Notes

Ruptured Ligament in Anabolic-Androgenic Anabolic steroid People: A new Cross-Sectional Cohort Examine.
echniques are used, SAPb significantly reduces postoperative pain and nausea and vomiting in patients undergoing VATS. Grading of Recommendations Assessment, Development and Evaluation rating are, nonetheless, quite low, due to high heterogeneity. Troglitazone Well designed and properly powered RCTs are necessary to confirm these preliminary findings.
Cannabis has increasingly been used for medical and recreational purposes. The main pharmacological compound in cannabis is tetrahydrocannabinol (THC), which has sedative, anxiolytic and analgesic effects. In some animal models, THC has also been shown to reduce the minimum alveolar concentration (MAC) of halothane and cyclopropane, but its effect on sevoflurane, currently the most commonly used inhalational anaesthetic agent, has not been investigated.

To investigate the effect of THC on the MAC of sevoflurane in rats.

Observer-blinded, randomised controlled trial.

Centre for Biomedical Research of the Medical University of Vienna, 2019.

Thirty-eight adult Wistar rats.

The rats were allocated randomly into one of two groups. Group A received THC 10 mg kg and group B received the corresponding volume of placebo via gastric gavage (administration through a tube placed in the distal oesophagus). The rats were then individually anaesthetised in an airtight sevoflurane-flooded chamber, and the MAC in both groups was determined using Dixon's up-and-down method. Blood samples were drawn to measure serum concentrations of THC.

The primary outcome was the MAC of sevoflurane in Groups A and B.

The bootstrap estimate of the MAC of sevoflurane was 2.1 (95% confidence interval 1.8 to 2.4) vol% in the THC group and 2.8 (95% confidence interval 2.7 to 2.9) vol% in the placebo group, corresponding to a significant MAC reduction of 26% in response to THC.

Gastric administration of THC 10 mg kg significantly reduced the MAC of sevoflurane by 26%.

Not applicable.
Not applicable.
Successful airway management is a priority in the resuscitation of critically ill or traumatised patients. Several studies have demonstrated the importance of achieving maximum first pass success, particularly in prehospital advanced airway management.

To compare success rates of emergency intubations between patients requiring cardiopulmonary resuscitation (CPR) for cardiac arrest (CPR group) and other emergencies (non-CPR group) using the C-MAC PM videolaryngoscope.

Ongoing analysis of prospective collected prehospital advanced airway management core variables.

Single helicopter emergency medical service (HEMS) 'Christoph 22', Ulm Military Hospital, Germany, May 2009 to July 2018.

We included all 1006 HEMS patients on whom prehospital advanced airway management was performed by board-certified anaesthesiologists on call at HEMS 'Christoph 22'.

The C-MAC PM was used as the first-line device. The initial direct laryngoscopy was carried out using the C-MAC PM without the monitor in sight. After scoe odds of achieving first pass success were approximately 12-fold higher with a favourable glottic view than with an unfavourable glottic view (OR 12.6, CI, 6.70 to 23.65).

Airway management in an anaesthesiologist-staffed HEMS is associated with a high first pass success rate but even with skilled providers using the C-MAC PM videolaryngoscope routinely, patients who require CPR offer more difficulties for successful prehospital advanced airway management at the first attempt.

German Clinical trials register (drks.de) DRKS00020484.
German Clinical trials register (drks.de) DRKS00020484.
There are no instruments specifically developed for the measurement of nursing workload in postanaesthesia care units (PACUs). An objective and valid instrument is essential for planning work flow and staffing in this unique hospital environment that encompasses elements of elective and acute postsurgical care. Previous studies show that increased workload is associated with increased complication rates in ICUs. Thus, workload assessment may be an important tool for improving postsurgical outcomes.

The aim of this study was to develop and validate a postanaesthesia workload instrument (PAWI) for measurement of workload in PACUs for adults above 18 years of age.

Development and validation consisted of three parts Delphi consensus to establish content validity; internal validation including feasibility, face validity and inter-rater reliability testing; and national external validation consisting of feasibility, inter-rater reliability, criterion validity, construct and face validities.

PACUs in nine ung workload in postanaesthesia care units. PAWI demonstrated good feasibility and metric properties.
The complex innervation of the clavicle makes general anaesthesia a preferred technique for clavicular surgeries in current practice. The role and approach of regional anaesthesia remains unanswered.

This study aims to delineate the relative effectiveness between interscalene brachial plexus block with either intermediate cervical plexus or superficial cervical plexus block (CPB) as the anaesthetics for clavicular surgery.

A randomised, double-blind prospective study.

Single-centre, tertiary care medical college and research institute.

Fifty patients with American Society of Anesthesiologist's (ASA) grade I to III, aged 18 to 70 years, scheduled for clavicular surgery, during May 2018 to April 2019 were enrolled in this study.

All patients received interscalene block with 10 ml of 0.5% bupivacaine. Patients were randomised to undergo additional ultrasound-guided intermediate CPB (Group-1) or superficial CPB (Group-2) with 10 ml of 0.5% bupivacaine.

The block success rate, sensory block onset tim CTRI/2018/05/013785.
Clinical trial registry of India (www.ctri.nic.in) - CTRI/2018/05/013785.
To describe the varied presentations of posterior keratoconus.

This is a 3-year institute-based retrospective study report from June 2015 to June 2018 that describes 13 eyes of 12 patients with varied presentations of posterior keratoconus, evaluating tomographic changes using Scheimpflug corneal tomography and anterior segment optical coherence tomography. Slit-lamp examination revealed circumscribed nebular corneal opacity with posterior corneal depression.

Eleven patients had unilateral and one had a bilateral presentation. Five patients presented in the first and second decade with a nebular opacity and circumscribed excavation of the posterior cornea. One patient was a 12-year-old girl who presented with systemic manifestations. Seven others were middle-aged adults with superior, central, or peripheral excavation. Two patients had microcornea.

This is the largest case series on posterior keratoconus, depicting its varied features. Diagnosis of this uncommon condition requires a high index of suspicion, meticulous slit-lamp examination, and systemic evaluation to rule out other associated anomalies.
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