Comparison of Tramadol and Pethidine for the treatment of shivering during spinal anesthesia

Objectives: The aim of the study is to compare the effectiveness of tramadol vs pethidine for treatment of shivering occurring after spinal anesthesia. Study Design: Double blind comparative study. Place and duration of study: Department of anesthesiology and pain medicine, Combined Military Hospital Malir Cantt Karachi from 1st September to 31st December 2017. Methodology: 70 patients were selected following non-random convenient sampling and were divided into Group A and B. Group A received 0.25mg/kg tramadol while Group B received 0.35mg/kg pethidine. Time to complete control of shivering was noted. Nausea and vomiting were also evaluated by using a four-point scale (Table1). Results: Shivering was successfully controlled in 91.4% and 85.7% respectively in group A and B; success rates were not statistically different (p=0.23). Average time between injection tramadol to complete control of shivering in successfully treated Group A patients was 210±63 seconds (range of 100 to 310 seconds) and for pethidine average time was 174±52 seconds (range of 90 to 258 seconds). Pethidine showed a shorter time to control shivering which was statistically significant (p=0.09) but in real time amounted to an average of 0.6 minutes (Figure 2). Nausea and vomiting were more frequent (14.3% vs 8.6%) in group B as compared to Group A and this was statistically significant (p=0.03). Conclusion: Tramadol was found to be as effective as pethidine in controlling shivering with fewer side effects in spinal anesthesi

Kenakalan siswa Sekolah Dasar Negeri 2 Salopa pasca perkembangan Game Online : Penelitian di Desa Mandalaguna Kecamatan Salopa Kabupaten Tasikmalaya

Kenakalan siswa sekolah dasar merupakan suatu perilaku yang dilakukan siswa tanpa adanya nilai-nilai sosial yang ada, kenakalan siswa menggambarkan perilaku menyimpang yang dilakukan siswa, dan dapat merusak karakter dirinya serta pola pikir siswa tersebut di lingkungannya. hanya berasal dari kalangan orang dewasa namun telah sampai pada anak-anak. Tujuan dari penelitian ini untuk mengetahui: kenakalan siswa SDN 2 Salopa di Desa Mandalaguna Kecamatan Salopa Kabupaten Tasikmalaya pasca mengenal game online, upaya orang tua dalam menghadapi dekadensi pada siswa sekolah dasar setelah adanya game online dan implikasi akibat dari game online terhadap sikap dan periaku pada siswa SDN 2 salopa. Dalam sudut pandangan kajian sosiologi penelitian ini mengkaji pada teori perubahan sosial John Philip Gillin dan John Lewis Gillin serta teori tindakan sosial Max Weber dimana di dalam teori perubahan sosial menjelaskan inidividu mengalam perubahan sosial yang terjadi akibat salah satu variabel dari perubahan-perubahan salah satunya adanya penemuan baru, sedangkan di dalam teori tindakan sosial menjelaskan bahwa bahwa tindakan yang dilakukan oleh individu dapat didasarkan suatu pilihan dengan penuh kesadaran yang berhubungan dengan tujuan dari tindakan tersebut. Penulis dalam hal ini menggunakan penelitian deskriptif adalah suatu penelitian yang diarahkan untuk memberi gejala gejala, fakta, kejadian kejadian secara sistematis dan akurat. Teknik pengumpulan data dengan cara observasi, wawancara dan dokumentasi. Berdasarkan hasil penelitian ini menunjukan bahwa perkembangan game online berdampak pada perilaku siswa Sekolah Dasar Negeri 2 Salopa yang berperilaku tidak wajar, seperti mengabaikan interaksi dengan masyarakat sekitar dan menghindari kontak sosial, tidak disiplin dan bersikap tidak jujur, pemalas, keras kepala, dan suka membantah. Pemicu bermain game online, lantaran ketidakadaan kesibukan atau aktivitas positif dalam keseharian, ajakan teman, kurang perhatian dari orang tua dan rasa penasaran yang tinggi. Adapun upaya orang tua alam mengantisiapasi anaknya untuk tidak sering bermain game online, orangtua menjadi lebih memperhatikan dan selalu menasehati untuk melakukan aktivitas dan menggunakan waktunya untuk hal yang lebih bermanfaat

The Essence of Law of Community's Participation in the Local Development Planning in Papua

Centralized development strategy is an example of uncertainty bureaucracy to variety of local community development and less responsive of the local community needs/interests including in the lowest level of bureaucracy – called village. The spirit and participation of the local community to develop their capacity and /or their region then cannot be done properly. Basically, the public participation has been governed in some laws such as the Law No. 25/2004, the Law No.32/2004 – has been amanded into the law No. 23/2014 concerning Local Governance. Therefore, the form of the participation as stipulated in those laws needs to use optimally either in terms of planning, implementation, or evaluation of the development in Papua. As it is known that the essense of the public particpation is because the people basically are more understand to the real problems and needs of the development that they are faced. Keywords: The essence of law, public participation, and developemnt planning

The Legal Standing of the Papuan People's Assembly on Local Government System in the Province of Papua

Legal standing of Papuan People's Assembly (hereinafter referred to MRP) in the local government system in Indonesia is an auxilary state organ, which has the same position with the local government and the Papuan House of Representative (hereinafter referred to DPRP), but differentiate in terms of  duties, functions, and authorities. MRP basically is the spirit of the Papua Special Autonomy. In the context of power-sharing system, the Government has authorities to implement the provision of services, community development, and implementation of development. It has also the authority to carry out the functions of coordination, guidance, and supervision of the administration of the local government in the level of regency / minacipality in the area of the province of Papua. DPRP as a legislative body has been authorized to exercise the functions of: ( a) legislation; (b) budgeting; and (c) controlling. MRP furthermore has the authority to carry out the functions of protection of the rights of indigenous people (Papuans), which is based on respect for local customs and culture, empowerment of women, and strengthening religious life in harmony. To find a legal and institutional harmonization of the Local Government, DPRP and MRP, in achieving the law (rechts idea), the Law No. 21 of 2001 on Special Autonomy and the Law No. 64 of 2008 on the Papua People's Assembly have the cornerstone of the Special Autonomy. However,  in terms of  institutional formation of MRP, there are some articles to be revised due to they are not in accordance with the actualization of the implementation of the special autonomy in Papua. Keywords: Legal Standing, the Papuan People's Assembly, the Local Government, Papua.

Is Anesthesia an attractive career choice for undergraduates and young doctors of Pakistan?

Objective:To evaluate the factors that act as a barrier for medical students and young doctors inPakistan to choose anesthesia as a career choice. Study design:Cross-sectional study. Study settings:CMH Lahore.Study duration: From January toJune 2021. Materials and Methods:A total of 163 medical students and house officers who were on rotation in operation theatre in various specialties were recruited for this study. A questionnaire was distributed to all the participants. Participants had to select theirspecialty of choice and the reason for not choosing anesthesia. They also had to choose the most important factor for choosing the specialty and the person who influenced them the most to choose the specialty. Results:Only 10 (6.1%) participants chose the anesthesia specialty for their post-graduation, out of these ten, 5 (50%) were male and 5 (50%) were female. The most commonly chosen option {62 (54.87%)} for not selecting anesthesia was “no personal interest”. In response to “What is the most important factor while choosing a specialty?” most of the participants (55%) chose the option “Scope of the specialty”. In response to “Who had the most influence in choosing a specialty?” most of the participants {63 (38.7%)} chose the option “Teachers of the clinical rotations”. Conclusion:It is concluded in our study that only a very small number of students and young doctors willingly opt for anesthesia for their post-graduation which results in a shortage of workforce in this specialty. It is recommended that anesthesia rotation be made compulsory and that the barriers tomentorship in anesthesia be properly addressed. Keywords:Anesthesia, career choice, Influencing factors, specialty, workforce

Is Anesthesia an attractive career choice for undergraduates and young doctors of Pakistan?

Objective:To evaluate the factors that act as a barrier for medical students and young doctors inPakistan to choose anesthesia as a career choice. Study design:Cross-sectional study. Study settings:CMH Lahore.Study duration: From January toJune 2021. Materials and Methods:A total of 163 medical students and house officers who were on rotation in operation theatre in various specialties were recruited for this study. A questionnaire was distributed to all the participants. Participants had to select theirspecialty of choice and the reason for not choosing anesthesia. They also had to choose the most important factor for choosing the specialty and the person who influenced them the most to choose the specialty. Results:Only 10 (6.1%) participants chose the anesthesia specialty for their post-graduation, out of these ten, 5 (50%) were male and 5 (50%) were female. The most commonly chosen option {62 (54.87%)} for not selecting anesthesia was “no personal interest”. In response to “What is the most important factor while choosing a specialty?” most of the participants (55%) chose the option “Scope of the specialty”. In response to “Who had the most influence in choosing a specialty?” most of the participants {63 (38.7%)} chose the option “Teachers of the clinical rotations”. Conclusion:It is concluded in our study that only a very small number of students and young doctors willingly opt for anesthesia for their post-graduation which results in a shortage of workforce in this specialty. It is recommended that anesthesia rotation be made compulsory and that the barriers tomentorship in anesthesia be properly addressed. Keywords:Anesthesia, career choice, Influencing factors, specialty, workforce

Does 10mg versus 12.5mg of 0.5% hyperbaric bupivacaine influence the incidence of epigastric discomfort encountered during caesarean section under spinal anesthesia?

Objective: To determine effect of two different volumes of 0.5 % hyperbaric bupivacaine in relation to epigastric discomfort during Cesarean section under spinal anaesthesia. Study design: Randomized double blind study. Place and Duration of study: Department of anaesthesiology, Combined Military Hospital Lahore over period of twelve months from June 2020 to May 2021. Methodology: A total of 168 women presenting for elective Cesarean section were divided in two equal groups. In group A, 2 milliliters of hyperbaric 0.5% bupivacaine was given in intrathecal space while in group B, 2.5 milliliters of hyperbaric 0.5% bupivacaine was given after standard volume loading. Presence or absence of epigastric/visceral pain was observed. Mean arterial pressure was also recorded at 1, 5, 10, 20 and 40 minutes.    Results: Demographic data including age, body mass index and American society of anesthesiology status was comparable in both groups. Hypotension was seen in 44 (52.38%) in group A whereas it was seen in 52 (61.9%) in group B. This difference was insignificant with p-value of 0.212. In group A, 22 (26.19%) patients complained of epigastric discomfort, while in group B, 12 (14.29%) patients complained of epigastric discomfort. Though fewer patients in group B suffered epigastric discomfort but this difference was statistically insignificant with a p-value of 0.055. Conclusion: There was no statistically significant difference between 2 ml and 2.5 ml 0.5% hyperbaric bupivacaine in terms of frequency of visceral pain