scholarly journals A Comparative Crossover Randomized Study of Miller and Macintosh Blade for Laryngoscopic View and Ease of Intubating Conditions in Adults

2021 ◽  
Author(s):  
Kadirehally Bheemanna Nalini ◽  
Anupama Gopal ◽  
Sadasivan Shankar Iyer ◽  
Nagaraj Mungasuvalli Chanappa
Keyword(s):  
Statistical Analysis ◽  
General Anaesthesia ◽  
Adult Population ◽  
Randomized Study ◽  
Paediatric Population ◽  
P Value ◽  
Laryngoscopic View ◽  
P Values ◽  
Intubating Conditions ◽  
Laryngoscope Blades

Background: Although several types of laryngoscope blades of different sizes and shapes are present, Miller (MIL) blade is the most preferable blade among paediatric population. However, there is dearth in the literature regarding the use of these blades in the adult population. This study aimed to compare the laryngoscopic view and ease of intubation using MIL and Macintosh (MAC) blade among adults. Methods: A total of 172 patients who were >18 years age, with ASA grades I and II, undergoing elective surgeries with general anaesthesia were included. Patients were distributed in two groups (MAC/MIL and MIL/MAC), where laryngoscopy was first done with MAC blade, followed by MIL blade in the MAC/MIL group and vice-versa in the MIL/MAC group. Grading of laryngoscopic views, number of attempts, ease of intubation and use of backward, upward, rightward pressure (BURP) were noted. R v 3.6.0 was used for statistical analysis and P values≤0.05 were considered as statistically significant. Results: MIL blade showed better laryngoscopic view compared to MAC blade (32.6% vs. 15.1%; P< 0.002). BURP application helped improve the laryngoscopic views with MAC blade. Intubation with MIL blade was easier with regards to ease of intubation and number of attempts 19 (P value<0.05). Conclusion: Glottis visualization is better with the MIL blade as compared to the MAC blade. Therefore, the MIL blade might be helpful in securing the airway among adult patients.

Comparative study of inj. Rocuronium with priming dose and inj. Rocuronium without priming with respect to onset, time of intubation and intubating conditions in patients undergoing general anaesthesia

2021 ◽  
Vol 19 (2) ◽  
pp. 39-43
Author(s):  
Sachin Swami ◽  
Keyword(s):  
General Anaesthesia ◽  
Randomized Study ◽  
Age Groups ◽  
Onset Time ◽  
Control Group ◽  
P Value ◽  
Priming Dose ◽  
Intubating Conditions ◽  
Significant Difference ◽  
The Difference

Background: Rocuronium is fastest among non-depolarizing muscle relaxants ,but still it produces appropriate intubating conditions comparable to succinylcholine, in >90 seconds on administering 2 × ED95 dose as a bolus dose. In present study we compared the effect of inj. Rocuronium with priming dose and inj. Rocuronium without priming on intubating conditions and onset time of intubation with respect to rocuronium as bolus. Material and Methods: Present study was single-center, prospective, randomized study, conducted in patients of age groups from 18-60 years of either sex , 40-60 kgs weight, ASA grades I and II, undergoing surgeries under general anaesthesia and given valid written consent for participation. The patients were randomly allocated into 2 groups of 30 patients each as Group C (control group) and Group P (priming group). Results: Overall, 60 patients were studied in age group of 18 to 60 years, 30 patients in each group C and group P. we compared mean age, weight, gender and ASA grade between group C and group P and difference was statistically not significant (p value >0.05). We compared mean HR, mean MAP and mean SPO2 preoperatively baseline, at induction, at intubation, mean HR at 1 minute after intubation and mean HR at 5 minute after intubation between group C and group P, the difference between two groups was statistically insignificant. (P value >.05) In group C, out of 30 patients ,17 patients were having score 9 while 12 patients were having score 8, while 1 patient had score 7 which was comparable with the group P in which out of 30 patients ,18 were having score 9,while 11 patients were having score 8 and 1 patient was of score 7,so in both groups most of the patients (96.67% in each group) had excellent intubating condition, and the groups were comparable as statistically no significant difference was noted. In group C mean Onset Time of Intubation was 92.33± 6.26 seconds, while in group P it was 56± 6.75 seconds, so the difference between the groups on the basis of OTI was statistically highly significant. (P value 0.0001) Conclusion: Rocuronium with priming would be an excellent alternative to succinylcholine, whenever fast induction will be needed. Intubating conditions were good to excellent and comparable in both rocuronium with priming and without priming. NMT monitoring is a useful tool for indicating the clinically acceptable paralysis.

scholarly journals Objective Evaluation of the Difficulty of Endotracheal Intubation. A Comparative Study of Two Different Laryngoscope Blades

1997 ◽  
Vol 25 (6) ◽  
pp. 655-658 ◽  
Author(s):  
E. Papageorgiou ◽  
K. Kokkinis ◽  
P. Goumas ◽  
G. Mochloulis ◽  
C. Alexopoulos
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Statistical Analysis ◽  
Comparative Study ◽  
Light Beam ◽  
General Anaesthesia ◽  
Endotracheal Intubation ◽  
Objective Evaluation ◽  
Laryngoscope Blade ◽  
Laryngoscope Blades

A method for objective evaluation of the difficulty of endotracheal intubation is described. Our data indicate that the angle formed by the light-beam axis of the laryngoscope blade and the laryngotracheal axis, which we call “angle ϕ”, is analogous to the degree of difficulty of endotracheal intubation. Using this method, we compared the effectiveness of a standard Macintosh and a modified bevelled Macintosh blade in 27 tracheostomized Intensive Care Unit patients under general anaesthesia. Statistical analysis of our results indicate that the bevelled blade significantly facilitates endotracheal intubation.

scholarly journals Diphtheria serology in adults in Central Java and East Java, Indonesia: the importance of continuous diphtheria vaccination

2021 ◽  
Vol 21 (3) ◽  
pp. 1148-1154
Author(s):  
Sunarno ◽  
Febriyani Asri ◽  
Subangkit ◽  
Mursinah ◽  
Herna ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Immune Status ◽  
Geometric Mean ◽  
P Value ◽  
Cytotoxicity Test ◽  
Geometric Mean Titer ◽  
P Values ◽  
Central Java ◽  
The Status ◽  
The Relationship

Background: Vaccination increase immunity against diphtheria, yet will decrease by aging. Therefore, boosters are needed to be done regularly. Objectives: This study aims to determine the immunity to diphtheria for the population of 16 years old and above. Methods: The sample of study were 295 collected blood serums by Riskesdas project in 2013, the criteria was above 15 years of age and originating from the Provinces of Central Java or East Java inclusively. Immunity assessment was based on antibody titer (IgG) against diphtheria using Vero Cell cytotoxicity test. Statistical analysis was performed using the X2 test. Results: The full protective IgG titer (>0.1 IU/ml) at the age of 16-20 years included 75% sample with a geometric mean titer (GMT) of 0.19 IU/ml. Yet, at the age of 21-60 years and > 60 years, full protective IgG titers only cover 45.5% and 33.3% sample with GMT respectively 0.06 IU / ml. Statistical analysis showed the relationship between age and immune status with p-value 0.003. Otherwise, no relationship between the status of immunity with sex and residency with p-values of 0.16 and 0.43. Conclusions: The immune status against diphtheria at the age of above 15 years decreases with aging. Keywords: Adult; diphtheria; Indonesia; serology.

scholarly journals Relatioship of Some Biochemical Variance with Hepatitis Patients

2018 ◽  
Vol 26 (4) ◽  
pp. 204-212
Author(s):  
Abdulhussien Mahdi Aljebory ◽  
Abdulhussien Mahdi Aljebory
Keyword(s):  
Chronic Hepatitis ◽  
Liver Disease ◽  
Statistical Analysis ◽  
Total Protein ◽  
Viral Disease ◽  
Wide Distribution ◽  
P Value ◽  
P Values ◽  
Male And Female ◽  
Male Patients

Hepatitis is a viral disease; it has a wide distribution among peoples in different countries' and it has more than five common types named; A, B, C, D and E. The serum level of total protein, albumin and ferritin was estimated in patients with chronic hepatitis B and C, in male and female aged from 19 – 50 years; at the same time same variance was measured in apparently normal healthy volunteers. A patient with other liver disease was excluded from this search.       The average values for total protein, albumin,and ferritin for normal volunteers are (5.33, 4.724 and 51.485 g/ dl) respectively for male and 5.342, 4.733 and 51.667 g/ dl in thefemale. While its value in HBV was (3.399, 2.878 and 77.909 g/dl) for male and 3.429, 3.092 and 137.091g/dl in female respectively. While in HCV, the value for total protein, albumin and ferritin was (4.045, 3.462 and 151.182 g/dl) respectively in male and 3.838, 3.391 and 68.167 respectively in thefemale. Using statistical analysis, the results indicate that there is a significant value for all variances when compared with the control in both cases B and C. The p-value was highly significant its value in HBV male patients is 6.4E-19, 5.11E-17 and 1.96E-12 for total protein, albumin and ferritin respectively and 1.6E-18, 2.03E-15 and 3.65E-24 for female. While in type HCV male patients the p- values were 8.01E-10, 1.9E-10 and 5.13E-17 for total protein, albumin and ferritin respectively, in female the values are 1.79E-16, 3.36E-12 and 1.78E-05 respectively.The results indicate also a positive correlation between all of the variance in the two types of patients

scholarly journals SAT0210 FACTORS ASSOCIATED WITH TIME TO SEVERE LUPUS NEPHRITIS IN A COHORT OF COLOMBIAN PATIENTS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1048.2-1048
Author(s):  
S. Herrera ◽  
J. C. Diaz-Coronado ◽  
D. Rojas-Gualdrón ◽  
L. Betancur-Vasquez ◽  
D. Gonzalez-Hurtado ◽  
...  
Keyword(s):  
Lupus Nephritis ◽  
Renal Involvement ◽  
Classification Criteria ◽  
P Value ◽  
Systemic Lupus ◽  
P Values ◽  
Interval Censored ◽  
Severe Lupus Nephritis ◽  
Age And Sex

Background:Systemic lupus erythematosus (SLE) clinical manifestations, and their severity, vary according to age, ethnicity and socioeconomic status. Both Hispanic and Afro-Americans have a higher incidence and more sever presentation when compared to Caucasian patients with SLEObjectives:To analyze clinical and immunological characteristics associated with time to severe renal involvement in patients with Systemic Lupus Erythematous in a Colombian cohort followed for one year, between January 2015 and December 2018Methods:Retrospective follow-up study based in clinical records. Patients with SLE diagnosis that fulfilled either 1987 American College of Rheumatology Classification Criteria for SLE or 2011 Systemic Lupus International Collaborating Clinics (SLICC) classification criteria for SLE. We included patients with diagnosis of lupus nephritis according to Wallace and Dubois criteria. Patients who did not have at least two follow-up measurements or had a cause of nephritis other than lupus were excluded. The main outcome was defined as time from diagnosis to sever renal involvement defined as creatinine clearance ≤50 ml/min, 24-hour proteinuria ≥3.5 grams o end stage renal disease.We analyzed clinical and immunological characteristics. Descriptive statistical analyses of participant data during the first evaluation are reported as frequencies and percentages for categorical variables, and as medians and interquartile ranges (IQR) for quantitative variables. Age and sex adjusted survival functions and Hazard ratios (HR) with 95% confidence intervals and p-values were estimated using parametric Weibull models por interval-censored data. P values < 0.05 were considered statistically significantResults:548 patients were analyzed: 67 were left-censored as they presented renal involvement at entry, 6 were interval censored as outcome occurred between study visits, and 475 were right-censored as involvement was not registered during follow-up. 529 (96.5%) patients were female, median age at entry was 46 (IQR = 23) and median age to diagnosis was 29.5 (IQR = 20.6). 67% were mestizo, 13% Caucasian and 0.3% Afro-Colombian. Age and sex adjusted variables associated with time to severe lupus nephritis were high blood pressure HR = 3.5 (95%CI 2.2-5.6; p-value <0.001) and Anti-RO (per unit increase) HR = 1.002 (95%CI 1.001-1.004; p-value = 0.04). Figure 1 shows age and sex adjusted survival function.Conclusion:In our cohort the appearance of severe lupus nephritis occurs in less than 15% of patients at 10 years. Both high blood pressure and elevated anti-Ro titers were associated with a higher rate of onset in the presentation of severe lupus nephritis, as seen in some polymorphs of anti Ro.References:Disclosure of Interests:Sebastian Herrera Speakers bureau: academic conference, Juan camilo Diaz-Coronado: None declared, Diego Rojas-Gualdrón: None declared, Laura Betancur-Vasquez: None declared, Daniel Gonzalez-Hurtado: None declared, Juanita Gonzalez-Arango: None declared, laura Uribe-Arango: None declared, Maria Fernanda Saavedra Chacón: None declared, Jorge Lacouture-Fierro: None declared, Santiago Monsalve: None declared, Sebastian Guerra-Zarama: None declared, Juan david Lopez: None declared, Juan david Serna: None declared, Julian Barbosa: None declared, Ana Sierra: None declared, Deicy Hernandez-Parra: None declared, Ricardo Pineda.Tamayo: None declared

scholarly journals Obesity, Blood Pressure, and Intraocular Pressure: A Cross-Sectional Study in Italian Children

Obesity Facts ◽  
2021 ◽  
pp. 1-9
Author(s):  
Claudia Pileggi ◽  
Rosa Papadopoli ◽  
Caterina De Sarro ◽  
Carmelo Giuseppe Angelo Nobile ◽  
Maria Pavia
Keyword(s):  
Blood Pressure ◽  
Intraocular Pressure ◽  
School Children ◽  
Adult Population ◽  
Paediatric Population ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Drinking Habits ◽  
Physical Examinations ◽  
Italian Children

<b><i>Introduction:</i></b> Several studies in the adult population have shown that obesity is an independent risk factor for elevated intraocular pressure (IOP), whereas data in the paediatric population are sparse and controversial. The purpose of the present study is to investigate the relationship between body mass index (BMI), blood pressure (BP), and IOP in healthy school children. <b><i>Methods:</i></b> The survey was conducted among a random sample of 8-year-old Italian students. Data were collected on their health status and behaviours related to obesity (physical activity, food and drinking habits, etc.). Physical examinations, conducted at school, included measurements of height, weight, BP, and IOP. <b><i>Results:</i></b> Five hundred and seventy-six subjects were recruited (92.8% response rate); 42.4% were overweight or obese, 58.9% consumed inadequate daily servings of fruit and vegetables, and 87.5% were involved in sedentary activities. Elevated BP/hypertension (HTN) affected 3.6% and high IOP was revealed in 12.5% of the children. In the multivariate analysis, elevated BP/HTN was the only significant determinant of ocular HTN (OR 5.36, 95% CI 1.95–14.73, <i>p</i> = 0.001). <b><i>Conclusions:</i></b> Our results show that high IOP affects 12.5% of 8-year-old school children and appears to be associated with high BP related to a high BMI.

scholarly journals McGrath Video Laryngoscope May Take a Longer Intubation Time Than Macintosh Laryngoscope

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Prerana N. Shah ◽  
Kaveri Das
Keyword(s):  
Randomized Study ◽  
Macintosh Laryngoscope ◽  
Total Duration ◽  
Video Laryngoscope ◽  
Intubation Time ◽  
Laryngoscopic View ◽  
Lehane Grade ◽  
Secondary Endpoints ◽  
Grade Ii ◽  
Grade Iii

Background. Video laryngoscopes provide better view and can improve ease of intubation compared with standard laryngoscopes. Methods. A prospective randomized study was done on 60 patients, 18 to 65 years old, comparing McGrath video laryngoscope and Macintosh laryngoscope. The aim was to compare the ease, efficacy, and usability of them during routine airway management. The primary endpoint was duration of intubation and the secondary endpoints were Cormack and Lehane grade of laryngoscopic view, number of intubation attempts, and incidence of complications. Results. There was an increase in total duration of intubation with McGrath video laryngoscope with 42.9 ± 19.5 seconds compared to Macintosh laryngoscope with 17.9 ± 4.6 seconds. In Macintosh group, 73.3% had grade I, 20% had grade II, and 6.7% had grade III Cormack Lehane view, while in McGrath group, 83.3% had grade I, 13.3% had grade II, and 3.3% had grade III. In McGrath group, 6 patients (20%) required more than 120 seconds to get intubated and only 73.3% were intubated in 1 attempt, while patients in Macintosh group had 100% successful intubation in 1 attempt. Pharyngeal trauma was seen with McGrath videolaryngoscopy. Conclusion. Duration of laryngoscopy, intubation, and total duration of intubation were significantly higher in McGrath group than in Macintosh group. McGrath group required a higher number of intubation attempts.

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