- Pondicherry university, Anaesthesiology, Faculty Memberadd
- Working in a tertiary care referral health institute and associated with teaching (undergraduate as well as postgraduate), training, patient care and research.edit
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There is a rising incidence of coronary artery diseases and myocardial infarction (MI). Mortality associated with acute MI (AMI) is directly linked to the time to receive treatment and missed diagnoses. Although health professionals are... more
There is a rising incidence of coronary artery diseases and myocardial infarction (MI). Mortality associated with acute MI (AMI) is directly linked to the time to receive treatment and missed diagnoses. Although health professionals are aware of typical AMI presentation, atypical MI is difficult to diagnose, which on the other hand, is likely to have an impact on morbidity and mortality. Therefore, it is prudent to know such atypical presentations, especially for emergency and primary care physicians. We aimed to systematically evaluate the clinical presentations of atypical MI and analyze them to characterize the common clinical presentations of atypical MI. We researched the PubMed database, did citation tracking, and performed Google Scholar advanced search to find the cases reported on the atypical presentation of MI published from January 2000 to September 2022. Articles of all languages were included; Google Translate was used to translate articles published in languages other than English. A total of 496 (56 PubMed articles, 340 citations from included PubMed articles, and 100 articles from Google Scholar advanced search) were screened; 52 case reports were evaluated, and their data were analyzed. Atypical presentations of myocardial infarction are vast; patients may have chest pain without typical characteristics of angina pain or may not have chest pain. No typical characterization could be done. Most patients were in their fifth decade or above of their life and commonly presented with pain and discomfort in the abdomen, head, and neck regions. Prodromal symptoms were consistent findings, and many patients had two to three comorbidities out of four common comorbidities, i.e., diabetes, hypertension, dyslipidemia, and substance abuse. A patient who is 50 years old or more, having comorbidities such as diabetes, hypertension, dyslipidemia, history of tobacco or marijuana usage, presenting with prodromal symptoms like shortness of breath, dizziness, fatigue, syncope, gastrointestinal discomfort or head/neck pain should be suspected for atypical MI.
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: Various social, cultural, and ethnic factors can play a role even in the use and availability of medical resources; religious belief, although less reported, is one such strong factor. Not much scientific literature is available... more
: Various social, cultural, and ethnic factors can play a role even in the use and availability of medical resources; religious belief, although less reported, is one such strong factor. Not much scientific literature is available regarding the use of porcine and bovine-derived medications and medical devices for patients practicing Judaism, Islam, and Hinduism. Consideration and knowledge of these issues are necessary to facilitate successful communication with a diverse patient population and respect her religious convictions. The anesthesiologist may also have to face this situation, albeit rarely. To play safely, one needs to have a sound knowledge about the origin of the medications intended to be used and adequate interview with the patient or his attendants to avoid any untoward event. This editorial compliments a case report being published in this issue on a similar topic
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Research Interests: Surgery, Animal Science, Health Economics, Anesthesiology, Health Informatics, and 12 morePublic Health, Health Care Management, Medicine, Health Information Technology, Hospital Management, Anaesthesiology, Anaesthesia, Anesthesia, Health Information Management, Risk Stratification, THORACIC SURGERY ANESTHESIA, and Preoperative Evaluation
This chapter (chapter 14) of Handbook for Practice of Research Methodology 1st edition (c) 2015, published by the Department of Medical Education, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong,... more
This chapter (chapter 14) of Handbook for Practice of Research Methodology 1st edition (c) 2015, published by the Department of Medical Education, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India is aimed at providing basic information on ethical principles to be followed while conducting clinical researches with human subjects.
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Complex congenital heart diseases like univentricular cardiac defects are relatively common. Tricuspid atresia (TA) with hypoplastic right ventricle is one such univentricular congenital defect which if not corrected surgically leads to... more
Complex congenital heart diseases like univentricular cardiac defects are relatively common. Tricuspid atresia (TA) with hypoplastic right ventricle is one such univentricular congenital defect which if not corrected surgically leads to fatality. Palliative bidirectional Glenn procedure is usually done as initial measure for such patients. We present this case report based discussion to enumerate the challenges faced by the anesthesiologists while managing such cases for bidirectional Glenn shunt surgery (BDGS) during perioperative period.
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Objective: The present study was aimed at exploring the patient profile and the unmet needs of labour analgesia in relation to caesarean delivery on maternal request (CDMR) as a reason for it. Methodology: The departmental electronic... more
Objective: The present study was aimed at exploring the patient profile and the unmet needs of labour analgesia in relation to caesarean delivery on maternal request (CDMR) as a reason for it. Methodology: The departmental electronic database was searched for all the CDMR cases and was included. The anaesthetic management chart, pre-anaesthetic assessment chart, verbal interview records were reviewed for the study to complete the data as far as possible. Data were analyzed as a percentage and mean and standard deviation as applicable using INSTAT software. Results: There were 38 (2.64%) CDMR among the 1437 LSCS evaluated. Twenty four out of 38 (63.16%) of the patients were primigravida. 57.89% of CDMR had reason related to pain, fear, and anxiety. Medical comorbidity was associated and probably contributed as a reason for choosing CDMR in association with pain in 48.57% cases. 5.26% had received antenatal counseling for painless labour and 23.68% had prior knowledge of labour analge...
Research Interests: Obstetrics, Anesthesiology, Regional Anesthesia, Regional anaesthesia, SPINAL AND EPIDURAL ANAESTHESIA, and 12 moreAnaesthesiology, Anaesthesia, Gynecology and Obstetrics, Obstetrics and Gynaecology, Anesthesia, Obstetrics and gynecology, Regional Anaesthesia Pain Mangement, Obstetric Anesthesia, Obstetric Anaesthesia, Obstetrical Anesthesiology, Epidural Analgesia, and Labor Analgesia
Abstract: Background and objectives: The shortage of medical teachers and quality teaching is felt greatly in the current medical education system. The Medical Council of India (MCI) has initiated faculty development programs to reduce... more
Abstract: Background and objectives: The shortage of medical teachers and quality teaching is felt greatly in the current medical education system. The Medical Council of India (MCI) has initiated faculty development programs to reduce this deficiency. However, this program doesn't include residents, who are actually involved in teaching to a great extent. The present study was aimed to evaluate the efficacy of adapted Medical Education Technology (MET) workshop for resident doctors in changing their perception as teachers of medicine. Methods: After obtaining the informed consent regarding this study and data collection, the resident doctors participating in the MET workshop were given a set of question papers designed to quantify their own perception (a 0 to 10 scale) about themselves as a medical teacher both for pre-workshop and post-workshop time. Data thus collected were analyzed by paired t-test using INSTAT software and a p-value of <0.05 was taken as statistically si...
Research Interests: Emergency Medicine, Anesthesiology, Critical Care Nusing, Critical Care, Critical Care Medicine, and 12 moreAnaesthesiology, INTENSIVE CARE, Anaesthesia, Critical Care Nursing, Anesthesia, Neurosurgical Intensive Care, Ear Nose and Throat, General Anesthesia, Intensive Care Medicine, Head and Neck Surgery, Endotracheal intubation, and Otolaryngology Head and Neck Surgery
Maxillofacial injuries affect airway in many ways. Knowing the factors which may lead to airway management other than Macintosh laryngoscopy will help the emergency medical team in decision making and thus avoid any fatal situation. The... more
Maxillofacial injuries affect airway in many ways. Knowing the factors which may lead to airway management other than Macintosh laryngoscopy will help the emergency medical team in decision making and thus avoid any fatal situation. The present retrospective observational study was aimed to evaluate fractures and airway management patterns in cranio-maxillofacial injury patients with fracture of the mandible. It was also aimed to assess the clinical findings which predict airway management by other than Macintosh laryngoscopy. Anaesthesia management record, critical care assessment record and surgical team notes were evaluated in all craniomaxillofacial injury patients with mandible fracture who required anaesthesia, critical care, and ENT specialty services. The duration of the study was between 2009-10 to 2013-14 and the collected data were evaluated by using INSTAT software. Fifty-nine (64.13%) out of 92 cranio-maxillofacial injury patients (with at least one head and neck or fac...
Research Interests: Health Sciences, Dentistry, Anesthesiology, Airway Management, Medicine, and 15 moreTrauma, Oral and Maxillofacial Surgery, Anaesthesiology, Anaesthesia, Oral Surgery, Anesthesia, Ear Nose and Throat, Dentistry Oral and Maxillofacial Surgery, Difficult Airway Management, Craniomaxillofacial Surgery, Facial Injury, Dentistry of Oral and Maxillofacial Surgery, Mandible Fracture, DIFFICULT INTUBATION, and Facial Injuries
ABSTRACT<br> Preoperative consultation of a surgical patient by a cardiologist is intended to treat an inadequately treated<br> cardiac condition before undergoing surgery. This can yield in terms of a new therapy, lead to... more
ABSTRACT<br> Preoperative consultation of a surgical patient by a cardiologist is intended to treat an inadequately treated<br> cardiac condition before undergoing surgery. This can yield in terms of a new therapy, lead to optimization<br> of the patients' cardiac comorbidity, impact significantly in terms of perioperative management and<br> potentially reduce postoperative adverse cardiac events. However, judicious use of preoperative<br> consultation request is required both for avoiding unnecessary consultation, investigation and delay in<br> proceeding with surgery as well as cost-effective health care delivery. This mini-review is aimed at finding<br> the practice patterns of anesthesiologists' preoperative requests for cardiology consultations. Different<br> clinical situations faced in preoperative evaluation of cardiac patients planned for non-cardiac surgery<br> with regard to the need for preoperative cardiac co...
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This article reports one can't ventilate can't intubate situation in relation to informed consent
This is a century of corona virus. The world is still coping up with the third wave of COVID-19, while the scientists have already warned that a fourth wave is imminent. This wave is expected to be more lethal due to multiple mutated... more
This is a century of corona virus. The world is still coping up with the third wave of COVID-19, while the scientists have already warned that a fourth wave is imminent. This wave is expected to be more lethal due to multiple mutated variety of the corona virus, including one of the most lethal one known as Indian variant or delta variant. Meanwhile, the health staff has to deal with those patients who survived COVID-19, but continued to have a variety of new complaints, including respiratory distress, dysautonomia, intravascular thrombosis and endocardial myocarditis etc. Anti-corona therapy, in itself lead to multiple syndromes including acute kidney injury, bone marrow depression and deranged blood sugar levels. One of the more lethal complication is mucormycosis-a fungal disease. It has effected thousands of recovering or recovered corona patients in India. This editorial highlights the salient features of post-corona syndrome or long covid. Key words: COVID-19; Genome; Mutation...
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Key words: Chest tubes; Drainage; COVID-19; Pneumothorax; Thoracic injuries Citation: Dantis K, Rajput V, Karim HMR. Chest tube management in COVID-19 thoracic trauma care unit. Anaesth. pain intensive care 2021;25(4):550–551. DOI:... more
Key words: Chest tubes; Drainage; COVID-19; Pneumothorax; Thoracic injuries Citation: Dantis K, Rajput V, Karim HMR. Chest tube management in COVID-19 thoracic trauma care unit. Anaesth. pain intensive care 2021;25(4):550–551. DOI: 10.35975/apic.v25i4.1578
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Monitoring and highly sophisticated care of the Covid-19 pandemic patients has taught us many new lessons. The ever-changing management strategies and the therapies for the disease containment is one aspect of the wide spectrum of... more
Monitoring and highly sophisticated care of the Covid-19 pandemic patients has taught us many new lessons. The ever-changing management strategies and the therapies for the disease containment is one aspect of the wide spectrum of innovations and refinements, which were the result of global effort by the scientists and the healthcare workers; the self-protection of front-line workers soon became immensely important to save them from contracting the disease and thus prevent rapid reduction in their numbers. Personal protective measures were vehemently enforced and means and measures to reduce (if not eliminate) direct contact with the known as well as yet unknown Covid positive patients were advocated. Different countries adopted different measures according to their customs and resources, but all with the same purpose. This paper is written to highlight the same and present our approach at our center. Key words: COVID-19; Monitoring; Surveillance; Intensive Care; Gadgets Citation: P...
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Acute pulmonary edema during pregnancy is very rare and occurs in 0.08% pregnancies. About 3% of severe preeclamptic patients develop acute pulmonary edema. Among them 30% develop it in the antenatal period with 90% having pre existing... more
Acute pulmonary edema during pregnancy is very rare and occurs in 0.08% pregnancies. About 3% of severe preeclamptic patients develop acute pulmonary edema. Among them 30% develop it in the antenatal period with 90% having pre existing chronic hypertension and 70% develop it in the postnatal period. Several risk factors have been identified: preeclampsia or eclampsia, use of tocolytic therapy, severe infection, cardiac disease, iatrogenic fluid overload, and multiple gestations. No matter what the underlying pathology, resuscitation is the foremost priority. Only after the patient has been stabilized, attention can be turned to the formulation of a differential diagnosis to address the underlying condition and initiate specific treatment. This case examines one such presentation and reviews some of the diagnostic possibilities.
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Methods of opening the airways like tracheostomy are used to provide appropriate ventilation for patients with upper airway problems. Tracheostomy may be accompanied by some complications. In the present study, we reported a 6 year old... more
Methods of opening the airways like tracheostomy are used to provide appropriate ventilation for patients with upper airway problems. Tracheostomy may be accompanied by some complications. In the present study, we reported a 6 year old boy with progressive dyspnoea and cyanosis induced by fracture of a tracheostomy tube. A chest x-ray was obtained showed fracture of the tracheostomy tube within the trachea. He underwent bronchoscopy and the fractured tracheostomy tube was removed. Conclusion: Fracture and aspiration of tracheostomy tube is a rare complication which requires a prompt and precise
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Respiratory support in terms of mechanical ventilation is very common in critically ill patients. These patients are often hemodynamically unstable too. The mechanophysiology of mechanical ventilation also affects other organ system and... more
Respiratory support in terms of mechanical ventilation is very common in critically ill patients. These patients are often hemodynamically unstable too. The mechanophysiology of mechanical ventilation also affects other organ system and needs assessment and management accordingly. The procedure is not devoid of complication. It also has potential to failure to achieve the treatment objective requiring frequent assessment and adjustment. There is a very close temporal relationship between patients monitoring and management decision in critically ill patients in critical care practice. Early and appropriate information from monitoring can lead to better outcome including reduced mortality. The present review is intended to briefly highlight the current opinions and strategies for cardio circulatory and respiratory monitoring in such patients in critical care unit. Received: 4 Jun 2018Reviewed: 6 Jun 2018Accepted: 13 Sep 2018 Citation: Karim HMR. Cardio circulatory and respiratory moni...
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Chronic kidney disease is one of the leading co-morbidity at present. With the increasing prevalence of diabetes mellitus and hypertension, more and more peoples are developing diabetic and hypertensive nephropathy. As chronic kidney... more
Chronic kidney disease is one of the leading co-morbidity at present. With the increasing prevalence of diabetes mellitus and hypertension, more and more peoples are developing diabetic and hypertensive nephropathy. As chronic kidney disease patient can present as an asymptomatic stable patient in one end and a multi-organ involved complicated end-stage disease in other ends, their management plan also varies. The serum creatinine levels of as low as 1.5 mg% have been linked to perioperative major cardiac events like myocardial infarction and arrest; these patients poses a challenge to the perioperative team. Moreover, a chance of developing acute kidney injury on the chronic kidney disease is also higher. These patients are also often elderly, with diabetes mellitus and/or hypertension. Therefore, accepting such patient for perioperative care needs systematic and meticulous approach. Preoperative assessment, risk stratification, and optimization play a great role. Both intraoperati...
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Critically ill patients often require multiple organ supports; respiratory support in terms of mechanical ventilation (MV) is one of the commonest. But, only providing an organ support contributes less to the complete well being of the... more
Critically ill patients often require multiple organ supports; respiratory support in terms of mechanical ventilation (MV) is one of the commonest. But, only providing an organ support contributes less to the complete well being of the patients. Moreover, MV itself can affect various physiological systems, metabolic response, and cause side effects. A very close temporal relationship exists between patients, monitoring and management decision too, and therefore, appropriate information from monitoring can lead to better outcomes. The present review is intended to briefly highlight the current opinions and strategies for non cardio-respiratory monitoring in such critically ill patients.Abbreviations: AKI-Acute Kidney Injury; APACHE-Acute Physiology and Chronic Health Evaluation; BPS-Behavioral Pain Scale; CAM-ICU-Confusion Assessment Method for the Intensive Care Unit; CPOT–Critical Care Pain Observation Tool; EVLWI-Extra vascular lung water index; FDA-Food and Drug Administration; I...
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Cardiac surgery-associated kidney injury (CSA-AKI) is common but relatively less is known about its progression. The present study is aimed at evaluating the incidence and course of CSA-AKI and its relationship with the different... more
Cardiac surgery-associated kidney injury (CSA-AKI) is common but relatively less is known about its progression. The present study is aimed at evaluating the incidence and course of CSA-AKI and its relationship with the different durations of cardiopulmonary bypass (CPB) and cross clamp times. Occurrences of CSA-AKI are evaluated as per the Akin Kidney Injury Network (AKIN) criteria over the course of 5 postoperative day (POD) in 100 patients. The relationship of different durations of CPB and aortic cross clamp time with CSA-AKI is analyzed by Chi-squared test for trend and other appropriate tests using INSTAT software. One hundred (43 male, 57 female; mean age of 37.01 ± 12.28 years, and baseline mean serum creatinine 0.99 ± 0.20 mg %) patients undergone mostly valve replacement, and congenital heart disease correction was evaluated. Nearly 49% suffered CSA-AKI (81.63% AKIN Class I) with maximum numbers on 2 nd POD. Serum creatinine followed a falling trend 3 rd POD onward except ...
Research Interests: Acute kidney injury, Adolescent, Medicine, Cardiac Surgery, Humans, and 15 moreFemale, Male, Incidence, Risk factors, Clinical Sciences, Aged, Middle Aged, Adult, Time Factors, Retrospective Studies, Risk Factors, Constriction, Cardiopulmonary bypass, Postoperative Complications, and Cardiovascular medicine and haematology
Low Cardiac Output Syndrome (LCOS) following Cardiopulmonary Bypass (CPB) is common and associated with increased mortality. Maintenance of adequate cardiac output is one of the primary objectives in management of such patients. To... more
Low Cardiac Output Syndrome (LCOS) following Cardiopulmonary Bypass (CPB) is common and associated with increased mortality. Maintenance of adequate cardiac output is one of the primary objectives in management of such patients. To compare Levosimendan, Milrinone and Dobutamine for the treatment of LCOS after CPB in patients who underwent valve replacement surgeries. Sixty eligible patients meeting LCOS were allocated into three treatment groups: Group A-Levosimendan (loading dose 10μg/kg over 10 minutes, followed by 0.1μg/kg/min); Group B-Milrinone (loading dose 50 mcg/kg over 10 minutes followed by 0.5mcg/kg/min) and Group C-Dobutamine @ 5μg/kg/min to achieve target cardiac index (CI) of > 2.5 L/min/m(2). In case of failure, other drugs were added as required. Hemodynamic parameters were monitored using EV1000TM clinical platform till 30 minutes post CPB. INSTAT software was used for statistics and p<0.05 was considered significant. The mean±standard deviation of time taken ...
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Pre-operative investigations are often required to supplement information for risk stratification and assessing reserve for undergoing surgery. Although there are evidence-based recommendations for which investigations should be done,... more
Pre-operative investigations are often required to supplement information for risk stratification and assessing reserve for undergoing surgery. Although there are evidence-based recommendations for which investigations should be done, clinical practice varies. The present study aimed to assess the pre-operative investigations and referral practices and compare it with the standard guidelines. The present observational study was carried out during 2014-appen2015 in a teaching institute after the approval from Institute Ethical Committee. A designated anaesthesiologist collected data from the completed pre-anaesthetic check-up (PAC) sheets. Investigations already done, asked by anaesthesiologists as well as referral services sought were noted and compared with an adapted master table prepared from standard recommendations and guidelines. Data were expressed in frequencies, percentage and statistically analysed using INSTAT software (GraphPad Prism software Inc., La Zolla, USA). Sevent...
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Scrub typhus and malaria can involve multiple organ systems and are notoriously known for varied presentations. However, clinical malaria or scrub typhus is unusual without fever. On the other hand, altered sensorium with or without... more
Scrub typhus and malaria can involve multiple organ systems and are notoriously known for varied presentations. However, clinical malaria or scrub typhus is unusual without fever. On the other hand, altered sensorium with or without fever, dehydration, hemorrhage and hemolysis may lead to low blood pressure. Presence of toxic granules and elevated band forms in such patients can even mimic sepsis. When such a patient is in the peripartum period, it creates a strong clinical dilemma for the physician especially in unbooked obstetric cases. We present such a case where a 26-year-old unbooked female presented on second postpartum day with severe anemia, altered sensorium, difficulty in breathing along with jaundice and gum bleeding without history of fever. Rapid diagnostic test for malaria was negative and no eschar was seen. These parameters suggested a diagnosis of HELLP (Hemolysis, Elevated Liver enzymes, Low Platelet) syndrome with or without puerperal sepsis. Subsequently she was...
Research Interests: Internal Medicine (General Medicine), Obstetrics, Tropical Medicine, Emergency Department Critical Care, Medicine, and 13 moreCritical Care, Critical Care Medicine, Case Report, Internal Medicine, INTENSIVE CARE, Gynecology and Obstetrics, Scrub Typhus, Obstetrics and Gynaecology, Obstetrics and gynecology, HELLP Syndrome, Critical Care Obstetrics, Intensive Care Medicine, and Medical and Health Sciences
Research Interests: Pharmacology, Neurology, Immunology, Critical Care Nusing, Epilepsy, and 15 moreClinical Pharmacology, Emergency Department Critical Care, Medicine, Critical Care, Critical Care Medicine, Adverse Drug Reactions, INTENSIVE CARE, Critical Care Nursing, Adult neuro intensive care, Neurosurgical Intensive Care, Neuroanesthesia, Intensive Care Medicine, Skin infection, Neurocritical Care, and Neuroanestesia
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Assessment and optimization of hemodynamic parameters and oxygen delivery may improve outcome in critically ill patients. Optimum fluid management often needs to take hemodynamic parameter in to account. Comorbidity and critical illness... more
Assessment and optimization of hemodynamic parameters and oxygen delivery may improve outcome in critically ill patients. Optimum fluid management often needs to take hemodynamic parameter in to account. Comorbidity and critical illness during pregnancy contribute significantly to maternal and fetal morbidity and mortality. This article will focus on the role of hemodynamic monitoring in the field of practice of obstetrics, perioperative and critical care management of obstetric patients with current evidence and type of hemodynamic monitoring technique for such patients. PubMed advanced and Google Scholar search with index word "hemodynamic monitoring", "haemodynamic monitoring", "shock", "obstetric", "preeclampsia", "heart disease", "cardiac disease", "hemodynamic monitoring in obstetric", "hemodynamic monitoring in obstetrics", and "haemodynamic monitoring in obstetric" in different combinations to retrieve clinical trials, case series, and review articles for the current literature review.
Research Interests: Obstetrics, Anesthesiology, Medicine, Critical Care, Critical Care Medicine, and 14 moreAnaesthesiology, INTENSIVE CARE, Anaesthesia, Gynecology and Obstetrics, Obstetrics and Gynaecology, Anesthesia, Astrocyte, Obstetrics and gynecology, Anaesthesia and Critical Care, Intensive Care Unit, Obstetric Anesthesia, Critical Care Obstetrics, Intensive Care Medicine, and Obstetrical Anesthesiology
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Increasing input self-sufficiency is often viewed as a target to improve sustainability of dairy farms. However, few studies have specifically analysed input self-sufficiency, by including several technical inputs and without only... more
Increasing input self-sufficiency is often viewed as a target to improve sustainability of dairy farms. However, few studies have specifically analysed input self-sufficiency, by including several technical inputs and without only focussing on animal feeding, in order to explore its impact on farm sustainability. To address this gap, our work has three objectives as follows: (1) identifying the structural characteristics required by specialised dairy farms located in the grassland area to be self-sufficient; (2) analysing the relationships between input self-sufficiency, environmental and economic sustainability; and (3) studying how the farms react to a decrease in milk price according to their self-sufficiency degree. Based on farm accounting databases, we categorised 335 Walloon specialised conventional dairy farms into four classes according to their level of input self-sufficiency. To this end, we used as proxy the indicator of economic autonomy - that is, the ratio between cos...
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Accidental impaction of small fish bone in upper gastro intestinal tract is relatively common. Most of the time people ignore such small fish bone impaction as they become asymptomatic with subsequent swallowing of food. Rarely, it may... more
Accidental impaction of small fish bone in upper gastro intestinal tract is relatively common. Most of the time people ignore such small fish bone impaction as they become asymptomatic with subsequent swallowing of food. Rarely, it may perforate esophagus and cause serious complications and may even be fatal. A 28-year-old male was referred to us with a 4 day history of painful swallowing, and rapidly enlarging right sided neck swelling for last 3 days. He had a history of a fish bone impaction 2 weeks ago on the same side which he felt had resolved with subsequent dry rice swallow. Radiological investigation showed a pseudoaneurysm of the right common carotid artery (CCA) with impacted fish bone in the neck outside gastro intestinal tract impinging on the wall of CCA. The neck was explored; the CCA repaired, and patient was discharged in good health. This is an unusual complication of fish bone impaction. Urgent surgical intervention, rapid resuscitation and multidisciplinary approach are necessary for a good patient outcome.
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Background: Laparoscopic cholecystectomy (LC) has become firmly established as a procedure of choice for gallstone disease. The procedure usually necessitates general anaesthesia and endotracheal intubation to prevent aspiration and... more
Background: Laparoscopic cholecystectomy (LC) has become firmly established as a procedure of choice for gallstone disease. The procedure usually necessitates general anaesthesia and endotracheal intubation to prevent aspiration and respiratory embarrassment secondary to the induction of pneumoperitoneum. There is a paucity of data in the literature on the procedure being performed under regional (epidural) anaesthesia, especially in patients with coexisting
Research Interests: Medicine, Humans, Respiratory Disease, Female, Male, and 15 moreClinical Sciences, Aged, Middle Aged, Adult, Chronic obstructive pulmonary disease, Pulmonary function test, Abdominal Pain, Pulmonary disease, Cholelithiasis, Pain Threshold, Endotracheal intubation, Laparoscopic Cholecystectomy, Respiratory function tests, High risk, and General Anaesthesia
Basic life support (BLS) is an integral part of emergency medical care. Studies have shown poor knowledge of it among health care providers who are usually taught BLS by lecture-based teachings in classes. This study is designed to assess... more
Basic life support (BLS) is an integral part of emergency medical care. Studies have shown poor knowledge of it among health care providers who are usually taught BLS by lecture-based teachings in classes. This study is designed to assess the effectiveness of class lecture versus workshop-based teaching of BLS on acquiring the practice skills on mannequin. After ethical approval and informed consent from the participants, the present study was conducted among the health care providers. Participants were grouped in lecture-based class teaching and workshop-based teaching. They were then asked to practice BLS on mannequin (Resusci Anne with QCPR) and evaluated as per performance parameters based on American Heart Association BLS. Statistical analyses are done by Fisher's exact t-test using GraphPad INSTAT software and P < 0.05 is taken as significant. There were 55 participants in lecture-based teaching and 50 in workshop-based teaching group. There is no statistical difference...
Research Interests: Emergency Medicine, Anesthesiology, Medical Education, Critical Care Nusing, Emergency Management, and 15 moreEmergency Department Critical Care, Medicine, Critical Care, Critical Care Medicine, Emergency Medical Services, Anaesthesiology, INTENSIVE CARE, Anaesthesia, Critical Care Nursing, Cardio Pulmonary Resuscitation, Anesthesia, Cardiopulmonary Resuscitation, Cardiorespiratory Resuscitation, Intensive Care Medicine, and Basic Life Support Training
Background: Periorbital melanosis (POM) is a common aesthetic condition with significant impact. Chemical peeling is a frequently used treatment; yet, an ideal peeling agent is however to find. The aim of the study was to compare the... more
Background: Periorbital melanosis (POM) is a common aesthetic condition with significant impact. Chemical peeling is a frequently used treatment; yet, an ideal peeling agent is however to find. The aim of the study was to compare the clinical efficacy and safety of 20% glycolic acid (GA) and 30% lactic acid (LA) peels in POM.Methods: With approval and consent, the study was conducted from September 2016-August 2017. Patients aged 18-60 years of both sexes, having a constitutional POM were enrolled. Patients known to be allergic to the peeling agents were excluded. Alternate patients were enrolled into Gr-G (20% GA) and Gr-L (30% LA) and were treated every 3 weeks, for 3 sessions and evaluated till 9 weeks. Clinical improvement using POM grading, patients’ global assessment, satisfaction, and physician's global satisfaction were noted. Data are presented in number, percentages and mean±standard deviation. INSTAT software was used for statistical analysis; p<0.05 was considered...
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Ever since the SARS-CoV-2 infection crisis has affected the human, the popularity of hydroxychloroquine (HCQ) as prophylaxis has been in limelight. The article by Chatterjee et al1 is very timely and gives a ray of hope. While the authors... more
Ever since the SARS-CoV-2 infection crisis has affected the human, the popularity of hydroxychloroquine (HCQ) as prophylaxis has been in limelight. The article by Chatterjee et al1 is very timely and gives a ray of hope. While the authors have done a commendable job, it is felt that the data and results need to be taken cautiously and a few facts need to be clarified before we accept it wholeheartedly.
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Background and Aims: Postoperative pain following tonsillectomy is troublesome, and non-pharmacological methods can be a valuable adjunct to reduce the intensity of pain. Cooling can attenuate the damage done to tissues by hot dissection... more
Background and Aims: Postoperative pain following tonsillectomy is troublesome, and non-pharmacological methods can be a valuable adjunct to reduce the intensity of pain. Cooling can attenuate the damage done to tissues by hot dissection techniques. The study was aimed to assess the effect of fossa cooling on post-tonsillectomy pain. Materials and Methods: Forty patients aged 8-18 years of American Society of physical status I and II scheduled for elective bilateral tonsillectomy with bipolar under general were recruited. After obtaining consent and approval from the institutional ethical committee, they were randomly assigned to one of the two groups. At the end of tonsillectomy, the fossa was packed for 10 minutes using gauze soaked in ice-cold 0.9% saline (5–10 ) in group T (test) and saline at room temperature in group C (control). The postoperative pain scores using Faces Pain Scale-Revised (FPS–R) and sore throat were evaluated at 15 minutes, 1 hour, 6 hours and 12 hours. All ...
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This is a century of corona virus. The world is still coping up with the third wave of COVID-19, while the scientists have already warned that a fourth wave is imminent. This wave is expected to be more lethal due to multiple mutated... more
This is a century of corona virus. The world is still coping up with the third wave of COVID-19, while the scientists have already warned that a fourth wave is imminent. This wave is expected to be more lethal due to multiple mutated variety of the corona virus, including one of the most lethal one known as Indian variant or delta variant. Meanwhile, the health staff has to deal with those patients who survived COVID-19, but continued to have a variety of new complaints, including respiratory distress, dysautonomia, intravascular thrombosis and endocardial myocarditis etc. Anti-corona therapy, in itself lead to multiple syndromes including acute kidney injury, bone marrow depression and deranged blood sugar levels. One of the more lethal complication is mucormycosis-a fungal disease. It has effected thousands of recovering or recovered corona patients in India. This editorial highlights the salient features of post-corona syndrome or long covid.
Research Interests:
1. Apostolidou E, Beale C, Poppas A, Stockwell P. Pseudoaneurysm of the mitral‐aortic intervalvular fibrosa: A case series with literature review. CASE (Phila) 2017;1:221‐6. 2. Zencirkıran Ağuş H, Atamaner O, Uygur B, Kalkan AK, Ertürk M.... more
1. Apostolidou E, Beale C, Poppas A, Stockwell P. Pseudoaneurysm of the mitral‐aortic intervalvular fibrosa: A case series with literature review. CASE (Phila) 2017;1:221‐6. 2. Zencirkıran Ağuş H, Atamaner O, Uygur B, Kalkan AK, Ertürk M. Infective endocarditis of a bicuspid aortic valve complicated by septal aneurysm and mitral‐aortic intervalvular fibrosa pseudoaneurysm. Turk Kardiyol Dern Ars 2018;46:147‐50. How to cite this article: Hosseinsabet A, Abbasi K. Pseudoaneurysm of the mitral–aortic intervalvular fibrosa in a patient with a history of bentall operation. Ann Card Anaesth 2021;24:120-1.
Research Interests:
First, all anaesthetic agents have some impact on the pulmonary system, and anaesthesia technique used per-se has minimal impact on the postoperative pulmonary morbidity (2), whereas the mechanical ventilation technique used, parameter... more
First, all anaesthetic agents have some impact on the pulmonary system, and anaesthesia technique used per-se has minimal impact on the postoperative pulmonary morbidity (2), whereas the mechanical ventilation technique used, parameter settings and the addition of the amount of positive end-expiratory pressure, operative insult, and the patient’s ongoing pathophysiological insults have a significant impact on postoperative pulmonary functional adversities and ensuing increased morbidity (3). In addition to the amount and type of intravenous fluid used, overall fluid balance is a significant predictor (4). Elaboration and clarification of this information will help us better understand and interpret the results.
Research Interests:
In conclusion, we agree that that the judgement of noninferiority or equivalence in a noninferiority trial needs various considerations. In our study, we focused on the use of high-flow nasal cannula in maintaining oxygen delivery... more
In conclusion, we agree that that the judgement of noninferiority or equivalence in a noninferiority trial needs various considerations. In our study, we focused on the use of high-flow nasal cannula in maintaining oxygen delivery compared with a current clinical standard procedure. As high-flow nasal cannula has become increasingly popular to improve airway management strategies, we are looking forward to more clinical research projects which could provide evidence to support or oppose the use of this new technique.
372 The Editor, Cardiopulmonary dysfunction is a very critical aspect that needs consideration in postoperative cardiac surgical patients. We read with great interest this article about hemodynamic and gaseous exchange effects of BiLevel... more
372 The Editor, Cardiopulmonary dysfunction is a very critical aspect that needs consideration in postoperative cardiac surgical patients. We read with great interest this article about hemodynamic and gaseous exchange effects of BiLevel positive airway pressure (BiPAP) in post-cardiac surgery.[1] This is an exciting yet controversial topic, with significant relationships with postoperative complications such as cardiac failure and others. In this study, the authors focus on cardiovascular parameters. We feel that a few aspects of the study need more information for better acceptance of the result.
This chapter (chapter 11) of Handbook for Practice of Research Methodology 1st edition (c) 2015, published by the Department of Medical Education, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong,... more
This chapter (chapter 11) of Handbook for Practice of Research Methodology 1st edition (c) 2015, published by the Department of Medical Education, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India is aimed at providing basic information on how to design, conduct, report a randomized controlled trial.
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This chapter (chapter 14) of Handbook for Practice of Research Methodology 1st edition (c) 2015, published by the Department of Medical Education, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong,... more
This chapter (chapter 14) of Handbook for Practice of Research Methodology 1st edition (c) 2015, published by the Department of Medical Education, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India is aimed at providing basic information on ethical principles to be followed while conducting clinical researches with human subjects.
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This book contains the write up of few of the topics presented in Indian College of Anaesthesiologists national conference (ICACON) 2016 held in Shillong, India.