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AIM: This single-blind study aimed to compare the combination of paracetamol with various doses of ibuprofen as multimodal analgesia in C-section surgery patients under spinal anesthesia. Levels of interleukin (IL)-6 and C-reactive protein (CRP) were analyzed as markers of inflammation. METHODS: Treatment groups (20 patients each) were: Group A, 750 mg paracetamol and 400 mg ibuprofen; Group B, 750 mg paracetamol and 600 mg ibuprofen; and Group C, 750 mg paracetamol and 800 mg ibuprofen. Degree of pain (movement and rest), scored using the numeric rating scale (NRS) and levels of IL-6 and CRP were assessed at various time points within 24 h of surgery. Side effects and numbers of subjects requiring rescue fentanyl administration were also recorded. RESULTS: Group C showed a rest NRS score of 1.00 ± 0.00 6 h postoperatively, compared with 2.00 ± 0.00 in Group B and 2.35 ± 0.87 in Group A. 4 h postoperatively, movement NRS scores were 1.00 ± 0.00 for Group C, compared to 3.00 ± 1.77 for Group B, and 4.85 ± 1.81 for Group A. At 12 h, IL-6 levels hours were 2.66 ± 0.04 pg/mL for Group A, 2.39 ± 0.02 pg/mL for Group B, and 2.05 ± 0.01 pg/mL for Group C. At 6 h, CRP levels were 1.18 ± 0.04 mg/L for Group A, 0.95 ± 0.01 mg/L for Group B, and 0.70 ± 0.02 mg/L for Group C. Overall, Group C showed the lowest values for all parameters analyzed, compared with other groups, and the differences were significant (p < 0.05). In addition, none of the patients in Group C required rescue fentanyl (p < 0.05), and no patients in any of the groups showed any side effects. CONCLUSION: For pain management after C-section surgery, the combination of 750 mg paracetamol and 800 mg ibuprofen yielded the best results as assessed by NRS scores, levels of IL-6 and CRP, and fentanyl rescue.

Latar Belakang: Sistem penilaian yang dipakai dan lazim digunakan di Intensive Care Unit (ICU) untuk memprediksi outcome terapi High Flow Nasal Cannula (HFNC) adalah melalui ROX Index. ROX index adalah skor yang telah tervalidasi berdasarkan terapi yang diberikan pada pasien Acute Respiratory Distress Syndrome (ARDS) dan pneumonia. Kehandalan ROX Index dalam memprediksi kegagalan terapi HFNC sudah diakui secara luas, namun masih diperlukan prediktor lain yang lebih akurat dan cepat. Tujuan: Mengetahui skor Sequential Organ Failure Assessment (SOFA), kadar ferritin, Rasio Neutrofil Limfosit (RNL), kadar D-Dimer serta C-Reactive Protein (CRP) sebagai prediktor kegagalan terapi HFNC pasien sakit kritis dengan COVID-19 di ICU. Metode: Penelitian ini merupakan penelitian retrospektif case control dengan mengambil data rekam medis pasien sakit kritis dengan COVID-19 yang menggunakan terapi HFNC di ICU Infection Center RSUP Dr. Wahidin Sudirohusodo Makassar. Sampel adalah seluruh populasi terjangkau yang memenuhi kriteria inklusi. Data yang memenihi kriteria ditabulasi menggunakan Microsoft Excel, analisis menggunakan Statistical Product and Service Solutions (SPSS) for Windows 25.0. Analisis dilakukan secara bertahap, meliputi analisis deskriptif, analisis bivariat (data diolah menggunakan T Test atau Mann Whitney U Test). Dilakukan juga analisis regresi logistik untuk mengetahui kemampuan masing-masing variabel sebagai suatu prediktor Hasil: Terdapat perbedaan yang bermakna skor SOFA (p value = 0.027), parameter Ratio Neutrofil Limfosit (p value = 0.014), dan kadar C-Reactive Protein (p value =0.046) terhadap kelompok Sukses Terapi HFNC dan Gagal Terapi HFNC (p=0.027). Tidak terdapat perbedaan yang bermakna kadar feritin (p value = 0.747) dan kadar D-Dimer (p value = 0.251) terhadap kedua kelompok. Uji regresi logistik menunjukkan bahwa yang dapat digunakan sebagai prediktor adalah nilai Skor SOFA (p=0.017) dan RNL (p= 0.046), sedangkan variabel lain memiliki nilai p > 0.05 Simpulan: Skor SOFA dan Rasio Neutrofil Limfosit (RNL) dapat digunakan sebagai prediktor kegagalan terapi HFNC pada pasien sakit kritis dengan COVID-19 di ICU.

Introduction: Hemorrhoidectomy is one of the most common anorectal surgeries performed in a surgical room or ambulatory clinic. The procedure is linked to severe postoperative pain. Both general and regional anesthesia with spinal anesthesia is used in anorectal surgery. However, these predominantly used anesthesia methods leave postoperative side effects of nausea, vomitus, urinary retention, headache, dizziness, back pain, prolonged inferior muscle weakness, and the level of postoperative pain after the anesthesia wears off. Case presentation: Three cases of severe hemorrhoids were reported, and they underwent open hemorrhoidectomy with a perianal block. Postoperatively, all cases reported no side effects, minimal level of pain, and faster recovery. Recently, the perianal block has been used to curtail the side effects. Conclusion: Perianal block is performed by infiltrating the inferior rectal nerves innervating the anus and sphincter muscle. Sedation is sometimes performed prior to injection of the anesthetic block. This technique is considered safe and effective for hemorrhoidectomy.

Bencana gempa bumi yang terjadi di Kabupaten Mamuju dan Kabupaten Majene, Provinsi Sulawesi Barat ini terjadi pertama kali pada hari kamis 14 Januari 2021 pukul 14:35 wita dengan magnitudo 5,9 skala richter. Asian Medical Students Association (AMSA) UMI bekerja sama dengan AMDA(Association of Medical Doctor of Asian) Internasional dalam membentuk tim relawan. Dibentuknya Tim Relawan ini diaharapkan dapat membantu korban banjir bandang Masamba kegiatan ini sebagai kegiatan sosial. Waktu pelaksanaan tanggal 16 – 19 Januari 2021 di Madjene, Provinsi Sulawesi Barat. Kegitan ini dibentuk untuk membantu meringkan beban korban Gempa bumi dalam segi pemeriksaan kesehatan dan penyaluran donasi dan juga beberapa kebutuhan yang diperlukan, pada 17 Januari 2021 terdapat 246 pasien, tanggal 18 Januari 2021 sebanyak 249 pasien, pada tanggal 19 Januari 2021 sebanyak 758 pasien. Penyakit tersering didapatkan yaitu hipertensi, demam, batuk, gangguan pencernaan, diare, gatal pada kulit, suara serak, pusing, insomnia, flu. Untuk pemberian bahan logistic untuk korban juga dilakukkan pada tanggal 17 dan 19 Januari 2021 berupa bahan pangan dan susu formula untuk bayi, genset, tikar dan lainnya.

Bencana banjir bandang yang terjadi di Masamba pada senin, 13 Juli 2020 menimbulkan banyak korban jiwa, korban luka-luka dan korban mengalami kerugian dalam segi material maupun mental. Oleh karena itu, dibutuhkan upaya-upaya yang dapat melibatkan masyarakat dalam penanggulangan bencana yaitu upaya yang meliputi penetapan kebijakan dalam kegiatan pencegahan, tanggap darurat bencana dan penyaluran donasi dalam aspek material. Asian Medical Students Association (AMSA) UMI bekerja sama dengan AMDA(Association of Medical Doctor of Asian) Internasional dalam membentuk tim relawan yang dapat membantu korban bencana Masamba dalam segi penyaluran donasi berupa dana untuk keperluan biaya pemulihan bencana kepada Tim Badan Penaggulangan Bencana Daerah (BPBD). Waktu pelaksanaan pada tanggal 17-19 Juli 2020, di Masamba, Kabupaten Luwu Utara. Metode yang digunakan pada pelaksanaan ini yaitu partisipatif, yakni AMDA Indonesia dan AMDA Internasional serta anggota AMSA-UMI yang berperan aktif dalam kegiatan ini. Jenis kegiatan yang dilakukan yaitu pemeriksaan kesehatan di posko dan penyaluran donasi berupa dana pemulihan bencana banjir bandang serta pemberian bantuan berupa pakaian dewasa dan anak, selimut dan sarung dewasa dan anak-anak pada tanggal 17 Juli 2020. Bantuan berupa makanan siap saji serta pemberian obat-obatan kepada masyarakat yang membutuhkan yang dilakukan pada tanggal 18 Juli 2020 di beberapa titik pengungsian, dan pada tanggal 19 juli 2020 dilakukan pembagian alat pelindung diri dan penyemprotan disinfektan bekerjasama dengan Fakultas Tehnik Industri Universitas Muslim Indonesia. Bencana banjir bandang yang terjadi di Masamba pada senin, 13 Juli 2020 menimbulkan banyak korban jiwa, korban luka-luka dan korban mengalami kerugian dalam segi material maupun mental. Oleh karena itu, dibutuhkan upaya-upaya yang dapat melibatkan masyarakat dalam penanggulangan bencana yaitu upaya yang meliputi penetapan kebijakan dalam kegiatan pencegahan, tanggap darurat bencana dan penyaluran donasi dalam aspek material. Asian Medical Students Association (AMSA) UMI bekerja sama dengan AMDA(Association of Medical Doctor of Asian) Internasional dalam membentuk tim relawan yang dapat membantu korban bencana Masamba dalam segi penyaluran donasi berupa dana untuk keperluan biaya pemulihan bencana kepada Tim Badan Penaggulangan Bencana Daerah (BPBD). Waktu pelaksanaan pada tanggal 17-19 Juli 2020, di Masamba, Kabupaten Luwu Utara. Metode yang digunakan pada pelaksanaan ini yaitu partisipatif, yakni AMDA Indonesia dan AMDA Internasional serta anggota AMSA-UMI yang berperan aktif dalam kegiatan ini. Jenis kegiatan yang dilakukan yaitu pemeriksaan kesehatan di posko dan penyaluran donasi berupa dana pemulihan bencana banjir bandang serta pemberian bantuan berupa pakaian dewasa dan anak, selimut dan sarung dewasa dan anak-anak pada tanggal 17 Juli 2020. Bantuan berupa makanan siap saji serta pemberian obat-obatan kepada masyarakat yang membutuhkan yang dilakukan pada tanggal 18 Juli 2020 di beberapa titik pengungsian, dan pada tanggal 19 juli 2020 dilakukan pembagian alat pelindung diri dan penyemprotan disinfektan bekerjasama dengan Fakultas Tehnik Industri Universitas Muslim Indonesia.

Pain management is one of the main focuses on coronavirus disease 2019 (COVID-19) patients treatment. Based on the review, we make some pain management recommendations for Indonesian COVID-19 patients based on the Indonesian Society of Anesthesiology for Pain Management meeting. We follow some recommendations by health organizations and make some recommendations for general pain management and postoperative pain management for Indonesian COVID-19 patients including, the choice of analgesic, pain management post-operative, and personal protective equipment.

Background Cleft treatment is frequently performed in Indonesia, mostly in charity missions, but without a postoperative protocol it is difficult to establish the risks and complications of cleft treatment. The present study was designed to give an overview of current cleft lip and palate treatment strategies in Indonesia and to assess the complication rates during and after surgery. Methods This prospective study evaluated anesthetic, intraoperative surgical, and short-term postoperative complications in patients undergoing primary, secondary, or corrective surgery for cleft lip and palate deformities. The population consisted of 98 non-syndromic cleft patients. The main anesthetic complication that occurred during general anesthesia was high blood pressure, whereas the main intraoperative surgical complication was excessive bleeding and the main early postoperative complication was extremely poor wound hygiene. Results In this study, there were no cases of perioperative or postoperative mortality. However, in 23 (23.4%) of the 98 operations performed, at least one perioperative complication related to anesthesia occurred. The intraoperative and early postoperative complications following cleft lip and/or palate were assessed. There was a significant difference in the complication rate between procedure types (χ 2=0.02; P0.05). Nonetheless, a significant difference was found between procedure types regarding perioperative complications and the occurrence of postoperative complications (χ 2=0.031; P Conclusions Further evaluation of these outcomes would help direct patient management toward decreasing the complication rate.

BACKGROUND: β-endorphin plays a role in the descending pain control in the central nervous system. Central sensitization may be involved in the generating and maintenance of osteoarthritis (OA) pain. However, the correlation between β-endorphin and pain severity in OA has shown conflicting results. The aim of this study was to investigate the association between plasma β-endorphin and the severity of the disease. METHODS: This study was an observational cross-sectional study carried out on 60 female subjects with knee OA who fulfilled the inclusion criteria. Plasma β-endorphin was measured by a commercial enzyme-linked immunosorbent assay (ELISA) kit. Osteoarthritis knees were classified by the Kellegren-Lawrence (KL) grading (1-4) criteria. The Western Ontario McMaster University Osteoarthritis (WOMAC) scoring method was used to assess self-reported physical function, pain and stiffness. RESULTS: The mean of the participants' ages was 58 years old, ranging from 42 to 83 years. Overall, more than 70% of the participants were overweight with a mean of body mass index (BMI) of 27.59. More than 54% of the participants were diagnosed of having KL grading 3 or 4. Plasma β-endorphin was correlated inversely with the WOMAC subscale of stiffness (r=-0.286, p=0.0311), but no correlation was noted with the WOMAC subscale of pain and physical activity. There was no significant difference of the mean of plasma β-endorphin among the KL gradings. CONCLUSIONS: Plasma β-endorphin is associated with better WOMAC total score and stiffness subscale, but not associated with KL grading of OA. KEYWORDS: knee osteoarthritis, female, β-endorphin, WOMAC, Kellgren-Lawrence

Postoperative pain experienced by patients who completed surgery should receive serious attention, because of effective postoperative pain management will reduce morbidity and mortality, accelerate the mobilization and reducing hospitalization time of patients. These studies aim to determine the effect of pregabalin on antinociception and substan-glutamate levels in the blood of patients with postoperative P hysterectomy. This research is an experimental study, namely the Controlled Trial Randomized clinical trials in which patients were randomly divided into two groups by the number of patients who be included 52 people (aged 20-50 years) who underwent hysterectomy surgery. They were divided into group I (n=26) orally administered pregabalin 3 mg/kg body weight and group II (n=26) placebo given orally, 1 hour before surgery. All patients are given general anesthesia that premedication with atropine sulfate and fentanyl injection, induction with propofol and atracurium injection, intubation and breath control, and maintenance of anesthesia with N2O:O2 and isoflurane. The total of postoperative use of morphine injection is assessed until 24 hours postoperative. Examination of the levels of glutamate and substan-P performed preoperative blood before administration and 1 hour postoperative pregabalin. The results showed a marked increase in the level of pain (VAS), blood pressure, heart rate and the amount of postoperative morphine consumption in patients who were given the placebo group, compared with patients given pregabalin group. It was concluded that preoperative pregabalin administration can suppress the increase in glutamate production and can reduce postoperative production of substan-P, and the subsequent decline in glutamate levels in the blood substan-P will provide antinociception effect is a decrease in the level of postoperative pain experienced by patients.