4^th International Anesthesia and Pain Medicine Conference November 18-19, 2019 Courtyard by Marriot Bali Seminyak Resort | Bali, Indonesia

Muhammad Amin Baig is a chairman at International Alternative Medical Council (IAMC) , He continued his profession at Islamabad Pakistan as HoD & Professor of Unani Medicine & TCM, at Ajmal Unani Medical College Rawalpindi. He is a visiting Professor Open International University for Complementary Medicine, Sri-Lanka.

Background: Ancient old technique of Wet cupping commonly known as Hijama has proven its effectiveness in number of medical ailments including sciatic nerve pain. It is a long term study to evaluate the effectiveness of Wet cupping after 2 years and 5 years for patients suffering from sciatic nerve pain.

Method: 250 patients were randomly selected having no previous physical injury, between ages 18-80 years. Wet cupping sessions were done on every alternate day, 3 sessions were done in which removal of subcutaneous blood with the help of glass suction cups was done after making superficial incisions. One cup was generally applied between shoulders at T1 and C7 vertebrae area and two cups were applied on L3-L4 or L4-L5 and L5- S1 vertebrae. After these sessions the decrease in sciatic pain and improvement in quality of life of patient was assessed by Visual Analogue Score, Numeric Pain Rating Scale and WHOQOL scale at before treatment, after treatment, 1 year after treatment, 2 years after treatment and 5 years after treatment (data were analyzed by paired t test and ANOVA).

Result: Out of 250 patients, about 225 (90%) of patients have shown marked decrease in sciatic nerve pain. After 1 year of treatment, 175 (70%) of patients were satisfied and does not need any further treatment of sciatic pain, after 2 years of treatment more than 125 (50%) patients showed marked decrease in pain as compared to before treatment. 5 years after treatment 92 (37%) of patients were enjoying good quality of life as shown by their WHOQOL scale.

Conclusion: Long term benefits of Wet cupping in patients suffering from sciatic nerve pain was observed, it is concluded that overall quality of life of patient is improved and pain score is significantly decreased after 2

years and 5 years of Hijama treatment.

It has been more than Ten years since Mr. Ahmed Yahya Ayoub have become an official healthcare provider. He finished his bachelor’s degree from Philadelphia University in Jordan 2009. Eventually he proceeds to Study Master’s in Oncology Nursing from Hashemite University in 2013. He has an impressive work experience as a Senior Charge Nurse at King Hussein Cancer Center, Jordan in Medical/Surgical/VIP/ OPD. He is currently working now in Al Dhafra Hospitals (Madinate Zayed Hospital) / SEHA United Arab Emirates as outpatient Staff Nurse for more than three years. Mr. Ahmed Ayoub is a champion of Nursing Research in Al Dhafra Hospitals and follows up around 9 hospitals. He has published 4 papers entitled: Do Not Resuscitate: An Argumentative Essay, Distributed in Ethics eJournal Vol 6, Issue 81, May 14, 2013. Consent Form Analysis, Distributed in Health Care Law & Policy eJournal Vol 5, Issue 20, April 08, 2013. The Effectiveness of Initial Assessment on Pressure Ulcer Prevention among Adult Jordanian Cancer Patients, Under Review. Assessment of Nurse’s Knowledge about Glasgow Coma Scale at Al Dhafra Hospitals, Abu Dhabi, United Arab Emirates. Journal of Clinical Review & Case ReportsVol3, Issue7, 01 Sep 2018.

Background: The most important assessment in the neurological examination is to assess the level of consciousness (LOC), which is considered as the first step in neurological examination. Detecting the changes in level of consciousness depends on the accuracy of nursing assessment. The nurses should be knowledgeable, confident, and quick in performing this task. Purpose: This study is to assess UAE nurses' knowledge about GCS working in Al Dhafer Hospitals, Abu Dhabi, United Arab Emirates. Methodology: This study was carried out in the Dhafra hospitals, Abu Dhabi, United Arab Emirates in April

2018. It is a cross-sectional, descriptive study. Eighty-five nurses met the inclusion criteria, the survey was sent to 165 nurses (Respondent rate 51%). Data collection was carried out using a survey monkey instru¬ment called

“Glasgow Coma Scale”. Data coding, entry and analysis has been conducted using SPSS 20 software. The difference has been tested at 95% level of significance, and the difference that has P-value < 0.05 was considered significant. Results: The study revealed that the knowledge percentages mean of correct answers about GCS is 56.1 % {SD: ±11.7; 95% CI: [26.67-100]}. On the other hand, it revealed also that the percentages of nurses who have a good

knowledge about GCS was 50.6% and staff whom have poor knowledge were 49.4 %. Moreover, the results revealed significant relation between gender and GCS training with level of GCS knowledge. Conclusion and recommendations: The present study showed that the nurses in Al-Dhafra hospitals reflect inadequate knowledge. This finding raises concerns about the importance of knowledge and skill in assessing GCS. Continuing education and practice on the use of the GCS tool are important. A Brochure and booklet should be designated and distributed to all nurses who working in critical care units and dealing with an unconscious patient. Specific and advanced courses about GCS should be conducted in Al-Dhafra hospitals.

Jobell D Matias Mercado is currently an Anesthesiology Resident in De La Salle Medical and Health Sciences Institute, Philippines. One of her interest is to train further in the fields of cardiothoracic anesthesia, critical care medicine and neuroanesthesia. She is also enthusiastic to create researches that will contribute significantly to the advancement of the anesthetic field and care for the patients

Background & Objective: Spinal anesthesia using hyperbaric bupivacaine has become the preferred technique in cesarean section because it provides rapid anesthesia and analgesia. In many years, the conventional dose of bupivacaine is associated with hypotension that increases maternal and neonatal morbidity and mortality. Fentanyl is known to have a selective effect on the spinal cord which it enhances the action of bupivacaine on the efferent pathways but without an effect on the sympathetic pathways. The main objective of this study is to determine if low dose bupivacaine plus fentanyl is associated with less maternal hypotension compared to conventional dose bupivacaine from induction to delivery of the fetus in cesarean section. Methods: A total of 50 pregnant patients between the age of 18 and 45 years of American Society of

Anesthesiologists (ASA) physical status II for cesarean section are included. Study group-A received a total volume of 2-3 ml with a combination of 15 mcg fentanyl and less than or equal to 10 mg of 0.5% hyperbaric bupivacaine, whereas group-B also received 2-3 ml of 0.5% hyperbaric bupivacaine more than 10 mg only. The baseline demographics (age, weight, height, body mass index), baseline and intraoperative Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Maternal Heart Rate (MHR), Oxygen Saturation (O2

Sat) and Respiratory Rate (RR), duration of the procedure, number of hypotensive episodes and number of vasopressor used from induction to the delivery of the fetus and the APGAR score were all obtained and analyzed in this study. Results: Results after 1 minute of anesthesia administrations showed bupivacaine only group had significantly lower SBP (81.56±7.16 vs. 94.64±11.01, p-value<0.001) and DBP (51.8±9.33 vs. 63.76±9.1, p-value=01)

compared to bupivacaine plus fentanyl group. The bupivacaine only group presented with more episodes of hypotension (1, range 0-3 vs. 0, range 0-1, p value<0.001), thus with more vasopressor use as well (20 vs. 3,p-value<0.001). No notable difference in the APGAR score between the two anesthetic groups and none of the newborns delivered had an APGAR score lower than 7 at either 1 or 5 minutes of life. Conclusion: Spinal anesthesia for cesarean section using less than or equal to 10 mg bupivacaine plus fentanyl 15 mcg is effective in providing rapid anesthesia and analgesia with significantly less hypotension

and vasopressor requirements.

M S Suchi is an experienced International Pre School Principal/Manager who picked up laughter exercises from many coaches around the world. She then designed ‘Laughter Therapy' which is being used in many places such as hospitals and senior activity centres. She provides individual and group therapy in educational and home settings. She currently engages in building social awareness about holistic approach for recovery, be it depression, anxiety caused by physical or emotional pain, death in the family and the harm the unhappiness brings to people, families and communities. Her aim is to encourage people to seek help early and get on the path to recovery. Her works has been featured in local press, TV and radio and has been an invited speaker at various community clubs and educational institutions. She has also been awarded by MINDS and various community clubs in recognition of her social work.

Statement of the Problem: There is a lack of awareness about what happy hormones are, how to use positive words to feel energetic and what can be done to get happy hormones. People tend to feel unhappy for multiple reasons and neuropathic pain adds on stress levels of not only the patient but the caregivers as well. Being in pain, leads to feeling depressed and anxious in some cases. Methodology & Theoretical Orientation: Review of books and research shows that getting a dosage of happy hormones will not only ease slight pain of the patient but feeling happy will also have a positive impact on the recovery of the patient. Adopting laughter therapy and getting hormones which makes one feel good will help many to recover from neuropathic pain/long term sadness caused by having grief, anger or resentment, depression and anxiety.

 

Findings: One needs to work on his/her energies using laughter therapy which is a positive approach for not having depression and anxiety caused by neuropathic pain. The therapy can be used as a holistic way to recovery.

 

Conclusion & Significance: The laughter therapy which includes ways to get the dosage of happy hormones promotes overcoming depression and anxiety caused by neuropathic pain is a fun way to manage pain. Repeated sessions to be conducted to remind patients that life while having pain or during the recovery should go beyond just seeking medical and counselling help and also include rebuilding spiritual, physical, emotional, relational and mental health. The model has been put together for testing in many settings including hospitals, elderly homes and senior citizen centres. This study is just an effort to demystify the help available for depression and anxiety caused by pain. It is an attempt to motivate and encourage people to seek help and take a simple approach to remember and work on all aspects of their recovery.