bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of epidural dexamethasone vs triamcinolone to relieve neuropathic pain of cervical disc herniation patients; 3-months follow-up
Authors: Budisulistyo Trianggoro , Yudhasyah Ria Astari , Kustiowati Endang , Husni Amin , Muhartomo Hexanto , Suryadi Suryadi 
Published: August 2024

Background & objective: Cervical disc herniation (CDH) is the most common cause of radicular pain; with one-third of the patients suffering for more than six months. Epidural steroid injections (ESI) are widely performed by the pain specialists and the neurosurgeons in this disorder, acute or chronic. We compared triamcinolone and dexamethasone regarding their efficacy to improve neuropathic pain at three months follow-up.
Methodology: This randomized blinded control trial was conducted at Dr. Kariadi Hospital in Semarang, Indonesia, on 42 chronic CDH patients. Patients were divided into two equal groups of 21 each, to receive, interlaminar cervical epidural injections of triamcinolone or dexamethasone under fluoroscopic guidance. The study was conducted from January 2022 to July 2023. Follow-up on the PainDETECT score was carried out before and 3 months after the ESI. Data collected was analyzed by using the Mann-Whitney test (P < 0.05).
Results: Forty-two CDH subjects were involved in the study grouped as Dexamethasone group (21) and Triamcinolone group (21). Both groups observed significant pain improvement (P < 0.001, and P = 0.020). In the Dexamethasone group 16 out of 21 (76.2%) subjects showed improvement at 3 months of follow-up in the neuropathic pain, while in Triamcinolone group 10 out of 21 (47.6%) showed improvement at 3 months of follow-up. The differences in the two groups were significant (P < 0.001 vs P = 0.007).
Conclusion: The results of this study prove that epidural injection of dexamethasone is more effective than triamcinolone for improving neuropathic pain syndrome associated with chronic cervical disc herniation.
Keywords: Chronic CDH, Neck pain, Epidural steroid injection, Dexamethasone, Triamcinolone, Pain DETECT
Citation: Budisulistyo T, Yudhasyah RA, Kustiowati E, Husni A, Muhartomo H, Suryadi. Effectiveness of epidural dexamethasone vs triamcinolone to relieve neuropathic pain of cervical disc herniation patients; 3-months follow-up. Anaesth. pain intensive care 2024;28(4):732−736; DOI: 10.35975/apic.v28i4.2515
Received: December 28, 2023; Reviewed: February 12, 2024; Accepted: February 17, 2024
Assessing the impact of opioid-free anesthesia using the modified Mulimix technique on postoperative pain in bariatric surgery patients: a correlative randomized double-blinded trial
Authors: Seyam Sameh Hamdy Abdelhamid , Hassan Abdallah Elabd , Elsayed Mostafa Mohamed 
Published: August 2024

Background & objective: The effective management of postoperative pain in bariatric surgery poses significant challenges to the anesthesiologists and the surgeons. Opioids have been the mainstay of postoperative pain management; but recently, opioid-free anesthesia (OFA) has been a popular option in an effort to prevent the opioid related side-effects. The objective of this study was to assess the effects of OFA utilizing the modified mulimix technique on the levels of plasma interleukin-2 (IL-2) and interleukin-6 (IL-6). In addition, the study aimed to evaluate the duration of analgesia and the analgesic requirements during the first 24 hours postoperatively.
Methodology: A total of 60 patients were randomly assigned to the OFA Group, which received opioid-free anesthesia, and the OBA Group, which received Opioid-Based Anesthesia. The modified Mulimix technique was used in both groups. Serum samples were collected from all patients during skin incision and after the surgical procedure. Subsequently, these samples were assessed for IL-2 and IL-6 levels. The postoperative analgesic consumption was compared in both groups.
Results: Regarding serum IL-2 and IL-6 levels in the two study groups, there was a statistically significant difference after the conclusion of surgery, and the skin incision was made. Regarding the initial rescue analgesia postoperatively assessment, the OBA group demonstrated a substantially greater overall consumption of analgesics within the first 24 h. The study revealed a significant difference in VAS values between the OBA Group and the OFA Group at 2 h, 4 h, and 6 h postoperatively.
Conclusion: The modified mulimix technique effectively reduces postoperative plasma inflammatory mediators, interleukin-2 and interleukin-6, and results in decreased postoperative pain, thus reducing the postoperative analgesia consumption
Abbreviations: OBA - Opioid based anesthesia; OFA - opioid-free anesthesia; IL-2 - interleukin-2; IL-6 - interleukin-6; VAS - visual analogue scale
Keywords: Bariatric surgery, interleukin, Mulimix, opioid, pain, immunological response.
Citation: Seyam SHA, Hassan AE, Elsayed MM. Assessing the impact of opioid-free anesthesia using the modified Mulimix technique on postoperative pain in bariatric surgery patients: a correlative randomized double-blinded trial. Anaesth. pain intensive care 2024;28(4):721−726; DOI: 10.35975/apic.v28i4.2516
Received: March 04, 2024; Reviewed: May 18, 2024; Accepted: May 19, 2024
Antimicrobial resistance patterns in patients admitted in a medical intensive care unit at Rawalpindi, Pakistan
Authors: Bacha Muhammad Faisal , Sayed Tahir Mukhtar , Maqsood Jehanzaib , Noaman Muhammad , Aslam Muhammad , Noureen Fakhra , Ikram Nadeem 
Published: August 2024

Background & objective: The prevalence of antibiotic resistance has increased with the excessive use of antibiotics in our country. We aimed to examine the patterns of antibiotic resistance in different organisms found in patients admitted to our Medical Intensive Care Unit (MICU). Additionally, the study sought to determine the relationship between the pathogen causing the infection and the outcome of the patients.
Methodology: This retrospective observational cross-sectional study was conducted in the MICU of Farooq Hospital affiliated with Akhtar Saeed Medical College, Rawalpindi, Pakistan, from January 01, 2024 to March 31, 2024. The data was collected from the medical records of adult patients (aged 12-79 y) who were admitted to the MICU during the study period. SPSS 29 was used for data analysis. Analyzed data included information on demographics, culture results, and antibiotic resistance patterns. We included culture results of blood, urine, and Foley catheter tip. The final disposal of the patients was noted and linked to the pathogen responsible for the disease.
Results: The study involved 104 patients admitted to the MICU. The average duration of stay was 5.36 days, the average age was 51.17 ± 18.47 y, and 61.53% of the patients were male. The primary diagnoses were urinary tract infection (18.22%) and sepsis (15.76%). Pre-existing conditions included diabetes mellitus (24.15%) and hypertension (23.59%). Klebsiella pneumoniae was the predominant organism, followed by E. coli. Overall, 58.52% of the isolates showed resistance to the tested antibiotics. Specific drugs, such as ceftazidime and amoxicillin-clavulanic acid, demonstrated absolute resistance (100%), while vancomycin and tigecycline showed no resistance. In this study, patients with infections caused by Enterobacter, Enterococcus faecalis, Proteus, and Salmonella spp. had discharge rates of 100%. In contrast, infections caused by Candida, Acinetobacter species, and Klebsiella pneumoniae were associated with 100%, 75%, and 48.5% mortality rates, respectively.
Conclusion: The study revealed a significant prevalence of antibiotic resistance among microorganisms in our Medical Intensive Care Unit. Klebsiella pneumoniae was the predominant organism, and distinct bacterial infections were linked to diverse patient outcomes.
Abbreviations: MDR - multidrug resistance; MICU - Medical Intensive Care Unit; MRSA - methylene resistant S. aureus XDR - extensively drug resistant
Keywords: Antibiotic, Resistance, Pakistan, Intensive Care Units.
Citation: Bacha MF, Sayed TM, Maqsood J, Noaman M, Aslam M, Noureen F, Ikram N. Antimicrobial resistance patterns in patients admitted in a medical intensive care unit at Rawalpindi, Pakistan. Anaesth. pain intensive care 2024;28(4):727−731; DOI: 10.35975/apic.v28i4.2521
Received: June 10, 2024; Reviewed: June 21, 2024; Accepted: July 15,2024
Dexmedetomidine administration in a laryngeal cancer patient with emergency tracheostomy: a case report
Authors: Kaya Filiz , Evirgen Evren Selma , Aydin Eda Uysal , Kocagil Sümeyye , Erkiliç Ezgi 
Published: August 2024

The maintenance of vital functions in any patient depends upon the preservation and maintenance of airway patency. Conditions that may cause difficult airway, such as a laryngeal mass, require rapid and expert intervention. We briefly review the current knowledge on this subject by presenting the report of a patient who required emergency airway intervention and in whom a tracheostomy had to be resorted to under sedation. A 59-year-old male patient who was scheduled for total laryngectomy and neck dissection due to laryngeal cancer was taken to the operating room with the decision of emergency tracheostomy after developing respiratory distress. Nasoendoscopic visualization of the patient showed an exophytic lesion starting from the root of the tongue on the left and extending to the chordae. Inj fentanyl and dexmedetomidine were administered to the patient for sedation and dexmedetomidine infusion was continued after the loading dose. When the thyroid isthmus was encountered during the surgical intervention, a tracheostomy was made at 45 min. A 7.5 mm cuffed tube was inserted and respiratory control was achieved. This case report stresses that a combination of dexmedetomidine and fentanyl can be used safely in such cases.
Keywords: tracheostomy, dexmedetomidine, diffuculut airway
Citation: Kaya F, Evirgen ES, Aydin EU, Kocagil S, Erkiliç E. Dexmedetomidine administration in a laryngeal cancer patient with emergency tracheostomy: a case report. Anaesth. pain intensive care 2024;28(4):772−775; DOI: 10.35975/apic.v28i4.2522
Received: April 17, 2024; Reviewed: June 05, 2024; Accepted: June 05, 2024
Radiofrequency ablation of superior hypogastric ganglion and dorsal root ganglion reduces neuropathic pain in L5-S1 disc anterior protrusion: a case report
Authors: Budisulistyo Trianggoro 
Published: August 2024

Approximately 36%-55% of patients with chronic low back pain (LBP) have neuropathic pain syndrome. Prescription of adjuvant analgesics or antidepressants is effective in reducing pain but requires special attention.
A female patient, 57 y, presented with complaints of LBP for 5-7 days. Pain was spread bilateral in the hips-groin, as well as to the fingers and soles (NRS 6-8, PainDETECT 35). She had history of falls 10 y ago, but still worked for 5 hours daily. She had allodynia, dysesthesia, hyperalgesia, and L4-5 and L5-S1 hypesthesia. Magnetic resonance imaging (MRI) showed postero-central and lateral bulged L4-5 and L5-S1 discs. Radiofrequency ablation (RFA) 70o of superior hypogastric ganglion for 90 sec, and pulsed radiofrequency (PRF) 42o of dorsal root ganglion (DRG) L4-5, L5-S1 bilaterally for 2 min reduced nociceptive pain (NRS 2-3) and neuropathic pain (PainDETECT 12). Post-surgical medication included levofloxacin, gabapentin, paracetamol, amitriptyline and Vitamin B12.
The sympathetic ganglia supply the anterior segments of the lumbar vertebrae and the anterior longitudinal ligament, often overlooked as a cause of pain. The management of LBP patient depends upon the etiology, whether associated to structural abnormalities or nerve dysfunction.
Keywords: anterior disc herniation, dorsal root ganglion, lumbar disc herniation, neuropathic pain, superior hypogastric ganglion, radiofrequency
Citation: Budisulistyo T. Radiofrequency ablation of superior hypogastric ganglion and dorsal root ganglion reduces neuropathic pain in L5-S1 disc anterior protrusion: a case report. Anaesth. pain intensive care 2024;28(4):757−761; DOI: 10.35975/apic.v28i4.2523
Received: August 02, 2023; Reviewed: December 26, 2023; Accepted: December 26, 2023
Manejo da síndrome do olho vermelho: uma revisão de literatura
Authors: Jung Vidigal Correa Arthur , Gomes Luana , De Lima Rodrigues Thiago , Fernandes da Silva João Vitor 
Published: August 2024

Este artigo tem por objetivo realizar uma varredura da literatura médica vigente sobre a síndrome do olho vermelho. Trata-se de uma revisão integrativa utilizando como base de dados a BVS, a SciELO, o LILACS e o PubMed, nos últimos 5 anos. Foram avaliados 41 artigos sobre o tema com ênfase em uma síntese dos conhecimentos mais recentes e de maior consistência científica. A Síndrome do Olho Vermelho é uma queixa comum na prática ambulatorial. Uma pequena porcentagem de pacientes com olhos vermelhos precisa de encaminhamento e tratamento oftalmológicos urgentes, embora a grande maioria possa ser tratada pelo médico generalista. Conclui-se que o quadro de olho vermelho é uma queixa extremamente comum na prática clínica. Existem poucos dados epidemiológicos sobre o olho vermelho, mas a conjuntivite é provavelmente a causa mais comum de olho vermelho na comunidade, mas também podem ocorrer várias condições mais graves.
CARACTERIZAÇÃO EPIDEMIOLÓGICA DAS MENINGITES NO BRASIL (2018-2023)
Authors: De Melo Filho Edson Ricardo , Ferreira da Silva Antônio Gabriel , Barretto Teixeira de Freitas Iasmin , Cardoso Oliveira Silva João Alexandre , Fontes Julieinnie , Nunes Ferraz Sheila 
Published: August 2024

Introdução: A meningite é uma doença infecciosa que afeta as meninges, podendo ser viral, bacteriana ou não infecciosa. Causada principalmente por enterovírus e bactérias como Neisseria meningitidis, a transmissão ocorre via gotículas respiratórias. Os sintomas incluem febre, cefaleia e rigidez de nuca, com diagnóstico feito por análise do líquido cefalorraquidiano. Complicações como surdez e déficits cognitivos podem ocorrer, especialmente em crianças. A letalidade varia de 3 a 19%. No Brasil, todos os casos são de notificação compulsória devido à sua gravidade e custos em saúde pública. Por isso, estudos epidemiológicos, são essenciais para entender o perfil desta doença. Objetivo: O objetivo do presente estudo é identificar e analisar o perfil epidemiológico das meningites no território brasileiro, no período de 2018 a 2023. Metodologia: Trata-se de um estudo epidemiológico, retrospectivo, de caráter descritivo, sobre casos de meningite no Brasil e regiões, com dados obtidos do SINAN, entre 2018 e 2023. As variáveis de interesse foram: ano e mês do 1º sintoma, unidade federativa, faixa etária, sexo, raça/cor, escolaridade, gestante, etiologia, sorogrupo, critério de confirmação e evolução dos casos. Resultados: No período de 2018 a 2023 foram registrados 63.259 casos de meningites. Durante 2018 a 2021 e 2022 a 2023 houve um decréscimo nos números de casos notificados. Entretanto, de 2021 para 2022 houve um aumento significativo nos casos de meningites. Além disso, verificou-se também muitos casos relatados como ignorados ou branco no que tange o sorogrupo relatado. Conclusão: Constatou-se que os indivíduos mais acometidos por meningite são do sexo masculino, na faixa etária de 1 a 4 anos, brancos, por causa viral. Os moradores da região sudeste do Brasil também tiveram uma incidência mais alta. Os meses de Março e Outubro foram os meses de maior prevalência. Em geral, os casos relatados das meningites mostraram cursar com uma boa evolução, evoluindo, em grande maioria, com alta.
Modern Diplomacy and the Changing Nature of International Politics in the 21st Century
Authors: Oosthuizen Marc E. 
Published: August 2024

International politics have become more complex since the end of the Cold War in the late 1980s, and consequently, it confuses traditional diplomats.[i] This intricacy is because the post-Cold War international era requires diplomacy to move from being foremost about high politics such as security, military and geopolitical issues to incorporating a wider and growing scope of issues outside of a state’s national borders like migration, gender, global warming, desertification and diseases. Not only are these novel policy themes an indication of how diplomacy’s agenda is growing, but they also indicate that an increasing number of participating stakeholders must be included in contemporary diplomatic practice.[ii] To further scrutinise the phenomena driving change and influencing modern diplomacy, the research utilises specific and relevant international political issues such as post-Cold War international politics, the hegemonic decline of the US, the rise of China, the problems in the Middle East, nuclear disarmament, climate change, Globalisation, the Fourth Industrial Revolution (4IR), the COVID-19 pandemic and diplomatic inflation.

1) Haynes 2011, 5-6, 8; Stern 2015; Spies 2019a, 42-43.
[ii]) Haynes 2011, 8; Sharp 1999, 33; Spies 2019a, 42-43.
Experimental research of a flexible retaining wall model in laboratory conditions
Authors: Bryksin V. V. 
Published: August 2024

Introduction. The Russian standards determine the lateral earth pressure at the failure surface stage, which corresponds to the Coulomb’s theory. In this case, the limit values of earth pressure on the flexible wall remain independent from the nature and intensity of deformation of the retaining structure. Therefore, computational methods for retaining walls are to be improved considering the above-mentioned factors.Aim. To obtain experimental data in order to develop a computational method for determination of the active earth pressure on retaining structures depending on their deformations.Materials and methods. Experimental tests were carried out by physical simulation for various models of flexible retaining walls using a purpose-designed laboratory test bench. Medium sand was used as a model backfill soil; its physical properties were determined under laboratory conditions in accordance with State Standard 5180-2015.Results. The tests provided data on the character of backfill soil deformations within the wedge of failure for different kinematic conditions of the retaining wall model and, accordingly, justified the application of inclined block phenomenological model, used to develop a computational method for determining the active earth pressure on retaining walls.Conclusions. Experimental tests indicate the correlation between deformation nature of the backfill soil and accepted conditions of soil operation during the development of engineering method for determining the lateral earth pressure. The obtained experimental data can be used in adoption and verification of the suggested computational method that enables shoring of excavations to be designed more reasonably in mutual conformity with the actual earth pressure diagrams.
Production of effective materials on the basis of sulfuric acid industry wastes
Authors: Sokolova S. V. , Sidorenko Yu. V. 
Published: August 2024

Introduction. Solving the urgent problem of the production of special concretes using certain varieties of substandard natural raw materials and a number of industrial wastes will support introducing the principles of resource saving and improving the technological features of production.Aim. To make a comprehensive assessment of the impact of sulfuric acid production wastes and substandard natural clay raw materials on the production of high-quality and durable concretes for special purposes.Materials and methods. Easily fusible clay rocks serve as a raw material for the production of expanded clay gravel. Organic (solar oil) and ferruginous (pyrite cinders) additives were used. X-ray analysis was carried out to determine the crystalline phases in the clay of the Nikolskoe oil-field, in the resulting expanded clay gravel, as well as to analyze the factory bulk samples of pyrite cinders. A tubular electric furnace was used for firing in a two-stage mode of 700 and 1100 °C to obtain high-strength expanded clay gravel under laboratory conditions. The research involved studying parameters of phosphate binder formation and properties of iron phosphate concrete based on H3PO4 and sulfuric acid industry wastes – pyrite cinders.Results. It was found that Nikolskoye field clay forms a good raw material for the production of high-strength heavy expanded clay gravel with a strength of up to 550 kg/cm2, water absorption of 1.5 % and resistance to aggressive environments, thereby making it suitable for manufacturing special concretes. The results obtained specify the test methods and technical requirements, control methods and product acceptance rules, thus improving the quality and durability of the concretes considered.Conclusions. The investigated non-bloating clay can be used with organic and ferruginous additives to obtain high-strength expanded clay gravel for the manufacture of structural concretes. A mixed iron phosphate binder serves for producing heat-resistant concretes for linings of melting and casting units in non-ferrous metallurgy with high resistance and durability.
Wind load simulation for the analysis of the antenna dual-purpose poles aerodynamics
Authors: Belash T. A. , Safin R. R. 
Published: August 2024

Introduction. In addition to the location of cellular communication equipment, dual-purpose poles perform the function of a lighting pole. Since dual-purpose pole are located on the central streets of the city, they have strength margins and minimum dimensions. The growing number of urban dual-purpose poles makes the correct calculation very relevant for ensuring their safe operation.Aim. Analysis of the change in the wind load on the dual-purpose pole with panel antennas and its effect on the strength of the dual-purpose pole structure. In order to achieve this, the following tasks were formulated: to deter-mine the dependence of the aerodynamic coefficient and the magnitude of the wind load on the dimensions of panel antennas and their location; to formulate recommendations for the installation of panel antennas on the upper dual-purpose pole section with a diameter of 114 mm.Materials and methods. An analysis of changes in the wind load and aerodynamic coefficient of the dual-purpose pole section, 114 mm in diameter, with panel antennas, installed thereon, depending on the dimensions of antennas and their location.Results. The aerodynamic coefficient was established to decrease at an increase in the projection of the panel antennas beyond the pipe rack, regardless of their dimensions. The more the panel antennas are pressed against the pipe rack, the closer they are to the neighboring antennas, thereby making it difficult to blow the cross-section in the center. Despite the fact that the aerodynamic coefficient decreases with an increase in the projection beyond the pipe rack, the value of the wind load remains almost constant.Conclusions. Panel antennas on a pipe rack with a diameter of 114 mm must be designed taking into account the cross-section dimensions of panel antennas. If the panel antenna width and thickness exceed 350 and 150 mm, respectively, the installation of such panel antennas should be as close as possible to the considered pipe rack in order to reduce the wind load on the dual-purpose pole. In other cases, the projection of panel antennas will have no significant effect on the change in the wind load.