorphone, with the subsequent improvement of the patient’s symptoms
of arachnoiditis.
Key words: Adhesive arachnoiditis, arachnoiditis, cancer pain, complications, intrathecal catheter, intrathecal drug
delivery system, intrathecal hydromorphone, intrathecal inflammation, intrathecal morphine, intrathecal
pump, intrathecal opioid, intrathecal ziconitide
OPTIMIZATION TECHNIQUES IN DESIGNING PHARMACEUTICAL FORMULATIONS
Authors: Navya Pusukuri , k Priyarini , k Tejaswi , D Prasanthi
Published: May 2021

This review determines various optimization techniques which are used commercially for pharmaceutical formulations. A glance on the terminology used in optimization, about the software which is used for design of experiments and information regarding optimization parameters.In this various experimental designs are listed such as Factorial design, fractional factorial design,mixture design, star design, Plackett-Burmann design,Central composite design, Box-Behnken design, Taguchi design, D-Optimal design,sequential optimization design etc.In this it describes about the future scope of the optimization techniques and also various types of experimental designs used for various research works were listed. Thus optimization techniques plays key role in the formulation of various pharmaceutical formulations which brings prots and save time for pharmaceutical industry.
NURSING THEORIES APPLIED ON CLIENTS
Authors: Peter Stella , Peter Supriya
Published: May 2021

Nursing Theories are a set of interrelated stereotypes that give a systematized view of a that's interpretive and prophetic in
nature . These are composed of stereotypes, vignettes, models propositions & are hung on assumptions. They're
extrapolated through two high manners; derivable logic and inductive logic. Nursing interpreters use both of these manners. Proposition is " a
creative and rigorous structuring of ideas that projects a conditional, purposeful and orderly view of miracles ".A proposition makes it possible to “
organize the relationship among the generalities to describe, explain, foretell, and control practice.”
FETO-MATERNAL OUTCOME IN HELLP SYNDROME
Authors: Siddiqui Shagufta , Saxena Bharti , Gupta Kumkum
Published: May 2021

Background: HELLP Syndrome is a serious obstetric complication in pregnancy characterised by haemolysis, elevated
liver enzymes and low platelet count. Incidence is 0.5-0.9% of all pregnancies and in 10-20% of cases with severe
preeclampsia (PE) and eclampsia. Aim of the present study is to evaluate the incidence, demographic and clinical prole; and maternal and
perinatal outcome in women with HELLP syndrome. Methods: All women with hypertension with 28 weeks of gestation admitted to labour
room in a single unit of tertiary care hospital at Government medical College Kota, Rajasthan from January 2019 to June 2020 and fullled the
inclusion criteria. Incidence of HELLP syndrome was 1.9% of total deliveries and Results: 15.3% of total HDP cases. Out of 50 cases of HELLP
syndrome, 62% belonged to class III, 22% to class II and 16% to class I of Mississippi classication. Mean age of patients of HELLP syndrome in
present study was 24.72 4.18 years. 32 (64%) were primigravida while 18 (36%) were gravida two or more. Mean gestational age in study group
was 35.98+ -3.33 week. Maternal mortality was seen in 6 (12%) cases and most common cause attributed to MODS 4 (66.67%). Conclusions:
HELLP Syndrome is a severe variant and a dreadful complication of PE and eclampsia, it needs early diagnosis which is based upon clinical and
laboratory ndings and timely intervention in the form of termination of pregnancy to arrest further progress of pathophysiology leading to
complications.
Characterization of two Cucumber mosaic virus isolates infecting Allium cepa in Turkey
Authors: SANTOSA Adyatma I. , ERTUNC Filiz
Published: May 2021

Cucumber mosaic virus (CMV) is polyphagous, infecting plants in several families. CMV has occurred as a minor pathogen in Allium crops in several Mediterranean countries, but little was known of the virus naturally infecting Allium spp. This study completed molecular and biological characterization of CMV-14.3Po and CMV-15.5Po, two newly identified CMV isolates infecting onion (Allium cepa L.) in Turkey. Phylogenetic, and nucleotide and amino acid sequence identity analyses of partial RNA2 and RNA3 of the two isolates showed that they were very similar to other CMV isolates from Mediterranean, European, and East Asian countries. Phylogenetic analysis of the partial sequence of RNA3 also showed that the onion isolates belong to subgroup IA. Onion isolates were mechanically transmissible, and caused mild leaf malformation on onion, severe leaf malformation and stunting on garlic (Allium sativus L.), and mosaic and mottle on cucumber (Cucumis sativus L.) and melon (Cucumis melo L.).
Cardiopatias congênitas: desafios e perspectivas para o cuidado de enfermagem
Authors: Fernandes Rocha Souza Beatriz , Da Silva Buck Eliane Cristina , Bezerra de Souza Ilana Vanina , Rocha Souza Carolina , De Oliveira Regina Célia , Abrantes Cordeiro Morais Camila
Published: May 2021

Objetivo: Analisar as evidências cientí­ficas sobre cuidados de enfemagem í  criança com cardiopatia congênita. Método: Trata-se de uma revisão integrativa realizada nas bases de dados MEDLINE, LILACS e BDENF, por meio da BVS, e SciELO no perí­odo de agosto a setembro de 2020, a partir da combinação dos descritores selecionados. Foram identificados 39 artigos e, após critérios de inclusão e exclusão, obtiveram-se 9 estudos que compuseram a amostra. Resultados: A partir dos dados emergiram duas categorias temáticas: Atuação da enfermagem no cuidado í  criança com cardiopatia congênita e Cuidado í  famí­lia da criança com cardiopatia congênita. Os estudos destacam a importância dos cuidados sistematizados í  criança com cardiopatia congênita, além da crescente necessidade de envolver a famí­lia no processo de cuidado.Conclusão: Destaca-se o importante papel da equipe de enfermagem, direcionando a assistência a partir de prioridades estabelecidas o que contribui para a implementação de cuidados integrais e individualizados.
Segurança do paciente submetido í cirurgia cardí­aca: implicações para a prática de enfermagem
Authors: Rodrigues Bastos Amanda , Rianne Pereira Alves Salmana , Sousa da Silva Glaydes Nely , Soares de Araújo Hirla Vanessa , De Oliveira Regina Célia , Abrantes Cordeiro Morais Camila
Published: May 2021

Objetivo: analisar as evidências cientí­ficas acerca da segurança do paciente submetido í  cirurgia cardí­aca. Método: Trata-se de uma revisão integrativa realizada no perí­odo de agosto a setembro de 2020, a partir da combinação dos descritores selecionados nas bases de dados: MEDLINE, LILACS, BDENF, IBECS e SciELO. Resultados: Com base nos critérios de inclusão e exclusão, consideraram-se para análise 7 estudos. Emergiram duas categorias temáticas: Eventos adversos em unidades de cardiologia: fatores que interferem na segurança do paciente e Atuação da enfermagem no cuidado ao paciente submetido í  cirurgia cardí­aca. Os estudos destacam a importância da assistência de enfermagem através de condutas que visam reduzir a ocorrência de eventos adversos. Conclusão: Foi possí­vel identificar os principais fatores relacionados as complicações durante o perí­odo perioperatório, bem como a importância da implementação de ações quanto í  prevenção de tais eventos, visando garantir uma assistência de qualidade e a segurança do paciente.
Não conformidades no processo de administração de antimicrobianos: revisão integrativa
Authors: Sanches Couto Daniela , Scalon da Costa Perinoti Lí­via Cristina , Da Silva Felix Adriana Maria , Moralez de Figueiredo Rosely
Published: May 2021

Objetivo: identificar as possí­veis não conformidades no processo de administração de antimicrobianos descritas em literatura. Método: revisão integrativa, com busca realizadas nas bases de dados Web of Science, PUBMED, LILACS e BDENF. A pergunta norteadora foi elaborada de acordo com a estratégia PICo: P (população) – enfermagem; I (interesse) – não conformidades; Co (contexto) – administração de antimicrobianos, sendo: Quais são as possí­veis não conformidades no processo de administração de antimicrobianos descritas em literatura? Critérios de inclusão: artigos com resumos e textos completos nos idiomas português, inglês ou espanhol e publicados no perí­odo de 2014 a 2019. A busca foi realizada entre dezembro de 2019 e janeiro de 2020. Resultados: nove artigos foram selecionados para a pesquisa. As principais não conformidades apontadas foram erros de dose e atraso na administração de antimicrobianos. Todos os estudos foram do ní­vel de evidência quatro. Conclusão: Sugere-se que o enfermeiro amplie suas ações nessa temática.
Estratégias educacionais no ensino técnico em enfermagem durante a pandemia por COVID-19
Authors: Teixeira de Macedo Silva Maria Claudia
Published: May 2021

Durante a pandemia, a obrigatoriedade do distanciamento social, mostrou uma nova forma de ensinar e de se reinventar. Objetivo: Apresentar estratégias de ensino utilizadas por um enfermeiro docente, durante o retorno í s aulas presenciais no perí­odo de pandemia. Métodos: Trata-se de um relato de experiência profissional e pesquisa bibliográfica, a aplicabilidade dos métodos foi desenvolvido em uma Instituição de Ensino Técnico em Enfermagem, no mês de setembro de 2020. Resultados: As atividades realizadas que mais motivaram os discentes foram: storytelling, quiz e passa ou repassa. Quando o professor utiliza ferramentas voltadas para a teoria da andragogia, passa a observar o aluno como sujeito ativo no processo de aprendizagem. Conclusões: O trabalho deve ser coletivo, para se inserir uma pedagogia crí­tica, com um aprendizado dinâmico, fazendo com que o aluno em sua realidade, possa não causar danos em sua assistência prestada ao paciente.