Comparison of Nasopharyngeal Airway Device and Nasal Oxygen Tube in Obese Patients Undergoing Intravenous Anesthesia for Gastroscopy: A Prospective and Randomized Study

Objective. This prospective and randomized study evaluated the efficacy and safety of the nasopharyngeal airway relative to the nasal oxygen tube in obese patients undergoing painless gastroscopy.Materials and Methods. Obese patients (BMI≥28 kg/m2;n=260) were randomly and equally apportioned to the nasopharyngeal airway (Group A) or nasal oxygen tube (Group B) group. Three patients were excluded due to failure of insertion of the nasopharyngeal airway. The duration of endoscopy, anesthetic dose, recovery time, and adverse events were recorded. The satisfaction of the anesthetist, physicians, and patient was scored.Results. The SpO2reduction was significantly less in Group A than in Group B. Use of a respirator for assisted ventilation occurred significantly less in Group A. The groups were similar regarding mean arterial pressure, heart rate, anesthetic dose, duration of gastroscopy, recovery time, and adverse events. Satisfaction of the physician and anesthetist was greater in Group A; the groups were similar in patient satisfaction.Conclusions. Use of the nasopharyngeal airway for obese patients during painless gastroscopy resulted in less SpO2reduction relative to the nasal oxygen tube. Altogether, it is a safe and effective device for obese patients undergoing painless gastroscopy.

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Observation of the clinical efficacy of dexmedetomidine in flexible bronchoscopy under general anesthesia: clinical case experience exchange

Journal of International Medical Research ◽

10.1177/0300060519880763 ◽

2019 ◽

Vol 47 (12) ◽

pp. 6215-6222 ◽

Cited By ~ 2

Author(s):

Hongtu Li ◽

Na Zhang ◽

Ke Zhang ◽

Yanhua Wei

Keyword(s):

Heart Rate ◽

Mean Arterial Pressure ◽

Adverse Events ◽

Arterial Pressure ◽

General Anesthesia ◽

Recovery Time ◽

Flexible Bronchoscopy ◽

Stress Indices ◽

Group A ◽

Group B

Object To investigate the clinical efficacy and safety of dexmedetomidine in flexible bronchoscopy under general anesthesia. Methods A total of 114 patients were randomly divided into intervention group A and control group B. Group A received dexmedetomidine, fentanyl, and propofol as anesthesia, while Group B received fentanyl and propofol only. Changes in heart rate, mean arterial pressure, pulse oxygen saturation, stress indices (blood cortisol, adrenaline, and norepinephrine levels), incidence of adverse events, anesthesia dose, duration of procedure, and recovery time were compared between the groups at specific time points T0, T1, and T2 during bronchoscopy. Results There was no statistical difference between the groups at T0. At T1 and T2, pulse oxygen saturation, mean arterial pressure, heart rate, and stress indices in group A were significantly more favorable than those in group B. The incidence of adverse events (5.26%) in group A was significantly lower than that in group B (17.54%), and patients in group A required less propofol and had a faster recovery time than patients in group B. Conclusion Dexmedetomidine use in flexible bronchoscopy under general anesthesia is safe and effective and decreases the stress response in synergy with propofol to provide hemodynamic stability.

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Use of Nanotechnology-Designed Footsock in the Management of Preulcerative Conditions in the Diabetic Foot: Results of a Single, Blind Randomized Study

The International Journal of Lower Extremity Wounds ◽

10.1177/1534734608318138 ◽

2008 ◽

Vol 7 (2) ◽

pp. 82-87 ◽

Cited By ~ 9

Author(s):

Banchellini Elisa ◽

Macchiarini Silvia ◽

Dini Valentina ◽

Rizzo Loredana ◽

Tedeschi Anna ◽

...

Keyword(s):

Treatment Group ◽

Adverse Events ◽

Water Loss ◽

Diabetic Foot ◽

Randomized Study ◽

Clinical Score ◽

Transepidermal Water Loss ◽

Group A ◽

Group B ◽

Single Blind

The Difoprev system constituted by a sock loaded with nanocapsules containing a hydrating agent in the diabetic foot is tested. A total of 30 neuropathic outpatients with foot anhydrosis were randomized into group A, treated with the application of the sock with the nanocapsules, and group B wearing only the socks without the nanocapsules. Patients were blindly evaluated with a clinical score, hygrometry, transepidermal water loss, skin temperature, and skin hardness at baseline and after 6 weeks. No difference between the groups emerged at baseline. Although group B showed no changes at the end of the treatment, group A significantly ( P < .05) improved in all the parameters evaluated. No adverse events were recorded in both groups during the study. The use of hydrating agents carried by nanocapsules-loaded socks is safe and effective for the neuropathic diabetic foot.

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Comparison between endoscope assisted powered and conventional adenoidectomy

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20205619 ◽

2020 ◽

Vol 7 (1) ◽

pp. 50

Author(s):

Dimple Sahni ◽

Gurleen Kaur ◽

Sanjeev Bhagat ◽

Parvinder Singh ◽

Peeyush Verma ◽

...

Keyword(s):

Random Sampling ◽

Recovery Time ◽

Operative Time ◽

Randomized Study ◽

Intraoperative Blood Loss ◽

Systematic Random Sampling ◽

Medical College ◽

Significant Difference ◽

Group A ◽

Group B

Background: Adenoidectomy is one of the commonest operations done on children. It is conventionally performed using the curettage method. This present study was done to compare the results of endoscopic powered adenoidectomy and conventional adenoidectomy.Methods: The present prospective randomized study was conducted among 50 patients between 4-16 years of age requiring adenoidectomy with or without tonsillectomy in department of ENT in Government Medical College and Rajindra Hospital, Patiala. All the 50 patients were divided into two groups (group A and group B) by systematic random sampling. Group A consisted of 25 patients who underwent conventional curettage adenoidectomy and group B consisted of 25 patients who underwent Microdebrider-Assisted Adenoidectomy. Results: In group A and B, mean±SD intraoperative blood loss (in ml) was 20.60±7.96 and 30.60±7.96 respectively. Mean±SD operative time (in minutes) was 28.60±4.71 in group A, while in group B it was 39.60±4.71 with statistically significant difference. Complete adenoid removal was found in 52% of the subjects in group A while it was found in 96% of the subjects in group B with statistically significant difference. In group A, mean±SD recovery time (in hrs) observed was 33.52±10.58 while in group B, recovery time (in hours) observed was 36.22±11.31.Conclusions: Based on the results of this study, it can be concluded that the new method of microdebrider assisted powered adenoidectomy was found to be safer and more useful tool for adenoidectomy than conventional method.

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Sedation for ERCP - Comparison Between Ketamine Diazepam Combination with Propofol Fntanyl Combination

Journal of the Bangladesh Society of Anaesthesiologists ◽

10.3329/jbsa.v20i2.3990 ◽

2009 ◽

Vol 20 (2) ◽

pp. 45-50 ◽

Cited By ~ 1

Author(s):

Iqbal Hossain Chowdhury ◽

Abdullah Al Maruf ◽

Kazi Ashkar Lateef ◽

Sayeed Mahmud Ali Reza ◽

M Abdul Hye

Keyword(s):

Body Weight ◽

Cost Effectiveness ◽

Recovery Time ◽

Randomized Study ◽

Cost Effective ◽

Physical Status ◽

Endoscopic Retrograde ◽

Group A ◽

Group B ◽

Sedation Regimen

For Endoscopic Retrograde Cholangio-pancreatography, an anaesthesiologist usually administers sedation to patient and search for more suitable regimen continues. This prospective randomized study was carried out to compare the efficacy, safety, tolerability and cost effectiveness of ketamine, diazepam combination to propofol, fentanyl combination for sedation during ERCP. One hundred and fifty patients of both sex, age between 18 to 70 years, ASA physical status I and II scheduled to undergo ERCP were included in this study. Patients were randomly allocated into two groups. Group A (n=75) sedated with ketamine 1.5mg/Kg body weight and diazepam 5-10 mg intravenously. Group B (n=75) sedated with propofol 1mg/Kg body weight and fentanyl 1μg/Kg body weight intravenously and intravenous infusion of propofol maintained at 50μg/Kg body weight/min throughout procedure. Both groups showed satisfactory sedating condition for ERCP. Incidences of hypertension and tachycardia were more in group A than group B and differences between two groups were statistically significant (P< 0.01). Agitation and nightmares were found in 10 (13.33%) patients in group A. Mean recovery time was more in group A than group B and difference between two groups was statistically highly significant (P<0.001). Sedation regimen of group B found 7 times more costly than group A. Both regimens found safe, effective, and tolerable for ERCP. However, recovery time is more with ketamine, diazepam but it found more cost effective than propofol fentanyl that is a concern in developing country like Bangladesh. Key Words: Endoscopic Retrograde Cholangiopancreatography (ERCP), Sedation, Ketamine, Diazepam, Propofol, Fentanyl, Intravenous. Journal of BSA, Vol. 20, No. 2, July 2007 p.45-50

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COMPARISON OF ENDOTRACHEAL INTUBATION VERSUS SUPRAGLOTTIC AIRWAY DEVICE IN PATIENTS UNDERGOING CORNEAL TRANSPLANTATION UNDER GENERAL ANAESTHESIA

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i4.4066 ◽

2021 ◽

Vol 71 (4) ◽

pp. 1420-24

Author(s):

Sana Abbas ◽

Omar Zafar ◽

Beenish Abbas ◽

Basit Mehmood ◽

Umer Hayat ◽

...

Keyword(s):

General Anaesthesia ◽

Endotracheal Intubation ◽

Recovery Time ◽

Penetrating Keratoplasty ◽

Corneal Transplantation ◽

Airway Device ◽

Supraglottic Airway ◽

Number Of Patients ◽

Group A ◽

Group B

Objective: To compare endotracheal intubation versus Suraglottic airway device in patients undergoing penetrating keratoplasty under general anaesthesia. Study Design: Quasi-experimental study. Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi, from Jan 2018 to Mar 2020. Methodology: Total 28 patients enrolled with a mean age of 42.82 ± 7.86 years and age-range of 18-55 belonging to American Society of Anesthesiology I, II & III undergoing penetrating keratoplasty under general anaesthesia. The airway was secured with I–Gel and Endotracheal tube in group A (n=14) and group B (n=14) respectively. Pre anaesthesia assessment along with informed written consent performed. General Anesthesia is given and patients monitored as per standard protocols. Postextubation incidence of cough, sore throat, bronchospasm, stridor and blood on device recorded in addition to surgery and recovery duration. Results: Twenty-eight patients were enrolled in the study with a mean age of 42.82 ± 7.86 years. There were 9 (32.1%) females and 19 (67.9%) males in the study group. The recovery time was significantly lower for group A as compared to group B (72.64 ± 5.06 vs 80.43 ± 3.75, p<0.001). Similarly, a significantly lesser number of patients experienced post-extubation complications i.e. cough, among group A as compared to Group B [1 (7.1%) vs 8 (57.1%) p0.005]. Conclusion: I-Gel provides smooth recovery with reduced mean recovery time and decreased potential of raised intraocular pressure, when compared with endotracheal intubation in patients undergoing penetrating keratoplasty under general anaesthesia.

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Effects of Full Inhalation of Sevoflurane and Total Intravenous Anesthesia on Hemodynamics, Serum Myocardial Enzymes, and Myocardial Markers in Elderly Patients Undergoing Hysterectomy

BioMed Research International ◽

10.1155/2021/9983988 ◽

2021 ◽

Vol 2021 ◽

pp. 1-5

Author(s):

Xing Lan ◽

Dong Yang ◽

Shengnan Xie ◽

Zhenghua Zhao

Keyword(s):

Blood Pressure ◽

Elderly Patients ◽

Recovery Time ◽

Plasma Cortisol ◽

Cortisol Concentration ◽

Intravenous Anesthesia ◽

Plasma Cortisol Concentration ◽

Group A ◽

Group B ◽

Myocardial Enzymes

Objective. To compare the effects of sevoflurane inhalation and intravenous anesthesia on hemodynamics, serum myocardial enzymes, and myocardial markers in elderly patients undergoing hysterectomy. Methods. Group A and group B were established randomly regarding a total of 126 elderly patients who underwent an elective hysterectomy. Patients in group A were given full anesthesia with sevoflurane, and patients in group B were given anesthesia with intravenous anesthesia. The operation time, anesthesia time, and recovery time in Postanesthesia Care Unit (PACU) were compared; plasma cortisol concentration, hemodynamics, serum myocardial enzymes, and myocardial markers were detected and compared between the two groups of patients before anesthesia ( T 0 ), after anesthesia ( T 1 ), and after surgery ( T 2 ). Results. Group A observed a longer extubation time and recovery time in PACU than group B ( P < 0.05 ). Results show a lower systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and plasma cortisol concentration of T 1 by comparison with those of T 0 ( P < 0.05 ), but no significant difference remains in terms of intergroup SBP, DBP, and HR ( P > 0.05 ), and there was no interaction effect of groups and time ( P > 0.05 ). The two groups showed no great disparity in the levels of lactate dehydrogenase (LDH), aspartate transaminase (AST), creatine kinase (CK), and CK-MB as a subtype of CK before surgery between the two groups of patients ( P > 0.05 ). After surgery, LDH, AST, CK, and CK-MB levels in both groups were witnessed a surge, in which group A obtained higher levels of LDH, AST, CK, and CK-MB (all P < 0.05 ). Conclusion. Total intravenous anesthesia will not increase the hemodynamic fluctuation of elderly patients undergoing hysterectomy and can reduce the damage to the myocardium of patients with surgical trauma, which can protect the myocardium of elderly patients to a certain extent, so it can be adopted as the optimal anesthesia protocol for surgery.

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Efficacy and Safety of Oral Ivermectin and Topical Permethrin in the Treatment of Scabies

TAJ Journal of Teachers Association ◽

10.3329/taj.v33i1.49824 ◽

2020 ◽

Vol 33 (1) ◽

pp. 41-47

Author(s):

Mohsena Akhter ◽

Ishrat Bhuiyan ◽

Zulfiqer Hossain Khan ◽

Mahfuza Akhter ◽

Gulam Kazem Ali Ahmad ◽

...

Keyword(s):

Skin Diseases ◽

Close Contact ◽

Randomized Study ◽

Sarcoptes Scabiei ◽

Efficacy And Safety ◽

Common Skin ◽

Group A ◽

The Mean ◽

The Difference ◽

Group B

Background: Scabies is one of the most common skin diseases in our country. It is caused by the mite Sarcoptes scabiei var hominis, which is an ecto-parasite infesting the epidermis. Scabies is highly contagious. Prevalence is high in congested or densely populated areas. Individuals with close contact with an affected person should be treated with scabicidal which is available in both oral and topical formulations. The only oral but highly effective scabicidal known to date is Ivermectin. Amongst topical preparations, Permethrin 5 % cream is the treatment of choice. Objective: To evaluate the efficacy & safety of oral Ivermectin compared to topical Permethrin in the treatment of scabies. Methodology: This prospective, non-randomized study was conducted at the out-patient department of Dermatology and Venereology of Shaheed Suhrawardy Medical College & Hospital over a period of 6 months, from August 2016 to January 2017. The study population consisted of one hundred patients having scabies, enrolled according to inclusion criteria. They were divided into two groups. group A was subjected to oral Ivermectin and the group B to Permethrin 5% cream. Patients were followed up on day 7 and 14 for assessment of efficacy and safety. Result: The mean scoring with SD in group A (Ivermectin) and group B (Permethrin) were 8.26 ± 2.22 and 7.59 ± 2.01 respectively at the time of observation. The difference between the mean score of the two group is not significant (p=0.117) the mean scoring with SD in group A and group B were 4.54 ± 2.05 and 1.64 ± 1.84 respectively at 7thdays. The difference between the mean score of the two group is significant (p<0.001). The mean scoring with SD in group A and group B were 2.68± 2.35 and .36± 1.10 respectively at 14th day difference between the mean score of the group is significant (p<0.001). Conclusion: Topical application of permethrin 5% cream is more effective and safer than oral Ivermectin in the treatment of scabies. TAJ 2020; 33(1): 41-47

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Microecological preparation combined with an modified low-carbon diet improves glucolipid metabolism and cardiovascular complication in obese patients

Diabetology & Metabolic Syndrome ◽

10.1186/s13098-021-00697-6 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Jianguo Liu ◽

Liehui Xiao ◽

Hezhongrong Nie ◽

Yong Pan ◽

Yan Liu ◽

...

Keyword(s):

Intestinal Barrier ◽

Intestinal Barrier Function ◽

Control Group ◽

Obese Patients ◽

Carotid Atherosclerotic Plaque ◽

Low Carbon ◽

Balanced Diet ◽

Group A ◽

Group B ◽

Control Group Group

Abstract Objective To investigate the impact of microecological preparation combined with modified low-carbon diet on the glucolipid metabolism and cardiovascular complication in obese patients. Methods From August 2017 to July 2020, 66 obese patients were recruited, and administrated with an modified low-carbon diet with (group A) or without (Group B) microecology preparation and a balanced diet in control group (group C) for 6 months. Meanwhile, 20 volunteers administrated with a balanced diet were recruited as the healthy control group (group D). Results After 6-month intervention, obese subjects in group A and B showed significant improvement of body and liver fat mass, reduction of serum lipid levels, intestinal barrier function markers, insulin resistance index (IRI), high blood pressure (HBP) and carotid intima thickness, as compared with subjects in group C. More importantly, subjects in group A had better improvement of vascular endothelial elasticity and intimal thickness than subjects in group B. However, these intervention had no effect on carotid atherosclerotic plaque. Conclusion Administration of microecological preparation combined with modified low-carbon diet had better improvement of intestinal barrier function, glucose and lipid metabolism, and cardiovascular complications than low-carbon diet in obese patients, but the effect of a simple low-carb diet on carotid atherosclerotic plaque need to be further addressed.

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Anterior approach levator plication for congenital ptosis, absorpable versus non absorpable sutures

European Journal of Ophthalmology ◽

10.1177/11206721211005320 ◽

2021 ◽

pp. 112067212110053

Author(s):

Moustafa Salamah ◽

Ashraf Mahrous Eid ◽

Hani Albialy ◽

Sherif Sharaf EL Deen

Keyword(s):

Randomized Study ◽

Early Postoperative Period ◽

Polyglactin 910 ◽

Exclusion Criteria ◽

Congenital Ptosis ◽

History Of ◽

Group A ◽

Group B ◽

Over Time

Purpose: To compare the efficacy of two different suture types in levator plication for correction of congenital ptosis. Subjects and methods: Prospective comparative interventional randomized study involving 42 eyes of 42 patients aged more than 6 years with congenital ptosis and good levator action. The exclusion criteria were as follows: bilateral ptosis, history of previous surgery, fair or poor levator action, and associated other ocular diseases. Patients were randomized into group A, in which double-armed 5/0 polyester Ethibond were used, and group B, in which double-armed 5/0 Coated Vicryl® (polyglactin 910) suture material we used. Outcomes including eyelid height and stability of eyelid height over time were compared with follow-up data. The MRD was 4.05 ± 0.36 mm and 3.95 ± 0.34 after 1 week for both groups A and B, respectively. At the end of study follow up period (24 weeks), the MRD was 3.60 ± 0.42 mm in group A, and 2.52 ± 0.85 mm in group B. Conclusion: No difference in eyelid height between two groups in early postoperative period, but the postoperative eyelid height was more stable over time in the 5/0 polyester Ethibond group (group A) than in the 5/0 Coated Vicryl® (polyglactin 910) group (group B).

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Management of walled-off necrosis with nasocystic irrigation with hydrogen peroxide versus biflanged metal stent: randomized controlled trial

Endoscopy International Open ◽

10.1055/a-1480-7115 ◽

2021 ◽

Vol 09 (07) ◽

pp. E1108-E1115

Author(s):

Sudhir Maharshi ◽

Shyam Sunder Sharma ◽

Sandeep Ratra ◽

Bharat Sapra ◽

Dhruv Sharma

Keyword(s):

Hydrogen Peroxide ◽

Adverse Events ◽

Clinical Success ◽

Controlled Trial ◽

Procedure Time ◽

Metal Stent ◽

Technical Success ◽

Group A ◽

Group B ◽

Walled Off Necrosis

Abstract Background and study aims Walled-off necrosis (WON) is a known complication of acute necrotizing pancreatitis (ANP). There is no study comparing nasocystic irrigation with hydrogen peroxide (H2O2) versus biflanged metal stent (BMS) in the management of WON. The aim of this study was to compare the clinical efficacy of both the treatment strategies. Patients and methods This study was conducted on patients with symptomatic WON who were randomized to nasocystic irrigation with H2O2 (Group A) and BMS placement (Group B). Primary outcomes were clinical and technical success while secondary outcomes were procedure time, adverse events, need for additional procedures, duration of hospitalization, and mortality. Results Fifty patients were randomized into two groups. Group A (n = 25, age 37.8 ± 17.6 years, 16 men) and Group B (n = 25, age 41.8 ± 15.2 years, 17 men). There were no significant differences in baseline characteristics between the two groups. The most common etiology of pancreatitis was alcohol, observed in 27 (54 %) patients. Technical success (100 % vs 96 %, P = 0.98), clinical success (84 % vs 76 %, P = 0.76), requirement of additional procedures (16 % vs 24 %, P = 0.70) and adverse events (4 vs 7, P = 0.06) were comparable in both the groups. The duration to clinical success (34.4 ± 12 vs 14.8 ± 10.8 days, P = 0.001) and procedure time (36 ± 15 vs 18 ± 12 minutes, P = 0.01) were longer in Group A compared to Group B. Conclusions Nasocystic irrigation with H2O2 and BMS are equally effective in the management of WON but time to clinical success and procedure time is longer with nasocystic irrigation.

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