bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preemptive analgosedation with ketamine-dexmedetomidine versus ketamine-propofol in upper limb surgeries under supraclavicular brachial plexus block
Authors: Makwana Mehul D. , Pathak Bhumika P. , Panchal Nirali Nimeshkumar , Chaudhari Madhavi Sanjay , Phatak Ajay Gajanan 
Published: August 2023

Background and Aims:
Analgosedation before and during regional anesthesia provides analgesia, anxiolysis, and amnesia. This study has been conducted to compare ketamine-dexmedetomidine (KD) versus ketamine-propofol (KP) for sedation, pain on needle prick while giving block, hemodynamics, and their side effects under supraclavicular brachial plexus block.

Materials and Methods:
After obtaining ethics committee approval, CTRI registration and patient consent, 75 patients were recruited who satisfy inclusion and exclusion criteria. Patients were divided into two groups. Group KP received a loading dose of ketamine 0.5 mg/kg, propofol 1 mg/kg over 10 min, followed by a maintenance dose of ketamine 0.3 mg/kg/h and propofol 10 μg/kg/min. Group KD received loading dose of ketamine 0.5 mg/kg, dexmedetomidine 0.5 μg/kg over 10 min, followed by maintenance dose of ketamine 0.3 mg/kg/h and dexmedetomidine 0.3 μg/kg/h. Patients were monitored for sedation, pain on needle prick while performing block, side effects of study drugs, hemodynamic and respiratory parameters. An independent sample t-test was used to compare continuous outcomes, descriptive statistics were used to depict the baseline profile of the study participants, Chi-square test was used to compare the categorical outcomes. A value of P < 0.05 was considered statistically significant.

Results:
Pain on needle prick was experienced in 5.7% and 42.9% in Group KD and Group KP, respectively. In Group KD, 28.6% and Group KP 5.7% of patients experienced nausea.

Conclusion:
In this study, group KD has adequate sedation as compared to group KP with less pain on needle prick while performing supraclavicular block. Group KD has higher incidence of nausea than gruop KP.
The comparison of arm and forearm double tourniquet in terms of the onset and duration of analgesia, tourniquet pain, and the return of sensation and movement in distal upper extremity surgery
Authors: Modir Hesameddin , Moshiri Esmail , Modir Amirreza , Shakeri Saide , Moradi Amir Hosein 
Published: August 2023

Aims:
The current study aimed at comparing arm and forearm double tourniquet in terms of the onset and duration of analgesia, tourniquet pain, and the return of sensation and movement in distal upper extremity surgery.

Methods:
This double-blind clinical trial was performed on 70 patients who were candidates for distal upper extremity orthopedic surgeries. The patients were randomized into two groups of arm and forearm double tourniquet. The onset time and duration of sensory and motor blocks were recorded. The pain level was recorded by visual Analog Scale (VAS) after inflating the tourniquet every 15 min till the end of operation at 15, 30, and 45 min as well as every 30 min for 2 h (at 30, 60, 90, and 120 min.) and at 6, 12, and 24 h after deflating the tourniquet. SPSS version 20 was used to analyze the data.

Results:
During 8–24 h after the surgery, the pain in arm double- tourniquet group was less than that in the other group (P < 0.05). There was no statistically significant difference in the time to onset of sensory–motor block between the two groups (P > 0.05). The duration of sensory block in arm double tourniquet was longer than that in forearm double tourniquet group (P = 0.002). In addition, the duration of motor block in arm double tourniquet was also longer than that in forearm double tourniquet group (P = 0.001). The pain level was equal in both the groups at all times except for the time interval of 8–24 h after the operation in arm double tourniquet group. Furthermore, there was no statistically significant difference in the pain level, and the time to onset of sensory–motor block was the same in both the groups as well. However, the duration of sensory–motor block was longer in the arm double tourniquet group, while no complication was found in either group.

Conclusion:
Both the techniques are applicable in hand and distal upper extremity surgeries provided that the surgical duration is not too long. Using forearm double tourniquet technique is preferable to arm double tourniquet, but the surgical duration should not exceed 60 min. That is because less amount of anesthetic drugs is needed in forearm double tourniquet technique, hence leading to a decrease in the potential side effects.
Effect of low dose ketamine on perioperative analgesia in patients undergoing open abdominal hysterectomy - A double-blind, randomized, placebo-controlled trial
Authors: Mariappan Ramamani , Cherian Verghese T. , Joy Melvin , Selvaraj K. G. 
Published: August 2023

Background:
Low-dose ketamine can provide effective perioperative analgesia while reducing its side effects. This study aims to estimate the effect of a low dose of ketamine administered preemptively and during the surgery on postoperative opioid requirement and the incidence of side effects of ketamine.

Methods:
This prospective, double-blind, randomized control trial enrolled 60 adult women (>18 years) scheduled for open abdominal hysterectomy. All patients received general anesthesia using a standard protocol. Patients were randomized to receive 0.2 mg/kg of ketamine as bolus before induction of anesthesia, followed by an infusion of 0.002 mg/kg/min for the duration of surgery (Group K) or an equivalent volume of 0.9% saline (Group C). The primary outcome was to compare the morphine requirement over the 24 h postoperatively between the two groups. The secondary outcomes were to compare the intraoperative morphine requirement, and the incidence of side effects of ketamine.

Results:
The intraoperative morphine requirement was significantly less (P = 0.006) in those who received ketamine (6.5 ± 1.5 mg) compared to the placebo (7.67 ± 1.7 mg). The 24-hour morphine requirement was less in the Group K (7.87 ± 4.7 mg) compared to Group C (9.2 ± 4.5 mg), but was not statistically significant. The incidence of hallucination and nystagmus was significantly higher in the ketamine group, but it lasted <2 h.

Conclusion:
The preemptive and the intraoperative infusion of low-dose ketamine decreases the morphine requirement intraoperatively but not during the postoperative period.
Role of ultrasound-guided lumbar “Erector spinae plane block” and ultrasound-guided transmuscular “Quadratus lumborum block” for postoperative analgesia after hip surgeries
Authors: Tiwari Prashant , Bhatia Rohan , Asthana Veena , Maheshwari Rajesh 
Published: August 2023

Background and Aims: Our aim was to assess the postoperative analgesia after ultrasound-guided transmuscular “Quadratus lumborum block” (QLB) and lumbar “Erector spinae plane block” (ESPB) in hip surgeries postoperatively.Design:Double-blinded, randomized prospective study.Materials and Methods:Sixty-three patients who underwent hip surgeries were divided into three groups, with 21 patients each. Each group was given spinal anesthesia using 30 ml of 0.5% hyperbaric bupivacaine. After the completion of the surgery, Group I patients were given ipsilateral transmuscular QLB and Group II patients were given ipsilateral lumbar ESPB. No block was given in Group III. In the postanesthesia care unit (PACU), pain was assessed using the Numeric Rating Scale (NRS) scoring. The time of first analgesic requirement and the total postoperatively tramadol consumption in first 24 h was recorded.Results:No significant difference was seen between the three groups pertaining to patient's demographic data, type, and duration of surgery. Statistically significant lower NRS scores were present in QLB group and ESPB group than the control group in the first 24 h (P< 0.001). The total tramadol consumption was significantly more in the control group (346.67 ± 71.37) mg than QLB group (159.05 ± 39.74) mg and ESPB group (190.48 ± 33.83) mg withP< 0.001. Time duration of first analgesic requirement in PACU was 344.05 min, 267.86 min, and 105.24 min for QLB, ESPB, and control group, respectively.Conclusion:In conclusion, both QLB and ESPB provide good postoperative pain control in hip surgeries with QLB providing a better analgesic profile when compared to ESPB.
Ultrasound-guided injection of platelet-rich plasma in partial anterior cruciate ligament injury
Authors: Selima Zeinab M.A. , Khallaf Hamdy A. , El-Saadany Hanan M. , Rehan Fahema S. 
Published: August 2023

Background
The most common injuries in athletes are anterior cruciate ligament (ACL) tears and are associated with a nontouch pivoting harm mechanism in a deceleration maneuver. Platelet-rich plasma (PRP) therapy is a low-cost, simple, and minimally invasive therapy that can provide a concentration of natural blood growth factors. The use of PRP has been validated to be beneficial in enhancing ligament healing, mainly ACL in vitro, in animals, and in humans.

Aim
The goal of the work was to study the effect of ultrasound (US)-guided injection of PRP in the treatment of partial ACL injury.

Patients and methods
This study included 30 patients with partial ACL injuries selected from the outpatient medical institution of Physical Medicine, Rheumatology and Rehabilitation Department, Tanta University Hospitals. All patients underwent detailed history taking, clinical examination, and MRI examination. Visual analog score, Lachman test, Tegner Activity Scale, and knee outcome survey were performed before and after injection. Patients were injected with 5 ml of PRP two times 1 week apart under US guidance.

Results
There were significant differences between visual analog score before injection and 1 week after second injection and after 6 months of follow-up. There was insignificant improvement of the Lachman test 6 months after injection. There were significant improvements of Tegner Activity Scale, knee outcome survey of Activities of Daily Living Scale, and Cincinnati Sports Activity Scale after injection.

Conclusion
Although US-guided PRP injection failed to show any structural improvement in partial ACL injury, it showed improvement of pain and functional activity.
Evaluation of mitochondria dysfunction in streptozotocin-induced diabetic nephropathy
Authors: Khedr Nada M.I. , Gaber Rasha A. , Shafik Noha M. , El-Ashwah Nadia E.-H. 
Published: August 2023

Background
Oxidative stress, mitochondrial stress, and autophagy are profoundly implicated in β-cell dysfunction and in the pathophysiology of type 2 diabetes mellitus.

Aim
The study was designed to explore the relationship between mitochondrial dysfunction and oxidative stress on one hand and their correlation to severity of diabetic nephropathy on the other hand.

Material and methods
This study was conducted on 40 male albino rats approximately weighing 100–150 g, which were randomly divided into two equal groups (20 rats each).

Results
The results revealed an increase in the body weight and in the plasma levels of glucose, urea, and creatinine in the diabetic nephropathy group I compared with the control group II. Moreover, there was a significant increase in the level of dynamin-related protein 1 and in 24-h urinary microalbumin excretion in the diabetic nephropathy group compared with the control group. On the contrary, a significant decrease in the levels of optic protein atrophy 1 and reduced glutathione levels was found in the diabetic nephropathy group compared with the control group.

Conclusion
The study has proved that mitochondrial dysfunction is closely related to diabetic nephropathy that is expressed in decreased optic protein atrophy 1 level and increased dynamin-related protein 1 level on one side, and also related to hyperglycemic oxidative stress evidenced by decreased glutathione level on the other side, and their correlation to the severity of diabetic nephropathy.
Multiple Scale of Complexity for Anorectal Fistulas
Authors: Melo Ingrid M. , Vargas Elvis D. , Briceño Julimar del C. , Chiantera Daniel , Pérez Mariangela C. , Bonilla Eliana C. , Coacuto Jenils D. , Zarza Patricia 
Published: August 2023

Background:
Anorectal fistulas are frequently prevalent proctological entities, in which the complexity is frequently garbled. Objective: To create a scale of complexity for fistulas based on identification, medical history, physical examination, and ultrasonography findings.

Design:
A retrospective and descriptive study of a prospectively maintained database. Setting: A single medical group performed three-dimensional endoanal ultrasonography at two different tertiary care hospitals in Caracas, Venezuela.

Patients and Methods:
All patients who underwent anorectal three-dimensional endoanal ultrasonography at the two hospitals between 2010 and 2017 were included in the study. We created an arbitrary numerical scoring system ranging from 0 to 14 points, which classifies the structure of fistulas as simple, intermediate, and complex. The chi-squared test performed with Statistical Program of Social Sciences was used to establish the significance level of P < 0.005. Sample Size: a total of 1173 patients were evaluated, and perianal fistulas were identified in 989 patients.

Results:
Of the 232 intersphincteric fistulas, 75.86% were simple, 22.41% were intermediate, and 1.72% were complex. Of the 295 lower transsphincteric fistulas, 51.19% were simple, 42.71% were intermediate, and 6.10% were complex. Of the 327 high transsphincteric fistulas, 17.74% were simple, 59.94% were intermediate, and 22.32% were complex. Of the 48 extrasphincteric fistulas, 66.67% were intermediate and 33.33% were complex. Finally, of the 18 suprasphincteric fistulas, 50% were intermediate and 50% were complex.

Conclusions:
The complexity of fistulas may not be easy to determine, even in cases requiring further complementary studies. The application of our scale helped to prevent the factors that may be responsible for the deterioration of the complexity of fistulas, with a statistically significant difference compared to the classic Goodsall's classification, based exclusively on the anatomy of the fistula tract.

Limitations:
A single operative group study without surgical usefulness validation that warrants a further multicentric randomized study.

Conflict of Interest:
The authors have no conflict of interest to declare.
Does Fellowship Matter? A Comparison of Overall Survival and Lymph Node Sampling in Colon Cancer Resections amongst Colorectal Fellowship Trained Surgeons vs. Non-Colorectal Specialty Trained Surgeons
Authors: Pahlkotter Maranda K. , Snyder John , Gygi Jesse , Sause William T. , Kim H. Tae 
Published: August 2023

Background:
Approximately 1 in 23 people will be diagnosed with colorectal cancer, resulting in nearly 50,000 cancer related deaths per year in the United States. An effective surgical resection plays an integral role in the success or failure of these patients' oncologic treatment.

Objective:
This study was designed to focus on lymph node sampling and survival of patients undergoing resections for colon cancer to determine if additional training leads to better outcomes.

Design:
This is a retrospective review from 2006–2017. Patients who presented through the emergency room were considered elective if their surgery was performed >72 hours after admission. One-hundred and thirty-five surgeons were included, and 13 were colorectal trained. We excluded patients with metachronous or synchronous tumors. Analysis was performed using the Wilcoxon rank sum test.

Settings:
Twenty-three hospitals within a single healthcare system.

Patients:
Final analysis included patients undergoing a primary, elective resection for colon cancer.

Sample Size:
We focused at 2335 patients.

Main Outcome Measure:
Survival after resection and number of lymph nodes sampled.

Results:
Among the patients, 2657 met the inclusion criteria, with only 322 resections being considered nonelective. In the elective population of 2335 patients, 536 underwent resection by a colorectal specialty trained surgeon. The survival probability was greater for patients who underwent resection by colorectal surgeons than those for patients who underwent resection by non-colorectal surgeons (p = 9e-05). Lymph node sampling in elective resections by colorectal surgeons was significantly higher (p = < 2e-16), with the mean being 23.8 vs 19.1, respectively.

Conclusion:
Colorectal trained surgeons have significantly better outcomes than non-specialty trained surgeons considering the overall survival rates and number of lymph nodes sampled for elective resections.

Limitations:
There was insufficient evidence to conclude that any difference existed in the outcomes when considering the non-elective patient population given the low numbers of these resections being performed by colorectal surgeons.

Conflict of Interest:
The authors have no conflict of interest to declare.
Pengaruh Kompensasi dan Disiplin Kerja terhadap Prestasi Kerja Karyawan PT. Artha Guna Mandiri dan Primkoveri Grup
Authors: Fitralisma Gian , Yulianto Andi , Amelia Fahira 
Published: August 2023

Prestasi kerja kerap menjadi masalah yang sering diabaikan kebanyakan perusahaan, kaitannya dalam hal ini pada PT. Artha Guna Mandiri dan Primkoveri Grup ingin memberikan apresiasi bagi karyawan/ pegawai yang kiranya bisa berprestasi dalam bekerja. Penelitian yang dilakukan ini memliki tujuan memahami seberapa besar pengaruh dari variabel kompensasi dan disiplin kerja terhadap prestasi prestasi kerja karyawan pada PT. Artha Guna Mandiri dan Primkoveri Grup. Sampel yang diambil adalah sejumlah 99 responden untuk penelitian ini dengan teknik secara random. Metode dalam mengumpulkan data penelitian adalah memakai kuesioner dengan memberikan kepada seluruh karyawan/ pegawai PT. Artha Guna Mandiri dan Primkoveri Grup. Untuk menganalisis data pada penelitian ini yaitu menggunakan uji asumsi klasik, uji F, uji t serta uji korelasi determinasi namunu sebelumnya harus mengujikan validitas dan reliabilitas terlebih dahulu datanya. Dengan mengetahui hasil penelitian ini terkait dengan prestasi kerja, PT. Artha Guna Mandiri dan Primkoveri Grup dapat mengerti secara lebih mendalam mengenai pandangan karyawan/ pegawai terhadap kompensasi serta disiplin kerja karyawan/ pegawai yang semakin baik dan dapat bekerja lebih baik kedepannya.
Kata Kunci: Kompensasi, Disiplin Kerja, Prestasi Kerja.
Analisis Pemasaran Ikan Asin Di Desa Krakahan Kecamatan Tanjung Kabupaten Brebes (Studi Kasus Pada UD. Dasti)
Authors: Barkah Dwi Ariyanti , Ikhwan Syariefful 
Published: August 2023

Penelitian yang dilaksanakan di Desa Krakahan, Kecamatan Tanjung, Kabupaten Brebes tepatnya di usaha pengasinan ikan yang bertempat pada UD. Dasti. Penelitian yang bertujuan untuk mengetahui saluran pemasaran produk ikan asin yang diproduksi oleh UD. Dasti. Selain itu untuk mengetahui margin pemasaran, farmer’s share serta efisiensi pemasaran pada setiap saluran pemasaran yang terbentuk dalam UD. Dasti. Penelitian ini termasuk dalam jenis penelitian deskriptif kuantitatif. Metode pengumpulan data yang digunakan dalam penelitian ini dengan cara observasi langsung ke lapangan dan wawancara pada produsen UD. Dasti. Data yang diperoleh berupa data primer dan data sekunder. Kemudian data yang diperoleh dianalisis dengan teknik pendekatan kuantitatif. Hasil penelitian yang diperoleh menunjukan bahwa terdapat tiga pola saluran pemasaran yang terbentuk dalam UD. Dasti yaitu: pola saluran pemasaran I terjadi dari produsen UD. Dasti ke pedagang besar kemudian ke pedagang pengecer lalu ke konsumen. Pola saluran pemasaran II dari produsen UD. Dasti ke pedagang pengecer lalu konsumen, dan pada pola saluran pemasaran III terjadi dari produsen UD. Dasti langsung ke konsumen. Pola saluran pemasaran I memperoleh total margin pemasaran dari tiga jenis ikan yang diasinkan sebesar Rp 21.000,00/kg, farmer’ share dari tiga jenis ikan yang diasinkan sebesar 73,6% dan esisiensi pemasarannya sebesar 10,10%. Pola saluran pemasaran II memperoleh total margin pemasaran dari tiga jenis ikan yang diasinkan sebesar Rp 13.000,00/kg, farmer’ share dari tiga jenis ikan yang diasinkan sebesar 81,1% dan esisiensi pemasarannya sebesar 4,53%. Dan pola saluran III farmer’ memperoleh farmer’s share dari tiga jenis ikan yang diasinkan sebesar 100% dan esisiensi pemasarannya sebesar 1,07%.
Kata Kunci : Saluran Pemasaran, Margin Pemasaran, Farmer’s Share dan Efisiensi Pemasaran
SIMULASI UJIAN PERSIAPAN TOEFL BERBASIS WEB DENGAN MENGGUNAKAN METODE INCREMENTAL PROCESS MODEL
Authors: Kurniawan Rudi 
Published: August 2023

Test of English as Foreign Language (TOEFL) merupakan sebuah ujian atau tes yang mengukur kemampuan Bahasa Inggris seseorang. Tes ini menguji kemampuan listening, structure, dan reading. Bagi mahasiswa STMIK “AMIKBANDUNG”, tes TOEFL menjadi persyaratan yang wajib diikuti sebagai persyaratan sertifikat kompetensi untuk kelulusan mahasiswa (sidang akhir). Saat ini peserta melakukan test di pihak ketiga dan harus membayar biaya administrasi ujian serta meluangkan waktu belajar yang belum tentu dapat menjamin untuk meraih score yang ditetapkan. Sebagai alternatif solusi, dibutuhkan sebuah sarana pembelajaran yang hemat tempat, hemat waktu, dan hemat biaya. Pengembangkan media pembelajaran dan simulasi ujian persiapan TOEFL berbasis Website menjadi sebuah pilihan. Website yang dirancang ini mampu memberikan simulasi ujian persiapan TOEFL seperti ujian TOEFL sebenarnya yang akan dihadapi. Metode pengembangan sistem digunakan metode Incremental Process Model, di mana metode ini berfokus pada penyampaian produk operasional pada setiap increment yang merupakan versi stripped-down dari produk akhir, tetapi produk tersebut memberikan kemampuan untuk melayani pengguna. Aplikasi basis website ini dapat digunakan oleh masayarakat umum sebagai sarana simulasi tes TOEFL. Dari hasil ujicoba, website yang dibangun telah mampu memberikan simulasi TOEFL bagi calon peserta tes. Web ini bersifat online dan free, sehingga dapat memudahkan pengguna untuk mengetahui berapa score TOEFL yang didapatkan.
Kata kunci— simulasi TOEFL, Incremental Process Model, TOEFL berbasis web, Persiapan TOEFL, STMIK AMIK BANDUNG.
MANAJEMEN STRATEGI PEMASARAN PENDIDIKAN UNTUK MENINGKATKAN DAYA SAING SMA NEGERI 1 BANDAR DUA
Authors: Muhsin Muhsin , Purba Sukarman , Rangkuti Irsan 
Published: August 2023

Education marketing management is an activity of analyzing, planning, implementing, and evaluating. The objectives of this study are to determine (1) education marketing planning at SMA Negeri 1 Bandar Dua, (2) to determine the implementation of education marketing at SMA Negeri 1 Bandar Dua, (3) to determine the evaluation of education marketing at SMA Negeri 1 Bandar Dua. In this study, researchers used qualitative methods in a descriptive and analytical way. Furthermore, the data were taken with data collection techniques through observation, interviews, and documentation. Then, the research subjects were the principal of SMA Negeri 1 Bandar Dua and the Head of Public Relations of SMA Negeri 1 Bandar Dua. Furthermore, according to the results of the research obtained, educational marketing management needs to be carried out with good management, be it planning, implementation, and marketing evaluation. Planning at the school is carried out by holding meetings with related fields for programs that will be implemented in the future, designing time, place, and target. Then the implementation of education marketing is carried out by means of a promotion system, distributing brochures, and conducting socialization to targeted schools. Finally, the evaluation stage is carried out by controlling every semester, and seeing whether it is in accordance with the initial plan or not.Keywords : Marketing Strategy Management, Competitiveness, New student interest