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res during the early post-operative period.
Providing safe anaesthesia to paediatric patients is a challenging task. This requires a thorough knowledge of the soft and pliable paediatric airway. Owing to the vulnerability of the anatomical structures involved, choosing an appropiate sized endotracheal tube (ETT) is important in these cases. A larger sized ETT may lead to trauma and a smaller one would result in leakage and risk of aspiration. Both situations demand an immediate tube change, thereby complicating the condition. see more The physical indices- based formulae have often failed to justify the purpose leading to repeated laryngoscopy and tube change during intubation. The increase in availability of the modern ultrasound devices have shown promise in these cases.
In this study we examine the accuracy of ultrasonography (USG)to assess the appropriate ETT size, comparing it with physical indices based formulae suggested ETT size so that repeated attempts on intubation can be minimized.
The study group included 100 patients of 1-5 years, ASA I- II, requiring orotracheal intubation under general anaesthesia. The tracheal sub-glottic diameter was estimated by pre-anaesthetic USG to determine the ETT size, both cuffed and uncuffed. ETT data obtained by these methods were compared by Pearson's correlation coefficient and
-test.
USG predicted ETT size were significantly more consistent than the physical indices based formulae. Also the age based formulae were found to be more precise than the height based ones. Seven patients required change of tube once.
Ultrasonography is an effective tool in predicting paediatric ETT size.
Ultrasonography is an effective tool in predicting paediatric ETT size.
The aim of the study is to measure the postoperative adequacy of pain relief and functional recovery after unilateral primary total knee arthroplasty or total knee replacement (TKR) with a multimodal approach.
This was a retrospective observational study done in a tertiary care center.
Eighty patients aged 18-65 years (yrs) with ASA Physical Status Classes I, II, and III operated for unilateral primary TKR surgery under suitable Anaesthesia and was administered ultrasound-guided adductor canal block + periarticular infiltration (PI) from January 2018 to January 2019 were included. Thereafter, the patients visual analog scale (VAS) scores at rest, 45° knee flexion, and mobilization as well as additional analgesia given were noted after going through the records at following time points 12 hourly for 24 h and thereafter on postoperative day 1 (POD1) and POD2. Level of block, adverse events, and functional recovery (time up and go [TUG] test, 10 s walk test) on POD1 and POD2 were also noted.
The statistiwas not hampered.
Periarticular infiltration (PAI) analgesia has been found to be an effective analgesia modality after total knee arthroplasty (TKA). Dexmedetomidine has many beneficial effects on postoperative analgesia by different routes, but studies on PAI are lagging.
In this study, we compared postoperative analgesia after PAI with dexmedetomidine versus ketorolac as an additive to ropivacaine after TKA.
This is a prospective, randomized, double-blind study conducted on 75 patients belonging to American Society of Anesthesiologists I to III, undergoing total knee arthroplasty, of either gender, belonging to American Society of Anesthesiologists I to III.
After institutional ethics committee approval and written informed consent, patients were randomly allocated into three groups. Group C (
= 25) received cocktail of 60 mL ropivacaine (0.25%) infiltration with adrenaline 5 mL (0.1 mg.mL
), Group D (
= 25) received additive dexmedetomidine 1 ug.kg
to above cocktail, and Group K (
= 25) received ketorolac ive analgesia after TKA.
Ketorolac was a better additive to ropivacaine than dexmedetomidine for postoperative analgesia after TKA.Coronavirus disease (COVID), also known as COVID-19, has brought the immense challenges for the health-care system globally. All the branches of medicine are equally involved in managing these patients. During this pandemic, care of obstetric patients in terms of obstetric analgesia becomes crucial. Hence, the purpose of this review was to draft a basic model of strategies related to the provision of safe obstetric analgesia during this coronavirus pandemic, which will assist the health-care providers across the developing countries to formulate their own protocols depending upon the resource availability. All research articles related to obstetric analgesia during the COVID-19 pandemic from January 2020 to December 01, 2020 available on PubMed, Cochrane, Google scholar, and Embase are included in this study. The keywords used for data search were "obstetric analgesia during COVID-19," "coronavirus pandemic," "Labor pain," "obstetric pain management guidelines," and "regional anesthesia during COVID-19." Eventually, our review yielded the most recentmodel for the provision of safe and effective obstetric analgesia practices during the COVID-19 pandemic across the developing countries.Most research is conducted on convenience and purposive samples that may be randomly or nonrandomly drawn. A convenience sample is the one that is drawn from a source that is conveniently accessible to the researcher. A purposive sample is the one whose characteristics are defined for a purpose that is relevant to the study. The findings of a study based on convenience and purposive sampling can only be generalized to the (sub)population from which the sample is drawn and not to the entire population. This article explains the concepts involved with the help of examples of both good and bad sampling practice. Database studies and studies with enriched designs are cited as special examples of convenience and purposive sampling. Issues related to the internal and external validity of convenience and purposive samples are explained. The importance of good sampling techniques in the design and interpretation of research is understated; this must change.Reports on behavioral interventions for the treatment of Tourette's disorder (TD) from India are limited. This patient series describes the usefulness and feasibility of conducting behavioral interventions for patients with TD from an Indian general hospital psychiatric unit. Behavioral treatments in these seven consecutively treated adult/adolescent patients with TD included all components of habit reversal treatment, comprehensive behavioral intervention for tics, and exposure with response prevention in some patients. Patients were predominantly male, with adolescent-onset severe TD, typical features and psychiatric comorbidities, and poor response to multiple medications prior to the institution of behavior therapy. In addition to long delays in diagnosis, none of the patients or their caregivers had been informed by the doctors they had consulted earlier about TD or the need for behavioral treatments before attending our center. Institution of behavioral treatments along with medications led to a 75% reduction in the severity of tics and reduction in comorbid symptoms. Patients and caregivers also reported similar rates of improvement as well as reductions in subjective distress and caregiver burden. Five patients have been followed up for seven months to seven years; apart from one patient, all others have had only minor exacerbations of tics during this period. This limited experience suggests that behavior therapies for TD can be successfully implemented in low-resource, non-specialized Indian settings. They are effective, and gains from such treatment are usually enduring.
Internet use has spread across the world due to easy accessibility and affordability. However, it has been creating many problems at several levels. So, there is a need to identify the suitability of psychometric properties and the factor structure of the widely used Internet Addiction Test (IAT) in the Indian settings. Our objective was to perform an exploratory factor analysis on the IAT and to test the reliability of the scale.
It was a cross-sectional study that included various professional groups. We used an online questionnaire that included sociodemographic details and Young's IAT. Exploratory factor analysis was used to identify the factor structure of Young's IAT in the Indian setup.
The mean age of the sample (N = 1,782) was 27.7 years (SD = 8.74) with a predominantly male population 1040 (58.4%). In total, 1.0% (17) of the sample had significant problems with internet usage, whereas 13% (232) were in the range of frequent/occasional problems, and the mean score on IAT was 32 (SD = 16.42). Exploratory factor analysis revealed two factors that explained 49% of the variance (Kaiser-Meyer-Olkin measure of sampling adequacy 0.95, Bartlett's test of sphericity P = 0.000). They were "mood and relationship issues" and "duration and productivity." Cronbach's α was 0.92, which indicates a high level of internal consistency.
In Indian settings, IAT can be understood based on the two-factor structure. The scale has excellent reliability. Further studies are needed to replicate these results, by using confirmatory factor analysis and validity testing.
In Indian settings, IAT can be understood based on the two-factor structure. The scale has excellent reliability. Further studies are needed to replicate these results, by using confirmatory factor analysis and validity testing.
Stigma related to mental illness is a reality among health care providers. This study is an attempt to understand the attitudes of doctors from different specialties toward mental illness and the stigma related to it.
We used a concurrent nested mixed-methods approach to understand and identify the various factors of mental-illness-related stigma in medical practitioners. Between November 2018 and March 2019, 100 medical practitioners from South India were administered a self-reporting OMS-HC (Opening Minds Scale for Health Care Providers), followed by in-depth interviews among 25 of the 100 participants selected using purposive sampling. Quantitative surveys were analyzed using SPSSv23. In-depth interviews were transcribed as extended notes, translated, and initially explored using focused coding and the constant comparative method.
Though findings from quantitative analysis show low to moderate stigma (Mean = 53.52, SD = 7.61), the qualitative study revealed unintended and covert negative attitude toward mental illness.
As stigma occurs at various levels-structural, institutional, interpersonal, and personal-anti-stigma measures also need to be systematically designed. Qualitative studies give more insight regarding the nature of stigma in medical practitioners toward mental illness.
As stigma occurs at various levels-structural, institutional, interpersonal, and personal-anti-stigma measures also need to be systematically designed. Qualitative studies give more insight regarding the nature of stigma in medical practitioners toward mental illness.
Successful identification of emotional expression in patients is of considerable importance in the diagnosis of diseases and while developing rapport between physicians and patients. Despite the importance of such skills, this aspect remains grossly overlooked in conventional medical training in India. This study aims to explore the extent to which medical students can identify emotions by observing photographs of male and female subjects expressing different facial expressions.
A total of 106 medical students aged 18-25, without any diagnosed mental illnesses, were shown images of the six universal facial expressions (anger, sadness, fear, happiness, disgust, and surprise) at 100% intensity with an exposure time of 2 seconds for each image. The participants marked their responses after each image was shown. Collected data were analyzed using Statistical Package for the Social Sciences.
Participants could identify 76.54% of the emotions on average, with higher accuracy for positive emotions (95.6% for happiness) and lower for negative emotions (46% for fear).
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