bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identification of Flo11-like Adhesin in Schizosaccharomyces pombe and the Mechanism of Small-Molecule Compounds Mediating Biofilm Formation in Yeasts
Authors: Zhang Yu-Gang , Zhang Tong , Lin Lan 
Published: February 2024

Fungal infection is initiated by the adhesion of pathogens to biotic and abiotic surfaces, with various manifestations including biofilm formation and invasive growth, etc. A previous report, though devoid of functional data, speculated that the Schizosaccharomyces pombe glycoprotein SPBPJ4664.02 could be the homology of Saccharomyces cerevisiae Flo11. Here, our studies with S. pombe substantiated the previously proposed speculation by (1) the deletion of SPBPJ4664.02 attenuated biofilm formation and invasive growth in S. pombe; (2) the S. pombe’s lack of SPBPJ4664.02 could be complemented by expressing S. cerevisiae flo11. Furthermore, indole-3-acetic acid (IAA) and dodecanol were examined in S. pombe for their respective effects on biofilm formation. IAA and dodecanol at high concentrations could inhibit biofilm formation, whereas opposing effects were observed with low concentrations of these molecules. Mechanism studies with the SPBPJ4664.02Δ and SPBPJ4664.02Δ/flo11OE versus the wild type have demonstrated that IAA or dodecanol might exert regulatory effects downstream of SPBPJ4664.02 in the signaling pathway for biofilm formation. Moreover, our research extrapolated to Candida albicans has pinpointed that IAA inhibited biofilm formation at high concentrations, consistent with the transcriptional downregulation of the biofilm-related genes. Dodecanol suppressed C. albicans biofilm formation at all the concentrations tested, in accord with the downregulation of biofilm-related transcripts.
Effectiveness of ultrasound-guided stellate ganglion block in a patient with Dejerine-Roussy syndrome
Authors: Novy Theresia Chandra Tania 
Published: February 2024

Dejerine-Roussy syndrome or Central Post-Stroke Pain (CPSP) is one of the most debilitating complications of cerebrovascular accidents. Sympathetic block such as stellate ganglion block (SGB) is one of the modalities used for this condition. Ultrasound guidance provides advantages for these procedures by increasing accuracy and practicality with lower exposure to radiation. A 43-year-old man came to our clinic with chronic pain which started nine years earlier after an episode of hemorrhagic stroke. The pain was refractory to analgesics, which were prescribed by healthcare facilities he visited. Further examination revealed a burning sensation and allodynia on the left side of his body. We then proceeded to perform ultrasound-guided SGB using 8 ml of 1% lidocaine along with dexamethasone 5 mg as an adjuvant agent. After two procedures within two months, SGB decreased the patient’s pain by 50−85%. Ultrasound-guided stellate ganglion appears to be safe and effective as a treatment for Dejerine-Roussy syndrome.
Abbreviations: CPSP: Central Post-Stroke Pain; IPM: Interventional Pain Management; NRS: Numeric Rating Scale; SGP: Stellate Ganglion Block
Key words: Case report, Dejerine-Roussy syndrome, Pain, Stellate ganglion block, Ultrasound
Citation: Novy TCT. Effectiveness of ultrasound-guided stellate ganglion block in a patient with Dejerine-Roussy syndrome. Anaesth. pain intensive care 2023;27(3):441−343; DOI: 10.35975/apic.v27i3.2165
Received: March 08, 2023; Reviewed: April 15, 2023; Accepted: April 20, 2023
Self-medication in general ailments and its potential risks
Authors: Waqar Muhammad Ahsan , Riaz Tehseen , Munir Minahal , Abid Syed Zeeshan , Tayyab Saqiba , Razaq Ansa , Iqbal Sehrish , Yousaf Arooj 
Published: February 2024

Self-medication is thought to be very widespread, especially among adults and teenagers. It is the practice of using medications to treat conditions or symptoms that one has recognized or diagnosed oneself. The area of healthcare involving self-medication is becoming more and more significant. Self-medication is widely used for many common illnesses, including headaches, common cold, flu and diarrhea. During the COVID-19 pandemic, self-medication was also discovered to be very prevalent. However, self-medication with antibiotics is not considered as safe. People may self-medicate due to socioeconomic factors like lifestyle, drug availability, or financial hardship. Individuals who cannot afford the cost of a doctor's visit or clinical services can self-medicate because it is a less expensive option. Self-medication does, however, come with risks, such as the potential for prolonged use, misdiagnosis, overdosing, polypharmacy and drug interactions. This review describes the use of various drugs as self-medications in general ailments, in COVID-19 as well as use of antibiotics as self-medication and various risks associated with the self-medication.
Key words: Self-medication; Illness; COVID-19; Antibiotics; Headache
Citation: Waqar MA, Riaz T, Munir M, Abid SZ, Tayyab S, Razaq A, Iqbal S, Yousaf A. Self-medication in general ailments and its potential risks. Anaesth. pain intensive care 2023;27(4):579−584.
DOI: 10.35975/apic.v27i4.2089
Received: December 13, 2023; Reviewed: May 18, 2023; Accepted: June 21, 2023
Prone vs supine position in intubated COVID-19 patients with ARDS: a systematic review and meta-analysis
Authors: Aditianingsih Dita , Sugiarto Adhrie , Manggala Sidharta Kusuma , Angkasa Hansen , Natanegara Ahmad Pasha 
Published: February 2024

Background & Objective: The recent COVID-19 pandemic has tested the healthcare sector to the maximum, but it also has taught us some valuable lessons, especially in the context of intensive care, and particularly in the respiratory support. This review determined the effect of prone positioning in changes of partial pressure of arterial oxygen/fraction of inspired oxygen (PaO2/FiO2) ratio, partial pressure of carbon dioxide (PaCO2), mortality rate, ICU length of stay and duration of mechanical ventilation in intubated COVID-19 patients with ARDS.
Methodology: A computer-aided comprehensive electronic bibliographic search from MEDLINE, EMBASE, and Science Direct were conducted. The search comprised the articles written in English and intubated adult (≥ 18 y old) patients with COVID-19. The primary outcome was comparing PaO2/FiO2 ratio between prone and supine position groups. Secondary outcomes were comparisons of PaCO2, ICU discharge, and mortality rate. Review Manager version 5.4 (The Cochrane Collaboration) was used for statistical analyses of the included studies.
Results: A total of 7 articles were determined to be eligible, consisting of 1403 intubated COVID-19 patients with ARDS that showed prone position was associated with a higher PaO2/FiO2 ratio compared to the supine position (MD 60.17, 95% CI 46.86−73.47; P < 0.00001). Four studies reported the PaCO2 measurements and showed no significant difference between prone and supine positions (MD 2.07, 95% CI -2.79−6.92; P < 0.40). Only two studies reported mortalities, one study had 262 deaths out of 648 patients (40.4%) and the other study lost 11 out of 20 patients (55%). One study reported median ICU stay and mechanical ventilation duration (16 days) were significantly longer in prone position group.
Conclusion: This meta-analysis showed that prone position improved PaO2/FiO2 ratio in intubated COVID-19 patients with ARDS. It also prolonged ICU stay and mechanical ventilation duration, but had no effect on mortality rate.
Abbreviations: APACHE-II- Acute Physiology and Chronic Health Evaluation-II; ARDS - acute respiratory distress syndrome; ICU – Intensive Care Unit; MD – Mean Difference; NOS - Newcastle-Ottawa scale; SOFA - Sequential Organ Failure Assessment
Key words: Prone Position; Supine Position; COVID-19; ARDS, Intubation; Meta-Analysis
Citation: Aditianingsih D, Sugiarto A, Manggala SK, Angkasa H, Natanegara AP. Prone versus supine position in intubated COVID-19 patients with ARDS: a systematic review and meta-analysis. Anaesth. pain intensive care 2023;27(4):535−544; DOI: 10.35975/apic.v27i4.2136
Received: January 20, 2023; Reviewed: May 04, 2023; Accepted: June 23, 2023
Pre-emptive use of prolonged release oxycodone/naloxone combo significantly reduces postoperative pain after total hip arthroplasty
Authors: Jocović Jovan , Jocović Milena , Thieme Matthias , Eberle Thomas , Reppmann Jacqueline 
Published: February 2024

Background & Objective: The role of pre-emptive analgesia remains controversial. Targeting the end of the surgery, the needed serum levels of analgesic can be achieved using prolonged release preparations, reducing acute postoperative pain and related complications. We assessed the efficacy of pre-emptive intake of prolonged release oxycodone/naloxone combination tablets on postoperative pain.
Methodology: We enrolled 152 patients who underwent an elective total hip arthroplasty under general anesthesia in the current study. The patients who prospectively received a tablet of prolonged release oxycodone 10 mg + naloxone 5 mg just before induction of general anesthesia, were categorized in the pre-emptive group (n = 76). The hospital records of 76 patients, already operated, and who did not receive any pre-emptive opioids before induction were included in the control group. Patients’ postoperative pain was measured on the Numerical Rating Scale (NRS). Piritramide is routinely used in our hospital for postoperative pain titrated until NRS level of 3 or less is achieved. Study outcomes were; the dose of piritramide used, and the time spent in post anesthesia care unit (PACU).
Results: Preoperative use of oxycodone/naloxone combination reduces the frequency of postoperative opioid use (25% vs. 7.8%; P = 0.007) and the piritramide usage (12 mg vs. 15 mg; P = 0.001) in the pre-emptive group compared to the control group. The number of patients who needed relatively small doses of piritramide (≤ 9 mg piritramide) was more in the pre-emptive group compared to the control group (44.7% vs 25%; P = 0.017).
Conclusion: The pre-emptive use of oxycodone/naloxone combination is a safe and effective way to reduce postoperative pain after total hip arthroplasty.
Abbreviations: NRS - Numerical Rating Scale; PACU - Post Anesthesia Care Unit; BMI - Body Mass Index; NSAIDs - Non-Steroidal Anti-inflammatory Drugs
Key words: Analgesia, Pre-emptive; Oxycodone; Pain, Postoperative; Total Hip Arthroplasty
Citation: Jocović J, Jocović M, Thieme M, Eberle T, Reppmann J. Pre-emptive use of prolonged release oxycodone/naloxone combination significantly reduces postoperative pain after total hip arthroplasty. Anaesth. pain intensive care 2023;27(4):464−469; DOI: 10.35975/apic.v27i4.2150
Received: February 06, 2023; Reviewed: March o3, 2023; Accepted: June 06, 2023
The anesthesiologist, stress, burn-out and the coping strategies
Authors: Zahid Muhammad Arslan , Nasir Huma , Zahid Zahra 
Published: February 2024

Burnout among anesthesiologists is a significant concern, and is thought to be due to the highly demanding and stressful nature of their work. Anesthesiologists face unique stressors, including long working hours, on-call duties, emotionally challenging situations, and limited control over surgical procedures. Factors such as inadequate institutional support, lack of adequate resources, and insufficient job recognition, contribute to the risk of burnout. We highlight the negative impact of burnout on anesthesiologists' physical and mental health, including increased risks of cardiovascular problems, a weakened immune system, and emotional exhaustion. Also are discussed coping mechanisms, such as seeking emotional support, practicing mindfulness and relaxation techniques, prioritizing self-care, and engaging in physical exercise. The role of organizational culture and support in addressing stress among anesthesiologists by policies promoting work-life balance and providing access to support programs is emphasized. It also explores emerging trends and advancements in stress management techniques tailored specifically for anesthesiologists, including mind-based therapies, resilience training, and technology-enabled stress management tools. Understanding and effectively managing stress is crucial for anesthesiologists to maintain their well-being, enhance job satisfaction, and ensure quality patient care.
Key words: Burnout Syndrome; Anesthesiologist; Stress Management; Job satisfaction; Professional development; Counselling
Citation: Zahid MA, Huma Nasir H, Zahra Zahid Z. The anesthesiologist, stress, burn-out and the coping strategies. Anaesth. pain intensive care 2023;27(4):444−448; DOI: 10.35975/apic.v27i4.2254
Received: June 10, 2023; Accepted: June 14, 2923
The Cappuccini Test: an audit of anesthesia supervision
Authors: Saleem Huma , Iqbal Almas , Bukhari Sadaf , Durrani Romana Shaida 
Published: February 2024

Background & Objective: Cappuccini test was launched on 22th May 2019, at Royal College of Anesthetists 2019 conference. This is an audit tool to improve the patient safety in anesthesia, based on lessons learned from Frankie Cappuccini’s death. It has been incorporated into standards set by Royal College of Anesthetists and into their hospital accreditation process as a quality improvement tool. We conducted this audit to explore the current status of supervision of trainees in anesthesia in our hospital and to suggest potential improvement of training standards.
Methodology: This prospective audit was conducted in Shaukat Khanum Memorial Cancer Hospital & research Centre, Lahore, Pakistan. It was conducted for 6 weeks from June 20, 2021 to July 31, 2021. We used the tool kit provided by Royal College of Anesthetists and compared our practicing standards against Royal College of Anesthetists' newly set standard for safety of patients and healthcare staff.
Results: We collected twenty-one operation lists during the audit time period. All these lists had trainees under supervision by a consultant grade anesthetist (100%). In response to questions (1−3 and 6) related to trainees’ knowledge about who was the supervising consultant, how she/he could be contacted if needed, being able to contact and supervisor able to attend if required, were all 100%.
The two questions (4 and 5) were related to supervising consultants, about their awareness of the operating list being supervised by them (90.5%) and accurate description of the nature of the work being supervised by them (81%).
Conclusion: The Cappuccini test is a simple safety and quality improvement tool. It provides assurance that the trainee is working in a safe environment and has full access to contact the supervising consultant. It is a useful indicator of supervision and potential improvement of training standards.
Abbreviations: AAGBI- Association of Anesthetists in Great Britain and Ireland RcoA-Royal College of Anesthetists UK; NCEPOD-National Confidential Enquiry into Patient Outcome and Death
Key words: Cappuccini test; Patient safety; Safer surgery; Supervision
Citation: Saleem H, Iqbal A, Bukhari S, Durrani RS. The Cappuccini Test: an audit of anesthesia supervision. Anaesth. pain intensive care 2023;27(4):490−495; DOI: 10.35975/apic.v27i4.2257
Received: November 27, 2022; Reviewed: June 04, 2023; Accepted: June 07, 2023
The effect of vitamin D supplementation on pain due to periodontitis in Wistar rats with hypovitaminosis
Authors: Budisulistyo Trianggoro , Yuwono Eko , Muhartomo Hexanto , Pramukarso Dodik Tugasworo 
Published: February 2024

Background & Objective: Vitamin D (vit D) plays an important role in inflammation and pain as a result of inflammatory processes, probably through its neuroprotective function. But the association of dietary supplementation and pain improvement remains unclear. We conducted this experimental study on to evaluate the effect of vit D supplementation in Wistar rats with hypovitaminosis D due to periodontitis.
Methodology: We used 20 samples of Wistar rats with induced hypovitaminosis D due to periodontitis during 7 weeks; the first week allocated for cage adaptation, in next 2 weeks, frontal teeth ligation done aimed for vit D deficiency, and during next 4 weeks vit D supplementation was done. The rats were divided into four groups; P1 (controls without ligation), P2 (ligated without vit D supplementation), P3 (vit D 4000 IU/kg supplementation), and P4 (vit D 2000 IU/kg supplementation). Pain intensity was observed by rat grimace score (RGS) at one week of cage adaptation and at four weeks after periodontitis, as well as vit D levels.
Results: Vit D deficiency was observed at 6 weeks, either the RGS worsened. The improvement noticed in P2 (49.95%), P3 (34.30%), and P4 (59.23%) supplemented groups without statistically significant differences (P = 0.236; P = 0.280). The RGS showed decrease on P1 (P = 0.009), P2 (P = 0.011), and P4 (P = 0.049), but without significance in accordance to vit D improvement (P = 0.528).
Conclusion: Vit D supplementation is beneficial for chronic pain when its level in the serum is low, but the effect is not statistically significant.
Abbreviations: MSK: Musculoskeletal; RGS: Rat Grimace Score; CWP: Chronic Widespread Pain
Keywords: Vitamin D; Supplementation; Wistar rat, Periodontitis; Chronic pain; Perception
Citation: Budisulistyo T, Yuwono E, Muhartomo H, Pramukarso DT. The effect of vitamin D supplementation on pain due to periodontitis in Wistar rats with hypovitaminosis. Anaesth. pain intensive care 2023;27(4):502−507; DOI: 10.35975/apic.v27i4.2259
Received: December 18, 2021; Reviewed: March 28, 2023; Accepted: April 04, 2023
Preventive efficacy of ibuprofen and dexamethasone combination for postoperative pain in posterior vertebral stabilization: a randomized controlled study
Authors: Gaus Syafruddin , Darise Sukriyah A. , Ala Alamsyah A. , Ahmad M. Ramli , Musba A. Takdir , Tan Charles W. 
Published: February 2024

Background: Posterior vertebral stabilization procedures often cause acute postoperative pain that can turn into chronic pain if not managed adequately. We compared the interleukin 6 (IL-6) level and pain intensity with preventive use of multimodal analgesia with different combinations of intravenous ibuprofen and dexamethasone in these patients.
Methodology: Thirty-nine eligible patients were randomized to receive intravenous ibuprofen 400 mg and dexamethasone 10 mg (Group A), ibuprofen 800 mg and dexamethasone 10 mg (Group B), and ibuprofen 800 mg alone (Group C). The study drugs were injected 30 min before surgical procedure followed by fentanyl 24 h postop in a single‑blinded fashion. Serum levels of IL-6 were measured with ELISA. and pain intensity was measured using numeric rating scale (NRS) at preop, then at 2 h and 24 h postoperatively.
Results: There was a significant difference in the NRS scores between all treatment groups (P < 0.005) at all measurement times, where Group B had the lowest value. There was a significant difference between IL-6 levels between all treatment groups (P < 0.005) at all measurement times, where Group B had the lowest value at all measurement times. No side effects were observed in all treatment groups.
Conclusion: Preventive combination of ibuprofen and dexamethasone has efficacy and safety in managing acute postoperative pain in posterior vertebral stabilization procedures.
Abbreviations: COX – Cyclooxygenase; IL-6 - Interleukin 6; MAC - Minimum Alveolar Concentration; NRS - Numeric Rating Scale; NSAIDs - Non-Steroidal Anti-Inflammatory Drugs; PSA - Patient-Controlled Analgesia
Key words: Analgesia; Dexamethasone; Ibuprofen; Interleukin-6; Preventive Medicines; Spinal Surgery
Citation: Gaus S, Darise SA, Ala AA, Ahmad MR, Musba AT, Tan CW. Preventive efficacy of ibuprofen and dexamethasone combination for postoperative pain in posterior vertebral stabilization: a randomized controlled study. Anaesth. pain intensive care 2023;27(5):548−554; DOI: 10.35975/apic.v27i5.1851
Received: March 22, 2023; Reviewed: August 26, 2023; Accepted: September 04, 2023
The knowledge and attitudes of healthcare professionals of an orthopedic ward regarding opioid administration: a Caribbean perspective
Authors: Ventour Dale , Ragoonath Michele 
Published: February 2024

Background & Objective: Opioids remain the mainstay of management of postoperative pain, despite a number of associated side effects and a chance of habituation or even addiction. This study aimed to look at the knowledge and attitudes of Health Care Professionals (HCPs) towards opioid use as the both of these directly impact management of post-operative pain in surgical patients.
Methodology: A questionnaire like the one used in a Taiwan study by Luo Ping Ger et al. was administered. A total of seventeen questions were used to evaluate knowledge and attitudes towards opioid use using a 5-point Likert scale ranging from Strongly agree to strongly disagree. The questionnaire was administered to HCPs at various levels who were involved in the treatment of the orthopedic patients.
Results: The paucity of knowledge about opioids and the methods of administration leads to poor attitudes regarding opioid prescribing, administration, and side effect profile. This would, in turn, lead to general noncompliance by nursing staff regarding administration of the drug. Also, it was determined in the survey that a notable percentage of HCPs may not know what to do if there was a side effect related to opioid administration, as there was a general lack of knowledge about how to recognize and precautionary measures to be instituted.
Conclusion: Most health care professionals had a positive attitude regarding respiratory depression and opioids; however, this was not seen with the other side effects such as abdominal distension, nausea and vomiting, and constipation where negative attitudes were expressed by the senior nursing staff. This may be attributed to lack of continuous medical training regarding pain management on the ward.
Key words: Health Care Worker; Opioids; Orthopedics; Pain, Acute; Pain, Perception; Pain, Relief; Pain, Attitude
Citation: Ventour D, Ragoonath M. The knowledge and attitudes of healthcare professionals of an orthopedic ward regarding opioid administration: a Caribbean perspective. Anaesth. pain intensive care 2023;27(5):539−547; DOI: 10.35975/apic.v27i5.2310
Received: February 16, 2023; Reviewed: July 27, 2023; Accepted: September 01, 2023