bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of intra-articular injection of local anaesthetic Ropivacaine versus Ropivacaine+Ketorolac and Ropivacaine+Tramadol for post-operative pain relief in knee and hip arthroplasty surgeries under spinal anaesthesia
Authors: Surana Anita , Baxi Vipin 
Published: June 2021

Local anaesthetic infiltration in knee and hip arthroplasty is employed as a part of multi-model analgesia to reduce opiate consumption and help in early ambulation of elderly people It reduces post-operative pain effectively and thus reduces complications like Deep vein thrombosis, pulmonary embolism, pneumonia and even myocardial infection. Addition of ketorolac or Tramadol further prolongs the duration of analgesia. To compare the local anaesthetic infiltration of Ropivacaine alone and Ropivacaine with Ketorolac and Ropivacaine with tramadol for postoperative pain relief in knee and hip arthroplasty. Randomize double-blind study was conducted on 60 patients undergoing knee or hip arthroplasty under spinal anaesthesia. Group A patients received wound infiltration with Inj. Ropivacaine0.75% 50ml (5-7 mg/kg), Group B patients received Inj. Ropivacaine 0.75% 50 ml+1ml Inj. Ketorolac(30 mg) and Group C patients received Inj Ropivacaine 0.75% 50 ml+ Inj Tramadol 2ml (100mg), all diluted with NS to make 100 ml infiltration. Post-operative pain scores, time of first rescue analgesia (FRA), hemodynamic parameters and total rescue analgesic consumed in 24 hrs. as Inj Diclofenac and Tramadol was assessed and any untoward incidences like nausea, vomiting, knee swelling & Hypotension etc. were noted. The VA Score was significantly lower in Grp C as compared to Grp B and A in first 4-6 hrs. as tramadol and ketorolac significantly prolongs the duration of analgesia. VA score in Grp Cis 3.8+_0.52, as compared to 4.02 ± 1.58 in Grp B and 5.7 ± 1.014 in Grp A. which was statistically significant (P value 0.0141). The time of first rescue analgesia (FRA) was also prolonged by 2.2 hrs. in Grp C as compared to Grp B and C which is statistically significant. (P value 0.003). The total rescue analgesia in 24 hrs. given as Inj Diclofenac and Inj Tramadol was significantly lower in Grp C as compared to Grp B and A. No of pts requiring rescue analgesia was also less 45% in Grp C as compared to 50% and 95% in Grp B and A respectively. 25% pts in Grp C has excellent pain relief as compared to 20% in Grp B and 10% in Grp A. No untoward effect like nausea vomiting is noted in any patient, only 3 pts in Grp A and 2 pts in Grp B required bl transfusion. Local infiltration of Ropivacaine provides good analgesia. Addition of tramadol or Ketorolac prolongs the analgesic effect of Ropivacaine and lowers the VAS significantly and improves patient satisfaction score. It also decreases post-operative 24hrs NSAID or opioid consumption.
Comparative study of physiological changes of nil per oral vs glucose water vs free water in patients undergoing laparoscopic cholecystectomy: A randomized prospective study
Authors: Anand Neelesh , Prakash Shashi , Madia Mandeep M H , Singh Braj Nandan , Gupta Reetika 
Published: June 2021

The aim of this study was to compare the effect of ingestion of clear water and glucose water over 10 hours NPO in elective laparoscopic cholecystetctomy surgery.An observational study was conducted in Sir Sunderlal hospital, Banaras Hindu University. The study included ASA I-II patients undergoing laparoscopic cholecystectomy surgery. Patients undergoing general anaesthesia were included in the study. Among three groups, the control fasted in accordance to nil per os for 10 hours, second and third group received 200 mL of clear water and 200 ml of glucose water, respectively 2 hours before the surgery. Arterial Blood Gas analysis and blood glucose level was done in the immediate post-operative period. Arterial pH, serum electrolytes, serum lactate and blood glucose levels were compared for the above 3 groups. Results were given as mean ± SD. Data collected were analysed using Student’s t-test. Differences were considered statistically significant if P values were &#60;0.05. A total of 45 patients were included and 15 patients each were randomly assigned to one of the 3 groups. Patients who had 200 ml of clear water before surgery had lesser variation in serum K+ [p=0.045] and serum lactate level [p=0.001] than NPO. Patients fed with 200 ml of glucose water before surgery had lesser variation in serum K+ level [p=0.02], serum lactate level [p&#60;0.001], in Random Blood Sugar level [p&#60;0.001] and no episode of hypoglycaemia observed as compared to NPO. Patients given 200 ml of glucose water exhibited lesser variation in serum lactate level [p=0.004], in RBS level [p&#60;0.001] and no hypoglycaemic episode recorded contrary to those supplied with 200 mL of clear water. More fluctuations in extreme values of pH and serum electrolytes values observed in group A. Episodes of hypoglycaemia found more frequent in NPO and patients that received only clear water. No significant side-effects were observed in any group.We conclude that it is safe to give clear drinks 2 hours prior to surgery. Prolonged withholding of oral fluid may cause imbalance in pH, serum electrolytes and hypoglycaemia. The finding confirms the recent ASA guidelines which no longer recommends an indiscriminate ‘NPO after midnight’ policy.
Transversus abdominis plane block versus wound site infiltration using 0.25% bupivacaine for post-operative analgesia after caesarean delivery performed under subarachnoid block
Authors: Kumar Deepak , Wadhawan Sonia , Kohli Amit , Bhadoria Poonam , Kumar Abhijit 
Published: June 2021

: Transversus abdominis planeTAP) block has been described as an effective technique to reduce postoperative pain after caesarean section. Wound site infiltration (WSI) has been a traditional method for pain relief. In our study we attempt to compare the analgesic effect of TAP block with wound site infiltration after caesarean section. A randomized comparative study was conducted on 60 parturients. Patients were randomized into Group T (TAP block, n=30) and Group I (WSI, n=30). Spinal anaesthesia was administered and at the end of surgery, Group T was administered TAP block with 20 ml of 0.25% of bupivacaine on each side and in Group I, 20 ml of 0.25% bupivacaine was infiltrated along the wound site. Postoperatively parameters assessed were time to first rescue analgesia, postoperatively patient’s Numeric pain score (NPS) which was assessed periodically over 24hrs and if NPS ≥4 or patient demanded rescue analgesia, Inj diclofenac 75mg i/m was given as first rescue analgesic, total number of doses of first rescue analgesic given over 24hrs, total number of second rescue analgesic and complications were assessed.: The mean time to first rescue analgesia in Group T was 13.40±4.51 hours and in Group I was 6.20±4.25 hours (p-0.001). NPS at 2, 4,6,12 and 24 hours were lower in Group T compared to Group I. Also, analgesic requirement in first 24hours was significantly less in Group T (p-0.001).: TAP block was found to be superior to wound site infiltration in providing effective postoperative pain relief in patients undergoing caesarean section.
Dexmedetomidine as an adjuvant for extension of postoperative analgesia in ropivacaine induced supraclavicular brachial plexus block
Authors: Soni Deepak , Vangani Mahendra 
Published: June 2021

Pain is recognized as the fifth vital sign. The pain must be adequately treated esp. in postoperative period. The study was carried out at Department of Anesthesiology, Sri Aurobindo Institute of Medical Sciences Indore. The aim of the study was to assess the role of Dexmedetomidine in extension of post-operative analgesia. The study included 88 participants who were equally divided randomly into two groups i.e. with and without Dexmedetomidine intervention after the inclusion and exclusion criteria’s. The duration of post-operative analgesia in both groups indicating that contemplated surgery could be finished without need for additional analgesic supplement as the minimum and maximum time for surgery were within the range of effective analgesia without movement of limb. The time for demand of dose of rescue analgesic by the patients in both groups was 493.6±48.6 minutes and 961.0±141.6 minutes. The Dexmedetomidine group had a less demand of rescue analgesia. (P = 0.000). Whereas 23(52.2%) patients of Nonintervention group needed 2 to 4 doses of injection of diclofenac sodium by intramuscular route to control pain.Addition of Dexmedetomidine 100 mcg to ropivacaine 0.5% solution for conduct of supraclavicular block improved the block quality and provided prolonged postoperative pain free period and decreased the demand of systemic analgesics.
The role of tolvaptan in prevention of hyponatremia in patients undergoing transurethral resection of prostate surgery- A randomized double blind study
Authors: Singh Dinesh Kumar , Baj B B , Goyal Vipin 
Published: June 2021

The aim of our study to determine the role of tolvaptan in prevention of hyponatremia in transurethral resection of prostate surgery. This is randomized double-blind study conducted in 60 ASA grade status 1 and 2 patients age group between 45-80 yrs undergoing TURP under spinal anaesthesia in urology operation theatre in Mahatma Gandhi hospital Jaipur after receiving permission from hospital ethical committee. A detailed history, complete physical examination and routine investigation were done for all patients followed by informed written consent was obtained. Patients are randomly divided into 2 groups. In group A -30 patients who received orally tab tolvaptan 15 mg and group B-30 patients who received orally tab multivitamin 2 hrs before surgery after doing electrolytes of the patients in the morning. In both groups age (in yrs), wt (in kg), ASA grade, volume of irrigating fluid (in litres), volume of prostate resected (in gm) and duration of surgery (in minutes) all demographic and surgical details data were compared. Electrolytes were compared in both groups pre and post-operatively and statistical analysis was done.There was significant difference in post-operative sodium level between the two groups (A and B). The mean level of sodium significantly reduced post-operatively in group –B (control grp). The mean level of sodium significantly increased post-operatively in group –A (tolvaptan grp). We conclude single dose of tolvaptan -15 mg found to effective in prevention of hyponatremia in patients undergoing TURP.
Business Models of Solar Thermal and Hybrid Technologies
Authors: Reiter Patrick , Poier Hannes , Holter Christian , Putz Sabine , Doll Werner , Moser Maria , Gerardts Bernhard , Provasnek Anna 
Published: June 2021

District Heating required annually 600 TWh in the European Union and represents more than 10% of the EUs heat demand. Fossil fuels are the major source for heat production. Approximately 5000 district heating grids in the EU are operated by burning fossil fuels valued at € 18 billion (600 TWh) and emitting more than 150 million tons of CO2 emissions every year.
Simulation and design of collector array units within large systems
Authors: Kong Weiqiang , Furbo Simon , Fan Jianhua 
Published: June 2021

Solar collectors are the core components of solar district heating plants. Annual solar heat yield of solar heating plants on average is around 400-500 kWh/m2 in Denmark. Most solar collectors in the large solar district heating plants in Denmark are ground-mounted flat plate collectors. Arcon-Sunmark A/S is the main manufacturer of the large flat plate collectors for district heating in Denmark. Arcon-Sunmark A/S has installed more than 80% of the world’s large solar heating plants connected to district heating networks.
Integration concepts of decentral ST systems in DHC
Authors: Leoni Paolo , Lennermo Gunnar 
Published: June 2021

This factsheet focuses on the integration hydraulics and control of central ST systems in DHC. The first part gives an overview of decentral feed-in: international state of the art (including comparison and selection criteria of the different integration schemes), hydraulics and components, details of the return-to-supply scheme (challenges, pump operation, control). The second part describes concepts for the secondary-side integration of ST without feed-in. The third part illustrates selected best-practice examples in Austria (Wasserwerke Andritz and Berlinerring in Graz) and Sweden (Ystad).
Individual creativity factor in proactive crisis management in micro and small enterprises
Authors: Ulku Tugay , Bektas Cetin 
Published: June 2021

In crisis situations, the survival of businesses depends on the policies which they apply. Businesses that have been able to internalise the concept of crisis management and prepare an environment for their employees that can turn the crisis into an opportunity will be able to survive the crisis moments with the least damage. In this study, it is aimed to determine the effect of individual creativity factor on proactive crisis management, which is necessary for the success of crisis management. Within the scope of the study, the data were collected from 118 participants who were working in micro and small enterprises in Tokat province via questionnaire. t-Test, analysis of variance, correlation analysis and simple regression analysis were applied to obtained data. As a result of the analysis, it has been determined that individual creativity and proactive crisis management have a positive relationship (r = 0.505; Sig. = 0.000) and individual creativity positively effects proactive crisis management (R2 = 0.255; p = 0.000; ß Change = 0.16).

Keywords: Individual creativity, proactive crisis management, micro enterprises, small enterprises.
Jel Codes: M1, M10, M19
Qualitative study of Yogyakarta palace culinary gastronomic tourism
Authors: Wijaya Tony , Nurhadi Nurhadi , Kuncoro Andreas Mahendro , Rahmawaty Penny 
Published: June 2021

This study aims to explore in-depth information on the factors that become gastronomic tourist attractions of the Yogyakarta palace culinary. This research is qualitative research and data collection was carried out by interviews. In this study, the informants were the Yogyakarta palace’s gastronomic tourists and the Yogyakarta palace’s culinary managers. The data analysis technique used is a descriptive interactive model. These research results show that each restaurant has different concepts and segments serving culinary tourism services. The concept is presented with traditional and modern nuances. Each restaurant offers different advantages, such as private dinner programmes, home tours or different culinary service experiences. The segments of each Yogyakarta palace culinary restaurant are divided into tourists and the general public, although culinary managers focus more on overseas tourists. Based on domestic and foreign tourists’ perspective, the appeal of the Yogyakarta palace culinary tourism is the need for experience, curiosity, invitations, tourism information and a sense of pride. The responses given by the informants were related to experiences during the gastronomic or culinary tours of the palace, namely getting new experiences, fun, satisfaction, a sense of pride and willingness to recommend to others. Recommendations on the tourism office to introduce gastronomic tourism to foreign countries can boost the level of tourist visits. The palace’s culinary service providers need to provide a satisfying experience and historical services that stick in visitors’ minds by providing complete guidance and information regarding the historical and cultural value of food and its procedures.

Keywords: Culinary, gastronomy, palace, tourism.
Does medical or surgical treatment for aortic stenosis improve outcome in dogs?
Authors: Thomas Julia , Marshall Sophie , Gormley Karin , Conway Georgia , Borgeat Kieran 
Published: June 2021

PICO question
In adult dogs with aortic stenosis does treatment with beta blockers compared with surgical intervention show a longer survival time with improved clinical parameters?

Clinical bottom line
Category of research question
Treatment
The number and type of study designs reviewed
Eight studies were reviewed. One was a randomised controlled study, three were cohort studies, one was a case series and three were case reports
Strength of evidence
Moderate to weak
Outcomes reported
Intervention appeared to improve survival times ± physiological parameters when compared to no treatment at all. The severity of clinical signs was reduced, but the risk of sudden cardiac-related death was not diminished according to a number of papers. The direct comparison of surgical treatment with the use of beta blockers showed no significant difference in survival times or physiological parameters across all papers. There is not enough evidence available comparing the different beta blockers used for treatment to draw a meaningful conclusion as to which is more effective
Conclusion
Treatment of some form should be given to a dog diagnosed with aortic stenosis. This will improve clinical signs and there is evidence to say that it will prolong survival as well as improve quality of life.More research into this area is essential. Controlled, randomised clinical trials should be carried out in order to find a reliable and strong recommendation for treatment. Ethical implications need to be considered when going forward with this, which is why the evidence pool is likely to be so limited currently

How to apply this evidence in practice
The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
DETERMINANTS OF ADOLESCENT MARRIAGES INHIBITING THE MATURING OF MARRIAGE AGE
Authors: Kartika Norma Yuni , Efendi Muhammad , Normelani Ellyn , Nurhidayah Nurhidayah 
Published: June 2021

<p><em>Incidence of adolescent marriages in South Kalimantan is still high and acts an obstacle to maturing the marriage age program. This paper aims to analyze the dominant factors which contribute to the maturity of women’s marriages by modifying the social ecological framework theory. This survey study had 180 respondents with 113 women who were married under 19 years and 47 respondents who were married at 19-30 years, while the anlaysis was using bivariate and multivariate analysis. The variables used refer to the social ecological framework theory and there are 2 variables used here, namely individuals (education and work status) and interpersonal (father’s education, father’s occupation and the economy of the respondent’s previous household). The results of the bivariate analysis are in line with social ecological framework theory. Furthermore, the results of multivariate analysis show that all of these variables are 35.7 percent influencing the adolescent marriages. Based on multivariate analysis, the most influential determinants on adolescent marriages are respondents from poor households before marriage, father’s working in agriculture, respondents do not work, fathers do not graduate from elementary school and respondents have low education.</em></p>
THE ACTIVITIES OF SEBELAS MARET SURAKARTA UNIVERSITY STUDENT STUDY SERVICE (KKN) VOLUNTEERS IN THE EDUCATION OF COVID-19 RESPONSE TO THE COMMUNITY IN BANYUMAS REGENCY
Authors: Syahrizal Fadli , Koesuma Sorja 
Published: June 2021

<p>Public understanding and awareness of Covid-19 is still slightly poor that cause them ignore the current situation. This research is carried out in purpose to strengthening the understanding or education of COVID-19 disaster . This article uses descriptive qualitative research method. Where the article present the results of the data as it is without manipulation or other handlings. Data collection techniques used are: 1) Participant observation, in which the researchers play a direct role as the executors and are directly involved in research activities, 2) Interview, to find out the situation through informant, 3) Documents analysis in the form of homecomers' data, and 4) Documentation in the form of activity photos . Some of the activities or projects carried out by the volunteers of KKN Covid-19 Response are Socialization of the Importance of PHBS (Clean and Healthy Behavior), Assistance of Learning Activities during Covid-19, Online Discussions about Covid-19, The Efforts to Create Food Security within The Scope of Family, and Monitoring of Homecomers Data.</p>
Scenic Beauty Estimation Analysis of Sara Besar Island for The Development of Coastal Ecotourism in Talaud Islands District
Authors: Kumaat Joyce , Andaria Kalvin S , Oroh Hilda F 
Published: June 2021

<p><em>This study aims to determine the potential of coastal areas in ecotourism development through a spatial approach using Scenic Beauty Estimation (SBE) analysis. The benefits related to the use of geographic information technology will conceptually provide the right solution for planning and regional development in ecotourism development. Activities carried out include collecting data in the field related to physical and non-physical factors in coastal areas through surveys and mapping, then analyzing data in a Scenic Beauty Estimation (SBE) and designing geographic information systems in the form of mapping on 1) physical, artistic potential, and tourist activities, 2) accessibility (transportation), 3) information and accommodation services. The contribution of this research is to provide information and input for the government to facilitate and determine the planning and development of ecotourism in the coastal area of Talaud Regency on the island of Sara. It can increase regional or regional income, participation, and support in managing and utilizing coastal regions.</em></p>
The Accessibility Analysis of COVID-19 Referral Hospitals to The Location of Fundamental Student
Authors: Pamungkas Bella Theo Tomi , Rahmawati Arfita 
Published: June 2021

The Covid-19 pandemic that occurred in all parts of the world has had an impact on the various sectors. Not only in the economic sector but also in the educational sector. Until Month June Year 2020, the Indonesian government had carried out a new-normal policy. The purpose of the study was to analyze the affordability of the Covid-19 referral hospital to the position of students during the new-normal era. The affordability could be observed by the distance traveled by students to the nearest Covid-19 referral hospital. This study used the OD matrix layer from ArcMap 10.3. The sample used in this study was 87 students with 11 Covid-19 referral hospitals in East Nusa Tenggara Province. Based on the research results in the form of maps produced, showed that from 87 students observed, only 59 or 67.82% could reach the Covid-19 referral hospitals. Meanwhile, the other 28 students or 32.18% couldn’t be reached by the hospitals. The amount of students observed, located less than 15 km from the Covid-19 referral hospitals were 35 or 40.22% from the total of 87 students. The hospital which students refer to based on their location was the WZ. Yohanes hospital.