scholarly journals C-MAC D-Blade vs Airtraq for Intubation with Manual Inline Axial Stabilisation- A Randomised Clinical Trial

2021 ◽  
Author(s):  
Nikitha Mani ◽  
Nagalakshmi Palanisamy ◽  
Mamie Zachariah ◽  
Sagiev Koshy George ◽  
Allen Aloysius Dsilva ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Heart Rate ◽  
Repeated Measures ◽  
Macintosh Laryngoscope ◽  
Randomised Clinical Trial ◽  
Significant Rise ◽  
P Value ◽  
Laryngoscopic View ◽  
Comparison Results ◽  
Intergroup Comparison

Introduction: One of the most important skills in anaesthesia is securing the airway with an endotracheal tube. Difficult tracheal intubation however is considered one of the major contributors of anaesthesia related morbidity and mortality. Video laryngoscopy offers several advantages during endotracheal intubation. The view of the glottis provided by Videolaryngoscopes is better compared to the Macintosh laryngoscope in difficult airways which makes it more attractive for routine difficult airway intubations. Aim: To compare the time taken for intubation between two Videolaryngoscopes, namely C-MAC D-blade and Airtraq and to assess the quality of laryngoscopy view between the two groups. Materials and Methods: This was a randomised clinical trial conducted in 116 American Society of Anesthesiologists 1 (ASA1) and ASA2 patients undergoing elective surgeries in Pondicherry Institute of Medical Sciences. Patients are randomised into two groups, Group C-MAC D-blade and Group Airtraq by computer randomisation. Statistical analysis was performed using t-test, Repeated measures of ANOVA was used to find the significance from preinduction to 10 mins period for each group and Bonferoni’s correction for intergroup comparison. Results: The time taken for intubation was comparable in two study groups (Group C-MAC D-blade 41.88 secs) and (Group Airtraq -40.78 sec) with p-value of 0.734. Laryngoscopic view was not statistically significant with p-value of 0.083. Optimisation maneuvers were required in 63.8% in Group Airtraq on comparison with 44.8% in Group C-MAC D-blade. In both Group C-MAC D-blade and Group Airtraq, there was a significant rise in the heart rate and BP at 0 minute compared to preinduction. But after 5 minutes, the heart rate and BP were back to preinduction values. Conclusion: Both the Videolaryngoscopes, C-MAC D-blade and Airtraq performed equally, with respect to time taken for intubation and laryngoscopic view. However, External Laryngeal Manipulation (ELM) was required more in Group Airtraq and was statistically significant.

scholarly journals Effect of Consuming Milk Tea with Stevia on Plaque pH among Dental Students: Cross-Over RCT

2021 ◽  
pp. 59-69
Author(s):  
CM Marya ◽  
Mandeep Kaur Sandhu ◽  
Ruchi Nagpal ◽  
Sakshi Kataria ◽  
Pratibha Taneja ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Repeated Measures ◽  
Dental Students ◽  
Controlled Clinical Trial ◽  
P Value ◽  
Artificial Sweetener ◽  
Clinical Trial Registry ◽  
Time Intervals ◽  
Plaque Ph ◽  
Intergroup Comparison

Background: Stevia is a natural, healthy, unconventional replacement to the table sugar and artificial sweetener. Phytochemicals present in it exerts an influence on the microbial flora of the mouth. Hence, study was planned to compare the effects of stevia with different sugars on the plaque pH. Methodology: The present study was carried in department of Public Health Dentistry between 9am-12pm. It was a triple blinded Crossover Randomized Controlled Clinical Trial with LSD design. All the 40 subjects were exposed to all four interventions sequentially, at weekly intervals with 1 week wash out period. (Intervention: A- Table sugar, B- Jaggery, C- Stevia, D- Milk tea without sugar). Inferential statistics was done using Repeated measures of ANOVA followed by Post hoc pairwise comparison and Three-way RMANOVA to determine relationship between SUGAR * WEEK * TIME interaction. Level of significance was set at p value at 0.05. Results: Plaque pH assessments were performed at 4 points of time intervals (at baseline, 1 min, 20min, 60 min). Overall significance differences were seen in plaque pH at different time intervals for all interventions. Intergroup comparison showed potential efficacy of stevia in maintaining plaque pH. Conclusion: In the present study, it was found that stevia has the least cariogenic potential when compared with jaggery and refined sugar. Jaggery also did not show a significant reduction in plaque pH. Therefore, Stevia and Jaggery can be compared for their anti-cariogenic properties. This study has been registered under the Clinical Trial Registry of India CTRI/2020/12/03003

scholarly journals Evaluation of Intraocular Pressure Changes with Topical Dexamethasone 0.1%, Prednisolone 1% and Difluprednate 0.05% Postcataract Surgery- A Randomised Clinical Trial

2021 ◽  
Author(s):  
Sachit Mahajan ◽  
Sanjay Kai ◽  
Sadaf Choudhary ◽  
Kiran Bala ◽  
Bhavna Sahni
Keyword(s):  
Clinical Trial ◽  
Intraocular Pressure ◽  
Cataract Surgery ◽  
Repeated Measures ◽  
Mixed Model ◽  
Statistical Significance ◽  
Randomised Clinical Trial ◽  
Significant Rise ◽  
Topical Steroids ◽  
Mixed Model Analysis

Introduction: Topical corticosteroids are most commonly used for the control of postoperative inflammation after cataract surgery. Topical steroids may cause increase in Intraocular Pressure (IOP) which, if left untreated may lead to progressive optic nerve damage and glaucomatous field defects. Aim: To compare the ocular hypertensive response of three commonly used corticosteroids in an effort to generate evidence for managing postcataract surgery inflammation more effectively. Materials and Methods: This randomised clinical trial was carried out for a period of one year from November 2018 to October 2019, among 150 patients undergoing cataract surgery. Patients were divided into three groups. Group A-50 patients received topical dexamethasone 0.1%, Group B-50 patients received topical prednisolone 1% and Group C-50 patients received topical difluprednate 0.05% four times a day for six weeks after cataract surgery. Postoperative IOP was recorded preoperatively, on first postoperative day and at the end of first week, third week and sixth week with non contact tonometer and statistical significance was assessed with the help of repeated measures mixed model Analysis of Variance (ANOVA). Results: The mean age of the patients was 64.4±9.39 years, 48% were males and 52% patients were females. Mean IOP in the three drug groups was not statistically significant at 1st week, 3rd week and at 6th week after cataract surgery. Two patients belonging to difluprednate group at the end of 1st week and one patient at the end of 3rd week after cataract surgery developed significant rise in IOP (>31 mmHg). Conclusion: It can be concluded that all three steroids were equally safe and did not cause any statistically significant rise in IOP over six-week postoperative period. However, higher values were noted in difluprednate group at the end of first and third week after cataract surgery.

scholarly journals Highland Dance: Heart-Rate and Blood Lactate Differences Between Competition and Class

2007 ◽  
Vol 2 (4) ◽  
pp. 371-376 ◽  
Author(s):  
Yvonne Baillie ◽  
Matt Wyon ◽  
Andrew Head
Keyword(s):  
Heart Rate ◽  
Blood Lactate ◽  
Repeated Measures ◽  
Training Stimulus ◽  
Lactate Concentration ◽  
Significant Rise ◽  
Physiological Effects ◽  
Heart Rate Data ◽  
Repeated Measures Analysis ◽  
Before And After

Purpose:This study looked at the physiological effects of performance in Highland-dance competition to consider whether the traditional methods used during class and rehearsal provide an appropriate training stimulus toward this performance.Methods:Nine championship standard, female Highland dancers (age 14.2 ± 1.47 years) had their heart rate and blood lactate concentrations measured before and after 3 dances during a championship competition. Heart rate was also measured during the same 3 dances in rehearsal and during class.Results:Repeated-measures analysis of variance showed significant differences in pre dance lactate concentrations between the first dance (Highland Fling, 1.4 ± 0.3 mM/L), the second dance (Sword dance, 2.3 ± 0.8 mM/L), and the third dance (Sean Truibhas, 3.5 ± 1.8 mM/L; F2,16 = 11.72, P < .01. This, coupled with a significant rise in lactate concentration during the dances (F1,8 = 76.75, P < .001), resulted in a final post dance lactate concentration of 7.3 ± 2.96 mM/L. Heart-rate data during competition, rehearsal, and class (195.0 ± 6.5, 172.6 ± 5.4, and 151.9 ± 7.4 beats/min, respectively) showed significant differences between all 3 (F2,16 = 107.1, P < .001); these are comparable to research on other dance forms.Conclusions:Given the disparity between the anaerobic predominance of competition and the aerobic predominance during class, it is suggested that the class does not provide an appropriate training stimulus as preparation for competitive performance in Highland dance.

scholarly journals A Randomised Clinical Trial to Compare the Efficacy of Tramadol and Nalbuphine for Treatment of Shivering after Spinal Anaesthesia in Patients Posted for Lower Limb Orthopaedic Surgery

2021 ◽  
Author(s):  
Sara Mary Thomas ◽  
Ananya Pradhan ◽  
Dinesh Chauhan
Keyword(s):  
Clinical Trial ◽  
Side Effects ◽  
Spinal Anaesthesia ◽  
Muscular Activity ◽  
Total Sample ◽  
Randomised Clinical Trial ◽  
Muscle Group ◽  
P Value ◽  
Entire Body ◽  
Grade 3

Introduction: Nalbuphine and tramadol are opioids which have been used to control post-anaesthetic shivering. Aim: To compare the efficacy of nalbuphine and tramadol in the treatment of post-spinal anaesthesia shivering. Materials and Methods: This was a randomised clinical trial conducted on 60 patients of either gender (20-60 years age group) from January 2019 to June 2020, American Society of Anaesthesiologists (ASA) Grade I or II, having post-spinal anaesthesia shivering. The total sample was divided into two groups of 30 patients each. Group T received injection (Inj) tramadol 1 mg/kg intravenously (iv) and Group N received Inj. nalbuphine 0.1 mg/kg iv. Grade of shivering was assessed with a five point scale as Grade 0- no shivering; Grade 1; No visible muscle activity, but one or more of piloerection, peripheral vasoconstriction or peripheral cyanosis Grade 2; Muscular activity in only one muscle group; Grade 3: Moderate muscular activity in more than one muscle group, but not generalised shaking; Grade 4: Violent muscular activity that involves the entire body. The time taken for disappearance of shivering, assessment of improvement of shivering (complete- if grade of shivering becomes 0, partial- if grade of shivering deceased but not zero), recurrence rate and side-effects such as nausea, vomiting, deep sedation were noted. Independent t-test and Chi-square test were used to analyse the data. A p-value <0.05 were considered statistically significant. Results: The time taken for disappearance of shivering was shorter in group N than T (3.20±0.96 minutes and 6.43±0.97 minutes respectively, p=0.001). Significantly better sedation (p-value 0.04) was seen in nalbuphine group as grade 3 sedation were seen in 15 patients of nalbuphine group as compared to none in tramadol group. All the patients in group N had complete improvement of shivering and there was no recurrence, while in group T six patients had partial improvement in shivering and four (13%) had recurrence. Complications such as nausea (three patients) and vomiting (one patient) were seen in Group T while none were seen in Group N. Conclusion: The efficacy of nalbuphine is greater than tramadol in controlling post-spinal anaesthesia shivering, with minimal side-effects.

scholarly journals Impact of oat processing on glycaemic and insulinaemic responses in healthy humans: a randomised clinical trial

2019 ◽  
Vol 121 (11) ◽  
pp. 1264-1270 ◽  
Author(s):  
Thomas M. S. Wolever ◽  
Jodee Johnson ◽  
Alexandra L. Jenkins ◽  
Janice C. Campbell ◽  
Adish Ezatagha ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Primary Endpoint ◽  
Test Meal ◽  
Repeated Measures ◽  
Randomised Clinical Trial ◽  
Minimally Processed ◽  
Repeated Measures Anova ◽  
Healthy Humans ◽  
Healthy Males ◽  
Meal Consumption

AbstractOats can be processed in a variety of ways ranging from minimally processed such as steel-cut oats (SCO), to mildly processed such as large-flake oats (old fashioned oats, OFO), moderately processed such as instant oats (IO) or highly processed in ready-to-eat oat cereals such as Honey Nut Cheerios (HNC). Although processing is believed to increase glycaemic and insulinaemic responses, the effect of oat processing in these respects is unclear. Thus, we compared the glycaemic and insulinaemic responses elicited by 628 kJ portions of SCO, OFO, IO and HNC and a portion of Cream of Rice cereal (CR) containing the same amount of available-carbohydrate (23 g) as the oatmeals. Healthy males (n 18) and females (n 12) completed this randomised, cross-over trial. Blood was taken fasting and at intervals for 3 h following test-meal consumption. Glucose and insulin peak-rises and incremental AUC (iAUC) were subjected to repeated-measures ANOVA using Tukey’s test (two-sided P&lt;0·05) to compare individual means. Glucose peak-rise (primary endpoint, mean (sem) mmol/l) after OFO, 2·19 (sem 0·11), was significantly less than after CR, 2·61 (sem 0·13); and glucose peak-rise after SCO, 1·93 (sem 0·13), was significantly less than after CR, HNC, 2·49 (sem 0·13) and IO 2·47 (sem 0·13). Glucose iAUC was significantly lower after SCO than CR and HNC. Insulin peak rise was similar among the test meals, but insulin iAUC was significantly less after SCO than IO. Thus, the results show that oat processing affects glycaemic and insulinaemic responses with lower responses associated with less processing.

scholarly journals Intravenous Propofol and Inhalational Sevoflurane for Ease of Classic Laryngeal Mask Airway Insertion in Patients Undergoing Elective Surgery: A Randomised Clinical Trial

2021 ◽  
Author(s):  
Nilanjan Chakraborty ◽  
Prosenjit Mukherjee ◽  
Rita Pal
Keyword(s):  
Clinical Trial ◽  
Laryngeal Mask Airway ◽  
Induction Time ◽  
Elective Surgery ◽  
Randomised Clinical Trial ◽  
Laryngeal Mask ◽  
Insertion Time ◽  
P Value ◽  
Induction Agent ◽  
Haemodynamic Changes

Introduction: The Laryngeal Mask Airway (LMA) has gained extensive popularity for airway management during surgery. Propofol, the most commonly used induction agent for LMA insertion, causes significant haemodynamic changes. Sevoflurane has the potential to be as good an induction agent as propofol. Aim: To compare ease of insertion of classic LMA in patients undergoing elective surgery using intravenous propofol and inhalational sevoflurane. Materials and Methods: The study was a randomised clinical trial conducted in the Operation Theatres of Midnapur Medical College and Hospital, Medinipur, West Bengal, India, from August 2019 to July 2020. Eighty patients of American Society of Anaesthesiologists (ASA) physical status grade I and II, of both sexes, and aged between 18 years to 65 years were equally divided into two groups: group P (Propofol group) and group S (Sevoflurane group). Group P was given injection Propofol 2.5 mg/kg body weight and group S was given vital capacity breath induction with 8% sevoflurane and oxygen at 8 litres/min. Loss of Consciousness (LOC) was confirmed and induction time was noted for each group. After confirmation of ease of mouth opening, by an independent observer, LMA insertion was attempted. Ease of LMA insertion was assessed by a predefined 18 points table along with time to LMA insertion and number of attempts. Haemodynamic changes and adverse effects were also recorded. Chi-square test or Student’s t-test were used and a p-value ≤0.05 was considered as statistically significant. Results: With respect to age, sex and weight there were no significant differences between the two groups. Induction time was significantly less in group P (51.85±6.66 seconds) compared to group S (68.38±13.93 seconds) (p-value=0.0001), but LMA insertion time, number of attempts and overall ease of LMA insertion conditions according to the 18 points score were comparable between the two groups. Mean arterial pressure at certain points after induction was significantly less in group P (at 3 minute p-value=0.009 and at 5 minute p-value=0.007). Apnea was significantly more in group P (p-value=0.023). Conclusion: Sevoflurane was comparable to propofol for LMA insertion in respect of ease of insertion and insertion time. Although induction time was significantly less for propofol, sevoflurane offered better haemodynamic stability and lesser incidence of apnea.

scholarly journals Evaluation of Intubating Conditions during Direct Laryngoscopy using Sniffing Position and Simple Head Extension- A Randomised Clinical Trial

2021 ◽  
Author(s):  
Amanjot Singh ◽  
Rupinder Kaur ◽  
Gurpreet Singh ◽  
Kewal Krishan Gupta
Keyword(s):  
Clinical Trial ◽  
Tracheal Intubation ◽  
Direct Laryngoscopy ◽  
Randomised Clinical Trial ◽  
P Value ◽  
Group I ◽  
Head Extension ◽  
Number Of Patients ◽  
Lehane Grade ◽  
Group Ii

Introduction: Optimal laryngeal visualisation during direct laryngoscopy requires adequate positioning of the head and neck. Traditionally, Sniffing Position (SP) is the recommended position to provide superior glottic visualisation. However various studies in recent past have challenged the superiority of SP. Aim: To evaluate whether SP provides better glottic visualisation and ease of intubation {as assessed by total Intubation Difficulty Score (IDS) score as well as its individual components} compared to Simple Head Extension (SHE) during direct laryngoscopy and endotracheal intubation. Materials and Methods: The randomised clinical trial was conducted at GGS Medical College and Hospital, Faridkot, Punjab, India, from May 2019 to October 2020, on 220 patients. Patients undergoing elective surgeries under general anaesthesia were randomly divided into two groups. Laryngoscopy and tracheal intubation in Group I was done in SP, which was obtained by placing a non compressible pillow of height 8 cm under the patient’s head. Patients in Group II underwent laryngoscopy and tracheal intubation in SHE position. Glottic visualisation using modified Cormack and Lehane (CL) grades, IDS and sympathetic responses between the two groups were studied. The data was compared using student’s t-test and Chi-square test. Results: Cormack and Lehane Grade I was seen in 69 (62.7%) of patients in Group I as against 51(46.4%) of patients in Group II (p-value=0.015). Easy intubation (total IDS score=0) was seen in a greater number of patients in Group I (60.9%) as compared to Group II (40.95%) (p-value=0.003). Slight difficulty in intubation (total IDS score=1-5) was encountered in 50.0% of patients in group II (n=55) and 35.5% of patients in group I (n=39) (p-value=0.029). Conclusion: The present study concluded that use of SP resulted in better glottic visualisation and was associated with favourable intubation conditions as compared to SHE position.

scholarly journals The Effect of Simultaneous Application of Transcutaneous Electrical Nerve Stimulation (TENS) on Specific Lumbar and Acupuncture Points on Labour Pain Relief: A Randomised Clinical Trial

2020 ◽  
Author(s):  
Fatemeh Farjad Bastani ◽  
Seyedeh Hajar Sharami ◽  
Soudabeh Kazemi Aski ◽  
Forozan Milani ◽  
Bahareh Khakifirooz ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Placebo Group ◽  
Pain Relief ◽  
Transcutaneous Electrical Nerve Stimulation ◽  
Labour Pain ◽  
Randomised Clinical Trial ◽  
Acupuncture Points ◽  
P Value ◽  
Electrical Nerve Stimulation ◽  
Pain Scores

Introduction: Labour pain is among the most challenging experiences a woman could face during life. Non Pharmacological modalities like Transcutaneous Electrical Nerve Stimulation (TENS) are rather new methods, introduced for relieving this pain. Aim: To investigate the effect of concurrent use of TENS application on the labour pain relief. Materials and Methods: This is a double-blind randomised clinical trial study where, a total of 104 eligible pregnant women qualified for normal vaginal delivery. They were randomly divided into four groups treated with Lumbar-TENS or Acupuncture points-TENS as A: both inactive (placebo group), B: Active Acupuncture points TENS, C: Active Lumbar TENS and D: both active. TENS was applied on four points of toraco-lumbo sacral, while Acupuncture points-TENS was applied on Hegu and Sanyinjiao points. The pain scores were evaluated by Visual Analogue Scale (VAS) criteria, four times during the study for each individual. A questionnaire was used to evaluate the final impression of the subjects about the TENS method. The groups were compared using chi-square or Kruskal Wallis test. The trend of pain score over the study time points were assessed using Generalised Estimating Equation (GEE). Results: The mean age of the women were 27.86±5.92 years. There were no significant differences between the groups based on the pain scores over the study periods (p-value=0.588). There was a statistically significant difference between groups for satisfaction about the procedure and the placebo group had the lowest rate of tendency to reuse TENS at the future Labour (74%) compared to the other three groups (93-100%) (p-value=0.046). Conclusion: Lumbar or Acupuncture points-TENS had no significant relieving effects on Labour pain among the participants.

scholarly journals Comparing the efficacy and safety of Dexmedetomidine/Ketamine with Propofol/Fentanyl for sedation in colonoscopy patients: A double-blinded randomized clinical trial

2021 ◽  
Vol 20 ◽  
Author(s):  
Reza Aminnejad ◽  
Ahmad Hormati ◽  
Hamed Shafiee ◽  
Faezeh Alemi ◽  
Maryam Hormati ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Pain Score ◽  
Randomized Clinical Trial ◽  
Repeated Measures ◽  
Vital Signs ◽  
P Value ◽  
Chi Square ◽  
Ramsay Sedation Scale ◽  
Repeated Measures Analysis ◽  
Double Blinded

Background: In this double-blinded randomized clinical trial, we aimed to compare the safety and efficacy of a combination of dexmedetomidine and ketamine [DK] with propofol and fentanyl [PF] for sedation in colonoscopy patients. Methods: In this study, 64 patients who underwent colonoscopy were randomized into two groups: 1) A, which received PF, and 2) B, which received DK for sedation. Among 64 patients, 31 patients were included in PF, and 33 patients were included in the DK group. Both groups were similar in terms of demographics. Patients’ sedation score (based on Ramsay sedation scale) and vital signs were recorded at 2, 5, 10, and 15 minutes. Complications including apnea, hypotension, hypoxia, nausea, and vomiting, along with gastroenterologist satisfaction and patients’ pain score (based on Wong-Baker faces pain assessment scale), were recorded by a checklist. Data were analyzed by SPSS v.18 software, using chi-square, independent t-tests, and repeated measures analysis with p<0.05 as the criterion for significant differences. Results: The mean score of sedation was 4.82±0.49 in the DK group and 5.22±0.45 in the PF group [p value=0.001]. Serious complications, including hypotension [p value=0.005] and apnea [p value=0.10] were significantly higher in the PF group. Satisfaction of gastroenterologist [p value= 0.400] and patients’ pain score [p value = 0.900] were similar among groups. Conclusion: Combination of DK provides sufficient sedation with fewer complications in comparison with PF in colonoscopy patients.

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