Comparisons between Desflurane and Isoflurane or Propofol on Time to Following Commands and Time to Discharge

Background Anesthesiologists can best decide whether to use desflurane based on the magnitudes of its effects compared to other general anesthetics. The goal of this study was to estimate the mean decrease in times to following commands when desflurane was being used instead of isoflurane or propofol. The mean decrease in time to hospital discharge after ambulatory surgery when desflurane was used instead of propofol also was examined. Methods Published studies that met entry criteria were collected up to November 1994. Included are studies in which patients were randomly assigned to groups, extubation was planned at the end of surgery, and general anesthesia was induced with an intravenous agent. We used random-effects metaanalysis to calculate confidence intervals for pooled mean differences. Results Six studies (with 229 patients) that compared desflurane to propofol met the inclusion criteria. Eight studies (with 316 patients) compared desflurane to isoflurane. A statistically significant difference in the time to following commands after discontinuation of desflurane versus propofol (mean difference 0.7 min (propofol minus desflurane), 95% confidence interval -0.2 to 1.7 min) was not found. Patients who received propofol were discharged to home a mean of 17 min (4-30 min) more quickly than patients who received desflurane. Patients who received desflurane followed commands a mean of 4.4 min (3.3-5.4 min) more quickly than did patients who received isoflurane. Conclusions There are only minor clinically important differences between desflurane and isoflurane or propofol with respect to time to following commands and time to discharge.

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Assessment of decrease in renal function associated with hypothyroidism

World Journal of Advanced Research and Reviews ◽

10.30574/wjarr.2021.12.1.0477 ◽

2021 ◽

Vol 12 (1) ◽

pp. 275-286

Author(s):

Ayesha Ammar ◽

Kahkashan Bashir Mir ◽

Sadaf Batool ◽

Noreen Marwat ◽

Maryam Saeed ◽

...

Keyword(s):

Renal Function ◽

Confidence Interval ◽

Creatinine Clearance ◽

Confidence Intervals ◽

Standard Error ◽

Radioactive Iodine ◽

T Test ◽

Euthyroid State ◽

Significant Difference ◽

The Mean

Objective: Study was aimed to see the effects of hypothyroidism on GFR as a renal function. Material and methods: Total of Fifty-eight patients were included in the study. Out of those forty-eight patients were female and the rest were male. Out of fifty eight patients, fifty three patients were of thyroid cancer in which hypothyroidism was due to discontinuation of thyroxine before the administration of radioactive iodine for Differentiated thyroid cancer.Moreover, remaining five patients were post radioactive iodine treatment (for hyperthyroidism) hypothyroid. All of the patients were above eighteen years of age with TSH value > 30µIU/ml. Pregnant and lactating females were excluded.Renal function tests (urea/creatinine, creatinine clearance) and serum electrolytes followed by Tc-99m-DTPA renal scan for GFR assessment (GATES’ method) were carried out in all subjects twice during the study, One study during hypothyroid state (TSH > 30 µIU/ml) and other during euthyroid state (TSH between 0.4 to 4µ IU/ml). The results of Student’s t-test showed significant difference in renal functions (Urea, creatinine, creatinine clearance, GFR values) in euthyroid state and hypothyroid state (p-value <0.05). RESULTS: In case of creatinine the paired t test reveal the mean 1.014±0.428, with standard error of 0.669 within 95% confidence interval, for creatinine clearance 80.11±14.12 with standard error of 1.94 within 95% confidence intervals, for urea the mean 28±12.13 with standard error of 1.607 within 95% confidence intervals and for GFR for individual kidney is 38.056±8.56 with standard error of 1.3717 within 95% confidence interval. There was no difference in the outcome of the 2 groups. Conclusion: Hypothyroidism impairs renal function to a significant level and hence needs to be prevented and corrected as early as possible.

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Evaluating Endoscopic Ipsilateral Endonasal Corridor Approaches to the Anterolateral Wall of the Maxillary Sinus: A Computerized Tomography Study

International Archives of Otorhinolaryngology ◽

10.1055/s-0041-1724092 ◽

2021 ◽

Author(s):

Navarat Vatcharayothin ◽

Pornthep Kasemsiri ◽

Sanguansak Thanaviratananich ◽

Cattleya Thongrong

Keyword(s):

Confidence Interval ◽

Maxillary Sinus ◽

Inferior Turbinate ◽

Radial Access ◽

Sinus Wall ◽

Nasal Floor ◽

Significant Difference ◽

Anterolateral Wall ◽

The Mean ◽

Maxillary Sinuses

Abstract Introduction The endoscopic access to lesions in the anterolateral wall of the maxillary sinus is a challenging issue; therefore, the evaluation of access should be performed. Objective To assess the accessibility of three endoscopic ipsilateral endonasal corridors. Methods Three corridors were created in each of the 30 maxillary sinuses from 19 head cadavers. Accessing the anterolateral wall of the maxillary sinus was documented with a straight stereotactic navigator probe at the level of the nasal floor and of the axilla of the inferior turbinate. Results At level of the nasal floor, the prelacrimal approach, the modified endoscopic Denker approach, and the endoscopic Denker approach allowed mean radial access to the anterolateral maxillary sinus wall of 42.6 ± 7.3 (95% confidence interval [CI]: 39.9–45.3), 56.0 ± 6.1 (95%CI: 53.7–58.3), and 60.1 ± 6.2 (95%CI: 57.8–62.4), respectively. Furthermore, these approaches provided more lateral access to the maxillary sinus at the level of the axilla of the inferior turbinate, with mean radial access of 45.8 ± 6.9 (95%CI: 43.3–48.4) for the prelacrimal approach, 59.8 ± 4.7 (95% CI:58.1–61.6) for the modified endoscopic Denker approach, and 63.6 ± 5.5 (95%CI: 61.6–65.7) for the endoscopic Denker approach. The mean radial access in each corridor, either at the level of the nasal floor or the axilla of the inferior turbinate, showed a statistically significant difference in all comparison approaches (p < 0.05). Conclusions The prelacrimal approach provided a narrow radial access, which allows access to anteromedial lesions of the maxillary sinus, whereas the modified endoscopic Denker and the endoscopic Denker approaches provided more lateral radial access and improved operational feasibility on far anterolateral maxillary sinus lesions.

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Confidence interval approach for evaluating bias in laboratory methods

Journal of Automatic Chemistry ◽

10.1155/s1463924688000276 ◽

1988 ◽

Vol 10 (3) ◽

pp. 144-146 ◽

Cited By ~ 2

Author(s):

K. F. Yee

Keyword(s):

Confidence Interval ◽

Statistical Tests ◽

Laboratory Methods ◽

Mean Values ◽

Practical Concern ◽

Alternative Approach ◽

Interval Approach ◽

Significant Difference ◽

The Mean

A statistically significant difference in mean values between two laboratory quantitation methods is interpreted as a bias. Sometimes such a difference is so minute that it does not constitute any practical concern. An alternative approach is to test statistically whether the two methods are close enough, not for equality. This is to look at the confidence interval of the mean method difference and does not entail any additional statistical tests.

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Coverage versus Confidence

The Mathematica Journal ◽

10.3888/tmj.23-1 ◽

2021 ◽

Vol 23 ◽

Author(s):

Peyton Cook

Keyword(s):

Confidence Interval ◽

Confidence Intervals ◽

Negative Binomial Distribution ◽

Binomial Distribution ◽

Coverage Probability ◽

Negative Binomial ◽

Asymptotic Confidence Interval ◽

Population Proportion ◽

Coverage Probabilities ◽

The Mean

This article is intended to help students understand the concept of a coverage probability involving confidence intervals. Mathematica is used as a language for describing an algorithm to compute the coverage probability for a simple confidence interval based on the binomial distribution. Then, higher-level functions are used to compute probabilities of expressions in order to obtain coverage probabilities. Several examples are presented: two confidence intervals for a population proportion based on the binomial distribution, an asymptotic confidence interval for the mean of the Poisson distribution, and an asymptotic confidence interval for a population proportion based on the negative binomial distribution.

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Abstract 17292: Does Morbid Obesity Worsens Outcomes in COVID-19?

Circulation ◽

10.1161/circ.142.suppl_3.17292 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Sohaib Roomi ◽

Waqas Ullah ◽

Nayab Nadeem ◽

Rehan Saeed ◽

Donald Haas ◽

...

Keyword(s):

Morbid Obesity ◽

Mechanical Ventilation ◽

Hospital Mortality ◽

Invasive Mechanical Ventilation ◽

Multivariate Logistic Regression Analysis ◽

Odds Ratios ◽

Increased Risk ◽

Significant Difference ◽

The Mean ◽

Mean Differences

Introduction: Given the high prevalence of obesity around the globe, patients with coronavirus disease 2019 (COVID-19) are at an increased risk of devastating complications. Hypothesis: We hypothesize that morbid obesity is independently associated with increased risk of in-hospital mortality, upgrade to intensive care unit, invasive mechanical ventilation(IVM), and acute renal failure necessitating dialysis. Methods: A retrospective cohort study was performed to determine the association of basal metabolic index (BMI) with the above-mentioned outcomes. Independent t-test and multivariate logistic regression analysis were performed to calculate mean differences and adjusted odds ratios (aOR) with its 95% confidence interval (CI), respectively. Results: A total of 176 patients with confirmed COVID-19 diagnosis were included. The mean age was 62.2 years, with 51% of male patients. The mean BMI for non-surviving patients was significantly higher compared to patients surviving on the 7th day of hospitalization (35 vs. 30 kg/m2, p=0.022) and patients with a higher BMI had higher in-hospital mortality (21% vs. 9%, OR 3.2, 95% CI 1.3-8.2, p=0.01) compared to patients with a normal BMI. Similarly, patients requiring IMV had a higher BMI (33 vs. 29, p=0.002) compared to non-intubated patients. aOR of patients needing IMV (56% vs. 28%, OR 3.3, 95% CI 1.6-7.0, p=0.002) and upgrade to ICU (46% vs. 28%, OR 2.2, 1.07-4.6, p=0.04) were significantly higher compared to patients with a lower BMI. There was no significant difference between the two groups in terms of the need for dialysis (5% vs. 13%, OR 3.8, 13% vs. 4%, 1.1-14.1, p=0.07). Adjusted odds ratios controlled for baseline comorbidities and medications mirrored the overall results, except for the need to upgrade to ICU. Conclusions: In patients with confirmed COVID-19, morbid obesity serves as an independent risk factor of high in-hospital mortality and the need for invasive mechanical ventilation.

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The Shortest Confidence Interval for the Mean of a Normal Distribution

International Journal of Statistics and Probability ◽

10.5539/ijsp.v7n2p33 ◽

2018 ◽

Vol 7 (2) ◽

pp. 33

Author(s):

Traoré Boubakar ◽

Diabaté Lassina ◽

Touré Belco ◽

Fané Abdou

Keyword(s):

Confidence Interval ◽

Normal Distribution ◽

Confidence Intervals ◽

Mathematical Statistics ◽

Standard Normal Distribution ◽

Pivotal Quantity ◽

Construction Technique ◽

Standard Normal ◽

The Mean ◽

Shortest Confidence Intervals

An interesting topic in mathematical statistics is that of the construction of the confidence intervals. Two kinds of intervals which are both based on the method of pivotal quantity are the shortest confidence interval and the equal tail confidence intervals. The aim of this paper is to clarify and comment on the finding of such intervals and to investigation the relation between the two kinds of intervals. In particular, we will give a construction technique of the shortest confidence intervals for the mean of the standard normal distribution. Examples illustrating the use of this technique are given.

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Analysis of smile esthetics in American Board of Orthodontic patients

The Angle Orthodontist ◽

10.2319/072813-562.1 ◽

2013 ◽

Vol 84 (3) ◽

pp. 486-491 ◽

Cited By ~ 9

Author(s):

Sercan Akyalcin ◽

Leslie K. Frels ◽

Jeryl D. English ◽

Stephen Laman

Keyword(s):

Stepwise Regression ◽

Positive Association ◽

Inclusion Criteria ◽

Significant Difference ◽

Standard Deviation Range ◽

Orthodontic Patients ◽

The Common ◽

The Mean ◽

General Dentists ◽

Smile Esthetics

ABSTRACT Objective: To investigate the common denominators of an esthetically pleasing smile in patients who were considered to be successfully treated upon the submission to American Board Orthodontics (ABO) clinical examination. Material and Methods: A total of 462 patients were examined. Ninety subjects that fulfilled the inclusion criteria were included. Standardized digital smile photographs of the subjects were rated by 30 panel members, including orthodontists, general dentists, and parents of orthodontic patients, using a numeric version of the visual analog scale. Three groups were formed using the mean esthetic score ± standard deviation range: unattractive (n = 21), average (n = 47), and attractive (n = 22) smiles. Eleven smile characteristics were digitally measured on the photographs and compared between the groups using one-way analysis of variance and χ2 tests. Additionally, regression analyses were used to investigate the association of the smile characteristics with the esthetic score. Results: A significant difference was found between the three groups for the comparison of smile arc relationship (P < .001). When all the variables used in this study were entered in the regression analysis, a positive association was found (r = 0.658; r2 = 0.434; P < .001). Additionally, two models were defined using stepwise regression. The first model included the smile arc (r = 0.478; r2 = 0.228; P < .001), and the second model had both the smile arc and right gingival display/visible dentition display ratio (r = 0.567; r2 = 0.321; P < .001). Conclusions: A harmonious smile arc relationship and less gingival display during a smile are significantly associated with smile attractiveness in patients considered successfully treated according to ABO standards.

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Explorations in statistics: confidence intervals

AJP Advances in Physiology Education ◽

10.1152/advan.00006.2009 ◽

2009 ◽

Vol 33 (2) ◽

pp. 87-90 ◽

Cited By ~ 43

Author(s):

Douglas Curran-Everett

Keyword(s):

Confidence Interval ◽

Confidence Intervals ◽

Hypothesis Test ◽

Statistical Information ◽

Experimental Result ◽

P Value ◽

Population Parameter ◽

True Value ◽

Level Of Confidence ◽

The Mean

Learning about statistics is a lot like learning about science: the learning is more meaningful if you can actively explore. This third installment of Explorations in Statistics investigates confidence intervals. A confidence interval is a range that we expect, with some level of confidence, to include the true value of a population parameter such as the mean. A confidence interval provides the same statistical information as the P value from a hypothesis test, but it circumvents the drawbacks of that hypothesis test. Even more important, a confidence interval focuses our attention on the scientific importance of some experimental result.

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Influence of Varieties and Seasons upon the Mineral Nutrient Levels, of Coffee Leaves from Puerto Rico

The Journal of Agriculture of the University of Puerto Rico ◽

10.46429/jaupr.v53i3.11156 ◽

1969 ◽

Vol 53 (3) ◽

pp. 177-186 ◽

Cited By ~ 1

Author(s):

Juan A. Bonnet

Keyword(s):

Acid Soil ◽

Late Summer ◽

Mineral Nutrient ◽

Late Winter ◽

Yield Data ◽

Significant Difference ◽

Young Leaves ◽

The Mean ◽

Mean Differences ◽

Leaf Composition

Twenty-six young coffee trees grown under shade in an acid upland soil of 2 farms were selected representing 3 varieties and 2 yield-groups. The yield data were recorded for the crop harvested in the fall of 1962 from 15 highyielding and 11 low-yielding trees. Young leaves from each tree were sampled in the late summer of 1961 and in the late winter of 1962. The following 10 essential plant nutrients were determined: N, P, K, Ca, Mg, Mn, Fe, B, Zn, and Cu; as well as 2 nonessential elements, Na and Al. The yield and leaf-composition data were analyzed statistically. The high-yielding trees produced 2.6 times as much coffee as the lowyielding ones, a highly significant difference. There was no significant difference between the mean yields of the varieties. "Highly significant" or "significant" mean differences were obtained in all the essential nutrients except zinc, in the coffee leaves, between varieties; in the nutrients: N, P, K, Ca, Mg, and B, between seasons; and only in Ca and Mg between yield-groups. The acid soil, Alonso clay, is high in exchangeable manganese and in aluminum; the coffee trees used here also contained high Mn and Al in their leaves.

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EMERGENCY LAPAROTOMIES UNDER SPINAL ANESTHESIA: A RETROSPECTIVE, FACILITY BASED OBSERVATIONAL STUDY, IN KABUL, AFGHANISTAN

International Journal of Advanced Research ◽

10.21474/ijar01/13072 ◽

2021 ◽

Vol 9 (06) ◽

pp. 751-756

Author(s):

Wais Farda ◽

◽

Ahmad Bashir Nawazish ◽

Keyword(s):

Length Of Stay ◽

Observational Study ◽

General Anesthesia ◽

Spinal Anesthesia ◽

Average Length ◽

Emergency Laparotomy ◽

Complication Rates ◽

Abdominal Incision ◽

Significant Difference ◽

The Mean

Background: Laparotomy is most commonly performed under general anesthesia, but spinal anesthesia (SA) is considered an alternative to in the context of limited resources. The safety and efficacy of using SA as substitute for general anesthesia(GA) has not been explored in Afghanistan. Methodology: We conductedan observational study in the general surgery department of Isteqlal hospital in Kabul, Afghanistan on 196 adult patients undergoing emergency laparotomy under spinal anesthesia betweenApril 2018-April 2020. Results: The mean age of patients was 41.5 years (SD=19.4), the ratio of males to females was 1.9:1 and almost half (44.4%) had comorbidities. 21% were classified as ASA grade III and IV with a similar pattern among males and females. A total of 11 (5.6%) cases were converted to GA. Conversion pattern to GA was similar amongmales and females(P=0.71), ASA grade (P=0.432) and age group (P=0.642). The mean length of stay after operation was 6.5 days (SD=4.1). 32 (16.3%) patients suffered SA complications with no significant difference in terms of sex (P=0.134). Hypotension and headache accounted for 97% of complications. Complication rates were similar in terms of intervertebral level (P=0.349), type of abdominal incision (P>0.1) and average length of stay (P=0.156). 18 patients (9.2%) died due to MOF, sepsis, respiratory failure, thromboembolism and cardiogenic shock. Conclusion: Spinal anesthesia is considered a safe and effective anesthesia for emergency laparotomies, even for those with comorbidities. Based on our findings we would recommend spinal anesthesia as an alternative to general anesthesiain emergency laparotomy in Afghanistan.

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