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Brig Professor Zafar Ahmed Malik Zafar Ahmed Malik准将教授
IF 0.2 Q4 Medicine Pub Date : 2020-12-22 DOI: 10.35975/apic.v24i6.1418
Brigadier M Salim
Zafar Ahmed Malik was born on 20th March, 1937, he spent his early years in Talagang, a small town near Rawalpindi. He completed his matriculation from Talagang High School and the interesting aspect was that all of his teachers were matric fail with the exception of one. He completed his MBBS from the University of Peshawar in 1962, and joined the army service. He qualified MCPS on 16th February 1968, and FCPS (Anesthesiology) on 9th February 1974. He then went to Ireland where he did his FFARCS(I)  in 1976 from the Royal College of Surgeons. During his Army service he participated in the 1965 and 1971 wars with India; and was awarded with Tamgha-i-Jand and Sitara-i-Harb for his selfless and fearless services.
扎法尔·艾哈迈德·马利克出生于1937年3月20日,早年在拉瓦尔品第附近的小镇塔拉冈度过。他从塔拉岗高中完成了入学考试,有趣的是,除了一位老师外,他的所有老师都没有通过入学考试。1962年,他在白沙瓦大学完成了MBBS,并加入了军队。1968年2月16日获得MCPS资格,1974年2月9日获得FCPS(麻醉学)资格。1976年,他去了爱尔兰,在那里他从皇家外科学院完成了FFARCS(I)。在服役期间,他参加了1965年和1971年与印度的战争;并因其无私无畏的服务而被授予Tamgha-i-Jand和Sitarai-Harb。
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引用次数: 0
Ischemic heart disease 缺血性心脏病
IF 0.2 Q4 Medicine Pub Date : 2020-12-22 DOI: 10.35975/apic.v24i6.1417
P. Sehrawat, P. Bansal
With a growing population of old people and the changes in the life style have increased the frequency of the anesthesiologist’s encounters with surgical patients who have ischemic heart disease as a comorbid condition. Here are some questions related to ischemic heart disease.
随着老年人口的增长和生活方式的改变,麻醉师遇到伴有缺血性心脏病合并症的手术患者的频率增加。这里有一些与缺血性心脏病有关的问题。
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引用次数: 0
Professor Jawaid-ur-Rehman Jawaid-ur-Rehman教授
IF 0.2 Q4 Medicine Pub Date : 2020-12-22 DOI: 10.35975/apic.v24i6.1419
Majidi Ali
Born on March, 31st 1957 in Attock to Capt. Abdur Rehman Shaheed and Mubarka Jamila Akthar. His father was martyred in the line of duty when he was three years old. As a young man, he joined Cadet College Petaro as a student at the age of twelve, where he learned to be a valuable member of his community and an asset for his country. His love for, and commitment to, help and serve his fellow man drove him to choose medicine as his profession. To pursue his dreams of a career in medicine, he joined Army Medical College (AMC) in 1978. He was part of the second intake batch of this prestigious institution. After two years in AMC, he transferred to Punjab Medical College (PMC), Faisalabad, where he completed his MBBS. He built on his skills by completing his house job training at Rawalpindi General Hospital.
1957年3月31日出生于阿托克,父母分别是阿卜杜勒·拉赫曼·沙希德上尉和穆巴尔卡·贾米拉·阿克塔尔上尉。他的父亲在他三岁时因公殉职。作为一个年轻人,他在12岁时作为一名学生加入了佩塔罗军校,在那里他学会了成为社区的宝贵成员和国家的资产。他对同胞的爱、对同胞的帮助和服务促使他选择了医学作为自己的职业。为了追求医学事业的梦想,他于1978年加入陆军医学院(AMC)。他是这所著名学府第二批录取的学生之一。在AMC工作两年后,他转到费萨拉巴德的旁遮普医学院(PMC),在那里完成了MBBS。他在拉瓦尔品第综合医院完成了家庭工作培训,从而巩固了自己的技能。
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引用次数: 0
A promising therapy of tocilizumab and helmet CPAP to prevent intubation for COVID-19 induced severe ARDS: a case report 托西珠单抗和头盔CPAP预防新冠肺炎诱导的严重ARDS插管的一种有前景的治疗方法:一例报告
IF 0.2 Q4 Medicine Pub Date : 2020-12-22 DOI: 10.35975/apic.v24i6.1416
S. Permana, A. Sugiarto, M. Thamrin, Arifin, Harsini
A 59 yrs old male with severe ARDS due to COVID-19 infection was in life threatening ‘cytokine storm’. He had also co-morbids including diabetes mellitus and hypertension. He had come from Grobogan, a red area for COVID-19. Clinical finding indicted systemic inflammatory response syndrome (SIRS) with dyspnea, tachycardia, and high fever. Laboratory tests showed raised leukocyte count, CRP, SGOT/SGPT, blood sugar, PCT, low PaO2/FiO2 ratio. RT PCR showed he was infected by COVID-19. Sputum culture showed Klebsiella infection and CXR showed bilateral pneumonia. Patient was treated with standard therapy and a combination of tocilizumab for cytokine-storm and helmet CPAP for severe ARDS. Helmet CPAP has become the first modality for COVID-19 ARDS in some countries but not in Indonesia. We chose helmet CPAP because of the cost efficient, comfortable, and easy operation compared to other modality. We chose tocilizumab because it uses a single dose. Although it is expensive, only one dose is enough and it is effective in blocking the cytokine storm. We found that helmet CPAP and tocilizumab combination in COVID-19 lead severe ARDS could be promising to prevent intubation for patients. Key words: Helmet CPAP; ARDS; COVID-19; Tocilizumab; Cytokine storm Citation: Permana SA, Sugiarto A, Thamrin MH, Arifin, Harsini. A promising therapy of tocilizumab and helmet CPAP to prevent intubation for COVID-19 induced severe ARDS: a case report. Anaesth. pain intensive care 2020;24(6):659-663; DOI: 10.35975/apic.v24i6.1409 Received - 17 September 2020, Reviewed – 01 October 2020, Accepted – 6 November 2020
一名59岁男性因感染新冠肺炎而患严重ARDS,目前正处于危及生命的“细胞因子风暴”中。他还患有糖尿病和高血压等合并症。他来自新冠肺炎红区格罗博根。临床发现全身炎症反应综合征(SIRS)伴有呼吸困难、心动过速和高烧。实验室检测显示白细胞计数、CRP、SGOT/SGPT、血糖、PCT升高,PaO2/FiO2比值降低。RT PCR显示他感染了新冠肺炎。痰培养显示克雷伯菌感染,CXR显示双侧肺炎。患者接受标准治疗和托西利珠单抗联合治疗细胞因子风暴和头盔CPAP治疗严重ARDS。在一些国家,头盔CPAP已成为新冠肺炎ARDS的第一种模式,但在印度尼西亚没有。我们选择头盔式CPAP是因为与其他方式相比,它具有成本效益、舒适和易于操作的特点。我们选择tocilizumab是因为它使用单一剂量。尽管它很昂贵,但只需一剂就足够了,而且它能有效阻断细胞因子风暴。我们发现,头盔CPAP和tocilizumab联合治疗新冠肺炎导致严重ARDS可能有望预防患者插管。关键词:头盔CPAP;ARDS;2019冠状病毒疾病托奇利珠单抗;细胞因子风暴引文:Permana SA,Sugiarto A,Thamrin MH,Arifin,Harsini。托西珠单抗和头盔CPAP预防新冠肺炎诱导的严重ARDS插管的一种有前景的治疗方法:一份病例报告。Anaesth。疼痛重症监护2020;24(6):659-663;DOI:10.35975/apic.v24i6.1409 2020年9月17日收到,2020年10月1日审查,2020年11月6日接受
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引用次数: 0
The need for extreme caution while stopping short term dexamethasone therapy in SARS-CoV-2 infection: An experience 在SARS-CoV-2感染中停止短期地塞米松治疗时需要极度谨慎:一种经历
IF 0.2 Q4 Medicine Pub Date : 2020-12-12 DOI: 10.35975/APIC.V24I6.1381
Monjuri Borkotokey, K. Dutta
The mental and physical impact of the SARS-CoV-2 pandemic has led to the indiscriminate and desperate use of medications with the intention of saving lives. Dexamethasone has come across as a key player in the treatment of the infection. Short term therapy of dexamethasone, up to 10 days does not usually require tapering while discontinuing the therapy. However, the dose and duration of steroid required to suppress the Hypothalamic-Pituitary-Adrenal Axis (HPAA) is unpredictable. Hence, extreme caution should be taken while stopping dexamethasone therapy irrespective of the duration or the dose of the drug.
SARS-CoV-2大流行对精神和身体的影响导致不加区分和不顾一切地使用旨在挽救生命的药物。地塞米松在治疗感染方面发挥了关键作用。短期地塞米松治疗,最多10天,通常不需要逐渐减少,同时停止治疗。然而,抑制下丘脑-垂体-肾上腺轴(HPAA)所需的类固醇剂量和持续时间是不可预测的。因此,在停止地塞米松治疗时,无论药物的持续时间或剂量如何,都应非常谨慎。
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引用次数: 0
Modified thoracolumbar interfascial plane block versus epidural analgesia at closure for lumbar discectomy: a randomized prospective study 改良胸腰椎筋膜间平面阻滞与硬膜外镇痛在腰椎间盘切除术闭合:一项随机前瞻性研究
IF 0.2 Q4 Medicine Pub Date : 2020-12-04 DOI: 10.35975/apic.v24i6.1396
E. Çelik, Mürsel Ekinci, A. Yayik, A. Ahıskalıoğlu, Muhammed Enes Aydi, N. C. Karaavci
Background & objective: The postoperative period of lumbar discectomy surgery usually involves a period of moderate to severe pain if adequate pain management is not practiced. Various pain controlling methods have been used other than oral and/or parenteral analgesic administration. We aimed to examine the effect of epidural analgesia at closure (EAC) versus modified thoracolumbar interfascial plane (mTLIP) block on postoperative opioid consumption in patients undergoing lumbar discectomy. Methodology: It was a randomized, prospective study involving sixty adult patients undergoing single-level lumbar discectomy. Patients were randomly assigned to two groups. mTLIP group (n=30) received ultrasound-guided bilateral mTLIP block with 20 ml of 0.25% bupivacaine. EAC group (n=30) received 20 ml of 0.25% bupivacaine to the epidural space by the surgical team at the closure stage of surgery. Postoperatively, analgesia was performed with intravenous tramadol with a patient-controlled analgesia (PCA) pump. Visual analog scale (VAS) scores, opioid consumption, rescue analgesia and side effects were recorded. Results: Groups had similar demographic measures. There was statistically no difference in terms of opioid consumption from zero to 4th hr and VAS scores in the 1-2 hrs postoperatively (p > 0.05) between groups. At 4-12 hrs and 12-24 postoperatively hrs intervals, total opioid consumption was significantly lower in Group mTLIP compared to Group EAC (p < 0.05). At the 4th, 8th, 12th, and 24th hrs VAS scores were lower in Group mTLIP compared to Group EAC (p < 0.05). Rescue analgesia usage was significantly higher in the Group EAC than in the Group mTLIP, e.g. 11/30 vs. 3/30 respectively (p = 0.015). Conclusion: Preoperative bilateral, ultrasound-guided modified thoracolumbar interfascial plane block offers more effective postoperative analgesia, thus reducing tramadol consumption as compared to epidural analgesia at closure after lumbar discectomy surgery. Key words: Thoracolumbar interfascial plane block; Epidural analgesia’; Lumbar discectomy; Postoperative pain; Ultrasound guidance Citation: Çelik EC, Ekinci M, Yayik AM, Ahiskalioglu A, Aydi ME, Karaavci NC. Modified thoracolumbar interfascial plane block versus epidural analgesia at closure for lumbar discectomy: a randomized prospective study. Anaesth. pain intensive care 2020;24(6):__ Abbreviations: EAC – Epidural analgesia at closure; TLIP – thoracolumbar interfascial plane; mTLIP – modified thoracolumbar interfascial plane
背景与目的:如果没有适当的疼痛管理,腰椎间盘切除术术后通常会出现中度至重度疼痛。除了口服和/或肠外给药外,已经使用了各种控制疼痛的方法。我们的目的是研究硬膜外闭合镇痛(EAC)与改良胸腰椎膜间平面(mTLIP)阻滞对腰椎间盘切除术患者术后阿片类药物消耗的影响。方法:这是一项随机的前瞻性研究,涉及60名接受单节段腰椎间盘切除术的成年患者。患者被随机分为两组。mTLIP组(n=30)采用超声引导双侧mTLIP阻滞,0.25%布比卡因20 ml。EAC组(n=30)在手术结束阶段由手术组向硬膜外腔注入0.25%布比卡因20 ml。术后使用患者自控镇痛泵静脉注射曲马多镇痛。记录视觉模拟量表(VAS)评分、阿片类药物消耗、抢救镇痛及不良反应。结果:各组人口统计指标相似。两组术后0 ~ 4小时阿片类药物消耗及1 ~ 2小时VAS评分差异无统计学意义(p < 0.05)。术后4 ~ 12 h和12 ~ 24 h, mTLIP组阿片类药物总消耗量显著低于EAC组(p < 0.05)。第4、8、12、24小时mTLIP组VAS评分低于EAC组(p < 0.05)。EAC组抢救镇痛的使用明显高于mTLIP组,分别为11/30和3/30 (p = 0.015)。结论:术前双侧超声引导下改良胸腰椎筋膜间平面阻滞比腰椎间盘切除术后闭合时硬膜外镇痛更有效,从而减少曲马多的消耗。关键词:胸腰椎筋膜界面阻滞;硬膜外镇痛”;腰椎椎间盘切除术;术后疼痛;超声引导引文:Çelik EC, Ekinci M, Yayik AM, Ahiskalioglu A, Aydi ME, Karaavci NC。改良胸腰椎筋膜间平面阻滞与硬膜外镇痛在腰椎间盘切除术闭合:一项随机前瞻性研究。Anaesth。疼痛重症监护2020;24(6):__缩写:EAC -硬膜外闭合镇痛;lip -胸腰椎筋膜界面;mTLIP改良的胸腰椎界面平面
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引用次数: 1
Management of burns 烧伤的管理
IF 0.2 Q4 Medicine Pub Date : 2020-10-19 DOI: 10.35975/apic.v24i5.1373
P. Sehrawat, I. Yousuf, P. Bansal
Anesthetists have dual responsibilities when encountered with burns patients; they are often called to share the initial management in Emergency Department in view of their expertise in IV access and airway management, in the ICU for further management including ventilation, and in OR as patients with burns are regular visitors there.
当遇到烧伤病人时,麻醉师有双重责任;鉴于他们在静脉输液和气道管理方面的专业知识,他们经常被要求在急诊科分享最初的管理,在重症监护室进行进一步的管理,包括通气,在手术室,因为烧伤患者是那里的常客。
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引用次数: 0
COVID-19 induced mental suffering is more painful than physical suffering: an experience-based perspective 基于经验的观点:COVID-19引发的精神痛苦比身体痛苦更痛苦
IF 0.2 Q4 Medicine Pub Date : 2020-10-06 DOI: 10.35975/apic.v24i5.1354
Habib Md Reazaul Karim
COVID-19 pandemic has affected the lives of billions of human beings, either directly or indirectly. The physical presentation of the disease and its course to cure, permanent residual structural damage or death has been well documented. Few aspects that have recently been emphasized are the COVID fatigue and the mental suffering, not only by the general population, the COVID patients but also the healthcare professionals who are deputed to look after these patients. This manuscript throws some light on this very important aspect with long lasting impact. Keywords: COVID-19; Healthcare worker; Mental health; Stress Citation: Karim HMR.COVID-19 induced mental suffering is more painful than physical suffering: an experience-based perspective (Perspective). Anaesth. pain intensive care 2020;24(5):
2019冠状病毒病大流行直接或间接影响了数十亿人的生活。疾病的物理表现及其治疗过程,永久性残余结构损伤或死亡已被充分记录。最近被强调的几个方面是COVID疲劳和精神痛苦,不仅是普通人群,COVID患者,还有代表照顾这些患者的医疗保健专业人员。这篇手稿对这个非常重要的方面有了一些启发,并产生了持久的影响。关键词:COVID-19;卫生保健工作者;心理健康;强调引用:Karim HMR。COVID-19引发的精神痛苦比身体痛苦更痛苦:基于经验的观点(perspective)。Anaesth。疼痛重症监护2020;24(5):
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引用次数: 0
Geriatric Anesthesia 老年麻醉
IF 0.2 Q4 Medicine Pub Date : 2020-08-16 DOI: 10.35975/apic.v24i4.1326
I. Yousuf, P. Bansal
it is a quiz.
这是一个小测验。
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引用次数: 0
Three difficult airway management strategies in the same patient at three different times 同一患者在三个不同时间的三种困难气道管理策略
IF 0.2 Q4 Medicine Pub Date : 2020-08-16 DOI: 10.35975/apic.v24i4.1318
E. Erkılıç, Handan Güleç, Z. Kónya, Selvinaz Hocuk, E. U. Aydın, M. Sahap
Unpredictable difficult intubation is a commonly faced clinical issue and one of the most important reasons of morbidity related to anesthesia. We present a case of a 50 y old, 100 kg, 1.8 m tall (BMI=37) male patient, taken to OR (transoral robotic) for a planned biopsy because of a mass in his larynx. Videolaryngoscope was used two times but still intubation was unsuccessful.
无法预测的插管困难是一个常见的临床问题,也是与麻醉相关的发病率的最重要原因之一。我们报告了一例50岁、100公斤、1.8米高(BMI=37)的男性患者,由于喉部有肿块,他被带到OR(经口机器人)进行计划中的活检。视频喉镜使用了两次,但插管仍不成功。
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引用次数: 0
期刊
Anaesthesia, Pain & Intensive Care
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