bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative study of midazolam–dexmedetomidine combination with propofol for sedation during awake fiberoptic nasotracheal intubation
Authors: Mishra Namita , Arora Divya , Kumar Madhav , Kaur Satinder , Kumar Parmod 
Published: July 2024

Aim and objective
The present study was conducted to compare the efficacy and safety of dexmedetomidine and midazolam with propofol alone for sedation during awake fiberoptic nasotracheal intubation. The study was conducted on 40 patients of either sex aged between 18 and 60 years belonging to ASA I–II grade scheduled for elective surgery. The patients were randomly divided into two groups of 20 patients each. Group I patients received intravenous midazolam 0.02 mg/kg followed by dexmedetomidine 1 μg/kg bolus infusion over 10 min, and then an infusion of dexmedetomidine 0.1 μg/kg/h and titrated to 0.7 μg/kg/h to achieve an adequate level of sedation. Group II patients received intravenous propofol 6 mg/kg/h bolus over 10 min with an additional dose of 2.4 mg/kg/h as infusion until they were adequately sedated. Hemodynamic parameters, comfort scale values, and patient’s tolerance were assessed.

Patients and methods
Fiberoptic nasotracheal intubation was done in both groups of patients, and after securing the tube, general anesthesia was administered. Within 24 h of the surgical procedure, each patient was asked to assess their experience with awake fiberoptic intubation. The data were recorded in the proposed proforma, and the final result was analyzed statistically.

Results
During sedation during fibreoptic procedure (FOS) and ET insertion, pulse rate (P=0.0116), systolic blood pressure (P=0.30), diastolic blood pressure (P=0.326), oxygen saturation (P=0.53), total comfort score (TCS) (P=0.031), and patient tolerance (P=0.023) were observed and showed statistically significant values.

Conclusion
Dexmedetomidine and midazolam group had a lower baseline mean heart rate. Systolic and diastolic blood pressure responses measured at preoxygenation, fiberoscope insertion and endotracheal tube placement were not significantly different for both patient groups. The five-point fibreoptic intubation scores showed better patient tolerance in the dexmedetomidine and midazolam group of patients and better comfort score as compared with propofol, and patients were calmer in the dexmedetomidine group.
Electrical cardiometry assessment of cardiac output compared to echocardiography in septic shock patients
Authors: Mahrous Atef A. , Helmy Tamer A. , Nabil Ahmed M. , Ibrahim Nagy Rawan M.K. 
Published: July 2024

Background
Cardiac output (CO) measurement is essential for guiding therapeutic decisions in critically ill patients. Electrical cardiometry (EC), which is based on thoracic electrical bioimpedance, can measure CO in a continuous and noninvasive way. The benefits of EC are continuous monitoring, low time consumption, portability, and user independence. Transthoracic echocardiography has been a noninvasive method to assess CO despite being noncontiguous and operator dependent.

Aim
This study aimed to compare EC and echocardiography (Echo) in measuring CO in septic shock patients and assess the reliability and accuracy of EC for noninvasive CO monitoring.

Patients and methods
Fifty adult patients were admitted to the Critical Care Medicine Department, diagnosed with septic shock according to the surviving sepsis campaign, and fulfilling the inclusion and exclusion criteria from January 2023 to October 2023, and they were subjected to EC, Echo, and ECG recording.

Results
There was a strong positive significant correlation between CO measurements by echo and EC (r=0.988, P<0.001), and there was a strong positive significant correlation between stroke volume (SV) measurements by echo and EC (r=0.999, P<0.001). Also, there was a strong positive significant correlation between SV and CO measured by both techniques (r=0.782, P<0.001) (r=0.790, P<0.001, respectively).

Conclusion
Compared to Echo, EC can be used as a continuous, noninvasive method for monitoring CO and SV, as it provides accurate and reliable measurements.
Intraperitoneal instillation versus port-site infiltration or subcostal transversus abdominis plane block for post-operative analgesia following laparoscopic cholecystectomy
Authors: D’Cunha Delma , Somayaji Ananth S. 
Published: July 2024

Background
Although pain after laparoscopic surgery is less compared with open cholecystectomy, pain management in the first 24 to 72 h in the postoperative period is tricky and most patients complain of pain with cough, breathing and mobilization during the initial hours. The aim of this study was to evaluate the most efficacious route of analgesia in patients following laparoscopic cholecystectomy by comparing port-site wound infiltration, intraperitoneal infiltration and subcostal transversus abdominis plane block in providing post-operative analgesia following laparoscopic cholecystectomy.

Methods
This was an observational study performed on patients who underwent elective laparoscopic cholecystectomy at a tertiary care hospital in Mangalore. Group A received bupivacaine instilled in gallbladder fossa after removal of gall bladder before closure. Group B received Bupivacaine as an infiltration into the skin incision site (fascia, muscle, preperitoneal space) at each of the four port sites based on the length of the skin incision before closure. Group C received bupivacaine as subcostal transversus abdominis plane block under ultrasound guidance immediately postclosure. Collected data was entered in Microsoft Excel 2007 and analyzed using SPSS version 22.0 to find frequency, Mean and SD. Significance was assessed using Kruskal–Wallis test, χ
2 test and ANOVA for repeated measures.

Results
Hemodynamic parameters, i.e. the heart rate and mean arterial pressure were comparable at the end of 2 h and 4 h. At 6 and 8 h postoperatively however, visual analog scale was significantly better in group C compared with groups A and B. Time until the first analgesic request in group C was 359.35±45.55 min which was significantly lesser than the other two groups. Only three patients from group B had shoulder tip pain which was not seen in the other two groups.

Conclusion
Infiltration of bupivacaine at port sites is helpful in providing effective analgesia for upto 2 h post operatively whereas intraperitoneal instillation is both effective at meeting analgesic requirements as well as preventing shoulder tip pain. However, the substantial finding of our study is in providing further evidence to existing data that Subcostal transversus abdominis plane block can produce effective analgesia for laparoscopic cholecystectomy, effectively reduces analgesic requirement, and ensures faster recovery.
Stealing-like phenomenon with interscalene nerve block and its influence on the regional blood flow during shoulder arthroscopic surgery
Authors: Kamel Walid Y. , Khattab Yosra A. , Haggag Adham M. 
Published: July 2024

Background
Hypotensive anesthesia during shoulder arthroscopy is mandatory. Hypotension in the supine or decubitus position is safe and effective for reducing blood losses and for maintaining a clear surgical field. However, in the beach chair position, major complications have been reported. The current study claims that the alignment of the vessel in these regions favor a stealing-like phenomenon associated with interscalene block. This phenomenon has a good impact on the surgical field.

Results
There was a significant change in the peak systolic velocity between the two populations with values of 57±5 in group I versus 90±12 in group G, with a clearer surgical field in group I than in group G. The need for the intraoperative adjuvant analgesics was higher in group G (29 patients) compared with group I (10 patients) as was the pain score at early postoperative intervals of 6 and 12 h.

Conclusion
The distribution of blood vessels in this region favors a stealing-like phenomenon may be because of the associated vasoplegic effect with the interscalene nerve block, yielding a favorable surgical field without deliberate hypotension.
Randomized control study to evaluate the effect of adding Dexmedetomdine to levobupivacaine in femoral sciatic block in total knee replacement
Authors: El Derh Maha S. , Ewiss Hassan Bahaa E. D. , El Shaer Ahmed N. , Shady Mohamed A. A. , Saleh Mohamed 
Published: July 2024

Background
In recent years there has been an increasing interest in the practice of regional anesthesia especially peripheral nerve blocks for surgical anesthesia and postoperative analgesia. Imaging guidance for nerve localization helps the promise of improving block success with fewer complications. Among the imaging modalities available nowadays, ultrasonography seems to be the most suitable for regional anesthesia. One the most significant advantage of ultrasound (US) technology is the availability to provide anatomic examination of the area of interest.

Aim
The aim of this study is to evaluate the additive effect of dexmedetomidine to levobupivacaine in femoral sciatic block in total knee replacement regarding the onset and duration of both sensory and motor blockade, postoperative analgesia requirements.

Patients and methods
After ethical approval, 60 patients aged 45–65 years old, with an American Society of Anesthesiologists (ASA) physical class I and II who underwent total knee replacement using combined femoral-sciatic nerve block, were included in this prospective, randomized, controlled, double-blinded study. Patients were randomly assigned to receive levobupivacaine alone (group B) or dexmedetomidine 100 µg added to levobupivacaine (group BD) [n=30 patients for each group] for combined femoral-sciatic nerve block.

Results
This study showed that the addition of dexmedetomidine 100 µg to levobupivacaine during ultrasound-guided combined femoral-sciatic nerve block for total knee replacement was associated with, −20% shorter onset times for sensory and motor block, −25% faster time for surgical readiness, and longer duration of sensory and motor block (+45% and +40%, respectively) and +50% longer duration of analgesia.

Conclusion
Addition of dexmedetomidine to levobupivacaine during combined femoral-sciatic nerve block for total knee replacement was associated with faster onset of sensory and motor block, decrease intraoperative and postoperative requirements of analgesia and longer duration of motor block than levobupvicaine alone.
Evaluation of preoperative melatonin on emergence agitation after herniorrhaphy surgeries in pediatrics
Authors: Mansour Mostafa S. , Sedky Asmaa M. , Sultan Amany A. 
Published: July 2024

Background and objective
Emergence agitation is a common phenomenon in children recovering from general anesthesia. An emergence agitation reaction increases the risk of injuring the surgical repair, the patient, and the caregivers. Thus, we aim to explore the efficacy of melatonin premedication on emergence agitation in children undergoing herniorrhaphy surgeries.

Patients and methods
A randomized prospective triple-blinded trial was conducted on 117 children with herniorrhaphy surgeries conducted at the Anesthesia, ICU, and Pain Management Department, Menoufia University hospitals from April 2022 to July 2023.

Results
Yale preoperative scale at the start did not significantly differ among the studied groups (P>0.05). However, the Yale preoperative scale at 1 was significantly higher in group 1 with a mean of 10.2±1.9 than in group 2 (9.5±1.4) and group 3 (5.9±1.4) (P<0.001). The agitation score at 5 h was significantly higher among group 1 with a mean of 2.77±0.67 than group 2 (2.56±0.64) and group 3 (2.03±0.96) (P<0.001). Also, agitation scores at 10 and 15 h were significantly higher in group 1 (3.36±0.63, 4.2±0.66) than in group 2 (3.2±0.66, 3.79±0.73) and group 3 (1.74±0.88, 2.03±1.04), respectively (P<0.001).

Conclusion
Melatonin premedication decreased the agitation scale postoperatively. The decrease was significantly higher in high doses in preventing emergence agitation in children. High-dose melatonin compared with low dose might have a significant effect in preventing emergence agitation.
Enhanced Comprehensive Care Programme: a retrospective study of patient empanelment by generalist-led multidisciplinary teams to reduce acute care utilisation
Authors: Nashi Norshima , Chan Derek Kam Weng , Goh Ginny Jing Xian , Loo Swee Chin , Soong John Tshon Yit 
Published: July 2024

Abstract

Introduction:
Singapore faces an increasingly aged population with complex multimorbidity and psychosocial impairment. This change in demographic is challenging for existing healthcare systems. Breaks in care coordination and continuity result in poor health outcomes, increased acute care utilisation and higher healthcare costs. We proposed a patient empanelment approach adapted for the Singapore context based on the University of Chicago Comprehensive Care Physician model.

Methods:
This retrospective quasi-experimental, matched-controlled observational study sought to assess the effectiveness of the Enhanced Comprehensive Care Programme (ECCP) in reducing acute care utilisation at National University Hospital, Singapore. The primary outcomes were the number of hospitalisations and emergency department (ED) visits 6 months pre- and post-enrolment in ECCP. We used propensity score matching to balance prior healthcare utilisation between the intervention and control groups.

Results:
Fifty-seven participants were recruited in the programme between October 2019 and April 2020. There was a reduction in the mean number of hospitalisations after intervention compared to before intervention (0.58 ± 1.03 vs. 1.90 ± 1.07, P < 0.001). There was also a reduction in the mean number of ED visits (0.77 ± 1.05 vs. 1.96 ± 1.14, P < 0.001). In the propensity-matched cohort, the mean number of hospitalisations was reduced in the intervention group (from 1.92 ± 1.07 to 0.58 ± 1.03, P < 0.001) compared to the control group (from 1.85 ± 0.99 to 1.06 ± 1.17, P = 0.04).

Conclusion:
This observational study shows the potential benefits of ECCP healthcare redesign to reduce acute care utilisation.
NSAID-Induced Lower Gastrointestinal Bleeding: A Case Report
Authors: Nafie Mahmoud , Chadbunchachai Weeraput , Lapa Christo , Gregory Stephen , Nunoo-Mensah Joseph William 
Published: July 2024

Abstract
Nonsteroidal anti-inflammatory drugs (NSAIDs) are well known to cause ulcers and bleeding in the upper gastrointestinal tract. Furthermore, several studies to date have demonstrated that NSAIDs may also cause ulcers in the lower gastrointestinal tract, or the bowel, resulting in small bowel bleeding. The diagnosis and management of bleeding in the small bowel region pose a significant challenge. Here, we present the case of a 30-year-old female who presented to the hospital with lower gastrointestinal bleeding after taking an NSAID for a prolonged period. The results of all investigations, including computed tomography angiography, esophagogastroduodenoscopy, colonoscopy, and digital subtraction angiography, were negative. The patient was transferred to the operating room for an on-table colonoscopy and surgical intervention because of continuous bleeding and hemodynamic instability. During the operation, a suspected bleeding site was located in the terminal ileum, leading to the resection of the small bowel, which revealed ulcerative lesions. NSAIDs are believed to have caused the ulcer in this patient, as evidenced by all the available information, including the pathological results.
ANALISIS DAN EVALUASI PERAWATAN SARANA BANTU NAVIGASI PELAYARAN (SBNP) DI PELABUHAN TANJUNG PERAK
Authors: Laju I Kadek , Hasugian Sereati , Novaliana Siahaan Renta , Dahri Muh. , Wahyu Ardi Eka 
Published: July 2024

Pelabuhan Tanjung Perak, yang terletak di Indonesia, telah menjadi salah satu pelabuhan terbesar dan paling sibuk kedua di negara ini. Selama beberapa tahun terakhir, pelabuhan ini telah mengalami peningkatan yang signifikan dalam jumlah kapal yang datang dan aktivitas bongkar muat di pelabuhannya.. Namun, pertumbuhan ini juga membawa sejumlah tantangan yang perlu dianalisis dan dievaluasi dengan cermat. Tantangan tersebut mencakup alur pelayaran yang semakin kompleks, kedalaman area labuh, luas area labuh, dan layanan pandu untuk keamanan, kenyamanan, dan keselamatan maritim. Penelitian ini bertujuan untuk melakukan analisis dan evaluasi komprehensif terhadap perawatan Sarana Bantu Navigasi Pelayaran (SBNP) di Pelabuhan Tanjung Perak. Evaluasi ini mempertimbangkan dampak yang luas dari perawatan SBNP terhadap kinerja keseluruhan pelabuhan.
Penelitian terdiri dari beberapa tahap, pertama tahap awal melibatkan pemeriksaan mendalam terhadap keadaan eksisting SBNP di Pelabuhan Tanjung Perak, dengan fokus pada kondisi sarana bantu navigasi tersebut. Tahap ini bertujuan untuk mengetahui kondisi saat ini dari fasilitas navigasi. Selanjutnya, dilanjutkan dengan pengumpulan data aktivitas perawatan yang dilakukan oleh otoritas pelabuhan setempat. Pengumpulan data ini memungkinkan evaluasi terhadap praktik perawatan, mengungkapkan wawasan terkait frekuensi, metode, dan efektivitas prosedur perawatan terkait SBNP. Selanjutnya, dilakukan proyeksi volume penanganan muatan dan lalu lintas kapal di Pelabuhan Tanjung Perak di masa depan. Langkah ini berfungsi untuk memahami kebutuhan pengembangan pelabuhan. Proyeksi volume muatan dan lalu lintas kapal memfasilitasi perumusan kebutuhan SBNP yang diperlukan untuk meningkatkan efisiensi dan keselamatan operasional pelabuhan.
Dengan pendekatan yang cermat dan sistematis, penelitian ini bertujuan untuk memberikan wawasan berharga bagi para pemangku kepentingan yang terlibat dalam manajemen dan pengembangan Pelabuhan Tanjung Perak. Temuan dan rekomendasi dari penelitian ini dapat menjadi instrumen penting dalam mengoptimalkan sarana navigasi, meningkatkan kualitas layanan, meningkatkan standar keamanan, dan meningkatkan produktivitas keseluruhan pelabuhan.
Analisis dan Perancangan Sistem Informasi Data Perikanan Di Pelabuhan Perikanan Nusantara Karangantu
Authors: Fatullah Rizki , Solihati Tifani Intan , Maulana Fikri Sulaiman , Hidayanti Nur 
Published: July 2024

The data is recapitulated into a report to the institution. PPN Karangantu is an institution tasked with managing data on fisheries caught by fishermen. As an employee in the fisheries catch data management section, he is tasked with managing fishermen's catch data, starting from fishing vessel data, number of catches, types of catches, and recap reports. In this activity, the Enumerator had problems with the capture fisheries data management process. Based on the existing problems, employees to carry out rework so that the time required is longer. this paper uses the Waterfall method as a system development method, system modeling uses Unified Modeling Language (UML), as well as a system display design that provides a general description of the system being created. The result of this research is that the Fisheries Data Information System can assist the Karangantu PPN agency in reporting recap activities and managing fishing data.
Analisis Arsitektur Convolutional Neural Network Untuk Klasifikasi Citra Bunga
Authors: Munandar Annisa Nurfitri Rida , Rozi Anief Fauzan 
Published: July 2024

Pengenalan karakteristik tentang keilmuan hayati makin popular dalam penelitian ilmiah, khususnya dengan memanfaatkan komputasi. Indonesia merupakan salah satu negara dengan keanekaragaman hayati terbesar di dunia, Saat ini, Indonesia telah mengidentifikasi dan memberi nama pada 19.232 spesies tanaman berbunga. Klasifikasi citra bunga telah menarik minat banyak peneliti untuk menyelidiki metode-metode baru. Salah satu metode yang banyak digunakan adalah metode deep learning dan neural network. Convolutional Neural Network (CNN) adalah salah satu metode deep learning yang paling umum digunakan dalam pengolahan citra. Penelitian ini bertujuan untuk menganalisis kinerja klasifikasi citra bunga menggunakan arsitektur VGG16 dan NasNetMobile dengan fine tune dan tanpa fine tune. Model arsitejtur NasNetMobile dengan fine tune mencapai akurasi terbaik sebesar 99.15%, sedangkan model arsitektur NasNetMobile tanpa fine tune mencapai akurasi terendah sebesr 97.45%.
The Origin of American, British and Australian English Varieties Due to Distinct Dialects and Accents
Authors: Binte Nasir Khadija 
Published: July 2024

The present research on ‘The origin of American, British and Australian English varieties due to distinct dialects and accents’ is aimed to determine the major cause of these different variety formations due to variations in the dialect and accent in the inner circle of Kachru’s model. The research question is analyzed completely based on phonetics, vowel pronunciation, and syllabification, intonation of asking questions, vocabulary, and spelling. The research is focused on a qualitative approach. The already present information corpus, personal critique, and research analysis are the principal constituents of the experimentation. With the obtained and analyzed data, the researchers verified the cause of distinct English varieties like British, American, and Australian. The obtained result showed that the most obvious difference between British, Australian and American English is in the accent (or pronunciation), especially with vowel sounds. Moreover, another difference lies in the melody and tone, which is the rise and fall of sound, while asking questions. Some other general differences that we figured out were vocabulary and spellings. Hence, we can say that the reason of the origin of American, Australian and British English varieties, which occur in the inner circle of Kachru’s model, is due to the difference in accents and dialects depending heavily upon vowel sound variations, intonations, vocabulary and grammar.
Pelatihan “Learning and Motivation” untuk Guru
Authors: Savitri Jane , Kiswantomo Heliany , Destalya Anggrainy  , Janice Grace Lusiani Larasati Simanjuntak  , Alicia Yosi Reviana  
Published: July 2024

Guru adalah figur di sekolah yang berperan penting dalam ketercapaian tujuan pendidikan. Kemampuan guru untuk memfasilitasi proses belajar siswa dan memotivasi siswa untuk mengikuti aktivitas pembelajaran di kelas merupakan salah satu kompetensi dasar yang perlu dikembangkan oleh guru. Peningkatan pengetahuan dan kemampuan guru untuk mengaplikasikan teknik-teknik learning dan melakukan pendekatan motivasional yang tepat terhadap siswa inilah yang menjadi tujuan dalam pelatihan tentang “learning and motivation”. Pelatihan dilakukan secara hybrid, sedangkan metode pelatihan yang diberikan meliputi direct instruction, small-group discussion, inquiry teaching, dan experiential learning. Berdasarkan hasil evaluasi level reaksi, seluruh peserta memberikan reaksi yang positif terhadap sesi-sesi pelatihan yang diberikan. Sedangkan berdasarkan evaluasi hasil belajar peserta, pelatihan ini menunjukkan adanya peningkatan pemahaman dan sikap guru mengenai materi learning, namun mereka belum menunjukkan adanya perubahan dalam pemahaman konseptual atas teori motivation; kondisi ini didiskusikan lebih lanjut. Secara umum dapat disimpulkan bahwa pelatihan ini memberikan dampak yang baik bagi peningkatan pemahaman guru atas materi pelatihan, sehingga diharapkan bahwa guru lebih mampu memotivasi dan menolong siswa dalam belajar.