bluuebunny/crossref_metadata_2025 huggingface dataset:
Formação e prática docente reveladas nas memórias de professoras leigas do Sertão Paraibano
Authors: Alves Rozilene Lopes de Souza , Conceição Joaquim Tavares da
Published: January 2024

Este artigo apresenta uma compreensão historiográfica a respeito da formação e prática docente de professoras leigas. A discussão se insere no campo da história da educação e desenvolve investigação a respeito da formação e prática de professoras leigas que atuaram nas quatro primeiras séries do ensino primário ou de primeiro grau, em escolas do Sertão Paraibano, entre as décadas de 70 e 80 do século XX. Evidencia, a partir das narrativas das professoras narradoras-colaboradoras, o porquê da escolha pela profissão docente, as formas de ingresso na profissão e os percursos formativos para o exercício do magistério primário. A metodologia foi baseada nos pressupostos da história oral temática. A fonte principal foram as entrevistas gravadas com quatro professoras. Para as professoras primárias leigas que atuaram no Sertão Paraibano a profissão docente é entendida como uma “vocação”, contudo, na prática representou uma condição de emancipação financeira. Em geral, iniciaram a prática docente sem uma formação específica para o magistério, no decorrer do exercício da profissão tiveram acesso à formação para o magistério, a partir da implantação do Projeto Logos II, implantado para habilitar professores para lecionar nas séries iniciais do Ensino de 1º Grau.
Development instrument of interdisciplinary thinking skills in science lesson planning (IITSSL)
Authors: Santiani Santiani , Winarto Winarto , Nadrah Yatim Md , Jumini Sri
Published: January 2024

The IITSSL is an interdisciplinary thinking assessment rubrics for science teacher candidates in a science lesson plan. The IITSSL rubric was developed and qualitative evaluated in three phases: rubric design, first and second pilot tests. The qualitative evaluation during three phases with novice-expert interviews was carried out in four science education classes at three different universities. The rubric development result of the IITSSL rubric with dimensions are objective, disciplinary grounding, integration, and critical awareness in a component science lesson plan are learning objectives, instructional activities, and assessments with valid categories of content validity and  fair ICC (0.637) reliability. Evidence of novice and expert validity of the IITSSL rubric from the results of interviews with novices and experts, which in general are meaningful according to the values of validity and reliability. The IITSSL rubric with four dimensions and ten criteria as items is very simple, easy to use, and can in fact detect pupils' capacity for interdisciplinary thinking with accuracy and reliability. in science lesson plans in a range of course settings. The science teacher candidates appear to comprehend the importance of interdisciplinary thinking according to their experience of the science lesson plan coursework and the IITSSL rubric. The IITSSL rubric not only measure understanding of interdisciplinary thinking, but is likely to promote a more integrated method of knowledge how science teacher candidates solve real word problems
Early Childhood Teachers' Perspective on The Implementation of Inclusive Education
Authors: Marwiyati Sri
Published: January 2024

The purpose of the study was to determine the views of early chilhood teachers and their preparation in implementing inclusive education in the city of Salatiga. This research method uses descriptive qualitative and field research. Data were obtained through interviews and questionnaires from early chilhood teachers in Salatiga City. The collected data is followed up with data reduction, data display and drawing conclusions. The results show that not all early chilhood teachers understand that Salatiga has declared itself as an inclusive city since 2012. The research data shows that some early chilhood teachers understand about inclusive education but they are not ready to accept children with special needs because they feel incapable in providing services, facilities, have special teachers for children with special needs, and do not yet have an inclusive curriculum so they are afraid that it will make the child's situation worse. The preparations needed by early chilhood teachers to implement PAUD inclusive schools are preparing facilities and infrastructure for learning for both children with special needs and normal children, preparing mature programs through mature inclusion curricula, preparing special teachers such as psychologists/special therapists and equipping teachers and parents in receiving and handling children with special needs through training activities. The success of inclusive education apart from the readiness of educational institutions is to change the public's understanding of children with special needs, children with special needs have the same rights as normal children so it is necessary to build cooperation with parents and the community to learn together to build inclusive schools.
Assessment and Evaluation of Early Childhood Education Institutions
Authors: Koenarso Dyah Ageng Pramesty
Published: January 2024

Assessment is a systemic and continuous process or activity to collect information about the process and learning outcomes of students in order to make decisions based on certain criteria and considerations. This study aims to determine the reality of assessment and evaluation conditions in early childhood education. This study used a qualitative approach and was conducted in five A-accredited ECE institutions in Banjarbaru City. The techniques used to collect data were by interview, observation and documentation. Data analysis used in this study followed the Miles and Hubermen model. Based on the results of the research, the five institutions use 3 types of assessments in their implementation for their students, namely diagnostic assessments, formative assessments, and summative assessments. The results of children's reports to parents in the form of report cards each semester which use checklist techniques, work results, anecdotal records, and serial photos. The activity of reporting the results of children's assessments to parents is carried out every semester. So if the school has already completed the semester, the results of the assessment will be given to the children's parents. The report form for each semester is in the form of a report card. So the report card will represent all children's assessments in their learning.
FACTORS AFFECTING SURVIVAL OF PEOPLE LIVING WITH HIV IN LOW-POPULATED AREAS
Authors:   Kamchatka Regional TB Dispensary, Petropavlovsk-Kamchatsky, Russia, Gromov Andrey , Mikhailova Yuliya ,   Federal Research Institute for Health Organization and Informatics of the Ministry of Health of the Russian Federation, Moscow, Russia, Sterlikov Sergey ,   Federal Research Institute for Health Organization and Informatics of the Ministry of Health of the Russian Federation, Moscow, Russia
Published: January 2024

Significance Since areas with low population density have a number of specific parameters, in order to reduce mortality from the disease caused by HIV, it is advisable to assess the influence of factors affecting life expectancy of people living with HIV. The purpose of the study was to analyze predictors and risk factors of death that arise or are present during the follow-up and treatment of people living with HIV in low-populated areas. Material and Methods: A survival analysis was carried out for 133 people living with HIV registered at the AIDS-Center of the Kamchatka Territory in 2017 after a 6-year follow-up period. To analyze the influence of nominal characteristics on life expectancy of people living with HIV, Cox regression analysis was undertaken using the “Survival”, “Survminer”, “ggpubr” packages in the R environment. To study the effect of viral load and immune status on survival, a correlation analysis was used. Results: risk factors of early death from HIV in low-populated areas are as follows: parenteral transmission (p=0.0026), late detection (p<0.0001), failure to achieve the undetectable viral load (p<0.0001), lack of restoration of the immune status (p<0.0001), alcohol (p=0.00015), drug use (p=0.036), tuberculosis (p<0.0001). Participation in the patient school improved the prognosis (p=0.05). Living in rural areas (p=0.23), having a family (p=0.8), including couple discordance (p=0.7), viral load (r=-0.2; p=0.2), CD4+ cell count at detection (r=0.2; p=0.3), refusal of further treatment in case of its initiation (p=0.8), viral hepatitis C (p=0.4), and adverse events (p=0.32) did not affect a 6-year survival. Conclusion: in order to increase survival, the following target parameters of the quality of organization of treatment of patients living with HIV in low-populated areas can be set: achieving the undetectable viral load, abstaining from alcohol and drugs, and attending the patient school. Scope of application. The results obtained can be used to develop programs of care delivery to people living with HIV.
POSSIBLE ORGANIZATION OF ADDITIONAL TRAINING IN BASIC SURGICAL SKILLS
Authors:   Kuban State Medical University of the Ministry of Health of the Russian Federation, Krasnodar, Russia, Sukhinin Andrey , Malyshko Vadim ,   Kuban State Medical University of the Ministry of Health of the Russian Federation, Krasnodar, Russia, Chernyaeva Ekaterina ,   Kuban State Medical University of the Ministry of Health of the Russian Federation, Krasnodar, Russia, Kushnir Diana ,   Kuban State Medical University of the Ministry of Health of the Russian Federation, Krasnodar, Russia, Gavrilova Eleanora ,   Kuban State Medical University of the Ministry of Health of the Russian Federation, Krasnodar, Russia, Aleksandrova Natalia ,   Kuban State Medical University of the Ministry of Health of the Russian Federation, Krasnodar, Russia
Published: January 2024

Significance. Within the educational process in medical universities, one of the important aspects is the development of basic surgical skills. During the educational process this helps to decide on your specialty in general, and also improves the quality of training of future doctors. At present, there is no well-established structure for conducting courses in basic surgical skills. The purpose of the study was to evaluate the demand for an additional course in basic surgical skills among 1-6-year students of the Kuban State Medical University. Material and methods. To identify feasibility of an additional training in basic surgical skills, a survey was conducted covering 2190 students of the Kuban State Medical University in a remote format based on the GoogleScholar platform in September-October 2022. The questionnaire included the choice of the most optimal, from the point of view of the student, schedule, the number of students in the group and materials used. Results. Out of the students surveyed, the majority support the idea of ​​introducing additional training in small groups using biomaterials or artificial materials with the predominance of practicing surgical skills. Conclusion. According to the survey results, introducing an additional course to train students in basic surgical skills will be relevant and help to improve manual skills during the educational process, as well as to decide on specialty in the future. Scope of application. The aspects of the possible organization of additional training in basic surgical skills presented in the article will contribute to better training of medical university students.
CRREL Environmental Wind Tunnel upgrades and the Snowstorm Library
Authors: Slone Scott , Torres Marissa , Stott Alexander , Thomas Ethan , Ibey Robert
Published: January 2024

Environmental wind tunnels are ideal for basic research and applied physical modeling of atmospheric conditions and turbulent wind flow. The Cold Regions Research and Engineering Laboratory's own Environmental Wind Tunnel (EWT)—an open-circuit suction wind tunnel—has been historically used for snowdrift modeling. Recently the EWT has gone through several upgrades, namely the three-axis chassis motors, variable frequency drive, and probe and data acquisition systems. The upgraded wind tunnel was used to simulate various snowstorm conditions to produce a library of images for training machine learning models. Various objects and backgrounds were tested in snowy test conditions and no-snow control conditions, producing a total of 1.4 million training images. This training library can lead to improved machine learning models for image-cleanup and noise-reduction purposes for Army operations in snowy environments.
Effects of Magnesium Sulphate on Hemodynamic Response to Carbondioxide Pneumoperitoneum in Patients undergoing Laparoscopic Appendicectomy
Authors:   Postgraduate, Department of Anaesthesiology, Rajah Muthiah Medical College, Annamalai nagar, Tamil Nadu 608002, India., Karthikeyan G , Dhakshinamoorthy M ,   Professor, Department of Anaesthesiology, Rajah Muthiah Medical College, Annamalai nagar, Tamil Nadu 608002, India.
Published: January 2024

Carbondioxide pneumoperitoneum in laparoscopic appendicectomy is associated with adverse hemodynamic effects like increases in blood pressure, heart rate and systemic vascular resistance. These adverse effects are due to release of catecholamine and vasopressin. We conducted this randomized double blinded study to assess the effect of magnesium sulphate on attenuating these adverse hemodynamic responses. Materials and Methods: Sixty ASA I and II patients of either sex aged 20–60 years posted for elective laparoscopic appendicectomy were randomized into two groups of thirty patients each. Group M received magnesium sulphate 20 mg / kg intravenously before creating pneumoperitoneum. Group C received same volume of 0.9 % saline. Results: Systolic blood pressure, diastolic blood pressure and heart rate were significantly less in patients of Group M when compared to the placebo group. Conclusion: Magnesium sulphate given at a dose of 20 mg / kg before pneumoperitoneum attenuates adverse hemodynamic responses and ensures better hemodynamic stability during pneumoperitoneum created for laparoscopic surgery.
Segmental Spinal: Is It Possible?
Authors:   Associate professor, Department of Anesthesiology, Dr. Panjabrao Deshmukh Memorial Medical College, Amravati, Maharashtra 444601, India., Paliwal Naresh W , Lawhale Sunil S ,   Professor and HOD, Department of Anesthesiology, Dr. Panjabrao Deshmukh Memorial Medical College, Amravati, Maharashtra 444601, India.
Published: January 2024

The name Segmental spinal anaesthesia is often widely used synonymously with Thoracic spinal anaesthesia. But in real sense segmental spinal anaesthesia means “blocking of the required dermatomes essential for the proposed surgical procedure with very low effective local anaesthetic drug dose “. This often necessitates dural puncture at high lumber or thoracic levels apart from the conventional spinal. Segmental spinal anaesthesia has been found to be feasible, safe, and effective alternative to conventional general anaesthesia in abdominal and some thoracic surgeries. The objective of this special article is to demonstrate the safety, benefits, risks and utility of this technique as a sole anaesthetic technique or combined with epidurals.
Comparative Study between Dexmedetomidine and Midazolam in Inducing Conscious Sedation in Patients Undergoing Cataract Surgery
Authors:   Senior Consultant, Department of Anaesthesiology, Chikkaballapura District Hospital, Chikkaballapura, Karnataka 562101., M.K Mamatha
Published: January 2024

Background: Cataract surgery are usually done in elderly patients. Dexmedetomidine is a potent non-opiod sedative and analgesic devoid of respiratory depression. Midazolam is the most commonly used sedative which is commonly associated with respiratory depression specially in elderly patients. Objectives: To compare the effects of intravenous dexmedetomidine and midazolam on the haemodynamic stability, sedation and intraocular pressure and to study the safety profile of the drug Methodology: After obtaining permission from institutional ethical committee and patient informed consent, study was conducted at BMCRI from November 2016 to May 2018 in ASA Grade 1 and 2 patients of 40 to 70 year age undergoing cataract surgery. Patients were randomly allocated to two Group D and M of 32 each. Group D received inj. dexmedetomidine 0.25mcg/kg, Group M received inj. midazolam 0.02mg/kg diluted to 10ml over 10 minutes as intravenous injection. Peribulbar block was given with 8-10ml of injection 2% lignocaine with adrenaline with hyaluronidase. Haemodynamic parameters like Heart Rate, Mean Arterial Pressure and SpO2, Intra Ocular Pressure in non-operating eye, Ramsay Sedation Score, Visual Analogue Score and Modified Aldrete Score were recorded. Results: We concluded that in our study demographic data were comparable. Patients of Dexmedetomidine group had reduction of IOP after drug injection (p=0.001) and at post bulbar block (p=0.002) which is statistically significant compared to Group M patients and also there was statistically significant difference in RSS Score between two groups. Conclusions: Dexmedetomidine provides same conscious sedation as Midazolam. Dexmedetomidine reduces intraocular pressure and maintains SpO2 when compared to Midazolam in cataract surgery.
A Comparative Study of Intrathecal Hyperbaric Bupivacaine 0.5% with Fentanyl versus Hyperbaric Bupivacaine 0.5% with Buprenorphine in Lower Limb and Lower Abdominal Surgeries
Authors:   MD, Department of Anaesthesiology , B.L.D.E (Deemed to be university) Shri B. M. Patil Medical College, Hospital and Research Centre , Vijayapur 586103, Karnataka, India., N Nithyashree , V Katti Vijay ,   Associate Professor, Department of Anaesthesiology , B.L.D.E (Deemed to be university) Shri B. M. Patil Medical College, Hospital and Research Centre , Vijayapur 586103, Karnataka, India.
Published: January 2024

Background: Various adjuvants have been added to bupivacaine to shorten the onset of block and prolong the duration of block. Present study was undertaken to compare the efficacy of intrathecal fentanyl or buprenorphine with bupivacaine for all infraumbilical surgeries. Materials and Methods: 60 ASA I and II patients posted for various infraumbilical surgeries were chosen for the study and the patients were divided into two groups of 30 each. Group F received 3ml of 0.5% bupivacaine with 25µg of fentanyl and group B received 3ml of 0.5% bupivacaine with 60µg of buprenorphine.Sensory block was tested with pinprick method and motor block was assessed by onset of Bromage scale 3. Results: Patient in Buprenorphine group showed a significantly prolonged duration of motor and sensory block than patients in fentanyl groyp and also postoperative VAS scores were significantly low for the buprenorphine group when compared with fentanyl. Conclusion: To summarise, buprenorphine has higher efficacy with intrathecal bupivacaine with prolonged duration of sensory and motor blockade with decreased incidence of side effects, better haemodynamic stability and also analgesic sparing effect in the postoperative period when compared to fentanyl.
Comparative Evaluation of Effect of Dexmedetomidine Versus Normal Saline on Blood Glucose Levels in Diabetes Mellitus Patients Undergoing Spinal Anaesthesia Surgeries
Authors:   Junior Resident, Department of Anesthesia, Bharati Vidyapeeth Medical College (Deemed to be University), Dhankawadi, Pune, Maharashtra 411043, India., Amogh M , Bhosle P N ,   Department of Anesthesia, Bharati Vidyapeeth Medical College (Deemed to be University), Dhankawadi, Pune, Maharashtra 411043, India.
Published: January 2024

ontext: Surgical trauma gives rise to a stress response in the human body resulting in hyperglycaemia in the perioperative period. This adversely affects the patient’s outcome. Hyperglycaemia is particularly detrimental in patients with diabetes mellitus. Dexmedetomidine, an alpha 2 adrenoreceptor agonist attenuates this surgical stress response and helps in preventing perioperative hyperglycaemia. Aims: The aim of our study was to monitor and compare the effect of dexmedetomidine versus normal saline on blood glucose levels intraoperatively and postoperatively in patients with diabetes mellitus undergoing spinal anaesthesia surgeries. Other objectives were, to compare haemodynamic changes, ramsay sedation scores intraoperatively andthe requirement of analgesia in the postoperative period between both the groups. Methods: A double blind prospective randomized controlled study was conducted in a tertiary hospital. Out of 60 patients with diabetes mellitus, 30 random patients were administered with intravenous dexmedetomidine after giving spinal anaesthesia. The other half of patients received a placebo. Vital parameters and blood glucose levels were monitored and compared in both the groups. Statistical analysis used: Data was tabulated and compared using unpaired T-test. Results: Statistically significant differences were found in mean heart rate and blood pressure between both the groups. The differences in the blood sugar values in the intra operative period and the postoperative period between both the study groups were also statistically significant. Requirement of additional postoperative analgesics were also considerably less in the dexmedetomidine group. Conclusion: Intravenous dexmedetomidine attenuates the surgical stress response by inhibiting the adrenal surge and prevents hyperglycaemia.
Comparative Efficacy of EMLA Cream and Ethyl Chloride Spray for Reducing the Venipuncture Pain During Intravenous Cannulation
Authors:   Professor and Head, Department of Anesthesia, Critical Care and Pain Management, Shamanur Shivashankarappa Institute of Medical Science and Research Center, Davangere, Karnataka 577005, India., Kumar Ajjappa Arun , S M Sagar ,   Professor,  Department of Anesthesia, Critical Care and Pain Management, Shamanur Shivashankarappa Institute of Medical Science and Research Center, Davangere, Karnataka 577005, India., H M Surya ,   Post Graduate, Department of Anesthesia, Critical Care and Pain Management, Shamanur Shivashankarappa Institute of Medical Science and Research Center, Davangere, Karnataka 577005, India.
Published: January 2024

Background and Objectives: Intravenous Cannulation is a pain full procedure. Pain associated with intravenous cannulation can be decreased by using local anaesthetics. This study was conducted to evaluate the efficacy of EMLA cream against the reduction of the venipuncture pain during IV cannulationin comparison with Ethyl chloride spray. Methods: This single center, prospective randomized study with two parallel groups was conducted at Department of Anaesthesiology, Critical Care and Pain Management, S.S Institute of Medical Sciences, Davanagere. A total of 100 subjects admitted due to various illnesses were enrolled into the study. Study subjects were randomly divided into two groups viz. G1 and G2 with 50 subjects in each group. Subjects in G1 were anesthetized with topical application of EMLA cream, and in G2 with Ethyl Chloride spray. Results: The results of VAS score depicted that following application of EMLA cream causes mild venepuncture pain during intravenous cannulation, whereas Ethyl chloride spray causes moderate venepuncture pain during intravenous cannulation. Furthermore, our study findings delineated that EMLA cream was safe to use without any side effects when compared to Ethyl chloride spray wherein burning sensation, itching and redness like side effects were experienced by study subjects. Conclusion: EMLA cream is safe and effective in reduction of venipuncture pain during IV cannulation. Keywords: EMLA cream; Ethyl chloride spray; Pain; IV cannulation; VAS; Efficacy; Safe.
Comparative Evaluation of Hemodynamic Changes in Different Positions in Normotensive Versus Hypertensive Patients Undergoing Percutaneous Nephrolithotomy (PCNL) Under Regional Anaesthesia
Authors:   Third Year Post Graduate Resident, Department of Anaesthesiology, Bharati Vidyapeeth Deemed to be University Medical College, Pune, Maharashtra 411043, India., D Allampalli Varun , S Aphale Shubhada ,   Professor, Department of Anaesthesiology, Bharati Vidyapeeth Deemed to be University Medical College, Pune, Maharashtra 411043, India.
Published: January 2024

Background: Hemodynamic changes occur with position change, are exaggerated under anesthesia and differ in magnitude between normotensive and hypertensive patients. Aim: To evaluate hemodynamic changes in different positions in 2 groups of patients: Normotensive versus Hypertensive undergoing PCNL under regional anaesthesia (RA). Methods: After ethical committee’s approval, a comparative study was conducted at a tertiary healthcare center, included 50 consenting patients >25 years age of ASA Class 1 and 2 undergoing PCNL under RA and divided into two groups of 25 patients each, Group 1-Normotensive patients and Group 2- Hypertensive patients. Hemodynamic variables (heart rate, Systolic, Diastolic and Mean arterial pressures, Electrocardiogram) were monitored throughout surgery and were recorded at Baseline (before instituting RA), Supine to Lithotomy, Lithotomy to Supine, Supine to Prone and Prone to Supine. Hypotensive episodes (Fall in systolic blood pressure (SBP) >20% from baseline) and vasopressor requirement (If SBP <80mm Hg then Inj. Ephedrine IV 5 mg given) were recorded in both the groups. Results: Statistical analysis was done using Chi-Square test and independent sample t test. Inter group comparison of hemodynamic parameters were comparable and statistically insignificant for all positions. Intragroup comparison of hemodynamic parameters showed lower readings as compared to baseline in all with respect to position change. Number of hypotensive episodes and vasopressor usedid not differ significantly betweentwo study groups. Conclusion: A well-controlled hypertensive patient behaves like a normotensive patient hemodynamically with respect to position change under anesthesia. Therefore, preoperative control of hypertension is essential. Keywords: PCNL; Regional anesthesia; Position change; Hypertension. Key Message: Control of hypertension enables a hypertensive patient to behave like a normotensive patient hemodynamically with respect to position change under anesthesia.
Anaesthetic Management of Patient with Xeroderma Pigmentosum Posted for Basal Cell Carcinoma Excision
Authors:   Post Graduate, Department of Anaesthesiology, Sri Devaraj Urs Academy of Higher Education & Research, R L Jalappa Hospital, Kolar, Karnataka 563101, India., L N Mahima , Madhusudhana Ravi ,   Professor and HOD, Department of Anaesthesiology, Sri Devaraj Urs Academy of Higher Education & Research, R L Jalappa Hospital, Kolar, Karnataka 563101, India.
Published: January 2024

Introduction: Xeroderma Pigmentosum (XP) is a hereditary autosomal recessive disorder due to defect in nucleotide repair genes. In this condition patient might require multiple surgeries for removal of skin and ocular lesion. Case report: A 17 year old male patient, weighing 43 kg presented with multiple lesions over face since 2 months. He had cutaneous lesions over full body with no major neurological deficit. General anaesthesia was planned. Patient’s body protection from artificial light and eye protection given in operating room. Patient Pre medicated with Inj glycopyrrolate, Inj Midazolam and Inj fentanyl. Preoxygenation done with 100% oxygen for 3 min. Induced with Inj Propofol. After elimination of reflexes and reaching enough depth of anaesthesia laryngeal mask airway(LMA) number 3 inserted and good lung ventilation confirmed by chest rise and ETCO2 then LMA fixed in place. Anaesthesia maintained with 50% nitrous oxide in oxygen, IV Propofol with intermittent positive pressure ventilation. Further analgesia supplemented by inj.Bupivacaine 0.25% infiltration locally around wound given. The procedure lasted for 40 min. Conclusion: Xeroderma pigmentosum patients have risk of worsening neurological disorder with genotoxic drugs and volatile anaesthesia and prolongation of recovery from muscle relaxants. In this case report demonstrated that patient with XP can safely be managed under general anaesthesia with IV propofol, without muscle relaxant and inhalational volatile anaesthetics.
Intraoperative Management of Atrial Fibrillation Secondary to Hypercalcemia in a Patient with Parathyroid Adenoma
Authors:   Post Graduate, Department of Anaesthesiology, Sri Devaraj Urs Academy of Higher Education & Research, R L Jalappa Hospital, Kolar, Karnataka 563101, India., B Sinchana , N Kiran ,   Professor, Department of Anaesthesiology, Sri Devaraj Urs Academy of Higher Education & Research, R L Jalappa Hospital, Kolar, Karnataka 563101, India., VD Sandeep ,   Senior Resident, Department of Anaesthesiology, Sri Devaraj Urs Academy of Higher Education & Research, R L Jalappa Hospital, Kolar, Karnataka 563101, India.
Published: January 2024

Introduction: Atrial fibrillation is one of the most common arrhythmias occuring in 0.45% of adult population and usually are not assoicated with any cardiac disease. Atrial fibrillation may be seen preoperatively in patients posted for anesthesia. Case Report: A 48 Vyshya male patient with swelling in the neck, palpitations since two years, hypercalcemia and chronic kidney disease with irregularly irregular pulse (88 per min), BP of 110/60 mmHg and respiratory rate of 20/min. Electrocardiogram showed atrial fibrillation. Echocardiography showed non obstructive hypertrophic cardiomyopathy with dilated left atrium and right atrium , moderate pulmonary artery hypertension with ejection fraction of 60%. Patient was diagnosed to have left parathyroid adenoma and was posted for parathyroidectomy. Serum parathyroid hormone levels was 756 pg/ml. Patient was on Inj. Enoxaparin 40 mg that was stopped twelve hours before day of surgery and Amiodarone 100mg and Metoprolol 25mg which was continued on day of surgery. Continuous ECG, invasive arterial blood pressure, pulse oximetry, capnography, neuromuscular monitoring was done. After preoxygenation, induced with propofol and fentanyl.Intubation done with injection vecuronium. Anaesthesia was maintained with Isoflurane ,oxygen, nitrous oxide and vecuronium. Arterial line was established. Left inferior parathyroidectomy was done in 4 hours. Inj. Amiodarone 3mg/kg diluted in 100 ml normal saline was started before skin incision. Patient was in persistent atrial fibrillation throughout the surgery, extubation was done and the patient was sent to intensive care unit. Conclusion: Patients with atrial fibrillation secondary to hypercalcemia undergoing a crucial non cardiac surgery needs thorough understanding of hemodynamic changes, vigilant intraoperative monitoring with proper preoperative and intraoperative cardiac medication.
Dose Related Prolongation of Hyperbaric Bupivacaine Spinal Anaesthesia By Dexmedetomidine
Authors:   Assistant Professor, MD Anaesthesiology, Gadag Institute of Medical sciences, Gadag, Malasamudra, Karnataka 582103., Joshi Sapana , JS Soumya ,   Assistant Professor, DNB Anaesthesiology, SVS Medical college, Mahabubnagar, Telangana 509001., Rajpurohit Shravan ,   MS General surgery, Department of Anaesthesiology, M R Medical college, Gulbarga, Karnataka 585105, India.
Published: January 2024

Spinal anaesthesia is commonly used for abdominal and lower limb surgeries. This study has been designed to evaluate the addition of two doses of dexmedetomidine(10μg and 15μg) as an adjuvant to 0.5% hyperbaric bupivacaine 3ml intrathecally for elective abdominal and lower limb surgeries. Methods: In this randomized, double-blind prospective study, 60 patients of ASA I and II were randomized to three groups: group I, II and III(n=20). All patients received a drug volume of 3.5ml containing 3 ml hyperbaric bupivacaine(15 mg). They received dexmedetomidine 10μg (Group II) or 15 μg (Group III) added to bupivacaine ; the control group (Group I) received 0.5ml of 0.9% saline added to bupivacaine. Results: It was found that the onset of sensory block upto T10 and motor block is significantly faster in group II (174 sec and 109.5 sec) and III (93 sec and 57.75 sec) over group I (294 sec and 155.25 sec).The mean time for two segment regression and sensory regression to L1, the mean duration of analgesia and motor blockade is significantly prolonged in Group III(138.75 min,469.5 min,438 min,510.5 min) over Group II (104.25 min, 321 min,277.5 min, 323.25 min) and Group II over Group I(88.5 min,257.25 min,238.5 min,265.5 min) (p<0.001). Conclusion: I conclude that 15μg of dexmedetomidine added to local anaesthetic in subarachnoid block has proved to be a better adjuvant in prolonging the sensory and motor blockade and the duration of postoperative analgesia. Keywords: Spinal anaesthesia; Dexmedetomidine; Hyperbaric Bupivacaine; Intrathecal adjuvant; Alpha 2 agonist.
Comparative Study of Upper Lip Bite Test and Modified Mallampatti Classification in Predicting Difficult Endotracheal Intubation
Authors:   Junior resident, Department of Anesthesiology, Government Medical College, Latur, Maharashtra 413512, India., S Ajanth , Sirsat Vinayak ,   Associate professor, Department of Anesthesiology, Government Medical College, Latur, Maharashtra 413512, India., Chauhan S ,   Professor and HOD, Department of Anesthesiology, Government Medical College, Latur, Maharashtra 413512, India., Kokane Deepak M ,   Associate professor, Department of Anesthesiology, Government Medical College, Latur, Maharashtra 413512, India.
Published: January 2024

Objective: To compare sensitivity, specificity, positive and negative predictive values of upper lip bite test and modified mallampatti test to predict difficulty in endotracheal intubation in patients between 16 to 55 years of age. Methods: One hundred ASA1/2 patients admitted for elective surgical procedure requiring endotracheal intubation were prospectively studied to predict difficult intubation in age group 16-55 years of age after obtaining an informed consent. Preoperative Airway assessment was done with modified mallampatti test and upper lip bite test. Results: In our study, eighty four had Upper lip bite test (ULBT) class I and II and sixteen patients had class III. Of these two ofthe ULBT class Iand II and five of the ULBTclassIII had Cormack Lehane grade III . There were one hundred patients predicted to be easy for intubation by MMT (i.e. patients who had ULBT class I and II) out of whom however, we encountered difficult intubation in 6 patients. One in MMT class III also had difficult intubation. None of the patients had class IV MMT.Of the entire one hundred patients, a total of seven patients had difficult intubation, all of whom had Cormack Lehane class III on laryngoscopy. Conclusion: Upper Lip Bite Test (ULBT)is a better test at predicting difficult endotracheal intubation when compared toModified Mallampati Test (MMT). Upper lip bite test and modified mallampatti classification are good predictors of easy intubation rather than difficult intubation. Upper lip bite test should be used in combination with other airway assessment methods viz. Thyromental distance, hyomental distance, inter incisor distance to predict difficult intubation.
Comparison of Bag and Mask Ventilation versus I-Gel use in Electroconvulsive Therapy
Authors:   Junior resident, Department of Anesthesiology, Bharati Vidyapeeth Medical College (Deemed to be University), Pune, Maharashtra 411043, India., Pandey Shriya , Swami Sarita S ,   Professor and Head of Department, Department of Anesthesiology, Bharati Vidyapeeth Medical College (Deemed to be University), Pune, Maharashtra 411043, India.
Published: January 2024

Background: Electroconvulsive therapy formerly known as electroshock is a psychiatric treatment in which seizures were electrically induced to provide relief from psychiatric disorder. The most common technique of anaesthesia used during ECT is General Anaesthesia with bag and mask ventilation which is being used for a long time. However, there are case reports of pulmonary edema, bronchospasm, hemodynamic changes during this technique, so we want to compare the effectiveness of I-gel over bag and mask ventilation in ECT. Methods: In our study 50 patients were randomized and 25 of them were ventilated with bag and mask. The other 25 patients were ventilated with I-gel. Vital parameters were monitored intra-operatively and postoperatively we observed nausea, vomiting, bronchospasm, sore throat, laryngospasm. Results: Statistically significant difference were found in mean heart rate and blood pressure values in both the groups. Also we noticed 2 cases of nausea, 1 case of vomiting 2 cases of sore throat in bag and mask group whereas 2 cases of bronchospasm in I-gel group. Conclusion: Hemodynamic variables were better controlled in I-gel group. Also the post operative complications were less in I-gel group.
Arterial Hypertension and Diabetes Mellitus in Adult Surgical Patients: Prevalence and Perioperative Impact
Authors:   Assistant Professor, Department of Anesthesiology, SVS Medical College, Mahabubnagar, Telangana 509001, India., Chaitanya Savala , Reddy S Abhilash ,   Assistant Professor, Department of Anesthesiology, SVS Medical College, Mahabubnagar, Telangana 509001, India.
Published: January 2024

Background: Arterial hypertension and diabetes mellitus are prevalent co-morbidities in surgical patients, and they might have an impact on perioperative care. Many times, the healthcare team will conduct a preoperative test for diabetes that has gone unnoticed. However, it is rarely assessed how much these disorders affect perioperative anaesthetic care. Aim: The aim of the study was to determine the prevalence of new, managed, and uncontrolled hypertension, diabetes mellitus, and their perioperative sequelae in adult surgical patients. Methods: This prospective observational study was conducted in a tertiary care teaching hospital. Total 186 adults of both sexes, planned for elective non-cardiac surgery were included. Arterial hypertension (AHTN) and Diabetes Mellitus (DM) was defined as per JNC-7 and ADA definition. The prevalence of new, controlled, uncontrolled AHTN and DM and their perioperative anaesthetic were assessed. Results: Total 186 patients’ 98 (53% )cases posted were evaluated were with hypertension, 67(36%) cases with diabetes mellitus followed by 21 (11%) cases with both HTN and DM. The prevalence of these co morbidities was found to be highest in 6th decade. The prevalence of DM was also higher in male than female , but the differences were statistically insignificant for AHTN, DM and for both . The prevalence of renal failure and coronary artery diseases, mean age in the patients with both the comorbidity were higher than either of hypertensive and diabetic group and both the differences were statistically significant.12 (12.2% ) hypertensive and 2 (3%) diabetic and patients were in the range of postponement of elective surgery. Conclusion: Adults have a high prevalence of AHTN and DM, which increases dramatically with age. Both men and women are affected in the same way. The prevalence of uncontrolled AHTN and DM is concerning, demanding immediate action to treat these serious noncommunicable diseases.
A Study of Prevalence of Metabolic Syndrome in Apparently Normal Population in Rural Maharashtra
Authors:   Professor and head, Department of Medicine, P.D.V.V.P.F'S Medical College, Vilad Ghat, Ahmednagar, Maharashtra., Tyagi Arun , Phatake Satish ,   Associate professor, Department of Medicine, P.D.V.V.P.F'S Medical College, Vilad Ghat, Ahmednagar, Maharashtra., Srivastava A.K. ,   Associate professor, Department of Medicine, P.D.V.V.P.F'S Medical College, Vilad Ghat, Ahmednagar, Maharashtra., Jariwala Nikhil ,   Resident, Department of Medicine, P.D.V.V.P.F'S Medical College, Vilad Ghat, Ahmednagar, Maharashtra.
Published: January 2024

With the receding threats of communicable diseases, and looming over threats of Coronary Artery Disease, Hypertension and Diabetes Mellitus, the research in the later has been focused on detection of their preclinical stages. The co-occurrence of metabolic risk factors for both Type 2 Diabetes and CVD suggested the existence of a “metabolic syndrome”. From a clinical perspective, the importance of the metabolic syndromes is attributable to two factors: 1) it is extremely common, and 2) it is a target for the prevention of and therapy for the multiple disorders with which it is associated. In India, age-standardized prevalence rates of metabolic syndrome are 33.5%. Sedentary lifestyle, older age, female gender, obesity, inadequate fruit intake, hypercholesterolemia, and middle-to-high socioeconomic status significantly contribute to increased risk of metabolic syndrome. This study was conducted to assess the prevalence of metabolic syndrome in apparently normal population attending Medicine Outpatient Department of a tertiary care hospital and to analyse the risk factor profile of the individuals with Metabolic Syndrome. In our study 39 out of 150 subjects (26%) were found to have metabolic syndrome using ATP III Revised Criteria. The prevalence increased as the age advanced (51% in 40-59-year age group and there was female preponderance (37 vs 19%). High blood pressure, Body mass index, Waist circumference, Hypertriglyceridemia, high fasting blood sugar level, Low HDL cholesterol in blood, Aging & High LDL cholesterol in blood were the risk factors associated with high prevalence of Metabolic syndrome.
Epididymo: Orchitis in an Adult with Scrub Typhus
Authors:   Postgraduate, Department of General Medicine, Sri Manakula Vinayagar Medical College and Hospital, Puducherry., Teja T. Vishwa , Subramanian Girija ,   Professor, Department of General Medicine, Sri Manakula Vinayagar Medical College and Hospital, Puducherry., Balu Karthikeyan ,   Assistant professor, Department of General Medicine, Sri Manakula Vinayagar Medical College and Hospital, Puducherry., Rajaram Harish. ,   Senior Resident, Department of General Medicine, Sri Manakula Vinayagar Medical College and Hospital, Puducherry.
Published: January 2024

Introduction: Scrub typhus is a re-emerging Rickettsial infection presenting with protean manifestations and increasingly reported from all over the country. It is an important cause of acute febrile illness. Case Report: A middle aged adult male presented with complaints of fever, abdominal pain and pain in the testes of about two weeks duration. On examination patient was toxic, icteric, had inguinal and cervical lymphadenopathy, hepatosplenomegaly and unilateral tender testes and epididymis. All common causes of FUO (viz) Malaria, Typhoid fever; Dengue and Brucellosis were ruled out by laboratory tests. Serology for Scrub typhus was positive. The patient responded in 24 hours to Doxycycline thus clinching the diagnosis. Conclusion: This case is reported because of the unusual complication of epididymo orchitis in an adult due to Scrub typhus.
Triangle of Wound Assessment (TOWA) and its Use in Postoperative Wound Management
Authors:   Senior resident, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Pondicherry 605006, India., P. Babu , R.K. Chittoria ,   Professor, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Pondicherry 605006, India., K.S. Reddy ,   Senior resident, Department of Plastic Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) Pondicherry 605006, India.
Published: January 2024

Wound management forma a key part of the plastic surgeon’s daily practice. In addition to being a financial burden to the patient, it is a major social and emotional problem. The key to management of any wound is proper wound assessment. Wound assessment not only enables the treating physician to know the current status of the wound but enables us to monitor the progress of the wound to intervention. Though many wound assessment tools are available currently, none assess the periwound skin which also forms an integral part of the wound. In this article, the authors have assessed the efficacy of the triangle of wound assessment (TOWA) and its application in the management of postoperative wounds.
Comaparative Study of Neutrophil Lymphocyte Ratio in Diabetic Patients with Foot Ulcer and without Foot Ulcer
Authors:   Professor, Department of Medicine, S Nijalingappa Medical College, HSK (Hanagal Shree Kumareshwar) Hospital and Research Centre, Bagalkot, Karnataka 587102, India., Goornavar S.M. , ... Sanganabasappa ,   Junior Resident, Department of Medicine, S Nijalingappa Medical College, HSK (Hanagal Shree Kumareshwar) Hospital and Research Centre, Bagalkot, Karnataka 587102, India.
Published: January 2024

Objective: Diabetes, is fast growing the status of potential epidemic in India with more than 62 millions diabetic individuals currently diagnosed with disease [1]. Over 85% of lower limb amputations are preceded by foot ulcer and diabetes remains the major cause of non-traumatic amputation across the world with rates being as much as 15 times higher than in non-diabetic population. Method: Diabetic patients aged above 18 years with(cases) and without (controls) foot ulcer admitted in H.S.K Hospital during the study period i.e., from 1st Janvary 2016 to 30th June 2016. Statistical analysis: Data was analyzed statistically by Mean, Standard Deviation, proportions, Chi square test and other relevant statistical tests using SPIS Softwares. Result: There is statistically significant correlation between DFU and NLR with a p value 0.000 which shows high level of significance. Conclusion: NLR can be directly calculated from the neutrophil and lymphocyte counts and can be easily be obtained from a complete blood cell count on admission and during follow up. Thus increasing values of NLR during follow up can be used to predict sub clinical inflammation and impending complications like DFU.
Relation between Pyuria and Bacteriuria in Urinary Tract Infection
Authors:   Lecturer, Department of Microbiology, Government Medical College, Jammu, Jammu and Kashmir 180001, India., Chirag Sikander , Kotwal Suman Kumar ,   Consultant, Department of Medicine, Government Medical College, Jammu, Jammu and Kashmir 180001, India., Kotwal Shalija ,   Demonstrator, Department of Pathology, Government Medical College, Jammu, Jammu and Kashmir 180001, India., Choudhary Nadia ,   Medical Officer Health Department, Government Medical College, Jammu, Jammu and Kashmir 180001, India.
Published: January 2024

Introduction: As urinary tract infections are very common in all age groups and its prevalence is increasing due to various factors like poor hygiene, increasing prevalence of diabetes and injudicious use of antimicrobials. Some patients have significant pyuria with bacteriuria, some have only pyuria without bacteriuria, while some have bacteriuria without pyuria. This study was conducted to find relationship between pyuria and bacteriuria in patients with urinary tract infections. Materials and methods: Urine samples from 100 patients were taken out of which 71 were females and 29 were males. Routine microscopy of urine samples was done and WBC count of more than 5/HPF was taken significant. Urine samples were processed according to guidelines and cultured on Hichrome UTI agar,Macconkey agar and Blood agar which was incubated at 370C. The organisms which growed on them were biochemically confirmed. Results: Out of 100 urine samples 40 showed significant pyuria and 60 showed insignificant pyuria. 21 were culture positive with significant pyuria and 19 were culture negative.