Notes

Midst Ear Ceruminous Sweat gland Adenoma Hindering the particular Eustachian Tube Orifice.
Sixty patients were included in the study. Both NP-BAL and B-BAL had concordance with the CPIS at 69.1%. The concordance between NP-BAL and B-BAL was better at 67.6% with a kappa coefficient of 0.064 (
= -0.593). The yield and sensitivity of NP-BAL were comparable to that of B-BAL.

The blind NP-BAL is an equally effective method of airway sampling and could be a better alternative to replace more invasive B-BAL for microbiologic diagnosis of VAP.
The blind NP-BAL is an equally effective method of airway sampling and could be a better alternative to replace more invasive B-BAL for microbiologic diagnosis of VAP.
Acute postoperative pain is managed with parenteral and oral medications requiring skilled personnel for administration and vigilance. selleck chemicals Previous studies have been done either with transdermal buprenorphine or diclofenac patch separately in mitigating postoperative pain.

The primary aim was to compare pain scores and rescue analgesia requirement. The secondary aims were comparison of side effects, time to mobilization and oral intake start, sedation scores, and satisfaction scores of surgeons and patients receiving transdermal patches of buprenorphine and diclofenac versus placebo and diclofenac patches following laparoscopic cholecystectomy.

This is a randomized double-blinded (11), case-control study.

One hundred patients undergoing laparoscopic cholecystectomies were enrolled for the study. Patients were allocated into two groups by computer-generated randomization those receiving dual patch of buprenorphine and diclofenac (DP) and those receiving patches of diclofenac and placebo (SP). Outcomes werey.
Malaria is a significant public health problem with people worldwide at risk for the disease. It is a mosquito-borne disease causing high-grade fever, chills, and flu-like illness. The World Health Organization (WHO) recommends the case with severe malaria should be admitted in the intensive care unit (ICU). Severe malaria is a medical emergency and often managed in ICU with regard to the definition of hyperparasitemia. The WHO amended the criteria for definition of severe malaria in 2006, 2010, and 2015.

All patients had a full workup for fever that included three smears for malarial parasites, serology for dengue, leptospirosis, scrub typhus, enteric fever, blood, urine, sputum or endotracheal cultures, and other tests as clinically indicated. A diagnosis was made when a patient is tested positive for malarial antigen with a rapid diagnostic test and other causes of fever excluded. Patients were treated with intravenous Artesunate along with enteral Doxycycline.

Of total patients, the vasopressor requirements being Dopamine (7.40%), nor adrenaline (7.40%) and vasopressin (3.70%). None received packed red blood cell transfusions, whereas 14.81% had platelet transfusions. 66.66% required Noninvasive ventilation, none required invasive mechanical ventilation (IMV) and both noninvasive and IMV. None of the patients had received hemodialysis. The mean duration of ICU and hospital stay was 4.14 and 6.26 days, respectively. No deaths were observed during the study period.

In our study, we hereby conclude the incidence of clinical features is in agreement with other studies with no in-hospital mortality.
In our study, we hereby conclude the incidence of clinical features is in agreement with other studies with no in-hospital mortality.
Total intravenous anesthesia (TIVA) has proven advantage over inhalational anesthesia in terms of stable hemodynamic, eco-friendly, and good recovery profile, but apprehension regarding adequate depth of anesthesia and intraoperative recall is still pertaining. This study aims to compare propofol-dexmedetomidine-based TIVA with sevoflurane-based inhalational anesthesia in modified radical mastectomy in terms of depth of anesthesia, intraoperative recall, recovery profile, and hemodynamic status.

This prospective randomized controlled study was conducted at a tertiary care center over a time frame of 1 year.

In this randomized controlled study, 100 patients were randomly distributed into two groups TIVA (Group T) and inhalational anesthesia (Group I). Group T patients received injection dexmedetomidine 1 μg.kg
over 10 min followed by 0.7 μg.kg
.h
and injection propofol 25-100 μg.kg
.min
. Ventilation was maintained with oxygen-air gas flow. In Group I, patients were ventilated with nitrous oxide-owith stable hemodynamic and good recovery profile, at low cost in an eco-friendly manner.
During the administration of general anesthesia, direct laryngoscopy and endotracheal intubation cause an increase in heart rate, arterial pressure, and dysrhythmias in upto 90% of patients. These changes can be particularly hazardous for patients with cerebral or coronary diseases. Both clonidine and gabapentin have been used for anesthetic effects, but a better drug for controlling hemodynamic parameters is being investigated.

The study was done to evaluate and compare the efficacy of oral clonidine 0.3 mg and oral gabapentin 900 mg as a premedication for attenuation of pressor response to laryngoscopy and endotracheal intubation.

After obtaining approval from the ethics committee, 75 patients, American Society of Anesthesiologists physical status classes I and II between the ages of 18 and 60 years scheduled to undergo elective noncardiac surgical procedure were enrolled in the study. Patients were randomized into three groups of 25 each who received 0.3 mg clonidine, 900 mg gabapentin, and placebo. lonidine.
Using clonidine or gabapentin, one can effectively provide stable hemodynamic conditions during laryngoscopy and endotracheal intubation, but more so with clonidine.
With increasing focus on outpatient care, there has been an increased demand for short-acting spinal anesthetics, facilitating early recovery and mobilization of the patient.

The aim of the study was to compare 1% chloroprocaine, characterized by short latency and short duration with 0.5% levobupivacaine, which has shown to preserve motor function at low concentrations, with recovery from motor block as the primary objective and recovery from sensory block and hemodynamic stability as secondary objectives.

A prospective study to evaluate newer isobaric chloroprocaine and levobupivacaine intrathecally in a cohort of patients using randomization and double blinding.

Sixty American Society of Anesthesiologist physical status Classes I and II patients undergoing perianal surgeries were randomly divided into Group C (
= 30) receiving intrathecal 1% chloroprocaine 3 mL and Group L (
= 30) receiving 0.5% levobupivacaine 1.5 mL. Patients were assessed for sensory and motor block characteristics, hemodynam levobupivacaine and is well suited for day care surgeries.
In laparoscopic cholecystectomy, pneumoperitoneum results in tachycardia, hypertension, and increased myocardial oxygen demand. These changes are more pronounced in hypertensive patients. The intravenous administration of dexmedetomidine attenuates sympathoadrenal response and provides better hemodynamic stability intraoperatively.

To evaluate the hemodynamic stabilizing and sedation properties of two different doses of dexmedetomidine including 0.7 μg.kg
.h
and 0.5 μg.kg
.h
in hypertensive patients undergoing laparoscopic cholecystectomy.

This was a randomized, prospective, double-blind controlled trial.

A total of 60 controlled hypertensive patients of either sex, aged 30-60 years, and ASA class 2 without any other serious comorbid conditions who were undergoing laparoscopic cholecystectomy under general anesthesia were randomly assigned into three groups of 20 each. Group A and B received loading dose of dexmedetomidine 1 μg.kg
over 10 min and maintenance dose at 0.7 and 0.5 μg.kg
.h
, respectively. Group C received normal saline infusion only. Hemodynamic parameters (heart rate and systolic, diastolic, and mean arterial pressure) and sedation score were compared at different time intervals among groups.

The Chi-square test, ANOVA, and Tukey
Test.

Fluctuations in the hemodynamics of hypertensive patients are effectively attenuated by dexmedetomidine and there is no difference in the attenuation of these hemodynamic changes by maintenance dose of 0.5 or 0.7 μg.kg
.h
. However, maintenance dose of 0.5 μg.kg
.h
causes lesser sedation.

Dexmedetomidine administered as infusion in a maintenance dose of 0.5 μg.kg
.h
serves as an ideal anesthetic adjuvant in hypertensive patients undergoing laparoscopic cholecystectomy.
Dexmedetomidine administered as infusion in a maintenance dose of 0.5 μg.kg-1.h-1 serves as an ideal anesthetic adjuvant in hypertensive patients undergoing laparoscopic cholecystectomy.
Although the conventional awake fiber-optic nasal intubation is most commonly used in anticipated difficult tracheal intubation, it has several potential difficulties.

The aim of this study is to compare another technique modified tube first (MTF) technique with the conventional one in terms of time taken, ease of glottis visualization, number of attempts needed, and complications.

This was a prospective, randomized, open-label trial conducted on 60 patients with an anticipated difficult airway undergoing oromaxillofacial surgery at a tertiary care center.

The patients were randomized into the MTF and conventional technique groups. Times from insertion of the fiber-optic scope into nares till vocal cord visualization (T1) and from T1 to complete intubation (T2) were measured and compared.

Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) software version 21.

Time taken to visualize glottis was significantly less in the MTF technique as compared to the conventional method (mean ± standard deviation = 108.6 ± 43.1 vs. 142 ± 49.2 s, respectively,
= 0.007). Similarly, the total time taken for nasotracheal intubation with modified technique is significantly less as compared to the conventional technique (
= 0.004). Furthermore, there is significantly better ease of glottis visualization (
= 0.001), higher success in minimal attempts (
= 0.02) with significantly lesser incidence of desaturation in MTF technique (
= 0.026).

The alternative technique (MTF) is a quicker, easier approach with higher success rate and lesser complications for the placement of an endotracheal tube in a difficult airway scenario.
The alternative technique (MTF) is a quicker, easier approach with higher success rate and lesser complications for the placement of an endotracheal tube in a difficult airway scenario.
Parturient controlled epidural analgesia (PCEA) is an established method of providing safe and effective labor analgesia.

The aim of this single-blind, randomized controlled trial was to compare the efficacy of PCEA with or without basal infusion (BI) of ropivacaine and fentanyl for the effective management of labor pain associated with normal vaginal delivery.

A total of 78 nulliparous parturients with vertex presentation at term and with cervical dilatation of 3-5 cm demanding for epidural analgesia (EA) were enrolled in the study. EA was initiated and maintained with ropivacaine 0.125% and fentanyl 2 μg/mL. Following an initial epidural loading volume of 8-10 mL, parturients were randomly allocated in two groups of 39 each. PCEA group received bolus of 5 mL at 200 mL/h with lockout interval of 15 min and with maximum volume of local anaesthetic was 20 mL/h and PCEA + BI group - receiving added BI rate of 5 mL/h along with same programmed parameters of PCEA pump.

No statistically significant difference was observed between the groups in terms of demographic characteristics, duration of labor, delivery methods, maternal satisfaction as well as Apgar score.
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